Objective To explore the clinical application of mirabilite abdominal hot compression bag designed by ourselves for the moderately severe acute pancreatitis ( MSAP ) or severe acute pancreatitis ( SAP) .Methods Seventy MSAP and SAP patients were randomly divided into the observed and control groups according to the admission date.Each group included 35 patients.All the patients received the routine treatment.The patients in observed group received the treatment of compression action on abdomen by mirabilite abdominal continual hot compression bag designed by ourselves, while the traditional mirabilite hot compression action was used in the control group.The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αof all patients on the 1st, 3rd, 6th, and 9th day after being admitted, the rate of complications including the intra-abdominal hypertension (IAH), pancreatic pseudocysts (PPC) and pulmonary infection, the recovery time of intestinal function and mean hospitalization time were all recorded and the therapeutic efficacy was compared between the two groups.Furthermore, the therapeutic effects of MSAP and SAP were compared between two groups.Results The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αwere not statistically different between the two groups on the 1st day after hospitalization.The APACHEⅡscore and the levels of plasma CRP, IL-1 and TNF-αon the 3rd day in the observed group were significantly lower than those in the control group(P<0.05 or <0.01).The APACHEⅡ score and the levels of plasma CRP, IL-1 , IL-6 and TNF-αon the 6th day in the observed group were significantly lower, comparing to those in the control group.The levels of serum IL-1 and TNF-αin the observed groups were significantly lower than those in control group on the 9th day.All the differences above were statistically significant ( P<0.05 or <0.01).In the observed group, 4 cases (11.4%) had IAH and 7 cases (20.0%) developed other complications.The time of intestinal recovery and mean hospitalization was (4.9 ±0.8)d and (13.1 ±2.1)d, respectively, in the observed group.In the control group, 11 cases (31.4%) had IAH and 10 cases (28.6%) had other complications, and the time of intestinal recovery and mean hospitalization was (5.5 ±0.8) d and (15.4 ±3.9)d,respectively,.The rate of IAH, intestinal function recovery time and hospitalization time in the observed group were significantly less than those in control group (P<0.05 or <0.01).There was no statistical difference on other complications between the two groups.The intestinal function recovery time and hospitalization time of MSAPs in the observed group were significantly less than those in control group [(5.0 ± 0.8)d vs (5.5 ±0.8)d, P=0.03; (12.7 ±1.7)d vs (15.2 ±3.6)d, P=0.02].The APACHEⅡ score and the levels of plasma CRP, IL-1, IL-6 and TNF-αof SAPs were not statistically different between the two groups.Conclusions The application of the mirabilite abdominal continual hot compression bag could alleviate inflammatory response of MSAP and SAP, decrease the rate of IAH, improve the intestinal function recovery time,and shorten the hospitalization time.

Objective To evaluate the neonatal outcomes and the prevalence of congenital malformations in children born after in-vitro fertilization(IVF). Methods IVF children (211 cases) born of 156 mothers from July 1994 to October 2003 and 218 controls were studied. Those controls were randomly chosen from the same hospital matched for the time and season of birth and maternal age. Results The incidence of multi-gestation (37.2% vs 2.3%, OR =24.62, 95% CI : 9.1~72), preterm birth (37.2% vs 8.5%, OR =6.41, 95% CI : 3.5~12.0), cesarean section (97.0% vs 71.8%, OR =14.9,95% CI :5.0~49.5), pregnancy-induced hypetension (22.4% vs 10.8%, OR = 2.39, 95% CI :1.3~4.9), threatened abortion (4.5% vs 0%, OR =3.11,95% CI :2.0~4.8) were significantly higher in the IVF group, but the prevalcnce of fetal distress (14.6% vs 4.5%) was lower comparing with control group( P

To evaluate the influence of known coronary artery disease(CAD)on perioperative cardiac events in elderly patients undergoing noncardiac surgery,3028 consecutive patients who underwent major noncardiac procedures, with or without a history of CAD, were analyzed in terms of types and nature of surgery, clinical history and perioperative cardiac complications. Among the patients CAD, there were more urologic operations, and clinical history of internal diseases compared with the patients without CAD. Patients with CAD had an increased odds ratio for myocardial ischemia and arrhythmia (OR, 20 3 [95% CI, 6 5 to 65 7] and OR, 7 4 [CI, 4 4 to 12 3]) during operation, and also for postoperative myocardial ischemia, myocardial infarction, cardiogenic pulmonary edema and arrhythmia (OR, 8 3 [95% CI, 4 7 to 14 7], OR, 3 9 [95% CI, 1 2 to 12 2], OR, 7 9 [95% CI, 3 8 to 16 6] and OR, 1 7 [CI, 1 3 to 2 4]) compared with patients without CAD. The results indicated that elderly patients with CAD who underwent noncardiac surgery were more frequently associated with clinical history of internal diseases, and had a higher rate of major perioperative cardiac complications.

HIV-1 integrase (IN) is an essential enzyme for retroviral replication. There is no analogue for this enzyme in human cells so that inhibition of IN will not bring strong effect on human body. Thus, HIV-1 IN has become a rational target for therapy of AIDS. This review provides a comprehensive report of alpha, gamma-diketo IN inhibitors discovered in recent years. Compilation of such data will prove to be beneficial in developing QSAR, pharmacophore hypothesis generation and validation, virtual screening and synthesis of compounds with higher activity.

Objective To explore the effect of early nasogastric tubing bile reinfusion on gastrointestinal function recovery for patients undergoing laparoscopic bileduct operation.Methods One hundred patients undergoing laparoscopic bileduct operation were divided into observation group and control group with 50 cases each by random digits table method.The control group received routine nursing,and the observation group received early nasogastric tubing bile reinfusion on the basis of routine nursing.The recovery of postoperative gastrointestinal function and the incidence of postoperative abdominal distention between the two groups were observed and compared.Results The length of time needed for intestinal voice restoration and exhausting were (17.12 ± 3.88),(33.92 ± 8.96) h in observation group,and (24.08 ± 7.25),(43.64 ± 11.18) h in control group,and the differences were statistically significant (t =5.99,4.80,P ＜ 0.01).The incidence of postoperative abdominal distension was 22％(11/50) in observation group,and 42％(21/50) in control group,and the difference was statistically significant (x2=4.60,P＜ 0.05).Conclusions The early nasogastric tubing bile reinfusion in patients undergoing laparoscopic bileduct operation can effective promote their gastrointestinal function recovery and reduce the occurrence of postoperative abdominal distension.

Objective To investigate the disease assessment and prognosis value of serum copeptin level in patients with acute cerebral infarction (ACI). Methods One hundred first diagnosed ACI patients were selected as ACI group. According to the National Institutes of Health stroke score (NIHSS), the ACI patients were divided into mild (NIHSS<7 scores), moderate (NIHSS 7-15 scores) and severe (NIHSS>15 scores). Sixty cases of healthy subjects were selected as control group. The serum copeptin level was measured by double antibody sandwich enzyme linked immunosorbent assay method in control group and ACI group (onset within 24 h). The NIHSS, Alberta stroke program early CT score (ASPECTS) and modified Rankin score (mRS) onset within 24 h and 14 d were evaluated in patients with ACI, and the mRS 90 d and 180 d after ACI were evaluated. The neurological impairment was assessed by mRS 180 d after ACI, mRS ≤ 2 scores was good prognosis, ≥ 3 scores was poor prognosis. The correlation was analyzed. Results Among the 100 patients with ACI, mild was in 52 cases, moderate in 34 cases, and severe in 14 cases; good prognosis was in 79 cases and poor prognosis in 21 cases. The serum copeptin levels within 24 h of ACI in mild, moderate and severe patients of ACI group were significantly higher than that in control group:(4.82 ± 1.25), (6.39 ± 2.21) and (9.28 ± 3.82) pmol/L vs. (1.95 ± 0.28) pmol/L. The serum copeptin level within 24 h of ACI in moderate patients was significantly higher than that in mild patients, in severe patients was significantly higher than that in moderate patients, and there were statistical differences (P<0.05). Within 24 h of ACI , the ASPECTS in moderate and severe patients were significantly lower than that in mild patients:(10.02 ± 2.10) and (6.24 ± 3.05) scores vs. (12.16 ± 0.84) scores, in severe patients was significantly lower than that in moderate patients, and there were statistical differences (P<0.05). The NIHSS in moderate and severe patients were significantly higher than that in mild patients:(10.68 ± 3.14) and (16.20 ± 4.26) scores vs. (4.35 ± 1.52) scores, in severe patients was significantly higher than that in moderate patients, and there were statistical differences (P<0.05). The serum copeptin levels within 24 h of ACI and NIHSS in each time point in good prognosis patients were significantly lower than those in poor prognosis patients:(3.52 ± 1.26) pmol/L vs. (8.68 ± 3.06) pmol/L and (5.68 ± 2.11) scores vs. (15.36 ± 3.25) scores, (4.85 ± 1.86) scores vs. (12.60 ± 3.89) scores, (3.68 ± 1.21) scores vs. (6.35 ± 2.96) scores, (2.16 ± 0.75) scores vs. (5.21 ±1.96) scores, and the ASPECTS within 24 h of ACI was significantly higher than that in poor prognosis patients:(11.38 ± 2.21) scores vs. (7.86 ± 2.49) scores, and there were statistical differences (P<0.05). The single factor Logistic regression analysis results showed that the age, ASPECTS, NIHSS and serum copeptin level were the influencing factors of severity of illness in patients with ACI (OR = 1.21, 5.36, 5.61 and 6.62;95%CI 0.99-1.39, 3.34-9.21, 2.86-7.52 and 1.38-12.64;P=0.04, 0.01, 0.01 and 0.00), and the influencing factors of poor prognosis (OR=1.32, 5.21, 4.86 and 6.82;95%CI 0.84-1.43, 3.52-8.39, 2.62-5.35 and 2.67-11.85;P=0.04, 0.01, 0.01 and 0.00). ROC analysis results showed that the area under curve of NIHSS, serum copeptin level and ASPECTS in predicting poor prognosis in patients with ACI were 0.926, 0.863 and 0.624. In the mild, moderate and severe patients, the serum copeptin level was negative correlated with ASPECTS ( r=-0.682,-0.594 and-0.572;P<0.01), and the serum copeptin level was positively correlated with NIHSS ( r = 0.652, 0.614 and 0.586; P<0.01). Conclusions The serum copeptin level in patients with ACI is significantly elevated. The serum copeptin level is positively correlated with neurologic impairment severity and prognosis in patients with ACI, and it has important significance in evaluating pathogenetic condition and prognosis.

Purpose To evaluate the role of 18F-FDG PET/CT tumor metabolic imaging in the detection of lung cancer lesions,using receiver operating characteristic (ROC) curves analysis and investigate the diagnostic value of TNR and TLR in lung lesions.Materials and Methods A total of 82 patients who were confirmed with lung space-occupying lesionsby 18F-FDG PET/CT tumor metabolic imaging were retrospectively analyzed.Based on the pathological gold standard,evaluate the diagnostic value of 18F-FDG PET/CT tumor metabolic imaging in lung space-occupying lesions by t-test and ROC curve.Results There was a significant difference of TNR and TLR between benign and malignant lesion (P＜0.01).The AUC on ROC curve of TLR ratio was 0.943 in the lung lesions while the TNR was 0.927.The sensitivity,specificity and the accuracy were 86.36％,62.50％ and 81.71％,respectively with the TNR cutoff of 6.87.The sensitivity,specificity and the accuracy were 90.91％,68.75％ and 86.58％,respectively with the TLR cutoff of 2.86.Conclusion 18F-FDG PET/CT tumor metabolic imaging is useful for differentiating lung space-occupying lesions.But for cases of atypical 18F-FDG uptake,it is suggested to combine with clinical information.

ObjectiveTo evaluate the application value of serum bile acid in diagnosing intrahepatic cholestasis of pregnancy (ICP).MethodsThe clinical data of 92 prepartal patients with ICP was analyzed retrospectively.The patients were divided into observation group ( ＞ 40 μ mol/L ) and control group ( ≤40 μ mol/L) with 46 cases each according to serum bile acid level.The nccurrence time of skin pruritus,jaundice degree,serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and degree of polluted amniotic fluid of two groups were observed and compared.ResultsThe occurrence of skin pruritus in observation group was earlier than that in control group [(29.1 ± 3.4) weeks vs.(33.9 ± 3.2) weeks,P＜0.05 ] ;the cases with severe jaundice,ALT ＞ 100 U/L,AST ＞ 100 U/L and amniotic fluid contamination Ⅲ degree in observation group were more than control group [27 cases vs.15 cases,28 cases vs.20 cases,28 cases vs.18 cases,23 cases vs.15 cases,P＜ 0.01 or ＜ 0.05].ConclusionsSerum bile acid,as a sensitive indicator to assess TCP,has important value in determining the condition of pregnant women and prognosis analysis,and it can reflect the occurrence possibility of bad perinatal outcomes.

Objective To evaluate the serum anti-Müllerian hormone(AMH)level in female patients with systemic lupus erythematosus (SLE),and to explore the association between AMH and anti-ovarian antibody(AOAB).Methods Serum levels of AMH and AOAB were measured with ELISA in 84 female SLE patients and 90 age-matched healthy women.The patients were not treated with steroids or immunosuppressive agents before their blood samples were collected.Clinical and laboratory data of the SLE patients were also analyzed by two independent samples t-test.Results The mean serum AMH level of 84 female SLE patients was (3.2±1.5)ng/ml,which was higher than that of 90 age-matched healthy women[(2.6±1.4)ng/ml,P<0.05].Moreover,the serum AMH level was closely associated with rash,lupus nephritis,and disease activity in the 84 SLE patients.The results showed that the serum AMH levels increased first,then decreased with aging,both in SLE patients and healthy women,but the appearance of peak serum AMH level in SLE patients was delayed.The frequency of AOAB wilts higher than that in healthy women.Interestingly,the mean serum AMH level of the AOAB-positive group[(4.1±1.8)ng/ml]was higher than that of the AOAB-negative group [(2.7±1.1)ng/ml,P<0.01].Conclusion The mean level of serum AMH in female SLE patients is higher than that in age-matched healthy women,and its high level in SLE patients is closely associated with rash,lupus nephritis,disease activity and serum AOAB level.

Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.