Objective To investigate the technique and clinic value of non-operation management for ERCP-related peripancreatic and retroperitoneal abscess. Methods Five patients with post-ERCP peripancreatic and retroperitoneal abscess were reviewed. Guided by ultrasonic or CT, all the 5 pa-tients underwent puncture and the drainage tube was disposed to the lowest place of abscess. Non-op-eration managements for patients also included the use of anti-inflammatory drugs and enzyme activity inhibition drugs. Results All patients responded to the draining treatment and discharged from hospi-tal after complete recovery. There was no conversion to surgical intervention. Mean draining duration was 52. 4(20-90)d and average hospital stay was 91.8(35-165)d. Conclusion Puncture and drainage management is an effective and safe approach for post-ERCP peripancreatic and retroperitoneal ab-scess. It has advantages of less trauma, less pain, fast recovery and low rate of complications. Punc-ture point should be situated at the bottom or lowest position of abscess and drainage can achieve the best results.

Objective To explore the effects of enalapril on spatial learning and memory,and to identify synaptophysin expression in hippocampus of streptozotocin-diabetic rats.Methods Forty rats were randomly divided into control group,diabetic model group and the enalapril treatment group.Streptozotocin-diabetic rat model was developed.The diabetic rats were treated with enalapril for 12 weeks.Then,the learning and memory abilities of rats were tested with Morris water maze;mRNA and protein expression of synaptophysin in hippocampus was detected by RT-PCR and immunostaining.Results Compared with diabetic model group,the enalapril treatment group showed a significant decrease in the mean time of escape latencies(P

Narcolepsy is a rare sleep-wake rhythm disorder in clinic practice, mainly characterized by recu-rrent unstoppable sleep during the day and often accompanied by cataplexy, sleep paralysis and hypnagogic hallucinations.Clinicians′ insufficient knowledge about narcolepsy is one of the main causes of misdiagnosis and delayed diagnosis.Moreover, narcolepsy may get easily confused by epilepsy because of complex and diverse types of epileptic seizures.Therefore, it is necessary to distinguish the two forms each other.When they are comorbidity, the diagnosis and treatment will be much more difficult.In this article, the clinical characteristics of narcolepsy and the causes of delayed diagnosis were analyzed, differential diagnosis between narcolepsy and epilepsy was investigated, and practical expe-rience in diagnosis and treatment of comorbidities were summarized, so as to raise clinicians′ awareness of narcolepsy and its comorbidity with epilepsy and improve patients′ prognosis and their quality of life.

Glucocorticoid is an important treatment for many pediatric diseases and it often leads to osteoporosis, osteonecrosis of the femoral head, and growth retardation. Among them, glucocorticoid-induced growth retardation has been a particular focus in the treatment of children patients, which leads to a decrease in final height. The mechanism of glucocorticoid-induced growth retardation is complex, and there is no safe and effective treatment.This article summarized the mechanisms underlying glucocorticoid-inhibited longitudinal bone growth and reviewed the potential therapeutic targets discovered in recent years.

Objective To analyse effect of different dose of sustained-release theophyline on prealbumin, C-reactive protein and white blood cell count in patients with pediatric asthma.Methods 58 children with acute asthma attack in our hospital were collected.All children were randomly divided into high dose group and low dose group,29 cases in each group.On the basis of conventional treatment, high dose group were treated with high dose theophylline sustained release tablets 5 mg/kg, one times per eight hours,orally,and low dose group was treated with low dose theophylline sustained release tablets,2 mg/kg, one times per eight hours,orally.Two groups were treatment for two weeks.After the treatment, the serum levels of pre albumin, C-reactive protein and veinal blood level of white blood cell count were detected in all children.Results Compared with high dose group post-treatment, the serum level PA was higher in low dose group (P<0.05);the serum level of CRP was lower in low dose group (P<0.05);the veinal blood level of WBC, percentage of neutrophils and percentage of eosinophils was lower in low dose group (P<0.05) .Conclusion Compared with high dose of sustained-release theophyline,the low dose of sustained-release theophyline can significantly reduce the serum CRP level and veinal blood level of WBC, percentage of neutrophils and percentage of eosinophils, improve serum PA level in patients with pediatric asthma, reduce inflammation in patients.

Objective:To explore the optimal dose of atrovastatin treating acute coronary syndrome (ACS) .Methods:A total of 86 ACS patients were randomly and equally divided into atorvastatin large dose group (40 mg/d) and rou-tine dose group (20 mg/d ) . Blood lipid levels , blood lipid standard-reaching rate , serum levels of adiponectin (APN) and high sensitive C reactive protein (hsCRP) were compared between two groups before and after treat-ment .All patients were followed up for six months after discharge ,and incidence rates of cardiovascular events and adverse reactions were compared between two groups .Results:Compared with routine dose group ,the levels of TC and LDL-C significantly reduced on 3 months after treatment ,in large dose group (P<0.01 ,<0.05 respectively);the standard-reaching rates of TC and LDL-C [TC:(23.3% vs .44.2% ) ,LDL-C:(37.2% vs .60.5% ) ,P<0.05 all];level of APN [ (8.47 ± 1.73) mg/L vs .(12.96 ± 2.15) mg/L] significantly rose ,level of CRP [ (6.23 ± 1.26) mg/L vs .(4.07 ± 1.54) mg/L] significantly reduced ,P<0.01all;incidence rate of adverse cardiovascular e-vents (23.3% vs .7.0% , P= 0.035) significantly reduced ,but there was no significant difference in incidence rate of adverse reactions between two groups ,P=0.213.Conclusion:Atorvastatin therapy can effectively reduce in-cidence rate of cardiovascular events in ACS patients ,and the dose 40mg/d is optimal dose .

Objective To understand the types and risk factors of human papillomavirus (HPV ) infection among the patients with cervical intraepithelial neoplasia in Chongqing to provide a scientific basis for prevention and treatment of cervical cancer . Methods The patients with TCT screening in many hospital of Chongqing from June 2012 to December 2013 were selected and performed the HPV typing ,9 328 cases succeeded in HPV typing .The main types of HPV infection in different grades of cervical intraepithelial neoplasia were statistically analyzed for determining the risk factors .Results HPV16 was the most common infection type among patients with cervical intraepithelial neoplasia in Chongqing area ,followed by HPV52 ,58 ,33 ,18 .Some factors such as multiple sex partners ,young female with sexual debut and induced abortion were the risk factors of HPV infection .Conclusion Single and high-risk type is the main feature of HPV infection among the patients with cervical intraepithelial neoplasia in Chongqing .The infection rate is higher with the higher grade of cervical intraepithelial neoplasia .Publicity and education for risk factors of HPV infection should be strengthened ,which will help to prevent the occurrence of cervical cancer .

Objective To observe the clinical effect of Zhenwu decoction combined with Linggui-Zhugan decoction on senile patients with heart failure. Methods A total of 123 patients with heart failure who met the inclusion criteria were randomly divided into 3 groups by random number table method, each group of 41 cases. The patients in the control group were treated with routine western medicine, Zhenwu decoction group was treated with Zhenwu decoction on the basis of the control group treatment, and the combined decoction group was treated with Zhenwu and Linggui-Zhugan decoction on the basis of the control group. The treatment last 4 weeks as 1 course, 2 courses in total. The TCM syndrome score, left ventricular ejection fraction, brain natriuretic peptide level, nt-probnp level and TGF-?1 level were observed, and the clinical effect was evaluated. Results After 8 weeks treatment, Palpitation (0.68 ± 0.53 vs. 0.79 ± 0.64, 1.12 ± 0.70, F=7.207), chest distress (0.66 ± 0.52 vs. 0.79 ± 0.60, 1.36 ± 0.70, F=6.367), edema (0.32 ± 0.31 vs. 0.43 ± 0.41, 0.52 ± 0.37, F=7.054), wheezing (0.62 ± 0.55 vs. 0.82 ± 0.69, 0.88 ± 0.68, F=6.634), fatigue (0.73 ± 0.47 vs. 0.94 ± 0.62, 1.49 ± 0.58, F=5.832), spontaneous sweat (0.46 ± 0.39 vs. 0.89 ± 0.62, 0.99 ± 0.79, F=7.207), insomnia (0.42 ± 0.39 vs. 0.74 ± 0.50, 0.79 ± 0.58, F=6.672) in the combination group were significantly lowere than those in the other two groups (P<0.05). The TGF-?1 (102.75 ± 15.79 ng/L vs. 121.57 ± 19.25 ng/L, 184.35 ± 23.74 ng/L, F=160.776) in the combination group was significantly lowere than that in the other two groups (P<0.01). The total effective rate was 81.8% (27/33) in the combination group, 78.1% (25/32) in the Zhenwu group, and 62.16% (23/37) in the control group. The the difference of total effective rates among three groups were statistically significant (χ2=7.089, P=0.037 ). Conclusions The Zhenwu decoction and Linggui-Zhugan decoction combined with the routine therapy can improve the symptoms and signs of elderly patients with heart failure, and reduce the serum TGF-1 level.

OBJECTIVETo observe clinical therapeutic effect of fuzhong (supporting the middle-jiao) manipulation of tuina for infantile anorexia.

METHODSEighty-one children with anorexia were treated with fuzhong manipulation, including abdominal kneading, acupressure at Zhongwan (CV 12), Lanmen (Extra), Tianshu (ST 25), Zusanli (ST 36), Sanyinjiao (SP 6), spine pinching, warm moxibustion and warm scraping with supporting-yang cupping, three times a week, six times as a session. Onset time, therapeutic effect and TCM symptom scores before and after treatment were observed after two sessions and differences of therapeutic effect among different patterns were compared.

RESULTSSeventy-two children had the effect in one session while 41 children had the effect within half of a session. 38 cases were clinically cured, 15 cases were markedly effective, 23 cases were effective and 5 cases were failed. The total effective rate was 93.8%. Compared with before treatment, TCM symptom scores, including appetite, food intake, complexion and defecation, were all obviously improved after treatment (all P < 0.001). The clinical cured rate was 45.2% (19/42) in the pattern of dysfunction of spleen in transportation, 45.8% (11/24) in the pattern of qi deficiency of spleen and stomach, 50.0% (4/8) in the pattern of yin deficiency of spleen and stomach, 57.1% (4/7) in the pattern of liver sufficiency and spleen insufficiency, which had no obvious differences among different patterns (all P > 0.05).

CONCLUSIONThe fuzhong manipulation of tuina has quick onset time and satisfied clinical therapeutic effect, which could obviously improve symptoms and is fit for different patterns of infantile anorexia.

Adolescent ; Anorexia ; physiopathology ; therapy ; Child ; Child, Preschool ; Eating ; Female ; Humans ; Infant ; Male ; Massage ; Meridians ; Spleen ; physiopathology ; Stomach ; physiopathology ; Yin Deficiency ; physiopathology ; therapy

Two cases of special intracranial otogenic complications were analyzed in the aspects of clinical characteristics, diagnosis and therapy. We concluded that for patients with huge cholesteatoma which damaged the bone of skull base, or chronic otitis media patients with sharp deterioration in symptoms, accompanied by headache and fever, we should promptly do the enhanced magnetic resonance to avoid the missed diagnosis of intracranial complications.
Cholesteatoma ; diagnosis ; physiopathology ; Chronic Disease ; Headache ; Humans ; Otitis Media ; diagnosis ; physiopathology ; Skull Base ; pathology