Objective To investigate the clinical effect of the application of the clinical effect of the use of lamivudine and the safety in the treatment of infantile enteritis.Methods From August 2013 to May 2016 in our hospital for diagnosis and treatment of 112 cases of enteritis were retrospectively analyzed,according to the application in the treatment of antibiotics into ceftazidime group in 60 cases,cefotiam group 52 cases,two groups of children with rehydration,correct electrolyte disorders such as basic treatment,the difference of clinical effect comparison.Results After 3d treatment,ceftazidime group stool frequency was significantly lower than that of cefotiam group(P<0.05); ceftazidime group the duration of diarrhea,stool leukocyte recovery time were significantly lower than cefotiam group(P<0.05); three day,five day after treatment of serum CRP,PCT levels were ceftazidime group significantly lower than cefotiam group(P<0.05); the two groups of serum CRP and PCT levels before treatment were significantly decreased(P<0.05); After five days treatment,5D after treatment,ceftazidime group the effective rate of 58.33％,effective 41.67％,invalid rate 0％,cefotiam group the effective rate was 42.31％,effective 53.85％,invalid rate 3.85％,ceftazidime treatment group is better than that of cefotiam group(P<0.05).Conclusion In the treatment of infantile enteritis,the effect is reliable and the safety is high.

Objective To explore the relationship of glucagon in many phases with insulin and blood glucose in patients with insulin resistance syndrome,and to provide theory and practice support for the treatment of insulin resistance syndrome.Methods Totally 93 patients with insulin resistance syndrome (observation group),107 patients with type 2 diabetes (diabetes group) and 80 patients without diabetes (non-diabetes group) in our hospital from July 2008 to October 2011 were selected.The general information were collected.Patients with stable blood glucose stopped taking anti-diabetic drug for 10 hours.The fasting blood glucose,fasting insulin,and fasting glucagon were tested.Then patients took 75 g glucose,blood glucose,insulin and glucagon were respectively tested after 30 and 120 minutes.Data were processed by SPSS 17.0 software,and P＜0.05 was considered as being statistically significant.Results The levels of fasting glucose,early phase glucose and late phase glucose were lower in observation group than in diabetes group,but higher than in non-diabetic group,and the differences were statistically significant (all P＜0.05).The levels of fasting insulin,the early phase insulin,and late phase insulin were higher in observation group than in diabetes group and non-diabetic group,and the differences were statistically significant (both P＜0.05).The insulin levels in observation group and diabetes group were lowest after fasting and were highest at 120 minutes after the oral glucose load,but the insulin levels were highest at 30 minutes and decreased at 120 minutes after the oral glucose load in non diabetic group.The differences in fasting glucagon,early phase glucagon and late phase glucagon among three groups were statistically significant (all P＜0.05).The glucagon levels in observation group and diabetes group were lowest after fasting and highest at 120 minutes after the oral glucose load,but the glucagon levels in non-diabetic group were highest after fasting and were lowest at 120 minutes after the oral glucose load.There were positive correlations between glucagon and glucose in 3 phases in observation group (r=0.65,0.63,0.67,respectively,all P＜0.05).Conclusions Glucagon and glucose in different phases are positively correlated in patients with insulin resistance syndrome,and blood glucose can be controlled by improving glucagon secretion.

Objective:To explore the effects of omeprazole combined with somatostatin on intra-abdominal pressure and intestinal mucosal barrier function of elderly patients with severe acute pancreatitis.Methods:Selected 82 cases of elderly patients with severe acute pancreatitis from our hospital.They were divided into research group (48 cases) and control group (34 cases).The control group was treated with basic therapy,and the research group was treated with omeprazole combined with somatostatin on the basis of the control group.Analyzed and compared the clinical effects,intestinal mucosal barrier function and symptom indexes of patients in the two groups.Results:①The total effective rate of the research group was significantly better than that of the control group,and the difference was statistically significant (P=0.005).②After treatment,the D-lactose and diamine oxidase (DAO) levels of both groups were significantly lower than before treatment,and the difference was statistically significant (both P＜0.001).In addition,after treatment,the D-lactose and DAO levels were significantly lower in the research group than in the control group,and the differences were statistically significant (mean P ＜ 0.001).③After treatment,patients of the research group showed better results in abdominal pain and abdominal distension relief time,bowel recovery time,hospital stay and blood amylase index than those in the control group,and the difference was statistically significant (mean P ＜ 0.001).④After treatment,the intra-abdominal hypertension of two groups was significantly lower than before treatment,with statistical difference (P ＜ 0.001).Yet it was significantly lower in the research group than in the control group,with statistical difference (P ＜ 0.001).Conclusion:The combined treatment of omeprazole and somatostatin can effectively improve the clinical efficacy of severe acute pancreatitis in elderly patients,correct intra-abdominal hypertension and improve the intestinal mucosal barrier function of patients,so it is worthy of reference and promotion.

The use of flaps for plastic and reconstructive surgery is very popular today.More and more surgeons have realized that the blood supply plays an important role in the design and survival of flaps.After Ian McGregor and Ian Jackson first introduced the axial flaps into clinics,Mathes divided the flaps into two types in 1981,the fasciocutaneous perforator flaps and musculocutaneous perforator flaps.In 1989,the concept of perforator flap was first brought into clinical practice.With the development of microsurgery and anatomy,the epidermis of human skin is divided into areas based on the vascular anatomy.A new century of musculocutaneous perforator flaps has been established.The terminology,classification,characteristics and application of musculocutaneous perforator flaps are described in this paper.

Objective To explore the clinical characteristics and treatment of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The clinical data of 67 children with PSVT were analyzed retrospectively, and the therapeutic effects of different treatments were compared. Results The clinical manifestations of infants were paleness, shortness of breath, irritability and sweating, and children showed chest tightness, palpitations, abdominal discomfort and fatigue. The curative effect of electric cardioversion, transesophageal atrial pacing, physical therapy, and drug therapy was statistically different (P<0.05), The different cardioversion rates of them were observed for the treatment of paroxysmal supraventricular tachycardia. The cardioversion rate of transesophageal atrial pacing, was the highest, and the rate of physical therapy was the lowest. There was no significant difference in the cardioversion rate between propafenone, digoxin and amiodarone. Conclusion The clinical manifestations of PSVT in infants are atypical and easily to be ignored. There are many methods for treatment of PSVT. The vagus nerve can be stimulated first, and, if no response, either drugs or electric cardioversion and transesophageal atrial pacing can be used. The cardioversion rate of transesophageal atrial pacing is higher. The drug effectiveness for the treatment of PSVT depends on many factors, and our choice of medication varies from person to person.

Objective To summarize the experience of intraoperative rapid parathyroid hormone (PTH) detection by immunochromatography in thyroid surgery.Methods Patients undergoing thyroid surgery in Shanghai Tenth People's Hospital from Nov.2016 to Jul.2017 were collected and the clinical data including level of blood calcium,serum phosphorus and PTH,and pathological findings were analyzed.Results In this study,im munochromatographic assay was used in 45 cases (experimental group) and nano carbon method was used in 47 cases (control group).In benign cases,levels of blood calcium and PTH in experimental group were higher than those in the control group ((2.07±0.09) vs (2.04±0.06) and (3.41±1.82) vs (3.34±1.84),P＞0.05).In malignant cases,blood calcium level in experimental group was higher than that in the control group ((2.02±0.13) vs (1.99±0.38),P＞0.05) and PTH level was significantly higher than that in the control group ((2.22±1.27) vs (1.44±1.44),P＜0.05).Serum phosphorus level in experimental group group was much lower than that in the control group ((1.02±0.17) vs (1.14±0.23),P＜0.05).Conclusions Using intraoperative rapid PTH detection by immunochromatography can identify parathyroid and avoid accidental injury of parathyroid gland,which can reduce the postoperative incidence of hypocalcemia.

Instructional system design is an important component of instruction. Chaos theory is used in instructional system design of clinical teaching. Application of butterfly effect, fractals and strange attractors theory enhances students’clinical capabilities and comprehensive ability to analyze and solve problems.

OBJECTIVE To investigate the bacterial distribution and antibiotic resistance situation with urinary tract infection(UTI) for the guidance of rational use of antibiotics.METHODS The antibiotic resistance of clinical isolates from urinary tract infection from Mar 2005 to Jul 2006 was analyzed. RESULTS The most common pathogens in urinary tract infection were Escherichia coli(50.2%),Enterococcus(14.4%),Staphyloccus aureus(8.7%),Klebsiella pneumoniae(7.3%),and Proteus mirabilis(3.9%).E.coli,K.pneumoniae,and P.mirabilis were found to be highly resistant to ampicillin,quinolones and SMZ(70.6-100.0%).Enterococcus were highly resistant to penicillin and quinolones(81.0-96.8%).41.4% of E.coli and 31.3% of K.pneumoniae isolates produced ESBLs.HLGR-Enterococcus were 79.4%.78.9% S.aureus isolates were resistant to oxacillin.CONCLUSIONS The high antibiotic resistance of commonly encountered pathogens is a serious problem and much attention should be paid to detect pathogens and their antibiotic resistance.

65Y) on maintenance hemodialysis at our hospital from Jan 2005 to Oct 2006 was selected.All subjects were divided into two groups according to serum albumin level:group A(ALB0.05);and mortality was higher in group A than in group B(P

Objective:To evaluate the efficacy and safety of rosuvastatin and atorvastatin in the treatment of the patients with primary hyperlipidemia in China.Methods:The related literatures in CNKI,VIP,Wanfang medicine network,PubMed/MEDLINE,CBM and Chinese dissertations full text database were retrievaled by computer from the establishment time of database to December 31,2015. Two researchers according to the inclusion and exclusion criteria independently selected the studies and extracted the data and assessed the quality of the literatures.The Revman 5.0 software was used to perform Meta analysis of all effect indicators in various groups.Results:A total of 7 randomized controlled trial (RCT)were included,and there was no significant abnormality in bias evaluation. 8 weeks after treatment, the total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C)levels of the patients in 5 mg rosuvastain group and 10 mg atorvastatin group had no significant differences between before and after treatment (P >0.05);the HDL-C levels of the patients in 10 mg rosuvastatin group and 10 mg atorvastatin group had significant differences between before and after treatment (P < 0.05),but the TG,TC,and LDL-C levels had no significant differences (P >0.05);the TG,TC,LDL-C and HDL-C levels of the patients in 5 mg and 10 mg rosuvastatin groups had no significant differences between before and after treatment (P > 0.05).12 weeks after treatment,there were no significant differences in the TC and LDL-C levels between 10 mg rosuvastatin group and 10 mg atorvastatin group (P >0.05),but there were significant differences in the TG and HDL-C levels (P <0.01).The incidence of adverse reactions of the patients in three groups had no significant differences (P >0.05).Conclusion:5 mg rosuvastatin and 10 mg atorvastatin in the treatment of the patients with primary hypercholesterolemia have similar lipid-lowering effect;with the the increase of the treatment time and the dose,10 mg rosuvastatin can obviously reduce the TG level and increase the HDL-C level of the patients,and the incidence of adverse reactions of two kinds of doses of rosuvastatin has no obvious difference.