Objective To study the etiology of severe acute pancreatitis (SAP) in Tibetan population at high altitude area.Methods Data of patients with acute pancreatitis (AP) from January 2013 to January 2016 were retrospectively collected.Tibetan and Han patients were selected.According to AP diagnosis criteria, the patients were divided into SAP and non-severe acute pancreatitis (NSAP).Chi square test and multiple Logistic regression analysis were used for data analysis.Results There were 53 Tibetan SAP patients, 98 Tibetan NSAP patients, and 47 Han SAP patients.The results of etiology analysis indicated that the ratios of biliary diseases caused pancreatitis in Tibetan SAP patients, Tibetan NSAP patients and Han SAP patients were 5.7% (3/53), 51.0% (50/98) and 6.4% (3/47), respectively;those alcohol caused pancreatitis were 39.6% (21/53), 10.2% (10/98) and 34.0% (16/47), respectively;those hyperlipidemia caused pancreatitis were 39.6% (21/53), 9.2% (9/98) and 40.4% (19/47), respectively;those drug caused pancreatitis were 1.9% (1/53), 2.0% (2/98) and 2.1% (1/47), respectively;those infection caused pancreatitis were 1.9%(1/53), 6.1%(6/98) and 2.1%(1/47), respectively;those trauma caused pancreatitis were 1.9%(1/53), 5.1%(5/98) and 2.1%(1/47), respectively;those other reasons were 3.8% (2/53), 13.3% (13/98) and 4.3% (2/47), respectively;and those unexplained pancreatitis were 5.7% (3/53), 3.1% (3/98) and 8.5% (4/47), respectively.The ratio of biliary diseases caused pancreatitis in Tibetan SAP patients was lower than that of Tibetan NSAP patients (5.7%, 3/53 vs 51.0%, 50/98), however the ratios of alcohol and hyperlipidemia higher than those of Tibetan NSAP patients (39.6%, 21/53 vs 10.2%, 10/98;39.6%,21/53 vs 9.2%, 9/98), and the differences were statistically significant (x2=31.069, 18.246 and 20.019, all P<0.01).Biliary disease was the independent etiology of NSAP in Tibetan (odd ratios (OR)=20.668, 95% confidence interval (CI) 5.072 to 59.427, P<0.01), but alcohol (OR=16.007, 95%CI 3.700 to 45.654) and hyperlipidemia disease (OR=11.590, 95%CI 2.581 to 33.859) were the independent etiologies of SAP (both P<0.01).There was no statistically significant difference in etiology of SAP between Tibetan and Han (P>0.05).Conclusion The etiology of SAP in high altitude Tibetan people is different from that of NSAP, however there is no difference in etiology of SAP between Tibetan and Han in the same area.

Objective To discuss the blockage reasons and countermeasures of temporary catheter in central venous including femoral vein and internal jugular vein for hemodialysis patients.Methods The reasons of blockage of temporary catheter in central venous among 60 hemodialysis patients from January 2014 to September 2015 in Hemodialysis Room of the First People's Hospital of Longquanyi district of Chengdu were reviewed.There were 32 cases in femoral vein and 28 cases in the right internal jugular vein.The incidence of blockage of the two temporary catheter in the first two weeks,the incidence of blockage caused by mechanical factors and blood clots or fibrous sheath and the incidence of blockage which needed to change the catheter in the two groups patients within the first two months were analyzed.Results The first rate of defective function in the first two weeks of femoral vein group was 53.13％(17/32),and 7.14％(2/28) of the right internal jugular vein group,there were significant difference between the two groups (x2=13.061,P＜0.001).The incidence of catheter blockage due to mechanical factors of femoral vein group was 96.88％ (31/32),and 53.57％ (15/28) of the right internal jugular vein,there were significant difference between the two groups (x2 =15.654,P＜0.001).The incidence of blockage caused by blood clots or fibrous sheath and the incidence of blockage which needed to change the catheter in the first two months were no significant differences between the two groups(P=0.061,0.096).Conclusion The cases of temporary catheter in femoral vein have blockage earlier,and they have a higher risk of catheter jam than the cases of temporary catheter in right internal jugular vein.

As an exposing part of the human body,facial surface is easy to be injured in our daily lives.With the increase of living standards,the patients have an ever more urgent require for aesthetic treatment for the medical and plastic surgical treatment for the exposing parts of body,especially for the facial surface.But we found in the clinical work some aesthetic treatment were not satisfying,and some patients even needed a second restitution.We have analyzed the reasons for this phenomenon and proposed some corresponding solving methods.

Tissue engineering of oral and maxillofacial surgery is a newly subject and animportant branch of tissue engineering. The study is to evaluate fundamental medical ethics principle in the tissue engineering of oral and maxillofacial surgery on the view medical ethcs. Strengthening the ethical education on oral and maxillofacial surgeon and right education on patients are in favor of development of tissue engineering in the oral and maxillofacial surgery.

This article mainly discusses the psychological characteristics of old patients having tooth pulled out on the view of medical ethics and tries to acquire its corresponding countermeasures.Through strenghtening the ethical education on oral and maxillofacial surgeons and giving right guidance to patients,it's helpful to lighten patients' burden and achieve good relationship and cooperation between doctors and patients to complete treatment successfully.

The present study is to explore the change process and distribution of phosphorylated DARPP-32 (p-DARPP-32) in rat brain including cortex, hippocampus and striatum and to further deduce whether p-DARPP-32 was possibly involved in epilepsy induced by repetitive low doses of pentylenetetrazol (PTZ). PTZ-induced epilepsy model in rat was established with 30 male SD rats randomly divided into 6 groups, control group and five trial groups [PTZ 1 h, PTZ 6 h, PTZ 24 h, PTZ 48 h and PTZ 72 h respectively, after onset of status epilepticus (SE)]. Immunohistochemistry and immunofluorescence double-labeling were used to detect the temporal time change and distribution of p-DARPP-32 expression and to analyze the coexpression of DARPP-32 and p-DARPP-32 in rat brain after the onset of PTZ-induced generalized SE. The results showed that there was a temporal time change of p-DARPP-32 expression in rat brain after the onset of SE. The number of p-DARPP-32-positive cells increased significantly and reached the peaks at the ends of 1 hour and 6 hours after the onset of SE, but decreased at the end of 24 hours. The moderate to strong p-DARPP-32-immunopositive neurons were observed in cortex, hippocampus and striatum, and located in cell cytoplasm and cell nucleus. Further immunofluorescence double-labeling revealed that denser colocalization of p-DARPP-32 and DARPP-32 in the neurons existed in the area mentioned above. Therefore, PTZ-induced SE may cause phosphorylation of DARPP-32 in rat brain. The temporal time change and distribution of p-DARPP-32 suggest that phosphorylation of DARPP-32 may be involved in PTZ-induced epilepsy in rat brain including cortex, hippocampus and striatum, and p-DARPP-32 may play a central role in the onset of SE.
Animals ; Cerebral Cortex ; metabolism ; Corpus Striatum ; metabolism ; Dopamine and cAMP-Regulated Phosphoprotein 32 ; metabolism ; Hippocampus ; metabolism ; Male ; Neurons ; metabolism ; Pentylenetetrazole ; Rats ; Rats, Sprague-Dawley ; Status Epilepticus ; chemically induced ; metabolism

ObjectiveTo report the first laboratory-confirmed human monocytic ehrlichiosis (HME) case in Shandong Province.MethodsThe epidemiological investigation was done by filling out questionaires.Blood sample was collected for detecting the specific 16S rRNA gene of Anaplasma phagocytophilumandEhrlichiachaffeensisbynested-polymerasechainreaction(PCR).ResultsThis case was characterized by acute onset of fever,leukopenia and thrombocytopenia.The specific 16S rRNA gene of Anaplasma phagocytophilum was negative and the specific 16S rRNA gene of Ehrlichia chaffeensis was positive by nested PCR test.The PCR product was sequenced.The homology was above 99 ％ between the acquired nucleotide acid sequence and the Ehrlichia chaffeensis sequences registered in GenBank.ConclusionThe Ehrlichia chaffeensis infection exists in Shandong Province,which warrants further research on these natural loci of HME in this area.

Objective To explore the relationship between G-protein β3 subunit (GNB3) gene C825T polymor?phism and the weight gain of schizophrenics treated with olanzapine. Methods Ninety schizophrenics of first time hospi?talization were collected and treated with olanzapine for 12 weeks. The changes of body weight and body mass index (BMI) were detected before and after 12-week olanzapine treatment. The GNB3 gene C825T polymorphism in patients was determined by polymerase chain reaction (PCR) and DNA sequencing technique. The correlation of GNB3 gene C825T polymorphism and change of clinical parameters was analyzed. Results Body weight and BMI in patients were all increased significantly after treatment (all P<0.01). Weight gain rate (WGR) and increase of BMI in the TT genotype group were higher than those in the CC genotype group (all P<0.01). WGR and increase of BMI in the T-allele carrier (TT and CT genotypes) were higher than those in the T-allele non-carrier (CC genotype) (all P<0.01). There was signifi?cant difference in distribution of genotypes between WGR ≥7% group (CC 15.69%, CT 54.90%, TT 29.41%) and WGR <7% group (CC 38.46%, CT 43.59%, TT 17.95%) (P<0.05). The frequency of T-allele in the WGR≥7% group (63.33%) was higher than that in the WGR<7%group (39.74%) (P<0.05). Multi-variable linear regression indicated that TT genotype (contrasted with CC genotype) was an influential factor for change of body weight after treatment with olan?zapine (β=1.83, standardized β=0.29, P<0.01). Conclusions The GNB3 gene C825T polymorphism is associated with olanzapine-induced weight gain.

Objective To study the feasibility and safety of performing nephrectomy together with the removal of complicated inferior vena cava tumor thrombus under profound hypothermia and arrested circulation. Methods After made the median thoraco-abdominal incision, the exploration of the abdominal organs was done. The right kidney, inferior vena cava and renal pedicle were well exposed then. After the whole body heparinization, cannulas were put into ascending aorta, superior vena cava, aortic root and right superior pulmonary vein. The body temperature was reduced to 20℃ with cardiopulmonary bypass unit and the extracorporeal circulation was stopped then. Cut open the inferior vena cava at vena renalis dextra ingress and the F16 urinary catheter was inserted into atrum dextra through inferior vena cava and inflated. The tumor thrombus was pulled out and the right kidney was removed. The inferior vena cava incision was sutured to close and the extracorporeal circulation was resumed and patient was re-warmed.Results The operation time was 330 min and the extracorporeal circulation time was 90 min, while the profound hypothermia with circulatory arrest time was 20 min. The estimated blood loss during operation was 400 ml and 6 unit red cells and 600 ml blood plasm were transfused. The patient was awaked 2.5 h after the operation, food intake resumed 4 days after operation and the patient was discharged on day 10 post-operatively. After 6 months'follow-up, there were no local recurrence and metastasis occurred. Conclusion The technique of profound hypothermia and circulation arrest could improve the safety and efficacy in the treatment of renal cell carcinoma with suprahepatic (level Ⅲ) caval tumor thrombus.

Objective:To establish the control charts for early warning of diarrhea based on the syn-dromic surveillance data from enteric clinic in Beijing .Methods:The outpatient data from enteric clinic of a Grade Three General hospital in Haidian district , Beijing from April 1 to Oct.31, 2009 and from May 1 to Nov.10, 2010 were collected, according to the moving average method , the baseline calcula-ted, the value of probability αand μα, the early warning value based on the formula “w=Xj +μαSj”calculated and the early warning control charts drew at last .Results:According to the harmfulness , the severity and controllability of diarrheal diseases , the value of probability αwas determined as 0.01, thenμα( unilateral) as 2, based on the early warning value , the control charts of diarrheal diseases , bacillary dysentery and other infectious diarrhea were established .Conclusion:The enteric clinic requires to fur-ther collect baseline data to evaluate and continuously adjust the established control charts for the best early warning model in accordance with the enteric clinic .