Objective To study the exocrine pancreatic function in critically ill children with septic shock,sepsis and hyperlactacidemia.Methods A total of 64 critical pediatric patients were admitted from Jan 2009 to Oct 2012,and clinical and laboratory findings including pancreatic function,and histopathological features and score after autopsy were reviewed.Results (1) Compared with non-septic shock children,the pancreatic pathology score and serum lipase in septic shock group were significantly higher and serum calcium was significantly reduced (P ＜0.05) ; (2) The pancreatic histopathology score was significantly increased in patients with elevated plasma lactate ≥2 times (P ＜0.05),but there were no significant differences in serum calcium and blood amylase and lipase between patients with elevated plasma lactate level and patients with normal plasma lactate level; (3) The concentrations of serum amylase,lipase and urinary amylase were significantly increased in patients with pancreatic histopathology score ＞4 points compared with score ≤4 points patients,but there were no significant differences in above three biomarkers between patients with score ≤3 points and patients with score ＞3 points.Conclusions The pancreas is vulnerable to damage easily occurred in septic shock children especially complicated with hyperlactacidemia.The pancreatic histopathology score ＞ 4 points can be as a sensitive and reliable indicator of pancreas damage.

Objective To summarize the clinical characters, diagnostic and therapeutic strategy of the cured patient with human H5N1 avian influenza pneumonia in mainland of China,and to provide effective experiences for the physicians to diagnose human avian influenza infection.Methods The clinical data of the cured patient with H5N1 avian influenza infection in China was analyzed.Results The patient was treated with short-term symmetrel and ribavirin for antiviral therapy companied with the lowdosage and long-term(4 weeks) glucocorticoid therapy.The CPAP assistant ventilation was used and the airway was kept unobstructed.The antibiotic was used to prevent and control the followed infection.The supportive treatment was applied to protect the organ′s function of the patient.The pathogenetic condition of the patient became better with the hemogram risen and the lungs pathological changes absorbed gradually.The chest CT reexamined at the 7th day of the hospitalized-term suggested that the left lung fibrosis started to be absorbed and it was obviously absorbed at the 16th day.The breath function and all the internal organs functions became better.The patient convalesced and left hospital at the 46th day.Conclusion In the human avian influenza infection,the pathogenetic condition may progress quickly after the pneumonia appears.The lung injury and lung fibrosis as well as the multi-organs dysfunction were emerged in the patient rapidly.The progression of disease can be controlled and the prognosis can be improved by the prompt and correct treatment.

Objective To investigate the relationship between sleep duration and obesity, and the risk of common chronic diseases in the occupational population in Shanghai City. Methods A total of 18 775 occupational individuals were selected as the study subjects using convenience sampling method in Shanghai City. Data on personal lifestyle behaviors and medical examination results were collected. The relationship between sleep duration and different types of obesity with dyslipidemia, hyperuricemia, hypertension, and hyperglycemia was analyzed. Results The incidence of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia among the study subjects was 24.9%, 16.2%, 11.5%, and 7.3%, respectively. The incidence of these four chronic diseases were higher in individuals with central obesity and suboptimal sleep compared to the control group (all P<0.01). Multivariate logistic regression analysis showed that suboptimal sleep combined with general obesity/overweight increased the risk of dyslipidemia, hyperuricemia, hypertension, and hyperglycemia in the study subjects ［odds ratio (OR) were 2.40, 3.47, 3.30, and 2.79, respectively; all P<0.01］, after adjusting for age, gender, education level, marital status, occupation type, labor intensity, smoking, and drinking. Suboptimal sleep combined with central obesity also potentially increased the risk of these four chronic diseases (OR were 2.25, 3.09, 3.09, and 2.98, respectively; all P<0.01). Conclusion The incidence of common chronic diseases is relatively high in the occupational population in Shanghai City. Suboptimal sleep combined with different types of obesity increases the risk of common chronic diseases.