The surgical intervention and criteria of severe acute pancreatitis has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery.Many kinds of minimally invasive technologies which take laparoscopy as a representative are constantly applied to the treatment of severe acute pancreatitis and make its mortality and postoperative complication rate decrease obviously.However,there are many different ways using laparoscopic techniques to treat severe acute pancreatitis.In this review,the author will discuss the current status of the different approaches.

OBJECTIVE:To prepare glycyrrhetic acid derivatives-modified norcantharidin(NC)liposome(GDNL)and study its liver-targeting property.METHODS:Gal-GAOSt targeting molecules were synthesized to modify NC and prepare GDNL,with the parameters such as the entrapment efficiency and particle diameter,etc.investigated.Mice were enrolled to be injected with GDNL and NC water solution,respectively via vena caudalis followed by determination of NC concentration in different tissues to compute the targeting-index(TI)of GDNL in liver.RESULTS:The prepared GDNL had an entrapment efficiency of 56.29%,particle diameter of(210?20)nm and TI of 5.213 in liver.CONCLUSION:The prepared GDNL has high entrapment efficiency and remarkable liver-targeting property.

The relationships between serum endothelin-1,calcitonin gene-related peptide and hypoxic-ischemic brain injury(HIBD) has been widely importance.Their respective functions,mutual relations and their relationships with HIBD has become a hot research.Understanding of their biological characteristics,mechanism and regulation of gene expression characteristics,is conducive to more in depth study on its pathogenic characteristics,provide a theoretical basis for clinical diagnosis and treatment.

Objective To investigate the use of cardiopulmonary auscultation model in clinical skills teaching, and students' feeling about this teaching form. On the basis of this teaching model, we have reflected on the teaching mode. Methods Through the questionnaire survey, 145 medical stu-dents of grade 2009 were asked to investigate their learning experience about cardiopulmonary aus-cultation model and other aspects of it. Results There are 71.7% students liking cardiopulmonary auscultation model in teaching; 96.5% students can establish contacting abnormal cardiopulmonary auscultation signs with cardiovascular diseases after the training; There are 91.7% students thinking teaching hours about auscultation model is not enough. For the open question “what do you think is the difficulty of cardiopulmonary auscultation learning?” The representative answer is: I think car-diopulmonary auscultation is unable to recognize visual things. Conclusion Cardiopulmonary aus-cultation model can successfully improve the students' clinical skills and achieve good teaching effect. Students have a positive and supportive attitude to it.

Adult ; Ear Neoplasms ; Eustachian Tube ; pathology ; Humans ; Male ; Teratoma

BACKGROUND: The inheritance tendency and immunity imbalance of atherosclerotic brain infarction (ABI) have attracted the attention of many scholars at home and abroad, which suggests that immune mechanism plays a key role in ABI development. It has been found that ABI is related to polymorphism of human immune inheritance gene (HLA), particularly HLA-DR gene.OBJECTIVE: To investigate the correlation between HLA and ABI immune heredity.DESIGN: Single sample and single factor analysis.SETTING: Sino-Japanese Friendship Hospital of Jilin University; Neurological Department of the First Hospital of Harbin City.PARTICIPANTS: Totally 31 patients in experimental group and 30 healthy people in control group, whose three generations were of the Han Nationality in north China and who had no blood relation, were selected from Department of Neurology in First Hospital of Harbin between January 1998 and December 2000.METHODS: The experiment was conducted in the Blood Research Center of Department of Neurology in First Hospital of Harbin between June and December 2003.5 mL peripheral blood in both groups was taken to extract genome DNA with the previous method. Human HLA gene map had been described at gene bank in the Internet, in which mono-nucleic acid obtained from HLA of the sixth chromosome were retrieved. Each DR and DQ allele, sense primer and antisense primer were composed selectively. Amplification of DNA fragment was checked respectively and specifically. The primer was provided by Shanghai Gene Research Institute. PCR instrument (4 800) and its related reagents produced by PE Company (the US) were used. Fourfold table exact probability method was used to calculate the relative risk (RR) and P value.which was obviously higher than that of other sites (P ＜ 0.05). However,associated with the ABI susceptible gene of the Han Nationality in north China.

Objective To analyse the efficacy of lamivudine(LAM) combined adefovir dipivoxil(ADV) and entecavir(ETV) in the treatment of naive patients with chronic hepatitis B (CHB) .Methods Cochrane Library ,MEDLINE ,Web of Science ,CNKI (China National Knowledge Infrastructure ) ,WANFANG database and VIP database were searched and the references of eligible studies were screened .All relevant literatures published before March 6th ,2012 were reviewed .Comparison of the efficacy of lami-vudine combined adefovir dipivoxil and entecavir in the treatment of naive patients with chronic hepatitis B was included and Rev Man 5 .1 software was used for Meta analysis .Results Four eligible studies (587 patients in all) were included for the analysis .In the entecavir monotherapy group ,the serum ALT normalization rate was a little higher at the 12 weeks and 24 weeks of the treat-ment compared to the combination group[OR=0 .52 ,95% CI(0 .28 ,0 .97) ,Z=2 .04 ,P=0 .04] ,[OR=0 .45 ,95% CI(0 .22 ,0 .95) , Z=2 .11 ,P=0 .04] ,respectively .But after 36 weeks there was no significance between the two groups .For HBV DNA undetect-able rate ,there were no significant differences between the two groups at the 12 weeks ,24 weeks ,36 weeks ,48 weeks ,18 months , 24 months and 30 months of the treatment (P=0 .22 ,P=0 .30 ,P=0 .86 ,P=0 .31 ,P=0 .93 ,P=0 .84 and P=0 .83 respectively) . At the 48 weeks ,HBeAg negative rate has no significant difference between the two groups [OR=0 .93 ,95% CI(0 .29 ,2 .95) ,Z=0 .13 ,P=0 .90] .Conclusion Both LAM+ADV combination therapy and ETV monotherapy are effective in the treatment of naive patients with CHB ,but further studies are still needed to obtain long term results and safety by high quality ,large scale randomized controlled trials .

Objective To explore the perioperative experiences of congenital heart disease in infants.Methods From Jan.2000 to Aug.2006,109 patients with congenital heart disease were operated in our department,their clinical data were retrospectively collected and analyzed.The patients′ age ranged from 31 days to 3 years old (13.6 months).The body weight ranged from 2.1 to 16 kg (8.6 kg).Ninety-three patients were operated under hypothermic anaesthesia with cardiopulmonary bypass(CPB).Sixteen patients underwent deep thermal and low flow CPB.Ultrafiltration was used in 62 patients.Results There were 8 deaths and the operative mortality was 7.3%,4 cases caused by low output syndromeclos(LOS),3 cases caused by pulmonary hypertension and 1 case caused by lung intection.The morbidity was in 25 cases(22.9%),the main complications were LOS in 6 patients and respiratory complications in 18 patients,hydropericardium in 1 case,respectively.Conclusion To improve the operative and CPB technique,and to improve the skills of the postoperative managements of LOS and respiratory complications are the main points in the success of the cardiac operation in infants.

Objective:To explore the curative effect and safety of febuxosta for the patients with primary gout complicated with mild to moderate renal insufficiency.Methods:60 male patients with primary gout complicated with mild to moderate renal insufficiency were enrolled in the affiliated Hospital of integrated traditional Chinese and Westem Medicine,Nanjing University of Chinese Medicine from January 2015 to August 2016 and randomly divided into two groups,the control group (n=30) was treated by allopurinol,and the study group (n=30) was treated by febuxosta treatment.The blood uric acid (BUA) and hepatorenal function were compared in the treatment period,and the incidence of adverse reactions and the recurrence of gout in post-treatment were compared.Results:At 1,2 and 3 month after treatment,the serum level of BUN in the study group was significantly lower than that of the control group (P＜0.05).The renal function of all patients were significantly improved compared with pre-treatment (P＜0.05),but the no significant difference was found between two groups at the same time(P＞0.05).The control group showed the adverse reactions with limb discomfort,drowsiness,nausea,abdominal distension,diarrhea and itch of skin,and the study group showed limb discomfort,drowsiness and abdominal distension,and one patients presenting allergic skin rash and discontinuation of allopurinol.The total incidence of adverse reactions in the study group was significantly lower than that of the control group (P＜0.05).Conclusions:Febuxosta could effectively and safely decrease the blood uric acid levels and improve the renal function of patients with primary gout complicated with mild to moderate renal insufficiency.

This study is to establish a cell-based model targeting to neuraminidase (NA) of the 2009 H1N1 influenza A virus. NA is an influenza virus structural protein with enzymatic activity of the cleavage of HA-sialic acid interaction to release new viral particles from cells. A model of HIV-1 (pNL4-3.Luc.R(-)E(-)) based pseudovirions packed with HA [hemagglutinin, A/VietNam/1203/2004 (H5N1)] and NA [A/California/04/2009 (H1N1)] was established to evaluate compounds activities on NA function. The viral release can be blocked by neuraminidase inhibitors, oseltamivir and oseltamivir carboxylate, with IC50 of (61 +/- 31) nmol L(-1) and (5.5 +/- 2.9) nmol L(-1) respectively. A point mutation of H275Y on NA leads oseltamivir-resistance. This corresponding mutation was introduced into the system which was also confirmed by oseltamivir and oseltamivir carboxylate.