Objective To explore the timing of surgical intervention for severe acute pancreatitis (SAP). Meth-ods One hundred and fifty-seven cases with SAP treated in our hospital from March, 1998 to December, 2007 were analyzed retrospectively. Influence of surgical intervention and conservative treatment on curative rate were e-valuated in pancreatic necrotic area and with or without infected pancreatic necrosis. Results The overall curative rate of surgical treatment and conservative treatment was 80.4%, 87.1% respectively; the two methods had no sta-tistical difference. Conservative treatment was better than surgical treatment in patients with lesa than 30% necrotic area and surgical treatment was better than conservative treatment in patients with more than 50% necrotic area. But the two methods had no statistical difference in 30% ～ 50% necrotic area. Conservative management was better than surgical management in sterile pancreatic necrosis, but surgical management was better than conservative manage-ment in pancreatic necrosis with infection or suspection of infection. Conclusion Surgical intervention treatment plays an important role in SAP patients, we should combine pancreatic necrotic area and with or without infection to choose the timing of surgical intervention for severe acute pancreatitis.

Objective To investigate the development of the digital wireless network billing system of oxygen flow in clinical application. Methods By random 220 cases of patients who need to absorb oxygen were divided into the observation group(108 cases)and the control group(112 cases), the observation group used the digital wireless network billing system of oxygen flow, and the control group adopted the traditional buoy type oxygen gauge instrument. The following items were compared between the two groups: dispute rates between nurses and patients for different amount of absorbed oxygen, the average time cost for nurses in measuring the duration of oxygen absorbing, total income per barrel for recycling oxygen. Results For the dispute rates between nurses and patients for different amount of absorbed oxygen were 0.93% in the observation group, and 75.89% in the control group. The average time cost for nurses in measuring the duration of oxygen absorbing was 2.03 minutes for the observation group, and 12.54 minutes for the control group; total income per barrel for recycling oxygen was 42.68 yuan per barrel of the observation group, and 28.23 yuan in the control group. The statistical analysis between the two groups was supported by 95% confidential level. Conclusions Using the digital wireless network billing system of oxygen flow in clinical can reduce the dispute rates between the nurses and patients, improve patients' satisfaction degree, reduce the total time cost for nurses in measuring the duration of oxygen absorbing, raise efficiency, build a clear scientific charge system of oxygen flow, and restore economic loss.

Objective The widely use of ultrasound elastography has increased the detection rate of breast cancer.It has great advantage of differential diagnosis of breast tumor.Our study is to evaluate and compare the value of the quantitative ultrasound elastography parameters of AR ( area ratio) , ESR ( entire strain ratio) , LSR ( locolized strain ratio) , EFLR( entire fat to lesion ratio) and LFLR( locolized fat to lesion ratio) in the differential diagnosis of breast tumor. Methods 110 patients with 113 breast tumors were collected from Nanjing General Hospital of Nanjing Military Region between January 2015 and January 2016 who underwent breast exami-nation.The tumors were divided into two groups according to patholo-gy which acts as gold standard:benign group with 59 lesions and ma-lignant group with 54 lesions.Participants underwent quantitative ul-trasound elastography parameters examination.AR、ESR、LSR、EFLR、LFLR were compared between benign group and malignant group and ROC curve was drawn.Conventional ultrasound and ultrasound elastography parameter are combined to differentiate the benign or malignant lesion.Calculate the various parameters on the accuracy、susceptibility、specificity、positive likelihood ratio、negative likeli-hood ratio of the diagnosis of benign and malignant lesions, and determine the quantitative parameter with the highest accuracy. Results The mean value of AR、ESR、LSR、EFLR and LFLR of malignant lesions were all significantly greater than that of benign le-sions (P=0.000).Compared with the conventional ultrasound, AR、ESR、LSR、EFLR and LFLR have higher AUC in the differentia-tion of benign and malignant breast lesions;AUC of AR and ESR are higher than conventional ultrasound、LSR、EFLR and LFLR( P<0.000).Compared with conventional ultrasound(1.523) alone, conventional ultrasound combined separately with AR、ESR、EFLR and LFLR have higher positive likelihood ratio(11.581、8.272、3.482、2.458、2.100) in the differentiation of benign and malignant breast lesions, so as accuracy、susceptibility、specificity(P<0.000).The AUC of conventional ultrasound combined separately with AR and ESR[0.940(0.890~0.990)、0.941(0.891~0.990)] were higher than conventional ultrasound and conventional ultrasound com-bined separately with LSR、EFLR、LFLR[0.669(0.669~0.768)、0.837(0.759~0.915)、0.763(0.673~0.852)、0.787(0.701~0.874)],so as accuracy、susceptibility、specificity and positive likelihood ratio(P<0.000). Conclusion Quantitative ultrasound elastography may be helpful in differentiation of benign and malignant breast lesions, especially combining conventional ultrasound with AR and ESR, which were superior to combining with the other parameters and provide a more objective and credible basis to differenti-ate benign and malignant breast tumors with conventional ultrasound.

0.05).Tn-C、CD44v6 were negative expression in group C.Conclusion Tn-C、CD44v6 protein are useful in early diagnosis of follicular thyroid carcinoma.

Objective To evaluate the value of CT and bronchoscopy in diagnosis of solitary pulmonary nodules.Methods The CT,FOB and histologic data of 60 patients with solitary pulmonary nodules were analysed retrospectively.Results 60 pulmonary lesions were all detected by CT scan,the detected rate was 100%.The detected rate by endoscopy was 67%(40/60).Conclusion CT can be used as the routine method in evaluating pulmonary nodules and guiding biopsy by fibroptic bronchoscopy.

OBJECTIVE:To observe the compatibility of moxifloxacin hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs(etamsylate injection,aminomethylbenzoic acid injection,vitamin K1 injection,and aminocaproic acid injection).METHODS:The concentration of moxifloxacin in the mixture of Moxifloxacin Hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs at 25℃ and 37 ℃ were determined by UV-spectrophotometry and dual wavelength spectrophotometry within 8 h.The changes of the mixture in appearance and pH were also observed.RESULTS:The mixture of moxifloxacin hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs experienced no obvious changes in both contents of moxifloxacin and pH and appearance.CONCLUSION:The mixture of moxifloxacin hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs was stable in contents of moxifloxacin and property.However,further studies remain to be done to investigate whether there are changes in the contents of the other four injections.

AIM: To observe the level of vascular endothelial growth factor (VEGF) secreted by monocytes cultured with electrical burn serum, and to explore the effect of VEGF on monocyte-endothelial cell adhesion.METH-ODS:The electrical burn serum of the rat was prepared.The normal serum from the rats without treating electric current was also collected for control.The contents of VEGF and its soluble receptor sFlt-1 in electrical burn group were determined by double-antibody sandwich ELISA.THP-1 cells were randomly divided into normal serum group and electrical burn serum group.The contents of VEGF and sFlt-1 in the culture supernatants were measured by double-antibody sandwich ELISA. THP-1 cells were also randomly divided into another 4 groups:normal serum group, electrical burn serum group, normal serum +inhibitor group and electrical burn serum +inhibitor group.THP-1 cells, which were incubated with the serum for 3 h and 6 h, were labeled with calcein-AM and then were added into the well with monolayer of endothelial cell line EA.hy926 to detect monocyte-endothelial cell adhesion.RESULTS:The levels of serum VEGF of the rats with electrical burns were significantly increased, the levels of serum sFlt-1 were significantly decreased as compared with the controls. The levels of VEGF secreted by THP-1 cells cultured with electrical burn serum were significantly increased, the levels of sFlt-1 were decreased correspondingly.Electrical burn serum enhanced monocyte-endothelial cell adhesion, sFlt-1 inhibi-ted the adhesion between monocytes and endothelial cells.CONCLUSION:The monocytes exposed to the electrical burn serum secrete VEGF, which enhance the adhesion between monocytes and endothelial cells.Blockage of VEGF activity may effectively inhibit monocyte-endothelial cell adhesion.

This study was aimed to investigate allergic reactions of traditional Chinese medicine (TCM) injections, and to determine contents of serum IgE in sensitized animals. The correlation between preceding contents in serum and allergic reactions may be found, in order to offer experimental evidences for advancing the accuracy of anticipa-tion by allergic reactions. Passive cutaneous anaphylaxis (PCA) tests and anaphylactoid reactions were used in a vari-ety of TCM injections. ELISA method was used to determine the content of total serum IgE in sensitized animals. The PCA results of SHL, QKL, YXC, XST, GGS and CHN were negative. The PCA result of CWJ was positive. There was no significant difference for total serum IgE level between the experimental group and the normal saline group in the group of SHL, QKL, YXC, XST, GGS, CHN and CWJ. All TCM injections caused anaphylactoid symp-toms in guinea pigs. It was concluded that all TCM injections can cause allergic reactions in guinea pig. And the al-lergic reactions of TCM injections were not correlated with serum total IgE.

Objective To study the application effect of feedback training mode on new neonatal recovery technology.Methods 101 midwives,obstetric doctors and pediatricians who participated the training were tested about the professional knowledge and skills of new neonatal recovery technology according to the teaching material of neonatal asphyxia recovery and neonatal resuscitation guidelines (2007 revision in Beijing).The results showed no statistical significance.And they were randomly divided into the control group (51 cases) and the observation group(50 cases).The control group adopted traditional method,that was,the teacher taught first and then the students took practice.The observation group used feedback training method.Results The theoretical and technical results of the observation group were significantly higher than those of the control group.The learning motivation,learning initiative,cooperation degree,ability of observation and solving problem and operation proficiency were also significantly higher than those of the control group.Conclusions Feedback training methods can significantly increase the learning effect of perinatal personnel,and make popularized the new neonatal recovery technology.

Objective To observe the anaphylactoid reactions of Shuanghuanglian injection, determine the serum histamine level of sensitized animal, and to investigate its correlation with anaphylactoid reactions.Methods The guinea pigs were randomly selected to observe the anaphylactoid reactions using Shuanghuanglian injections in the different injection speed or different doses, and the serum histamine and the serum IgE of sensitized animals were determined by ELISA. Results The anaphylactoid reactions were induced by Shuanghuanglian injections in the different conditions of injection speed and doses in guinea pigs. There were no obvious difference about the serum IgE level between Shuanghuanglian group and saline group were injected in injection speed and doses. The serum histamine level was significantly increased in Shuanghuanglian group both different conditions of injection speed and doses, and it related to doses and speed. Conclusion Shuanghuanglian injection can cause anaphylactoid reactions in guinea pigs, and the changes of serum histamine level are related to injection speed and doses of Shuanghuanglian injection.