Objective To evaluate the surgical management of pancreatic fistula caused by pan-creatic trauma and pancreatitis through surgical drainage. Methods A series of 45 patients with pancreat-ic fistula undergoing Roux-en-Y surgery with or without fistulectomy from 2004 to 2014 was analyzed. Pa-tients were divided into two groups:patients in group A(n=21)underwent external drainage of pancreatic secretion by Roux-en-Y surgery,and patients in group B(n= 24)underwent Roux-en-Y surgery with fistu-lectomy. The surgery was performed at 4~6 months after formation of the fistula,and somatostatin was used postoperatively. Results Patients in group A developed more severe side effects than patients in group B, including chronic abdominal pain(6/21 vs. 1/24),pancreatic leakage(8/21 vs. 2/24),digestive bleeding (5/21 vs. 5/24)and incision infection(9/21 vs. 3/24). Conclusion Resection of the fistula plus Roux-en-Y surgery can significantly reduce the incidence of surgical complications,which is a safe and efficient management for pancreatic fistula.

OBJECTIVE:To observe the efficacy and safety of rebamipide triple therapy in the treatment of gastric ulcer with bleeding. METHODS:130 patients with gastric ulcer with bleeding were randomly divided into control group(65 cases)and obser-vation group(65 cases). Control group received Omeprazole enteric-coated capsule 20 mg,orally,twice a day+Aluminum magne-sium carbonate tablet 500 mg,orally,once a day;observation group was additionally received Rebamipide tablet 0.1 g,orally,3 times a day. They were treated for 12 weeks. Clinical efficacy,remission time of belching,abdominal pain,bloating,hematemesis/hematochezia,clinical symptom score before and after treatment,rebleeding and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,remission time of symptoms and signs were significantly shorter than control group,the incidence of rebleeding was significantly lower than con-trol group,with statistical significances (P<0.05). Before treatment,there was no significant difference in the clinical symptom score (P>0.05). After treatment,the clinical symptom scores in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significances (P<0.05). And there was no significant difference in the inci-dence of adverse reactions (P>0.05). CONCLUSIONS:Rebamipide triple therapy shows obvious short-term efficacy in the treat-ment of gastric ulcer with bleeding,which can effectively improve patients'gastrointestinal symptoms,reduce rebleeding risk,and does not increase the incidence of adverse reactions.

Objective:To study the metabolic effect in in-patients chronic schizophrenia receiving horticultural therapy.Methods:One hundred and ten in-patients with schizophrenia meeting the criteria and signed informed consent at the rehabilitation wards were included.The random-number methods were used to classify patients into either the intervention group or the control group.The two groups both received normal medications while the intervention group alsoreceived horticultural therapy.The body weight and waist circumference were recorded at baseline,6 and 12-week-follow-up.And fasting blood sugar,triglyceride values were tested at the baseline,4th,8th,and 12th week-session.Results:Fifty-two patients of each group finished the evaluation.Covariance analysis results showed that the average waist circumference was much shorter in the intervention group than in the control group at 12-week-follow-up (F =13.98,P ＜ 0.001).When divided into 3subgroups according to the different drugs,after repeated ANOVA,the average waist circumference of the intervention group became shorter after intervention (olanzapine F =3.62,P ＜ 0.05;risperitone,F =4.46,P ＜ 0.05;aripiprazole,F =4.14,P ＜ 0.05) no matter what the antipsychotics they took.Conclusion:It suggests that horticultural therapy could effectively narrow waist circumferences in hospitalized patients with chronic schizophrenia whatever the antipsychotics the patients take.

Objective: To systemically review the safety and efficacy of Absorb bioresorbable vascular scaffold (Absorb BVS) versus cobalt chromium-everolimus eluting stent (CoCr-EES) for treating the patients with coronary artery disease (CAD) by percutaneous coronary intervention (PCI).
Methods: We searched relevant literatures in PubMed, Embase, Cochrane Library, CNKI and Wanfang database from 2008-01 to 2015-10, meanwhile, collected published data and randomized controlled trials from meeting abstracts and websites to compare Absorb BVS and CoCr-EES for treating CAD patients. The quality of literatures were assessed and extracted by modiifed Jadad score, Meta-analysis was conducted by STATA 12.0 soft ware.
Results: There were 4 eligible trials with 3,389 patients were enrolled. Absorb BVS group, n=2,164 and CoCr-EES group, n=1,225. During the mean of 1.1 years follow-up period, the following incidences were similar between 2 groups:target lesion failure (OR=1.29, 95%CI 0.95-1.74, P=0.10), all cause death (OR=1.31, 95%CI 0.60-2.87, P=0.50), cardiac death (OR=1.38, 95%CI 0.45-4.24, P=0.57), myocardial infarction (OR=1.30, 95%CI 0.93-1.80, P=0.12), deifnite or probable stent thrombosis (OR=2.08, 95%CI 0.95-4.54, P=0.07), re-vascularization (OR=1.03, 95%CI 0.80-1.33, P=0.81), target lesion re-vascularization (OR=1.06, 95%CI 0.67-1.66, P=0.81) and the patient-oriented composite endpoint (OR=0.95, 95%CI 0.66-1.35, P=0.76).
Conclusion: Absorb BVS and CoCr-EES had the similar safety and efifcacy for treating the low and moderate risk CAD patients who had angina, ischemia while without symptoms. The longer period of follow-up study and larger randomized, controlled clinical trials were needed for Absorb BVS application in clinical practice.

Objective To investigate the effects ofYangyin Yiqi Mixture on pulmonary fibrosis caused by bleomycin in rats;To discuss its possible mechanism.Methods SD rats were randomly divided into normal control group, model group, dexamethasone acetate group, low-dose, middle-dose and high-doseYangyin Yiqi Mixture groups. Bleomycin was used to establish pulmonary fibrosis rat models through endotracheal instillation. One day after molding, each medication group received gavage with relevant medicine. Lung tissues were taken on the 7th, 14th and 28th day. Masson staining was used to observe pathological change;alkalinehydrolysis was used to detect HYP content;Western blot was used to detect the protein expressions of MMP-2 and TIMP-1.Results Compared with the normal control group, on 7th day, collagen in lung tissue of rats in model group markedly increased;the content of HYP in lung tissue significantly increased (P<0.01). On 28th day, collagen was deposited diffusely and the alveolar was destroyed;content of HYP in lung tissue increased significantly (P<0.01). Compared with model group, deposited collagen in lung tissue was alleviated, and the content of HYP were remarkable reduced in middle and high doseYangyin Yiqi Mixture groups and displayed dose-dependent. Western blot results showed that the protein expressions of MMP-2 and TIMP-1 increased quickly compared with the low expression of normal lung tissue in the 7th day of molding (P<0.05), and reached high expression in the 28th day. Compared with the model group, the level of MMP-9 in high-dose Yangyin Yiqi Mixture group decreased significantly in the 14th day;the expression of TIMP-1 decreased significantly in the 7th, 14th and 28th day (P<0.05).ConclusionYangyin Yiqi Mixture can effectively resist pulmonary fibrosis, which may be realized by inhibiting the expressions of TIMP-1 and MMP-9, regulating and promoting collagenic hydrolysis and restraining deposition of collagen.

Objective To introduce the experience of prophylaxis and management of the complications of carotid endarterectomy (CEA) during perioperative period because those complications can not be avoided yet.Methods During Oct 2000 to Jan 2013,318 patients were performed CEA.There were 213 men and 105 women with an average age of 74.8 years ranged from 48 to 85y.There were 186 patients in the left,120 patients in the right,and 12 patients in two sides.Simply,CEA are performed in 166 patients,CEA and patch in 140,and 12 patients were performed bypass with the autogenously great saphenous vein after the lesions removal.Results The perioperative complications were preoperative stroke in 3 cases,hypotension during operation in 16,after-operation deaths in 3,hyperperfusion syndrome in 18,postoperative severe cerebral infarction in 1,hoarseness in 14,and hematoma in 28.Conclusions Perioperative complications of CEA can be decreased by cautious surgical procedure and postoperative observation.

Objective To explore the effect of the expressive psychotherapy on the feeling of inadequacy and loneliness of inpatients with chronic schizophrenia.MethodsTotally 120 chronic schizophrenia inpatients met recruited criteria were randomly divided into study group(n=60) and control group(n=60) according to random number table.57 patients in each group finished all the follow-ups finally.The patients in two groups were received normal medications while the patients in intervention group also attended expressive psychotherapy.All the patients were assessed at baseline,6 weeks and 12 weeks of treatment with the feeling of inadequacy scale (FIS) and the status and trait loneliness scale (STLS).Results(1) The FIS score(F=225.19,P<0.01),STLS total score(F=225.20,P<0.01),STLS status score(F=240.40,P<0.01) and STLS trait score(F=106.75,P<0.01) decreased significantly in both groups after intervention.(2) The FIS score of study group was much lower than those of control group at the at 6-week-follow-up(4.93±20.86,57.89±20.48,t=-2.250,P<0.01) and 12-week-follow-up(38.43±17.50,57.21±22.98,t=-4.900,P<0.01).(3) After 6 weeks treatment and 12 weeks treatment,STLS total score(6 weeks:(54.32±12.30) vs (68.46±15.53),t=-5.425,P<0.01,12 weeks:(44.16±10.81) vs (65.75±16.26),t=-8.386,P<0.01),STLS status score (6 weeks:(25.95±6.41) vs (34.31±7.91),t=-6.239,P<0.01,12 weeks:(19.15±5.49) vs (32.58±8.45),t=-10.103,P<0.01) and STLS trait score (6 weeks:(28.37±6.73) vs (34.15±8.45),t=-4.138,P<0.01,12 weeks:(25.00±6.18) vs (33.15±8.22),t=-6.019,P<0.01) in study group were lower than those in control group,and the difference was statistically significant.ConclusionExpressive psychotherapy can effectively improve the loneliness and inadequacy of patients with chronic schizophrenia.

Objective To explore surgical experience of stenoses or occlusion of the vertebral artery .Methods In this group, there were 28 patients including 21 men and 7 females with average of 52 ~73 (68.3 ±0.03) y, duration 3 months to 4 years , and 15 lesions in the left and 13 lesions in the right .All patients were performed operation under general anesthesia .There were 16 vertebral artery endarterectomy , 10 subclavian-vertebral bypass and 2 end-side anastomosis between vertebral artery and common ca-rotid artery.Results One patient had to be performed second operation at the 7th day after endarterectomy because of anastomotic bleeding.All patients were cured.The patency rate of 6 months was 89.28%(25/28) in all patients.Conclusions Surgical man-agement of stenoses or occlusion of the vertebral artery has excellent curative effect with simply operation .However , the technique must be selected according to anatomic circumstances of vertebral artery and subclavian artery .

OBJECTIVE:To provide a reference for rational clinical application of Reduning injection. METHODS:The rele-vant information about the patients who sought treatment in our hospital in 2014 and used reduning injection were collected to make statistical analysis to the age,dosage,course of treatment,frequencies,etc. RESULTS:Among the above-mentioned patients,the number of males was more than that of females,children under 10 years old accounted for 36.10%,47.54%of patients received re-duning injection for a treatment course of over five days,and 14.99% of patients failed to wash the infusion tube before injection. CONCLUSIONS:Irrational clinical application of reduning injection exists. The administration and dosage should be standardized and the dosage for children under three years old as specified in the label be detailed to reduce and avoid the occurrence of adverse drug reaction so as to ensure the safety of drug use by patients.

Objective To explore the influence of delivery mode and feeding pattern on cytomegalovirus (CMV) infection on infants born ≥ 32 gestational weeks,and to observe the outcomes after CMV infection.Methods In this retrospective study,378 pregnant women with positive CMV IgG and negative CMV IgM,and their offsprings (384 cases,including six pairs of twins),who got visited at five hospitals of our collaboration group during March 2013 and February 2016,were enrolled.Serum samples were retrieved from a previous study of these participants for CMV IgM and IgG detection with enzyme-linked immunosorbent assay.All participants were divided into exclusive artificial feeding (EAF) and breastfeeding groups (BF),and the latter included exclusive breastfeeding (EBF) and mixed feeding (MF).T or Chi-square or Fisher's exact tests were performed for statistical analysis.Results (1) Among the 378 pregnant women,there were 186 mothers and 190 infants (4 pairs of twins) in BF group,and the other 192 mothers and 194 infants (2 pairs of twins) in EAF group.The percentage of male infants were 54.7％(104/186) and 56.2％(109/194) in the BF and EAF group,respectively.The mean birth age was (38.9± 1.4) and (38.7± 1.7) weeks,and the age at followingup was (9.8± 2.2) and (10.5± 2.9) months,respectively.(2) The CMV IgG positive rate of infants in BF group was higher than in the EAF group [62.6％(119/190) vs 29.9％ (58/194),x2=41.403,P＜0.001].CMV IgG levels in infants were higher than the mothers [(537.1 ±249.5) vs (416.2±241.2) U/ml,t=4.609,P＜0.001].In infants with positive CMV IgG,the positive rates of CMV IgM were similar in the two groups [21.0％(25/119) vs 19.0％ (11/58),x2=0.101,P=0.751].(3) The positive rate of CMV IgG in vaginally born infants was higher than those born by caesarean section [55.2 (95/172) vs 38.7％ (82/212),x2=10.472,P=0.001].Further analysis in the EAF group showed that those infants born vaginally had a higher positive rate ofCMV IgG than those born by caesarean section [42.9％ (33/77) vs 21.4％ (25/117),~=10.231,P=0.001],while this figure did not show statistical difference in the BF group.(4) Infants with positive or negative CMV IgG were in similar age and gender proportion,as well as their height and weight.Among 36 infants with both positive CMV IgG and IgM,three failed in alanine aminotransferase (ALT) test due to hemolysis.However,among the other 33 cases,15.1％ (five cases) presented with lightly elevated ALT (42-107.2 U/L),which was similar to those infants with positive CMV IgG and negative CMV IgM (14/98,14.3％) and those with both negative CMV IgG and IgM (20/144,13.9％),(x2=0.036,P=0.982).Conclusions Although breastfeeding and vaginal birth may increase CMV infection rate in neonates and infants,but no obviously adverse prognosis was reported in those born over 32 gestational weeks.So we should encourage vaginal birth and breastfeeding in these population.