Objective To investigate the relationship between the plasma cytokines and the translocation of intestinal bacteria and endotoxin after gut barrier injury in severe acute pancreatitis (SAP) rats. Methods SD rats were divided randomly into sham operation group(n=36) and SAP group (n=36). The rat model of SAP was set up by retrograde injection of 4% sodium taurocholate in biliopancreatic duct. Morphological changes of pancreas and ileum were observed. The plasma levels of TNF-a,IL-6 and IL-10 were determined by ELISA. The plasma levels of DAO activities and LPS were measured at various time points. The rates of bacterial translocation to abdominal organs were also calculated. Results The plasma levels of TNF-a and IL-6 obviously elevated immediately after SAP induction and reached peak value at 48 hours, and the plasma IL-10 level significantly increased only 6 hours after SAP induction. Plasma DAO activities increased at the early stage of SAP and obviously decreased at 24 hours. Plasma LPS levels also increased significantly at the early stage of SAP and reached peak value at 48 hours. The rates of bacterial translocation to organs sharply increased 24 hours after SAP induction and reached 58.3% at 72 hours. Conclusion The levels of cytokines increased and gut barrier function was injured in the early stage of SAP. Cytokines may impair the intestinal microcirculation and gut barrier function, which could promote the intestinal bacteria and endotoxin translocation. Simultaneously, intestinal bacteria-endotoxin translocation could also induce excessive release of cytokines and aggravate the gut barrier damage, which might cause systemic inflammatory response syndrome and multiple organ disfunction syndrome. There was a close relationship beween cytokines and the translocation of intestinal bacteria and endotoxin in SAP.

Objective To describe the initial experience of transperitoneal laparoscopic renal plication for giant hydronephrosis,and to evaluate the clinical feasibility of the procedure. Methods This series included 12 cases of giant hydronephrosis (5 men and 7 women;age ranged from 19 to 64 years with a mean of 42.6 years).Of them 4 cases had upper ureter calculi;2 had ureteropelvic junction(UPJ) obstruction;2,middle ureter calculi;3,nephrolithiasis and 1,middle ureter stricture. The upper urinary tract obstruction was relieved and plication was performed via laparoscope. Results All the 12 operations were completed successfully.The intraoperative blood loss was 50 to 200 ml,operative time was 75 to 210 min.The postoperative follow-up lasted 3 to 18 months.In all these cases,hydronephrosis was relieved and renal function was improved. Conclusions Laparoscopic renal plication is an effective and minimally invasive method and can be considered as an alternative for treatment of giant hydronephrosis.

Objective To explore the clinical effect of edaravone on acute ischemic cerebrovascular disease ,and to observe its effect on serum C‐reactive protein (CRP) and matrix metalloproteinase‐9(MMP‐9) level .Methods Eighty four patients with acute ischemic cerebral vascular disease who were treated in our hospital during 2012 May to 2013 December were selected and divided in‐to observation group and control group ,with 42 cases in each group .The control group was treated with anti‐platelet ,regulating blood pressure and blood lipid ,reducing intracranial pressure ,improve microcirculation and other comprehensive treatment ;the pa‐tients in observation group were treated with increased dose of edaravone on the basis of the control group .America national institu‐tes of health stroke scale(NIHSS) and activities of daily living scale (ADL) were used to evaluate the neurological function and ac‐tivities of daily living ability of patients before and after the treatment ,the CRP and MMP‐9 level were detected before and after treatment ,and the adverse reaction during the treatment was recorded .Results After one week and two weeks after treatment , there were significant differences between treatment group and control group in the NIHSS score and ADL score (P<0 .05) ,and there were significant differences between treatment group and control group in CRP and MMP‐9 (P<0 .05) .There was no signifi‐cant difference between treatment group and control group in the reoccurrence rate of adverse reaction (7 .14% vs .4 .76% )(P>0 .05) .Conclusion Edaravone could improve the clinical treatment effect of acute ischemic cerebrovascular disease ,and reducing se‐rum CRP and MMP‐9 level mechanism pathway might be involved in the regulation of its pharmacodynamics .

Objective To study the effects of health promotion on prevention and treatment for hypertension in urban population performed by a community hospital. Methods Typical sampling was used to select 318 subjects in a sub-district government office of Chongwen District in Beijing and a factory under jurisdiction of the city as intervention community. Comprehensive intervention for hypertension was performed at this community during July 2003 to December 2004. All the subjects were interviewed with questionnaire of knowledge of hypertension and its behavioral risk factors before and after intervention. The data were analyzed with SPSS version 11.0. Results Totally, 272 of 318 subjects responded after intervention. Awareness of prevention and treatment for hypertension in the subjects was compared before and after intervention. Awareness of the harm of high blood pressure in the subjects increased to 60 percent after intervention from 51 percent before it (P

Objective To introduce the initial experience of transperitoneal laparoscopic uretero ureter anastomosis for ureteral obstruction. Methods This series included 9 cases (4 males and 5 females).Their mean age was 49 years (range,34-64 years).Five cases had obstruction on the left side and 4,on the right.Of the 9 cases,2 had upper segment ureterolithiasis with big polyps;1,retro venacaval ureter;1,upper segment ureter polyps;1,middle segment ureter tumor;1,middle segment ureter stricture;1,upper segment ureter stricture after open ureterolithotomy;1,middle segment ureterolithiasis with stricture;1,lower segment ureter ligation after hystero myomectomy.All the 9 cases underwent relief of ureter obstruction and uretero ureter anastomosis via laparoscope. Results The operations were all successful in 9 cases.The blood loss was 80-200 ml (mean,147 ml).No one needed blood transfusion.The operative time was 80-170 min (mean,116 men).Postoperative drain had no obvious leakage of urine.Double J tubes were removed 1 month after operation.The mean follow up was 14 months.IVU,BUS or RGU examinations showed that hydronephrosis was lessened and renal function was improved. No ureter stricture was found.One patient with ureter tumor was pathologically confirmed to suffer from ureter squamous carcinoma; the edge was negative.However,the patient developed recurrence 13 months after operation and then underwent renal fistulization again. Conclusions Laparoscopic uretero ureter anastomosis is an effective and minimally invasive method and can be used as an alternative approach to treatment of ureter obstruction.

Objective To discuss the clinical application of laparoscopic ultrasound (LUS) in laparoscopic nephron sparing surgery(NSS) for central renal tumors.Methods Eighteen patients underwent laparoscopic NSS for central renal tumors.The use of LUS was mainly lay in observing the nature and size of the tumor, the minimum distance from the tumor to capsule, collective system and renal artery, tumor's vasa vasorum,tumor localization and determination of margins.Results Of the 18 central renal tumors,the size was 11 - 29 mm,23.3 mm in average.The minimum distance from the tumor to capsule was 2 - 11mm,4.7 mm in average.The minimum distance within 5 mm to collective system and to capsule was 12 and 10 cases respectively.The tumor was surrounded by nephridial tissue completely on LUS, without protruding capsule.LUS diagnosis of 18 central renal tumors: 10 cases of renal angiomyolipoma,7 cases of renal cell carcinoma, 1 case of renal cyst with capsule wall calcification (at first diagnosed as renal carcinoma by CT).The findings of LUS were same to pathologic and(or) postoperative diagnoses.The accuracy of ultrasound localization was 100％.The surgical margins of 7 cases of renal cell carcinoma were all negative.Conclusions It is of high clinical value of LUS on locating the tumor and defining tumor margins in laparoscopic resection of central renal tumors.Besides, more information on tumor and vessel supply will be achieved.

In the marketing theory, service disparity model is a simple effective tool, capable of figuring out the five clusters of reasons leading to service failure. This article applies it in the community health service domain. Through the efforts of healing the five gaps in service delivery, including Consumer expectation-management perception gap, Management perception-service quality specification, Service quality specifications-service delivery gap Consumer expectation-management perception gap and Service delivery-external communications gap, we hope to improve the community health service quality radically.

Objective To investigate the effect of different intrathecal doses of meperidine on shivering during cesarean delivery under spinal-epidural anesthesia.Methods Sixty parturient women,ASA grade Ⅰ-Ⅱ grade,scheduled for cesarean delivery were enrolled in four groups by random digits table with 15 cases each group.All patients underwent combined spinal-epidural anesthesia.Spinal anesthesia consisted of isobaric bupivacaine 0.5％ (10 mg) in the standard group (group A),isobaric bupivacaine 0.5％ (10 mg) plus 5 mg meperidine in group B,isobaric bupivacaine 0.5％ (10 mg) plus 10 mg meperidine in group C,isobaric bupivacaine 0.5％(10 mg) plus 15 mg meperidine in group D.The signs and symptoms were recorded 10,20,30,60 min after anesthesia respectively.Results All patients were successfully operated,not unexpected.Four groups at each time point of vital signs,nausea and vomiting,and the number of cases of neonatal 1,5 min Apgar scores was no significant difference (P ＞ 0.05).Group A of shivering and the third grade shivering were significantly more than the number of group B,C,D(11 cases vs.2,1,1 cases;4 cases vs.0,0,0 cases,P＜ 0.01).Conclusion Epidural anesthesia,intrathecal meperidine 5-15 mg can effectively prevent shivering in cesarean section.

Objective:To establish an HPLC method for determining nectandrin B in Uygur medicine Arillus Myristicae. Meth-ods:The analysis was performed on a SunFireTM C18 column (150 mm × 4. 6 mm, 5 μm) at 30°C using methanol /water (52 ∶48) as the mobile phase at a flow rate of 1. 0 ml·min-1 with the UV detection wavelength at 228. 4 nm. Results:The linear range of nectan-drin B was 3. 98 -79. 60 μg·ml-1(r=0. 999 2). The average recovery was 99. 89% with RSD of 1. 11%(n=6). Conclusion:The method is accurate, convenient and reproducible in the determination of nectandrin B in Uygur medicine Arillus Myristicae.

Objective To report the surgical methods and results of pure laparoscopic radical cystectomy with orthotopic U-shape ileal neobladder.Methods From August 2010 to April 2014,19 patients with locally advanced bladder cancer (cT2-3 N0-2 M0) underwent pure laparoscopic radical cystectomy and Endo-GIA assisted orthotopic U-shape ileal neobladder reconstruction.Perioperative and follow-up data were collected.Results The surgeries were successful in all 19 cases with the operating time ranging from 261 to 380 min,blood loss of 100 to 350 ml.Postoperative hospital stay was 21±4 (15-26) days,postoperative intestinal function recovery time at 1.9±0.4 (1.5-2.3) days.Surgical margins were all negative.Lymph node positive rate was 32％ (6/19).Complications were including 1 case of lymphatic leakage; 3 cases of new bladder and urethra anastomotic fistula.There were 17 cases of urinary incontinence,all these cases were improved after 3 months,but there were still 8 cases of night-time incontinence.Three cases had unilateral ureteral reflux,ureter mild hydrocephalus,1 of the cases had recurrent infections within 1 month after surgery.After the anti-inflammatory and catheterization treatment,the symptoms were improved.Two cases had unilateral ureteral anastomotic stricture,one underwent percutaneous nephrostomy and cystoscope-assisted double J tube placement,another underwent laparoscopic ureteral neobladder reimplantation.One case had bilateral ureteral stenosis due to recurrent infections,and underwent bilateral laparoscopic ureteral-new bladder reimplantation.Patients were followed up for 8-42 months,no recurrence or distant metastasis was found.Conclusion Pure laparoscopic radical cystectomy with endo-GIA assisted orthotopic U-shape ileal neobladder can reduce surgical trauma and help patient's postoperative recovery.