Objective To explore the clinical features of Shenzhen service worker with upper gastrointestinal bleeding and association with medical insurance. Methods 169 patients(service workers in Shenzhen city)with upper gastrointestinal bleeding were retospectiveng analyzed, the treatment time, the severity of bleeding, the cause of the bleeding and bleeding incentive, diagnosis and treatment compliance, and other characteristics were analyzed; the differences between the case of group health insurance and the case of group no-health insurance, were observedResults For the case of non-insurance group the treatment time was delayed( P＜0. 01 ) ;the non-standard pre-hospital diagnosis and treatment was higher( P＜0. 01 ). The rate of moderate and severe cases was higher( P＜0. 05 ). The rate of the patients do not comply with gastroscopy and refused hospitalization, the non-insurance group was higher than the insurance group(P＜0. 01 and P＜0. 05 respectively). In compliance with the treatment of the cases,ly the efficiency and the total effective rate were sigmficantly higher in the insurance group than non-insurance. Conclusion Public participation in health insurance services enable the upper gastrointestinal bleeding in patients with timely medical treatment fixed medical institutions in order to get more early diagnosis and treatment,access to better efficacy and prognosis.

Objective To investigate the effects of recombinant human interleukin(IL)-10 on serum interleukin-1? in L-arginine-induced acute necrotizing pancreatitis of rats.Methods Ninty-two Sprague-Dawley rats were randomly divided into three groups.Group A(n=36) and Group I(n=32) received three intraperitoneal injections of 6% L-arginine(1.0 mg/g) at hourly intervals.Group I(n=32) was treated with 10,000 unites of intraperitioneal recombinant human IL-10 at the 2nd,5th and 8th hour after the last injection of L-arginine.Group C(n=24) received saline alone.Rats were killed at the 4th,12th,24th and 36th hour after the last L-arginine injection.Serum interleukin-1? and amylase were assayed.Pancreatic tissues were examined histopathologically by microscopy.Results Serum amylase,interleukin-1? and pancreatic histopathological scores in group A increased significantly after L-arginine injection(P

Objective To observe the effects of serum containing the medicine of Tujian Mixture on phospho-Akt and phospho-PTEN of glomerular mesangial cell (MC) cultured in high concentrations of glucose. Method The glomerular mesangial cells from SD rat were divided into six groups:the normal control group, the group of MC cultured in high concentrations of glucose, and four other groups cultured in high concentrations of glucose + different concentrations of rat’s serum containing Tujian Mixture. After 72 hours, the content level of phospho-Akt (Thr308) and phospho-PTEN (Ser380) in MC was detected by using sandwich ELISA. Results The level of phospho-Akt (Thr308) in the group of MC cultured in high concentrations of glucose was significant higher than that in the normal control group (P

ObjectiveTo investigate the value of early fluid resuscitation endpoints in evaluating blood volume in patients with acute pancreatitis. MethodsA retrospective analysis was performed for the clinical data of 445 previously untreated patients with acute pancreatitis who were admitted to The First Affiliated Hospital of Guangxi Medical University from 2003 to 2016 and had an onset time of less than 24 hours, and according the fluid resuscitation endpoints of mean arterial pressure (MAP), hematocrit (HCT), and blood urea nitrogen (BUN), the patients were divided into standard-reaching group (MAP ＞65 mm Hg, BUN ＜7.14 mmol/L, and HCT ≥0.35 and ≤044, n=219) and non-standard-reaching group (MAP ≤65 mm Hg or BUN ≥7.14 mmol/L or HCT ＞0.44 or ＜0.35, n=226). The standard-reaching group represented normal volume, while the non-standard-reaching group represented insufficient volume. The two groups were compared in terms of symptoms, signs, etiology, severity, complication, and prognosis. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of continuous data between two groups. ResultsCompared with the standard-reaching group, the non-standard-reaching group had significant increases in white blood cell count, BUN, and Computed Tomography Severity Index of the pancreas (Z=-2.85, -6.725, and -2.293, all P＜0.01). As for local complications, compared with the non-standard-reaching group, the standard-reaching group had significantly lower incidence rates of peripancreatic exudation (45.2% vs 54.9%, χ2=4.15, P＜0.05) and pancreatic necrosis (10.0% vs 186%, χ2=6.59, P＜0.05). As for systemic complications, compared with the non-standard-reaching group, the standard-reaching group had significantly lower incidence rates of acute respiratory distress syndrome (ARDS) (0.5% vs 4.4%, χ2=7.26, P＜0.05) and renal dysfunction (1.4% vs 6.6%, χ2=7.95, P＜0.05). The standard-reaching group had significantly lower proportion of patients with severe pancreatitis and hospital costs than the non-standard-reaching group (both P＜0.05). ConclusionFluid resuscitation endpoints can be used to evaluate the blood volume of patients with acute pancreatitis in the early stage after admission, and the patients not reaching the standard of fluid resuscitation tend to develop the complications such as peripancreatic exudation, pancreatic necrosis, ARDS, and renal dysfunction and may have higher hospital costs.

Objective: To evaluate the surgical treatment of calcaneal fracture malunion. Methods: A retrospective analysis was conducted of the 19 patients with calcaneal fracture malunion (19 feet) who had been treated from January 2011 to September 2017 at Departments of Joint Surgery and Orthopedic Trauma, The Third Affiliated Hospital, Sun Yat-Sen University. They were 16 males and 3 females with the average age of 36.2 years (from 22 to 57 years). According to Stephens-Sanders classification, the malunion was defined as type Ⅰ in 10 cases, as type Ⅱ in 6 and as type Ⅲ in 3. The patients with malunion of type Ⅰ were treated by lateral wall osteotomy and decompression of long and short peroneus muscles to preserve the subtalar joint, those with malunion of type Ⅱ by lateral wall osteotomy and decompression of long and short peroneus muscles followed by subtalar joint fusion, and those with malunion of type Ⅲ by lateral wall osteotomy, decompression of long and short peroneus muscles, medial oblique osteotomy for correction of varus deformity and subtalar joint fusion via both the medial and lateral approaches. The Maryland functional scores were used to assess the postoperative surgical efficacy. Results: No such complications happened as incision or implant infection, screw breakage or joint non-fusion. Of the 19 patients, 17 were followed up for 18 to 26 months (mean, 20.5 months). The Maryland scores at the final follow-ups were 90.2±7.3, significantly higher than the preoperative values (38.6±5.5) (t=53.370, P<0.001). Conclusions In the surgical treatment of calcaneal fracture malunion, satisfactory clinical efficacy can be achieved by lateral wall osteotomy and preservation of the subtalar joint for patients with maunion of Stephens-Sanders type Ⅰ, and by subtalar fusion for those with maunion of Stephens-Sanders types Ⅱ-Ⅲ.

Currently there is no successful platform technology for the sustained release of protein drugs. It seems inevitable to specifically develop new materials for such purpose, and hence the understanding of protein-material interactions is highly desirable. In this study, we synthesized cholesterol-grafted polyglutamate (PGA--Chol) as a hydrophobically-modified polypeptide, and thoroughly characterized its interaction with a model protein (human serum albumin) in the aqueous solution by using circular dichroism, fluorescence methods, and light scattering. With the protein concentration fixed at 5 μmol/L, adding PGA--Chol polymers into the solution resulted in continuous blue shift of the protein fluorescence (from 339 to 332 nm), until the polymer molar concentration reached the same value as the protein. In contrast, the un-modified polyglutamate polymers apparently neither affected the protein microenvironment nor formed aggregates. Based on the experimental data, we proposed a physical picture for such protein-polymer systems, where the polymer first bind with the protein in a 1:1 molar ratio a fraction of their hydrophobic pendant cholesterol resides along the polymer chain. In this protein/polymer complex, there are excess unbound cholesterol residues. As the polymer concentration increases, the polymers form multi-polymer aggregates around 200 nm in diameter the same hydrophobic cholesterol residues. The protein/polymer complex also participate in the aggregation their excess cholesterol residues, and consequently the proteins are encapsulated into the nanoparticles. The encapsulation was also found to increase the thermal stability of the model protein.