Objective Analysis of early risk predict markers within 24h after admission of prognosis in severe acute pancreatitis (SAP). Methods Medical records of 127 patients with sever acute pancreatitis admitted to our hospital within 72h after onset from February 2006 to July 2009 were retrospectively analyzed. These inpatients were grouped into survival group (102 cases) and death group (25 cases). The clinical and laboratory data within 24h after admission were compared between two groups. Results Compared with survival group, patients in death group had significantly difference in heart rate, respiratory, PaO2, pH value, serum calcium, serum kalium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱscores (P<0.05). Higher APCHE Ⅱ scores after admission was an independent early high risk predicator of death. Conclusions Death group was characterized as severe multiple organ dysfunction and severe internal disturbance. Heart rate, respiratory, PaO2, pH value, serum calcium, serum potassium, serum creatine, BUN, BE, LDH, serum albumin and APCHE Ⅱ scores were early risk predict markers of death in patients with sever acute pancreatitis.

Excessive release of glutamic acid plays an important role in the occurring and development of many nervous system diseases.Ionotropic glutamate receptors antagonists are shown to have therapeutic effect in animal models,but their clinical application is limited by their effects of blocking the normal excitatory neurotransmission.However,metabotropic glutamate receptors can suppress the release of glutamic via presynaptic mechanisms,which makes them the new targeting points of certain nervous system disease.This paper reviews the recent research progress of mGluRs in nervous diseases both at home and abroad.

Objective: To develop a cross-culture revision of career decision-making difficulties questionnaire(CDDQ) for undergraduate students. Methods: A total of 330 college students were tested with CDDQ. Results: ①Cronbach ? coefficients ranged from 0.68 to 0.84;②There were significant differences among different students. Conclusion: The psychometric properties of the inventory developed in this study are acceptable. It can be used as the instrument for measurement of undergraduates' career desicion making difficulties, However, revision should be made in accordance with the condition of China.

AIM: To study the dermal toxicity and absorption of Triptolide Compound Cream. METHODS: 2% azone+1% volatile oil of twig from Camellia. oleifera was used as permeation enhancer to prepare Triptolide Compound Cream. Acute dermal toxicity, irritation a sensitization test on mouse were carried out. And mouse skin in vitro was applied for studying the administration. RESULTS: This compound cream had no acute toxicity, irritation or hypersensitive effects. 2% azone+1% volatile oil had more powerful enhancement effects, after 12 h, amont of drug delivery/unit area Q/( μg/cm~2) and absorption percentage Q% of tfiptolide and meloxican in the preparation reached a platea conventration. The results also showed that there was a good linear correlation between the accumulative permeated amount per unit area and the time. CONCLUSION: The study showed that Triptolide Compound Cream has no toxicity on skin, and there is a good dermal absorption.

AIM: To study the dermal toxicity and absorption of Triptolide Compound Cream.METHODS: 2% azone+1% volatile oil of twig from Camellia.oleifera was used as permeation enhancer to prepare Triptolide Compound Cream.Acute dermal toxicity,irritation a sensitization test on mouse were carried out.And mouse skin in vitro was applied for studying the administration. RESULTS: This compound cream had no acute toxicity,irritation or hypersensitive effects.2% azone+1% volatile oil had more powerful enhancement effects.after 12 h,amont of drug delivery/unit area Q/(?g/cm2) and absorption percentage Q% of triptolide and meloxican in the preparation reached a platea conventration.The results also showed that there was a good linear correlation between the accumulative permeated amount per unit area and the time. CONCLUSION: The study showed that Triptolide Compound Cream has no toxicity on skin,and there is a good dermal absorption.

Objective To explore the lower limbs joints movement of patients with unilateral and primary artificial hip replacement in convalescence. Methods 100 cases of patients with unilateral and primary artificial hip replacement in convalescence were chosen as the ob-servation group,while 100 cases of matched healthy subjects were included as the control groups. The three-dimensional kinematics and mo-tion of lower extremities were monitored. Results The difference in operated knee flexion,operated ankle planter flexion and operated hip flexion of the observation group and the observation group were statistically significant(P<0. 05). The difference in the joint angle peak of hip backward extension of sagittal section,hip adduction of frontal plane,knee adduction of frontal plane,ankle adduction and outreach of frontal plane,hip internal rotation and extorsion of horizontal plane,ankle rotation and extorsion of horizontal plane in two groups were statisti-cally significant(P<0. 05). Conclusion There are abnormal prosthetic joint movement,limited range of operated movement in patients with unilateral and primary artificial hip replacement in convalescence,and coterminous kinematic chains appear compensatory changes,it should strengthen the muscle exercises of operated hip.

Paroxysmal nocturnal haemoglobinuria ( PNH) is a clonal hematopoietic stem cell disease characterized by intravascular hemolytic anemia , pancytopenia and thrombosis .Although PNH is an non-malignant disease , its complications have very negative impacts on patient's quality of life .The most common serious complication is thrombosis formation .

ObjectiveTo investigate the clinical value and pathological basis of peritumoral hyperenhanced rim (PHR) of renal cell carcinomas (RCCs) on CEUS.MethodsCEUS images of 53 patients with 54 renal tumors (27 RCCs,27 renal angiomyolipomas) were analyzed,and the detection and distribution of PHR were evaluated.HE staining and immunohistochemistry of CD34 were performed in tissue surrounding RCCs (TSR) to observe distribution of psuedocapsule,large vessels,and microvasculars among TSR with different modes of PHR.ResultsPHR was found only in RCCs.PHR distribution between RCCs and angiomyolipomas was statistically different (P＜0.05).Using PHR to diagnose RCC,the sensitivity,specificity,positive predictive value,negative predictive value,false positive and false negative was 44.44％ (12/27),100％ (27/27),100％ (12/12),64.29％ (27/42),0 (0/27) and 35.71％ (15/42),respectively.Pseudocapsule distribution between RCCs with PHR and RCCs without PHR was not statistically different (P＞ 0.05).There were rich large blood vessels in TSR with PHR in washin and both phases,and few or thimbleful large vessels were found in TSR without PHR in washout phase.Cancer tissue near the boundary (CTNB) of TSR had the highest microvessel density (MVD).MVD differences in different TSR with PHR were statistically different between washin and washout phases,washin and both phases,both phases with PHR and without PHR (P＜0.05),but no statistical difference was found between washout and both phases (P＞0.05).ConclusionPHR is a highly specific complementary indicator in diagnosing RCC,and it is correlated with rich blood vessels in TSR and (or) a higher MVD value in CTNB.

Objective To observe the effect of acute retrograde gastric electrical stimulation (RGES) on gastric accommodation,emptying and gastrointestinal hormones releasing in obese patients. Methods Sixteen obese patients were examined. On the first day,a pair of mucosal gastric electrodes was placed under endoscope. The liquid meal load test and the standard solid meal gastric emptying test were carried out on the second day. RGES was performed starting at 30 minutes before each test and through the whole testing process. The serum leptin,ghrelin,resistin and peptide YY were examined before and after the standard solid meal gastric emptying test. On the third day,sham stimulation was given. The effect of acute RGES on related index was compared by self-control.Results BMI of the 16 patients was (32. 90±2. 99) kg/m2. Acute RGES significantly reduced the liquid meal volume of fullness [(460±148) ml and (630±219) ml,t=-7. 200,P＜0. 01] and the maximal tolerable meal volume [(699±215) ml and (926±295) ml,t=- 5. 390,P＜0. 01]. The effects of RGES and sham RGES on half-emptying time of standard solid meal was (109±26) min and (103±31) min (t=1. 009,P= 0. 329);on the retention rate of standard solid meal at one hour and two hour was (63. 37±9. 75)% and (59. 73±12.87)% (t=1. 834,P= 0. 087),(42.22±13.97)%and (38. 33±16. 87)% (t= 1.780,P= 0. 095),respectively. The ratio of gastrointestinal hormones after and before the stimulation also of the sham stimulation,leptin was 1. 03±0. 34 and 1. 08±0. 38(t=-0.386,P=0. 705),ghrelin was 0. 99±0. 11 and 0. 98±0. 12 (t= 0. 413,P=0.685),resistin was 1. 11±0. 25 and 0. 99±0. 24 (t= 1. 753,P= 0. 100),and peptide YY was 1. 56±0. 71 and 1. 33±0. 61 (t=1. 402,P= 0. 181). Conclusions In obese patients,acute RGES significantly reduce the liquid meal volume by lower gastric accommodation,to certain extent which will delay gastric emptying. There is no significant influence on gastrointestinal hormones releasing.

Objective To investigate the prognostic value of fever burden in traumatic brain injury (TBI) patients.Methods A retrospective analysis of 355 TBI patients admitted to the emergency department and intensive care unit from November 2010 to October 2012 was performed,and the Glasgow outcome scale (GOS) was followed-up 6 months after the injury.The patients were divided into two groups according to the GOS:good outcome group (4 to 5) and poor outcome group (1 to 3).Relevant clinical findings were studied by statistical description,logistic regression analysis,Spearman correlation analysis and ROC curve analysis.Results Fever burden level was continuously increased with the decrease of GOS from score 5 to 2,except for score 1 of GOS,which was corresponding to a significant lower fever burden.There were significant differences in age,pupil reactivity,Glasgow coma scale (GCS) and fever burden between two groups (P ＜ 0.05).Compared to the good outcome group,the poor outcome group was featured with more advanced average age (P =0.000),poorer pupil reactivity (P =0.000),lower GCS score (P =0.000) and higher fever burden level (P =0.000).Univariate logistic regression analysis suggested that age,GCS,pupil reactivity and fever burden level (OR 1.166,95％ CI:1.117-1.217) were associatedwith poor outcome.The fever burden level and the other independent prognostic predictors as age,GCS and pupil reactivity were further included in the multivariate logistic regression model,and the adjusted OR of fever burden level was 1.098 (95％ CI:1.031-1.169,P =0.003).ROC curve analysis showed the respective AUC for fever burden was 0.713 (95％ CI:0.663-0.760).The relevant analysis revealed a significant negative correlation between the fever burden and the GOS score (r =-0.376,95％ CI:-0.462--0.283,P =0.000).Conclusions Fever burden can be considered as an independent predictor of poor outcome of patients with TBI.The TBI patients with early onset of high levels of fever burden will have increased poor outcome risk.