Objective To investigate the effect of continuous renal replacement therapy (CRRT) combined with Rhubarb at early stage on inflammatory cytokine in the treatment of severe acute pancreatitis.Methods Fifty two patients with SAP were randomly divided into three groups,the conventional treatment group,the CRRT group,and the combined group.CRRT was inplemented in 48 h after the diagnosis of SAP.APACHE-Ⅱ score,mortality were compared before and after treatment.Double sandwich ELISA method was used to detect the levels of interleukin 22 (IL 22),IL-18 and tumor necrosis factor α(TNF-α).Results The clinical effect in combined group was better than other groups,and the mortality was lower than other groups,but the difference was not statisticaly different(P＞0.05).The levels of IL-22,TNF-α and IL-18 were not significantly different among three groups before treatment (P＞0.05).After treatment,the inflammatory factors decreased in all groups.The levels of IL-18,TNF-and IL-22 in CRRT group and combined group were significantly lower than those in control group (P＜0.05),and the combined group decresed most abviously(P＜0.05).There was no significant difference in APACHE Ⅱ score among the three groups before treatment (P＞0.05),while the APACHE-Ⅱ scores were significantly decreased after treatment,the difference was statistically significant (P＜0.05).After treatment,the APACHE-Ⅱ score of the combined group were significantly lower than the other two groups(P＜0.05).Conclusion The therapy of CRRT combined with Rhubarb at early period in SAP patients can better clean up inflammatory cytokines of IL-22,TNF-,IL-18,so that patients with SAP can get more clinical benefits.

Objective:To establish a method for detecting the content of vitamin B2 in Weimeisu tablets by HPLC-FLD. Methods:A PAK C18(250 mmID × 4. 6 mm,5 μm) column was employed with methanol -0. 02 mol·L-1 ammonium acetate (35∶65) as the mobile phase, the flow rate was 1. 0 ml·min-1, and the injection volume was 10 μl. The detection wavelength λex and λem were 450mn and 522 mn, respectively. Results:Vitamin B2 was linear within the range of 1.0-20 μg·ml-1(r=0.999 9). The average recovery was 99. 20%(RSD=0. 63%, n=6). Conclusion:The method is specific, sensitive and accurate, and can be used to deter-mine vitamin B2 in Weimeisu tablets.

We made the third party medical disputes mediation organization dispose medical disputes more quickly and effectively by analyzing its theoretical knowledge,running mode,economic framework,administrative agency and personnel disposition,which provided institutional insurance for the establishment of harmonious relationship between doctors and patients in our country.

Objective To explore the significance and value of the anti-nucleosome antibodies(AnuA)in the diagnosis of system-ic lupus erythematosus(SLE).Methods The serum AnuA was detected in 177 patients with SLE,138 patients with other rheumat-ic diseases and 56 healthy controls by Western blot.The clinical manifestations,autoantibodies and other test results were recorded in the SLE patients.The AnuA and other autoantibodies were analyzed.Results The positive rate of AnuA in the SLE group was significantly higher than that in the disease control group,AnuA was negative in the healthy control group;the sensitivity of AnuA in the SLE group was 48.6% and the specificity was 95.3%;the sensitivity of AnuA was significantly higher than that of the anti-ds-DNA antibodies and anti-Sm antibodies,the difference had statistical significance (P <0.05).The specificity of AnuA was higher than that of ANA and histone (P <0.05 ).The sensitivity of joint detection of AnuA,anti-ds-DNA and anti-Sm antibodies was 89.8%,which was significantly higher than that of a single index detection.The positive rate of AnuA in the active period of SLE was significantly higher than that of the non-active period,moreover higher than that of the ds-DNA antibodies (P <0.05).Conclu-sion AnuA might participate in the pathogenesis of SLE.The joint detection of autoantibodies including AnuA,etc.has importance significance in the diagnosis,condition judgment and curative efficacy evaluation of SLE.

AIM: To specify optimization of the concentration, purification and drying for prepar ati on of Yuxianling Grannles and decrease the dosage on condition that is retentive of potency in order to provide a basis for mass production. METHODS: The contents of ferulic acid and the amount of extract wer e used as marker, the optimium of concentration, purification and drying for pr eparation were selected by orthogonal design and contrast test during aqueous ex tract alcohol precipitation process. RESULTS: Condition was optimum of herb-to-extract ratio in the range of 0.5 ∶1, pr ecipitation with ethanol containing 40% water and drying temperature not to exce ed 60℃ . CONCLUSION: The highest yield of active priciples is obtained by c ondition above.

Teaching method of grouping and numbering the experimental animals refers to management of laboratory animals by marking them with numbers. In an experimental group, the same marked experimental animal is performed surgery operation by each group member. As a whole, each group member gets the same score according to the evaluation of operation performance of that group and the score is recorded as usual performance score. This method is simple and easy to implement. It is the optimizing of traditional basic operative surgery teaching methods which is conducted not only to improve medical students' sense of responsibility and animal protection awareness, to make full use of teaching resources and reduce waste, to cultivate medical students' team cooperation awareness, but also to deepen medical students' knowledge about surgical complications and improve the quality of teaching.

Objective To evaluate the effect of bladder volume change on the doses to normal tissues in cervical cancer patients undergoing external three-dimensional conformal radiotherapy (3DRT)plus 3D conformal brachytherapy (3DCBT).Methods The study included 56 patients with cervical cancer who were admitted to our hospital from 2012 to 2013 and received radical external 3DRT and 3DCBT.During 3DCBT,the doses to 0.1,1.0,and 2.0 cm3(D0.1 cm3,D1.0cm3,and D2.0cm3,respectively) for the rectum,small intestine,sigmoid colon,and bladder under different bladder filling status (empty,50,100,and 150 ml) were compared and analyzed by paired t-test.Results The rectum D0.1cm3 with bladder volumes of 50and 100 ml were significantly reduced compared with that with an empty bladder (P =0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the small intestine with bladder volumes of 50,100,and 150 ml were significantly reduced compared with those with an empty bladder (P =0.008,0.000,0.000 and 0.000,0.000,0.000 or 0.000,0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the bladder with bladder volumes of 100 and 150 ml were significantly increased compared with those with an empty bladder (P =0.000,0.000 and 0.000,0.000 or 0.000,0.000).Conclusions The doses to the bladder and small intestine are influenced by different bladder filling status,but the doses to the rectum and sigmoid colon show no significant variation.The increase in bladder volume is helpful in reducing the dose to the small intestine.Without any change in the bladder dose,the bladder volume of 50 ml is more beneficial to reduce the dose to the small intestine than those of 100 and 150 ml.

Objective:To explore the curative effect and toxic and side effects of Xihuang Capsule in the patients with advanced esophageal cancer treated with chemoradiotherapy, and to clarify its mechanism.Methods:The patients with advanced esophagealcancer without treatment were selected.The patients treated with Xihuang Capsule combined with concurrent chemoradiotherapy were defined as combination treatment group(n=27), and then other 27 patients were randomly selected from 87 patients treated with concurrent chemoradiotherapy alone as chemoradiotherapy group.The observation time was 90 d from the begining of chemotherapy.The differences in KPS, degree of dysphagia, incidence, occurrence time and degrees of acute radiation esophagitis of the patients in two groups were compared, and local control of tumor was analyzed.Results: After treatment, the KPS scores of the pateints in two groups were decreased, and the KPS score in combined treatment group was significantly higher than that in chemoradiotherapy group (P<0.05).The grade of dysphagia of the patients in combined treatment group was lower than that in chemoradiotherapy group during the late period of treatment(P<0.05).The incidence of acute radiation esophagitis, the occurence time of acute radiation esophagitis of the patients in combination group was lower than that in chemoradiotherapy group (P<0.05);the occurrence time of acute radiation esophagitis was later than that in chemoradiotherapy group (P<0.05);but there were no significant differences in the grades of acute radiation esophagitis and tumor local control between two groups(P>0.05).Conclusion:Xihuang Capsule can improve the quality of life, reduce dysphagia degree and the incidence of acute radiation esophagitis,and delay the occurrence time;it can be used as an effective auxiliary treatment of advanced esophageal cancer.

OBJECTIVE:To explore the risk factors of adverse reaction of cefazolin drugs by Logistic model. METHODS:Re-lated information was collected from the information system of our hospital,and SPSS 19.0 software was conducted for statistical analysis. RESULTS:Totally 855 patients were enrolled,30 of which had adverse reactions(3.51%). According to the results of Logistic analysis,intravenous administration with the concentration of ≥20 mg/ml (OR=7.857,95% CI:1.566-39.431,P=0.003) was the risk factor of adverse reaction of cefazolin drugs when single dose was above 2 g (OR=13.75,95% CI:2.423-78.028,P<0.001)at 0:00-8:00(OR=2.340,95% CI:1.043-5.253,P=0.034). CONCLUSIONS:Adverse reaction of ce-fazolin drugs might be dose-related type. The drug adverse reaction predictive thresholds are single dose above >1.75 g with ad-ministration time of 0:00-9:05 and concentration of above 7 mg/ml. According to the predictive thresholds,the risk of patients with adverse reaction can be predicted to promote safe and effective use of cefazolin.

Many pediatric surgeons have little training in laparoscopic application.The major problem in clinical practice of laparoscopic technician is without regularly training,unsuitable indication,and ignoring peroperation management.so that there are much more serious complications.For these reasons,it is a prerequisite that surgon and anesthetist must be trained before clinical practice,and the qualification of admission should be strictly controlled.