Objective To study the change of serum procalcitonin(PCT) expression level and to investigate its clinical value for predicting the prognosis in the patients with severe acute pancreatitis (SAP) .Methods Totallay 48 inpatients with SAP in our hos‐pital from April 2012 to April 2014 were retrospectively analyzed .The PCT levels during different hospitalization period in the sur‐vial group and the death group were detected and analyzed .The scores of acute physiological and chronic health evaluation Ⅱ (A‐PACHE Ⅱ) were compared between these two groups .Results (1)The clinical characreristics of gender ,body temperature and WBC had no statistically significant differences beween the survival group and the death group (P>0 .05) ,but the PCT level had statistical differencet (P<0 .05) .(2)There was no statistically significant difference in the PCT level and APACHE Ⅱ score at ad‐mission between the two groups .In the later treatment process ,the PCT level and APACHE Ⅱ score in the survival group were progressively decreased ,while which in the death group were progressively inecreased (P<0 .05) .WT5HZ〗Conclusion PCT has an important clinical value in forcasting the prognosis of SAP .

Objective To investigate the clinical effect of low molecular heparin combined with mesalazine in patients with active ulcerative colitis(UC).Methods 90 cases of patients with UC were randomly divided into three groups:A group,B group and C group,with 30 cases in each group.A group was given oral treatment with sulfasalazine enteric-coated tablets,B group was given oral treatment with mesalazine and C group was given low molecular heparin calcium combined with mesalazine (4100 iu,1 /d).The three groups were treated for 2 weeks. Coagulant function index such as activated partial prothrombin time (APTT),fibrinogen(FIB),platelet count(PLT), platelet maximum aggregation rate(PAG(Max)),D-dimer(D-D),C-reactive protein(CRP)were detected in the two groups before and after treatment of 7 and 14d.Mayo disease activity index score was also recorded before and after treatment of 7 and 14d.And the differences among three groups were compared.Results There were significant differences in APTT,FIB,PLT and PAG(Max)after 7d,14d treatment among A,B and C groups(7d:F value were 17.652,12.427,42.873,14.318 respectively;14d:F value were 43.804,139.172,51.932,79.440 respectively,all P value <0.05).APTT of C group after 7d,14d[(36.32 ±3.56)μg/mL,(40.15 ±4.24)μg/mL]were higher than B group[(32.14 ±2.86)μg/mL,(33.04 ±3.32)μg/mL]and A group [(31.82 ±3.36 )μg/mL,(32.15 ± 3.24)μg/mL];FIB of C group after 7d,14d[(4.07 ±0.41 )g/L,(3.14 ±0.28)g/L]were lower than B group [(4.47 ±0.40)g/L,(4.06 ±0.33)g/L]and A group[(4.58 ±0.44)g/L,(4.23 ±0.37)g/L];PLT of C group af-ter 7d,14d[(262.22 ±60.61)×109 /L,(201.38 ±49.42)×109 /L]were lower than B group[(296.34 ±63.51)× 109 /L,(253.25 ±55.47)×109 /L]and A group[(301.71 ±70.62)×109 /L,(262.05 ±64.11)×109 /L];PAG (Max)of C group after 7d,14d[(0.46 ±0.08),(0.30 ±0.05)]were lower than B group[(0.57 ±0.10),(0.46 ± 0.06)]and A group[(0.59 ±0.12),(0.51 ±0.08)].There were significant differences in CRP,D-D after 14d treatment among A,B and C groups(F value were 91.967,139.172 respectively,all P value <0.05).CRP of C group after 14d[(7.50 ±1.35)mg/L]were lower than B group[(10.80 ±1.37)mg/L]and A group[(12.12 ±1.64)mg/L];D-D of C group after 14d[(0.26 ±0.02)mg/L]were lower than B group[(0.47 ±0.03)mg/L]and A group[(0.51 ± 0.04)mg/L].There were significant differences in Mayo index score,△Mayo index score after 14d treatment among A,B and C groups (F value were 182.170,89.802 respectively,all P value <0.05).Mayo index score of C group after 14d(1.51 ±0.33)were lower than B group(2.93 ±0.46)and A group(3.42 ±0.63);.△Mayo index score of C group after 14d(5.67 ±1.60)were lower than B group(4.25 ±1.32)and A group(3.79 ±1.21);Pearson corre-lation analysis showed that △Mayo Mayo index score were positively correlated with PAG(Max)reduction△PAG (Max),△D-D,△CRP,△PTL(r value were 0.616,0.702,0.734,0.569,respectively,all P <0.05).Multiple step-wise linear regression analysis showed that △PAG(Max),△D-D,△CRP,△PTL were closely related to △Mayo Mayo index score(partial regression coefficient were 4.209,2.451,0.801 respectively;t value were 7.890,4.787, 2.201,respectively,all P <0.05).Conclusion The clinical effect of low molecular heparin combined with mesala-zine in patients with active ulcerative colitis is effective,and the method can significantly improve the inflammation in patients with UC and high coagulation state,improving the clinical symptoms is better than the single drug,and worth clinical recommendations.

The pathogenesis of malignant lymphoma has been an important topic in tumor research ,but it is still unclear.Recent clinical studies showed that the expression level of Toll -like receptor 4(TLR4)was signif-icantly high in mantle cell lymphoma tissue and a variety of lymphoma cell lines .At the same time,the TLR4 ex-pression level was correlated with prognosis .The Role of TLR4 in malignant lymphoma for occurrence and devel-opment is reviewed in this article ,which may elucidate the pathogenesis and provide a new basis for the therapy of lymphoma.

Improving the basic medical and health service system is an important measure to deepen health care reform.Jilin province has explored its unique way of comprehensive reform of the primary organizations in the province by means of reforming grassroots medical operation mechanism and mode of service,and perfecting the compensation mechanism,achieving remarkable results.This article,based on the overall situation of Jilin province,main contradictions and countermeasures research,made detailed analysis of healthcare reform and bottlenecks encountered in the reform.The author pointed out the direction of Jilin province primary medical and health institutions reform,and put forward feasible policy adjustments and suggestions for such a reform.

[Objective] The artical summarizes in diagnosis and treatment of postnatal lack of lactation academic thoughts and characteristics of drug use,and own thoughts. [Method] Summary by reading text and access to my perception ,combined with the actual clinical,summarized his main syndrome differentiation and treatment of postnatal lack of lactation thought,medication,and explain orally .[Results] FU Qingzhu according to the cause of postnatal lack of lactation divided into two types, deficiency of Qi and blood,blockage of liver. Pointed out that the error appeared in the dialectical and put forward the correct opinions;and that the disease is mainly related to the lack of blood and liver qi stagnation; the main therapy is tonifying qi and blood, smoothing liver qi, dredging collateral for promoting lactation;the corresponding therapeutic prescriptions were given and analyzed;clinical application of good results.[Conclusion] FU Qingzhu 's idea put forward the original opinion and treatment of medicine, in order to inherit traditional Chinese medicine academic, improve the curative effect of postpartum hypogalactia,and give my opinion, may be the hope of the authority.

Objective:To optimize the extraction process of berberine hydrochloride from Sanhuang Diyu oil by Box-Benhnken re-sponse surface methodology. Methods:The extraction process was optimized with the size of each medicine ( X1 ) , the liquid-solid ra-tio ( X2 ) and the extraction time ( X3 ) as the independent variables and berberine hydrochloride extraction amount ( Y) as the depend-ent variable, and the effects of variables and their interactions on the extraction efficiency were studied. Results:The experiment results indicated that the optimal extraction conditions were as follows:the size of each medicine was 60 meshes, the liquid-solid ratio was 18, and the extraction time was 1. 5 h. Under the above conditions, 3 batches of berberine hydrochloride from Sanhuang Diyu oil were ex-tracted. The average extraction rate of berberine hydrochloride was (16.6 ±0.6) mg·g-1(n =3). Conclusion: The extraction process of Sanhuang Diyu oil optimized by Box-Behnken response surface methodology is simple, stable and predictable.

Pancreatic encephalopathy (PE)is a serious complication of pancreatitis,with difficulties in early diagnosis and poor prognosis. This article introduces the possible pathogenesis of PE involving pancreatin activation,cytokines,infection,water and electrolyte imbalance, and vitamin deficiency,summarizes the clinical manifestations and laboratory features of PE,and points out that the clinical manifestations of PE lack specificity and there are no reliable biochemical indices or diagnostic criteria.This article also elaborates on the diagnosis and treat-ment strategies for PE and points out that the key to PE treatment is active and effective treatment of the primary disease.Most PE patients are improved with the control of pancreatitis.

Objective To investigate the effects of tramadol hydrechloride pretreatment on the expression of calcitonin gene-related peptide (CGRP) in ischemic and non-ischemic myocardium following acute myocardial is-chemia in the rats. Method Eighteen adult male SD rats weighing 270 to 300 g were randomly divided into three groups(n = 6, in each): group Ⅰ ,sham operation; group Ⅱ , myocardial isehemia, and group Ⅲ, tramadol hydrochloride pretreatment. The anterior descending branch of left coronary artery was occluded(CAO)for 3 hours in rats of group Ⅱ and Ⅲ. In group Ⅲ, tramadol hydrochloride 12.5 mg·kg~(-1) was injected through caudal vein 15 minutes before CAO. At 3 hours after myocardial ischemia, the hearts were removed for determination of CGRP protein content in ischemic and non-ischemie myocardium by immuno-histochemistry and enzyme immunometric as-say, and the expression of CGRPmRNA by RT-PCR. One-way ANOVA was used for statistical analysis. ResultsOnly β-CGRPmRNA was found in rats myocardium. In the ischemic myocardium, the average light density of CGRP(0.215 ± 0. 100), positive unit (36.95 ± 1.70), concentration (39.06 ± 1.86) and expression of β-CGRP mRNA 0. 946 ± 0. 019) were significantly increased in group Ⅱ compared with those in group Ⅰ (0. 139 ± 0.006), (25.01 ± 1.03), (20.80± 1.24), (0.734±0.025) (P <0.05), and decreased markedly in group Ⅲ(0.158+0.008),(28.53±1.21),(28.58±2.10),(0.872±0.024) (P < 0.05) In the non-ischemic my-ocardium, the average hght density of CGRP(0.156 ± 0.017), positive unit(28.57 ± 2.23), concentration (28.58 ± 1.12) and expression of β-CGRP mRNA(0.810 ± 0.021) were significantly increased in group Ⅱ com-pared with those in group Ⅰ (0.109+0.013, 20.91 ～2.14, 17.35+2.72, 0.701 ～0.018) (P < 0.05), and decreased markedly in group Ⅲ(0.120±0.008), (22.58±1.18), (23.26±2.41), (0.779±0.022) (P < 0.05). Conclusions Tramadol hydrochloride pretreatment can significantly inhibit increase in CGRP expression in myocardium elicited by CAO, which might imply that tramadol hydrochloride might take part in protection of my-ocardium against acute myocardial ischemia by means of pain-relief.

Objective：To probe into the relation among the exerise behaviour, physical knowledge, attitute and self-efficacy， and to provide basis for helping to bring about students' lifelong physical exercises and formation of their health life manner,and NCD prevention. Method We randomly sample in cluster 1243 students(male 654 and female 589)studied in different specialities in six colleges or universities in Kunming, which filled in the question and answer paper about students'sports cognition and behaviour.Result The proportion of the male sports population is 51.22％ and that of the female is 41.77％. The scores of the self-efficacy, attitute and behaviour exist obvious sex difference. Scores of self- efficacy and behaviour of male students are 13.87 and 13.62,respectively,which are significantly higher than that of the femal are 12.35 and 12.17 (P＜0.01), respectively. The exercise attitude, self- efficacy and behaviour of the physical population group have an advantage over that of the case group(P＜0.01), meanwhile the difference among groups of students about sports knowledge and the sex difference are not viewed. The exercise behaviour and attitude,the exercise behaviour and self- efficacy of students are positively related to middle extent(r＝0.41 and 0.47, resp.),but the exercise behaviour and the knowledge dimension is related to little extent (r＝0.12). Conclusion There is a larger difference between students sports population and the aim of physical education in colleges or universities. The sports attitude and self-efficacy of students play an important role which have an effect on the exercise behaviour. The group of the female students is emphasis of intervention.

Radiation therapy (RT) plays an important role in the multimodality management of patients with breast cancer. Traditional RT techniques increase risk of death from cardiovascular diseases. With the development of new techniques, cardiac injury after RT has already been reduced. This article summarizes the studies on reducing cardiac injury by the development of RT techniques, as well as analyzes of risk factors for cardiac injury.Possible causes will also be discussed.