Objective To explore the timing of surgical intervention for severe acute pancreatitis (SAP). Meth-ods One hundred and fifty-seven cases with SAP treated in our hospital from March, 1998 to December, 2007 were analyzed retrospectively. Influence of surgical intervention and conservative treatment on curative rate were e-valuated in pancreatic necrotic area and with or without infected pancreatic necrosis. Results The overall curative rate of surgical treatment and conservative treatment was 80.4%, 87.1% respectively; the two methods had no sta-tistical difference. Conservative treatment was better than surgical treatment in patients with lesa than 30% necrotic area and surgical treatment was better than conservative treatment in patients with more than 50% necrotic area. But the two methods had no statistical difference in 30% ～ 50% necrotic area. Conservative management was better than surgical management in sterile pancreatic necrosis, but surgical management was better than conservative manage-ment in pancreatic necrosis with infection or suspection of infection. Conclusion Surgical intervention treatment plays an important role in SAP patients, we should combine pancreatic necrotic area and with or without infection to choose the timing of surgical intervention for severe acute pancreatitis.

Serum pepsinogen(PG)is an effective marker for evaluating gastric mucosa function and can be used as a supplement for screening and early diagnosis of gastric cancer. Recently,serum PG has become a hot spot of study in portal hypertensive gastropathy and functional dyspepsia. Serum PG detection is a noninvasive,simple and low cost investigation method with marked clinical value. This article reviewed the value of serum PG detection in warning gastric cancer and evaluating gastric mucosa function.

Objective To compare enteral nutrition (EN) and total parenteral nutrition (TPN) in the treatment of severe acute pancreatitis(SAP) elucidate the advantage of EN. Methods Fifty-nine patients were assigned to TPN and EN groups. The nutritional index was detected, and the therapeutic efficacy was reviewed comparetively. Results After giving the nutritional support, the serum contents of albumin, pre-albumin, transferrin and beamoglobin were increased obviously (P < 0.05);and prealbumin, transferrin had statistical difference between the TPN and EN groups(P <0.05). APACHE Ⅱ score was lowered significant-ly in the EN group, comparing with the TPN group (P <0.05). In the EN group, complications, infection rate, food intake time, and hospitalization costs were significantly lower compared with the TPN group(P< 0.05), although mortality rate, hospital stay days had no statistical significance (P > 0.05). Conclusion EN is on ideal modality of nutrition support in SAP patients, which has many advantages in improving nu-tritional status, preserving gut mucosa barrier, decreasing bacterium and toxin shifting, regulating inflamma-tory and infective response, decreasing costs in the hospital.

0.05).Univariate analysis showed SOFA,APACHEII,CTSI,age and pancreatic infection were related to prognosis of SAP.Multivariate analysis revealed that only SOFA,APACHEII,CTSI were independent prognosis-related factors of SAP.Conclusions SOFA,APACHEII,CTSI all have good predictive ability for prognosis of SAP during dynamic in-hospital observation,and combination of the three factors has greater ability for prognosis of outcome of SAP.

Objective To explore the current status and influencing factors of oral health knowledge and behavior among the elderly living in Gongshu District of Hangzhou City.Methods A total of 600 elderly individuals were selected by multi-stage stratified cluster random sampling and interviewed with a self-designed questionnaire which included demographic characteristics and oral health knowledge and behavior.The status and influencing factors of oral health behavior were analyzed by single and multiplefactor analysis methods.Results A questionnaire survey was conducted among 600 elderly residents,with a response rate of 99.3％ (596/600) and an effective response rate of 94.1％ (561/600).The rate of good oral hygiene was 50.4％.Those elderly with different age,education level,medical insurance and oral hygiene showed significant difference in qualified rate of oral health behavior (x2 values were 10.79,21.32,5.72 and 16.33,respectively; all P＜0.05).In Logistic regression model,education level was positively correlated with oral health behavior among the elderly,and the qualified rate of oral health behavior of the elderly with education level of junior school or above was 2.69 times higher than that of illiterate elderly (x2=10.53,P=0.001).Conclusion The awareness rate of oral health knowledge among the elderly living in Gongshu District of Hangzhou City is at a relatively higher level,though oral health behavior is moderate.Age,education level,medical insurance and oral hygiene could be impacting factors of oral health behavior.

Objective To explore the current status and influencing factors of oral health knowledge,attitudes and practice (KAP) among the teachers of primary and secondary schools in Gongshu District of Hangzhou City.Methods A total of 652 teachers of primary and secondary schools were selected by using multi-stage stratified cluster random sampling method and completed a self-designed questionnaire,which included demographic characteristics and oral health KAP.The status and influencing factors of oral health KAP were analyzed by single and multiple-factor analysis methods.Results The questionnaire was completed by all the 652 teachers,627 of whom were qualified (96.2％).The total ratios of oral health knowledge awareness,attitudes correctness and behaviors formation were 77.1％,68.7％ and 46.3％,respectively.There was significant difference of knowledge awareness rate by age,gender,marriage status,monthly income,life status and current cigarette smoking (x2 values were 11.48,8.57,8.12,8.46,23.97 and 4.64,respectively; all P＜0.05).There was significant difference in oral health attitudes correctness rate by gender (x2=10.65,P＜0.05) and behaviors formation rate by gender,education level and life status (x2 values were 3.95,10.88 and 10.41,respectively; all P＜0.05).In logistic regression model,impact factors of oral health knowledge awareness were age,gender,life status and physical exercises; the impact factors of oral health attitudes correctness were gender and monthly income; the impact factors of oral health behaviors formation were gender,level of education and physical exercises.Conclusion The oral health awareness and attitudes correctness are acceptible among the teachers of primary and secondary schools in Gongshu District of Hangzhou City,although the formation rate of oral health behaviors is low.Oral health education should be enforced among the teachers of primary and secondary schools.

To examine the changes in matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9) in the development and progression of endometriosis, real time quantitative polymerase chain reaction, enzyme-linked immunoabsorbent assay and gelatin zymography were employed to determine the mRNA and protein levels and activities of MMP-2 and MMP-9 from the first day to the 21(st) day after the induction in mice with induced endometriosis (experimental group) and sham-operated animals (controls). The results showed that the mRNA and protein levels and activities of the MMP-2 and MMP-9 were significantly increased on the first day after the induction and the level of MMP-2 stayed at a level higher than that in the control group. MMP-9 had two or three peaks during the 21 days, taking place at day 1, 4 and 15. It is concluded that the changes in the MMP-2 and MMP-9 might be involved in pathogenesis of endometriosis.

Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41～75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121～216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P＞0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P＞0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P＞0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.

To examine the changes in matrix metalloproteinase-2(MMP-2)and-9(MMP-9)in the development and progression of endometriosis,real time quantitative polymerase chain reaction,enzyme-linked immunoabsorbent assay and gelatin zymography were employed to determine the mRNA and protein levels and activities of MMP-2 and MMP-9 from the first day to the 21st day after the induction in mice with induced endometriosis(experimental group)and sham-operated animals (controls).The results showed that the mRNA and protein levels and activities of the MMP-2 and MMP-9 were significantly increased on the first day after the induction and the level of MMP-2 stayed at a level higher than that in the control group.MMP-9 had two or three peaks during the 21 days,taking place at day 1,4 and 15.It is concluded that the changes in the MMP-2 and MMP-9 might be involved in pathogenesis of endometriosis.

Objective: To explore the impact on prognosis in favorable-risk acute myeloid leukemia (AML) patients with different consolidation regimens after first complete remission (CR₁). Methods: A total of 107 cases of non-refractory adult AML from January 2010 to June 2015 in single center were enrolled in the study. HD-Ara-C group (38 cases) as the control group, we explore the prognosis in three consolidation regimens, including micro-transplantation (16 cases) , autologous transplantation (auto-PBSCT, 14 cases) , allogeneic transplantation (allo-HSCT, 39 cases). Results: Of 107 patients (59 males and 48 females) , with a median age of 33 (16-59) years old and a median follow-up of 36.5 (5.3-79.1) months, the overall relapse rate was 20.6% (22/107) , and overall mortality rate was 18.7% (20/107). The 5 years cumulative relapse rate (CIR) of HD-Ara-C, micro-transplantation, auto-PBSCT and allo-HSCT group were 39.7%, 6.2%, 14.3% and 5.6%, respectively (P<0.001). The CIR of the observed group was lower than the HD-Ara-C group. The 5 years progression-free survival (PFS) rate of HD-Ara-C, micro-transplantation, auto-PBSCT and allo-HSCT group were 44.7%, 93.8%, 85.7% and 78.1%, respectively (P=0.011). The PFS of observed groups were similar, but superior to that in HD-Ara-C group. The 5-year overall survival (OS) in four groups was 54.9%, 100%, 92.9% and 77.4%, respectively (P>0.05). Multiple factors analysis showed that compared to HD-Ara-C regimen, allo-HSCT could improve PFS (HR=0.376, P=0.031) , but not OS (P>0.05) ; micro-transplantation and auto-PBSCT could not improve the PFS or OS (P>0.05). Conclusion As compared with HD-Ara-C regimen, allo-HSCT could obviously decrease CIR, improve PFS, but treatment-related mortality is high. These results show that auto-PBSCT and micro-transplantation have similar outcomes, compared to HD-Ara-C regimen, so both can be used as a option of consolidation treatment for favorable-risk AML.