Microcirculation disturbance and ischemia of the pancreas are important pathophysiological changes in the onset of acute pancrea-titis,and organ hypoperfusion is a risk factor for poor prognosis.During the first 12 to 24 hours after admission,fluid resuscitation is the most important medical treatment for the early stage of acute pancreatitis,and timely and rational fluid infusion helps to improve prognosis. However,there lacks high -quality clinical evidence for type of fluid,infusion speed,and monitoring methods,and more randomized con-trolled trials are needed.

目的观察金钠多结合早期康复治疗急性缺血性脑卒中的临床疗效。方法将80例缺血性脑卒中患者随机分为金钠多加早期康复组和低分子右旋糖酐加早期康复组(对照组)。观察两组患者治疗前后血脂及血液流变学、神经功能缺损、肢体运动功能及日常生活活动能力评分的变化。结果金钠多加早期康复组治疗后血脂、红细胞压积、纤维蛋白原均降低,神经功能缺损评分减少值、肢体运动功能及日常生活能力增加值均高于对照组(P<0.05～0.01)。结论金钠多结合早期康复能减轻急性缺血性脑卒中患者的神经功能缺损,提高患者独立生活能力,改善功能结局,提高康复效率。

ObjectiveTo explore the effect of neuromuscular facilitation combined with faradism on limbs motor function in hemiplegic patient with early stroke.Methods108 patients were randomly divided into the therapy group(who accepted neuromuscular facilitation combined with faradism) and control group (who accepted neuromuscular facilitation only). The limbs motor function was evaluated with Fugl-Meyer Assessment (FMA) before and after 10 weeks by the same doctor. ResultsThere were not significant difference of scores of FMA between the two groups before rehabilitation(P>0.05), but there were significant difference 10 weeks after rehabilitation(P<0.01). ADL in therapy group was significantly higher than that in control group(P<0.01).ConclusionFaradism can significantly improve the effect of neuromuscular facilitation on limbs motor function and ADL.

Objective The aim of this study is to present two novel technique?Lying on position and rotational board TSEI in which uniform dose to the whole body as well as the soles and vertex of scalp can be achieved in one electron beam treatment fraction. Methods Patients are treated with two groups in prone and supine position by leaning on inner rotational board in prone and supine position, each group can further be separated into two subgroup with tilting and rotation positions for treatment. By incorporating all these setting on the aswirl board with the optimal gantry angle, the patient will final accumulate compensated dosages on whole body surface. Results The dose uniformity for the rotational board?TSET or Lying on position could be control within ±10%. Conclusions The two TSEItechnique?Lying on and Rotational board TSEI techniques presented in this study is able to deliver a uniform dose to the patient’s skin surface as well as to the vertex and the soles all in one time, eliminating the troubles of having to further boost fields for these two regions when using the Stanford Six Field Technique.

Objective To explore clinical results of posterior spinal approach microendoscopic disectomy(MED) for the treatment of lumbar disc herniation in adolescents.Methods A total of 25 consecutive patients treated by MED from February 2000 to August 2004 in this hospital were analyzed retrospectively.Clinical results were assessed with the modified Macnab criterion.Pre-and post-operative symptoms and functional states were evaluated by the Chinese version Oswestry Disability Index(ODI).Results A conversion to open procedure was required in 1 patient.The operating time was 35～65 minutes(mean,44.8?9.0 minutes);the estimated blood loss during operation was 30～80 ml(mean,51.3?14.6 ml);the postoperative hospital stay was 6～10 days(mean,7.5?1.0 days).All incisions healed by first intention.There were no dural tears,nerve root injuries,intervertebral space infections,or great vessel injuries.Twentg-two patients were followed for 7～57 months(mean,33.4?17.8 months).There were significant differences between preoperative ODI(46.2%?8.5%) and postoperative ODI(1.8%?3.0%).The improvement rate of ODI was 44.4%?9.2%(t=21.61,P=0.00).Clinical results assessment by the modified Macnab criterion revealed "excellent" in 19 patients and "good" in 3 patients,the rate of excellent or good results being 100%. Conclusions Microendoscopic disectomy can be performed safely and effectively for lumbar disc herniation in adolescents,resulting in little trauma,fast recovery,and excellent clinical results.

Aim To analyze the expression of phosphatidylethanolamine-binding protein(PEBP) and ERK in critical brain regions of psychological dependence rats.Methods Morphine-induced rats conditioned place preference(CPP) model was established to mimic different stages of morphine psychological dependence, during which PEBP expression and ERK activity were assayed in different brain regions.Results PEBP expression in hippocampus, prefrontal cortex, striatum and nucleus accumbens showed no change at three stages of psychological dependence.However, ERK activity increased notably in prefrontal cortex on CPP formation, and decreased remarkably in hippocampus on CPP reinstatement.Conclusions The formation and retrieval of associated memory between morphine effects and environment involve different neural circuits, in which ERK activity is critical, and PEBP might not be involved in such a memory-related ERK regulation.

This article is concerned about the practice and exploration on medical electronics teaching project and teaching pattern we have done before and the Active Participation Pattern thus formed. That is guiding, putting for ward questions, discussing, debating and summarizing in class while setting research problem after class. We also have made media courseware in medical electronics and have used it in our teaching process, which has aroused the students' interest in study and has enhanced the teaching efficiency and quality. This new method of teaching pattern helps us gain the strong feedback and affirmation and is welcome by the students.

Tyrosine kinase inhibitors (TKIs) are used as the primary first-line treatment for advanced hepatocellular carcinoma, and the combination of immune checkpoint inhibitors (ICIs) and angiogenesis inhibitors have also been recommended as first-line treatment recently. For hepatocellular carcinoma patients with portal vein tumor thrombus, hepatic artery infusion chemotherapy (HAIC) is supported by progressively more evidence in improvement in the overall survival benefit. Based on relevant literatures and combined with clinical practices, the authors investigate the clinical application and development trends of TKIs, ICIs and HAIC in the first-line treatment for advanced hepatocellular carcinoma.

ObjectiveTo evaluate the application of immunochemical fecal occult blood test for colorectal cancer screening in a gastroenterology clinic. MethodsTotal 512 outpatients received immunochemical fecal occult blood tests and colonoscopy for screening of colorectal cancer from January 2009 to October 2010 in Gastroenterology Clinic of Peking Union Hospital.The application of occult blood test was retrospectively evaluated using colonoscopy and pathological examination as the gold standard. Results Among 512 patients,203 were found positive for immunochemical fecal occult blood. According to the colonoscopy and histological study,115 patients had polyps,9 with high-grade dysplasia and 21 with colorectal cancer.The sensitivity,specificity,positive likelihood ratio and negative likelihood ratio of fecal occult blood to detect colorectal adenomatous polyps was 42.8％,60.9％,1.09 and 0.93,respectively.And those for detection of colorectal cancer and high-grade dysplasia were 76.6％,62.5％,2.05 and 0.37,respectively.ConclusionsImmunochemical fecal occult blood test was useful in the screening for colorectal tumors among gastroenterology clinic patients.More large-scale prospective studies are needed to establish a screening model for colorectal tumors.

Objective To observe the curative effect of cervical traction combined with low-cycle or intermediate frequency electrical current in cervical vertebrae.Methods 171 patients with cervical vertebrae were randomly divided into the therapy group and control group,86 cases in therapy group were performed the curative measure of cervical traction and low-cycle,85 cases in control group underwent the curative measure of cervical traction and intermediate frequency electrical current.Both of the two groups carried out continuous therapy for 10 days.Results There was significant difference before and after treatment within each group in CASCS score(P ＜ 0.01)and there was also significant difference after treatment between the two groups(P ＜ 0.05),the effective rate of therapy groupwas significant higher than that of control group(P ＜ 0.05).Conclusion The methods of cervical traction and low cycle or intermediate frequency electrical current has better curative effect in cervical vertebrae and cervical traction and low-cycle do much benefit in cervical vertebrae treatment.