Objective To evaluate the changes of blood coagulation and their clinical significance in pa-tients with severe acute pancreatitis (SAP). Method Two hundred and seven patients with acute pancreatitis ad-mitted from January 2005 to Deeember 2008 in People' s Hospital, Peking University, were recruited in this study. Patients were divided into two groups, severe acute pancreatitis (53 cases) and mild acute pancreatitis (154 cas-es), according to the diagnostic criteria set by the Chinese Medical Association in 2004. Plasma coagulation pa-rameters including prothrombin time (PT), prothrombin activity (PTA), international normalized ratio (PT-INR), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimmer were redorded. Results Com-pared with MAP group, there were significant differences on PT, PTA, PT-INR, FIB, and D-dimmer in SAP group [in MAP group, (12.45 ± 1.13) s,(94.01±21.21)% ,(1.08±0.14),(4.81±1.86)g/L,340.38 ng/ mL, respectively;in SAP group, (13.08±1.47)s,(86.92±17.36) %, (1.14±0.20), (5.49±2.30)g/L, 943.82 ng/mL, respectively; P <0.05]. There was no significant difference on APTT between the two groups (P > 0.05). D-dimmer was correlated to the APACHE Ⅱ score , and it was also correlated to the SIRS score (P < 0.05). The rate of systemic inflammatory response syndrome (SIRS) and the mortality were higher in patients with SAP patients than those in the MAP patients (in SAP group, 35.5%, 5.6%, respectively; in MAP group, 10.4%, 0, respectively; P < 0.05). Conclusions Disorders of coagulation and microcirculation disturbances were observed in patients with severe acute pancreatitis. These alterations may be useful in the assessment of the disease severity and prognosis of patients with acute pancreatitis.

Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot. The muscle flaps were covered with split-thickness skin grafts. Results The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot in 16 cases. The largest area of the soft tissue defect was 5 cm?7 cm. The smallest was 3 cm?4 cm. Primary healing occured in 14 cases undergoing muscle flap construction, second-stage healing occured in 2 cases, no total flap necrosis occured in any cases. Conclusion This technigue is a simple and complications are lesser. The successful rates are higher. This muscle flap is suitable to the mudium or small soft tissue defect especially.

OBJECTIVE: To investigate the status quo of pharmaceutical administration in primary hospitals.METHODS: According to the requirements of 2009 "Medical quality promotional campaign around China" held by Ministry of Public Health,pharmaceutical care of 7 hospitals in Pengzhou city were evaluated and scored in accordant with the detailed rules.The scoring percentages were calculated and pharmaceutical care of 7 hospitals were analyzed.RESULTS & CONCLUSIONS: The scoring percentages of 2 hospitals were more than 80%;those of 3 hospitals were between 60% and 80%;those of 2 hospitals were lower than 60%.No hospital had obtained score in the field of clinical pharmacy.In primary hospital several aspects should be strengthened,such as pharmaceutical professional staff,system construction,rational use of drugs and clinical pharmaceutical care.

Objective To investigate the application of colposcope in cervical cancer screening in Yunnan ethnic minority areas.Methods The questionnaire survey was conducted on 641 women,and the data of the colposcopy and biopsy were reviewed retrospectively.The colposcopy and pathological diagnosis results were compared.Results The minority women thought colposcopy more acceptable was 78.64％ (383/487).The colposcopy found suspected low-grade cervical lesions were 377 cases,high-grade cervical lesions were 245 cases,cervical condyloma were 15 cases,cervical cancer were 4 cases.The pathological results:278 cases of cervical intraepithelial neoplasia (CIN) Ⅰ,174 cases of CIN Ⅱ,55 cases of CIN Ⅲ,15 cases of cervical condyloma,4 cases of cervical cancer.The consistent rate of colposcopy and pathological examination was 68.17％ (257/377) in low-grade lesions,89.39％ (219/245) in high-grade lesions,cervical cancer and cervical condyloma was entirely consistent.Conclusions The colposcopy is more easily accepted in Yunnan ethnic minority areas,which could be a preliminary diagnosis of cervical lesions,cervical condyloma and cervical cancer.It has an important clinical application value in diagnosis of cervical diseases.

Objective To study the correlation between marital adjustment and personality characteristics in infertile patients. Method The Locke-Wollance marital adjustment measurement scale and Eysenck personality questionnaire(EPQ)were used among 156 patients with infertility to investigate the correlation between marital adjustment and personality characteristics in infertile patients. Results The total score on the marital adjustment was(100.7±15.5). The rate of good marital adjustment was 51.3%and the rate of marital maladjustment was 48.7%. Those with a marital time of shorter than 5 years were better at marital adjustment compared to those with more than 5 years adjustment(P<0.01). In the characteristics of personality,the items of psychoticism(P)and neuroticism(N)fell at the mode of propensity. The scores on introversion and covering were at the middle level. The groups between the marriage age of shorter than 5 years and more than 5 years were significantly different in psychoticism,introversion and extroversion and nervousness(P<0.01). The marital adjustment were negatively correlated with psychoticism and nervousness,but positively correlated with extraversion. The marriage adjnstmc-nt were positively correlated to cpsychoticism and nervousness,but postively correlated with extroversion. The marriage age was positively correlated with psychoticism and nervousness,but negatively related to extraversion and covering with statistically significant difference (P<0.01).Conclusions In the infertile patients,there are many cases of family marriage disorder. The marriage adjustment and age can affect the personality traits of infertile patients. It indicates that infertility affects the physical and mental health.

Objective To evaluated the improving effect of training method of point-line-plane on development quotient in premature infants with brain injury.Methods 174 cases of premature children with brain injury were randomly divided into study group (89 cases) and control group (85 cases).Control group given Bobath and Vojta traditional rehabilitation training,and the study group was given training method of point-line-plane.Patients in both groups were evaluated synthetically based on The Evaluation Chart on Neu-robehavioral Development of Children Aged 0-6 Years,developed by Capital Institute of Pediatrics,prior to the treatment,and after the first,the second,and the third course of the training programs,respectively.Re-sults The score of developmental quotient ( DQ) between study group and control group was no significantly different(P>0.05).Compared with before treatment, the scores of DQ was significantly increased after the first, the second and the third course of training treatment in study group and control group((82.71±12.28) vs (81.17±9.63), t=0.859, P>0.05;(89.65±10.02) vs (87.02±7.39), t=1.747, P>0.05). Compared with the control group, the scores of DQ in study group was no significant difference after the first and the second course of treatment,but there was significantiy different after the third course treatment((95.26±8.87) vs (91.31±7.63), t=2.945, P=0.004).Conclusion The training method of point-line-plane can improve the clinical efficacy of premature infants with brain injury at the early phase, which is worth widely applying in clinical practice.

10.3969/j.issn.2095-4344.2013.23.012

0bjective To investigate the pattern of disease relapse and prognostic risk factor of patients with cervical carcinoma and pelvic lymph node metastasis.Methotis A total of 124 cases of International Federation of Gynecology and Obstetricfi(FIG0)I bl-Ⅱ a cervical carcinoma with pelvic node metastasis who were treated at the Cancer Center of Sun Yat-sen University during January 1994 to December 2001 were selected for this study.Prognosis and recurrence were retrospectively analyzed using the clinico.pathological data.Results The overall 5 year flun,ival and 5 year disease-free survival were 63.3% and 61.4%.respectively.Overall recurrence rate was 39.5%(49/124),among which intra-pelvic relapse (61.0%,25/41)was significantly more common than extra-pelvic relapse(31.7%,13/41;P=0.008).Multivariate analysis identified involvement of common iliac node as an independent prognostic factor(P=O.035).According to this factor,node-positive patients could be divided into low risk group(without common iliac node involvement,104 cases)and hiSh risk group(with common iliac node involvement,20 cases).The 5 year disease-free survival were 69.4%and 24.5%respectively,with a significant difference(P=0.003).Intra.pelvic relapse was observed in 22.1%(23/104)of low risk and 25.0% (5/20)of high risk group respectively,with no significant difference(P>0.05).However extra-pelvicrelapse wag seen in 7.7%(8/104)of low risk and 40.0%(8/20)of hish risk group,with a significant difference(P<0.01).Conclusions Common iliac node involvement is a significant factor influencing the prognosis of patients with cervical carcinoma and pelvic lymph node metastasis.Patients with positive common iliae nodes have significantly decreased 5 year disease.free survival and hishcr extra-pelvic disease recurrence rates compared with those whose common iliac nodes are negative.These findings provide impo.rtant data for design of individualized treatment mode.

Objective To develop psychosocial skills training module for schizophrenic outpatients.Methods Structured psychosocial skills training program, which were made according to community rehabilitation plan for schizophrenia, featured convenience and well operability. Subjects were 96 of 204 schizorenic outpatients in remission who were randomly assigned to receive psychosocial skills training combined medicine(observation group) or medicine only(control group) and followed up by 24 months. The changes during treatment were evaluated by positive and negative syndrome scale(PANSS), Social Disability Screening Schedule(SDSS) and patients' cognition function were also evaluated longitudinally. Results Relapse rate of control group (37%) is higer than observation group (17.7%, P＜0.01). After Last Observation Carried Forward(LOCF), control group showed higer scores than observation group on positive syndrome (8.34±2.04 vs 7.66±0.97), negative syndrome(9.15±1.97 vs 813±1.15), total score (37.64±5.58 vs 34.79±3.64) and Social disability (2.81±1.90 vs 2.07±1.47) (P＜0.01); observation group also showed a significant progress on cognition function(P＜0.05). Conclusion This trial demonstrated the efficacy of the easy-operating structured psychosocial skill training grogram in preventing relapse and improving social adoptive function for schizophrenia.

Objective Infliximab is a kind of recombinant human mouse chimeric anti-tumor necrosis factor monoclonal antibody. Here we aimed to examine the impact of infliximab therapy on RANK/RANKL/OPG system in the peripheral blood of rheumatoid arthritis (RA) patients. Methods Fifty patients with RA were rigorously screened and randomly divided into 2 groups. One group was treated with infliximab (3 mg/kg)and methotrexate (MTX). As control, the other group was treated with MTX alone. Infliximab was administered at weeks 0, 2, 6 and 14. The expression of RANK, RANKL mRNA in the peripheral blood, serum OPG and clinical indicators changes at week 0 and 18 were compared.x2-test or t-test were used for statistical analysis.Results After treated with infliximab, bone damage of joints were slowed down when examined by radiography in RA patients compared with the control group. And the ratio of OPG/RANKL was also decreased in RA peripheral blood (w0: 80.25;w 18: 63.2); (control group w0: 83.37; w18: 30.87)(P＞0.05). Although after the treatment with either MTX alone [w0: (238±15) pg/ml; w18: (118±10) pg/ml] or infliximab combined with MTX [(w0: (223.1±6.2) pg/ml; w18:(162.4±5.5) pg/ml], the serum levels of OPG were all decreased (P＞0.05), the level of OPG in infliximab treatment group was declined slower than those in the control group. Conclusion RA bone destruction can be inhibited by the combination therapy of infliximab and MTX. The mechanism may be partly through the RANK/RANKL/OPG system.