ObjectrueTo evaluate magnetic resonancec ho langiopancreatography (MRCP) in the diagnosis of acute or chronic pancreatitis . MethodsMRCP was undertaken in 30 patients with chronic and 9 with acute pancreatitis. Comparison was m ade with findings at ERCP.ResultsOf 196 segments of biliary-pancreatic duct analyzed, 17 were not seen at MR CP (sensitivity, 91%). Of the segments visualized at MRCP, 14 were incorrect ly characterized (accuracy, 92%). At MRCP, segments not detected or mischara cterized were either normal, slightly dilated, or narrowed. MRCP image quali ty was not interpretable in two cases due to artifacts. ConclusionVery good correlation between ERCP and MRCP findings was demonstrated. MRCP may substitude for ERCP, particularly in pa tients who cannot undergo ERCP or in whom ERCP has been unsuccessful.

BACKGROUND:Absorbable suture with good biocompatibility and mechanical strength has been extensively used in the clinic. OBJECTIVE: To explorein vitro degradation of different absorbable sutures, to analyze the clinical superiority of absorbable sutures and the influential factors for itsin vitro degradation. METHODS: After retrieval of related literatures concerning degradation and application of absorbable suture material, we retrospectively analyzed relevant articles addressing influential factors for performance and degradation of absorbable suture materials, and comparison of clinical absorbable and nonabsorbable sutures, thereby providing theoretical evidence for clinical application. RESULTS AND CONCLUSION: Absorbable sutures can be completely degraded and absorbed by the body, with no adverse reaction and no scars after wound healing. Absorbable sutures overcome the shortcomings of nonabsorbable sutures that cannot break down in the body. The absorption of its degradation products in vivo has two pathways: one is the phagocytosis of giant cels and phagocytes in the body, and the other is that the degradation products enter the body fluids and blood. For example, lactic acid is absorbed and excretedvia the systemic circulation. There is a very complicated physiological environment in the human body, and various factors can affect material properties. In addition, the different kinds of materials have different degradation mannersin vivo. Therefore, it is necessary to design, synthesize and process biodegradable polymer materialswith special properties within a certain range to meet the clinical needs.

Four fractions (starches, water insoluble proteins, water soluble fractions and residue) were separated from oats by means of filtration and repeated high speed centrifugation, and the lipids were extracted by acid-hydrolysis as well. Then each group of experiment hyperlipemic mice, caused by high lipid diet, were fed with these fractions for 10 days respectively. The results showed that the effectiveness of the residue fraction which was rich in dietary celluloses and lipids was similar to the whole oats on depressing bl-ood-lipid and that the water insoluble proteins were effective too. The lip-ids, however,were important but not unique effective composition in the residue of oats.

Case-based teaching (CBT) on the basis of treatment guidelines was carried out to develop standard medical behavior, improve learning efficiency and students' ability of solving clini-cal problems. In clinical internship teaching, guidelines for common and frequently-occurring respira-tory diseases and CBT were organically combined. Cases were carefully selected and questions were meticulously set. Guidelines were thoroughly analyzed and teaching was reasonably evaluated. There-fore, students' learning interests were initiated and learning efficiency was improved. It not only trained evidence-based medicine thinking of intern students, but also improved the teaching ability of clinical teachers.

Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.

Objective To investigate whether the silicotic process leads to the predominant extrahepatic ceruloplasmin (Cp) gene expression found within the plasma and lung tissue contributing to the significant increase.Methods The previous work of our research group demonstrated changes of ceruloplasmin (Cp) in rat lung tissue and alveolar macrophages during silicosis by electrophoresis analysis, radioimmunological assay and immunoflurescent technique. It is of interest to clarify the cause of elevation of Cp, particularly in the silicotic lung. Though Cp is mainly synthesized in the liver, recent studies have also demonstrated Cp synthesis in rat sertoli cells and human synovial tissue. Wistar male rats (180-220 g) were instilled intratracheally with 50 mg of silica (more than 97% of SiO2 and 95% of the silica particles with diameters less than 5 μm) suspended in 1.0 ml saline. Rats were killed for excising their lung and liver on the 21st day after instillation. Lung cells were harvested by repeated bronchial lavages with saline. Monolayer cells were cultured for 12-16 hours in the serum-free culture medium. Then the alveolar macrophages were collected for assay.Results Dot blotting results showed that Cp mRNA content increased in the liver as expected and was also detectable in the lung, with a nearly 2-fold increase compared with the normal rat lung in the normal group (saline injection). In situ hybrodization and Northern blotting revealed that the lung mesenchymal cells and the alveolar macrophages can express Cp mRNA in silicosis.Conclusions These data indicate that the lung is a prominent site of extrahepatic Cp gene expression during silicosis, thus suggesting that this protein may play a previously unknown role in pulmonary injury or repair.

Based on the concept of "regulating the five zang organs and harmonizing the spleen and stomach"， globus hystericus is believed to originate from dysfunction of the five zang organs and disharmony of the spleen and stomach. Treatment primarily focuses on regulating the spleen and stomach while also considering other affected organs， with a self-prescribed Anpiwei Jingyan Formula （安脾胃经验方） for harmonizing the spleen and stomach as the foundational treatment. Additionally， syndrome-based modifications are applied according to imbalances in the heart， lung， kidney， or liver. For heart-yang deficiency， modified Linggui Zhugan Decoction （苓桂术甘汤） could be combined； for heart-yin deficiency， modified Tianwang Buxin Pill （天王补心丹） could be combined. For lung failing to disperse and descend and fluid retention， modified Sanao Decoction （三拗汤） could be combined； for lung and stomach yin deficiency， modified Shashen Maidong Decoction （沙参麦冬汤） could be combined. For kidney-yang deficiency with ascending counterflow of cold water， modified Jingui Shensi Pill （金匮肾气丸） could be combined； for kidney-yin deficiency， modified Liuwei Dihuang Pill （六味地黄丸） could be combined. For liver constraint and spleen deficiency， modified Sini Powder （四逆散） could be combined； for liver-yin deficiency or liver stagnation transforming into fire and attacking the stomach， modified Yiguan Decoction （一贯煎） could be combined.

Objective To investigate the distribution characteristics of Oncomelania hupensis in Guangxi Zhuang Autonomous Region, so as to provide insights into the assessment of the risk of schistosomiasis transmission and the scientific formulation of the schistosomiasis surveillance strategy. Methods From 2015 to 2019, a total of 19 national schistosomiasis surveillance sites were assigned in Guangxi Zhuang Autonomous Region, including 4 fixed sites and 15 mobile sites. Snail survey was performed by means of systematic sampling in combination with environmental sampling, and the infection of Schistosoma japonicum was detected by the crushing method combined with loop-mediated isothermal amplification (LAMP) assay. Results From 2015 to 2019, snail habitats were detected at areas of 17 040 to 39 527 m², including 6 214 m² emerging snail habitats and 16 563 m² re-emerging snail habitats. The overall mean density of living snails was 0.019 2 snails/0.1 m² and the occurrence of frames with snails was 1.11% in the national schistosomiasis surveillance sites; however, no S. japonicum infection was identified in snails. The area of snail habitats increased by 121.46% in the national surveillance sites in 2019 as compared to that in 2015; however, 50.34% (Z = −0.422, P > 0.05) and 42.85% (χ² = 130.41, P < 0.01) reductions were seen in the overall means density of living snails and the occurrence of frames with snails. All snail habitats were distributed in the 4 fixed surveillance sites, and were mainly found in ditches, paddy fields and dry lands, with weeds as the primary vegetation type. Conclusions There are still risk factors leading to re-emergent transmission of schistosomiasis in Guangxi Zhuang Autonomous Region, such as local snail spread, and the monitoring of schistosomiasis remains to be reinforced to further consolidate the achievements of schistosomiasis elimination in the region.

Heme/metabolism* ; Cryoelectron Microscopy ; Membrane Transport Proteins ; Escherichia coli Proteins/metabolism*