Objective To investigate the efficacy and significance of endoscopic sphincterotomy(EST)and endoscopic nasobiliary drainage(ENBD)combined with the continuous blood purification(CBP)in the treatment of severe acute pancreatitis(SAP).Meth-ods The clinical data of 179 patients with SAP treated in our hospital over a period of ten years were retrospectively analyzed.The cases were divided into four groups according to the treatment methods.The conventional group was treated with the routine meth-od,the CBP group received the CBP therapy combibed with routine methods,the endoscopic group was given EST and ENBD on the basis of the routine methods and the combined group was treated with CBP,EST and ENBD.The patients′vital signs,WBC,CRP, APACHE Ⅱ score,abdominal signs change,incidence of complications,mortality and hospitalization days were compared among 4 groups.Results Compared with the conventional group,the clinical indicators,WBC,CRP,APACHEⅡ scores,blood amylase lev-el,incidence of local complications,mortality and hospitalization days in the rest three groups were decreased significantly(P<0.05),the total effective rate of abdominal signs relief was significantly increased(P<0.05);compared with the rest groups,the to-tal effective rate of abdominal signs relief in the combined group was increased(P<0.05),the blood amylase level,incidence of local complications and hospitalization days were decreased significantly(P<0.05),the mortality was significantly lower than that in the conventional group(P<0.05),however there was no difference between the CBP group and the endoscopic group(P>0.05).Con-clusion CBP combined with EST and ENBD in treating SAP has the active and effective role for improving the disease condition, reducing complications and the mortality,and shortening the hospitalization time.

Bronchiolitis ; diagnosis ; Haemophilus Infections ; diagnosis ; Humans ; Silicosis ; diagnosis

Objective:To study the effect of breviscapine on visual function of the patients with primary open-angle glaucoma after filtration surgery. Methods:Twenty-nine cases (42 eyes) of patients with primary open-angle glaucoma at middle and late stage after filtration surgery were selected and randomly divided into the experimental group and the control group according to the defect degree of visual field. The 15 patients (21 eyes) in the experimengtal group ( TG) were intravenously injected 250ml saline containing 50mg breviscapine, while the 14 patients (21 eyes) in the control group (CG) were intravenously injected 250ml saline containing 1g vita-min C. The treatment course was 2 weeks followed by one-week withdrawal. After three treatment courses, the visual function in the two groups was investigated and compared before and after the treatment. Results:After the treatment, the visual field defect value and the thickness of retinal nerve fiber layer of the patients in TG were both better than those before the treatment (P<0. 01,P<0. 05). The values of visual acuity and visual field defect of the patients in TG were significantly better than those of the patients in CG ( P<0. 05, P<0. 01). Conclusion:After intraocular pressure is controlled, breviscapine injection can reduce the vision damage of patients with primary open-angle glaucoma at middle and late stage after filtration surgery and improve the visual field defect.

Unleashed growth of gross healthcare expenses has emerged a major headache for public administration of countries at large.In China as well,such a rapid growth is incurred mostly by overtreatment due to irrational healthcare compensation.Against this background,it is highly significant to have a brand new insight into over-treatment in China' s viewpoint,and to further study the role of an improved mechanism for primary healthcare compensation for the purpose of curbing over-treatment.These efforts will help improve the primary healthcare service and realize goals of the ongoing health reform.

A new method was developed for the separation and determination of inosine monophosphate (IMP) by ion chromatography (IC) with suppressed conductivity detection. Separation was achieved on an anion-exchange column Ionpac AS11-HC of high capacity within a short time. 30 mmol/L KOH produced by an EGC-KOH eluent generator was used for isocratic elution. No interferences existed between the seven common inorganic anions and IMP. Under the optimum conditions, the linear range of the calibration curve for IMP was 1. 0-200 mg/L, with correlation coefficient ( R2 ) of 0. 999. The relative standard deviations (RSDs) for retention time, peak height and peak area of IMP were 0. 16%, 0. 94% and 0. 86%, respectively, indicating good reproducibility of the method. The method was successfully applied to the determination of IMP in meat products, with spiked recovery ranging from 86. 0% to 110. 0%. This simple, accurate and reliable method could be served as a rapid and effective analytical tool for meat flavoring research.

ObjectiveTo explore the clinical and imageological features of reversible posterior leukoencephalopathy syndrome(RPLS) during gestation period.MethodsClinical and imageological data of 4 pregnant women with RPLS were analyzed retrospectively.ResultsHeadache, seizure, confusion and visual loss were the mainly clinical manifestations. At MR imaging, the brain typically demonstrated focal regions of symmetric hemispheric edema which may disappear in several weeks. The parietal and occipital lobes were most commonly affected, followed by the frontal lobe cerebral vasoconstriction syndrome. Three of the four patients suffered eclampsia which happened in two days after delivery.ConclusionThere are distinctively clinical features in posterior leukoencephalopathy syndrome during gestation period. Most of them are invovled in patients with eclampsia.

ObjectiveTo observe the clinical characteristics and influential factors of pulmonary hypertension (PH) in maintenance hemodialysis (MHD) patients.MethodsOne hundred and two patients with MHD patients whose therapy time were all more than one year were enrolled from June 2008 to May 2009.Pulmonary arterial systolic pressure (PASP) and parameters related with cardiac structure and function were checked out by echocardiography.These patients were divided into two groups according to PASP:PH group[PASP≥35 mm Hg( 1 mm Hg =0.133 kPa)] and non-PH group(PASP ＜ 35 mm Hg).Gender,age,dialysis time,dialysis access and urine volume during dialysis was recorded.The blood biochemistry,parathyroid hormone(PTH),hemoglobin,postdialysis urea nitrogen was recorded too and Kt/V was calculated.ResultsPH was detocted in 26 MHD patients (25.5％,26/102).Right atrium transverse diameter,right atrium long diameter and pulmonary artery internal diameter in PH group [(32.00 ± 8.13),(41.00 ±9.15),(24.38 ± 3.88) mm] were higher than those in non-PH group [(27.44 ± 4.43),(36.45 ±8.88 ),(21.78 ± 2.46) mm] and LVEF in PH group [(55.59 ± 7.88 )％] was lower than that in non-PH group [(59.09 ± 5.69)％] (P ＜ 0.01 or ＜ 0.05).There were significant differences in calcium-phosphorus product,PTH,serum phosphorus and hemoglobin between PH group and non-PH group [(61.36 ± 17.83)mg2/dl2 vs.(53.24 ± 18.28) mg2/dl2,(365.95 ± 178.65) ng/L vs.(287.02 ±209.91 ) ng/L,(2.24 ±0.60)mmol/L vs.( 1.95 ± 0.68) mmol/L,(98.65 ± 25.69) g/L vs.( 114.29 ± 22.31 ) g/L] (P ＜ 0.05 ).Logistic regression found that PTH levels,hemoglobin and calcium-phosphorus product were the major risk factors for PH.ConclusionsMorbidity of PH in MHD patients is obviously high.Secondary hyperparathyroidism,anemia and high calcium-phosphorus product level may take part in the pathogenesis of PH in MHD patients.

BACKGROUND: Tumor-adopted immunity and gene transduction technique are used to introduce tumor necrosis factor-α vector into carrier cells, which are then re-infused into the body so that cancer cells can be killed by tumor necrosis factor-α more directly and effectively with fewer side effects on the other tissues due to high local expression.OBJECTIVE: To study the bioactivity of in vitro cultured tumor necrosis factor-α transduced tumor-infiltrating lymphocytes as well as the inhibitory effects on cancer cells of cancer-loaded rats infused in different ways.DESIGN: A randomized controlled study based on experimental animals.SEETING: Cancer Research Institute of China Medical University.MATERIALS: This study was carried out at the Cancer Research Institute and the Experimental Animal Department, China Medical University,between January 2000 and December 2001. TJ8510 cell line (human brain glioblastoma cell line) was provided by the Neurological Research Institute of Tianjin Medical University Affiliated Hospital. The experimental animals were 36 BALB/C nude mice congenitally having no thymius.METHODS: Based on the establishment of tumor necrosis factor-α retroviral transduction system and the preparation of cartier cells tumor-infil-trating lymphocytes, the monoclonal virus cell line PLC-2 and PLJC-5available were used to introduce marked gene NeoR and targeted gene tumor necrosis factor-α into tumor-infiltrating lymphocytes, respectively.Then cell proliferation, tumor necrosis factor expression and in vitro antitumor activity were examined. After cancer cell inoculation, the 36 nude mice were randomly divided into 6 groups: local infusion control group, local tumor-infiltrating lymphocytes infusion group, local tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, venous infusion control group, venous tumor-infiltrating lymphocytes infusion group and venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, and the therapeutic effects on the cancer-loaded mice were observed.proliferation and tumor necrosis factor-α expression in tumor-infiltrating oR-tumor-infiltrating lymphocytes and tumor necrosis factor-tumor-infiltrating lymphocytes was not significantly different from each other (P ＞ 0.05).NeoR-tumor-infiltrating lymphocytes, though not significantly different (P ＞0.05), significantly differ from that of tumor necrosis factor-tumor-infiltrating lymphocytes (P ＜ 0.01); moreover, tumor necrosis factor-tumor-infiltrating lymphocytes were found to express higher tumor necrosis factor-α conactivity did not significantly differ between tumor-infiltrating lymphocytes and NeoR-tumor-infiltrating lymphocytes (P ＞ 0.05), but obviously increased come of the animal experiment: 40 days after tumor necrosis factor-tumorinfiltrating lymphocytes infusion, cancer size in local tumor necrosis factortumor-infiltrating lymphocytes infusion group was found smaller than that in local infusion control group [(307±42) and (2 048±278) mm3, P ＜ 0.01],and it was also smaller in venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group than that in venous control group [(954±195)and (1 989±305) mm3 , P ＜ 0.05].CONCLUSION: Tumor necrosis factor-α gene transduced tumor-infiltrating lymphocytes could effectively express tumor necrosis factor, exerting higher and in vivo anti-tumor effects than tumor-infiltrating lymphocytes in cancer-loaded nude mice. No obvious inhibitory effects on the growth of subcutaneous solid carcinoma could be observed in nude mice after venous infusion of human brain glioblastoma tumor-infiltrating lymphocytes, but the inhibitory effects became obvious due to venous infusion of tumor necrosis factor-tumor-infiltrating lymphocytes and significant due to local tumor necrosis factor-tumor-infiltrating lymphocytes infusion, indicating that local infusion is the preferable way in the treatment of glioblastoma by immuno-gene therapy.

Objective Toinvestigatethepossibilityandquantitativerangeofpepsinogen(PG)usedas the screening marker of gastric cancer by detecting serum pepsinogen level in different gastric mucous pathologic status.Method ThelevelofserumpepsinogenⅠ(PGⅠ)andpepsinogenⅡ(PGⅡ)bytimeresolvedfluoro-immunoassay(TRFIA)in 64 chronic atrophic gastritis patients,63 gastric mucous atypical hyperplasia patients, 67 gastric cancer patients and 20 healthy volunteers were defeeted ,and the ratio of PGR(PGⅠ/PGⅡ)was calculated.Then the three kinds of diseases were graded.The data was analyzed between groups and sub-groups.Result ①Compared with normal control group,the median PGⅠvalues were 1 24.01 ,91 .23 and 71 .23 respectively,which were all lower than that of healthy group (1 52.00).There were significant differ-ences(Z=-2.52,P=0.01 7 0;Z=-3.42,P=0.001 4;Z=-3.57,P=0.000 9).The median PGR values were 7.61 ,5.21 and 4.32 respectively,which were also lower than that of healthy group,the differences were significant(Z=-2.98,P=0.002 9;Z=-3.1 7,P=0.000 2;Z=-2.89,P=0.000 1 ).The PGⅡlevel of these diseases were not significantly different with control group.②The serum PGⅠlevel of gastric mucous atypical hyperplasia and gastric cancer were reduced significantly in contrast with atrophic gastritis (Z =-3.42,P =0.001 4;Z=-3.62,P=0.000 9);the levels of PGⅡand PGR were varied without significance (P>0.05 );③The levels of PGⅠamong atrophy gastritis and gastric cancer subgroup have no significant difference(χ2 =2.86,P=0.41 4 3;χ2 =1 .67,P=0.1 36 8).But the level of PGⅠwas significantly different in gastric atypical hyperplasia(χ2 =0.83,P=0.043 0).It decreased in light and medium grade dysplasia and went up in severe grade dysplasia.The levels of PGⅡ and PGR were varied without significance(P>0.05).④The areas under the ROC curves performed by the PGⅠ and PGR from normal control group and atypical hyperplasia group were 0.782 and 0.831 respectively;The sensitivity and specificity of PGⅠ≤72.1 2 μg/L and PGR≤4.32 for gastric dysplasia were 89.48%and 76.31%respectively.Conclusion ①The level of PGⅠand PGR were decreased along with the seriousness of gastric pathological changes and probably regarded as the screening markers of gastric mucous malignant transformation.②Serum pepsinogen level is closely correlated with gastric precancerous lesion,PGI≤72.1 2 μg/L and PGR≤4.32 has better specificity and sensitivity for gastric atypical hyperplasia in this area.

A simple,rapid and sensitive liquid chromatography-mass spectrometry (LC-MS) method was developed for the determination of salidroside in rat plasma and study of its pharmacokinetics after oral administration of suspension of Erzhi Wan and Fructus Ligustri lucidi into Wistar rats.Plasma sample of 200 μL was extracted with acetic etherisopropanol (2:1) and the extraction was performed on a Kromasil C18 column (150 mm×4.6mm,5 μm) with the mobile phase of methanol-water (41:59,v/v) within a run time of 6.0min.The analyte was monitored with positive electrospray ionization (ESI) by selected ion monitoring (SIM) mode.The target ions were m/z 323.05 for salidroside and m/z 411.05 for internal standard (IS) geniposide.A good linear relationship was obtained over the range of 5.0-500.0 ng/mL and the lower limit of quantification was 5.0 ng/mL.The validated method was successfully applied to the pharmacokinetic study of salidroside in rat plasma after oral administration of suspension of Erzhi Wan and Fructus Ligustri lucidi.