Objective To investigate the etiology and the efficacy of endoscopic management of acute recurrent pancreatitis. Methods Patients with acute pancreatitis (AP) who were admitted in Changhai Hospital from January 2002 to December 2008 were included in the study population. The medical records were reviewed; the ERCP procedures and other treatment options and complications were documented. After the follow-up the patients were divided into two groups: single attack group (SAG) and recurrent attack group (RAG). The etiology and the efficacy of endoscopic management were analyzed. Results 804 patients were included, 512 patients(63.68%) had AP attacked once, 292(36.32%) had AP recurrent attack . The SAG had a mean age of 52 years old; the RAG had a mean age of 44 years old, the age difference between the two groups had statistical significance (P<0.01). In 201 patients with severe AP, 104(20.31%) patients had AP attacked once, 97 (33.22%) had AP recurrently attacked , the difference between the two groups was statistically significant (P < 0.01). There were 46 cases in SAG complicated with pancreatic pseudocysts, and 44 cases in RAG complicated with pancreatic pseudocysts, the incidence between the two groups was statistically significant (P < 0.05). Biliary origin, hypertriglyceridemia were risk factors for recurrent AP. 139 patients with recurrent AP underwent ERCP, and 15 patients developed post-ERCP pancreatitis, 1 patient developed post-endoscopic sphincterotormy bleeding. Follow-up of 118 recurrent AP patients showed the overall remission rate of endoscopic treatment was 78.8%. Conclusions The patients in RAG were younger than those in SAG. The incidence of severe AP and pancreatic pseudocyst was higher in RAG. Cholelithiasis and hypertriglyceridemia were high risk factors of recurrent AP. Endoscopic management was an effective treatment for recurrent AP.

Objective To increase the appreciation of manifestations in autoimmune pancreatitis (AIP) and to decrease misdiagnosis rate by investigating the clinical characteristics of AIP. Methods Clinical data were collected and laboratory ,imaging and histopathology were analyzed from the Chinese PLA General Hospital from 1995 to 2009. Patients with AIP were included in the study. Results Eight patients (male 6, female 2) aged 35-69 (52.4 ±9.4) years were diagnosed as AIP from 2006 to 2009. The main clinical manifestations include intermittent jaundice in 6 cases (6/8), abdominal pain in 5 cases (5/8),weight loss in 4 cases (4/8), and accompanied with other diseases of immune system in 4 cases (4/8).The imaging showed head of pancreas enlargement in 3 cases (3/8) and whole pancreas enlargement in 5 cases (5/8). There is a "banana-peel like" ring around the pancreas and irregular stenosis of pancreatic duct. Massive lymphocytes and plasma cells infiltration and parenchymal fibrosis were shown in pancreatic tissues, bile duct,salivary gland and liver in pathology. Clinical manifestations, laboratory examinations and images in 7 cases (7/8) were improved after treatment with prednisone. Twenty-two of them were misdiagnosed as pancreatic or biliary carcinoma and 21 were performed laparotomy in the period of 1995-2005 ( 23 cases). After 2006, however, the misdiagnosis rate significantly decreased from 95.7% ( 22/23 ) to 0. Conclusions AIP seems to be a systemic autoimmune disease rather than an isolated disorder,markedly overlapping with other autoimmune diseases. Definitive diagnosis can be improved by the detection of immune parameters and pathological examination.

Objective To explore the therapeutic effect of loop electrosurgical excision procedure (LEEP)in the treatment of patients with cervical intraepithelial neoplasia (CIN) and its influence on pregnancy outcome.Methods 62 women with CIN who underwent LEEP were selected as treatment group,and 63 women with CIN who did not undergo LEEP in the same period were selected as control group.Then the curative effect and the pregnancy outcome were observed.Results The total effective rate was 93.65％ in the treatment group and 76.19％ in the control group,the difference was significant (x2 =7.034,P ＜ 0.01).The operation blood loss,operation time and the day of colporrhagia after operation in the treatment group were less than those in the control group(all P ＜ 0.05).There were no significant differences in the gestational age,incidence rates of abortion and cesarean section between the two groups (all P ＞ 0.05),while there were significant difference in the incidences of preterm delivery,premature rupture of membrane and low birth weight infant (all P ＜ 0.05).Conclusion LEEP is an effective treatment for patients with CIN,which can increase the incidence rates of preterm delivery,premature rupture of membrane and low birth weight infant,but not increase the gestational age,incidence rates of abortion and cesarean section.

Cutaneous pruritus is a kind ofdermatosis without primary lesions, which only manifested as the symptoms of secondary scratches and scabbing.Through the overview of such aspects of pruritus as definition, pathogenesis, treatment based on syndrome differentiation, patent medicines, the combination therapy, external treatment by Chinese medicine, the Chinese herb fumigation and steaming therapy, as well as daily nursing were summaried.

OBJECTIVE:To speed up the perfection of quality standards of traditional chinese medicine decoction pieces and control the quality.METHODS:To present the implication of traditional chinese medicine decoction pieces,and the influ?ence of its quality and processing on decoction.To discuss the present situation of quality standards,and to suggest some mea?sures.RESULTS&CONCLUSION:Further perfection of the quality standards of traditional chinese medicine decoction pieces will be beneficial to modernization of industry of TCM and to ensure the safe use of drugs.

Objective To investigate the combined detection of serum cystatin C (Cys‐C ) and homocysteine (Hcy) for the diagnosis of early renal damage in diabetic children. Methods Data of 97 cases of diabetic children were collected in our hospital. According to the levels of 24 hUAER ,diabetic children were divided into <30 mg group (n=34) ,30~299 mg group (n=42) ,and ≥300 mg group (n=21). 40 cases of healthy children were selected as control group (NC). Laboratory indexes were compared among different groups. The critical values of Cys‐C and Hcy in early diagnosis of renal damage were calculated by receiver operating curve (ROC). Results The levels of Cys‐C and Hcy in <30 mg group were significantly higher than in NC group [Cys‐C (1.04 ± 0.26 ) vs(0.79 ± 0.21 ) mg/L ,Hcy (13.09 ± 2.15) vs(8.57 ± 1.24)μmol/L ,respectively ,P< 0.05]. When Cys‐C cutoff point took 1.02 mg/L ,the diagnosis sensitivity for diabetic nephropathy diagnosis was 86.09% and the specificity was 83.28% ,the maximum diagnostic index reached 1.6937 ,ROC area under the curve was 0.841.When Hcy threshold took 13.00 μmol/L ,the sensitivity was 83.98% and the specificity was 79.24% ,with the maximum diagnostic index 1.6322 and ROC area 0.795.Cys‐C combined with Hcy had a sensitivity of 92.38% and a specificity of 89.17% ,with the maximum diagnostic index 1.764 and ROC area 0.928. Conclusion Cys‐C combined with Hcy detection for early diagnosis of renal injury in diabetic children has important clinical value.

ER, PR, HER-2 are signiifcant biological markers in guiding the choice of treatment and evaluating clinical prognosis. As the progression of tumor cells, the expressions of these receptors in recurrent tumors may be different from primary tumors. Nowadays clinicians have realized the necessity of receptor detection in the metastatic lesions. This article summarized the current research status on the above issues.

Bronchial asthma (also called asthma) is the most common chronic respiratory inflammatory disease in childhood.With the increased incidence of asthma in recent years,the guidelines for diagnosis and treatment of asthma have been also updated quickly at both domestic and overseas.Acute exacerbations of asthma will result in unscheduled medical attendances in emergency department or hospitalizations,and the severe one may be life-threatening,which brings a heavy burden to the families and society.Several guidelines,Meta analysis,and studies in treatment of childhood asthma exacerbations are reviewed in this article,so as to provide recommendations in the treatment of childhood asthma exacerbations for physicians.

Objective To construct a novel recombinant human IFN-ε,and to analyze its physi-cal,chemical properties and biological characteristics.Methods Human genomic DNA was used as the template to synthesize IFN-ε gene by PCR.The sequence was cloned into plasmid vector pET-32a(+),and the recombinant plasmid pET-32a(+)/IFN-ε was transformed into E.coli BL2l(DE3).The form of ex-pression product was inclusion bodies.After purification and renaturation.high purity active protein IFN-εwas achieved.The final product was tested for its physical.chemical properties and biological characteristics including anti-viral and anti-proliferative acfivities.Results IFN-ε was expressed in inclusion body in E.coli.After the protein renaturation and purification,the purity was more than 95%.The rhIFN-ε protein had a specific anti-viral activity of about 1.2×103 IU/mg.Its anti-poliferative activity is obvious and can in-duce cells to produce anti-viral protein MxA.Conclusion Human IFN-ε protein was expressed successful-ly.and this protein has anti-virus and anti-prolireration activity.

Based on 418 cases of patients with advanced lung cancer early assessment , actively deal with ac-companying symptoms , respect patients psychological needs and families , to provide personalized palliative care , proper view of death education , give family psychological comfort and care .8 patients with in-hospital deaths had not been in the last issue to rescue , family good acceptance .For patients with advanced lung cancer patients under-going palliative nursing care can reduce the pain of dying period and the fear of death , to improve patients′families to treatment satisfaction .