Objective To investigate different scoring systems in predicting the severity of acute pancreatitis(AP).Methods The clinical data of 1 56 patients with AP were retrospectively reviewed.Ser-um c-reactive protein(CRP)levels were measuredat admission.According to the Chinese guidelines for the management of acute pancreatitis(2007),all the patients were categorizedas either mild acute pancre-atitis(MAP)or severe acute pancreatitis(SAP).Ranson,acute physiology and chronic health evaluation (APACHE)-Ⅱ,bedside index for severity in acute pancreatitis(BISAP),and computed tomography se-verity index(CTSI)scoring systemswere calculated according to the corresponding grading standardsin all patients.Patients were divided into MAP group(APACHEⅡ <8,Ranson <3,BISAP <2,CTSI <3 and CRP <21 .4)and SAP group (APACHEⅡ≥8,Ranson≥3,BISAP≥2,CTSI≥3 and CRP≥21 .4)ac-cording to the scoring results.ROC curve was used to compare the difference among the systems.Results Among the 1 56 patients,21 (1 3.5%)were classified as SAP and 1 35 as (86.5%)MAP.AUCs for Ranson,BISAP,APACHEⅡ,CTSI,and CRP in predicting SAP were 0.69 (95%CI:0.62-0.76),0.74 (95%CI:0.66-0.80),0.78 (95%CI:0.70-0.84),0.69 (95%CI:0.61 -0.76),and 0.68 (95%CI:0.57-0.78),respectively.There were no significant differences among these scoring systems.Conclusion There were no significant differencesin predicting the severity of AP among these scoring systems. Therefore,the early prediction of SAP should consider multiple scoring systems,and the referential signifi-cance of accessing and applying a simpler laboratory indicator deserves further studies.

Yin-Yang1 (YY1),as a ubiquitous nuclear transcription factor with double transcriptional activity in eukaryotic cells,regulates many genes transcription and plays an important role in the cellule biological processes.Overexpression of YY1 is found in several tumor types recently,and may play a role in tumor development and progression by regulating oncogenes,tumor suppressor genes,angiogenesis related factors,as well as apoptosis.YY1 may become a new kind of tumor markers,is conducive to estimate the prognosis of patients with tumor and gain important breakthrough in cancer targeted therapy.

To analyze the actuality in the education of forensic postgraduates and discuss the cultivating goal,the ability cultivation of innovation and practice.There are scientific research degree and professional degree in the forensic medicine.

Histiocytosis, Langerhans-Cell ; diagnosis ; Humans ; Infant, Newborn ; Male

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.

Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery(FTS)program and nutrition support in the elderly patients with gastric cancer.Methods Totally 42 patients were equally randomized into FTS group(receiving perioperative FTS program)and control group(receiving a conventional therapy).The postoperative first defecation time,postoperative hospital stay,hospitahzation expenditure,and postoperative complications were compared between these two groups.Results The postoperative first defecation time and postoperative hospital stay were(75.4±24.3)hours and(11.2±3.2)days in FIS group and(98.0±22.6)hours and(14.4±4.6)days in control group(P=0.0165,P=0.0004;respectively).The hospitalization expenditure was significantly lower in FTS group than in control group[(3.66±0.48)×104 vs.(4.56±0.78)×104 RMB yuan;P=0.0001].The incidence of postoperative complications in FTS group was also significantly lower than that in control group(9.5% vs.28.6%,P=0.0422).Conclusion Perioperative FTS program can accelerate postoperative rehabilitation,shorten hospital stay,lower hospitalization expenditure,and reduce the incidence of postoperative complications.

Objective To understand the use of antiplatelet drugs in patients with coronary heart disease( CHD) ,and to compare the effect of different anti platelet drugs on cardiovascular events in patients with CHD,and to provide clinical evidence for the optimization of anti platelet therapy?Methods One thousand and twenty?three cases patients with CHD who were treated in the First Hospital Affiliated to Chongqing Medical University from April 2010 to June 2014 were chosen?On the basis of conventional treatment,according to the different anti platelet program,the patents were divided into A group(703 cases),B group(211 cases) and C group(109 cases)?Group A was treated with aspirin and clopidogrel,B group was treated with clopidogrel,and C group was given aspirin therapy?Cardiovascular events( MACE) and bleeding events were observed at 1 month,6 months and 1 year after treatment in the 3 groups?Results After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A were 9?1%( 64/703) ,16?6%( 117/703) and 28?4%( 200/703) ,in group B were 14?6%(31/211),25?5%(54/211) and 37?9%(80/211),in group C were 16?5%(18/109),29?4%( 32/109) and 34?0%( 37/109)?After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A was significantly lower than group B and C(P<0?05);after treatment for 1 month,6 months,the incidence rates of MACE in group B were lower than group C,while higher than group C after 1 year,but the differences were not signifiacnt( P>0?05)?There were no significant differences in total incidence of deaths,the recurrence rate of myocardial infarction and stent restenosis rate among the three groups ( P>0?05 )?After treatment for 1 month,6 months,the incidence of angina in group A was lower significantly than that in group B and C( P<0?05) ,but When the treatment time was extended to 1 year,there was no significant difference in the three groups(P>0?05)?At 1 year follow?up,the incidence of gastrointestinal bleeding in group A was slightly higher than that in group B and group C ( 4?3% vs? 2?4% vs?3?7%) , but the difference was not statistically significant ( P>0?05 )?Conclusion In the CHD patients receiving aspirin and clopidogrel dual antiplatelet therapy,the incidence of MACE was lower than that in patients with aspirin or clopidogrel treatment alone, especially a reduction in the incidence of angina,and without increase of the risks in the gastrointestinal bleeding events,but the advantages above waning with treatment time extended to 1 year.

[Objective] To investigate the roles of Nrf2-Keap1 system in the protection of skin from ultraviolet B (UVB)-induced damage.[Methods] The dorsal surface of ears of 8 wild-type and 8 nrf2-null mutant 8-week-old female mice was exposed to a single dose of UVB irradiation (200 mJ/cm2) by using a FL120SE UV lamp source.Then,the morphology of ears was observed with the measurement of thickness before,as well as on day 1,2,4,7,9,11 and 14 after,the irradiation.Biopsy specimens were taken from the ears 36hours after the irradiation and subjected to hematoxylin and eosin staining as well as terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay.The test Results were recorded and statistically analyzed by rank sum test and t test.[Results] A significant increase was observed in the thickness of mouse ears and number of sunburn cells per high-power field (400 ×) in nrf2-null mutant mice compared with wild-type mice ((0.49 ± 0.22) cm vs.(0.25 ± 0.03) cm,P＜ 0.01; 17.0 ± 3.9 vs.5.0 ± 1.7,t=13.8,P＜ 0.01).The number of TUNEL positive cells in the nrf2-null mutant mice was about 5 times that in the wild mice.The sunburn reaction appeared more intense and persistent in nrf2-null mutant mice than in the wild mice.[Conclusion] Nrf2-Keap1 pathway may protect skin against acute UVB damage,including cell apoptosis and oxidative damage.

Purpose:The value of color doppler ultrasonography( CDUS) in monitoring hemodynamic changes was investigated in patients with hyperdynamic circulatory state before and during 730 days after orthotopic liver transplantation.Materials and Methods:83 cases of orthotopic liver transplantation (OLT) were examined by CDUS to assess the hemodynamic changes of portal vein,hepatic artery,splenic artery and longitudinal diameter of the spleen ( LDS).Results:(1) Portal flow velocity ( PFV) was significantly lower in pre-OLT but higher than controls (P < 0.05 ) during 730 days after OLT.Resistance index of the hepatic artery ( HARI) in pre-OLT and within 7 days- after OLT was significantly higher (P<0.05).(2) Resistance index of splenic artery ( SARI) was also significantly higher in pre-OLT (P < 0.05 ).LDS was significantly higher after OLT than in both pre-OLT phase and controls(P<0.05).Conclusions: In early stage after OLT,HARI changed from high to low value and so did PFV,which kept the stability of hepatic blood flow.In late stage,high PFV and large spleen improved,but could not back to normal.