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.

With the advance of modern neonatal management, the increase of survival of infants born with ELBW has resulted in collateral increase in incidence of infants with serious chronic lung disease, typically brnchopulmonary dysplasia (BPD). Long-term sensory, motor and cognitive impairments are common outcomes in survivals with moderate and severe BPD and may persist during school years and adolescence. Increasing evidence suggest that BPD exerts a significant effect on brain growth and development and may be associated with chronic sublethal hypoxia which compond the risk of extended brain injury and NS complications such as cerebral palsy. Animal studies have demonstrated progressive gliosis and cerebral ventriculomegaly, injured subcortical white matter and corpus callosum, dysynchrony synaptic development and disrupted neurotransmitssion in the hypoxia newborn brain. In this literature we built upon the review of neurogical and congnitive outcome in preterm infants with BPD and structural, functional and neurochemical alterations in ainimals following clinical and experimental hypoxia respectively, which may underlie the primary or potential mle for chronic sublethal hypoxia on premature brain development.

Objective To explore the term efficacy and the influence on the immune function and hemotology toxicity of Shenqi-Fuzheng injection to advanced gastric cancer patients combined with SP chemotherapy.Methods 53 patients with advanced gastric cancer were randomly divided into an observation group (26 cases) and a control group (27 cases).All patients were treated in the oncology department of the Chinese People's Liberation Army 264th Hospital during 2010.1 ～2012.6.The observation group accepted SP chemotherapy plus Shenqi-Fuzheng injection and the control group was treated with SP chemotherapy.After 2 cycles of chemotherapy the term efficacy was evaluated,cellular immune function index and hemotology adverse reaction were observed.Results The objective response rate (RR) between the treatment group and the control group had no difference (x2=0.024,P＞0.05).After 2 cycles of treatment,CD3+ (64.09±7.59)％,CD4+ (44.17±6.09)％,CD8+ (27.60±7.64)％,CD4+/CD8+ (1.63±0.66) and NK(28.07±7.28)％ in the observation group were higher than the control group [accordingly (54.64 ± 6.39) ％,(35.01 ± 6.05) ％,(24.29 ±7.41) ％,(1.30 ± 0.72),(25.06 ± 7.24) ％,(P＜ 0.05)].The incidence of leukocyte decline in the observation group was 19.23％,and 44.44％ in the control group.There was significant difference (P＜0.05).Conclusion Shenqi-Fuzheng injection plus SP chemotherapy can improve the cellular immune function and the tolerance to chemotherapy and reduce hemotology adverse of patients with advanced gastric cancer.

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.

OBJECTIVE:To find out an effective way to control the unreasonable increase of drug expenses.METHODS:To analyse and evaluate the role of pharmacoeconomic research in suppression of unreasonable increase of drug expenses.RESULTS:The best therapeutic scheme could be found out by pharmacoeconomic research through the way of determination of the cost and efficacy of pharmacotherapy,and the unreasonable increase of drug expenses could also be cut down in5aspects.CONCLUSION:Pharmacoeconomic research is a practical and feasible way to control unreasonable increase of medical expenses.

OBJECTIVE:To analyze the cost of three schemes in treatment of unstable angina pectoris METHODS:88 patients with unstable angina pectoris were divided into three groups:group Ⅰ was given isosorbide,asprin,nifedipine and nitroglycerin;group Ⅱ was given isosorbide,asprin,nifedipine,nitroglycerin and red sage injection and group Ⅲ was given isosorbide,asprin,nifedipine,nitroglycerin and puerarin;then using pharmacoeconomic method,cost-effectiveness analysis was carried out RESULTS:The efficacy in the group Ⅱ and group Ⅲ was higher than that in group Ⅰ(P0 05),and the E/C(effectiveness/cost) of the three groups were 15 98,18 02 and 33 40 respectively Compared with group Ⅰ,?C/?E of group Ⅱ and Ⅲ were 24 66,83 90 respectively;Compared with group Ⅱ,?C/?E of group Ⅲ was 643 60 CONCLUSION:The scheme for group Ⅱ is the best one

Aim To study the activation of Nrf2 in-duced by baicalein ( BAI ) , and its protection against carbon tetrachloride ( CCl4 ) , ethanol and acetamino-phen ( APAP )-induced hepatotoxicity. Methods A reporter gene assay was conducted in human normal liver L-02 cells to detect the activation of transcription factor Nrf2 induced by baicalein. APAP ( 10 mmol · L-1 ) , CCl4 (10 mmol·L-1 ) and Ethanol (100 mmol · L-1 ) were used to induce hepatotoxicity in L-02 cells. After the pre-incubation with Baicalein (0, 1, 10, 25, 50, 100 μmol·L-1 ) for 15 min, cells were administrated with or without those above hepatotoxins. 48 h later, cell viability was detected by 3-(4, 5-dim-ethylthiazol-2-yl ) 2 , 5-diphenyltetrazolium bromide (MTT) method. Results Baicalein (25, 50 μmol· L-1 ) induced the activation of Nrf2 ( P <0. 01 , P <0. 05) in the reporter gene assay. As compared with control, three hepatotoxins ( APAP, CCl4 , Ethanol ) all decreased cell viability ( P<0. 01 ) , and baicalein significantly reversed such decreases in a concentra-tion-dependent manner ( P<0. 01 ) . Conclusion Ba-icalein can induce the activation of transcription factor Nrf2 , which is probably one of the mechanisms con-tributing to the protection of baicalein against hepato-toxins (APAP, CCl4, Ethanol)-induced hepatotoxici-ty.

Objective To assess the relationship between acute exposure to gaseous air pollutants (SO2, NO2) and daily mortality in Shanghai. Methods Semi-parametric generalized additive model was used to analyze the relationship between SO2/NO2 concentrations and daily death numbers from January 1, 2001 to December 31, 2004 in the urban area of Shanghai after adjustment for the long-term trend of death, weather conditions, and "days of the week" effect. Results An increase of 10 ?g/m3 of SO2 could increase the total mortality, cardiovascular disease mortality and respiratory disease mortality by 1.25%(95%CI: 0.85%-1.65%), 1.45%(95%CI: 0.86%-2.04%) and 1.71%(95%CI: 0.72%-2.71%) respectively; as for an increase of 10 ?g/m3 of NO2, the mortalities could be increased by 1.04%(95%CI: 0.72%-1.35%), 1.05%(95%CI: 0.59%-1.51%) and 1.43%(95%CI: 0.65%-2.21%) respectively. Conclusion The air SO2, NO2 of present levels in Shanghai have an adverse effect on the daily mortality of residents.

Objective To explore the efficacy and safety of human recombinant vascular endothelial inhibition (en) combined with gamma knife in the treatment of elderly advanced non-small cell lung cancer patents.Methods Totally 38 cases of senile non-small cell lung cancer patients were divided into two groups:A group was treatment group with 17 cases of recombinant human endostatin combined with gamma knife,group B was control group with 21 cases of patients receiving body gamma knife alone.Recombinant human endostatin was given intravenously 15 mg per day in 500 ml of saline for 3 ～ 4 hours for 14 days a cycle,and the total dose of body gamma knife therapy was 36 ～ 48 Gy/10 ～ 12f.Results The response rate (RR) of groups A and B were 58.82％ and 57.14％ without statistical difference.One-year survival rate of groups A and B were 47.06％ and 38.09％,respectively;and there was no statistical significance.The main side-effects of both groups were bone marrow suppression and gastrointestinal reactions,but no statistical difference was observed.Two groups of patients'quality of life were improved without statistical difference (P ＞ 0.05).Conclusions Body-gamma knife therapy combined with recombinant human endostatin in elderly advanced non-small cell lung cancer patients has better efficacy such as CR rate and long-term survival,and similar side-effects.

Objective To investigate the nursing cooperation in clinical application of RetCamⅢ wide-field digital pediatric retinal imaging system.Methods 119 patients were given pointed nursing guidance while they underwent RetCamⅢ wide-field digital pediatric retinal imaging system examination.Results All patients accomplished the examination.29 cases had adverse reactions after using mydriatic.27 cases felt discomfort during the examination.22 cases appeared adverse reactions after examination,but relieved after nursing cooperation and guidance.Conclusions RetCamⅢ wide-field digital pediatric retinal imaging system is a rapid,safe and effective method for pediatric fundus examination.Favorable nursing cooperation and guidance is the guarantee of accurate and effective examination and harmonious relationship between doctor-nurse-patient.