Objective To observe the effects of continuous blood purification(CBP) combined with early enteral nutrition (EEN) in the treatment of acute severe acute pancreatitis(SAP) complicating hyperlipidemia.Methods Fifty-six cases of acute SAP complicating hyperlipidemia in our hospital from January 2014 to October 2015 were selected as the research subjects and divided into the CBP plus EEN group(combined group) and blood purification(BP) group according to the random digital table method,28 cases in each group.The CBP group was treated with CBP,while on the basis of CBP group the combined group was combined with EEN therapy (within 2 d after admission).The clinical efficacy and the improvement situation of various indexes after treatment were observed in the two groups.Results After treatment,the total effective rate in the combined group was 96.43 ％,which was higher than 75％ in the CBP group,the difference was statistically significant (P＜0.05);the related indicators of TG,UAMY,LPS,SAMY,CRP and LDH after treatment in the two groups were decreased,but which in the combined group were more significant compared with the CBP group(P＜0.05).After treatment,the APACHE-[[score in the combined group was significantly lower than that in the CBP group(P＜0.05),the symptom relief time and hospital stay time in the combined group were shorter than those in the CBP group (P＜0.05).The incidence rate of complications in the combined group was 10.71％,which was significantly lower than 28.57％ in the CBP group,the difference was statistically significant(P＜0.05).Conclusion CBP combined with EEN can significantly improve the prognosis of SAP patients and effectively reduces the complications.

Objective To study the application of the genetic algorithm with two populations in optimization of both IMRT beam weight and orientation.Methods The genetic algorithm with two populations was used to optimize IMRT beam weight and orientations with three dimensional pencil beam dose calculation model. The algorithm was implemented in Visual c#. Net. And the results were analyzed. Results The modest change of the beam orientation resulted in more conformal dose distribution in target volume, and large high dose area was included. Further more, genetic algorithm with two populations gave such a clinically acceptable computation time. Conclusion Little change had distinct influence on dose distribution when there were few beam orientations. The genetic algorithm with two populations was an effective and global optimization method because of its parallel, robust and global. It provided satisfying results when used to optimize IMRT beam weight and orientations

Objective: To investigate the value and clinical significance of soluble CD26 (sCD26) in blood in the diagnosis of papillary thyroid carcinoma (PTC). Method: A total of 104 PTC patients who had undergone surgery at the Tianjin Medical University General Hospital from January 2013 to December 2017 were collected as the study group. In the study period, surgery had been performed for 25 cases of a benign thyroid lesion, who served as control group. The control also group included 55 cases that had undergone health examination. The fasting blood samples of the PTC group before and after the operation and those of the control group were collected. The sCD26 concentration was determined by ELISA. Clinical pathology features of PTC patients were recorded to analyze the diagnostic value of the sCD26 concentration on PTC and its relationship with clinicopathological features. Results: The preoperative sCD26 concentration in PTC patients increased and significantly differed from the control groups. The sCD26 concentration had significantly decreased postoperatively compared to the preoperative value but showed no significant difference from the control group. The sensitivity, specificity, diagnostic accuracy, and optimal diagnostic boundary values for sCD26 distinguishing thyroid carcinoma from benign thyroid lesions were 75.50%, 91.21%, 85.0%, and 545.20 ng/mL, respectively. The results of the chi-square test showed a significant correlation of the high concentration of sCD26 with the tumor size ≥4.0 cm and clinical stage III in patients with PTC, but there was no significant correlation with the sex, age, lymph node metastasis, tumor capsule invasion, or preoperative TI-RADS classification. Conclusions: The sCD26 concentration has a diagnostic value for PTC and may be an independent predictor of the PTC prognosis. Keywords: soluble CD26 (sCD26), papillary thyroid carcinoma (PTC), diagnosis, prognosis

Objective:To verify the clinical value of the good outcome following attempted resuscitation (GO-FAR) score in predicting the neurological status of patients with in-hospital cardiac arrest (IHCA) in the Chinese population.Methods:The clinical data of patients with IHCA who were admitted to the Zigong Fourth People's Hospital from January 1 to December 31, 2020 were retrospectively analyzed. Used Glasgow-Pittsburgh cerebral performance category (CPC) score 1 point as the end point, the subjects were divided into 4 groups according to the score: ≤ 0 group, 1-8 group, 9-20 group and ≥ 21 group. Taken the group which GO-FAR score ≤ 0 as the reference group, the odds ratio ( OR) of the other three groups compared with this group was calculated. The receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of the GO-FAR score in favorable neurological outcome. A calibration curve was drawn for the Hosmer-Lemeshow test to analyze the degree of calibration of the GO-FAR score for predicting good neurological outcome. Results:A total of 230 IHCA patients were enrolled in the study, including 130 males, aged 74 (65, 81) years old, and 23 case (10.0%) had good neurological prognosis. There were statistically significant differences in GO-FAR-related variables, including age, a normal neurological function on admitted, acute stroke, metastatic cancer, septicemia, medical noncardiac admission, hepatic insufficiency, hypotension, renal insufficiency or dialysis, respiratory insufficiency, pneumonia, etc (all P < 0.05). Taken the GO-FAR score ≤ 0 group as the reference group, the OR values of good neurological prognosis in the GO-FAR score 1-8 group were 0.54 [95% confidence interval (95% CI) was 0.17-1.53, P = 0.250], 9-20 group were 0.17 (95% CI was 0.02-0.67, P = 0.009) and ≥ 21 group were 0.25 (95% CI was 0.05-0.85, P = 0.025). The area under the ROC curve (AUC) of the GO-FAR score for predicting favorable neurological outcome in IHCA patients was 0.653 (95% CI was 0.529-0.777, P = 0.015) and there was no significant difference in Hosmer-Lemeshow test ( P = 0.311). All these suggested that there was no significant difference between the predicted value and the actual value. Conclusions:GO-FAR score can be applied to predict neurological prognosis of IHCA patients in Chinese population. It can help clinicians to predict the prognosis of cardio-pulmonary resuscitation (CPR) and propose critical recommendations in treatment for these patients or their families.