Objective To analyze and compare the effect of early surgical treatment and nonsurgical treatment for patients with severe acute pancreatitis.Methods Acccording to the including criteria,five randomized controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects,results of the studies were reviewed and analysed by using Revman 4.2 software.Results Compared with nonsurgical treatment,early surgical treatment was associated with a significantly higher(incidence) of mortality(RR 3.42,95% CI 1.81～6.47,P=0.0002) and complications(RR 3.16,95% CI 2.15～4.64,P

Objective To explore the incidence and possible risk factors of restless legs syndrome (RLS) in the maintenance hemodialysis patients.Methods A total of 375 maintenance hemodialysis patients were enrolled in this study from September 1 to 30 in 2012.The diagnosis and assessment of severity were based on the International Restless Leg Syndrome Study Group (IRLSSG) standard.The relevant laboratory parameters and dialysis indicators were collected,such as hemoglobin,serum ferritin,parathyroid hormone,blood flow and dialysis mode.The clinical data were analyzed by multivariate logistic regression method.Results The incidence of RLS was 13.3％ with the severity score of 18.69 ± 0.95.The logistic regression analysis showed that anuria (OR 0.292,95％ CI 0.114-0.750) and β2 microglobulin(OR 1.023,95％C1 1.003-1.044) were the risk factors for RLS in the maintenance hemodialysis patients,while hemoglobin,serum iron and parathyroid hormone were not correlated with RLS.Conclusions The incidence of RLS is high in the maintenance hemodialysis patients.The risk factors of RLS are anuria and β2 microglobulin.Therefore,the preservation of residual renal function and the improvement of dialysis adequacy,especially the removal of the middle molecular weight toxins,may reduce the occurrence of RLS and improve the quality of life in the hemodialysis patients.

Objective: To compare the volatile compounds extracted from Rhodiola renulata respectively by HS-SPME and SD. Methods:The volatile constituents from Rhodiola crenulata were extracted respectively by HS-SPME and SD, and then the contents and the names were confirmed by GC-MS. Results:Totally 39 compounds were identified from Rhodiola crenulata by HS-SPME while 16 ones were identified by SD. Among them, 4 common compounds were detected. Conclusion: There are some differences between the two methods. Compared with SD, HS-SPME is obviously better because more volatile constituents can be extracted from the herb, furthermore, HS-SPME has notable advantages of higher retrieval matching and sensitivity.

To improve the knowledge of students and strengthen the teaching effects of internal medicine teaching,the characters,teaching methods and notices of clinical guideline were analysed. Moreover,according to previous teaching experiences,a few unique opinions on it were put forward. The results showed that clinical guideline was one of the most important ways in internal medicine teaching.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.

Objective To evaluate the effects of continuous intra-tracheal gas insufflation (TGI) during mechanical ventilation for protecting the juvenile piglets with acute lung injury (ALI) induced by endotoxin. Method Twelve healthy juvenile piglets were anesthetized and mechanically ventilated at 2 cmH2O PEEP with 10 cmH2O peak inspiration pressure. The piglets were challenged with lipopolysaccharide (LPS) and randomly (random number) assigned to two groups (n = 6 each): (1) piglets treated with mechanical ventilation alone (group MV) and (2) piglets treated with TGI by continuous airway flow of 2 L/min (group TGI). FiO2 was set at 0.4 to avoid oxygen toxicity, and the piglets were continuously monitored with an oxygen analyzer. Results Tidal volume, ventilation efficacy index and mean airway pressure were significantly improved in piglets of TGI group (P < 0.01 or P < 0.05). Four hours after ALI, pH decreased to below 7.20 in piglets of MV group, and was higher in piglets of TGI group (P < 0.01). Similarly, PaCO2 was stable and was significantly lower in piglets of TGI group than that in piglets of MV group (P < 0.01). PaO2 and PaO2/FiO2 increased in piglets of TGI group (P < 0.05). There were no significant differences in heart rate, respiraaatory rate, mean arterial pressure, central venous pressure, dynamic lung compliance and mean resistance of airway between two groups. Lung histopathological changes showed severe inflammation,and intra-alveolar hemorrhage and interstitial patchy hemorrhage were ameliorated and the lungs were more homogenously expanded in piglets of TGI group. Conclusions Continuous TGI during MV can significantly improve gas exchange and ventilation efficacy, and may provide a better treatment for acute lung injury.

OBJECTIVE:To study the feasibility of 10 kinds of culture media used in pharmaceutical microbial limit test stated in Chinese Pharmacopoeia(2010 edition)autoclaving at 121 ℃ for 15 min. METHODS:The performance(color,pH,sterility,the growth-promoting activity,antibacterial ability,indication)of 10 kinds of culture media including Modified Martin Broth medium were tested after autoclaving at 121 ℃ for 15 min or in the parameters from the product instructions according to GB4789.28-2013 and the requirements for quality control of culture media in Chinese Pharmacopoeia(2010 edition). The quality of the media were compared after autoclaved by different parameters. RESULTS:The quality of the media which were autoclaved at 121 ℃ for 15 min were equivalent with the media which were autoclaved by the parameters from the product instructions,and their quality met the requirements for quality control of media in Chinese Pharmacopoeia(2010 edition). CONCLUSIONS:The sterilization parame-ters of 10 kinds of media in Chinese Pharmacopoeia (2010 edition) can be adjusted to be autoclaved at 121 ℃ for 15 min,the quality of the media remain stable after autoclaving.

Objective To compare the diagnostic significance of pleural SLPI,IFN-γ and ADA for differenti-ating TPE from pleural effusions with the other etiologies. Methods Pleural effusion samples were obtained from 93 patients who were divided into the following groups: tuberculous pleural effusion,malignant pleural effusion, bacterial pleural effusion and transudative pleural effusion. The pleural effusion and/or serum levels of SLPI , IFN-γand ADA were determined. Results 1.The concentrations of SLPI, IFN-γand ADA in tuberculous pleural effusion was higher than that in malignant group, bacterial group and transudative group. 2. The diagnostic value of SLPI, IFN-γor ADA for the diagnosis of tuberculous PE is high respectively. The combinations of SLPI, IFN-γand/or ADA gained the more valuable diagnostic performance. Conclusion Pleural SLPI, IFN-γand ADA may be helpful for the differential diagnosis of tuberculous pleural effusion and the other pleural effusion. The combinations of SLPI or/and IFN-γor/and ADA further increased diagnostic value.

OBJECTIVE:To investigate the effects of Shenfukang capsules on clinical efficacy and renal function indexes of patients with renal insufficiency. METHODS:Totally 100 inpatients with renal insufficiency treated by Shenfukang cap-sules in the First Affiliated Hospital of Guangxi Medical University during Feb. to Mar. 2015 were analyzed retrospectively in respects of general information of patients,therapy plan,renal function indexs before and after treatment and clinical effica-cy. The relationship of clinical efficacy with age and duration was also analyzed. RESULTS:There were 33 cases of acute re-nal insufficiency and 67 cases of chronic renal insufficiency. The route of administration of Shenfukang capsules was oral ad-ministration(97 cases,97.00%),the main dosage was 6 capsule/d(36 cases,36.00%),and treatment duration were 0-<7 days(39 cases)and 7-<15 days(49 cases). After treatment,the average serum creatinine concentration was lower than be-fore treatment,while mean GFR and Ccr were higher than before treatment,with statistical significance(P<0.05). The total response rate was 72.00%,and response rate of patients with acute renal insufficiency was 87.88% and significantly higher than 64.18% of patients with chronic renal insufficiency,with statistical significance(P<0.05). Among patients with ≤60 years old,the total response rate of patients with acute renal insufficiency was significantly higher than that of patients with chronic renal insufficiency,with statistical significance(P<0.05);among patients elder than 60 years old,there was no statistical significance in therapeutic efficacy between acute renal insufficiency and chronic renal insufficiency(P>0.05);among patients with chronic renal insufficiency,the total response rate of patients elder than 60 years old was significantly better than that of patients with ≤60 years old,with statistical significance (P<0.05). With the extension of treatment duration,the total response rate of patients with acute renal insufficiency was on the rise,and that of patients with chron-ic renal insufficiency increased first and then decreased. No obvious ADR was found during treatment. CONCLUSIONS:Shenfu-kang capsules can improve renal function in patients with renal insufficiency,and has definite curative effect on acute and chronic renal insufficiency with good security. The clinical efficacy may be related to age and treatment course.

Objective To study the effect of compound hypertonic saline solution (HSD) on sepsis.Methods 133 male Wistar rats were divided into four groups,sham operation group (n =15),cecal ligation and puncture (CLP)group (n =45),CLP plus normal saline (NS) group (n =45),and CLP plus HSD group (n =28).A rat model of sepsis was reproduced by CLP,and the rats in sham operation group received celiotomy without ligation and puncture.All rats in four groups received subcutaneous injection of 30 mL/kg 0.9％ sodium chloride after laparotomy.The rats in CLP plus NS group and CLP plus HSD group received infusion of 5 mL/kg 0.9％ sodium chloride or 7.5％ sodium chloride/6％ dextran post CLP via jugular vein for 3 hours,with the infusion rate of 0.4 mL·kg-1·min-1.The survival rate of each group was observed 9 hours and 18 hours after laparotomy.Mean arterial pressure (MAP) at 0,9,18 hours were monitored.Blood specimens were collected from all rats 0,9 and 18 hours after laparotomy,respectively,for measurement of the plasma levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),and procalcitonin (PCT).The rats were all sacrificed,and their lung tissues were harvested for the neutrophil count in bronchoalveolar lavage fluid (BALF),myeloperoxidase (MPO) activity in lung tissue,wet/dry weight ratio (W/D) of lung,and pathological changes in lung tissue.Results There was no death in the sham operation group.The survival rates at 9 hours and 18 hours were 62.2％ and 31.1％ in the CLP group,57.8％ and 35.6％ in the CLP plus NS group,85.7％ and 64.3％ in the CLP plus HSD group,and they were all significantly higher compared with those of the CLP group and the CLP plus NS group (P ＜ 0.05 or P ＜ 0.01).MAP levels in the CLP group and the CLP plus NS group were significantly lower than those in sham operation group,and the plasma levels of TNF-α,IL-1β and PCT were significantly higher compared with those of sham operation group,while there was no difference between CLP group and the CLP plus NS group.MAP and the plasma levels of TNF-α,IL-1β and PCT in the CLP plus HSD group were significantly improved compared with those of the CLP plus NS group at 9 hours and 18 hours [MAP (mmHg,1 mmHg =0.133 kPa) at 9 hours:102±5 vs.94±6,18 hours:90±2 vs.72±3; TNF-α (ng/L) at 9 hours:284.19±57.18 vs.329.67±45.79,18 hours:263.46±42.58 vs.349.68±52.40; IL-1β (ng/L) at 9 hours:219.28±39.21 vs.263.47±32.36,18 hours:195.98±39.06 vs.250.10±41.57; PCT (μg/L) at 9 hours:2.32±0.37 vs.4.52±0.75,18 hours:2.89±0.62 vs.5.02±0.84; P ＜ 0.05 or P ＜ 0.01].The ratio of neutrophils in BALF,MPO activity and lung W/D at 18 hours in the CLP group and the CLP plus NS group were significantly higher than those of the sham operation group,while they were all significantly lower in the CLP plus HSD group than those of the CLP group and the CLP plus NS group [ratio of neutrophils in BALF:0.094±0.019 vs.0.148±0.062,0.151 ±0.055; MPO (U/g):1.19±0.45 vs.2.31 ±0.79,2.64±0.69; lung W/D ratio:4.02 ± 0.63 vs.5.14 ± 0.59,5.12 ± 0.83,all P ＜ 0.05].Under light microscope,no pathobiological changes were found in sham operation group.The lung tissues in the CLP group and the CLP plus NS group showed congestion,edema,infiltrating inflammatory changes,while the inflammatory changes in the lung tissue in the CLP plus HSD group were significantly alleviated.Conclusion HSD can obviously ameliorate the circulatory failure in septic rats,alleviate immune disturbance and acute lung injury,and improve the survival rate of rats with sepsis.