Objective To evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.

Objective: To explore the effect of health education and supportive therapy on neuroses. Methods: Fifty six subjects were assigned into two groups according to the sequence of hospitalization. Both groups received the same drug treatment, average dosage: in experiment group fluoxetine 20～30mg/d (9 cases), Amitriptyline 75～150mg/d(8 case), Alprazolam 1.6～ 2.8mg/d(13 cases), received the health education and supportive therapy for 38 to 60 days in addition to drug treatment. In control group, fluoxetine 20～30mg/d(11 case), Amitriptyline 75～200mg/d(5 cases), Alprazolam 1.2～2.8mg/d(10 cases) were used. The Symptom Checklist 90 was used for assessment before and after treatment and cure rate was evaluated by clinical standard at discharge in both groups. Results: Cure rate was higher in the experimental group (94%) than control group (71%, P<0.05). The total score of the Symptom Checklist 90 and main factors were lower in the experimental group than the control group (P<0.01). Conclussion: Early health education and supportive therapy can improve the treatment outcome of patients with neuroses.

Objective To explore carotid atherosclerosis and its relative factors of maintenance peritoneal dialysis patients. Methods The general clinical conditions,hematobiochemical parameters and color ultrasound parameters of 27 maintenance peritoneal dialysis patients and 24 controll patients were collecled. General clinical conditions included body weight, height and BMI. Hematobiochemical paremeters included Hb, Alb, LP (a), TC, TG, HDL-C,LDL-C, CRP, plasma fibrinogen, C3, Apo-A 1, Apo-B, LP (a). Color ultrasound parameters included plaque incidence rate,thickness of vascularendothelium(IMT). Results Compared with the controll group,maintenance peritoneal dialysis patients: plaque incidence rate, thickness of vascularendothelium (IMT) increased significantly, Age, TC, TG,LDL-C,LP (a), dialysis time increased significantly in plaque-positive group(all p ＜ 0. 05), while Hb, Alb andPAB decreased significantly (all P ＜ 0.0 5) , CRP increased significantly (P ＜ 0.0 1) . Conclusions In maintenance peritoneal dialysis group,CRP,LP(a) had positive relationship with C-IMT. CRP had negative relationship with ALb. CRP had not relationship with age and dialysis time. There were relationships among malnutrition,inflammation and atherosclerosis in maintenance peritoneal dialysis patients. Interdiction of the relationship may played a very important role in ameliorating the prognosis of the maintenance peritoneal patients.

Syncope is a common pediatric emergency event,which can be caused by various metabolic disorders different from other illness. The major metabolic anomalies include hypoglycemia, hyperventilation,electrolytes imbalance,hypoxemia and others, in which hypoglycemia is caused by hyperinsulinemia,pituitary and adrenal disease, diabetes, ketotic hypoglycemia, inherited metabolic disorders of sugar, organic acids and amino-acids,etc. This article introduced the common metabolic anomalies and their causes,diagnosis and therapy.

There are some common problems such as recurrent symptoms and poor compliance among patients with chronic diseases. Although scientific knowledge and skills have been learned from traditional health education, patients with chronic diseases cannot improve their life style continuously. At present, many researches abroad have proved that health coaching contributes to setting feasible goals and encourages continuously behavior change of patients. In China, health coaching is in the stage of becoming familiar with its scientific definition, intervention effect and application characteristics. And health coaching also needs evidences from high-level evidence-based studies. Along with continuous improvement of intervention techniques on health management, health coaching will get further development and standardization.

Parathyroid hormone ( PTH) is an important hormone secreted by parathyroid cells , and regulates the metabolism of calcium and phosphorus in the body .In recent years , the toxic effect of PTH on myocardium has been re-ported.Calcium-sensing receptor (CaSR), a member of G protein-coupled receptor family, can feel the subtle change of extracellular calcium concentration and regulate intracellular calcium concentration through multifarious ways in order to control the secretion of PTH .The expression of CaSR is observed in parathyroid cells , renal tubular epithelial cells , myo-cardial cells, etc.Intracellular calcium, as a second messenger, participates in various cell functions , such as excitation-contraction coupling , fertilization and so on .The injury of myocardial cells is intimately linked with high concentrations of PTH and intracellular calcium , and high expression of CaSR .

Bronchiolitis is the most common lower respiratory tract disease in infants younger than 2 years of age.Many viruses can cause bronchiolitis,however,respiratory syncytial virus is most common etiology.The pathological characters are acute inflammation,edema,necrosis of epithelial cells and mucus productions increased.Diaguosis of bronchiolitis is based on clinical signs and symptoms and a thorough history and physical exam.The disease severity and risk factors for severe disease need to be assessed.The treatment of bronchiolitis has been largely supportive.Continuous positive airway pressure treatment has been accepted for severe cases.Palivizumab prophylaxis is probable in high risk infants.Hand hygiene,decreasing tobacco smoke and breastfeeding are considered as efficient preventive methods.

[Objective]To investigate a minimally invasive,safe and effective method for treating the nonunion of tibia fracture with Bastianti external fixators.[Method]Bastianti external fixators were used to treat nonunion tibia fracture with axial force followed by functional exercises in early stage.[Result]All cases showed tibia fracture union in 4~12 months after operation.According to the criterion of treatment effects,35 cases were as excellent,7 as good,and 1 as poor.[Conclusion]It is a good method that nonunion of tibia fracture was treated with Bastianti external fixators for maintaining pain-free joint activity and joint functional recovery in early stage.

Objective To study the efficacy and safety of methylcarboprost suppository in preventing postpartum hemorrhage of cesarean section.Methods Two hundred and nine puerperants with cesarean section were randomly divided into two groups: test group(n=103),1mg methylcarboprost suppository was given sublingually after peritoneotomy,and control group(n=106),20IU oxytocin intravenous drip immediately after neonate delivery. 20IU oxytocin were injected into uterine muscularis in the both groups after neonate delivery.The amount of bleeding in perioperation and 24 hours after delivery were measured.Results The blood loss volumes in perioperation and 24hour after delivery in test group were 191 2ml and 317 2ml respectively, and in control group were 216 6ml and 350 5ml respectively,and there was significant difference in the blood loss volume between the two groups(P

Objective To evaluate the safety of conscious venous anesthesia with fentanyl and propofol in elderly patients over 70 during gastrointestinal endoscopy. Methods Clinical data of 826 elderly patients over 70, who underwent gastrointestinal endoscopy with venous anesthesia, were retrospectively analyzed. The patients were divided into 2 groups according to their ages, with 618 patients aging from 70 to 80 in group A, in which 342 received endoscopy and 276 underwent colonoscopy, and 208 patients older than 80 in group B, in which 112 underwent endoscopy and 96 had colonoscopy. Another cohort of 600 patients younger than 70, who underwent venous anesthetic endoscopy during the same time period, was randomly selected as the control group, in which 400 patients received endoscopy and 200 had colonoscopy. Blood pressure, heart rate, peripheral oxygen saturation (SpO2) and adverse reaction were monitored in each patient during the procedure and compared among different groups. Results No procedure-related perforation or sedation-related mortality was observed, and no procedure was terminated clue to sedation complication. The average dosages of propofol used in procedure of endoscopy in groups A, B and control were 54.22±21.36 mg, 40.22±12.46 mg, and 86.44±34.26 mg, respectively. The average dosages of propofol in colonoscopy were 82.56±40.64 mg, 45.36±15.44 mg and 102.23±46.32 mg, respectively. With same procedure, there was no significant difference in heart rate and blood pressure among different groups, nor was there any difference in these variables before and after the procedure in each group (P>0.05). Sedation exerted more influence on SpO<,2> in elderly patients. A total of 18 cases in groups A and B experienced SpO<,2> <90%, which was mainly due to aspiration of saliva and relieved by oxygen inhalation. Conclusion Under appropriate monitor, it is safe and feasible to give conscious sedation to elderly patients over 70 during gastroimestinal endoscopy.