ObjectiveTo investigate the effect of early fluid resuscitation on the prognosis of SAP patients.MethodsPatients who were admitted to our hospital within 72 h after the onset of the SAP were enrolled.The parameters for the fluid resuscitation were as follow: heart rate ＜120 beat/h,urine output ≥ 1 ml ·h-1 · kg-1,hematocrit ≤35％ and mean arterial pressure 65 ～ 85 mmHg ( 1 mmHg =0.133 kPa).The effects of different time of reaching fluid resuscitation ( ＜48 h,48 -72 h,＞72 h) and parameters achieved (0 ～ 1parameter,2 parameters,3 parameters,4 parameters) on the prognosis were analyzed.ResultsThere were 70 patient enrolled in this study and 41 ( 58.6％ ) developed complications,20 ( 28.6％ ) were referred to surgical operation and 10( 14.3％ ) died.The median hospital stay was 23.5 d,and the median medical cost was 71.9(5.7～567.4 thousands RMB).The rates of surgical intervention in ＜48 h,48 ～72 h,＞72 h groups were 20.0％,33.3％,75.0％,and the rates of acute kidney injury were 20.0％,25.0％,75.0％,while the rates of complications were 50.0％,83.3％,100％,and the difference among the 3 groups was statistically significant (P ＜ 0.05 ).The rates of surgical intervention in patients achieving 0 ～ 1,2,3,4parameters within 48h of SAP onset were 50.0％,26.3％,13.0％,25.0％,and the rates of acute kidney injury were 45.0％,31.6％,17.4％,0,while the rates of ARDS were 35.0％,31.6％,13.0％,0,which showing a significant decreasing trend.ConclusionsAn appropriate fluid resuscitation in the first 48 h after the onset of SAP was benefit for improving the treatment effects and patients' outcome.

Acute compartment syndrome refers to a series of symptoms of muscles and nerves in the compartment of the fascia due to acute ischaemia and hypoxia. It is more common in the volar and calf of the forearm.[1] Due to long-term ischaemia of muscles and nerves in the fascia, muscle necrosis and neurological dysfunction can occur, causing serious irreversible damage to the limbs. However, rhabdomyolysis is one of the major complications in the absence of fractures or other trauma. Rhabdomyolysis syndrome refers to the destruction and disintegration of striated muscle caused by various causes, by which intracellular components such as creatine kinase and myoglobin enter the blood circulation, causing systemic disorders in the body and even acute renal failure and other clinical syndromes.[2] This case introduces rhabdomyolysis induced by skeletal muscle ischaemia and hypoxia caused by upper limb compression after drinking, accompanied by upper limb compartment syndrome.

The paper introduces the current status and the problems of servers in the data center of Institute of Medical Information,Chinese Academy of Medical Sciences,points out the necessity of virtualization in data center,expounds the concept of virtualization and server virtualization technology,then describes the implementation scheme of constructing the server virtualization platform based on VMware vSphere 5.5 products in detail.Finally,the application effect of server virtualization is summarized and the future work is prospected.

Objective: To investigate the effects of bovine plasma fibronectin on the proliferation and differentiation of rat osteoblasts. Methods:Rat osteoblasts were cultured and identified. AlamarBlue were used to determine the effect of various concentration of bovine plasma fibronectin on the proliferation of the osteoblasts. ELISA method was used to determine the alkaline phosphatase activity of the cells. Results: Fibronectin stimulated the proliferation of rat osteoblasts at 40 ?g/ml (P

Objective To study the clinical features,pathological characteristics and prognosis of renal cell carcinoma(RCC)in young adults,and to improve the recognition of RCC in young population. Methods The data of 35 young patients with RCC under the age of 35 years from August 1983 to June 2005 were analyzed retrospectively.There were 22 males and 13 females with a mean age of 31 years(age range, 19-35 years).The clinical presentations were as follows:painless hematuria in 12 cases(34%),low back pain in 12(34%),abdominal mass in 2(6%),fever in 3 and Stauffer syndrome in 1.The tumor size was 1.2-13.8 cm in diameter(mean,6.0cm).AJCC staging showed stage I tumor in 8 cases,stageⅡin 4, stageⅢin 18 and stageⅣin 5.Of the 35 cases,28 underwent radical nephrectomy(including simultaneous extraction of the vena cava emboli in 3 cases and extraction with pulmonary lobectomy in 1);5 cases under- went partial nephrectomy;and 2 cases lost the chance of operation(1 of them had biopsy).Results The operations were successful.The postoperative pathologic diagnoses consisted of clear cell carcinoma in 23 ca- ses,mixed cell carcinoma in 5,papillary cell carcinoma in 2,and chromophobe cell carcinoma in 2,low-dif- ferentiated and undifferentiated cell carcinoma each in 1.Of them,26 cases were followed for 12-148 months(mean,56 months).Postoperative 3-and 5-year survival rates were 65% and 50%,respectively. Conclnsions In young population,RCC is difficult to diagnose because of occult symptoms at early stage and lack of tumor specificity,which leads to relatively late clinical staging at diagnosis.RCC is characterized by higher malignancy,easy invasion to surrounding tissues and metastasis,and thus poor prognosis.

Objective: To investigate the related factors for the therapeutic efficacy of hilar cholangiocarcinoma. Methods: A retrospective clinical analysis was performed on the clinical data from 49 patients with hilar cholangiocarcinoma. Results: The mean survival time was 19.5 months, 8.79 months, and 5.44 months for the total 49 patients who received radical resection, palliative resection, and drainage operation, respectively. The mean survival time was 23.5 months, 9.37 months, and 2.90 months for patients at AJCC TNM stage I and II, III, and IV (IVa and IVb), respectively. The mean survival time was 3.62 months for patients with a total bilirubin level more than 300 μmol/L or 14. 74 months for those patients with a total bilirubin level less than 300 μmol/L. The mean survival time was 5.68 months, 11.59 months, and 22.17 months for patients whose total serum bilirubin level was more than 40 μmol/L, between 20 to 40 μmol/L, and less than 20 μmol/L one week after operation, respectively. Conclusion: TNM stage and curative resection degree are the main related factors influencing the therapeutic efficacy of hilar cholangiocarcinoina. The decreased degree in the serum level of total bilirubin before and after surgery has the potential to be used as a marker to predict the long-term therapeutic efficacy of hilar cholangiocarcinoma.

Nicotinamide N-methyltransferase (NNMT) is a S-adenosyl-L-methionine (SAM) dependent cytoplasm enzyme,which plays a vital role in the biotransformation and detoxification of many drugs and xenobiotic compounds.Recent studies have revealed abnormal expression of NNMT in many tumors,which may contribute to tumorigenesis and tumor development and radiotherapy or chemotherapy resistance.

Objective: To study expression of CD44 S and CD44 V6 in ameloblastoma (AB) and odontogenic keratocyst (OKC) . Methods: S-P method was used to detect CD44 S protein in 77 cases of AB (32 of primary, 39 of recurrent,6 of malignant), 19 cases of OKC and 12 cases of oral normal mucosa;and CD44 V6 protein in 61 cases of AB (24 of primary , 31 of recurrent and 6 of malignant), 19 cases of OKC and 12 cases of oral normal mucosa. Results: Expression of CD44 S and CD44 V6 were detected in cell membrane of stratum spinosum and stratum basale in normal oral mucosa. In 19 cases of OKC, loss of expression of CD44 S was detected in 10 cases, and loss of integrity of CD44 V6 expression was detected in 15 cases. Loss ration of expression and abnormal expression ratio of CD44 S in AB were 27.3% and 63.6%, respectively. That of CD44 V6 in AB were 11.5% and 50.8% respectively. There was a signifcant difference between loss of expression or abnormal expression of CD44 S and CD44 V6 in AB, OKC and normal oral mucosa (P

Objective To establish the method of depict ing the left ventricular (LV) pressure-volume loop automatically by computer which incorporates LV catherization simultaneous with LV acoustic quantification echocardiography and to assess echocardiography non-invasive evaluation LV chamber stiffness. Methods Thirteen patients with hypertrophic cardiomyopathy (HCM) underwent LV catherization simultaneously with echocardiography. LV pressure and volume curves were sent to computer, and LV pressure-volume loop was depicted automatically and modulus of LV chamber stiffness (Kc) was obtained. Pulsed Doppler echocardiography of mitral intraventricular flows was obtained in patients with HCM. Results Patients with HCM had significantly higher Kc obtained from LV pressure-volume loop ( 0.43 ? 0.11 vs 0.27 ). R-E 3/R-E 0, (R-E 2)-(R-E 1), (R-A 3)-(R-A 2) were correlated to Kc(r= 0.61 , 0.57 , 0.58 ,respectively). Conclusions This method provides a simple and reliable technique for automatically tracing pressure-volume loop and should facilitate further investigation of the left ventricular diastolic function in clinical practice. R-E 3/ R-E 0, (R-E 2)-(R-E 1), (R-A 3)-(R-A 2) offer new non-invasive indices in evaluating LV chamber stiffness.

Objective To investigate the independent factors associated with the apex of left atrial appendage(LAA) spontaneous echo contrast (SEC) in patients with valvular atrial fibrillation (VAF). Methods Seventeen normal subjects and 21 patients with VAF were included. Plasma fibrinogen (Fg),vov Willebrand factor (vWF),D-dimer (DD),P-selectin,thrombin-antithrombin complexes (TAT) and plasminogen activator inhibitor-1(PAI-1) were measured. The apex of LAA SEC was assessed quantitatively by integrated backscatter (IBS). LAA flow and pulmonary venous flow were detected by transesophageal echocardiography. Results Fg,vWF,DD,TAT and PAI-1 were increased significantly in patients with atrial fibrillation compared with control ( P