Objective To investigate the clinical characteristics and the course of diagnosis and therapy of asparaginase associated pancreatitis (AAP) in adults, in order to improve the ability of diagnosis and treatment.Methods Data of 384 cases of acute lymphoblastic leukemia (ALL) who received treatment in Department of Hematology, Zhejiang Hospital, and Department of Hematology, Second Hospital Affiliated to Wenzhou Medical University from January 2009 to June 2015 was retrospectively analyzed.All patients were given multi-drug chemotherapy including PEG-asparaginase or L-asparaginase, the incidence of AAP, clinical manifestations, diagnosis, treatment and prognosis were analyzed.Results Among the 384 cases, 18 patients developed AAP, and the incidence of AAP was 4.7％, including 13 cases of mild AAP (MAAP), 5 cases of severe AAP (SAAP).Sixteen cases of AAP occurred during the induction-remission treatment phase, 2 cases during the maintenance-intensification phase.The major manifestations of AAP were abdominal pain, and increased serum amylase and lipase.After treatment, abdominal pain of MAAP patients alleviated, serum amylase and lipase obviously decreased, and re-use of PEG-Asparaginase or L-Asparaginase was not associated with the recurrence of AP.Levels of serum amylase and lipase in 5 cases of SAAP repeatedly increased, 1 case died of severe infection, cyst rupture and hemorrhage.Conclusions Adults patients with ALL present with abdominal pain during chemotherapy of aspargase should consider the possibility of AAP, the measurement of serum amylase and serum lipase should be strengthened, in addition, ultrasound and CT scanning may be helpful for early diagnosis and treatment of AAP, and improve the prognosis.

Objective To explore the Chinese massage therapy for the treatment of infantile anorexia of spleen and stomach type clinical curative effect.Methods 2 to 6 years old anorexia children treated from September 2010 to September 2012 for general treatment and health care in our hospital were randomly recruited into a Qi deficiency of both spleen and stomach group and a Yin deficiency of both spleen and stomach group with 25 cases in each group.Both groups were treated with chiropractic therapy.On this basis,Qi deficiency of both spleen and stomach group was applied point-massage on Weishu,Pishu,and Zusanli; Yin deficiency of both spleen and stomach group was applied point-massage on Weishu,Ganshu,and Shenshu.Results ① The comparison of disease and syndromes:the total effective rate was 92％ (23/25)and 88％ (22/25) in Qi deficiency of both spleen and stomach group and Yin deficiency of both spleen and stomach group separately,showing no significant difference (x2=0.886,P＞0.05); the total symptoms improving rate was 92％(23/25) and 76％(19/25)in Qi deficiency of both spleen and stomach group and Yin deficiency of both spleen and stomach group separately,the difference showing statistically significant (x2=0.625,P＜0.05).② Symptom score comparison before and after treatment:The main symptoms score and accompanied symptoms score before and after the treatment were [(18.32±2.42) ％,(4.12±0.17) points] and [(16.80±3.77) ％,(5.30 ±0.41) points] in the Qi deficiency group and [(18.18±2.10),(4.45±0.30) points] and [(19.66 ± 3.62)％,(6.01 ± 1.02) points] in the Yin deficiency group.Both groups showed obvious improvements in the main and accompanied symptom scores after the treatment (P＜0.01),but no significant difference between the two groups (P＞0.05).Conclusion The treatment of anorexia due to deficiency of both spleen and stomch with chiropractic and point-massage was effective.

Objective:To investigate the influence of cognitive-behavior therapy on the psychological status of family members of terminal cancer patients. Method:A total of 60 families of terminal cancer patients were selected and randomly divided into observation group (30 cases) and control group (30 cases). The observation group was treated with cognitive-behavior therapy, while the control group was given general supportive psychological care. The Hamilton Depression Scale ( HAMD) , Hamilton Anxiety Scale ( HAMA) and Pittsburgh Sleep Quality Index ( PSQL) were used to evaluate the family members of the two groups of patients before and after the intervention. Results: Before the intervention, there was no statistical significance difference in the scores of HAMA, HAMD and PSQI between the two groups (P>0. 05). After the intervention, the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those before the intervention ( P <0 . 05 ); and the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those in the control group ( P<0 . 05 ) . Conclusion:Cognitive-behavior therapy can significantly improve the negative emotions of depression, anxiety and sleep disorder among family members of terminal tumor patients.

Objective To investigate the characteristics of liver deformation and changes in abdominal vascular diameter under artificial pneumoperitoneum based on CT images,and also to reveal the impact of intestinal adhesion on these characteristics.Methods A retrospective study was conducted on 61 patients who underwent abdominal CT scan and artificial pneumoperitoneum CT.Eight cases did not meet the inclusion criteria.The sample included 41 patients with postoperative intestinal adhesion(POIA)and 12 patients without POIA.A three-dimensional post-processing software was used to quantify the gas volume,liver volume,liver surface area,and lumen of the abdominal aorta,inferior vena cava,and portal vein on CT images of patients who underwent abdominal CT scan and artificial pneumoperitoneum CT.The measured indices were compared before and after artificial pneumoperitoneum in all patients,and the impact of intestinal adhesion on the aforementioned indices was evaluated.Results At equivalent levels of pneumoperitoneum pressure,no statistically significant difference was observed in the quantity of gas in the abdominal cavity between patients with and without POIA(P=0.753).In the absence of pneumoperitoneum,POIA patients exhibited a significantly higher liver volume than non-adhesion patients(P＜0.01).Following the application of artificial pneumoperitoneum pressure,both liver volume and liver surface area were reduced in all patients,with a more pronounced decrease in POIA group(P=0.003,P=0.002).In addition,the reductions in the internal diameters of the inferior vena cava at three locations and the portal vein position 1 were also observed in all patients(P＜0.05).Notably,the POIA group exhibited more significant decrease in the internal diameters of inferior vena cava position 1 and the portal vein position 1(P=0.022,P=0.038).No significant differences were observed in the changes of internal diameter of other blood vessels or in the intergroup comparison.Conclusion Artificial pneumoperitoneum can reduce the volum,the surface area of liver,and the inner diameter of some abdominal vessels,which provides a scientific basis for navigation and real-time correction in laparoscopic abdominal surgery for patients,especially for patients with POIA.