ObjectiveTo investigate the relationship between enhanced CT examination and acute kidney injury in patients with acute pancreatitis.MethodsThe clinical data of 162 acute pancreatitis patients were analyzed retrospectively.Acute kidney injury was diagnosed and graded by RIFLE criterion.The patients were divided into two groups according to enhanced CT examination:enhanced CT group and non-enhanced CT group.ResultsEnhanced CT group had 85 cases,and non-enhanced CT group had 77 cases.The increased creatinine level in enhanced CT group was higher than that in non-enhanced CT group [(59 ± 13 ) μ mol/L vs.(38 ± 11 ) μ mol/L],and there was significant difference between two groups (P ＜0.01 ).The incidence of acute kidney injury in enhanced CT group was higher than that in non-enhanced CT group [30.6％ (26/85) vs.15.6％ (12/77)],and there was significant difference between two groups (P ＜0.01 ).Enhanced CT examination increased the risk of acute kidney injury occurrence (OR =1.293,95％ CI1.089-1.443).After adjusted by diabetes and APACHE Ⅱ score,enhanced CT examination was still anindependent risk factor of acute kidney injury (OR =1.282,95％ CI 1.185-1.377 ).ConclusionsEnhanced CT examination is a potential risk factor of acute kidney injury in acute pancreatitis patients.The time of enhanced CT examination is worthy of further study.

Objective:To investigate the effects of exogenous melatonin on Hypothalamus-Pituitary-Adrenal(HPA) axis and immune function which inhibited by exogenous corticosterone.Methods:By means of radioimmunoassay and cytoimmunology techniques respectively, we observed the effects of two doses exogenous melatonin on the plasma concentrations of ACTH ,corticosteron0e as well as the variations of lymphocytes proliferating response, natural killer cytotoxicity(NKCC) and the level of IL-2 induced by ConA of rat model which Hypothalamus-Pituitary-Adrenal axis and immune function were inhibited by exogenous corticosterone.Results:After 14 consecutive days melatonin injection(i.p.),there were an increasing trends of plasma concentration of ACTH, corticosterone which inhibited by exogenous corticosterone were observed in the melatonin 100 ?g/kg treated group, but no significance in statistics, otherwise, there were significant increasing of plasma concentration of ACTH, corticosterone were observed in the melatonin 200 ?g/kg treated group( P

Objective To discuss the influence of preoperative family purge care for the quality of life of patients with long type of congenital Hirschsprung′s disease (HD) who had enterocolitis history in neonatal period. Preoperative family purge care, which can shorten the HD postoperative treatment, improve the quality of life. Methods A total of 40 cases of patients with long type of congenital HD who had enterocolitis history in neonatal period received 1-stage radical preoperative by family phone call. Nineteen cases from January 2010 to February 2013 were as normal group and 21 cases from March 2013 to April 2016 were as improved group. Routine family purge nursing care 3-6 months were used in both the groups, while the combined nursing care of expanding anus were used in the improved group in addition. Evaluated the effects of postoperative observation indicates: the first defecation time, length of hospital stay, time needed for expanding anus, patency rate of defecation and not patency rate in 9-12 days, need enema intervention to assist defecate rate after postoperative 1 year, the recurrence of enterocolitis at 1-3 years after operation. Results The first defecation time, length of hospital stay, time needed for expanding anus were (39.15±8.23) h, (7.89±0.82)d, (5.17±0.98) min in normal group, (23.79± 7.54) h, (7.10± 0.29) d, (3.15±0.73) min in improved group, and there were significant differences between two groups (t=6.13, 5.46, 15.54, all P<0.01). The patency rate of defecation and not patency rate in 9-12 days were 12/19, 7/19 in normal group, 100.00%(21/21), 0 in improved group, and there were significant differences between two groups (χ2=9.38, P<0.01). The intervention rate of no need for enema, occasionally enema, often enema were 2/19, 12/19, 5/19 in normal group, 76.19%(16/21), 23.81%(5/21), 0 in improved group, and there were significant differences between two groups (χ2=18.25, P<0.01). There was no significant difference in the recurrence of enterocolitis at 1, 2, 3 years after operation between two groups (χ2=2.33, P>0.05). Conclusions Patient with long type of congenital HD who had enterocolitis history in neonatal period neonatal period,received family enema and expanding anus in 3- 6 months before 1-stage radical preoperative can shorten the postoperative HD treatment, improve the quality of life.

Objective To review the authors′ experience in the diagnosis and management of Hirschsprung′s disease (HD) in newborn during a 7 year′s period (1995～2002),and evaluate a new therapeutic regime. Methods Clinical data of all 155 newborn HD cases were analyzed. Protocols were compared before and after May 2000. Results Barium enemas, anorectic manometry and rectal biopsies confirmed the diagnosis of HD in 155 newborn cases. Two stage radical procedure was performed in 107 cases , and one stage in 48 cases. One hundred and forty-seven cases were cured. Postoperative pneumonia occurred in 25 cases, wound dishences in 8 cases with 8 deaths. There was substantial difference in the incidence of complications, hospital stay and mortality between the two periods. Conclusions (1) Gastrointestinal perforation in neonatal HD cases should be managed by rectal biopsies during the exploration. (2)Different surgical treatment should be adopted in HD cases less than one month of age.