Objective:To analyze and compare the effect of integration of Traditional and Western Medicine treatment and western treatment for patients with severe acute pancreatitis.Methods:According to the including criteria,nineteen 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 analyzed by Revman 4.1 software.Results:Compared with integration of Traditional and Western Medicine treatment,western treatment was associated with a significantly higher incidence of mortality(RR=0.35,95%CI 0.25～0.48,P

From the perspective of both doctors and patients, the questionnaire survey was used in 1080 medi-cal workers and patients in 12 hospitals in Shandong province.They found that is extremely development trend to the doctor-patient relationship, doctor-patient trust evaluation is relevant, doctor-patient both pay attention to the influence factors of the government and society.Both doctors in the building of doctor-patient trust, is atta-ched importance to strengthen the construction of medical ethics of medical personnel, continue to deepen the re-form of the medical system and government regulatory functions into full play.

Statement of harmonious medical ethics education is the theoretical attribute in the specific field of medical ethics education in the overall time-value of constructing a harmonious society.This proposition is the inevitable theoretical response to the existent inherent contradictions in medical ethics domain,whose values mainly manifest three dimensions including the value pursuit of a harmonious life,the value construction of the harmony of humanity and utility,the value orientation of harmony of doctors and patients.Moreover,this article discusses the construction of harmonious medical ethics education from three levels,including strengthening the education of care ethics,paying attention to the value of situational ethics,promoting the cultivation of communication ethics.

Objective An investigation of the effectiveness of treatment of spinal cord injuries(SCI) from the point of view of the transforming factor. Methods Animal model of SCI was made by modified Allens method. Mixed grafts of Schwann cells(SCs) modified with nerve growth factor(NGF) and brain derived neurotrophic factor(BDNF) genes along with fetal spinal cord cell suspension(FSCS) were transplanted into SCI site after 1 month and 3 months. Immunocytochemical staining was conducted for neurofilament(NF), glial fibrillary acidic protein(GFAP), myelin basic protein(MBP), 5 hydroxytryptamine/serotonin(5 HT), NGF, BDNF and the results analyzed with image pattern analysis. Pathological changes of spinal cord tissues were observed with light and electronic microscopy. Results These findings demonstrate the advantages of using mixed grafts of NGF and BDNF genetically modified SCs with FSCS in SCI in the rat: 1) They can be well integrated with the host and survive, 2) FSCS plays the role of bridging and mesomerism, 3) SCs can act as canal tubes and guides for the axons, 4)NGF and BDNF may stimulate the growth of axons and salvage the injuried neruron. Conclusion Mixed grafts of SCs genetically modified with NGF and BDNF genes along with FSCS may be effective measures for the treatment of SCI.

Objective To approach the effect of prosthetic valve at preventing reflux esophagitis.Methods After the total gastrectomy and esophagojejunostomy,interrupted suture was apphed to form a prosthetic valve at output and input beyond Braun's stoma.Results Only one got light reflux esophagitis in 15 patients.Conclusion Prosthetic valve can prevent reflux esophagitis,and the operation is convenient and safe,which is deserved to be in generalization and approach the latest method.

China has entered the aging society , in urban communities and rural grassroots their are still many older people lack of health insurance , elderly patients with chronic diseases become the most difficult people to see a doctor, this needs to train more general practitioners to solve these problems .From a macroscopical view , general practitioners can bring substantial economic benefits and broad social benefits .From a microscopic view , they also can make effective use of family medical resources , bring convenient for old people going to a doctor and carry out an important role of health education .Improving the General Practitioner -Elderlyservice mode , the govern-ment needs to further improve the elderly medical service system and security system , vigorously promote grass -roots community health service institutions of medical conditions , develop specialized general medical personnel ac-cording to the needs of the elderly , implement contractual service relationships between general practitioners and the elderly.

0.05).The DPOAE incidence in sensorineural hearing loss group was 18%,compared with normal group and pseudo-anacousia group,the DPOAE incidence were significantly lower(P

Objective To investigate the gestation-specific reference intervals (GRIs) and dynamic changes of thyroid function at different gestational ages in Chongqing .Methods Combining self-sequential longtitudinal with cross-sectional study, the serum samples from 640 pregnant women with different gestational age were collected from June 2014 to September 2015 in the Third Military Medical University. The free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin (TG), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TGAb) were detected by the direct chemiluminescence method.According to China Guideline for the diagnosis and treatment of thyroid disease in pregnancy and postpartum in 2012, the reference interval of the thyroid function was calculated.The data were analyzed by Chi square test .Results Established GRIs of thyroid function during pregnancy in Chongqing:The GRIs was 3.68-5.59 pmol/L for FT3, 9.34-17.02 pmol /L for FT4, 0.18-5.26 mIU/L for TSH in 6-9+6 weeks of pregnancy; the GRIs was 3.69-6.03 pmol /L for FT3, 8.42-15.75 pmol/L for FT4、0.09-4.85 mIU/L for TSH in 10-13+6 weeks of pregnancy; the GRIs was 3.24-5.46 pmol /L for FT3, 6.50-14.24 pmol/L for FT4, 0.11-5.13 mIU/L for TSH in 14-27+6 weeks of pregnancy;the GRIs was 3.06-5.05 pmol /L for FT3, 6.12-11.69 pmol/L for FT4, 0.75-3.67 mIU/L for TSH in 30-34 weeks of pregnancy; the GRIs was 2.96-5.00 pmol/L for FT3, 6.26-11.36 pmol /L for FT4, 0.84-5.54 mIU/L for TSH in 36-40 weeks of pregnancy.Screening by GRIs, the prevalence of thyroid dysfunction was 8.75% (46), however, the prevalence was 37.07% (195) in according with the guidelines,χ2 =120.5,P =0.000.The overdiagnosis rate was 28.32%(149 /526).Using the guidelines of thyroid disease and our GRIs, the thyroid disease was found 116 (22.05%) and 30 (5.70%) in the first screening. Moreover, the thyroid disease was found 79(19.27%) and 10(3.23%) during the repeat screening in the normal population.Conclusions Using the GRIs for thyroid function tests in normal singleton pregnant women could reduce the risk of over diagnosis .The detection rate of repeat screening of TPOAb negative patients was close to the first screening detection rate , and repeated screening could reduce the risk of missed diagnosis for thyroid dysfunction in pregnancy women .(Chin J Lab Med, 2016, 39:511-515 )

Objective To establish the reference intervals of hemoglobin A 1c( HbA1c ) and fasting plasma glucose ( FPG ) in the first and second trimester of pregnancy in Chongqing , and to evaluate the viability of the combination of HbA 1c and FPG in screening gestational diabetes mellitus (GDM).Methods The study retrospectively selected the pregnant women seen at the Department of Obstetrics and Gynecology in Daping Hospital between September 2014 and August 2015.The results of FPG during 10-13 pregnant weeks and 75 g oral glucose tolerance test ( OGTT ) and HbA1c during 24-28 pregnant weeks were available.Totally 185 cases were assigned into GDM group , and 269 cases were assigned into normal group based on the American Diabetes Association ( ADA) guidelines.Reference intervals of HbA 1c and FPG in normal pregnant woman were developed .The difference of HbA 1c , FPG and OGTT results between two groups was analyzed.T-student test, NcMemar test,signed rank sum test, ROC curve were used for statistical analysis.Results The reference intervals of HbA 1c and FPG in first and second trimester were 4.58%-5.52%,4.21-5.49 mmol/L and 4.03-5.08 mmol/L.The FPG level in first and second trimester and HbA 1c level in GDM group vs normal group were(5.06 ±0.37) vs(4.85 ±0.32)mmol/L(t=6.569,P=0.000), 5.23(5.11,5.4) vs 4.74(4.54,4.91) mmol/L(z=-14.31,P=0.000)and 5.3(5.1,5.4)% vs 5.2(5.0, 5.3)%( z=-5.79,P=0.000) respectively.The area under receiver operating characteristic curve ( ROC) of HbA1c , and FPG in first and second trimester was 0.655, 0.659 and 0.890 respectively.When the cut-off value of HbA1c was 5.35%, the AUC of the combination of HbA 1c and FPG in second trimester was 0.898, the sensitivity was 0.838,and the specificity was 0.859.The kappa coefficient for identifying GDM between OGTT and the combined method was 0.692(P=0.000).Conclusion HbA1c combined with FPG is of some value in screening GDM.

Objective To evaluate the clinical significance of the intraoperative detection of peritoneal micrometastases of gastric cancer.Methods In selected 50 cases of gastric cancer in which no obvious peritoneal metastasis was found preoperatively or during laparotomy,Douglas′s pouch peritoneal biopsy was undertaken intraoperatively,then HE and CK-20 immunohistochemistry staining of the specimens was performed.The expression of CK-20 mRNA in peritoneal irrigation fluid was also determined by RT-PCR.Results HE staining of all cases was negative.The positive rate of CK-20 immunohistochemistry staining was 24.0 %(12/50),and 36.0 %(18/50) with RT-PCR method.The positive rate of CK-20 mRNA was significantly related with the histological type,the depth of invasion and the number of lymph node metastasis(P