Objective To determine the timing of surgical treatment for pancreatic pseudocyst(PPC) secondary to severe acute pancreatitis(SAP). Methods Twenty-seven cases of PPC appearing 4-8 weeks after SAP were treated with internal drainage were included in group A.Of the 27 cases,10 received cystojejunostomy by stapler.In other 30 cases in group B,surgical procedures were performed 24 weeks after the formation of the cyst.Several parameters were compared between the 2 groups.Results The incidence of anastomotic leakage,average duration of hospitalization and mean fee for hospitalization were significantly lower in group A than in group B(P0.05).Emergency surgical treatments were performed in 5 patients in group B due to complications of introcystic hemorrhage(1 patients),introcystic infection(2 patients) and cystic rupture(2 patients).Conclusions Accurate diagnosis and early surgical treatments are effective and safe for treatment of PPC secondary to SAP.Meanwhile,they might be helpful for avoiding complications of introcystic infection,introcystic hemorrhage and cystic rupture.

Space-time is extremely attached importance to in the thinking of recognizing diseases and syndrome differentiations in TCM. For instance, internal/external and upper/lower in Neijing, are the concept of compartmentalization of the tissue and structure in the body, also are the mechanism of recognizing generations and changes of diseases by combining both space and time organically. Moreover, the thinking of upper/lower and internal/external syndrome differentiations and treatments in TCM constitute a relatively completely space-time system, which are in favor of systematicness and integrality of syndrome differentiation and analysis, and then are usually used clinically. Therefore, upper/lower syndrome differentiation is the medical concept deriving from yin/yang. However, it exceeds mechanical space-time concept, also has the meaning of‘principle’ to guide syndrome differentiation and treatment. Thus, raising an issue that blending the thinking of upper/lower syndrome differentiation into eight principles and other methods of syndrome differentiation, in order to make methods of syndrome differentiation more practical.

Objective To explore the relationship between methylene tetrahydrofolate reductase (MTHFR) gene polymorphism and homocysteine (Hcy),and further to investigate their correlation to coronary heart disease (CHD) in females.Methods This study involved 29 premenopausal women with CHD,57 postmenopausal women with CHD,50 men with CHD and 46 postmenopausal women with non-CHD.All patients underwent coronary angiography.The patients' gender,age,history of hypertension,diabetes and smoking were recorded.The plasma Hcy level,blood lipids and MTHFR gene polymorphism were examined.Results The level of Hcy in postmenopausal women with CHD was (18.11±7.21)μmol/L,which was significantly higher than (15.01±6.53)μmol/L in premenopausal women with CHD,(12.98±5.46)μmol/L in postmenopausal women with non-CHD group and (14.32±6.01)μmol/L in men with CHD group (t=5.23,3.65,5.08,all P<0.05).The frequency of the MTHFR TT genotype in postmenopausal women with CHD was 28.1% which was significantly higher than postmenopausal women with non-CHD(17.4%)(χ2=5.13,P<0.05),but there was no statistically significant difference with the other two groups.The plasma Hcy level in patients with TT genotype was significantly higher than that with CT or CC genotype in all groups.Multivariate logistic regression analysis showed a significant positive correlation in Hcy and TT genotype.Multivariate logistic regression analysis showed that smoking,Hcy,hypertension and diabetes were independent risk factors for CHD.The odds ratios(OR) of Hcy for CHD was 2.601 (95% confidence interval,1.326 to 5.745).Conclusion Hcy may be an independent risk factor for CHD in females.MTHFR C677T genotype is significantly associated with hyperhomocysteinemia,and its mutation frequency increases significantly in patients with CHD,but MTHFR mutation is not related with the incidence of CHD.

Objective To compare the efficacy of acrossing the injured vertebra percutaneous pedicle screw fixation and traditional open surgery for Magerl A thoracolumbar fractures.Methods Retrospective analysis 56 patients with single segmental Magerl A thoracolumbar fractures without neurological symptoms were stabilized,including percutaneous fixation in 26 cases and open fixation in 30 cases.The operation time,intraoperative,blood loss,incision length,sagittal Cobb angle,height of injured vertebral,VAS,ODI,were compared between 2 groups.Results The precutaneous group less surgical blood loss,incision length and postoperative go to the fields time than the open group (P ＜ 0.05).There were improvements in Cobb angle and anterior height in two groups (P ＜ 0.05).The precutaneous group had lower VAS and ODI scores postoperation (P ＜ 0.05).The fracture vertebral front height and Cobb angle had significantly loss at final follow up than on the third day postoperation (P ＜ 0.05).Conclusions The percutaneous pedicle screw fixation can achieve similar effect in the treatment of Magerl A thoracolumbar fractures without neurological symptoms than open surgery,with less iatrogenic injury,less intraoperative blood loss and quick recovery for patients.

Objective To investigation effect of glucocorticoid combined with Qingkailing injection on lobar pneumonia IL-10 and serum TNF-levels.Methods 120 cases of lobar pneumonia in children were selected respiratory department fromasin our hospital in December 2012 to December 2014 as the object of study, were divided into control group and observation group, control group were treated with dexamethasone sodium phosphate injection,the observation group in the control group based on the combined with Qingkailing injection, serum IL-10, TNF-a level and curative effect were compared between the two groups pre-and post-treatment in patients.Results The total effective rate of the observation group was 86.67%, higher than that of the control group, the total effective rate was 70%(P <0.05).Before treatment, the two groups of patients with TNF-αand IL-10 were not statistically significant difference.After treatment, the two groups of patients with TNF-αand IL-10 were decreased, and lower than the control group (P<0.05) .Conclusion Glucocorticoid combined with Qingkailing injection can reduce serum IL-10, TNF-alpha level in lobar pneumonia,has a definite effect.

ABSTRACT:Norovirus infection in human and animals can cause acute viral gastroenteritis .With molecular biology ,cell culture and animal models of development ,the different groups of norovirus genome sequenced ,the virus capsid protein ex‐pressed in vitro in eukaryotic ,prokaryotic and plant systems ,and thus the characteristics of the virus with some new under‐standing and perspective .Recently ,an increasing number of studies were focused on the norovirus and related topics along with the research progress all around the world .Here we systematically expound the latest advances in norovirus research from dif‐ferent aspects ,such as genome structure and function ,cell culture ,tissue tropism ,epidemiology ,virus infection mechanism , detection methods and vaccine development .Furthermore ,different viewpoints for norovirus molecular evolution ,detection technology and transmission route will be discussed as well .

BACKGROUND:Articular capsule ligaments can lead articular surface to move normally and limit the excessive movement, especially to prevent any non-physiological movement. They are the important structures for stabilizing hip joints. It was previously thought that articular capsule should be routinely resected in the total hip arthroplasty (THA). OBJECTIVE: This study was designed to investigate the effect of retaining articular capsule in THA through posterior approach on maintaining hip stability. DESIGN, TIME AND SETTING: This study, a retrospective case analysis, was performed on 61 patients with femoral neck fracture, who received treatment in the Department of Orthopedics, Xiangya Second Hospital of Central South between January 2005 and December 2006. PARTICIPANTS: Twenty-nine patients who underwent THA with retaining articular capsule from January to December 2006 were included as retaining group, and thirty-two patients who underwent THA with routine resection of partial articular capsule were included as routine group. The two groups were kept identical in case selection, prosthesis selection, post-surgery processing and operators. METHODS: Four holes were drilled on greater trochanter on the proximal femoral bone. The superior part of articular capsule valve was sutured to the superior part of original articular capsule using No.1-0 absorbing thread, then sutured to base of femoral neck in mattress manner, and the suture was not ligated. The inferior part of articular capsule valve was sutured to the inferior part of original articular capsule using another suture. And the suture passed through two bone holes on base of femoral neck. The lower limbs were externally rotated and the suture was ligated. Subsequently, the excised extortor was repaired. Prior to and subsequent to suture, hip was slowly bent for 90° and femur was internally rotated for45°to investigate the suture of articular capsule on strengthening articular stability. MAI OUTCOME MEASURES: Operation time, bleeding volume and hip dislocation after THA. RESULTS: The operation time and bleeding volume were lower in the retaining group than in the routine group (P < 0.05). After THA, hip dislocation did not occur in any patients in the retaining group but occur in 2 patients (6.2%) in the routine group. Statistical tests could not be performed due to less data, resulting in no statistical significance.CONCLUSION: There has been no precise conclusion about the effects of retaining articular capsule or not on hip stability.But retaining articular capsule shortens operation time, reduces intrao-perative bleeding, unable raise operation risk, and re-establishes hip soft tissue balance.

Objective To explorethe complication and its cause and treatment of pace markers implantation in older patients. Methods To analyze the complication in 103 older patients with pace markers implantation. Resuits 5 patients happened complication(4.8 % ), the common complications related to operation were blood effusion and he matoma formation in pocket 4 cases,pocket infection 1 case. Occurrence of blood effusion was related to aspirin administration. Conclusion The older patient with pace marders implantation is safe.

Objective:To study the effect of repeated transient ischemic attacks(TIAs)on cumulative injury of cognitive function.Methods:The cognitive condition of 42 patients with repeated TIAs were assessed after each TIA using the event related potential,modified version of Wisconsin card sorting test,trail making test,digit span task,and verbal fluency test.The cognitive condition was compared and analyzed after different attack times.Results:There were significant differences among the cognitive condition after different attack times,latency and amplitude of P300,and detection rate of mild cognitive impairment.With the increase of the attack times,cognitive impairment aggravated gradually,and the detection rate of mild cognitive impairment increased gradually.Conclusions:Repeated TIAs have cumulative injury on cognitive function.The prevention and treatment of cerebral ischemia may become an important approach in decreasing cognitive impairment.

ObjectiveTo explore the clinical-pathway-based teaching effect in teaching urological postgraduate students in department of urology.Methods36 students were divided to two groups:18 students are the clinical pathway based teaching group, and the other 18 students are traditional teaching group.Examination was used to compare the effect of each teaching method after 6 month.The examination including history collection,physical examination and case file writing,clinical case analysis,clinical operational skills test and basic theory.ResultsThe record of history collection,physical examination and case file writing and basic theory test in clinical pathway based teaching group is not different between the two groups,but the record of clinical case analysis and clinical operational skills test in clinical pathway group is better than the traditional teaching group.ConclusionClinical pathway based teaching can improve the teaching effect of clinical case analysis and clinical operational skills in urological postgraduate students,and can improve the strengthen of clinical thinking and working ability.