Acute pancreatitis,a multiple system disease was associated with distant organs injury such as the liver,lung and kidney,etc.Acute renal failure is one of the major death causes in severe acute pancreatitis.Renal injury in acute pancreatitis and its pathogenesis was reviewed to further understand the mechanisms of systemic inflammatory response and multiple organ failure

Hepatocellular carcinoma (HCC)is a disease with high incidence and mortality and has become a serious threat to human health. So far,none of the available markers can be used alone for early diagnosis of HCC.Recently identified serum markers with potential clinical value for early diagnosis of HCC are summarized,and their diagnostic sensitivity and specificity,as well as their applications in assessment of progression of the disease,are reviewed.It is suggested that alpha -fetoprotein should be used in combination with other serum markers to achieve accurate diagnosis of HCC at early stages.

Objective To evaluate the symptom improvement of anxiolytics and antidepressant to hemifacial spasm(HFS)patients with anxiety and depression. Methods A total of 60 HFS patients with anxiety and depression were enrolled for the study and divided into experimental group and control group. Experimental group were treated with escitalopram and BTX-A ,and control group only received BTX-A. SAS and SDS were used to test all the patients before and after treatment. Results Both experimental group and control group were significantly improved after BTX-A therapy. There was no different between two groups at 1 week and 1 month,respectively. At 2 weeks and 3 months,more obvious improvement was seen in experimental group. The SAS and the SDS standard average scores of experimental group were significantly decreased compared with the control group. There was statistical significance in control group after 1 month and 3 months treatment(P<0.05),and in experimental group,the differences appeared after 2-week treatment(P<0.05). Additionally,after 1 month treatment,there were statistical differences between the two groups(P<0.05),and experimental group shown a longer effective period compared with control group. Conclusion Anxiety and depression state serves as a complication of HFS ,which is positively correlated with HFS. HFS patients with anxiety and depression benefit better from escital-opram and BTX-A combination therapy than BTX-A alone.

OBJECTIVE:To observe the effects of Cholinesterase inhibitor combined with Compound haishe capsule on prog-nosis of patients with Alzheimer’s disease (AD). METHODS:210 AD patients were divided into donepezil group,rivastigmine group,galantamine group,Compound haishe capsule group,donepezil + Compound haishe capsule group,rivastigmine + Com-pound haishe capsule,and galantamine + Compound haishe capsule group,30 cases in each group according to visiting order. Donepezil group received Donepezil hydrochloride tablet 5 mg(<1 month)before going to bed,10 mg(≥1 month),po,qd;riv-astigmine group received Rivastigmine hydrogen tartrate capsule 1.5 mg(<1 month)before going to bed,3.0 mg(≥1 month), po,bid;galantamine group received Galantamine hydrobromide tablet 2 mg (<2 weeks),4 mg (2-4 weeks),6 mg (>4 weeks),po,bid;Compound haishe capsule received Compound haishe capsule 3 casuples,po,tid;donepezil + Compound haishe capsule group received Donepezil hydrochloride tablet 5 mg,po,qd + Compound haishe capsule 3 casuples,po,tid;galantamine+ Compound haishe capsule group received Rivastigmine hydrogen tartrate capsule 1.5 mg,po,bid + Compound haishe capsule 3 casuples,po,tid;galantamine+Compound haishe capsule group received Galantamine hydrobromide tablet 4 mg,po,bid+Com-pound haishe capsule 3 casuples, po, tid. The treatment course for all groups was 3 months. Mini-mental state examination (MMSE),AD dementia rating scale (ADAS-cog) and ability of daily life (ADL score) before and after treatment,and TESS score after treatment in all groups were observed,and the occurrence of ADR was observed. RESULTS:There was no statistical significance in MMSE, ADAS-cog and ADL score between 2 groups before treatment (P>0.05).After treatment, MMSE, ADAS-cog and ADL score in all groups were obviously improved;MMSE scores in ChEI combined with Compound haishe cap-sule groups were obviously higher than appropriate ChEI alone groups and Compound haishe capsule alone group,ADAS-cog and ADL scores were obviously lower than appropriate ChEI alone groups and Compound haishe capsule alone group;TESS scores in-cidence of adverse reactions in Compound haishe capsule alone group or combined with ChEI groups were obviously lower than ap-propriate ChEI alone groups and Compound haishe capsule group,the differences were statistically significant (P<0.05). CON-CLUSIONS:ChEI combined with Compound haishe capsule can effectively improve the mental state of AD patients,cognitive function and life activity,with higher safety.

Early diagnosis and early intervention for cognitive impairment after ischemic stroke can delay disease progression and prevent the occurrence of dementia.This article reviews the advances in research on ischemic stroke caused each risk factor for cognitive impairment.

Objective To identify the pathogenic microorganism by MALDI-TOF MS.Methods A total of 560 strains were resuscitated,which included 260 gram-positive bacteria strains,180 gram-negative bacteria strains,60 yeast-like-fungi strains and 60 enteropathogenic bacteria strains.Comparing MALDI-TOF MS with Vitek2 Compact,the discordant results were validated by 16S rDNA sequencing.Results Comparing MALDI-TOF MS with Vitek2 Compact,the coincidence rate was 94.6％ (246/260) for gram-positive bacteria,96.7％ (174/180) for gram-negative bacteria,95％ (57/60) for yeast-like-fungi,and 93.3％(56/60) for enteropathogenic bacteria Fifteen strains were validated by 16S rDNA gene sequencing.Comparing with sequencing,the coincidence rate of two methods was 66.7％ ( 10/15 ) for MALDI-TOF MS and 26.7％(4/11 ) for Vitek2 Compact,respectively.Conclusion MALDI-TOF MS shows rapid turnaround time and modest reagent costs,and it will be another effective tool for microorganism diagnosis.

Objective: To compare the effectiveness of less invasive surfactant administration (LISA) and intubate surfactant extubation (INSURE) on respiratory distress syndrome (RDS) among premature infant, so as to provide insights into improving treatment effects and reducing complications of RDS among premature infants. Methods: A total of 71 premature infants with RDS in Anhui Provincial Maternity and Child Health Hospital were randomly assigned into the LISA and INSURE group, and pulmonary surfactant (PS) administration was carried out by LISA and INSURE with basic support therapy and respiratory support therapy. The general information, arterial blood gas analysis before and after treatment, respiratory support time and incidence of complications were collected and compared between the two groups. Results: There were 31 cases in the LISA group, with a gestational age of (29.81±0.99) weeks and 22 male cases, and 40 cases in the INSURE group, with a gestational age of (30.02±1.13) weeks and 26 male cases. There were no significant differences in basic characteristics (including gestational age, birth weight, gender, etc.) between the two groups (all P>0.05). After administration, the level of PaO2 was lower in the LISA group than in the INSURE group [(78.35±6.55) mmHg vs. (87.68±8.21) mmHg, P<0.05], the level of PaCO2 was higher in the LISA group than in the INSURE group [(43.03±6.34) mmHg vs. (38.68±9.69) mmHg, P<0.05], and the incidence of bronchopulmonary dysplasia was lower in the LISA group than in the INSURE group (48.39% vs. 72.50%, P<0.05). Linear regression analysis showed that with the duration of LISA administration increase (2-7 min), the minimum heart rate of premature infants increased linearly (β=13, P<0.05). Conclusions Compared with INSURE, LISA administration could slowly improve ventilation oxygenation, reduce hyperventilation and incidence of bronchopulmonary dysplasia among premature infants with RDS. The incidence of slow heart rate may be reduced by appropriately prolonging the administration duration.

Polymyxin E shows effective treatment of the infection induced by resistant gramnegative bacteria, but its nephrotoxicity severely limits the clinical application of this drug. In this work, methoxypolyethylene glycols 2000 (mPEG2K)-polymyxin E (PME) was synthesized via chemical grafting reaction and had been characterized. The antimicrobial activity and cytotoxicity of mPEG2K-PME in vitro were investigated on Escherichia coli and HK-2 cells, separately. Intra-abdominal infection model was further established in order to study the therapeutic effect and the toxic effect on kidney of mice. The results showed that mPEG2K-PME exhibited significant inhibitory effect on Escherichia coli and had a lower toxicity on HK-2 cells in vitro. At the same time, mPEG2K-PME had a good efficacy in the treatment of Escherichia coli infected mice in vivo. Moreover, nephrotoxicity caused by mPEG2K-PME was significantly reduced compared to free PME. mPEG2K-PME is promising in development of new preparations with high efficiency and low toxicity.

Objective To investigate the clinical indicators which can predict esophageal varices in patients with primary biliary cirrhosis (PBC).Methods A total of 351 patients with PBC from the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2016 were retrospectively analyzed, including 173 patients with esophageal varices and 178 patients without varicose veins.The alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptadase (γ-GT), total bilirubin (TBil), albumin (Alb), prothrombin time (PT), platelet (PLT), AST to ALT ratio (AAR), fibrosis index based on the 4 fator (FIB-4), AST to PLT ratio index (APRI) and Mayo scores were compared between two groups.Group t test or rank sum test was used to compare the two groups.Relation between the indicators mentioned above and esophageal varices were tested by univariate analysis.Multivariate unconditional Logistic regression was used to screen these indicators to independently predict esophageal varices in PBC patients.Results Age, PT, TBil, AAR, FIB-4, APRI and Mayo scores of PBC patients with esophageal varices were all higher than those of patients without esophageal varices ([60.3±10.6] years old vs [51.9±10.9] years old, [13.31±3.12] s vs [11.17±2.42] s, 28.06 [18.05, 60.06] mmol/L vs 15.39 [10.64, 33.63] μmol/L, 1.69±0.91 vs 1.23±0.95, 6.18 [4.05,9.16] vs 1.80 [1.10,2.74], 1.95 [1.12,3.08] vs 0.69 [0.38,1.57], 6.45±1.52 vs4.62±1.53, respectively).Whereas ALT, γ-GT, Alb and PLT levels were all lower than those without varicose veins (36.60 [19.88, 74.28] U/L vs 59.32 [23.58, 132.70] U/L, 71.00 [38.36, 165.38] U/L vs 125.00 [37.50, 336.21] U/L, [29.78±6.33] g/L vs [39.51±25.16] g/L, [103.43±52.84]×109/L vs [234.44±90.40]×109/L, respectively).The differences were all statistically significant (t=-7.25, t=-7.18, Z=-5.823, t=-4.60, Z=-8.427, Z=-12.661, t=-11.25, Z=-3.218, Z=2.987, t=4.94, t=16.63, respectively;all P<0.01).Multivariate unconditional logistic regression analysis showed that PLT<149×109/L (OR=0.966, 95% CI: 0.957-0.974), PT>11.95 s (OR=0.705, 95%CI: 0.569-0.874), TBil>17.19 μmol/L (OR=0.99, 95%CI: 0.982-0.999), FIB-4>3.02 (OR=0.868, 95% CI: 0.807-0.932) and Mayo score>4.88 (OR=6.053, 95%CI: 2.388-15.342) were independent clinical indicators for the prediction of esophageal varicose veins.Conclusions PLT, PT, TBil, FIB-4, and Mayo scores can be used as predictors of esophageal varices in patients with PBC.

Objective To investigate the changes of PTX3,NT -ProBNP level and the correlation between them and the prognosis of the patients with AMI combined T2DM.Methods 143 patients with primary AMI were enrolled,of which 63 patients with type 2 diabetes (observation group)and 80 patients with no diabetes (control group).Plasma PTX3 values were measured with ELISA method and NT -ProBNP was detected by the electrochemi luminescence method.All patients were observed for the occurrence of MACE during hospitalization and 12 months after discharge.The correlation between PTX3,NT -ProBNP concentration and occurrence of MACE in observation group were analyzed.Results The PTX3,NT -ProBNP concentration[(8.95 ±5.06)ng/mL,(1 609 ±1 049)pg/mL]in the observation group were significantly higher than those in the control group[(7.03 ±3.70)ng/mL,(1 198 ± 809)pg/mL](P =0.010,P =0.009);The number(n =26)of patients with occurrence of MACE in the observation group was significantly higher than 15 cases in the control group(P =0.003).In the observation group,the PTX3, NT -ProBNP concentration[(10.98 ±5.45)ng/mL,(2 007 ±1 097)ng/mL]in patients with MACE were signifi-cantly higher than those in patients without MACE[(7.53 ±4.28)ng/mL,(1330 ±930)ng/mL](P =0.007,P =0.010),and in MACE group,the PTX3,NT -ProBNP concentration[(13.88 ±6.84)ng/mL,(2 596 ±1 333)ng/mL] in patients with death weresignificantly higher than those in patients without death[(9.18 ±3.52)ng/mL,(1 639 ± 751)ng/mL](P =0.029,P =0.023).Conclusion More strong chronic inflammatory reaction and serious myocar-dial injury might occur in the patients with AMI combined and T2DM,and those patients would have poorer prognosis. The combined detection of PTX3,NT -ProBNP has an important significance in evaluating of the degree of myocardial damage and the prognosis of the patients with AMI combined T2DM.