Objective To investigate the clinical features and prognosis of elderly patients with acute panereatitis.Methods One hundred and twelve elderly patients with acute pancreatitis were included in our study.The clinical features and prognosis were compared with those of the 120 non -aged patients with acute pancreatitis during the same period.Results Cholecystolithiasis was the most common etiology of acute pancreatitis in both groups[81 cases(66.3%) in aged group,70 cases (58.3%) in non-aged group].Abdominal pain was the most common symptom in both groups, followed by fever.Two elderly cases were diagnosed only by autopsy because of mild abdominal pain and rapidly attack of shock.There were 31 cases with severe pancreatitis in aged group and 14 in non -aged group (P

Objective To evaluate the efficacy and safety of transdermal fentanyl path ( Durogesic, Xian Janssen) in patients with moderate to severe chronic non-cancer pain. Methods This open prospective study was approved by the Ethic committee of the hospital. After obtaining written informed consent we studied 46 ASA I - H patients (24 male, 22 female), aged 36-82 yr, suffering from moderate to severe chronic non-cancer pain. Durogesic 25 fxg/h was used. The patch and the site of application were changed every 3 days. The dose was adjusted to the level of pain reduction and side effects. The treatment was maintained for 2-4 weeks. The pain intensity measured using VAS, quality of life including appetite, mental state and sleep etc and side effects were recorded.Results Thirty-eight of the 46 patients completed the trial. The other 8 patients withdrew from the trial because of side effects. Durogesic significantly decreased pain (P

Objective To construct an recombinant adenovirus vector of vascular endothelial growth factor small interfering RNA(Ad5-VEGFsi) and to observe its inhibitory effect on the cell proliferation of human leukemia K562 cells. Methods The specific human VEGF siRNA was subcloned into the shuttle plasmid pSES-HUS and then cotransfected with plasmid pAdeasy-1 to produce pAd5-VEGFsi by homologous recombination. The identified recombinant plasmid pAd5-VEGFsi was packaged and amplified in 293 cells. At 72 h after the transfection of Ad5-VEGFsi into K562 cells, VEGF mRNA expression and the protein level of VEGF in the cell culture supernatant were determined by RT-PCR and ELISA, respectively. Cell proliferation was measured by MTT assay and cell apoptosis by flow cytometry. Results The recombinant adenovirus Ad5-VEGFsi was successfully constructed. Ad5-VEGFsi with the titer of 4.6?1011 pfu/ml was harvested by CsCl gradient purification. Compared with those in the control, EGF mRNA in cells decreased by 66.55% (P

Objective To analyze the main clinical manifestations of intestinal lipoma and discuss the treatment of intestinal lipoma.Methods The clinical data of 19 patients with intestinal lipoma treated in our hospital in recent 15 years were analyzed retrospectively.CT,ultrasonography,and colonoscopy were used in diagnosis.Local intestinal resection by laparoscopy and laparotomy were employde.Results Intestinal lipoma presented with a variety of symptoms including intestinal bleeding,abdominal pain,anemia,intussusception,and bowel obstruction.In 17 of the intestinal lipoma patients,the main clinical manifestations were change of bowel habits,abdominal pain and bloody stool;13 of them had intestinal intussusception or obstruction,and two patients were asymptomatic.Sixteen patients underwent colonoscopy,and seven of them were correctly diagnosed.Seventeen patients received surgical resection and recovered.The diameter of mass was 3-6.5 cm.The pathologic exam showed submucosal lipoma in 12 cases,two cases showed ulcer formation with erosion,2 cases had intermural lipoma and one case had atypical lipoma with potential malignant transformation.Two asymptomatic patients diagnosed by colonoscopic biopsy werre only followed up at regular intervals.Conclusions Imaging diagnosis and colonoscopy are helpful in the preoperative diagnosis of intestinal lipoma.The method of treatment is based on the size of the tumor and presence or absence of pedicle.Endoscopic electrosection is often used for tumor mass less than 3 cm in diameter,otherwise local intestinal resection is the treatment of chocie.

Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.

Objective To explore the effects of inhibiting DDR2 expression by siRNA on hepatic stellate cells and evaluate the role of DDR2 gene in hepatic fibrogenesis. Methods (1) Three pairs of chemically synthesized siRNAs targeting DDR2 were respectively transfected into HSC-T6 cells for evaluation of silence efficacy, and the most effective siRNA was used. (2) HSC-T6 cells were divided into three groups, group A served as normal controls, group B served as negative control and group C was RNA interference DDR2 (siRNA-DDR2) expression of HSC. The most effective RNA interference sequences targeting DDR2 gene was chosen to transfect HSC-T6 cells by plasmid transfection. The tendency of DDR2, α-smooth muscle actin(α-SMA) and collagen-Ⅰ mRNA expression were estimated using RT-PCR, and the protein expression of DDR2 was evaluated by Western blot. Meanwhile, MTT assay was employed to analyze the proliferation of HSC. Results (1) DDR2 siRNA, which began at nt 868, inhibited DDR2 gone expression stronger than the other two siRNAs. (2) After transfection of siRNA-DDR2, the mRNA expression of DDR2 (P<0.01) and α-SMA (P<0.01) significantly decreased compared with the normal group, and the protein expression of DDR2 also significantly decreased (P<0.01). In addition, the proliferation of HSC was also markedly suppressed as compared with the normal group (P<0.01). However, compared with the negative control group, none of them was markedly suppressed. Conclusion SiRNA targeting DDR2 significantly suppresses the activation, proliferation of HSC, and thus attenuates hepatic fibrogonesis in vitro.

Objective To explore the psychological availability of the full-time candidates for master degree of nursing during the clinical work. Methods A phenomenological approach was adopted in this study. About 11 full-time candidates for master's degree of nursing took part in the semi-structured and in-depth interviews and the acquired data were analysed. Results About 4 themes promoting psychological availability were identified: strong research knowledge and skills, career development confidence, perception of attention from leaders and more satisfactory salary. The four themes hindering psychological availability were:clinical work tasks, lower level of expertise, lack of social support and lower perception of self benefit. Conclusions The full-time candidates for master's degree hold active perception and much expectation about their clinical work but meanwhile they feel passive and disappointed. Nursing administrators should develop distinguishing and definite clinical personnel training and continuing education programs for them, offer them an access to learning chances and emotional support in order to improve the psychological availability and stabilize the nursing team.

Objective To investigate the combination of centralized and decentralized approachesin clinical teaching,in order to improve the teachingway and enhance the clinical quality for the trainees of obstetrics and gynecology.Method Conducting the questionnaire survey with 205 students of obstetrics and gynecology who are interns involving in this clinical method in our hospital. Results Trained by this way,82.9 percent of students believe that they fully understand the true meaning of the clinical work. 86.8 percent and 87.8 percent of students think that the quality of clinical practice is improved and their work ability has been strengthened. 88.3 percent of students agree that good communication between them and patients and their family members is increased. Referring to improvement on the understanding between trainees and their teachers,the number is 85.5 percent .92.6 percent of students think that their analytical sense benefits from this method and 86.8 percent of students agree that this model is useful for their problemsolving skills. Conclusion The combination of centralized and decentralized approach in clinical teaching helps students adapt to the work environment in hospital as soon as possible. Students also understand the truth of the clinical work. This method makes interns and patients as well as family members communicate more easily and the ability to integrate theory with practice is greatly improved.

Objective To investigate the expressions of Livin ? and Livin ? in marrow mononuclear cells(MMNCs)of childhood acute leukemia(CAL)and explore the clinical significance.Methods Real-time quantitative PCR and Western blot were used to detect the mRNA and protein expressions of Livin ? and Livin ? in MMNCs of CAL,respectively.Results Both Livin? and Livin? expression rates and expression levels were higher in preliminary diagnosis group(n=51)of CAL,including acute lymphoblastic leukemia(n=39)and acute myeloid leukemia(n=12),compared with the control group(P5%)to induction chemotherapy of ALL than in the patients without chemotherapy(P