Objective To investigate the optimal initial timing of Qingyi Decoction and clyster with rhubarb in patients with severe acute pancreatitis (SAP). Methods Patients with SAP were randomly divided into 2 groups. The group A (n = 34) received clyster with rhubarb and Qingyi Decoction after 12 h of SAP onset and the group B (n = 27) received samel therapy after 72 h of onset of SAP. The serum levels of TNF-α, CRP and APACHE Ⅱ scores, time to abdominal pain cessation, length of hospital stay and medical costs were compared. Results The serum levels of TNF-α and CRP of patients in group A were (265±66)U/ml, (32.1 ±7.1) mg/L, and the score of APACHEⅡ were 6. 3±2.0, time to abdominal pain cessation was (4±2) d, length of hospital stay was (18±5)d, medical costs was (42 000±18 000) yuan; while the corresponding values in the group B were (491±81)U/ml, (43.5±11.0) mg/L, 9.1±1.8, (8±3)d, (34±8)d, (71 000±26 000)yuan, and the difference was statistically significantly (P<0.05). Conclusions Qingyi Decoction and clyster with rhubarb should be given in the early phase of SAP in order to achieve better outcomes.

Objective To evaluate the diagnostic value of combined detection of c-reactive protein(CRP)and cystatin C(Cys C) for early renal function impairment in gout patients,and to provide clinical reference.Methods Two hundred cases of gout patients were investigated and divided into experimental group and control group:experimental group patients(n=100)were with early renal function impairment and the control group(n=100)were without early renal impairment.The concentration of CRP and Cys C were detected with turbidimetric immunoassay method by OLYMPUS AU 400 automatic biochemistry analyzer.Results Serum CRP and Cys C concentrations of gout patients with early renal function impairment were significantly higher than those of gout patients without early renal function impairment(P<0.05).In the group of gout patients with early renal function impairment,the positive rate of serum CRP(75%)and Cys C(81%)had no significant difference(P>0.05).The positive rate of combination detection of CRP and Cys C was 92%,which was significantly higher than either CRP or Cys C(P<0.05).Conclusion The combination detec-tion of CRP and Cys C can improve diagnostis of early renal function impairment in gout patients.

0.05).Pain-disappearing time,anus-bubbling time,and time for gas-fluid plane disappearing were shortened in group C,and drainage volume from nutrient canal during gastrointestinal decompression obviously reduced on the second day as compared with those in groups A and B(P

Objective To investigate the effect of Xiongshang RecipeⅠ(XPI)on serum inflammatory cytokines of tumor necrosis factor (TNF)and interleukin-8(IL-8)in acute pulmonary contusion patients.Methods Thirty acute pulmonary contusion patients were equally randomized into the control group (receiving routine western medical treatment)and the treatment group (received routine western medical treatment and oral use of XPI).The treatment lasted 2 weeks.Thirty healthy physical examinees served as the contemporaneous normal controls.Secondary pulmonary contusion,recovery time and the serum levels of TNF and IL-8 were observed after pulmonary contusion.Results Serum levels of TNF and IL-8 in the treatment group after treatment were decreased(P

目的观察有氧运动训练对老年性原发性高血压病血压的控制作用。方法160例老年性原发性高血压病患者分为轻度训练组、轻度对照组、中度训练组和中度对照组,各组40例。训练组采用有氧运动训练(步行或骑车) 60分钟/次,每周3次;中度患者配合药物治疗。比较训练3个月前后的收缩压和舒张压。结果训练后收缩压和舒张压与训练前相比,各训练组均有显著性差异(P<0.01或P<0.05),各对照组则无显著性差异。而训练组与相应对照组相比亦均有显著性差异(P<0.01或P<0.05)。结论有氧运动训练可有效降低或控制老年性原发性高血压。

Objective To evaluate short and medium term therapeutic effects of VIABAHN-covered stent in treat-ment of arteriosclerosis obliterans in lower extremity. Methods Among all 53 cases of arteriosclerosis obliterans in lower extremity with C/D TASC levels, 22 patients underwent VIABAHN-covered stent (stent group), while the other 31 patients were treated with femoral-popliteal artery bypass grafting surgery (graft group). The arterial patency rates were analyzed 3 and 6 months after the two different surgeries. Results The number of arterial patency cases were 28 (90.3%) at 3 months and 26 (83.9%) at 6 months in stent group while it is 22 (100%) at 3 months and 21 (95.5%) at 6 months in graft group. There were no significant differences in the arterial patency rate at 3 months and 6 months between the two different surger-ies (χ2 is 0.808 and 0.760 respectively, P>0.05). Conclusion VIABAHN-covered stent can be used as the preferred treat-ment for arteriosclerosis obliterans of lower extremity.

Objective To study the efficacy of radical surgery for the invasion of chest wall by lung cancers and the different methods of chest wall reconstruction. Methods A retrospective analysis of clinical data was conducted in 27 cases of lung cancer with chest wall invasion in this hospital. 24 cases received lobectomy, 3 cases received pneumonectomy, and all cases received wall reconstruction. The size of chest wall defect after resection ranged from 6.5 cm × 5.4 cm × 5.0 cm to 15.5 cm × 12.5 cm ×10.0 cm. The number of rib resection for each patient ranged from 1 to 4. The reconstructive methods were as follows: using polyester fabric to reconstruct costal pleura, using plexiglass, stainless steel wire and grid-like titanium plate to reconstruct bone defect, and using nearby muscle flap and pedunculated muscle flap to reconstruct muscle defect. Results Pathologic diagnosis was non-small cell lung cancer,including 22 cases of squamous cell carcinomas and 5 adenocarcinomas. There were pulmonary infections in 6 cases, chest hemorrhage in 1 case and chest purulence in 1 case. One-year survival was 77. 9 %,3-yearsurvival was 58.3 %, and 5-year survival was 29. 1 %. Conclusion The lung cancer with chest wall invasion is advisable to make active use of radical surgery. The different methods and repair materials are chosen to reconstruct the chest wall defect, supplemented by comprehensive treatments.

Objective To compare and discuss the clinical application effect of the end-to-end anastomosis of pancreatic and intestinal anastomosis,binding type of pancreatic and intestinal anastomosis,end-to side pancreatic duct anastomosis and modified pancreatic duct jejunum anastomosis.Methods Collected pancreatoduodenectomy in 95 cases,the end-to-end pancreatico duodenal sleeve type anastomosis in 23 cases,binding type pancreatic enteric anastomosis in 18 cases,end to side pancreaticojejunostomy anastomosis in 28 cases,improvement of the pancreatic duct jejunum end to side anastomosis in 26 cases,compared with four groups of patients with pancreatic enteric anastomosis time and postoperative complications.Results Anastomosis time:A group (34.0 ± 4.6) min,B group (31.0±5.8) min,C group (32.0 ±6.3) min,D group (14.0 ±4.2) min(P=0.037,P＜0.05).And the incidence rate of postoperative pancreatic fistula,bile leakage,abdominal cavity or digestive tract bleeding had no significant difference (P ＞ 0.05).Improvement of the pancreatic tube jejunum end to side coincident with a low incidence of pancreatic fistula,but different pancreatic enteric anastomosis way pancreatic fistula rate difference was not statistically significant,improvement of the pancreatic duct and jejunum mucosa end side group pancreatic enteric anastomosis anastomosis time significantly shorter in the three groups,the difference was statistically significant (P ＜ 0.05).Conclusion Improvement of pancreatic duct jejunum end to side anastomosis with short operation time,low incidence of pancreatic fistula,and the operation is simple and practical,safe.

Objective To investigate the effect of split-bolus spectral computed tomography(CT) on the portal venography and radiation dose.Methods The prospective study was adopted.The clinical data of 119 patients who underwent spectral CT at China-Japan Union Hopital from September 2014 to March 2015 were collected.Patients were randomly divided into the portal venography with split-bolus spectral CT single-phase enhanced scan group and portal vein multi-phase scan group by random sequence method.In the portal venography with split-bolus spectral CT single-phase enhanced scan group,the spectral CT was used with the method of split-bolus single phase imaging,and in the portal vein multi-phase scan group,standard spiral CT was used to perform three-phase scan.Two observers evaluated CT portal venography subjectively and objectively,measured CT values,contrast to noise ratio (CNR),signal noise ratio (SNR),and calculated radiation dose.Observed indices included (1) choice of optimal monochromatic images.(2) CT values of portal veins,measurement of CNR and SNR.(3) Subjective scoring of portal venography quality.(4) Comparison of radiation dose.Measurement data with normal distribution were presented as x ± s,comparison between groups was analyzed by independent sample t test.Comparison of count data was analyzed by chi-square test.Results The 113 patients were screened for eligibility,including 59 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 54 in the portal vein multi-phase scan group.(1) Choice of optimal monochromatic images:optimal monochromatic images were abstracted at 60 keV from spectral CT portal venography.(2) CT values of portal veins and measurement of CNR and SNR:the CT values of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were (319 ± 44) HU,(328 ± 53) HU,(294 ± 45) HU in the reconstructed images at the energy level of 60 keV in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (213 ±41)HU,(228 ±49)HU,(210 ±41)HU in the portal vein multi-phase scan group,with significant differences between the 2 groups(t =8.04,6.34,6.82,P ＜ 0.05).The CNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 15 ± 5,24 ± 8,22 ± 7 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 13 ± 4,20 ± 6,19 ± 6 in the portal vein multi-phase scan group,respectively,with no significant difference (t =-1.13,-1.89,-1.51,P ＞ 0.05).The SNR of intrahepatic portal vein,extrahepatic portal vein and branches of portal vein were 31 ± 6,29 ± 6,27 ± 6 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 29 ± 7,28 ± 9,26 ± 6 in the portal vein multi-phase scan group,respectively,with no significant differences (t =-0.688,0.615,0.600,P ＞ 0.05).(3) Subjective scoring of portal venography quality:the subjective score of image quality of portal venography was 14.3 ± 1.0 in the portal venography with split-bolus spectral CT single-phase enhanced scan group and 12.5 ± 1.8 in the portal vein multi-phase scan group,with a significant difference (t =12.43,P ＜ 0.05).(4) Comparison of radiation dose:the radiation dose was (8.1 ± 1.1)mSv of patients in the portal venography with split-bolus spectral CT single-phase enhanced scan group and (17.4 ± 7.5) mSv in the portal vein multiphase scan group,with a significant difference (t =24.14,P ＜ 0.05).Conclusion Spectral CT portal vein imaging combined with split-bolus protocol can achieve better manifestations of portal vein and its branches,and reduce radiation dose in the scanning process.