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 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

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

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 investigate the impact of squamous cell carcinoma antigen(SCCAg)in patients with recurrent squamous cell carcinoma of the uterine cervix.Methods Totally 72 patients with recurrent squamous cell carcinoma of the uterine cervix treated at the Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,between 1999 and 2005 were retrospectively analyzed to investigate the impact of SCCAg on diagnosis and prognosis by univariate and multivariate analysis.Results This study included 30 patients with recurrent disease after primary radical surgery and 42 patients with recurrent cervical cancer after radio-chemotherapy.Sixty one patients(85%)had serum SCCAg elevated (≥1.5 pg/L),and 20 of these(28%)had an increase of SCCAg before clinical manifestation of relapse.The median leading time was 3 months(range:1-13 months).Forty five patients had no symptoms with only SCCAg elevation,and 15 patients experienced leg edema and(or)sciatic pain,7 patients suffered from irregular bleeding and 5 patients had symptoms resulting from distant metastasis.Thirty three patients were diagnosed by histology biopsy and (or) cytology,39 patients were diagnosed with SCCAg elevation and clinical and radiological examinations,29 of these patients were diagnosed only by SCCAg elevation and CT or MRI.Fourteen patients recurred limited to the cervix or to the cervix and adjacent tissues(central recurrence),31 cases recurred at pelvis,and 20 patients with distant metastasis and 7 patients suffered from Pelvic recurrence and distant metastasis.Twenty three cases received salvage therapy including surgery for patients recurring after definitive radiotherapy and radiotherapy and or conform radiotherapy for patients after primary radical surgery,46 patients were given palliative chemotherapy and or radiotherapy,and 3 patients refused any treatment.The median and mean survival time were 11 months and 23 months respectively(2-62 months).The 3-year,5-year overall survival rate were 25%and 19%respectively.Univariate analysis showed SCCAg elevation before primary treatment,grade,recurrent site,treatment method,SCCAg≥10pg/L,SCCAg elevation during treatment,and SCCAg not within normal after treatment were correlated with 3-year survival rate.Twenty patients had an increase of SCCAg before clinical manifestation of relapse compared with other patients who did not,and the 3-year survival rate was not significantly different (22% vs 27%). Multivariate analysis revealed that only grade and treatment methods were independent risk factors. Conclusion The impact of the SCCAg in recurrent squamous cell carcinoma of the uterine cervix needs further study.

Purpose To estimate and discuss the feasibility of the threshold value of the internal tumor volume (ITV) of lung cancer based on the standardized uptake value (SUV) of the background.Materials and Methods The phantom was designed with 3 vacuous models fixed at the bottom of a barrel. The 3 vacuous models were filled with18F-FDG (55.0 kBq/ml) which represented a tumor and the barrel was filled with18F-FDG (5.9 kBq/ml), which represented the background of the lung. The barrel moved sinusoidally with distances of 10.9 mm, 21.8 mm, and 43.7 mm to simulate breathing, and then the phantom 2D PET/CT data were acquired. The SUV in the background was recorded as ±SD, and+3SD was regarded as threshold value to obtain the measured ITVs. The Dice similarity coefficient (DSC) and volume recovery coefficient (VRC) were used to evaluate the accuracy of the ITVs measured by seven methods, including that by SUV 2.5, 35% SUVmax, 41% SUVmax, a×mSUV70+b×, 0.42×(SUVmax+) and Riegel et al. computed threshold value followed the gross tumor volume, tumor-to-nontumor ratio and motion extent.Results Nine ITVs of three lung cancer models were 134.3 ml, 166.1 ml, 223.5 ml, 86.6 ml, 108.5 ml, 150.7 ml, 32.3 ml, 43.8 ml and 63.6 ml, respectively. The ITV measured by Riegel et al. showed no difference with the real ITV (t=-0.48,P>0.05). The ITVs measured by the other six methods were significantly different from the real ITVs (t=-5.11-2.76,P<0.05). The DSC of the ITV measured by+3SD and the method of Riegel et al. were 0.75-0.92 and 0.69-0.93, respectively; and the VRC were 0.82-0.97 and 0.74-0.96, respectively (differences without significance:t=-0.73,P>0.05). Moreover, they surpassed the results of the other five methods.Conclusion The threshold value (+3SD) of the SUV determined by the background has potential value in the description of the ITV of lung cancer, so as to provide reference for radiotherapy.