Objective To study the clinical features of hyperlipidemic acute pancreatitis(HL-AP)and to en-hyance the awareness of diagnosis and treatment of HL-AP. Methods To Retrospective analyse 159 cases with acute pancreatitis (AP), of which 18 cases of HL-AP(HL-AP group), 141 cases of other causes of AP(non-HL-AP group),to compare the age, triglyceride (TG), calcium (Ca2+) levels, blood glucose (GLU), CT severity index (CTSI), acute physiology and chronic health evaluation (APACHE Ⅱ) and the the incidence of combined diabetic ketoacidosis (DKA) in two groups,correlative analysis between TG in HL-AP group and the above-mentioned indicators was car-rird out. Results In addition to significantly decreased Ca22+ , TG, APACHEⅡ score, CTSI points, GLU, and the combined incidence of DKA were significantly increased (both P < 0. 05) in HL-AP group when compared with the control group,TG and APACHE Ⅱ score, CTSI score were positively correlated(P < 0. 05),TG and the Ca2+ was negatively correlated (r = - 0. 795, P < 0. 01). Conclusion HL-AP is not uncommon, mainly patients are young and middle-aged with positively correlated between serum TG levels and the HL-AP lesions, and the condition is more seri-ous and,we should pay attention to the early diagnosis and treatment of HL-AP, main treatment is non-surgical treat-ment.

Objective To investigate the cardiac affects of esophageal dilatation and stent implantation and its possible pathogenic mechanism. Methods One hundred patients who underwent esophageal dilation or stent implantation had investigeted with Hotter tape recorder, vectorcardiogram, oxygen saturation and cardiac enzymes checked at the time prior to. during and after the procedure respectively. Results During the procedure, incidence of frequent ventricular premature beats was 66%, paroxysmal ventricular tachycardia 9 cases; frequent atrial premature heats 73 cases, paroxysmal supraventricular tachycardia 21 eases, myocardial ischaemia 17 cases and hypoxia 69 eases with significant differences comparing with those prior to the procedure(9 cases; 0 case; 7 cases; 0 case; 0 case and 9 eases respectively) but all above changes as well as cardiac enzymes recorded 24 hours after the procedure had no statistical significance comparing with those prior to the procedure. Conclusion There is a high incidence of cardiac arrhythmia and myocardial ischaemia at the time of dilatation and stent implantation. However, most of these changes can subside without intervention 24 hours after the procedure. Pathogenic mechanisms involved may be related to hypoxia duo to the pain provoked by the procedure suggesting close observation is needed during the operation.

Objective To evaluate the endoscopic findings and clinicopathologic characteristics of ischemic colitis and risk factors in older to avoid misdiagnosis. Methods 101 cases with ischemic colitis underwent endosopy within 14 days of onset of symptom in center of our hospital were retrospectively reviewed for their endosopic findings , clinicopathologic characteristics and risk factors. Results The common features of 101 cases included abdominal pain,diarrhea,or bloody diarrhea and hematochezia. Endoscopic visualization of mild ischemic colitis included pete-chial hemorrhages,edematous and fragile mucosa,segmental erythema,scattered erosion,longitudinal ulcerations,and sharply defined segment of involvement. Stricture ischemic colitis was characterised by full-thickness mucosa, lumens stricture and haustrations disappeared. Clinicpathological examination revealed mucosal inflammation accompanied by erosion,granulation tissue hyperplasis and gland atrophy,lamina propria hemorrhage,especially macrophages with he-mosiderin pigmentation in submucosa. Hypertension pressure, diabetes, atrial fibrilation were risk factors for ischemic colitis ( P < 0.05 ). Conclusion Although there was on specific changes on endoscopic findings and pathologic characteristics , but combined with history, was helpfu in diagnosis of ischemic colitis and reducing the misdiagnosis.

AIM: A new type of unsaturated poly (ester-amide) viz maleic anhydride-phthalic anhydride-propylene glycol-neopentylene glycol-hexane diamine copolymer was prepared by melt polycondensation and characterized.METHODS: To use it as biodegradable bone fixation polymer materials, the flexural strength of unsaturated poly (ester-amide) prepared under different heat treatment conditions was measured after depth cross-linking. The degradation and hydrolysis of the polymer were investigated in phosphate buffer (0.1 mol/L, pH7.4) at 37 ℃ and in 0.1 mol/L NaOH standard solution at room temperature.RESULTS: The results obtained indicate that increasing heat treatment time or temperature can dramatically increase the flexural strength of cross-linked unsaturated poly (ester-amide). The maximum flexural strength of the cross-linked polymer containing 50 wt% of cross-linker was 123 MPa. After degradation 3 months, the flexural strength of the cross-linked polymer that contained 50 wt% of cross-linker and was heated at 195 ℃ for 18 hours could maintain as high as 114.3 MPa.Heat treatment conditions and cross-linker content play an important role to control the mass loss of the cross-linked polymer during the hydrolysis. The polymer exhibits bulk erosion property.CONCLUSION: The preliminary results obtained suggested that the copolymer might be used as bone internal fixation material.

Objective Toinvestigate iodine nutrition,thyroid volume and function of children and women in high water iodine areas,and to discuss the cut-off point of water iodine level where should be defined as iodine excessive areas.Methods In iodine excessive townships in Xiaodian and Qingxu Counties of Taiyuan City,all villages were divided to 4 groups according to the concentration of iodine in drinking water:50 ～ ＜ 100 μg/L (Group A),100 ～ ＜ 150 μg/L(Group B),150 ～ ＜ 300 μg/L(Group C) and ≥300 μg/L(Group D),and 2-3 villages were randomly selected from each group as investigation sites.Two hundred children aged 8-10 and 60 women (20 pregnant women,20 breasffeeding women and 20 women of childbearing age,respectively) were sampled.Drinking water,edible salt and once random urine samples for each studying object were collected,and the iodine content was measured.The goiter volume of children aged 8-10 and triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH) of women were determined.Results Totally 708 children and 236 women were selected as respondents who ate non-iodized salt.Iodine content in drinking water of children in groups A,B,C and D was 73.8,144.7,258.5 and 501.0 μg/L,respectively,and that of women was 73.8,144.7,242.7 and 485.9 μg/L,respectively.Median urinary iodine of children in groups A,B,C and D was 274.3,312.8,455.6 and 793.5 μg/L,respectively,and that of women was 238.3,235.2,371.6 and 641.6 μg/L,respectively.The median urinary iodine of children and women increased with increasing water content of iodine.The goiter rate of children was 5.6％ (11/196),13.2％ (25/189),12.6％ (20/158) and 10.9％ (18/165) for each group,respectively,which also increased with increasing water content of iodine.In groups A,C and D,the FT3 and FT4 levels[pmol/L:(3.70 ± 0.59),(14.01 ± 2.44); (3.43 ± 0.57),(12.87 ± 2.12); (3.42 ± 0.47),(12.66 ±1.78)] in pregnant woman were lower than those in breasffeeding women[pmol/L:(4.26 ± ±0.57),(14.73 ± 2.36;(4.28 ± 0.40),(14.77 ± 1.19); (4.36 ± 0.65),(15.66 ± 2.84)] and women of childbearing age[pmol/L:(4.80 ±0.50),(17.47 ± 2.11); (4.21 ± 0.48),(15.83 ± 1.64); (4.26 ± 0.52),(15.53 ± 1.81)].With increasing water content of iodine,FT4 level was decreasing and TSH level was increasing gradually in women.Conclusions When water iodine exceeds 100 μg/L,goiter rate of children has increased significantly.Iodine excessive women and children have appeared one after another with increasing water content of iodine.Women incidence of subclinical hypothyroidism risk has increased with increasing water content of iodine,and the detection rate of subclinical hypothyroidism is significantly higher when water iodine is higher than 300 μg/L.The cut-off point of iodine excessive areas should be descend from 150 μg/L to 100 μg/L.

Objective To investigate the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD). Methods Clinical data of 9 patients who underwent LPD operation from September 2014 to February 2017 in the first hospital of Shanxi Medical University were analyzed retrospectively. Results 9 patients attempted LPD, while one required conversation to open procedure. Two cases underwent hand assisted laparoscopic surgery .The average operative time was (553 ± 86.1) minutes, the average amount of bleeding was (333.3 ± 304.1) ml, and the average hospitalization time after operation was (25.3 ± 8.9) d. Postoperative bowel sound recovery time was (3.5 ± 1) d. Postoperative complications included pancreatic leakage in 4 cases (A grade pancreatic leakage in 1 cases, B grade in 3 case), lymph leakage in 1 case, abdominal hemorrhage in 1 case , gastric emptying in 2 cases , and bile leakage in 1 case. All patients with postoperative complications were cured by non operative treatment. Postoperative pathological examination showed that 5 cases had duodenal papillary adenocarcinoma, 1 case had pancreatic ductal carcinoma, 2 cases had common bile duct disruption differentiation of carcinoma, and 1 case had pancreatic head retention cyst. Patients were followed up 3 to 24 months after operation. 1 case of pancreatic duct died 17 months after operation. One case of middle bile duct carcinoma 12 months after surgery had liver and retroperitoneal lymph node metastasis. The remaining 7 cases had no complications. Conclusions laparoscopic pancreaticoduodenectomy is minimally invasive, safe and feasible.

Objective To evaluate the effects of dexmedetomidine or dezocine alone or the combination of the two agents on the emergence agitation in patients undergoing thoracic surgery.Methods Eighty ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 48-75 kg,scheduled for elective thoracic surgery under general anesthesia,were randomly divided into 4 groups (n =20 each):control group (group C),dexmedetomidine group (group DEX),dezocine group (group DEZ) and dexmedetomidine + dezocine group (group DEX + DEZ).In group DEX,dexmedetomidine 0.5 μg/kg was injected intravenously at 15 min before induction of anesthesia,followed by continuous infusion of dexmedetomidine at 0.4 μg· kg-1 · h-1 until beginning of chest closure.Dezocine 0.1 mg/kg was injected intravenously after beginning of chest closure in group DEZ.In group DEX + DEZ,dexmedetomidine 0.5 μg/kg was injected intravenously at 15 min before induction of anesthesia,followed by continuous infusion of dexmedetomidine at 0.4 μg·kg-1 ·h-1 until beginning of chest closure and then dezocine 0.1 mg/kg was injected intravenously.While the equal volume of normal saline was given instead in group C.Flurbiprofen axetil 50 mg was injected intravenously at beginning of skin closure in each group.Venous blood samples were collected for determination of plasma C-reactive protein (CRP),TNF-α and IL-10 levels at 10 min before induction of anesthesia (T1),before skin closure (T2),immediately after extubation (T3) and 15 min after extubation (T4).Side effects such as agitation during emergence from anesthesia were recorded.Sedation was assessed using Ramsay score.Results Compared with group C,the levels of plasma CRP and TNF-α at T2-4 and ratio of TNF-α/IL-10 were significantly decreased,the levels of IL-10 were increased at T2-4,the degree and incidence of agitation were decreased,and Ramsay score was increased in the other three groups (P ＜ 0.05).Compared with groups DEX and DEZ,the levels of plasma CRP and TNF-α at T2_4 and ratio of TNF-α/IL-10 were significantly decreased,the levels of IL-10 were increased at T2-4,and the degree and incidence of agitation were decreased in group DEX + DEZ (P ＜0.05).No side effects such as hypotension,bradycardia,respiratory depression,nausea and vomiting were observed in the four groups.Conclusion Dexmedetomidine or dezocine alone or combination of the two agents can decrease the degree and occurrence of emergence agitation and inhibit the inflammatory response simultaneously,and the combination of the two agents provides better efficacy than either alone in patients undergoing thoracic surgery.

Objective To investigate the nutritional status of iodine among residents and the goiter disease of children in high water iodine areas in Shanxi Province,and to provide a scientific basis for establishment of longlasting control strategies and measures.Methods In 2012,according to the historical monitoring data,in the 10 high water iodine counties (citys,districts),one town was selected based on its location (east,west,south,north and middle) in each county (citie,district).In county (city,district) with 5 townships or less,all townships were selected.Four villages were selected in each township and fifteen residents in each village were selected to test salt iodine level.In five high water iodine counties (city,district),one or two high water iodine villages were selected,water samples were collected and the iodine content was measured; one hundred students aged 8-10 years old were chosen to examine their thyroid size.Thirty children were chosen from above students to collect their urine samples and to determine the iodine content.Results In 10 high water iodine counties (citys,districts),1 680 salt samples were tested.The rate of non-iodized salt was 85.2％ (1 432/1 680); in six villages of five high water iodine counties (citys,districts),the median of urinary iodine of 256 children aged 8 to 10 was 487.2 μg/L; in three villages which had improved the quality of water,the median of urinary iodine was 271.0 μg/L; other three villages which had not improved the quality of water,the median of urinary iodine was 692.6 μg/L.In those villages which had not improved the quality of water,urinary iodine of children ≥300 μg/L accounted for 85.8％ (139/162); in those villages which had improved the quality of water,high urinary iodine of children accounted for 41.5％ (39/94),and the difference was statistically significant (x2 =53.06,P ＜ 0.05).The thyroid was investigated among 591 children aged 8-10 years old,and the goiter rate was 6.6％(39/591).In those villages which had improved the quality of water,the goiter rate of children was 3.8％ (11/291),but in villages which had not improved the quality of water,the goiter rate of children was 9.3％ (28/300),and the difference was statistically significant (x2 =6.52,P ＜ 0.05).Conclusion The iodine nutrition level of residents in high water iodine areas in Shanxi is excessive,children's goiter disease has not been effectively controlled; water improvement to reduce iodine is the basic way to control the disease of high iodine.

Objective To analyze the effect of adjustments of control strategy on epidemic trend of iodine deficiency disorders (IDD) in Shanxi Province after universal salt iodization (USI),and to provide basis for timely adopting targeted control countermeasure and scientifically adjusting intervention strategy.Methods A method of retrospective analysis was performed to collect data from IDD surveillance at national or province levels after 1995,and from iodized salt surveillance of the province after 2004.According to the statistics and analysis of children's goiter rate,median urinary,median and mean of salt iodine,coverage rate of iodized salt,qualified rate of iodized salt,consumption rate of qualified iodized salt and their relationship.Results Since 1995,the children's goiter rate by palpation and B-ultrasound showed a steady descending trend.The median salt iodine,mean salt iodine and children's median urinary iodine showed a trend of rise→decline→stable→decline.Namely:The three indicators began to rise year by year from 1995 (29.1 mg/kg,31.7 ± 15.0 mg/kg,199.3 μg/L),in 1999 (48.7 mg/kg,53.4 ± 29.4 mg/kg,407.5 μg/L) reached its climax; and then decreased,in 2001 (34.7 mg/kg,36.2 ± 11.9 mg/kg,282.1 μg/L)stoped; which were basically stable from 2001 to 2011; since 2013 (26.0 mg/kg,26.5 ± 6.3 mg/kg,192.0 μg/L),a significant decline began.The rate and edible rate of qualified iodized salt showed a trend of decline→rise→stable.Two indexes began to decline circuitously from 1995 (72.61％,68.25％),and dipped to a low point in 1999 (44.80％,43.67％); then began to rise,until 2002 (94.73％,91.80％) reached basic stability; and remained steady from 2002 to 2013.Conclusions Following the process of prevention and treatment of IDD for more than 30 years in Shanxi Province,with the depth understanding of the range of adequate iodine nutrition,according to the monitoringfeedback mechanism,the strategy of salt iodization has been adjusted several times,the target of continuous elimination of IDD has achieved since 2000 and the levels of iodine nutrition in population are more reasonable.Salt iodization strategy should continue to adhere to.