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.

ve To investigate the effect of ischemic preconditioning (IPC) on apoptosis induced by acute myocardial ischemia/reperfusion and expressions of Bcl-2 and Bax protein which were known to modulate apoptosis. Methods Twenty-four healthy SD rats of either sex, weighing (200()20)g were anesthetized with intraperitoneal pentobarbital 4.5mg?100g-1. The animals were tracheotomized and mechanically ventilated. Respiratory rate was 20 bpm and tidal volume 2 ml?100g-1. Myocardial ischemia/ reperfusion(I/R) model was established by ligation and untying of the anterior descending branch of left coronary artery. The animals were randomly divided into three equal groups with eight animals each. Group I : (control group) anterior descending branch was exposed and dissected but not ligated and was exposed for 50 min. Group II (I/R group): anterior descending branch was double ligated for 30 min and then untied for reperfusion which lasted 2h. Group III (IPC group): The anterior descending branch was tied for 5 min then untied for 5 min and the process was repeated 4 times according to Murray's method, then I/R was produced as in group II. A piece of myocardium of 2 mm thick was cut from ischemia-infarct area. Apoptotic myocardial cells were detected by TdT-mediated dUTP-biotin nick end labeling (TUNEL) and the expressions of Bcl-2 and Bax protein were measured by immunohistochemical technique. Results I/R increased the percentage of apoptotic myocardial cells and the optical density (OD) value of Bax protein and decreased the OD value of Bcl-2 protein as compared with those in the control group. IPC reduced the increased percentage of apoptotic myocardial cells and OD value of Bax protein induced by I/R and increased the OD value of Bcl-2 protein as compared with those in the I/R group. Conclusions IPC can inhibit the apoptosis induced by myocardial I/R by modulating the expression of Bcl-2 and Bax protein.

Objective To investigate the effect of ondansetron on the analgesic efficacy of tramadol for postoperative patient-controlled intravenous analgesia (PCIA). Methods Forty ASA I - II patients aged 22-74 years, weighing 40-90 kg scheduled for radical mastectomy were randomly allocated to one of two groups : control group ( n = 20) and ondansetron group ( n = 20) . The patients were premedicated with intramuscular atropine 0.01 mg?kg-1 and diazepam 0.2 mg?kg-1. Anesthesia was induced with midazolam 0.1-0.2 mg (total dose was limited to 15 mg), fentanyl 2.4?g?kg-1 , propofol 1.5-2.0 mg?kg-1 and vecuronium 0.12-0.15 mg?kg-1 . The patients were mechanically ventilated after tracheal intubation (VT 8-10 ml?kg-1 , RR 13 bpm). Anesthesia was maintained with enflurane inhalation and continuous infusion of vecuronium. The patients were attached to a PCIA pump after operation and received PCIA with 1 % tramadol (background infusion 2 ml?h-1 , bolus dose 2 ml, lockout interval 10min) in both groups. In ondansetron group the patients received ondansetron 6 mg iv during operation and a loading dose of tramadol 1 mg?kg-1 and ondansetron 2 mg after operation before PCIA. Pain score (VAS 0-10), sedation score (0-3), tramadol consumption and the incidence of nausea and vomiting were recorded at 4, 8, 12 and 24 h after operation. Results There was no significant difference in pain and sedation scores and the incidence of vomiting between the two groups. Significantly more tramadol was consumed at 4, 8 and 12 h after operation in the ondansetron group as compared with control group (P

Objective To evaluate the effectiveness of PGE1 therapy for survival and incidence of complications in patients with liver failure.Methods MEDLINE,EMBASE.com,Cochrane Controlled Register and CBMdisc were searched.Randomized controlled trials of PGE1 therapy for liver failure were collected and reviewed.The quality of articles was evaluated and data was extracted from it.The odds ratio for death and complications among the patients with PGE1 therapy as well as the blank controls was calculated at the end of therapy.The results of meta-analysis were assessed according to sensitivity and bias.RevMan4.2 was applied to process the data.Results The results of meta-analysis showed that PGE1 reduced the case-fatality ratio of liver failure [OR=0.30,95%CI(0.23～0.37)] and the risk difference was decreased 29% in PGE1 patients compared with the blank controls.And there was statistical significance in PGE1 reducing the incidence of hepatorenal syndrome,but occurance of the complieations such as hepatic encephalopathy,bleeding,infection etc.These results were not reversed in the analysis of sensitivity,and the analysis of bias showed little bias of them.Conclusions PGE1 can reduce the case-fatality ratio of liver failure and the incidence of hepatorenal syndrome.The accuracy of the results are low due to the poor quality of the included trials.Thus, the effect of PGE1 on liver failure needs to be further evaluated through randomized controlled trials of high quality to be carried out in multicenter and large samples.

Objective To investigate Bcl-2 expression in the peripheral blood mononuclear cells and its clinical significance of liver fibrosis (LF). Methods Tested Bcl-2 protein levels in T, B cells of 47 patients (male 17, female 30) with LF, 35 patients (male 24, female 11) with chronic hepatitis B and no LF and 41 cases (male 29, female 12) normal controls by two color cytofluorography. Results Among them, LF patients, chronic hepatitis B without LF and normal controls, the proposition of T cells (including CD3~+, CD4~+ and CD8~+ subgroups) and CD19~+ B cells expressed Bcl-2 protein increased significantly in LF patients (P

Objective To analyze the etiology and the clinical characteristis of fever in older patients in Wenzhou.Methods Totolly 87 cases admitted to the First Affiliated Hospital of Wenzhou Medical College from January 2001 to April 2004 were retrospectively analyzed;all cases displayed fever as the major clinical manifestation and met the criteria of fever well.Results The etiology of fever which was infectious disease was in 44 of the 87 cases,accounting for 50.6%,collagen-vascular diseases 4.6%,neoplasms 10.3% and miscellaneous diseases 5.7%.In 28.7% of the cases the etiology could not be found.And in the infectious disease the tuberculosis accounted for 13.6%(6/44). Ultrasonography ,X-rays,CT scan,MRI,the marrow puncture and biopsy contributed to the final diagnosis in 21.1%,16.9%,63%,0,16.7% and 57.1% of the cases,respectively.Conclusion Because the symptoms of the older patients'febrile diseases are atypical,the diagnosis is more difficult.Infectious disease still remains a major cause of the fever in the elderly.A thorough history of disease,full physical examination of the patient and routine laboratory studies,especially erythrocyte sedimentation rate,are very important in determining the etiology of febrile disease.Early and reasonable use of non-invasive imaging techniques and the essential invasive methods are helpful to diagnosis.

Objective To evaluate the role of antidepressants in the treatment of functional dyspepsia (FD). Methods 90 cases of FD with anxious depressive manifestations were randomizely allocated into antidyspepsia group, antidepressant group and antidyspepsia and antidepressants combination group. All patients were treated for 8 weeks. Results FD scores(upper abdominal distention, satiety, abdominal pain, belching) with Zung depression scale and HAMD scale decreased after treatment in all three groups. Symptoms in combination group improved with a total efficacy rate of 86.7%, and HAMD efficacy rate 86.7%. Both were much higher than those in antidyspepsia group(36.7% and 10.0%, respectively, P

Objective To investigate the clinical diagnostic and differential diagnostic values of antisense non-coding RNA in the INK4 locus (ANRIL) and tumor suppressors (p14ARF, p15INK4b and p16INK4a) mRNA expression levels in peripheral blood lymphocytes of patients with cirrhosis and hepatocellular carcinoma. Methods The patients with hepatocellular carcinoma and cirrhosis admitted in Shantou Central Hospital from October 2013 to April 2014 were selected. The real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR) was used to detect ANRIL, p14ARF, p15INK4b and p16INK4a mRNA expression levels of peripheral blood lymphocytes. The subjects having taken physical health examinations in outpatient clinics were assigned in the healthy control group. Results During the study period, 19 cases of hepatocellular carcinoma, 24 cases of cirrhosis, and 31 healthy controls were finally enrolled. In the hepatocellular carcinoma group, the mRNA expression level of ANRIL was significantly higher than that of the healthy control group (?Ct:13.07±0.62 vs. 12.45±0.84, P<0.01), while p15INK4b mRNA expression level was obviously lower than that of the healthy control group (13.24±0.98 vs. 13.99±0.99, P<0.05). But there were no significant differences in the mRNA expression levels of ANRIL (13.07±0.65 vs. 12.71±0.76) and p15INK4b (13.24±0.98 vs. 13.55±1.08) between the groups of hepatocellular carcinoma and cirrhosis (both P>0.05). There were also no statistically significant differences in p14ARF and p16INK4a mRNA expressions among the three groups (all P>0.05). Conclusion The elevation of ANRIL and descent of p15INK4b mRNA expression levels in peripheral blood lymphocytes in patients with liver lesion can be used as the reference indicators for the early diagnosis of hepatocellular carcinoma and to predict their prognoses.

Objective To analyze factors influencing β-blocker response rates of patients with portal hypertension and to explore the effect of nursing interference for increasing response rates with goal-directed nursing model. Methods 83 cases of portal hypertension were enrolled.Questionnaire about medical visiting behaviors and medication compliance were compared and analyzed after routine medication for 3 months.Bivariate and multivariate regression analysis were performed and related factors were used to establish a goal-directed nursing model for nursing interference guidance.52 non-response patients were randomly divided into the study group(27 cases)and the control group(25 cases).In the study group,compensation system and supportive-education according to Orem model were given,while the control group was given routine nursirng.Response rates and related factors were compared after 3 months of nursing intervention. Results Awareness of self-care responsibility,knowledge about the medication target,risk of sudden drug withdrawal,related medical knowledge,ability for pulse rate measurement and dose adjustment according to pulse rate changes were related to the response rates.Multivariate regression analysis showed that awareness of self-care responsibility,sudden drug withdrawal,utilization of social support and regular return visit were the independent factors.In the study group,ability for pulse rate measurement and dose adjustment acconding to pulse rate changes improved,phenomenon of sudden drug withdrawal declined and response rate increased,comparing with the control grpup. Conclusins For patients fail to respond to β-blockers,compliance behavior and medication compliance should be analyzed,and much attention should be paid to the education of the related medical knowledge,risk of sudden drug withdrawal and drag using targets.Goal-directed medel could be a guidance for nursing intervention to increase the response rates.