Objective To compare the therapeutic effects of continuous veno-venous hemofiltration (CVVH) versus repeated intermittent veno-venous hemofiltration (RIVVH) on patients with severe acute pancreatitis (SAP).Methods Fifty-six patients with SAP were randomly divided into the CVVH group (n =28) and the RIVVH group (n =28).The clinical symptoms and signs,the APACHE Ⅱ and MODS scores,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL-6,IL8 before and after treatment,the duration of mechanical ventilation,boosting drug application time,the length of stay in ICU,the surgical intervention rate and the mortality were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment (P ＜ 0.05).The APACHE Ⅱ and MODS scores were all reduced in the two groups after treatment (P ＜ 0.05).When compared with the RIVVH group,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL6,IL-8 were significantly decreased (P ＜ 0.05).The duration of mechanical ventilation,the length of stay in ICU and the mortality were also significantly decreased in the CVVH group (P ＜ 0.05).Conclusions CVVH was more efficacious than RIVVH in the treatment of SAP.

Objective To study the correlation between single nucleotide polymorphism (SNP) of downstream mononucleotide in signal transduction of Toll-like receptors and predisposing genes of rheumatoid arthritis (RA).Methods One hundred and sixty-two RA patients were selected from northern part of Han people in China,and 188 healthy subjects were enrolled as normal controls.Rs7744 of Myd88,rs5030445 of TRAF6,rs11265618 and rs4845626 of IL-6R were analyzed.The data of genotypic frequency and allele genotypic frequency were statistical analyzed by x2 test between the two groups.Results The difference of allele frequency of TRAF6 rs5030445 between the two groups were remarkable (x2=5.716,P＜0.05),and so did the IL-6R rs11265618 (x2=5.704,P＜0.05).But the difference of genotypic frequency was not statistically significant for locus of Myd88 rs7744,TRAF6 rs5030445 and IL-6R rs11265618 (P＞0.05).And the differenceof allele frequency and genotypic frequency between the two groups had no statistical significance in locus of Myd88 rs7744 and IL-6R rs4845626 (P＞0.05).Conclusion There is significant correlation between single nucleotide polymorphism and predisposing genes of RA.The G allele of TRAF6 rs5030445 gene locus is a possible predisposing gene for RA.The T allele of IL-6R rs11265618 is a possible predisposing gene of RA.

Objective To evaluate the effect of different blood purification modes on patients with hyperlipidemic pancreatitis (HLP).Methods 28 patients with HLP in our department were enrolled into this study from January 2010 to June 2013.The patients were randomly divided into the HP/CVVH group (15 patients) and CVVH group (13 patients).The clinical symptoms and signs of the two groups were observed.The plasma levels of TNF-α,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score before and after treatment were compared between the two groups.The duration of mechanical ventilation,ICU stay and mortality rate were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment.The plasma levels of TNF-α,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score were all reduced.However,the plasma levels of TNF-o,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score in the HP/CVVH group were lower than the CVVH group at the same time points,showing significant differences (P ＜ 0.05).The duration of mechanical ventilation,ICU stay and mortality rate decreased in the HP/CVVH group (P ＜ 0.05).Conclusions HP/CVVH was more efficacious in the treatment of HLP.

Objective To evaluate the value of covered self-expending metallic stent in the management of malignant esophageal and duodenal strictures or fistulas and explore the treatment for the associated common complications.Methods With interventional procedure under fluoroscopic guidance,95 self-expending mesh stents were implanted in 87 patients,including esophageal carcinoma(50 cases),esophagogastric anastomotic stenosis(23 cases),gastroduodenal malignant stenosis(5 cases),esophagobronchial fistula(3 cases),esophagogastric anastomotic fistula(6 cases).Results Stent placement was successful in all patients at the first trial,having no instant complication except one acute bleeding during the procedure and all of them with relief of stenostic complaint,restoration of clictelic function and closure of fistulas.The long-term curative effect showed something to do with different kind of disease,and the related treatment.Conclusion Self-expending metallic covered mesh stent is safe,effective and less complication;and could be further promoted with addition of radiotherapy and(or)chemotherapy.

Objective To evaluate the value of covered metallic stent and arterial embolization in the management of pseudoaneurysm of extremities or kidneys.Methods Endovascular covered stent graft was inserted for isolation of peripheral extremity pseudoaneurysm in 3 patients and intraarterial embolization was performed with gelfoam in 2 patients for pseudoaneurysm in kidney.Results All 5 pseudoaneurysms kept occluded after the treatment.Distal arterial pulse was normal in 2 patients treated with stent graft;new thrombosis formed within the stent during the procedure but disappeared after thrombolytic therapy through catheter in 1 case;and still another new pseudoaneurysm presented at puncture site in 1 other case due to other factors.Conclusions Pseudoaneurysms in extremities or kidneys can be effectively treated with interventional techniques of covered stent graft and percutaneous arterial embolization.The long-term investigation is needed.

We investigated the effects and optimal treatment frequency of pulsed electromagnetic fields (PEMFs) on postmenopausal osteoporosis (PMO). A comparison was performed with the cyclical alendronate and a course of PEMFs in the treatment for postmenopausal osteoporosis on bone mineral density (BMD), pain intensity and balance function. There was no significant difference between the two groups on mean percentage changes from baseline of BMD within 24 weeks after random treatments (P > or = 0.05). However, at the ends of 48 weeks and 72 weeks, the BMD of the PEMFs group were significantly lower than that of the alendronate group (P < 0.05). No significant difference was detected between the two groups with regard to treatment effects on Visual Analogue Scale score, the Timed Up & Go Test and Berg Balance Scale score. Compared with cyclical alendronate, a course of PEMFs was as effective as alendronate in treating PMO for at least 24 weeks. So its optimal treatment frequency for PMO may be one course per six months.
Alendronate ; therapeutic use ; Bone Density ; Bone Density Conservation Agents ; therapeutic use ; Electromagnetic Fields ; Female ; Humans ; Magnetic Field Therapy ; Osteoporosis, Postmenopausal ; therapy

OBJECTIVE To establish and optimize the detection of highly pathogenic influenza virus H5N1 subtype by RT-Multiplex (RT-M) PCR method. METHODS The viral RNA was reversely transcripted with universal primer,and the cDNA was sequenced and analyzed. According to the cleavage site of H5 and the conservative sequence of N1,designed two pairs of specificity primer,RT-M PCR was developed by these primers. Then verified the sensitivity of method and its specificity by detecting comparing with NDV,IBV and IBDV. RESULTS The results of H5N1 gene sequence showed the high homology with the Anhui H5N1 strain [avian influenza A/Anhui/1/2005 (H5N1)] after comparing in the GenBank. Two fragments of 302 bp and 567 bp were amplified by RT-M PCR. The method could detect 0.500 pg virus RNA at least,and own high specificity. CONCLUSIONS This method can be used for highly pathogenic avian influenza.

Objective To evaluate the diagnostic and therapeutic value and safety of transcatheter arterial angiography and embolization in patients with endoscopic refractory gastrointestinal bleeding.Methods Thirty-one cases of endoscopic refractory gastrointestinal bleeding were performed DSA and treated with transcatheter arterial angiography and embolization.The safty and efficacy was evaluated.Results Angiographic positive rate of bleeding was 80.65％ (25/31);28 cases was treated with embolization.The success rate of first embolization was 75.00％ (21/28),and the total success rate was 82.14 ％ (23/28) by the second embolization.Seven patients received surgical resection after interventional therapy,including 2 cases of jejunal stromal tumors and 5 cases of gastric malignant tumors.Four cases of gastric cancer patients underwent rebleeding within 30 days after interventional therapy,of which 2 died of heart or lung function failure due to basic diseases.Except for 1 patient of anastomotic bleeding after gastrointestinal anastomosis occurred anastomotic fistula after embolization,who recovery with the support treatment,no other cases occurred serious gastrointestinal ischemic necrosis.Conclusion Interventional diagnosis and treatment for gastrointestinal bleeding hemostasis is effective and safety,and also can achieve good results especially for malignant gastric tumor hemorrhage,which can be used for endoscopic refractory gastrointestinal bleeding patients.

Objective: To evaluate the predictive value of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) on short term prognosis in patients with acute coronary syndrome (ACS). Methods: Plasma NT-proBNP levels were measured in ACS patients within 24 h after admission with ELISA method. The 600 ACS patients were divided into two groups: event group （n=108）and no-event group （n=492）according to occurrence of cardiovascular events（including cardiac death, cardiac shock and heart failure）, The NT-proBNP levels were compared between two groups. Single factor and multiple factor Logistic regression analyses were used to evaluate if NT-proBNP was an independent predictor for short term prognosis. Results: The plasma NT-proBNP levels of event group were significantly higher than those of no-event group [1361.2 (965.3, 2088.6) pmol/L vs.605.7 (274.5, 1177.8) pmol/L, p<0.01]. Multiple factor Logistic regression analyses demonstrated that plasma NT-proBNP was an independent predictor for short term prognosis (OR=1.000, p<0.01) in ACS patients. Conclusion: Plasma NT-proBNP was an independent predictor for short term prognosis in ACS patients.

Objective To cxplore the variation of the range of motion (ROM) of operative level after different heights of artificial cervical disc replacement,and to provide guidance for clinical work in selecting appropriate height of artificial cervical disc prosthesis.Methods The preoperative cervical anteroposterior and lateral Ⅹ-rays of 9 fresh male cadaveric cervical spine specimens were obtained to measure the intervertebral height of C5-6,and 3 screened specimens with the height of about 5 mm were included in the experiment.The experiment was designed to test self-control,and other four groups of cervical specimens including intact group,appropriate height (5 mm) of C5.6 artificial cervical disc replacement group,1mm increased (6 mm) group and 2 mm increased (7 mm) group were made biomechanical test sequentially.The specimens were fixed to the cervical three-dimensional movement machine,with a 75 N follower load and pure moments of 2 Nm for flexion/extension 、left/right bending and left/right axial rotation,to measure the ROM of operative level under the condition of changes in 0.2 Nm/s.Results There were no significant differences in the ROM of flexion/extension,lateral bending and axial rotation between 5 mm group and intact group;the ROM of flexion/extension、lateral bending and axial rotation in 6 mm group increased compared with 5 mm group,but the difference was not statistically significant;the ROM of flexion/extension in 7 mm group was significantly less than that of intact,5mm and 6 mm group (9.5°± 1.0° vs 12.5°±0.9°、11.3°±0.8°、11.6°±0.9°),but significantly greater in axial rotation than 6 mm group (10.4°±1.4°vs 8.6°±0.3°),and there was no significant difference in lateral bending compared with other 3 groups.Conclusion 2 adjacent heights of cervical disc prostheses are implantedsuitably when testing the mold of disc prosthesis,the choice of cervical disc prosthesis with 1 mm increased can improve the ROM of operative level to some extent;while the height with 2 mm increased can lead to the ROM of flexion/extension at the operative level reduced,but the ROM of rotation shows an increasing trend.