ObjectiveTo investigate the effect of early fluid resuscitation on the prognosis of SAP patients.MethodsPatients who were admitted to our hospital within 72 h after the onset of the SAP were enrolled.The parameters for the fluid resuscitation were as follow: heart rate ＜120 beat/h,urine output ≥ 1 ml ·h-1 · kg-1,hematocrit ≤35％ and mean arterial pressure 65 ～ 85 mmHg ( 1 mmHg =0.133 kPa).The effects of different time of reaching fluid resuscitation ( ＜48 h,48 -72 h,＞72 h) and parameters achieved (0 ～ 1parameter,2 parameters,3 parameters,4 parameters) on the prognosis were analyzed.ResultsThere were 70 patient enrolled in this study and 41 ( 58.6％ ) developed complications,20 ( 28.6％ ) were referred to surgical operation and 10( 14.3％ ) died.The median hospital stay was 23.5 d,and the median medical cost was 71.9(5.7～567.4 thousands RMB).The rates of surgical intervention in ＜48 h,48 ～72 h,＞72 h groups were 20.0％,33.3％,75.0％,and the rates of acute kidney injury were 20.0％,25.0％,75.0％,while the rates of complications were 50.0％,83.3％,100％,and the difference among the 3 groups was statistically significant (P ＜ 0.05 ).The rates of surgical intervention in patients achieving 0 ～ 1,2,3,4parameters within 48h of SAP onset were 50.0％,26.3％,13.0％,25.0％,and the rates of acute kidney injury were 45.0％,31.6％,17.4％,0,while the rates of ARDS were 35.0％,31.6％,13.0％,0,which showing a significant decreasing trend.ConclusionsAn appropriate fluid resuscitation in the first 48 h after the onset of SAP was benefit for improving the treatment effects and patients' outcome.

The paper introduces the current status and the problems of servers in the data center of Institute of Medical Information,Chinese Academy of Medical Sciences,points out the necessity of virtualization in data center,expounds the concept of virtualization and server virtualization technology,then describes the implementation scheme of constructing the server virtualization platform based on VMware vSphere 5.5 products in detail.Finally,the application effect of server virtualization is summarized and the future work is prospected.

Acute compartment syndrome refers to a series of symptoms of muscles and nerves in the compartment of the fascia due to acute ischaemia and hypoxia. It is more common in the volar and calf of the forearm.[1] Due to long-term ischaemia of muscles and nerves in the fascia, muscle necrosis and neurological dysfunction can occur, causing serious irreversible damage to the limbs. However, rhabdomyolysis is one of the major complications in the absence of fractures or other trauma. Rhabdomyolysis syndrome refers to the destruction and disintegration of striated muscle caused by various causes, by which intracellular components such as creatine kinase and myoglobin enter the blood circulation, causing systemic disorders in the body and even acute renal failure and other clinical syndromes.[2] This case introduces rhabdomyolysis induced by skeletal muscle ischaemia and hypoxia caused by upper limb compression after drinking, accompanied by upper limb compartment syndrome.

Objective: To investigate the effects of bovine plasma fibronectin on the proliferation and differentiation of rat osteoblasts. Methods:Rat osteoblasts were cultured and identified. AlamarBlue were used to determine the effect of various concentration of bovine plasma fibronectin on the proliferation of the osteoblasts. ELISA method was used to determine the alkaline phosphatase activity of the cells. Results: Fibronectin stimulated the proliferation of rat osteoblasts at 40 ?g/ml (P

Objective To study the clinical features,pathological characteristics and prognosis of renal cell carcinoma(RCC)in young adults,and to improve the recognition of RCC in young population. Methods The data of 35 young patients with RCC under the age of 35 years from August 1983 to June 2005 were analyzed retrospectively.There were 22 males and 13 females with a mean age of 31 years(age range, 19-35 years).The clinical presentations were as follows:painless hematuria in 12 cases(34%),low back pain in 12(34%),abdominal mass in 2(6%),fever in 3 and Stauffer syndrome in 1.The tumor size was 1.2-13.8 cm in diameter(mean,6.0cm).AJCC staging showed stage I tumor in 8 cases,stageⅡin 4, stageⅢin 18 and stageⅣin 5.Of the 35 cases,28 underwent radical nephrectomy(including simultaneous extraction of the vena cava emboli in 3 cases and extraction with pulmonary lobectomy in 1);5 cases under- went partial nephrectomy;and 2 cases lost the chance of operation(1 of them had biopsy).Results The operations were successful.The postoperative pathologic diagnoses consisted of clear cell carcinoma in 23 ca- ses,mixed cell carcinoma in 5,papillary cell carcinoma in 2,and chromophobe cell carcinoma in 2,low-dif- ferentiated and undifferentiated cell carcinoma each in 1.Of them,26 cases were followed for 12-148 months(mean,56 months).Postoperative 3-and 5-year survival rates were 65% and 50%,respectively. Conclnsions In young population,RCC is difficult to diagnose because of occult symptoms at early stage and lack of tumor specificity,which leads to relatively late clinical staging at diagnosis.RCC is characterized by higher malignancy,easy invasion to surrounding tissues and metastasis,and thus poor prognosis.

Objective: To investigate the related factors for the therapeutic efficacy of hilar cholangiocarcinoma. Methods: A retrospective clinical analysis was performed on the clinical data from 49 patients with hilar cholangiocarcinoma. Results: The mean survival time was 19.5 months, 8.79 months, and 5.44 months for the total 49 patients who received radical resection, palliative resection, and drainage operation, respectively. The mean survival time was 23.5 months, 9.37 months, and 2.90 months for patients at AJCC TNM stage I and II, III, and IV (IVa and IVb), respectively. The mean survival time was 3.62 months for patients with a total bilirubin level more than 300 μmol/L or 14. 74 months for those patients with a total bilirubin level less than 300 μmol/L. The mean survival time was 5.68 months, 11.59 months, and 22.17 months for patients whose total serum bilirubin level was more than 40 μmol/L, between 20 to 40 μmol/L, and less than 20 μmol/L one week after operation, respectively. Conclusion: TNM stage and curative resection degree are the main related factors influencing the therapeutic efficacy of hilar cholangiocarcinoina. The decreased degree in the serum level of total bilirubin before and after surgery has the potential to be used as a marker to predict the long-term therapeutic efficacy of hilar cholangiocarcinoma.

Cardiovascular Diseases ; prevention & control ; Cerebrovascular Disorders ; prevention & control ; Humans ; Medicine, Chinese Traditional ; methods

Acupuncture ; history ; Acupuncture Therapy ; history ; Books ; history ; China ; History, Ancient ; Medicine in Literature ; Meridians

Objective To discuss causes and prevention of complications and recurrence following sphincter preserving procedure(SPP) for rectal cancer.Methods A retrospective study on clinical and follow-up data of 375 cases of rectal cancer treated by SPP from January 2000 to January 2006 was carried out.Factors relating complications and recurrence after the operation were analyzed with the Logistic regression.Results A follow-up was conducted for 1～60 months(mean,37 months).The 5-year survival rate was 75.77%,and 79 cases of those followed died.Postoperative complications included anastomotic leakage in 14 cases(3.73%),anastomotic stenosis in 37 cases(9.87%),and anastomotic bleeding in 13 cases(3.47%).Anastomotic tumor recurrence was seen in 25 cases.Logistic regression analysis showed that the distance between the tumor and the dentate line was the most important factor for postoperative complications(P=0.017),and the distance and patient's age were the most important factors for recurrence(P=0.040,P=0.041). Conclusions The distance of tumor and patient's age are the most important factors for complications and recurrence following sphincter preserving procedure for rectal cancer.Strict selection of patients for surgery,normative procedure performance,and proper peri-operative management are essential for the prevention of complications and recurrence.

Objective To evaluate the feasibility and efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)in the lateral position.Methods A total of 48 patients with staghorn(12 cases,2.2 to 5.8 cm in diameter)or multiple renal calculi(31)or upper ureteral stones(5)were treated with MPCNL in our hospital between July 2004 to October 2007.The patients were placed in a lateral position with the head 10? lower and the feet 20? lower.The puncture was made under the guidance of X-ray or ultrasonography,and then Holmium laser or EMS lithotripter was used for stone fragmentation.The stone debris was removed by irrigation.Results The procedure was completed in all of the 48 patients except one,who was converted to a supine position because of the difficulty in puncture.Among the 47 cases,41 were cured with the first operation,the other 6 received catheterization in the first procedure,and then underwent calculi removal in a second-stage operation.None of the patients were converted to open surgery.The mean operation time in this series was(137.5?39.6)min.The one-stage cure rate in our patients was 82.9%(34/41).None of the cases had massive blood loss,or injuries to the pleura and other organs.Follow-up was available in 21 cases for 1 to 3 months.During the period,among the 17 patients who had hydronephrosis,11 were cured and 6 were improved;and among the 4 who had residual stones,1 received ESWL in 1 months after the first operation and was cured afterwards;the other 3 were treated by traditional Chinese medicine,2 of them were cured.Conclusions The MPCNL performed on the patients in the lateral position is an effective alternative for renal calculi,and favorable to intra-operative anesthesia monitor.