China ; Dyslipidemias ; prevention & control ; Guidelines as Topic ; Humans

Pancreatic enzyme replacement therapy is given to manage pancreatic exocrine insufficiency (PEI) in cystic fibrosis (CF) and following pancreatectomy, total gastrectomy or chronic pancreatitis. The article reviews on aspects of pancreatic enzyme replacement therapy containing the assement of pancreatic exocrine function, the pathogenesis of exocrine pancreatic insufficiency, pancreatic enzyme preparations and their efficiency, dosing of pancreatic enzymes, enteral nutrition and pancreatic enzyme replacement, the modulation of pancreatic exocrine and adverse reactions to pancreatic enzyme.

Objective To study the diagnosis and treatment of choledocholithiasis in patients with low left and right posterior hepatic duct confluence.Methods Clinical data of 12 patients suffering from cholelithiasis with a low confluence of the left and right posterior hepatic ducts admitted between January 2000 to June 2013 were retrospectively analyzed.Results Of the 12 cases,the left and right posterior hepatic ducts joined between 2 cm below hilus hepatis and the superior border of the duodenum in 8 cases,below the superior border of the duodenum in 4 cases.Seven cases had a low confluence of the right and left hepatic ducts,and 5 cases had right posterior duct low confluence.As for bile duct stricture:the opening stricture at the junction of the right and left hepatic ducts were found in 4 cases,the opening stricture in the right hepatic ducts were found in 3 cases,the opening stricture of the left hepatic duct were found in 2 cases.There were left and right bile duct stones in 7 cases,right intrahepatic bile duct stones in 3 cases,left intrahepatic bile duct stones in 2 cases.Cystic duct joined the right hepatic duct in 5 cases,left hepatic duct in 2 cases.Seven cases with a low confluence of the right and left hepatic ducts were with double T tube drainage; five of low right hepatic duct confluence were treated by T tube drainage.The right posterior branch of hepatic ducts were injured in four cases and right hepatic duct was injured in one.Conclusions Low confluence of left and right posterior hepatic ducts often leads to misdiagnosis during surgery of cholelithiasis.Magnetic resonance cholangio-pancreatography or endoscopic retrograde cholangiopancreatography was helpful before cholecystectomy to avoid iatrogenic injury of biliary tract.

Objective To evaluate the role of serum homocysteine (HCY) in diabetes mellitus(DM ) complicating proliferative diabetic retinopathy (PDR) .Methods 174 patients with DM were selected and divided into PDR ,non‐PDR(NPDR) and non‐dia‐betic retinopathy (NDR) groups .The serum HCY level was detected .Results Serum HCY levels in the PDR ,NPDR and NDR groups were (18 .20 ± 5 .60) ,(14 .40 ± 6 .70) and ,(12 .10 ± 6 .80)μmol/L respectively ,which was highest in the PDR group (P<0 .05) .Conclusion HCY could result in PDR generation possibly by injuring the retinal blood vessels .

Objective: The aim of this study is to investigate the clinical factors in association with venous thromboembolism (VTE) in patients with lung cancer, and to provide evidence for prevention and therapy of VTE. Methods: Clinical information of 2 053 patients with lung cancer definitely diagnosed by cytology or pathology between July 2008 and June 2010 was retrospectively analyzed. VTE wasconfirmed by chest spiral computed tomography (CT), pulmonary arteriography and colorful Dopplerultrasound. The clinical factors including age, gender, pathological type, operation, clinical stage,body mass index, co-morbidity and platelet count as well as D -dimer, interleukin-1 (IL-1) and tumornecrosis factor (TNF) were considered as the potential VTE-related factors. Results: Of 2 053 patients,89 (4.34%) were confirmed with VTE. The incidence rates of VTE in patients with adenocarcinoma andnon-adenocarcinoma were 5.65% (58/1 027) and 3.02% (31/1 026), respectively, and the difference wasstatistically significant (P £?0.003). The incidence rate of VTE in stage I-III A lung cancer patients was significantly lower than that in stage IIIB-IV lung cancer patients [1.48% (10/677) vs 5.74% (79/1 376); P<0.001]. In patients with stage I-IIIA undergoing surgical operation or not, the incidence rates of VTE were 1.55% (10/645) and 0% (0/32), respectively (P=0.044). Significant difference of incidence rate of VTE was also found between the patients with and without co-morbidity [6.73% (56/832) vs 2.70% (33/ 1 221); P<0.001]. The incidence rates of VTE in patients with normal levels of platelet count, D -dimer,IL-1 and TNF were 3.72%, 0.31%, 2.44% and 3.27%, respectively; whereas, the incidence rates in patients with increased levels of these measurements were 6.26%, 19.91%, 10.26% and 7.74%, respectively; the differences between two groups were all significant (P<0.05). Logistic multivariant regression analysisrevealed that the clinical factors of adenocarcinoma, operation, co-morbidy and high levels of D-dimer,IL-1 and TNF in blood were associated with increased risk of VTE (P<0.05). Conclusion: Adenocarcinomais the most common pathological type in lung cancer patients with VTE. The risk factors of VTE include operation, co-morbidity and high levels of D -dimer, IL-1 and TNF in blood. Copyright© 2011 by TUMOR.

Objective To introduce the method and to evaluate the therapeutic effect of collagenase chemonucleolysis for treatment of cervical disc herniation.Methods 92 patients with cervical herniated discs were selected from January 2002 to December 2004.The procedure was guided by DSA and the puncture was defined from C_(6~7) or C_7-T_1 extradural cavity.Collagenase(1200~2400 u) was injcted in the herniated extradural cavity through the micrcatheter.Results The procedure of 88 cases was successful.80 cases were followed up from 6 to 12 months.The effect showed that 70 cases(87.5%) were excellent or good.No serious complication occurred.Conclusion The method of collagenase chemonucleolysis for treating cervical disc herniation is safe and effective,it can be used in clinic.

Fifteen journals related with liver diseases were selected from Chinese science and technology journal citation reports ( core ) ( CJCR ) during 2004 - 2009.Eleven important quantitative indicators including total cited frequency and impact factor were analyzed.At the same time,the dynamic evaluation model was also used to evaluate the academic influence of the 15 kinds of liver diseases journals.There were 5 kinds of trends:always arising,spiral arising,stabilizing after adjusting,vibrating highly and adjusting.The academic influence of liver diseases journals was rather high,but there were some problems including low academic influence,low ratio of funded papers and international papers and poor paper quality.

Objective To observe the influence of exercise intensity on cardiorespiratory function in the elderly with coronary heart disease using simplified 24-action Taijiquan and jogging. Methods A total of 115 sedentary elderly patients with heart disease were randomly divided into a control group ( no exercise), a low-intensity exercise group, a medium-intensity exercise group (whose exercise was simplified 24-action Taijiquan at 40-60% of their individual maximum oxygen consumption (VO2max) for 90 to 200 minutes per week) and a high-intensity exercise group ( whose exercise was jogging on a treadmill at ＞ 70% of their maximum oxygen consumption for 200 minutes per week). The regime was maintained for 6 months. All patients accepted a treadmill exercise test before and after the 6 months of exercise to evaluate the changes in VO2max, maximum heart rate ( HRmax), VO2max/HRmax and exercise time (t). Results ( 1 ) After 6 months of exercise, VO2max, HRmax, VO2/HRmax and t had increased sisnificantly in all three exercise groups. Work capacity had increased 18.6% , 33% and 34.4% and HRmax had increased 9.3% , 13.8%, 19.1%. There was no difference between before and after in the control group. (2) Compared with the control group the average VO2max, HRmax and t of all three exercise groups had increased significantly. VO2 max was 9.4% , 26% and 23. 1% better; HRmax was 6.7% , 8.8% and 12% better; t was 3.5,4 and 4.9 minutes longer. (3) Compared with the low-intensity exercise group, VO2max, HRmax and t in the medium- and high-intensity groups increased significantly more. VO2max increased 16.6% and 13.7% more; HRmax increased 2.1% and 3.2% more and average t was 0.5 and 1.4 minutes longer. (4) There was no significant difference between the medium- and high-intensity exercise groups in terms of VO2max. (5) The incidence of self-reported adverse responses to exercise such as dizziness, chest stuffiness and fatigue in the high-intensity exercise group increased significantly compared with the other 3 groups. Conclusions Exercise can gradually improve cardiorespiratory function in the sedentary elderly with heart disease. The effects of medium-intensity exercise are similar to those of high-intensity exercise, but medium intensity is safer.

Objective To observe the effect of cluster needling at scalp acupoints plus paraffin therapy on motor function in cerebral palsy patients.Method Forty eligible patients with spastic cerebral palsy were randomized into a control group and an experimental group, 20 cases in each group. The control group was intervened by cluster needling with long-time retaining of the needles plus Uyeda's approach and conventional rehabilitation trainings specifically for spastic cerebral palsy; the experimental group was intervened by paraffin therapy in addition to the treatment given to the control group. The interventions were conducted once a day, for a total of 8 weeks. The Gross Motor Function Measure-88 (GMFM-88) and Modified Ashworth Scale (MAS) were adopted to evaluate the motor function before and after the treatment.Result The GMFM-88 scores were significantly changed after the treatment in both groups (P<0.05), and there was a significant difference in comparing the GMFM-88 score between the two groups after the intervention (P<0.05). The MAS score was significantly changed after the intervention in the experimental group (P<0.05), while the score wasn't significantly changed in the control group (P>0.05); there was a significant difference in comparing the MAS score between the two groups after the intervention (P<0.05).Conclusion On the basis of conventional rehabilitation trainings, cluster needling at scalp acupoints plus paraffin therapy can produce a significant efficacy in improving the muscular tension and motor function, and benefit the development of cerebral palsy patients.

Objective To investigate pathogene city, replication and expression of hepatitis G virus (HGV) in rhesus monkey infected with HGV RNA genome or HGV RNA positive sera. Methods A full length cDNA clone of HGV was constructed. Rhesus monkey BY1 was inoculated intrahepatically with genomic RNA from this HGV clone resulted in viral replication. HGV RNA positive sera from BY1 were intravenously inoculated into rhesus monkeys BM1, and sera from BM1 were intravenously inoculated into BB1 in series. Sera were collected weekly or bi weekly and liver biopsies were performed regularly. RT PCR, in situ hybridization and immunological, serological, histological assays were carried out to study the infectivity and pathogenecity of HGV. Results The serological and pathological results indicated that all of the 3 rhesus monkeys developed HGV viremia and had slightly elevated alanine transaminase levels (up to 418 IU/ L) during the period of experiment. HGV RNA became positive at the 3 rd , 8 th and 3 rd week post inoculation in the animals BY1, BM1 and BB1 respectively, and existed up to 21 weeks. The histology, immunohistochemnistry, and in situ hybridization in the liver tissues of the inoculated animals also showed that there was a mild hepatitis with HGV E2 expression in cytoplasm of hepatocytes. RT PCR and quantitative PCR showed that HGV could replicate in liver.Conclusions The genomic RNA from HGV full length cDNA is infective to the rhesus monkeys resulting in mild hepatitis. Infection and the transmission of the HGV in the rhesus monkey provide an appropriate animal model for the study of HGV.