Objective To investigate the clinical risk factors of diabetic ketoacidosis (DKA ) combined with elevated serum amylase(AMS). Methods Totally 263 patients with DKA were enrolled in our study. They were divided into 2 groups according to the level of AMS:DKA with normal AMS (DKA,n=188);DKA with elevated AMS(HAMS,n = 75 ). HAMS patients then were divided into two subgroups according to the diagnosis with acute pancreatitis(AP)(HAMS+ AP,n = 25 )and without AP (HAMS,n = 50 ). TG,FPG and AMS were measured and analyzed with univariate analysis and multivariate analysis. Results HAMS group patients had a ratio of 28.5％ with elevated AMS and 9.5％ with AP.HAMS group had higher FPG,TG,HbA1 c,Na+ ,osmolality,BUN and Scr than DKA group(P <0.05).The levels of FPG,TG,osmolality,BUN and the time of CO2 CP recovery in HAMS+AP subgroup were all significantly higher than those in HAMS patients without AP (P < 0.05 ). Correlation analysis showed that HAMS was positively correlated with TG,FPG,Na+ ,Osmolality and BUN(P <0.05).Logistic regression analysis showed that hypertriglyceridemia was the independent risk factor of DKA combined with HAMS(OR 1.244,P <0.01),and was the independent risk factor of DKA combined with AP(OR 1.211,P <0.05). Conclusion Hypertriglyceridemia is the related risk factor of DKA combined with HAMS and AP. This study provides a theoretical basis to early screen patients with hyperamylasemia in DKA.

[Objective] We summarizes the professor Shao Changrong's experience in treating COPD by using invigorating spleen and draining dampnessmethod. [Method] This paper analyzes the etiology, pathology, therapeutic principle and relevant case revealing about the COPD patients with insufficien-cy of the spleen and phlegmatic hygrosis. And we explain the Pro. Shao's empirical prescription cal ed Ping-Ke-Hua-Tan decoction. [Results] In his view, COPD attack and aggravation are related with phlegmatic hygrosis. The fundamental reason is the insufficiency of the spleen and the external reason is phlegmatic hygrosis. Its mechanism is mostly the blending of excessiveness and deficiency. [Conclusion] Theinvigorating spleen and draining dampnessmethod is effective in treating COPD. Pro. Shao Changrong's diagnosing and treating of COPD is worthy widely clinical reference and promotion.

Objective To study the rehabilitation for batches of the wounded suffering from the earthquake in hospital. Methods 91 cases of trauma occurring in the earthquake were reported. Results There was no dead and any complication happened. 90 cases could self-care as they discharged. Conclusion Multiple specialty rehabilitation would be effective on the wounded suffering from earthquake.

Objective To investigate the effect of atorvastatin on the curative effect and cardiovascular events in patients with unstable angina pectoris.Methods128 patients with UAP were enrolled in Jinhua Central Hospital from August 2014 to August 2016, and 128 patients with UAP were randomly divided into observation group and control group.All the patients were given low salt and low fat diet.Two groups of patients were anti-platelet aggregation, blood pressure, lipid-lowering and other conventional treatment, observation group on the basis of simultaneous atorvastatin calcium 40mg/d, oral, once every month.The levels of TC, TG and LDL-C, HDL-C and the incidence of cardiovascular events were compared between the two groups before and after treatment.ResultsThere was no case of cardiac death in the observation group and the control group.The incidence of cardiovascular events in the observation group was 9.38%, which was significantly different from that in the control group (P<0.05).The levels of TC, TC and LDL-C in the observation group were significantly higher than those before treatment and control group, respectively.The clinical effect of the observation group was significantly better than that of the control group, the difference was significant (P<0.05).ConclusionAtorvastatin can significantly improve the efficacy of unstable angina treatment, and reduce blood lipid levels, reducing the incidence of cardiovascular events, improve the prognosis.

Objective To study and analyze the psychological intervention methods and effects of mifepristone combined with misoprostol in the treatment of abortion. Methods 200 cases of intrauterine pregnancy were selected from Hangzhou Red Cross Hospital from March 2015 to August 2016. They were randomly divided into the control group and the experimental group, 100 cases in each group. The patients in the experimental group were treated with mifepristone combined with misoprostol, which eliminated the negative emotions such as anxiety and restlessness, and paid close attention to the psychological status of the patients. Patients in the control group were treated with local medication of lidocaine. The clinical effects of the two groups were compared and analyzed. Results after the corresponding treatment, the effective rate of analgesia in the experimental group was 38.0％, and the effective rate was 52.0％. The effective rate of the control group was 16.0％, and the effective rate was 49％. The analgesic effect of the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the effective rate of cervical dilatation in the experimental group was 45.0％, and the effective rate was 51％. The degree of cervical dilatation in the experimental group was significantly better than that in the control group, and the amount of bleeding during operation was significantly less than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Misoprostol and mifepristone combined with psychological intervention can greatly improve the clinical effect of artificial abortion and alleviate the pain of patients, it has the significance of further popularization and application.

Simulating physiological neuronal and hormonal conditions during digestive and interdigestive periods, the study identified the changes of the motility of biliary system including bile duct and sphincter of Oddi (SO) before and after cholecystojejunostomy. Thirty-five rabbits were divided into five groups randomly. The experimental groups received the venous injection of CCK 10 ng/kg, erythromycin 10 mg/kg, atropine 3 micrograms/kg and L-NAME 10 mg/kg respectively. Each rabbit underwent manometry through introducing a three-lumen catheter via the papilla retrogradely, using the low-compliance papillary infusion system. Then the gallbladder and the upper segment of the jejunum was anastomosed and the manometric procedures repeated after one week. SO basal pressure was increased, contraction amplitude decreased, contraction time shortened after cholecystojejunostomy. L-NAME, CCK and erythromycin could all excite SO. L-NAME could increase basal pressure and contraction amplitude, CCK increase basal pressure contraction amplitude and frequency, and erythromycin increase contraction amplitude, respectively. But comparing with that before cholecystojejunostomy, the increasing extent was decreased. The tensional and spontaneous contractions of the SO were under the control of the neural and hormonal mechanism. The anastomosis of gallbladder and jejunum and the drainage of bile made the tensional contraction stronger, but the spontaneous contraction weakened after the operation due to the decreases of the sensitivity of SO to hormonal factors. The clinical symptoms may not be relieved when the patients with SO dysfunction accepted cholecystojejunostomy.
Cholecystectomy/*adverse effects ; Common Bile Duct/*physiopathology ; Gallbladder Emptying/*physiology ; Jejunostomy/*adverse effects ; Manometry/methods ; Muscle Contraction ; Postoperative Period ; Random Allocation ; Sphincter of Oddi/*physiopathology

Intracerebral hemorrhage accounts for about 10%-30% of all stroke types.It is characterized by rapid onset, rapid progress, varied clinical symptoms, high morbidity and mortality, and poor prognosis.After the intracerebral hemorrhage, various inflammatory mediators result in white matter lesions and cognitive impairment.Thrombin acting on thrombin receptors at low concentration induces neuroprotection and at high concentration causes brain injury.This article reviews the role and mechanism of thrombin in white matter injury after intracerebral hemorrhage.

Assurance system of Medical Quality is the core of teaching quality assurance work from colleges itself.This paper analysed the major factors affecting the teaching quality such as teachers,students,the teaching environment,teaching management based on quality management theory,making use of information technology to support the implementation of quality assurance system,constructing a system composed of five quality security system framework and forming protection of the quality of teaching based on information.

Objective To study the teaching effects of using case discussing-analysis method in the teaching course of Nursing Research among nursing students,and then make suggestion for relative teaching improvement. Methods Nursing students of Grade 2003 in main school and Grade 2004 in the affiliated WUZHOU school were divided into the trial group and control group at random. Part of teaching contents of nursing research were taught to the trial group students by case discussing-analysis method,and to the control group students by the methods of lecture-based learning. The teaching effect was evaluated after the course end. Results The ability of design to scientific research,recognition of Nursing research,learning attitude and learning interest,etc,in the trial group students were obviosly better than those in the control group students,and there was significant by statistical test. Conclusions Case discussing-analysis method can effectively excite the interest and the potential of students,and improve the ability of discovering and solving problems.

OBJECTIVETo investigate the biuret reagent to detect proteins in the application, the impact of different test conditions for test results.

METHODSThe biuret method to select three different instruments, reagents, calibrators are arranged in combination to form 27 sets of detection systems, each detection system is a combination of 5 serum samples for testing, 5 measured values obtained, the selection process normality good a serum for the study to determine the mean value of all AST after culling outliers obtained in order to calculate the various detection systems use a combination of biuret reagent to detect proteins bias.

RESULTSThe use of different detection equipment to detect proteins biuret reagent bias, homogeneity of variance (P = 0.467), the difference was not statistically significant (F = 1.688, P = 0.421). different detection reagents using biuret reagent to detect proteins bias, homogeneity of variance (P = 0.574), a statistically significant difference (F = 5.784, P = 0.011). different calibrators use biuret reagent to detect proteins bias, homogeneity of variance (P = 0.467), the difference was statistically significant (F = 5.289, P = 0.000).

CONCLUSIONBiuret reagent in the detection of protein applications, impact detection reagents and calibrators will test result, during the test than when it is necessary to detect deviation detection reagents and calibrators due to be considered.