Objective To investigate the clinical characters of pancreatitis in patients with primary hyperparathyroidism (PHPT).Methods The clinical data of patients with PHPT undergoing parathyroidectomy from Jan.2009 to May.2014 in Peking Union Medical College Hospital were retrospectively analyzed for coexistent pancreatitis.Results 571 patients received parathyroidectomy due to PHPT during this period.Thirteen patients (2.3％)with PHPT were confirmed with coexistent pancreatitis by clinical manifestation and abdominal imaging evaluation,including acute pancreatitis in 9 patients and chronic pancreatitis in 4 patients.PHPT with pancreatitis was associated with preoperative serum intact parathyroid hormone(iPTH)higher than 500 pg/ml (P=0.025)and occurrence of hypercalcemic crisis (P=0.013).The age and sex of patients,preoperative serum calcium,gallstones,urinary calculi and bone fracture were not related with pancreatitis in this group.The average follow-up period for these patients was 34(ranging from 13 to 68)months.All patients were free from hyperparathyroidism recurrence.Only one young lady with chronic pancreatitis suffered from repeated pancreatitis after surgery.Conclusions Serum iPTH higher than 500 pg/ml and occurrence of hypercalcemic crisis were possible risk factor of pancreatitis in patients with PHPT.Parathyroidectomy can help to prevent the recurrence of pancreatitis in these patients.

[Objective]To explore the effect of HSYA on pro/anti-inflammatory cytokine′s levels and mRNA expression in peripheral blood of mice.with sepsis.[Methods]Dividing NIH mice into four groups,as normal group,sham group,CLP group and HSYA group,24 mice in each group. The CLP sepsis mouse model was established. HSYA(120 mg/kg)were injected intravenously at 12 h before the operation ,and 0 h and 12 h following CLP ,and other groups were given normal saline. observed the animals behavior changes,measured the levels WBC,PLT,ALT,AST,BUN in serum,detected the levels and mRNA expression of IL-6, IL-10 ,TNF-α in peripheral blood. cultured of peripheral blood bacteria loads.[Results]24 h after surgery ,mice in CLP group appeared furring,feces residues on anus etc. compared to normal group,sham group and HSYA group,WBC,PLT,ALT,AST, BUN,levels and mRNA expression of IL-6,IL-10,TNF-αshowed significant increases,it was also found that bacterial load was significant increased in model group.[Conclusions]HSYA has a therapeutic effect in mice with sepsis ,can reduce bacteria into the blood,and inhibit inflammatory mediators which caused tissue damage.

Objective To investigate the clinical effects of liver transplantation including living related liver transplantation for Caroli's disease (CD). Methods Seven consecutive patients with diffused type of Caroli's disease had undergone liver transplantation (LT) from September 1999 to February 2007 in our single center. The clinical characteristics and survival of these patients were retrospectively reviewed. Results All 7 patients were diagnosed as Caroli's disease with diffused type which manifested recurrent cholangitis in clinical symptoms. Among them, 4 were female and 3 male.The mean age was 16 years old (ranging from 10 to 31 years old). Six patients were subjected to conservative therapy and only one patient had previously undergone cholecystectomy and T tube drainage before transplantation. In types of surgery, 4 patients accepted split liver transplantation with right liver lobe, two got whole liver transplantation and only one underwent living related liver transplantation. In two patients venovenous bypass was done during the operation. The mean duration of surgery was 9. 1 h. Post-transplant complications included pulmonary infection (3 cases), acute rejection (2 cases), pleural effusion (2 cases) and biliary leakage in the split section of donor liver (1 case). One patient died within 19 days caused by acute renal failure and multiple organs dysfunction.The rest six patients are alive without any signs of recurrence of protopathy and the longest survival time is 7 years. Conclusion Liver transplantation is a valuable treatment to Caroli's disease with diffused type. Due to the organ shortage, living related liver transplantation may own identical effects on LT.

OBJECTIVE:To establish a method for the content determination of polymer in cefatrizine propylene glycol. METHODS:High performance sephadex gel chromatography was performed on the column of Sephadex G-10 with mobile phase A of 0.01 mol/L phosphate buffer [0.01 mol/L Disodium hydrogen phosphate solution-0.01 mol/L Sodium dihydrogen phosphate solution (61∶39,V/V)](pH7.0)and mobile phase B of water at a flow rate of 1.0 ml/min,the detection wavelength was 254 nm,column temperature was 30℃,and volume injection was 200μl. RESULTS:The linear range of polymer was 2.07-103.30 mg/ml(r=0.999 4);the limit of quantitation of 10.4 ng,limit of detection was 4.1 ng;RSDs of precision and reprodicibility tests were lower than 3%. CONCLUSIONS:The method is specific with high sensitivity and good reproducibility,and can be used for the content determination of polymer in active pharmacentical ingredient cefatrizine propylene glycol.

Objective To evaluate the suitability of reported standard liver volume formulae for Chinese adults based on the practice of 216 cases of living donor liver transplantation in our transplantation center. Methods The graft volume was preoperatively estimated in 179 adult-to-adult right liver living donors by two methods: first, the radiological right liver volume by computed tomography (CT) and second,calculated graft volume obtained by reported standard liver volume formula and the percentage of the right liver volume ( given by CT). Both results were compared to the actual graft volume measured during surgery.Results The mean percentage of right liver volume was 55.4% (SD 5.41%). The results of Urata、Heinemann、Vauthey、 Lee、 Yoshizumi formula were significantly larger than the actual right liver volume (P ＜0. 01 ). The result of Sheung-tat Fan was less than the actual right liver volume, there was statistical ESLV =334. 024 + 11. 508 × BW, is most suitable to estimate adult Chinese donor's right liver volume.

Objective To explore the indications for liver transplantation among patients with hepatolithiasis.Methods Data from 1 431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis.Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones,hepatectomy,cholangiojejunostomy,and liver transplantation.Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones.The rate of residual stones was 7.5%(72/961).Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation;the rate of residual stones was 21.7%(102/470).Only 15 patients with hepatolithiasis underwent liver transplantation;they all survived.According to the degree of biliary cirrhosis,recipients were divided into 2 groups: a group with biliary decompensated cirrhosis(n=7),or group with biliary compensated cirrhosis or noncirrhosis group(n=8).There were significant differences in operative times,transfusion volumes and blood losses between 2 groups(P

Objective To construct a comprehensive evaluation model of long-term care for the elderly based on the situation of our country,which is suitable for the family,community and the pension service organization. Methods The model index item pool (7 one class indexes and 133 two class indexes) formed by literature research, theoretical extraction and qualitative interview were taken as the research object.To screen the model parameters by using the Delphi method,then formed a index system of hierarchical comprehensive evaluation model of long term care for the elderly. Results 25 experts were from 10 provinces of a total of 23 Medical Colleges and affiliated hospital,positive coefficients for the first round of 83.33% and the second round of 100.00%,the average value of the two authority coefficients were both >0.90, the coordination coefficient of the evaluation index for the first round of 0.221 and the second round of 0.266(both P<0.05).The primary model index system consists of 7 first level indicators,a total of 13 secondary indicators.Among them,the"daily life ability","cognitive ability","falling risk"and"pressure sore risk" evaluation were using very mature scales, the "medical care project", "abnormal performance/symptom" and "self care knowledge needs" evaluation were independently established in this study. Conclusions Preliminary construction process of the index system for the comprehensive evaluation model of long term care for the elderly was rigorous and had better theoretical support,and the Delphi method experts had higher degree of attention and participate in the research content, experts had good representativeness,can effectively guarantee the reliability of the selected items.

With the development of percutaneous transluminal angioplasty, stent implantation has gradually become an important treatment for peripheral artery diseases, especially for arterial diseases of lower extremities. Due to the continuous exposure of the disadvantages of permanent metal stents and the continuous development of absorbable materials, researchers gradually pay attention to the bioresorbable stents with fewer long-term complications. At present, the application of bioresorbable stents in coronary artery disease has been relatively mature. This paper reviews the research progress of bioresorbable zinc alloy stents in peripheral artery disease.

Hepatolithiasis is a common biliary tract disease in China and other Asian countries.It has insidious onset,recurrent disease,and may lead to biliary cirrhosis or even cancer in the late stage without inter-vention.At present,surgery is considered to be the best choice for treatment.In the 21st century of minimally inva-sive surgery,traditional procedures such as partial hepatectomy,choledochotomy,cholangioenterostomy and liver transplantation can be performed with the assistance of laparoscopy and da Vinci robots,and emerging endoscopic techniques such as endoscopic retrograde cholangiopancreatography(ERCP)and percutaneous transhepatic cho-ledochoscopic lithotripsy(PTCSL)have also been developed,bringing better treatment for patients with hepatoli-thiasis.As treatment options are becoming more varied,there are also some clinical problems that need to be addressed.In this article,we would like to briefly review the current surgical treatment modalities in order to provide a theoretical basis for optimizing the treatment modalities.

Objective:To investigate the influence of collateral circulation evaluated by CT perfusion (CTP) imaging in infarction progression and clinical prognoses of patients with acute large-artery occlusion of the anterior circulation before and after thrombectomy.Methods:One hundred and ten patients with acute large-artery occlusion of the anterior circulation within 24 h of onset, admitted to our hospital from May 2018 to September 2019, were chosen in our study; all patients completed thrombectomy; their clinical data were analyzed retrospectively. Regional leptomeningeal collateral-temporally fused maximum intensity projection (rLMC-tMIP) was used to evaluate the collateral circulation based on 4D-CT angiography (4D-CTA). According to the core infarct volume in CTP imaging and the diffusion weighted imaging (DWI) results of MR within one week of surgery, the progressive infarct volume was calculated. Modified Rankin scale (mRS) was used to evaluate the prognoses of these patients 3 months after surgery.Results:(1) There were 56 patients with good collateral circulation and 54 patients with poor collateral circulation. Age ( OR=0.951, 95%CI: 0.910-0.993, P=0.023), cardiac dysfunction ( OR=0.116, 95%CI: 0.018-0.731, P=0.022), baseline fasting blood glucose ( OR=0.788, 95%CI: 0.646-0.961, P=0.019), wakefulness stroke ( OR=0.093, 95%CI: 0.023-0.380, P=0.001), and site of vascular occlusion ( OR=7.604, 95%CI: 2.650-21.821, P=0.000) were independent influencing factors for collateral circulation. (2) Scores of rLMC-tMIP ( 95%CI: -2.947- -1.474, P=0.000), volume of ischemic penumbra ( 95%CI: 0.065-0.126, P=0.000), scores of edema in the brain tissues ( 95%CI: 2.952-7.600, P=0.000), hemorrhage transformation ( 95%CI: 8.966-23.114, P=0.000), and 24 h NIHSS scores ( 95%CI: 0.606-1.248, P=0.000) were independent influencing factors for volume of progressive infarction. (3) There were 59 patients having good prognosis and 51 patients having poor prognosis. Hemorrhage transformation ( OR=0.019, 95%CI: 0.001-0.275, P=0.004) and progressive infarction volume ( OR=0.824, 95%CI: 0.756-0.897, P=0.000) were independent influencing factors for prognoses of patients with acute large-artery occlusion of the anterior circulation after thrombectomy. Conclusion:The scores of rLMC-tMIP based on 4D-CTA can well predict the infarction volume in patients with acute large-artery occlusion of the anterior circulation within 24 h of onset, which can effctively evaluate the clinical prognoses of the patients.