Objective To investigate the correlation between serum epidermal growth factor,hepatocyte growth factor and acute pancreatitis severity or prognosis,and to provide the basis for acute pancreatitis clinical diagnosis and treatment.Methods A total of 112 patients with acute pancreatitis (AP) were selected,and they were divided into mild acute pancreatitis (MAP) group (n =66) and severe acute pancreatitis (SAP) group (n =46) according to severity.The patients in two groups were treated with conventional therapy.The levels of serum epidermal growth factor (EGF) and hepatocyte growth factor (HGF) in two groups were observed.The correlation analysis was performed with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score.The complications of patients in two groups were compared.Results The levels of serum EGF and HGF in MAP group and SAP group were significantly higher than those in control group,while they in SAP group were significantly higher than those in MAP group (P ＜ 0.01).The APACHE Ⅱ scores of MAP and SAP groups were (5.4 ± 1.6) ％ and (9 ±2.9) ％,and the APACHE Ⅱ score was positively related to serum EGF and HGF levels (P =0.00).The infection,abscess,necrosis,acute lung injury,or the incidence of ARDS in SAP Group were higher than that in MAP group (P ＜ 0.01).Conclusions AP severity and prognosis were related to patient's serum HGF and EGF levels.Therefore,early and timely monitoring changes of HGF,EGF,and HGF had a certain clinical value to assess condition and prognosis,and EGF had a strong tissue repair and regeneration functions,which might provide a new way to clinical treatment.

Acute kidney injury(AKI) is a common clinical severe emergency in children,with high morbidity,mortality and poor prognosis.The traditional indicators such as serum creatinine and urine can't diagnose early.Recently,with the deepening research of AKI,many higher specific and sensitive biomarkers have been found.But the study of biomarkers in children is behind the adult,and the etiology,pathophysiology of AKI in children have great difference from adult.So this paper will show the advances of biomarkers in children of AKI.

Objective To report the experience in diagnosing gastroenteric tuberculosis under en-doscopies, and arose enough attention to avoid missed or mis-diagnosis. Methods Biopsy is taken when lesions, such as gastroenteric mucosal protrusions, nodule, erythema and ulcer are found under endoscopies. Results In 7 cases studied, 2 of them are the gastric tuberculosis (1 ulceration, 1 proliferation) , the rest, colonic tuberculosis (4 proliferation and 1 mixed). Distribution of lesions: gastric antrum 2, each one in terminal ileum, ileocecal valve, terminal ileum plus ileocecum, terminal ileum plus pan colon, and ascending colon. Endoscopic diagnosis: colonic tuberculosis with infiltrative tuberculosis in both lungs 1; colonic malignant tumors 2, mucosal protrusions and ulcerative lesions with undefined nature 4. Caseous necrotic granu-lomas are found in all cases on pathological examination. Conclusion The various appearances of gastroenteral tuberculosis under endoscopies are hard in differentiating from those of colonic carcer, inflammatory bowel diseases ( Crohn' s disease etc. ) , gastric benign or malignant ulceration. The definite diagnosis of gastroenteral tuberculosis is greatly depended on pathological results.

Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome is a rare autoinflammatory bone disease, which caused by proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1) gene mutations.Due to a lack of awareness of it among clinicians, PAPA syndrome is hard to diagnose and easy to be misdiagnosed or miss-diagnosed clinically.In this paper, twin brothers with recurrent fever and joints pain were reported.They were diagnosed with suppurative arthritis by many hospitals, but after receiving the joint cavity incision operation with negative pressure drainage for several times and antibiotics treatment, their conditions were not improved.Genetic tests showed that the twin brothers had a heterozygous mutation p. E250K (NM003978.3; c.748 G>A; p.Glu250Lys) on the PSTPIP1 gene.They were finally diagnosed with PAPA syndrome and improved with glucocorticoid therapy.

Objective To explore the effect of the improved abdominal rotation card method in insulin injection. Methods A total of 100 hospitalized diabetes patients were randomly divided into control group (n=50) and observational group (n=50) according to the random number method. In the control group, insulin was injected to the subcutaneous tissue of abdomen with traditional method annular rotating method. Insulin was injected using improved abdominal rotation card method in the observational group. Compare accuracy and mastery rate of injection site rotation between the two groups. Compare fasting blood glucose (FBG), postprandial 2H blood glucose (PBG), HbA1c, the incidence of hypoglycemia and endermic induration between the two groups after three months. Results The nurses in the observation group had higher accuracy rate of the injection site rotation compared to the control group [98.6%(690/700) vs. 38.6%(270/700),χ2=584.66, P<0.01]. Mastery rate of the injection site rotation for the patients in the observation group were significantly higher than the control group [70.0% (35/50) vs. 20.0% (10/50), χ2=25.74, P < 0.01]. The incidence of endermic induration were significantly lower in observation group compared to the control group [2.0% (1/50) vs.16.0% (8/50), χ2=5.98, P < 0.01]. The incidence of hypoglycemia were significantly lower in observation group compared to the control group [4.0%(2/50) vs. 16.0%(8/50),χ2=4.00, P<0.01]. Conclusions The new abdominal rotation method in insulin injection can be a safe and effective therapy in patients with type 2 diabetes.

Objective To observe clinical efficacy of brinzolamide on mechanical contusion ocular trauma . Methods 50 patients(57 eyes) of mechanical contusion ocular trauma were selected and divided into observation group and control group randomly and evenly ( 29 eyes in the observe group ,28 eyes in the control group ) .On the basis of mechanical contusion ocular trauma basic treatment for all the patients , the observing group was added brinzolamide ophthalmic suspension .Their vision , intraocular pressure and ERG were observed .Results The vision of patients in the observing group was obviously better than that in the control group (χ2 =4.49,P<0.05).Intraocular pressure in the observing group (14.88 ±0.83)mmHg was obviously lower than that in the control group (19.64 ± 2.30)mmHg(P<0.05).Sum of a-wave amplitude and sum of b-wave amplitude after treatment were better than those before treatment ,and those in the observing group were higher than theose in the control group ( observation group:ta =0.44,tb =0.24;the control group:[ ta =1.03,tb =0.32;between two grous:ta =3.35,tb =2.37,P<0.05 ) ] .Conclusion Using Brinzolamide ophthalmic suspension to treat mechanical contusion ocular trauma preven -tively can obviously improve patients′vision, control their intraocular pressure and promote the recovery of retinal function.It has positive clinical effect .

OBJECTIVE: To discuss the clinical characteristics of bilateral bronchial foreign body in children, increase the curative rate and reduce the complications. METHOD: The clinical data of 35 cases with bilateral bronchial foreign body in children were retrospectively analysed, including surgery, key surgery points, and postoperative combined therapy. RESULT: The foreign bodies of all cases were removed under intravenous general and tropical anesthesia without complications. CONCLUSION The bilateral bronchial foreign body is a serious case, the timely and effective treatment can lower the mortality rate and postoperative complications. The children lack of oxygen for a long time before and in operation should be give comprehensive therapy, for example: sedation and hyperbaric oxygen.
Anesthesia ; Bronchi ; pathology ; Bronchoscopy ; Child ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Oxygen ; Postoperative Period ; Retrospective Studies ; Treatment Outcome

Objective The purpose of this study was to investigate the effect of a dietary modification intervention model applied by ward nurse on change of dietary behavior among patients with type 2 diabetes mellitus (T2DM).Methods A total of 80 participants were divided into intervention patients (n=40) and control subjects (n=40) by random number table.Except lecture-based diabetes educational which was applied for control subjects,a dietary modification intervention model was conducted in intervention patients for a period of two weeks.The intervention program consisted of evaluating an individual's stage of change after being provided dietary information regarding kind of food and portions,discussion with a role model,and keeping a food diary record.Body mass index (BMI),waist-hip ratio (WHR),fasting plasma glucose (FPG),postprandial 2-h plasma glucose (2hPG),glycosylated hemoglobin (HbAlc) and score of healthy eating behavior were measured at initial and six months later.Results Compared with control group,BMI,WHR,FPG,2hPG,HbA1c in intervention group were significantly decreased,P ＜ 0.01 or 0.05.After six months intervention,FPG,2hPG and HbA1c in both groups were significantly decreased compared with baseline levels,P＜ 0.01.Compared with control group,the scores of healthy eating behavior in intervention group were significantly decreased,P＜ 0.05.After six months intervention,the scores of healthy eating behavior in both groups were significantly elevated,P ＜ 0.01,compared with baseline levels.Conclusions This study yielded evidence for the benefits of using the dietary modification intervention model as a framework in healthy eating behavior among patients with T2DM.

Objective To improve the theoretical basis for the typical hemodynamic changes in subclavian steal syndrome (SSS) patients underwent transcranial doppler (TCD) by detailed hemodynamic analysis.Methods Patients with SSS were examined by transcranial doppler and some patients performed tourniquet test.Flow spectrum,flow velocity and pulsatility index (PI) of vertebral artery,basilar artery and middle cerebral artery (MCA) were recorded.Results The flow spectrum of steal side vertebral artery showed that there were 14 cases with systolic notch,18 cases with systolic reverse flow and 3 cases with flow completely reversed.The flow spectrum showed high resistance spectrum in vertebral artery and basilar artery and ipsilateral basilar artery vortex or turbulence in 32 cases.The PI value was higher in contralateral vertebral artery and basilar artery than in anterior circulation (q =9.56,9.98,both P ＜ 0.01),and there was no difference between contralateral vertebral artery and basilar artery (q=0.416,P＞0.05).The tourniquet test were positive in all 22 patients.Conclusions TCD is a convenient,fast,accurate and non-invasive method for hemodynamic examination,which is the first choice for the diagnosis of SSS.

BACKGROUND: Learning and memory disorder exist in diabetic rats,which can be improved by APP 17-mer peptide. However, it is unclear whether learning and memory disorder in diabetes mellitus is caused by influencing neuronal mitochondrial transmembrane potentials and apoptosis in hippocampus or not and what is the related action mechanism of APP17-mer peptide.OBJECTIVE: To observe the effects of APP17-mer peptide on neuronal mitochondrial transmembrane potentials (△ψm) and apoptosis in hippocampal area of diabetic rats.DESIGN: A completely randomized, grouping and controlled trial.SETTING: Beijing Research Laboratory for Brain Aging, Beijing Xuanwu Hospital, Capital University of Medical Sciences; the Department of Endocrine, the First Central Hospital of Baoding.MATERIALS: The data measurement of the experiment was carried out in the Instrument Testing Center, the General Hospital of Chinese PLA between May 2002 and August 2002. The modeling and intervention of the experiment was carried out in the Animal Laboratory of Xuanwu Hospital, Capital University of Medical Sciences. Eighteen male Wistar rats were enrolled and randomized into control group, model group and APP17-mer peptide group with 6 rats in each group.METHODS: ① Diabetic models in the model and APP17-mer peptide groups were established by intraperitoneal injection of 60 mg/kg streptozotocin (pH=4.4) in fasted rats(fasting for 12 hours). Three days later, modeling was successful if blood sugar level in caudal vein was more than 15 mmol/L. Rats in the control group were not subjected to modeling.Then, the rats in the APP17-mer peptide group were subjected to the subcutaneous injection of APP17-mer peptide (3.4 μg for each rat once) three times a week and totally for ten weeks, whereas rats in the other groups were given saline of the same volume. ② After ten weeks, rats were anesthetized and decapitated to take out brain tissues, and then hippocampal tissues were isolated in ice bath for preparation of single cell suspension.JC-1 labeled mitochondrial transmembrane potentials and cell apoptosis in hippocampal area were measured by means of flow cytometry. ③ One-way analysis of variance was adopted in the comparison among groups.RESULTS: Eighteen rats were involved in the results analysis. ①Neuronal mitochondrial transmembrane potential was lower in the model group as compared with the control group [(551.91±53.36) vs (809.88±82.41) △ψm,P＜0.01] while it was higher in the APP17-mer peptide group as compared with the model group [(705.99±89.92) vs (551.91±53.36) △ψm, P ＜ 0.05].There was no difference between the APP17-mer peptide group and control group (P=0.146). ②) Apoptotic percentage of single cell in hippocampus was significantly higher in the model group than in the control and APP17-mer peptide groups [(5.32±1.37)%, (1.03±0.55)%, (2.80±0.92)%, P＜0.01, 0.05].CONCLUSION: Neuronal mitochondrial transmembrane potential and cell apoptosis in hippocampus may be involved in the occurrence and development of diabetes mellitus, and APP17-mer peptide plays an improved role in the process.