Objective To investigate the optimal initial timing of Qingyi Decoction and clyster with rhubarb in patients with severe acute pancreatitis (SAP). Methods Patients with SAP were randomly divided into 2 groups. The group A (n = 34) received clyster with rhubarb and Qingyi Decoction after 12 h of SAP onset and the group B (n = 27) received samel therapy after 72 h of onset of SAP. The serum levels of TNF-α, CRP and APACHE Ⅱ scores, time to abdominal pain cessation, length of hospital stay and medical costs were compared. Results The serum levels of TNF-α and CRP of patients in group A were (265±66)U/ml, (32.1 ±7.1) mg/L, and the score of APACHEⅡ were 6. 3±2.0, time to abdominal pain cessation was (4±2) d, length of hospital stay was (18±5)d, medical costs was (42 000±18 000) yuan; while the corresponding values in the group B were (491±81)U/ml, (43.5±11.0) mg/L, 9.1±1.8, (8±3)d, (34±8)d, (71 000±26 000)yuan, and the difference was statistically significantly (P<0.05). Conclusions Qingyi Decoction and clyster with rhubarb should be given in the early phase of SAP in order to achieve better outcomes.

Objective To analyze the influence of sleep deprivation on expression of serotonin receptor 1A(5-HT1A) and dopanine-2 receptor (D2R) gene and to explore the differences between different neurotransmitter pathways involved in sleep regulation through measuring the gene expression of 5-HT1A and D2R in regions of hippocampus,hypothalamus and striatum with different sleep deprivation models.Methods Sleep deprivation was performed to male SD rats of 10-week-old for 24 hours,48 hours and 72 hours respectively as the experimental group and a control group was taken for comparison.The expressions of 5-HT1A and D2R gene in regions of hippocampus,hypothalamus and striatum were detected through RT-PCR technique to analyze the influence of sleep deprivation on gene expression in different regions.Results Sleep deprivation had a significant effect on the gene expression of 5-HT1A in regions of hippocampus and striatum(F=56.203,P＜0.01 ; F=77.288,P＜0.01).The three experimental groups were all superior to the control group and the difference was of statistic significance(P＜0.05).In the hippocampus region,the expression quantity of the 72 hours group(0.618±0.054) was superior to that of the 24 hours group and of the 48 hours group(24 hours:0.404±0.023,P＜0.01 ;48 hours:0.455±0.042.P＜0.05).In the striatum region,the differences between the 24 hours group(0.413±0.033),the 48 hours group(0.464±0.034)and the 72 hours group(0.610±0.040) were all of statistic significance(all P＜0.05).Sleep deprivation had a significant effect on the expression of D2R gene in regions of hippocampus and striatum(F=74.708,P＜0.01 ; F=80.687,P＜0.01).The expression quantity of the three experimental groups in regions of hippocampus (24 hours:0.386±0.027,48 hours:0.318±0.014,72 hours:0.250±0.010) and striatum(24 hours:0.396±0.013,48 hours:0.349±0.017,72 hours:0.260±0.013) were all inferior to the control group.The differences were of statistic significance (all P＜0.05).There was a negative correlation between the gene expressions of 5-HT1A and D2R of rats of the three experience groups(all P＜0.05).Conclusion For the sleep deprivation rats,the gene expression of 5-HT1A rises while that of D2R falls in regions of hippocampus,hypothalamus,and there is a negative correlation between the expressions of the two genes.

Objective To study the causes of early death of patients with acute severe cervical spinal cord injury.Methods A retrospective analysis was done on 78 cases of acute severe cervical spinal cord injury,who were treated in our hospital between January 2003 and December 2007.The patients were divided into death group and survival group(survived more than 30 days after the injury).The clinical data including age,level of spinal cord injury,time of injury and admission,surgical treatment,duration between injury and surgery,neurogenic shock,central hyperthermia,hyponatremia,serum level of albumin,percentage of lymphocytes in serum,tracheotomy,and pulmonary infection,were recorded and analyzed. Results The proportion of high-level spinal cord injures(C1-C4) in death group(8/9) was significantly higher than that in the survival group(49/69,?2=18.086,P=0.000).Whereas the duration between injury and surgery in the death group was significantly shorter than that in the survival group(1-12 d,median 2 d vs 1-39 d,median 3 d;Z=-2.664,P=0.008).In the death group,4 of the 9 patients had neurogenic shock,and 4 developed hyponatremia,which were significantly more than those in the survival group(6/69,?2=12.392,P=0.000;19/69,?2=4.526,P=0.033).The percentage of peripheral lymphocyte on admission was(11.84?5.80)% in the death group,which was significantly lower than that of the survival group(19.17?16.64)%(t=-4.006,P=0.000).In the death group,7 patients received tracheotomy,and 8 patients showed pulmonary infection,the proportions were significantly higher than those in the survival group(10/69,?2=29.749,P=0.000;and 15/69,?2=17.266,P=0.000).Conclusions Several factors,including high-level injury(C1-C4),neurogenic shock,pulmonary shock,and tracheotomy,may cause the death of patients with acute severe cervical spinal cord injury in an early stage.

Objective To study the optimal timing of tracheotomy in patients with acute cervical spinal cord injury who need ventilation for a long time . Methods A retrospective research on seventy-nine patients with acute cervical spinal cord injury who underwent tracheostomy in our hospital from January 2011 to December 2015 was conducted .The 79 patients were divided into two groups.The patients with a duration from intubation to tracheostomy less than or equal to 10 days were enrolled in group A , and the duration more than 10 days, group B.The duration of ventilation , the length of ICU stay , and the incidence rate of lung infection were compared between the two groups . Results The duration of ventilation in the group A (192 ±58) h was less than that in the group B (348 ±53) h (t=-12.490, P=0.000).The length of ICU stay in the group A (9.8 ±2.7) d was less than that in the group B (15.9 ±2.2) d (t=-11.058, P=0.000).The incidence of pneumonia in the group A (16.2%, 6/37) was lower than that in the group B (38.1%, 16/42,χ2 =4.686, P=0.030).Mechanical ventilation was successfully withdrawn in 34 and 38 cases of group A and B, without significant difference (χ2 =0.000, P=1.000). Conclusion Early tracheostomy in patients with acute cervical spinal cord injury who need ventilation for a long time could shorten the duration of ventilation and the length of ICU stay , and decrease the incidence of pneumonia .

Objective To investigate the relevant factors of early stage hyponatremia in patients with complete cervical spinal cord injury (CSCI). Methods A retrospective study was conducted in consecutive 49 individuals with complete CSCI from January 2010 to December 2015.The diagnostic criteria for hyponatremia was two consecutive tests (interval <24 h) of serum sodium <135 mmol/L.Twenty-six patients with hyponatremia were classified as hyponatremia group , and the other 23 patients without hyponatremia were classified as control group .Ten factors were included in the univariate analysis: age, gender, the highest level of CSCI , the degree of CSCI , the blood albumin when transferred to ICU , the serum sodium when transferred to ICU , the use of glucocorticoid , the incidence of neurogenic shock , the average daily urine output , and the average daily liquid balance .The variables with significance (P<0.05) in the univariate analysis then entered stepwise logistic regression analysis .The optimal critical point of the continuous variables with statistical significance in the univariate analysis was determined by drawing the receiver operator characteristic curve . Results There were differences in two variables between the two groups ( P<0.05 ) .The incidence of neurogenic shock before the occurrence of hyponatremia was 57.7% ( 15/26 ) in the patients with hyponatremia and 26.1% ( 6/23 ) in the patients without hyponatremia(χ2 =6.516,P=0.011).The average daily urine output was (2225 ±389) ml in the patients with hyponatremia and (1936 ±289) ml in the patients without hyponatremia (t=2.924,P=0.005).The stepwise logistic regression analysis indicated that these two factors may be the independent relevant factors (OR =13.708 and 0.996, P =0.004 and 0.002, respectively).The receiver operator characteristic curve demonstrated the average daily urine output more than 2331 ml was the optimal critical point . Conclusion The neurogenic shock and the average daily urine volume more than 2331 ml are the independent relevant factors of early stage hyponatremia in patients with complete CSCI .

Objective To compare the effectiveness and the influence on life quality of endovenous laser obliteration with those of traditional surgical ligation in treating varicosis of lower extremity.Methods By using numerical random grouping method,40 patients with varicosis of lower extremity were divided into traditional surgical ligation group (high ligation plus stripping,traditional group,n=20) and endovenous laser obliteration group (laser group,n=20).The curative effect and complications were compared between the two groups.According to the brief health survey (SF-36) scale,the influences of the two treatments on the life quality were evaluated.Results During the follow-up period,the differences in the curative effect and complications between two groups were not significant (P＞0.05).The life quality assessed by SF-36 scores in the laser group was better than that in the traditional group,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the treatment of varicosis of lower extremity,endovenous laser obliteration is safe and effective,it carries less influence on the patient's life quality when compared with traditional surgical ligation therapy.

Objective To evaluate hernia repair with Onlay (premuscular positioning of the prosthesis) for the treatment of parastomal hernia.Methods In this study 45 patients with parastomal hernia were treated with a tension-free manner of hernia repair in situ by Onlay using prolene mesh between February 2006 and April 2012.There were 24 males and 21 female cases,including 6 recurrent parastomal hernia cases.The average age was (49 ±8) years ranging from 43 to 80.The parastomal defect ranged from 4 cm to 9 cm.Results All operations were successful.There was no hospital death or severe postoperative complications.The mean operating time was (109 ± 23) min (96-148),and the average time of pulling out the gastrointestinal decompression tube was (2.0 ± 2.0) day (12 h-3 d) and the drainage tube was removed after (5.0 ± 2.0) days (4-9 d).The mean postoperative hospitalization was (11 ± 3) days (9-16 d).42 cases achieved primary healing.The serofluid swelling in 7 cases was cured by puncturing and pressing the incision.41 cases were followed-up from 8 to 48 months,and 4 patients suffered from hernia recurrence respestively after 3 months,4 months,4.5 months and 7 months.One recurrent case was healed by conservative therapy and the other three were healed by reoperation.Conclusions Hernia repair in situ with Onlay method for parastomal hernia with prolene mesh was a safe and effective.

Objective:To elucidate the phenomenon of natural remission or even natural recovery of asthma at puberty and put forward the laboratory evidences for the prevention and treatment of asthma Methods:The serum ECP, Tryptase and aeroallergen specific IgE antibody in 23 cases of asthmatics with remission at puberty, 15 cases of asthmatics, 29 cases of normal controls were detected respectively, using Pharmacia Unicap100 Type EIA fluorecent instrument Results: The positive rate of specific IgE antibody in asthmatics with remission at puberty was 66 66%, that in group of asthma was 71 42% and that in normal controls was 6 89% The positive rates of specific IgE in the former two groups were almost the same, and were significantly higher than that in normal controls (P

AIM To investigate the effect of puerarin (Pue) on tumor necrosis factor (TNF) ?, interleukin (IL) 6 secreted by neonatal rat cardiomyocytes during hypoxia/reoxygenation injury. METHOD The activities of TNF ? and IL 6 in the supernatants of cultured myocytes, which were sampled from different groups (control, model, and therapeutic groups with 1 g?L -1 Pue, 0 1 g?L -1 Pue, 0 01 g?L -1 Pue) at different time, were assayed by bioassay method. RESULTS TNF ? and IL 6 activity increased compared with that of control ( P