Objective To evaluate the diagnostic value of combined test of C-reactive protein,amylase and lipase for acute pan-creatitis patients in early stage,and its practicability in assessment of disease severity.Methods 71 cases of acute pancreatitis pa-tients in the hospital from March 2012 to March 2014 were enrolled in the study,including 60 cases of mild pancreatitis patients,11 cases of severe pancreatitis patients.Meanwhile,30 cases of non-acute pancreatitis patients were enrolled as Control Group A,and 50 cases of adults who underwent conventional examination and proved to be healthy were enrolled as Control Group B.Detection of C-reactive protein,amylase and lipase of these samples were performed and the results were recorded,compared and analyzed.Re-sults The serum amylase level of acute pancreatitis patients was (759.42±721.63)U/L,and serum lipase level were (1 624.34± 1 598.25)U/L,which were significantly higher than people in Control Group A and Control Group B,with statistical significance (P <0.05).However,C-reactive protein level of acute pancreatitis patients were (44.61±34.21)mg/L,which were not statistical-ly different compared with Control Group B.Combined test of the three indicators demonstrated that the sensitivity was 95.9%, specificity was 100% and accuracy was 96.9%,all of which were higher than other test combinations or singe test with statistical significance(P <0.05 ).Conclusion The combined test of C-reactive protein,amylase and lipase for acute pancreatitis patients doesn′t only improve early diagnostic efficiency,but also is helpful in disease severity judgment.

Tumor markers play an important role in tumor mass screening, diagnosis and differential diagnosis of tumor, tumor staging, therapeutic evaluation and prognosis assessment. According to the nature,tumor markers can be classified as follows: embryonic antigen, carbohydrate antigens, proteins, enzymes, hormones, and so on. And tumor markers have been used in clinical widely.

Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula ( AVF) and 8 cases of artificial vessel arteriovenous fistula ( AVG).In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension , while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing (χ2 =17.77, P<0.001).All patients underwent percutaneous transluminal angioplasty ( PTA ) . In all patients the vascular diameter was increased significantly after PTA treatment [(3.6 ±0.2) vs.(1.2 ±0.1) mm, t=18.52, P<0.001].The blood flow during hemodialysis was increased significantly after PTA treatment in patients with anastomoti stenosis [(265.4 ±21.5) vs.( 150.5 ±23.1 ) ml/min, t =21.81, P <0.001 ]; however, there were no significant changes in venous pressure [(68.6 ±8.7) vs.(69.3 ±6.1) mmHg(1 mmHg=0.133 kPa), P>0.05].The blood pressure was decreased after PTA treatment [( 71.2 ±7.9 ) vs.( 170.4 ± 15.7) mmHg, t=34.62, P<0.001] in patients with venous outflowtract stenosis , however, there were no significant changes in the blood flow [(264.1 ±15.2) vs.(260.7 ±17.3) ml/min, t=1.04, P>0.05].

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

Small molecule inhibitors of Bcl-2 are a novel class of anticancer drugs that target anti-apoptotic proteins. In recent years,small molecule inhibitors such as ABT-737 ,ABT-263, gossypol, apogossypol,TW-37,obatoclax, HAl4-1 have attracted much reseach attention. Preclinical trials have shown that the inhibitors have cancer killing effect on some tumors when used alone and exhibit striking synergistic effect when combined with radiotherapy and/or chemotherapy.

Embryonic stem cell possess multi-directional differentiation capacity and can differentiate into all sorts of cells of three germ layers,it has the widely use in the treatment of tissue repair.Recent study shows that,embryonic stem cells can differentiate into cartilage cells in the effect of cytokines,hormones,micro-environment etc.In the is review,the author explore several studies and review the effects of different factors to the differentiation of embryonic stem cell to chondrocyte.

Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis.Methods By summarized current situation and advancement of serum fibrotic markers,ultrasound,CT and MRI in assessing liver fibrosis,we investigated their value and limitations.Results In addition to diagnosis,non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis.For liver fibrosis,however,non-invasive methods can not monitor effectively reaction to therapy and progression.Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis,and reduce the need of liver biopsy.

Objective To study the results of diagnosis and treatment of duodenal papilla carcinoma. Methods The clinical data of 48 cases of duodenal papilla carcinoma admitted and treated in our hospital during a 7-year period were analyzed retrospectively. The main clinical symptoms included jaundice(43 cases), upper abdominal pain(23 cases), pruritus of skin(12 cases) and other symploms (7cases). The diagnosis accuracy rate of B ultrasound, CT, and ERCP examination were 39.6%, 50.0% and 93.3% respectively. Pancreaticoduodenectomy was performed in 39 cases. (of these, 1 case underwent pylorus-preserving procedure), 5 cases underwent cholecystojejunostomy and/or gastroenterostomy, and 3 were willfully discharged after diagnosis.Results Thirty-six patients were followed up.Survival beyond 1 year and beyond 2 years afer pancreaticoduodeneoctomy were 66.7% and 30.6% (respectively), and 2 cases among 8 cases of 7-year survivors are alive now. But the 3 discharged patients who refused operations lived less than 1 year; and only 1 patient among those who underwent cholecystojejunostomy and/or (gastroenterostomy) lived more than 1 year. Conclusions ERCP plus biopsy are the primary means of diagnosis, and radical resection is the main treatment modality for duodenal papilla carcinoma.

The change of lung lymph after endotoxin-induced lung injury was studied using a sheep model with chronic lung lymph fistula. After endotoxin injection Ppa、PMV、 Q_L、CL_p、L_A/P_A、and Kf all increased markedly. The ratios of effects of pressure and permeability on Q_L were 1:0.53 and 1:2.31 during phase I and phase H respectively. The results indicated that the formation of pulmonary edema after injury related mainly to the increases of PMV and Kf and to the decrease of effective colloid osmotic pressure. The PMV was the main factor of formating edema during phase I and the permeability was that during phase Ⅱ.