Acute pancreatitis(AP)is a frequently encountered acute abdominal syndrome in clinical settings,and the integrated model of traditional Chinese and Western medicine(TCM-WM)has demonstrated notable advantages in the diagnosis and treatment of AP.To systematize and standardize clinical practices related to develop clinical pathway for integrated TCM-WM diagnosis and treatment of AP,which enhances the efficiency and quality of patient care.This pathway focuses on AP,a common acute and life-threatening disease within the digestive system,and outlines that the central pathological mechanism involves pancreatic injury and localized inflammation resulting from the abnormal activation of pancreatic enzymes.It has the characteristics of rapid onset,multiple causes,and complex manifestations.Severe cases can be life-threatening.At present,conventional treatments encompass a diverse range of modalities.Moreover,traditional Chinese medicine(TCM)holds distinct advantages in alleviating relevant symptoms,and TCM-WM is gaining increasing prevalence.To enhance the standardization and consistency of diagnostic and therapeutic practices,this clinical pathway clearly delineates the target patient population,which includes individuals diagnosed with abdominal pain disorder according to TCM and with AP in accordance with WM criteria,as well as the corresponding inclusion standards.The diagnostic framework integrates both TCM and WM guidelines,and further incorporates disease staging,severity grading,and syndrome differentiation to support a comprehensive and integrated diagnostic strategy.The treatment integrates approaches from both TCM and WM.Within the WM framework,interventions consist of basic supportive care,infection control,nutritional support,and the management of complications.In the context of TCM,the protocol includes syndrome differentiation and corresponding therapeutic strategies(Distinct syndrome patterns are identified and managed during the acute and convalescent phases),such as acupuncture and retention enema.This clinical pathway addresses multiple key components,including preventive strategies,post-treatment follow-up,criteria for evaluating therapeutic efficacy,admission and discharge,admission examination protocols,discharge criteria,and the rationale for deviations or withdrawal from the pathway.It is designed to provide a systematic and standardized reference framework for relevant clinical practices.

Acute pancreatitis(AP)is a frequently encountered acute abdominal syndrome in clinical settings,and the integrated model of traditional Chinese and Western medicine(TCM-WM)has demonstrated notable advantages in the diagnosis and treatment of AP.To systematize and standardize clinical practices related to develop clinical pathway for integrated TCM-WM diagnosis and treatment of AP,which enhances the efficiency and quality of patient care.This pathway focuses on AP,a common acute and life-threatening disease within the digestive system,and outlines that the central pathological mechanism involves pancreatic injury and localized inflammation resulting from the abnormal activation of pancreatic enzymes.It has the characteristics of rapid onset,multiple causes,and complex manifestations.Severe cases can be life-threatening.At present,conventional treatments encompass a diverse range of modalities.Moreover,traditional Chinese medicine(TCM)holds distinct advantages in alleviating relevant symptoms,and TCM-WM is gaining increasing prevalence.To enhance the standardization and consistency of diagnostic and therapeutic practices,this clinical pathway clearly delineates the target patient population,which includes individuals diagnosed with abdominal pain disorder according to TCM and with AP in accordance with WM criteria,as well as the corresponding inclusion standards.The diagnostic framework integrates both TCM and WM guidelines,and further incorporates disease staging,severity grading,and syndrome differentiation to support a comprehensive and integrated diagnostic strategy.The treatment integrates approaches from both TCM and WM.Within the WM framework,interventions consist of basic supportive care,infection control,nutritional support,and the management of complications.In the context of TCM,the protocol includes syndrome differentiation and corresponding therapeutic strategies(Distinct syndrome patterns are identified and managed during the acute and convalescent phases),such as acupuncture and retention enema.This clinical pathway addresses multiple key components,including preventive strategies,post-treatment follow-up,criteria for evaluating therapeutic efficacy,admission and discharge,admission examination protocols,discharge criteria,and the rationale for deviations or withdrawal from the pathway.It is designed to provide a systematic and standardized reference framework for relevant clinical practices.

Objective To study the risk factors for progressive cardiogenic stroke (CS).Methods Seventy-one acute ischemic stroke patients admitted to our hospital from 2008-08-01 to 2014-12-31 were divided into progressive CS group (n=14) and non-progressive CS group (n=57).The NIHSS was used to assess the neurologic deficit when the patients were admitted and 30 days after the stroke onset.Their clinical data were retrospectively analyzed.The risk factors for progressive CS were analyzed by univariate logistic regression analysis and multivariate logistic regression analysis respectively,their critical thresholds were analyzed according to the ROC curve.Results The NIHSS improvent of the progressive CS group was significantly less than that of the non-progressive CS group (P＜0.01).The age was significantly older,the incidence of right-side infarction and the serum level of D-dimer were significantly higher while the serum level of glutamic pyruvic transaminase was significantly lower in progressive CS group than in non-progressive CS group (77.29±8.87 years vs 71.44±9.51 years,P=0.041;71.4％ vs 33.3％,P=0.009;2.82 mg/L vs 0.91 mg/L,P=0.048;13.79±4.44 U/L vs 21.98±17.34 U/L,P=0.002).Lo gistic regression analysis showed a significant difference in age,right-side infarction and serum D-dimer level between the two groups (P=0.030,P=0.007,P=0.025).The area under the ROC curve revealed that age ＞ 70.75 years and serum D-dimer level ＞1.23 mg/L were the risk factors for progressive CS.Conclusion Age,right-side infarction and serum D-dimer level are the risk factors for progressive CS and can thus be used as predictors of progressive CS.

BACKGROUND: Diabetes can lead to many complications. Of them, retinopathy is a common type. To explore the effect of erythropoietin in diabetic retinopathy, it is necessary to establish an animal model of similar pathologic features and high reproducibility in clinical retinal neovascularization.
OBJECTIVE: To investigate the protective effect of vitreous cavity injection of erythropoietin on optic nerve of rats with diabetic retinopathy.
METHODS: Rat models of diabetic retinopathy were established and injected with erythropoietin through vitreous space for 14 consecutive days. Results were compared between the model and normal control groups.
RESULTS AND CONCLUSION: (1) Transmission electron microscope: compared with the model group, retinal ganglion cel nucleus presented uniform red; cel membrane was intact; endoplasmic reticulum exhibited slight swel ing. A smal number of vacuoles were found in mitochondria around the nuclei. (2) Western blot assay and RT-PCR: compared with the model group, Caspase-3 and Bax protein expression was lower in the erythropoietin group (P < 0.05). Caspase-3 protein and Bcl-2 protein expression was significantly higher in the erythropoietin group than in the model group (P < 0.05). Significant differences in nuclear factor κB and Survivn gene expression were detected between the model and erythropoietin groups (P < 0.05). (3) Results verified that vitreous cavity injection of erythropoietin had neuroprotective effect on rats with diabetic retinopathy, which may be associated with the inhibitory effect on apoptosis.

Objective To investigate the effect of recombinant human erythropoietin(rh‐EPO ) on acute cerebral injury and expression of GLT‐1 and GLAST in rat .Methods Sixty SD rats were randomly divided into three groups by weight :control group (n=18) ,acute cerebral injury group(n=22) and rh‐EPO conditioning group(n=20) .Acute cerebral injury models were made by modified Feeney′s method .rh‐EPO was injected in abdominal cavity 15 min after acute cerebral injury in rh‐EPO conditioning group .Rats′brain were removed 48 h after experiments .Rat GLT‐1 and GLAST mRNA expression were determined by RT‐PCR , GLT‐1 and GLAST protein expression were determined by Western blot .Results GLT‐1/GLAST mRNA and protein expression decreased significantly after acute cerebral injury(all P<0 .01) ,but increased significantly in rh‐EPO preconditioning group com‐pared with acute cerebral injury group(all P<0 .01) .Conclusion rh‐EPO preconditioning may protect against acute cerebral injury by up regulating the expression of GLT‐1/GLAST .

OBJECTIVE:To establish a method for content determination of phosphatidylcholine in eustachian tube lavage fluid of patients with secretory otitis media. METHODS:HPLC was used. The samples were pretreated by liquid-liquid extraction. It was performed on the column of Hypersil CN with mobile phase of acetoneitril-methanol-phosphoric acid (100∶10∶0.6,V/V/V)at the flow rate of 1.8 ml/min,the detection wavelength was 205 nm,temperature was 30 ℃ and volume was 20 μl. RESULTS:The lin-ear range of phosphatidylcholine was 11.99-119.9 μg/ml(r=0.999 6);RSDs of precision tests of intra-day and inter-day were no more than 15%;average recovery was 97.54%(RSD=9.36%,n=9);the average content of phosphatidylcholine in eustachian tube lavage fluid of patients was(24.43±3.61)μg/ml. CONCLUSIONS:The method is simple and accurate,and can be used for the content determination of phosphatidylcholine in eustachian tube lavage fluid of patients with secretory otitis media.

AIM: To observe the effects of hypoxia on the levels of nitric oxide (NO), endothelin (ET-1) and the expression of inducible nitric oxide synthase (iNOS) mRNA in human umbilical vein endothelial cells (HUVECs), and further investigate the mechanism of hypoxic pulmonary hypertension. METHODS: On the basis of the HUVECs culture model, the methods of nitrate reductase and radioimmunoassay were used to determine the changes of NO and ET-1 in the medium secreted by HUVECs, and the expression of iNOS mRNA was analyzed by semi quantitative RT-PCR after exposure to hypoxia (3% O_2) for 6, 12 or 24 h. RESULTS: The contents of NO_2-/NO_3-and ET-1 in hypoxia group in the medium was significantly higher than that in control group at different time points (P

0 05) 97% Spectral edge frequency (SEF) and median power frequency(MPF) decreased after intravenous clonidine(P0 05) Conclusions The contents of NE and E in cortex can indicate the inhabitive degree of isoflurane on consciousness, and the change of MAC of isoflurane is independent of the changes of NE and E contents in cortex,suggesting that the region where to determine the MAC of isoflurane is not at cortex

Objective To investigate the effects of inhalation of different concentrations of isoflurane on global and regional cerebral glucose metabolic rate (CMRglu) in healthy volunteers using positron emission tomography (PET) scan.Methods The study was approved by the ethic committee of the hospital. After obtaining written informed consent we studied eight right-handed healthy volunteers (3 male, 5 female), aged 21-28 yrs. Each volunteer underwent 3 PET scans.They were fasted for 8 h prior to study. The PET scan was performed when conscious, at 0.5 and 1.0 MAC isoflurane anesthesia. The interval between two PET scans was 1 week. Scans were obtained with a MASEP CPET Plus scanner (2.0 mm resolution-FWHM) using the 18 fluorodeoxyglucose technique. Results The whole brain CMRglu averaged 30.0?1.1 ?mol?100 mg-1?min-1 when the volunteer was awake. Isoflurane anesthesia significantly reduced whole-brain CMRglu by 24% to 23.3?1.4 ?mol?100 mg-1?min-1 at 0.5 MAC and by 41% to 18.4?0.9 ?mol?100mg-1?min-1 at 1.0 MAC (P

Objective To study the changes in cerebral cortex glutamate (G) content induced by isoflurane inhalation alone or combined with 2-amino-5-phosphonovalerate (AP5),a NMDA receptor competitive antagonist.Methods Six adult male SD rats were anesthetized with isoflurane. Dialysis probe (internal diameter=0.05mm) which was connected to a micro-infusion pump filled with artifical cerebrospinal fluid(ACSF) was inserted into cerebral cortex. The dialysate was collected for determination of G concentration. After the baseline MAC for isoflurane was measured, the study was carried out in 4 groups based on the concentration of isoflurane inhalation: group Ⅰ:1%; group Ⅱ:1MAC; group Ⅲ:2% and group Ⅳ: the effect of AP5 on isoflurane MAC value. In group Ⅳ AP5 was continuously infused at a rate of 100 ?g?kg -1?h -1 via the vein in the tail and the MAC for isoflurane was measured again. G concentration of dialysate was measured and EEG and SEP were monitored in every group.Results G concentration of cerebral cortex dialysate was decreasing with increasing concentration of isoflurane from group Ⅰ to group Ⅲ. Concentration of isoflurane was negatively correlated with cerebral G content (r=-0.839,P