Objective:To study the clinical effect of different doses of ulinastatin combined with glutamine in treatment of acute severe pancreatitis.Methods:70 patients with acute severe pancreatitis patients admitted in our hospital from Jan. 2017 to Oct. 2019 were enrolled. According to the different dosage of ulinastatin, these patients were divided into 200 000 IU ulinastatin combined with glutamine group (200 000 IU combination group) , 400 000 IU ulinastatin combined with glutamine group (400000 IU combination group) , and 600 000 IU ulinastatin combined with glutamine group (600 000 IU combination group) . The study compared the 1-week mortality rate, abdominal pain relief time, respiratory frequency and heart rate back to normal time, blood amylase, glucose, C-reactive protein, procalcitonin levels, and white blood cell (WBC) count among the different groups.Results:The mortality of 400 000 IU combined group and 600 000 IU combined group were 4.35% and 5.56% respectively, which were significantly lower than 31.58% and 35% of the control group and 200 000 IU combined group ( P< 0.05) . The time of abdominal pain relief, respiratory rate and heart rate returning to normal in the 400 000 IU combined group were (7.21±1.25) d, (8.54±1.83) d and (9.54±2.23) d respectively, and (7.52±1.83) d, (8.13±1.75) d and (9.37±2.31) d in the 600 000 IU combined group, which were significantly lower than (9.12±2.78) d, (9.85± 3.16) d and (10.86±2.68) d in the control group and (8.76±1.96) d, (8.76±1.96) d and (10.62±1.43) d in the 200 000 IU combined group ( P<0.05) , There was no significant difference between the control group and the 200 000 IU combination group ( P>0.05) . Compared with the control group, there were significant differences in blood glucose, CRP and leukocyte count in different doses of ulinastatin+ glutamine treatment group ( P<0.05) ; However, there was no significant difference in blood glucose and CRP levels between different doses of ulinastatin+ glutamine treatment group ( P>0.05) , but compared with 200 000 IU combination group and 400 000 IU combination group, the leukocyte level of 600 000 combination group was significantly higher ( P<0.05) . Conclusion:ulinastatin combined with glutamine can significantly improve the clinical prognosis of patients with severe acute pancreatitis, but the clinical effect varies with the dose of ulinastatin. Conclusion Ulinastatin combined with glutamine can significantly improve the clinical prognosis of patients with acute severe pancreatitis, but the clinical effect varies with the dose of ulinastatin.

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.

Objective To observe the therapeutic effect of manipulative reduction combined with small-splint fixation for the treatment of Barton's fracture.Methods The apposition state,time for swelling disappearance,time for pain relief,and the score evaluated with Gartland-Werley(GW) criteria modified by Sarmiento were observed for the evaluation of therapeutic effect on Barton's fracture patients.Results After manipulative reduction combined with small-splint fixation,the apposition state was good,and volar tilting angle and ulnar inclination were improved in the patients.Time for the disappearance of swelling on the back of hand ranged from 4 to 14 days,averaged 6.0?1.6 days.Time for pain relief ranged from 3 to 10 days,averaged 6.4?1.6 days.Time for the union of fracture ranged from 30 to 60 days,averaged 35.4?8.3 days.The mean modified GW score was 3.6?2.5,and the score was excellent in 29 patients and good in 41 patients.Conclusion Manipulative reduction combined with small-splint fixation is effective and practical for the treatment of Barton's fracture.