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The effects of early enteral nutrition therapy combined with micro-ecological preparation on intestinal function recovery in patients with severe acute pancreatitis

Objective To explore the effects of early enteral nutrition therapy combined with micro-ecologicalpreparation on early intestinal function recovery in patients with severe acute pancreatitis (SAP). Methods The clinical data of 48 patients with SAP treated from January 2012 to January 2015 were retrospectively analyzed. Out of the 48 cases, 23 were treated with early enteral nutrition therapy (the control group), and 25 were treated with early enteral nutrition therapy combined with micro-ecologicalpreparation (the observation group). The counts of white blood cells (WBC), the levels of blood amylase, serum lipase, lactic dehydrogenase (LDH), and the scores of gastrointestinal function 1 day before treatment and on the 7th and 14th day of treatment were observed. The incidences of complications, case fatality rates, and lengths of hospital stay were recorded. Results One day before treatment, the differences in the counts of WBC, the levels of blood amylase, lipase, and LDH between the two groups were not statistically significant (P>0.05). On the 7th day of treatment, the counts of WBC, the levels of blood amylase, lipase, and LDH in the two groups decreased in varying degrees, and the decreasing in the observation group was more obvious (P<0.05). On the 14th day of treatment, the levels of blood amylase in the two groups were almost normal, and the difference between the two groups was not statistically significant (P>0.05); the levels of lipase, LDH and the counts of WBC in the observation group were lower than those in the control group (P<0.05). One day before treatment, the difference in the scores of gastrointestinal function between the control group (1.34±0.76) and the observation group (1.46±0.62) was not statistically significant (P>0.05); on the 7th and 14th day of treatment, the scores of gastrointestinal function in the observation group (0.37±0.18, 0.29±0.06) were lower than those in the control group (0.63±0.32, 0.47±0.08), and the differences were statistically significant (P<0.05). There were significant differences between the two groups in terms of the incidence of total complications and length of hospital stay (P<0.05), while the difference in the case fatality rate between the two groups was not statistically significant (P>0.05). Conclusion Early enteral nutrition combined with micro-ecological preparation is benefit to the intestinal function recovery in patients with SAP.

二次手术切除异位甲状旁腺腺瘤1例报告

Laser-induced chorioretinal venous anastomosis for retinal vein occlusion

Purpose To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion　(RVO)． Methods The investigation included 28 consecutive patients　(28 eyes) with RVO．The non-ischemic group 18-cases　(18 eyes) we re tre ated with the krypton red laser to induce chorioretinal venous anastomosis， the ischemic group underwent the same therapy and the grid or scattertype photoco agulation at the same time． All of the eyes were followed up for more than 5 mo nths， and with an average period of 6.6 months． Results Seven cases　(7 eyes， 38．9%) of the non-ischemic group created successful chorioretinal venous anastomosis， with mean improvement of 4．43plusmn;0．7 8　standard deviation lines of best corrected visual acuity compared to0.19plusmn;0.67 lines for 11 eyes with unsuccessful anastomosis　(Plt;0.001)．None of the seven eyes developed to ischemic state． Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36.4%) ．Two cases of the ischemic group created successful anastomosis with improvement in visual acuity． The other cases had no change in visual acuity． Conclusion Laser-induced chorioretinal venous anasto mosis is a new therapeutic method for RVO， especially for nonischemic type and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state． (Chin J Ocul Fundus Dis, 2001,17:8-11)

Diagnosis and Treatment of Adenomyepithelioma of Breast (Report of 6 Cases)

目的探讨乳腺腺肌上皮瘤临床特点、诊断及治疗方法。方法回顾性分析乳腺腺肌上皮瘤6例。结果6例均表现为乳腺包块，直径在1.5～3 cm之间，对其均行乳腺包块切除术。术后随访6个月～6年，无复发。结论乳腺腺肌上皮瘤为良性肿瘤，首选治疗为包括肿瘤组织的局部扩大切除术。

Herbert加压螺钉治疗桡骨头骨折疗效分析

【摘 要】 目的 总结切开复位Herbert加压螺钉内固定治疗桡骨头骨折的疗效。 方法 2009年1月－2010年9月，采用切开复位Herbert加压螺钉内固定治疗16例桡骨头骨折。男11例，女5例；年龄18～48岁，平均33岁。骨折按Mason分型：Ⅱ型13例，合并内侧副韧带损伤3例；Ⅲ型3例，合并内、外侧副韧带损伤各1例，尺骨冠突骨折1例。伤后至手术时间3～8 d。 结果 术后患者切口均Ⅰ期愈合。16例均获随访，随访时间12～24个月，平均18个月。X线片示术后2～5个月骨折愈合。4例肘关节运动受限；1例术后3个月出现肘关节异位骨化。末次随访时，按Broberg和Morrey肘关节评分标准，获优2例，良10例，可2例，差2例，优良率75%。 结论 Herbert加压螺钉治疗桡骨头Mason Ⅱ型骨折，固定牢靠，肘关节功能恢复满意；治疗MasonⅢ型骨折疗效尚未明确，临床选择需谨慎。

背阔肌肌皮瓣移位重建屈肘功能二例

The therapeutic efficacy of laser-induced chorioretinal venous anastomosis on macular edema of non ischemic retinal vein occlusion

Objective To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis on macular edema of non-ischemic retinal vein occlusion. Methods Thirty-seven eyes of 37 cases of non-ischemic retinal vein occlusion received the treatment of laserinduced chorioretinal venous anastomosis and were followed up for 6～12 months. All affected eyes underwent the clinical examinations of visual acuity, ocular fundus photography, fundus fluoreceine angoigraphy (FFA) and light sensitivity of central 5 degree of the retina, and the pre- and post-operative clinical materials were analyzed. Results Successful chorioretinal venous anastomosis was formed in 18 eyes (48.6%) within 2 months after laser photocoaglation, with the mean best improved corrected visual acuity of (4.25±0.46) lines, while the mean best corrected visual acuity of the other 19 eyes with unsuccessful anastomosis decreased (0.20±0.54) lines（P＜0.001）. The light sensitivity of central 5 degree of the 18 eyes with successful anastomosis improved（P＜0.001）, with resolution of macular edema in 16 eyes, although cystoid macular edema in 2 eyes remained no change. The light sensitivity of central 5 degree of the 19 eyes with unsuccessful anastomosis have decreased（P＜0.05）, with aggrevation of the macular edema. Conclusion Successful laser-induced chorioretinal anastomosis can resolute the macular edema caused by retinal vein occlusion, especially for diffused macular edema caused by early retinal vein occlusion. (Chin J Ocul Fundus Dis,2002,18:10-12)

Risk Factor and Population Attributable Risk of Children Leukemia in China: A Meta-Analysis

Objective　To systematically evaluate the risk factors and population attributable risk of children leukemia in China, so as to provide references for policy-making. Methods　The case-control studies about risk factors of children leukemia in China were searched in PubMed, CNKI, CBM, VIP and WanFang Data from inception to December 2011. According to the inclusion and exclusion criteria, two reviewers independently screened articles, extracted data, and evaluated the quality of the included studies. Then Meta-analysis was performed using STATA 11 and Excel 2003. The pooled odds ratio (OR) and 95% confidence interval (95%CI) of each risk factor were calculated, and the population attributable risk percent (PARP) based on the exposure rate of the risk factors was computed, and published bias was estimated according to the fail-safe number. Results　A total of 15 case-control studies were included. The first 5 risk factors related to children leukemia were: dwelling environmental pollution (OR=2.782, 95%CI 2.268 to 3.413), house decoration (OR=2.525, 95%CI 1.736 to 3.673), maternal exposure to chemical hazards (OR=2.428, 95%CI 1.976 to 2.985), family history of tumor (OR=2.212, 95%CI 1.677 to 2.919), and child exposure to electromagnetic field around dwelling (OR=2.144, 95%CI 1.761 to 2.610). Factors with higher PARP were influenza history (37.56%), house decoration history (32.95%), X-ray exposure history (20.47%), and chemical hazards exposure history (17.37%). The fail-safe number showed the results were generally reliable. Conclusion　In order to prevent and control children leukemia, positive and effective measures should be taken in the following aspects: strengthening child care, avoiding unnecessary X-ray exposure, and providing good living environment.

COMBINATION OF HIGH POROUS POLYETHYLENE LOWER EYELID SPACERS AND LATERAL TARSAL-STRIP PROCEDURE FOR RECONSTRUCTION OF EYELID CLOSURE FUNCTION IN PARALYTIC LAGOPHTHALMUS AFTER FACIAL PALSY

ObjectiveTo evaluate the effectivness of using high porous polyethylene lower eyelid spacers (Medpor LES) combined with the lateral tarsal-strip procedure for reconstruction of the eyelid closure function in paralytic lagophthalmus after facial palsy. MethodsBetween March 2008 and December 2012, 32 patients (32 eyelids) with hypophasis in facial palsy which all sorts of causes lead to were treated with Medpor LES combined with the lateral tarsal-strip procedure. Of 32 cases, 20 were male and 12 were female, aged from 20 to 72 years (mean, 46.8 years). The left eye was involved in 18 cases and the right eye in 14 cases with a disease duration of 1.5 months to 2 years (mean, 4.4 months). All the patients were shown as lower eyelid ectropion, lower eyelid retraction, exposure keratitis, and corneal ulcer, but no obvious upper eyelid retraction was observed. ResultsPrimary healing of incision was obtained in all patients. The edema time of the eyelid was from 5 days to 3 weeks (mean, 2 weeks). Conjunctival edema appeared in 4 cases after 2 weeks of operation, which was cured after expectant treatment. The patients were followed up 5-8 months (mean, 6 months). At 1 week, 3 and 6 months after operation, the height of palpebral fissure was reduced, and the degree of lagophthalmus and low eyelid retraction were significantly corrected (P<0.05), but no significant difference among different time points after operation (P>0.05). Outer canthus displacement occurred in 3 cases at 1 month postoperatively, and was cured after the lateral tarsal strip procedure. No lower eyelid ectropion, corneal exposure, or Medpor LES displacement and exposure occurred during follow-up. ConclusionMedpor LES combined with the lateral tarsal-strip procedure has good effectiveness for reconstruction of eyelid closure function in most cases of paralytic lagophthalmus after facial palsy.

Introduction of international evaluation process of genetic testing technology

ObjectivesTo provide a reference for the evaluation procedures of genetic testing technology applicable to China by combining the existing evaluation frameworks and procedures for genetic testing techniques globally, and also put forward design suggestions for the construction of evaluation procedures in China.MethodsThe literature research method was primarily used to summarize different evaluation progress, as well as put forward design suggestions.ResultsAt present, numerous developed countries have organized genetic testing technology evaluation projects. The various evaluation frameworks developed were based on the ACCE or HTA framework. The evaluation and decision-making procedures were similar in general, including topic selection, evaluation implementation, results reporting and making recommendations. However, there still remained difficulties such as limited evidence and uncertainty in decision-making.ConclusionsTo establish the procedures of genetic testing technology applicable in China, the following specific procedures are recommended: selecting target genetic testing technology topics; analyzing necessity and feasibility of target testing technology evaluation; evaluating and reviewing the evidence; applying results and decision-making transformation; developing regular review and revision mechanisms.