Significance of vulnerability assessment in establishment of Hainan provincal disaster medical system

Hainan is an island province in south China with a high frequency of unconventional emergencies due to its special geographic location and national military defense role.Given the limited transportation route from Hainan to the outside world,self-rescue is more important to Hainan Province than other provinces in China and it is therefore imperative to establish an independent, scientific as well as efficient provincal disaster medical system in Hainan.The regulatory role for vulnerability analysis/assessment has been demonstrated in establisment of disaster medical system in varoius countries and or regions.In this paper,we attempt to describe/propose how to adopt vulnerability assessment through mathematical modeling of major biophysical social vulnerability factors to establish an independent,scientific,effieicnt and comprehensive provincial disaster medical system in Hainan.

Suppressive effect of pectic polysaccharides extracted from Rauwolfia verticillata(Lour.) Baill.var.hainanensis Tsiang on inflammation by regulation of NF-κB pathway and interleukin-17 in mice with dextran sulphatesodium-induced ulcerative colitis

Objective:To investigate the effects of pectic polysaccharides extracted from Rauwolfia verticillata(Lour.) Baill.var.hainanensis Tsiang on an experimental murine colitis model.Methods:Experimental colitis was induced by dextran sulfate sodium(DSS),and mice were divided into 4 groups:control.DSS alone.DSS plus SASP,DSS plus pectic polysaccharides.The disease activity index(DAI) and histological score were observed.The tumor necrosis factor(TNF)-α and interleukin(IL)-17 levels were measured by enzyme-linked immunosorbent assay.I κ B and NF-κB p65 expression were assessed by western blot analysis.Myeloperoxidase(MPO) activity was determined by using MPO assay kit.Re.sults:Administration of pectic polysaccharides significantly reduced the severity of DSS-induced colitis as assessed by DAT and histological score,and resulted in down regulation of MPO activity and NF-κB p65 expression and subsequent degradation of IκB protein,strikingly reduced the production of TNF-α and IL-17.Conclusions:Pectic polysaccharides extracted from Rauvolfia verticillata(Lour.)Baill.var.hainanensis Tsiang exerts beneficial effects in experimental colitis and may therefore provide a useful therapeutic approach for the treatment of UC.

The protective effect and underlying mechanism of Hainan papaya water extract against neuronal apoptosis induced by A β 40

Objective:To investigate whether Hainan papayas has protective effects in an Aimary neuron injury model and elucidate the underlying molecular mecha β 40-induced prnism.Methods:Cultured primary neurons from the dorsal root ganglia(DRG) of Sprague-Dawley(SD) rats were treated with 20 μM A culture medium β 40 peptide,100 μg/L Hainan papaya water extract,peptide plus extract,or for 24 h.Cell viability was measured by MTT assay,and neuronal apoptosis was evaluated by DAPI staining.ERK signaling pathway-associated molecule activation and changes in Bax expression were analyzed by Western blotting and immunofluorescence.Results:A cell viability rate of(44.11±6.59)% in the Ading different concentrations of the extract β 40 group was rescued to(79.13±6.64)% by ad.DAPI showed pyknotic nuclei in 39.5% of A β 40-treated cells;the fraction dropped to 17.4% in the 100 μg/L extract group.ERK phosphorylation was observed in the Aent with 100 μg/L extract.Hainan papaya water ex β 40 group but was ameliorated by pretreatmtract also prevented Ation of MEK,RSK1 and CREB associated with ERK signaling and d β 40-induced phosphorylaownregulated Bax expression in the neurons.Conclusion:The resultss suggest that Hainan papaya water extract has protective effects on neurons;the mechanism may be related to suppression of ERK signaling activation.

SLCO1B1 &ApoE Gene Polymorphism Analysis of the Li People in Hainan Island and Its Clinical Significance

Objective: To analyze the distribution characteristics and clinical significance of SLCO1B1 and ApoE gene polymorphisms of the Li people in Hainan Island. Method: Selecting 502 high school students of the Li people from five cities and counties in Hainan Island (namely, Qiongzhong County, Dongfang City, Ledong County, Baoting County and Wuzhishan City) as research subjects in September, 2019;Applying PCR-fluorescence probe method to detect SLCO1B1 and ApoE genotypes of the Li people in Hainan Island, and statistically analyzing the distribution characteristics of gene frequency and the distribution differences in gene polymorphisms between different genders. Meanwhile, detecting the SLCO1B1 and ApoE gene of 527 people from the Han people in five regions mentioned before, so as to analyze the distribution differences of the SLCO1B1 and ApoE gene between the Han people and the Li people. Results: The frequency of each genotype of SLCO1B1 in the Li people in Hainan Island is: *1a/*1a 6.77%, *1a/*1b 27.09%, *1b/1b 41.63%, *1a/*5 0.00%, *1a/*15 4.78%, *1b/15 16.93%., *5/*5 0.00%, *5/*15 0.00%, *15/*15 2.79%;And that of ApoE is: e2/e2 0.40%, e2/e3 17.73%, e2/e4 2.39%, e3/e3 65.54%, e3/e4 12.55%, e4/e4 1.39%. There is no significant difference (P > 0.05) in other genotypes except weak metabolic genotypes (*5/*5, *5/*15 and *15/*15) between the Han and the Li peoples. Conclusion: The gene frequency of SLCO1B1 weak metabolic genotype is dramatically higher in the Li people of Hainan Island than that of the Han people in both Hainan Island and Central and South China, but there is no significant difference in ApoE gene frequency among them. Therefore, clinicians should adjust the dosage of statins and select the types of lipid-lowering drugs according to the differences in patients’ genotypes, and strengthen the management of patients with ApoE4 risk gene.

CETP polymorphism confer genetic contribution to centenarians of Hainan,south of China

Objective:In this paper,we will discuss if the CETP polymorphism contributes to the centenarians in Hainan island.Methods:We tested the Taq IB and I405 V polymorphisms of CETP gene among 276 centenarians and 301 matched healthy individuals by AS-PCR and analyzed the data with SPSS software package(Version 19.0).Results:Our data indicated that allele B1 and V have the significant differences between centenarians and healthy control groups with P<0.001.Further analysis implied that genotypes B1B1(P<0.001,OR=0.148,95% CI=0.095-0.230) and VV(P<0.001 and OR=0.353,95% CI=0.237-0.525) were significantly different between centenarians and matched controls.The combination of B and V,such as B1B1-II(P<0.001,OR=0.128,95% CI=0.049-0.329),B1B1-IV(P<0.001,OR=0.115,95% CI=0.056-0.237),B1B2-VV(P<0.05,OR=0.534,95% CI=0.310-0.920),and B2B2-VV(P<0.001,OR=0.198,95% CI=0.086-0.453) have significant differences between centenarians and matched healthy individuals from Hainan.Conclusion:Our results implied that allele B1B1 and VV,as well as the combination B1B1-II,B1B1-IV,B1B2-VV and B2B2-VV may contribute to the longevity in centenarians of Hainan,south of China.

Mutation Analysis of STR Locus on 23 Autosomes in Hainan Population

[Objective] To analyze the mutation signature and regularity of STR locus on 23 autosomes in paternity testing cases in Hainan. [Methods] A total of 2715 paternity testing cases accepted by the Forensic Medical Identification Centre of our hospital from 2017 to 2020 derived from counties and cities in Hainan Province were collected, the cases containing gene mutations were selected, the mutation rate and details of each locus were counted, and the mutation regu-larity of 23 STR loci was analyzed. [Results] Of the 2715 cases identified as “support”, 1487 were triplet cases and 1640 were dyad cases, totaling 4614 meioses;There were 50 gene mutation events (including 17 triplet mutations and 33 dyad mutations), with an average mutation rate of 0.0047% and a cumulative mutation rate of 1.0837%. A total of 19 of the 23 STR loci were mutated, with a mutation rate of 0.1301% at the D12S391 locus and 0.0217% at five loci, TPOX, D1S1656, D2S441, D22S1045, and PentaD, while no muta-tion events were found at four loci, D19S433, TH01, D13S317, and D7S820. Of the 50 mutation events, 47 were one-step mutations, 1 was two-step, and 2 were three-step. There were 35 paternal mutations (13 triplets and 22 dyads), 6 maternal mutations (4 triplets and 2 dyads), and 9 indeterminate pater-nal/maternal mutations, with a paternal to maternal mutation ratio of 5.83:1. [Conclusion] The mutation rate of D12S391 locus is the highest, and the muta-tion rate of TPOX, D1S1656, D2S441, D22S1045 and PentaD loci is the lowest in Hainan population, and paternal mutations are more than maternal muta-tions. In the paternity test, if 1 - 3 STR loci do not conform to the genetic law, especially when the mutant locus is homozygous or the next of kin is identi-fied, it is necessary to use other kits to review and increase the number of loci or use the second-generation sequencing technology to confirm, carefully de-termine the mutation and ensure the accuracy of the identification conclusion.

A survey on the epidemiology of trauma and China trauma care training in subtropical regions of Hainan Province

Objective: To investigate the epidemiology of trauma patients in subtropical areas of Hainan Province and the improvement of the level of trauma treatment in China trauma care training (CTCT). Methods: From 01-01-2015 to 01-01-2016, the epidemiological data of 2476 patients with trauma were collected. From 01-01-2016 to 01-01-2017, 105 professional doctors and nurses in emergency surgery took part in CTCT, and their knowledge were compared before and after training. Results: There were 1656 male and 820 female trauma patients with 1614 cases in the middle and young age and 478 cases were the elderly. In terms of occupational distribution, 736 peasants, 574 workers and 458 retirees were involved. In May, the number of patients was the highest 332. October to January was the high-incidence season of trauma. In 24 hours a day: 11:00-13:00, 18:00-19:00, 23:00-03:00 were the high incidence periods. Referred to trauma sites, 904 cases of trauma happened on roads, 540 cases in family and 370 cases in restaurants or entertainment facilities. Through CTCT, the scores of the theoretical examination, the assessment of the trauma treatment skills and the field test scores of the emergency surgery practitioners were better than before (P<0.05).The misdiagnosis rate of severe trauma patients decreased from 26.21% to 15.36% (P<0.05). The mortality rate of severe trauma patients decreased from 18.67% to 13.94% (P<0.05). Conclusions:Trauma epidemiology in Hainan is closely related to its special geographical environment, which provides a reference for the prevention and treatment of trauma in Hainan, and some information for the government to formulate corresponding laws and regulations, as well as emergency plans and other relevant strategies. CTCT training improves the level of theoretical knowledge and first aid skills of medical personnel involved in trauma treatment. Health departments and medical education departments may consider extending CTCT training and continuing education programs to Hainan and other parts of China.

Management of regional citrate anticoagulation for continuous renal replacement therapy:guideline recommendations from Chinese emergency medical doctor consensus

Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation during CRRT.Regional citrate anticoagulation(RCA)has been shown to potentially be safer and more effective,and is now recommended as the preferred anticoagulant method for CRRT.However,there is still a lack of unified standards for RCA management in the world,and there are many problems in using this method in clinical practice.The Emergency Medical Doctor Branch of the Chinese Medical Doctor Association(CMDA)organized a panel of domestic emergency medicine experts and international experts of CRRT to discuss RCA-related issues,including the advantages and disadvantages of RCA in CRRT anticoagulation,the principle of RCA,parameter settings for RCA,monitoring of RCA(mainly metabolic acid-base disorders),and special issues during RCA.Based on the latest available research evidence as well as the paneled experts'clinical experience,considering the generalizability,suitability,and potential resource utilization,while also balancing clinical advantages and disadvantages,a total of 16 guideline recommendations were formed from the experts'consensus.

Distribution characteristics of atypical pathogen infection in Hainan

Objective:To investigate the distribution characteristics of atypical pathogen infection in Hainan.Methods:A descriptive research was used to collect the data of 800 patients with atypical pathogen infection in Hainan,(including Burkholderia pseudomallei,Aspergillus,Mycobacterium nontuberculosis,Nocardia,Penicillium marneffei,Cryptococcus,Candida albicans,Mycoplasma,Rickettsia).To study the epidemiological characteristics of the above pathogen infection.Results:In the distribution of population infected with atypical pathogens,the female composition ratio of Aspergillus,Nocardia and Penicillium marneffei was higher than that of male,while the male composition ratio of Burkholderia melioidis,non-tuberculous Mycobacterium,Cryptococcus,Candida albicans,Mycoplasma and Rickettsia was higher than that of female.In terms of age,melioidosis,Aspergillus,non-tuberculous Mycobacterium,Penicillium Marneffei and Rickettsia were the highest in the middle-aged group,the highest in the young group infected with Cryptococcus,the highest in the elderly group infected with Candida albicans,and the highest in the children infected with Mycoplasma.Children and farmers were more common,accounting for 35%and 29.25%respectively.Coastal area is the highest incidence area,as high as 89%;The onset time was mostly concentrated in the third quarter,accounting for the largest proportion.According to the statistics of the sources of samples that could be isolated,sputum culture was the most common.Hypertension was the most common complication of underlying diseases,and more than 55%of patients had fever before or on admission.Conclusion:Atypical pathogens in hainan area differences in the population distribution,the pathogen infection all have good sex and age,occupational distribution occurs in children and farmers,coastal areas and in the third quarter for the high incidence area and season,in addition,the atypical pathogen infection,often accompanied by fever and hypertension patients with suspected atypical pathogen infection,clinical to improve the diagnosis and treatment of these diseases,we should actively search for pathogens from multiple specimen sources.

Screening of NKX2-5,GATA4,ZIC3 gene mutations in sporadic congenital simple heart disease in Hainan Province

Objective:Congenital heart disease(CHD)is caused by abnormal cardiac development,which is the most common congenital malformation at home and abroad.NKX2-5,GATA4 and ZIC3 have been shown to be associated with CHD.This experiment explored the relationship between NKX2-5,GATA4 and ZIC3 gene mutations and sporadic CHD in Hainan Province.Methods:To collect 210 sporadic CHD patients in Hainan,the DNA of patients was extracted from blood,and the target gene fragments were amplified.Using high-resolution melting(HRM)and DNA sequencing technology,and we analyzed the sequences of NKX2-5,GATA4 and ZIC3 genes.Results:NKX2-5,GATA4 and ZIC3 genes were sequenced in 210 CHD patients,and seven gene mutations were found,including NKX2-5 heterozygous missense mutation(c.178G>T)and three heterozygous mutations in GATA4(c.677C>T,c.928A>G,c.1123G>A),three heterozygous mutations in ZIC3(c.19G>C,c.1255C>G,c.1348C>T),in which NKX2-5(c.178G>T),GATA4(c.1123G>A),and ZIC3(c.1255C>G,c.1348C>T)are new mutation sites.These gene mutations were predicted to be pathogenic mutations by bioinformatics software.Conclusion:Conclusion:Seven gene mutations were found in 210 patients,and it was the first report that the gene mutations of NKX2-5,GATA4 and ZIC3 in Hainan Province associated with the pathogenesis of CHD.

Interviews on the Cooperation between Hainan and Macao region in the TCM Industry to Promote Hainan’s TCM Industry

Objective To develop the internationalization and modernization of Hainan’s TCM industry,explore the development direction and fill in the research gap.Methods Design qualitative approaches,including fieldwork,semi-structured interviews,and policy analysis,were employed to identify development challenges for the cooperation between Hainan and Macao region in TCM industry.Ten interviews with key TCM industry stakeholders in Hainan and Macao region were conducted in 2020.These stakeholders are from schools,hospitals,companies,and governments.Hainan Province is the only free trade port with Chinese characteristics.Macao region is an international free trade port that has special economic relations with European and Portuguese-speaking countries.Therefore,this study focuses on the cooperation in the traditional Chinese medicine(TCM)industry between Hainan and Macao region.Besides,it investigates the traditional Chinese medicine industry in Hainan and Macao region according to the SWOT model.Results and Conclusion The study revealed strengths,weaknesses,opportunities,and threats for cooperation between Hainan and Macao region in TCM industry.Cooperation between Hainan and Macao region can be taken as a priority outline and a standard for the internationalization and modernization of Hainan’s TCM industry.

Clinical characteristics of patients with early-and late-onset optic neuromyelitis optica spectrum disease

Objective:To analyze the different clinical features of patients with early-onset(EO-NMOSDs)and late-onset neuromyelitis optica spectrum diseases(LO-NMOSDs).Methods:A total of 51patients with neuromyelitis optica spectrum disease who were diagnosed in our hospital for the first time from January 2015 to December 2022 were included in the First Affiliated Hospital of Hainan Medical College and divided into 22 cases in the EO-NMOSDs group and 29 cases in the LO-NMOSDs group according to whether the age of onset was 50 years old.The basic data,Extended Disability Status Scale(EDSS)score,blood and cerebrospinal fluid test indicators of the two groups were statistically analyzed.Results:There were no significant differences in demographic characteristics,clinical features and serum AQP-4 antibody positivity rate between the two groups(all P>0.05),and there were significant differences in triglycerides(TG),low-density lipoprotein(LDL),apolipoprotein A(APOA),apolipoprotein B(APOB)and lipoprotein a(P=0.010,P=0.048,P=0.014,P=0.061,P=0.001,respectively),and cerebrospinal fluid LDH,There were significant differences between microprotein quantification and EDSS score(P=0.018,P=0.034,P=0.025,respectively),and the level of microprotein quantification in cerebrospinal fluid of LO-NMOSDs had a certain correlation with the degree of disability(r=0.52,P<0.03).Conclusion:LO-NMOSDs and EO-NMOSDs group patients have similar demographic characteristics,serum AQP-4 antibody positive rate and clinical features,but compared with EO-NMOSDs,patients in LO-NMOSDs group are prone to abnormal lipid metabolism,higher trace proteins in cerebrospinal fluid and more likely to be disabled,and among LO-NMOSDs,the higher the trace protein in the cerebrospinal fluid,the more severe the disability status of patients.

Correlation Study of Neurotransmitter and Immune Levels in Pre-Hospital Emergency Nurses with Post-Traumatic Stress Disorder

Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.

Evaluation of the Effectiveness and Efficiency of Extracorporeal Shock Wave Combined with Rehabilitation Training in the Treatment of Muscle Articulation Chronic Pain

Objective: To analyze the effect of combined extracorporeal shock wave and rehabilitation training treatment in patients with muscle articulation chronic pain (MACP). Methods: Ninety-seven MACP patients admitted to our hospital from September 2021 to September 2023 were randomly selected and were divided into Group A (control group, 46 cases, rehabilitation training treatment) and Group B (observation group, 51 cases, extracorporeal shock wave with rehabilitation training treatment), and outcomes of the two groups were compared. Results: The treatment efficiency, post-treatment clinical indexes (upper and lower limb function scores, activities of daily living (ADL) scores, visual analog scale (VAS) scores), and short-form 36 (SF-36) scores of Group B were better than those of Group A (P < 0.05). Conclusion: Combined extracorporeal shock wave and rehabilitation training treatment for MACP patients improved their limb function, daily activities, quality of life, and reduced pain.

Effect of partial splenic embolization on the immune function of cirrhosis patients with hypersplenism

Objective:To discover the effect of partial splenic embolization on the immune function of cirrhotic patients with hypersplenism.Methods:Patients involved in the study were enrolled and divided into three groups,including control group,experimental group,and complication group.Numbers of CD3^+,CD4^+ and CD8^+ T cells and CD4^+CD25^+CDl27^(low/-) Treg cells in the peripheral blood of patients before surgery,1 month,6 months,1 year,and 2 years after surgery were analyzed by fluorescence active cell sorting(FACS).Contents of immunoglobulins(IgA,IgG and IgM) were analyzed by auto immunoassay analyzer.Results:In the peripheral blood of patients from experimental group,numbers of CD3^+,CD4^+ and CD8^+ T cells initially declined,but afterwards increased to normal level;in the peripheral blood of patients from complication group,CD3^+ and CD8^+ T cells showed the same trend,but the number of CD4^+ T cells was below normal level at all detection times.Furthermore,CD3^+,CD4^+ and CD8^+ T cells in the peripheral blood of patients from complication group were initially less than those in experimental group,and afterwards were comparable between two groups.In patients from both experimental group and complication group,the number of CD4^+CD25^+CDl27^(low/-)Treg cells increased 1 month and 6 months after surgery,and gradually restored to normal level.CD4^+CD25^+CDl27^(low/-)Treg cell counts in patients from complication group were initially more than those in patients from experimental group 1 month and 6 months after surgery,but then they were comparable.Furthermore,contents of immunoglobulins(IgA,IgG and IgM) were comparable in three groups at all detection times.Conclusion:Partial splenic embolization influenced the immune function of cirrhotic patients with hypersplenism in the short term but the immune function could afterwards gradually restore to normal.Our results implicated that measures that prevent infection and improve immune function were necessary in early stage after undergoing PSE in order to reduce complications.

Clinical significance of dynamic detection for serum levels of MCP-1,TNF-α and IL-8 in patients with acute pancreatitis

Objective:To observe dynamic changes of levels of monocyte chemotactic protein-1(MCP-1),tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in patients with acute pancreatitis and to investigate its evaluation value on the severity of acute pancreatitis.Methods:A total of 109 patients with acute pancreatitis admitted were divided into mild acute pancreatitis group(MAP group,42 cases),moderately severe acute pancreatitis(MSAP group,35 cases)and severe acute pancreatitis(SAP group,32 cases).ELISA was used to detect the serum levels of MCP-1,TNF-α and IL-8 of patients at day 1,day 4 and day 7 of admission to hospital.Results:The serum levels of MCP-1,TNF-α and IL-8 from MAP group,MSAP group and SAP group at day 1 of admission to hospital all significantly increased.There was a significant difference between MAP group and control group,MSAP group and MAP group,SAP group and MSAP group(P<0.05).The serum concentrations of IL-8 from MASP group and SAP group obviously increased at day 1,and there was significant difference between MASP group and MAP group,SAP group and MSAP group(P<0.05),while the difference between MAP group and control group was not obvious(P>0.05);The serum concentrations of MCP-1,TNF-α and IL-8 from MAP group all reached the highest level at day 4,which were significantly higher than the detection levels at day 1.In MSAP group and SAP group,the serum concentrations of MCP-1,TNF-α and IL-8 were the highest at day 1,which were significantly higher than the detection levels at day 4 and 7.At each detecting timing,the serum concentrations of MCP-1,TNF-α and IL-8 from MSAP group and SAP group were all higher than those of MAP group and MSAP group,respectively.Conclusions:The dynamic changes of serum levels of MCP-1,TNF-α and IL-8 in patients with acute pancreatitis have their rules,and the change rule of MAP group was different with that of MSAP and SAP group,which showed the reference value for the diagnosis and illness severity evaluation of acute pancreatitis.

Assessment of hepatic functional reserve by cirrhosis grading and liver volume measurement using CT

AIM： To explore a method for quantitative assessment of hepatic functional reserve by combining computed tomography （CT） volumetry with CT grading of liver cirrhosis before liver resection in patients with hepatocellular carcinoma. METHODS： CT images of 55 patients undergoing liver resection were studied prospectively. The degree of liver cirrhosis was referred as ＂CT grade＂ and the percentage of remnant liver volume （PRLV） [PRLV = predicted RLV/predicted total liver volume （PTLV） × 100%; PTLV （mL） = 121.75 ＋ 16.49 × body mass （kg）] were calculated by adding slice by slice of CT liver images. The postoperative RLV, pathologic stages of liver fibrosis in non-tumor area and survival time in these cases were analyzed. RESULTS： There was a significant difference in survival time between the group with PRLV ≤ 50% and the group with PRLV 〉 50% （X^2= 4.988, P = 0.026）, and between the group with CT grade 0/1 and the group with CT grade 2/3 （X^2= 5.429, P = 0.026）. With combination of the both parameters, an oblique line was identified according to the distribution of 32 survivors versus 23 deceased subjects. The mortality rate above the line was 7.1% （1/14）, and that below the line was 53.7% （22/41）, indicating a significant difference between the two rates （X^2 = 9.281, P = 0.002, P 〈 0.05）. CONCLUSION： PRLV and CT grades are significantly correlated with hepatic functional reserve. The predicted line using these two parameters is useful in candidates undergoing liver resection for judging hepatic functional reserve.

Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis

AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatitis. METHODS： Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group （group 1） and control group （group 2）. Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis. RESULTS： On the second and fifth days after treatment, APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness （abdominalgia and burbulence relief time, hospitalization time） between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated （r = 0.552, 0.748, 0.923, P 〈 0.01） with APACHE Ⅱ scores. CONCLUSION： Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration （SVVH）, gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.

Comparison of anti-atherosclerotic effects of two different extracts from leaves of Mallotus furetianus

Objective:To compare the anti-atherosclerotic effects of two different extracts from the leaves of Mallotus fiiretianus by using rat model of atherosclerosis.Methods:The air-flriefl powdered Mallotus fiiretianus leaves were extracted with ethanol and then evaporated.The ethanol extract was experienced Diaion HP-20 CC with a gradient of MeOH and H2O（50:50,100:0,v/v） and two fractions,Mallotus fiiretianus A（Mf A） and Mallotus fiiretianus B（MfB） were obtained.RaLs were divided into control,atherosclerosis and vitamin E,Mf A and Mf B treated groups.Atherosclerotic model was established by administering u loading dose of vitamin D3 and feeding standard diet enriched with 2%cholesterol,0.5%porcine chelate,0.2%methimazole,5%sugar,10%pork fat. Vitamin E（0.20 g/kg）,Mf A（0.053 g/kg）,Mf B（0.057 g/kg）（with the potential） were administered to interfere with the development of atherosclerosis.After 9 weeks,rats were sacrificed and the blood lipid as well as composition of bile was examined.In addition,the thoracic aorta was harvested to evaluate histological changes and the intima-media thickness ratio.Results: Atherosclerosis model was successfully established,administration of vitamin E,Mf A and Mf B increased excretion of total bilirubin in bile,decreased triglycridc（TO）,total cholesterol（TC）, low density lipoprotein-cholesterol（LDL-C） level,enhanced ratio of high density lipoprotein-cholesterol and LDL-C in blood,improved histological changes and diminished intimamedia thickness ratio of thoracic aorta in atherosclerotic rats.As for the difference in antiatherosclerotic effects between Mf A and MfB,Mf A may be more powerful in declining TG level and Mf B may be more effective in decreasing TC level.Conclusions:The two different extracts. Mf A and Mf B can prevent the development of atherosclerosis.In detail,Mf A is more effective in regulating TG level and Mf B is more powerful in modulating TC.level in atherosclerotic rats.

Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

AIM: To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs). METHODS: Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole (n = 68), 30 mg of lansoprazole (n = 69), 40 mg of pantoprazole (n = 69), 40 mg of esomeprazole (n = 68) once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2: mild-moderate; 3: moderate; 4: moderate-severe; 5: severe). RESULTS: The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI. Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole (P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069, respectively), lansoprazole (P = 0.0020, P = 0.0046, P = 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole (P = 0.0006, P = 0.0005, P = 0.0009, P = 0.0031, P = 0.0119, respectively). There were no significant differences between the four groups in the rate of endoscopic healing of reflux esophagitis at week 8. CONCLUSION: Esomeprazole may be more effective than omeprazole, lansoprazole, and pantoprazole for the rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis.