Objective: To increase the success rate of endoscopic and laparoscopic surgery live broadcast by careful design and well-organized implementation in large medical meetings. Methods: A retrospective analysis of the experience of endoscopic and laparoscopic surgery live broadcast, including digestive, gynecologic, urologic and general surgical operations, from fifteen large-scale national and international conferences in our hospital from January 2006 to December 2012. After communicated with doctors and fully understood patient illness, we analyzed the characteristics, requirements and the forms of the meetings while making emergency measures for the live broadcast, then careful designed procedure for the meeting and next well-organized implementation of our plans. Results: All the endoscopic and laparoscopic surgery live broadcasts were successful. The audio and visual transmission system worked well during the meetings. There was no image interruption occurred in the live broadcast. Conclusion:Careful laparoscopic surgery live broadcast, which is a good method for endoscopic and laparoscopic surgery technique. Our experience of endoscopic and laparoscopic surgery live broadcast it has development application value.

The dialysis for three species of poplar stems apoplast was obtained by microdialysis method, and then the concentration of Na+, K+, Ca2+ in the dialysis sample was directly measured by graphite furnace atomic absorption spectrometry ( GF-AAS) . The flow rate of perfusate was 1μL/min and the cut-off molecular weight of probe was 30 kDa. The real-time and non-destructive test technique established for the detection of ion concentration could be applied in research of poplar biochemical physiology. The recovery of the proposed method was 95. 8%-103. 1%. The contents of sodium ion in Populus wutunensis, Populus simonii and Salix matsudana were 1034-1156 μg/L, 1493-1611 μg/L and 1586-1703 μg/L; potassium ion were 1012-1237 μg/L, 941-964 μg/L and 1095-1201 μg/L; calcium ion were 4976-5237 μg/L, 4786-5042 μg/L and 5893-6142 μg/L. The method could provide reliable data for the study of ion concentration changes of plant response to adapt to all kinds of external environment.

Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy ( NPWT) in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .

Objective To explore the effect of phenol oxidase antigen on liver pathologic change in mice infected with Schistosoma japonicum. Methods 42d-aged adult worms were incubated in RPMI 1640 containing 0.05% sodium phenobarbital for 8 h. The worms were washed three times with PBS (pH 6.8) and homogenized with a Teflon pestle. The homogenate was then centrifuged at 3000 g for 20 min at 4 ℃. Supernatant fractions containing phenol oxidase (PO) were analyzed by means of polyacrylamide gel electrophoresis (PAGE). The rude antigen of PO was obtained by cutting the corresponding gel of PO activities. Three groups were set up to observe whether PO could induce protective immunity: experiment group, adjuvant control group and water control group. On day 42 post infection with (40?1) cercariae of Schistosoma japonicum, the mice were sacrificed to observe liver pathologic changes. Results The liver surface of PO immunized group was rather smooth and the liver color was slightly gray. A few pale nods were seen indistinctly but not clearly. Necrosis and inflammatory cell infiltration were not clear. There were many immature eggs without granuloma reaction. The mean diameter and area of the granuloma in the experiment group were less than those in the control group. There were significant differences among the 3 groups (P

Objective To study the safety and feasibility of endobiliary intraductal radiofrequency ablation (RFA) to reopen occluded self-expandable metal stents in patients with malignant biliary obstruction.Methods 11 patients with malignant biliary obstruction and blocked metal stents were prospectively studied.During ERCP, after biliary cannulation, the blocked metal stents underwent RFA using a bipolar radiofrequency probe which was introduced into the stenotic bile duct via a guide wire.This was followed by a balloon to repeatedly remove debris and then endoscopic nasobiliary drainage.The patients were closely observed and followed up.Results RFA was successfully carried out in all the patients and patencies were achieved when compared with pre-RFA.The median post-RFA luminal diameter of the strictures showed significant improvement: 6 (4 ～ 10) mm versus 2 (0 ～ 5) mm, and the mean post-RFA total bilirubin level decreased sharply : (39.4 ± 8.7) μ mol/L versus (130.1 ± 38.2) μmol/L.Following this intervention, 3 patients developed fever, which were controlled with conservative therapy.There was no mortality, haemorrhage, bile duct perforation or bile leak.Of the 11 patients, 3 were dead and 6 were alive at a median follow-up of 187 (75 ～ 304) days.The median stent patency was 135 (75 ～ 203) days and the median survival was 278 (75 ～ 304) days.Four patients had their stents patent at the time of the last follow-up or death.Seven patients had their stents blocked on 113, 124, 154, 203, 96, 135 and 112 days post-procedure.Condusions Endobiliary intraductal RFA is technically feasible and safe to reopen occluded metal stents in malignant biliary obstruction.This efficacy needs to be confirmed by future randomized studies.

Objective Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus ( DM2).The aim of this study is to compare the effect of three diagnostic criteria on the prevalence of GDM.Methods 2864 pregnant women receiving obstetric care at 24 to 28 weeks of gestation at Peking University First Hospital,underwent the 75 g oral glucose tolerance test for routine GDM screening.The pregnancies were evaluated bythe American Diabetes Association (ADA 2004) Cuideline,the new criteria which was proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG 2010) based on the HAPO study,not by the criteria of American College of Obstetricians and Chinese Obstetrics and Gynecology (6th edition 2005).Venous plasma glucose was measured by the IDMS-traceable glucose oxidase method.Results The mean age of the women was 30 years.590 women were diagnosed with GDM using the IADPSG criteria.According to the IADPSG standard,GDM diagnostic rate reached 20.6％.The diagnostic rate of new criteria was increased by 307％ and 199％ compared with the Chinese Obstetrics and Gynaecology (6th edition) and the old ADA standard,respectively.If increasing the number of abnormal glucose values in the IADPS standard to 2 or more,the number of positive cases dropped to 227 people.The diagnostic rate of GDM plummeted to 7.93％,similar with that of the old ADA diagnostic criteria (6.8％).Conclusions The diagnosis rate of GDM was significantly higher using the IADPSG criteria,due to more stringent glucose abnormality recommended by the IADPSG.

ObjectiveTo explore the efficacy and safety of percutaneous antegrade stenting in the treatment of ureteral obstruction after renal transplantation.MethodsWe retrospectively reviewed 11patients with renal graft ureteral obstruction (2 cases of acute obstruction and 9 cases of chronic obstruction) from March 2009 to March 2011.The etiology of the obstruction was renal graft-ureter-bladder anastomotic stricture in 5 cases,stone obstruction in 2 cases,and undetermined in 4 cases.Renal graft and collecting system were examined by ultrasonography preoperatively to select suitable puncture position,and then ureteropyelography was performed under X-ray guidance.When the obstruction location was clear,the urology guidewire was implanted to the bladder by needle,and then guidewire was released by cystoscopy.Ureteral stent was implanted along the guidewire,and upper ureteral stents was observed under X-ray. After removal of guidewire,the stent location was confirmed once again.The renal pelvis fistula drainage lasted for 1-2 weeks,and ureteral stent to 6 months to one year.Ultrasound and renal function were tested after 1week,1month,3 months and 6 months,and then every six months.ResultsOperation was done successfully in 10 patients,and failed in one case due to a long segment of ureteral stenosis.The operating time of ureteral stent implantation was 54±27 min.Serum creatinine of patients was reduced from preoperative 326±147 to postoperative 89±49 μmol/L.During a follow-up period of 6 to 27 months,no complications occurred.ConclusionPercutaneous antegrade stenting in the treatment of ureteral obstruction after renal transplantation is safe and effective.

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients over 80 years old with biliary-pancreatic diseases. Methods One hundred and twenty patients over 80 years old who underwent ERCP between January 2004 and April 2008 were retrospectively analyzed. The clinical efficacy, safety and complication were observed and followed up. Results One hundred and seventeen patients successfully underwent therapeutic ERCP and the success rate was 97.5%. All diseases of the patients included cholangiocarcinoma in 22 cases, duodenal papilla carcinoma in 3 cases, pancreatic carcinoma in 8 cases, acute pancreatitis in 15 cases, chronic pancreatitis in 5 cases, acute suppurative cholangitis in 9 cases and choledocholithiasis in 58 cases. During the procedure of ERCP, 3 cases failed to insert the duodenoscope, 3 cases were found hemobilia and 2 cases were found acute pancreatitis. Conclusions Therapeutic ERCP is effective and safe in elderly patients over 80 years. Age is not the contraindication of therapeutic ERCP.

Objective To study on the value and safety of early endoscopic retrograde cholangiopan-creatography (ERCP)and endoscopic sphincterotomy (EST) in acute biliary pancreatitis. Methods Ninety-two patients with acute biliary pancreatitis underwent early ERCP (within 72 hours) and received endoscopic therapy (ERCP group). Another 40 patients with acute biliary pancreatitis were treated conservatively without ERCP (control group). The disappearance of abdominal pain, decrease of serum amylase level, the mean days and costs of hospitalization and complications were observed in all patients. Results In ERCP group, all patients were performed EST, stones in 72 choledocholithiasis patients had been removed with net-basket or air pocket. Ten cases of severe acute biliary pancreatitis received endoscopic pancreatic duct stents drainage. Ninety two cases of acute biliary pancreatitis received endoscopic nasal catheter bile drainage. The days of the disappearance of abdominal pain, the decrease of serum amylase levels, the cost of the hospitalization and the days of the hospitalization were significantly shorter in the early ERCP group than in the control group. The mortalities in ERCP and control group were 8. 3% and 33. 3% respectively. Conclusion Early ERCP endoscopic therapy is a safe procedure has the superiorities in lowering the mortality, hospital days and expense.

Objective:To evaluate the value of MAGiC STIR sequence inassessing bone marrow edema (BME) of the sacroiliac joint (SIJ) in ankylosing spondylitis (AS) patients.Methods:Twenty two AS patients from the Affiliated Fifth Hospital of Sun Yat-sen University from September 2019 to January 2020 underwent MR scanning, consisting of T 2WI fat-suppressed (FS) sequence and MAGiC sequence. Each SIJ was divided into four quadrants for analysis on oblique coronal MR image. Two radiologists [middle-higher seniority levels (radiologist 1 and radiologist 2) reviewed image sets of two sequences [T 2WI FS and MAGiC short T 1 inversion recovery (STIR) sequence] independently at separate times, using Hermann-Braun scoring system for degree of BME and summing numbers of quadrants based on BME findings. Disagreements were resolved to reach an agreement for final results.Assessments were repeated two weeks later by radiologist 2. Intra-class correlation coefficients (ICC) were calculated to assess the inter-and intra-observer agreement for the degree of BME and numbers of positive BME quadrants in the MAGiC STIR sequence, respectively. The differences between the two sequences for the degree of BME and numbers of positive BME quadrants were analyzed with Wilcoxon signed-rank test and Chi-square test, respectively. Taking the results of T 2WI FS sequence as a reference standard, the ROC curve was drawn, sensitivity, specificity, positive predictive value and negative predictive value in the detection of BME were calculated for the MAGiC STIR sequence. Results:Nineteen AS patients including 38 sacroiliac joints were enrolled in our study, being divided into 152 quadrants. Inter-and intra-observer agreement for the degree of BME and inter-observer agreement for numbers of positive BME quadrants in the MAGiC STIR sequence were all good (ICC=0.936, 95%CI 0.912-0.953, P<0.001; ICC=0.910, 95%CI 0.878-0.934, P<0.001; ICC=0.876, 95%CI 0.833-0.909, P<0.001). The difference between the two sequences for the degree of BME in quadrants was statistically significant ( Z=-3.132, P=0.002). But there was no statistically significant difference between sequences for numbers of quadrants in detecting BME (χ2=0.244, P=0.622). Area under the ROC curve of MAGiC STIR sequence in diagnosis of BME was 0.920 ( P<0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the MAGiC STIR sequence in the detection of BME were 82.0%, 95.1%, 89.1% and 91.5%, respectively. Conclusion:MAGiC STIR sequence can be used to evaluate bone marrow edema of SIJ in AS patients with high sensitivity and specificity.