Objective:Endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy (EST) are well accepted as the procedure of choice for diagnostic and therapeutic purposes of pancreaticobiliary disease. The aim of this study is to investigate the curative effect and complication of pancreaticobiliary disease managed by therapeutic ERCP. Methods: A total of 59 patients with common bile duct stone,acute obstructive suppurative cholangitis,malignant bile duct obstruction, acute or chronic pancreatitis,and sphincter of Oddi dysfunction. Each case was confirmed by ultrasonographic examination, diagnostic ERCP and blood amylase test. All patients underwent therapeutic ERCP such as EST, stone extraction and drainage. Results :Of the 59 patients, 16 patients with acute obstructive suppurative cholangitis and severe acute pancreatitis underwent urgent management of endoscopic intervention, stone extraction and endoscopic nasobiliary drainage. The remaining 43 patients underwent diagnostic ERCP,followed by therapeutic ERCP in cases of documented bile duct stone,sphincter of Oddi dysfunciton,or chronic pancreatitis. The success rate of endoscopic procedure was 100% ,and the complication rate was 6. 8% ,without mortality. Conclusion : In patients with pancreaticobiliary disease , therapeutic ERCP provides adequate management and is associated with low complication rates.

Objective To investigate the role of temporary placement of fully covered self-expandable metal stent (cSEMS) for treatment of uncontrolled bleeding after endoscopic sphincterotomy (EST).Methods From January 2000 to present,a total of 3460 cases of EST were performed,and bleeding after the procedure was complicated in 29 (0.84％) of them,in which 4 could not to be stopped by conventional managements.Covered SEMSs were placed across the major papilla in these 4 patients.Results The stents were successfully placed and hemostasis was achieved in all patients.The stent was removed in 1 patient 1 week later,and spontaneous stent dislodgment occurred in 1 patient within 4 weeks.The other 2 patients rejected to remove the stents,and the patency maintained for more than 6 and 12 months respectively.No complication was observed in procedures of placing and removing stents.Conclusion Covered SEMS placement is a safe,effective and simple method for patients with uncontrolled bleeding after EST.

Objective To evaluate the feasibility and safety of peroral direct cholangioscopy (PDCS) by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases.Methods Patients with bile duct dilation underwent standard ERCP and native papilla was dilated using EST and/or endoscopic papillary large balloon dilation,according to the size of the papilla.Then peroral direct cholangioscopy was performed by freehand intubation using routine straight-view endoscope.General data of patients,procedure of ERCP,diagnosis of PDCS and complications were recorded.Results A total of 5 patients underwent PDCS.Indications included common bile duct stones (n =2),intraductal papillary neoplasm of bile buct (n =2) and benign biliary stricture after removable metal stent placement (n =1).The diameter of common bile duct ranges from 1.2 cm to 2.4 cm.EST or/and EPLBD was required in 3/5 patients to facilitate PDCS.Freehand PDCS intubation of the bile duct was successful in all procedures (1 case into distal common bile duct,4 cases into proximal common bile duct).Complications were cholangitis managed with intavenous antibiotics (n =1).No procedure related death occurred.Conclusion Freehand PDCS is technically feasible and safe,and may be clinically useful for diagnostic and therapeutic purposes in managing select biliary tract diseases.

Recently,paclitaxel has been used as a new agent on patients with advanced esophageal cancer,and several studies have demonstrated that paclitaxel and paclitaxel-based regimens have significant activity in patients with advanced esophageal cancer and showed highly response rates than the combination of 5-fluorouracil (5-Fu) and cisplatin.However,there have been some problems which need to be solved such as drug-resistance,side effect,and so forth.The new medicament form of paclitaxel can not only depress poison without anti-allergy but also raise medicament curative effect as well as the pharmacal concentration.Although most of the research on the new medicament form of paclitaxel are still limited in the stage of laboratory,it has possessed potential advance in the treatment of advanced esophageal cancer.

Objective To study the effect of endoscopic treatment in acute severe pancreafitis. Methods EST(endoscopic sphincterepapiilotomy) and ENBD ( endoscopic naso-billary dralnage) or ENPD ( endoscopic naso-pancreatic drainage) were used to treat the acute severe pancreatitis(ASP). Results The recover time of blood dia-stase of the endoscopic therapy group and the contrast group was (3.2±1.5) days, (6.6±1.2) days, respectively (P<0.01) ; the incidence of needing to be operated was 0.7% (1/140), 6.5% (8/124), respectively (P<0.05) ;mortality rate was 0:7% (1/140) ,7. 3% (9/124) ,respectively(P <0. 01 ) ;the incidence of complication was 3.6% (5/140) ,41.9% (52/124), respecfivly(P<0.01). Conclusion EST + ENBD(or ENPD) in treating ASP has cer-tain effect and is the primary therapy to the ASP.

Objective: To compare the ocular parameters of acute angle closure glaucoma (AACG) and chronic angle closure glaucoma (CACG). Methods: Totally 106 patients with primary angle closure glaucoma were recruited: 58 patients with AACG and 48 with CACG. All patients were divided into 3 groups: AACG attack eyes group, AACG uninvolved fellow eyes group and CACG group and underwent the same ophthalmic examinations, comprising optometry, keratometry, and A-scan ultrasonography. The lens/axial length factor (LAF) and relative lens position (RLP) were calculated. Results: The AACG attack eyes had a significant shallow anterior chamber depth, thick lens, short axial length and larger LAF. hTere tended to be a reduction in the percentage of LAF>0.20 in AACG attack eyes, CACG eyes and AACG uninvolved fellow eyes, though there were no statistically signiifcant difference in all groups (P>0.05). Conclusion: The eyes with AACG attack have a more crowded anterior chamber structure compared with uninvolved fellow eyes and eyes with CACG.

Objective To explore the clinical value of the insulin pump(CSⅡ) and multiple subcutaneous insulin intensive treat-ment(MDI) for patients with type 2 diabetes and stroke .Methods A total of 80 patients with type 2 diabetes and stroke in Weifang Community Health Service Center from April 2011 to May 2014 were selected as subjects and divided into experimental group and control group according to random number table method ,with 40 cases in each group .Patients in the experimental group were trea-ted with CSⅡ ,patients in the control group were treated with MDI .Glucose level ,therapeutic time ,the number of low blood sugar , insulin dosage ,National Institute of Health Stroke Scale(NIHSS) score ,insulin secretion index(IS) ,insulin resistance index(IR) , hospital costs were compared before and after treatment in the two groups .Results The glucose levels ,therapeutic time ,the num-ber of low blood sugar ,insulin dosage ,NIHSS score ,IS ,IR in the two groups before and after breakfast ,before and after lunch ,be-fore dinner ,after dinner 2 hours before treatment had no significant differences(P>0 .05) ,the glucose levels ,therapeutic time ,the number of low blood sugar ,insulin dosage ,NIHSS score ,IS ,IR after treatment in both groups were significantly decreased at these time points ,but those indicators in the experimental group decreased more significantly ,and had significant differences with those of the control group(P<0 .05) .The cost of hospitalization of patients in the experimental group was significant lower than that in the control group(P<0 .05) .Conclusion CSⅡ treatment for type 2 diabetes and stroke patients ,not only control glucose level well ,re-duce the number of low blood glucose and insulin dosage ,significantly improved IS and IR ,reduce hospital costs ,and also could sig-nificantly improve the neurological disorders of consciousness ,which is an ideal treatment method compared with MDI .

Due to the high incidence and mortality of digestive system malignant tumor,so it is of great significance to make further research for digestive tract tumor.Platinum drugs,one of the traditional drugs which is used for the chemotherapy for digestive system tumor,which has been extensively applied to the chemotherapy for malignant tumor.However,the resistance to the drugs exerts a serious influence on its curative effect.At present,it is believed that the nucleotide excision repair(NER)constitutes one of the most important mechanisms which results in the resistance to platinum drugs,mainly because it causes the twisting of DNA helix by removing large numbers of platinum compounds.The nucleotide excision repair cross complementation group 1(ERCC1)plays an important role in the process of NER.The different expression of ERCC1 in peripheral blood and tumor tissue of patients with digestive sysem tumor has a close connection with therapeutic effect of the platinum-containing chemotherapy.This article aims to provide an overview of the relation between the ERCC1 research development and the curative effect of cisplatin chemotherapy for digestive system tumor.

The normal function of female lower urinary tract continence control system can prevent people from urinary incontinence. Up till now, pregnancy and childbirth have already been recognized as the most important risk factors causing female urinary incontinence. The development and perspective of the relative researches were reviewed in this article.

Listeria disease (LD) is a zoonosis,caused by Listeria monocytogenes (LM),the main route of transmission is foodborne spread,can cause outbreak.Pregnant women and their fetuses or neonates,older adults,and persons with underlying conditions that impair cell-mediated immunity are at a particularly high risk of invasive listeriosis.The gastroenteritis,meningitis and bacteremia are the common clinical feature.LD in children is rare.It can cause the neonates sepsis and central nervous system infection.Because of the natural resistance to cephalosporins,the choice of antibiotics seemd more important.By this article,LM in children and benefit for clinical work was recognized.