In recent years,with the continuous development of endoscopic and interventional techniques,many new devices and methods have been used in clinical practice,and the application of endoscopic retrograde cholangiopancreatography (ERCP)in biliary and pancreatic diseases has developed rapidly.This paper reviews and summarizes the recent progress in ERCP among patients with biliary and pancreatic diseases,including those with altered gastrointestinal anatomy,pregnant patients,patients with benign and malignant biliary strictures,and patients with pancreatic pseudocysts,as well as the application of SpyGlass,photodynamic therapy,and radiofrequency ablation,the man-agement of ERCP-related duodenal perforation,and the prevention of post-ERCP pancreatitis.All the progress has made a great contribu-tion to the diagnosis and treatment of biliary and pancreatic diseases.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Objective To analyze the effect of calcitonin combined with alfacalcidol on clinical outcome,lumbar vertebrae bone mineral density and safety in patients undergoing internal fixation of humeral shaft fracture.Methods 80 patients with humeral shaft fracture treated with internal fixation in Xunwu county people's hospital from June 2010 to June 2016 were selected,and randomly divided into control group and observation group,40 cases in each groups.The control group was given calcium carbonate D3 tablets and functional exercise therapy,the observation group treated calcitonin combined with alfacalcidol on the basis of control group,analysis and comparison the clinical effects,lumbar spine BMD and safety.Results Compared with before treatment,serum calcium level of two groups increased significantly at treatment 2 weeks and 3 weeks(P<0.05);The control group BMD of lumbar spine was significantly increased in treatment 12 weeks(P<0.05),the observation group BMD of lumbar spine was significantly increased in treatment 4 weeks and 12 weeks(P<0.05).Compared with control group,the level of serum calcium in observation group was higher at treatment 2 weeks and 3 weeks (P<0.05),BMD of lumbar spine was higher at treatment 4 weeks and 12 weeks(P<0.05);The total adverse reaction rate of observation group was 10%,the difference was not statistically significant to control group 15%.Conclusion The combination of calcitonin and alfacalcidol treatment of internal fixation of humeral shaft fractures in patients with significant results, can improve serum calcium levels in patients with and improve bone mineral density, and less adverse reactions.

Objective To explore the application of laparoscopy in non-traumatic acute abdominal emergency. Methods The authors retrospectively analyzed 201 cases of emergency laparoscopy between March 1999 and May 2002. Results All the 201 patients were unequivocally diagnosed during operation. Laparoscopic operations were successfully completed in 190 cases (139 cases of acute appendicitis, 21 cases of acute cholecystitis, 19 cases of upper gastrointestinal tract perforation, 10 cases of intestinal obstruction and 1 case of common bile duct stones accompanied with acute cholecystitis), with a success rate of 94.5% (190/201). The remaining 11 patients underwent a conversion to open surgery. Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal emergency with unknown causes but also simultaneously offer a therapeutic method in at least 90% of cases.

Based on the extensive experience in circuit serving for military medical equipment,problems in managing military medical equipment are discussed and solutions are proposed so as to strengthen management standardization of medical equipment in basic unit army and enhance the support ability of medical equipment.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Paralyses, Familial Periodic ; therapy

Adult ; Aged ; Aged, 80 and over ; DNA Primers ; Female ; Humans ; Lymphoma ; genetics ; Male ; Middle Aged ; Mutation ; Myeloid Differentiation Factor 88 ; genetics ; Polymerase Chain Reaction

By using the method of clonal analysis the evidence to prove that Hemophagocytic syndrome (HPS) is reactive or malignant was investigated to probe into the pathogenesis of HPS and its relations with clinical prognosis. The macrophages abnormally proliferated in bone marrow were isolated. Electrophoresis analysis was made after DNA extraction, enzyme restriction of human ardrogen receptor (HUMARA) genetic locus, and PCR amplification. In the 9 specimens, clonal proliferation was found in 2 cases and nonclonal proliferation in 7. Among the 7 cases of nonclonal proliferation, 3 were voluntarily discharged without clinical outcome, 2 cases fully recovered after 2-3 week treatment of large dose gamma globulin intravenous drip and hormone therapy, 1 case died at the 43th day after the hormone and anti-infection therapy, and one case was found to have granular leukoblast in peripheral blood after 3 weeks and diagnosed as having M2a after bone puncture. For the two patients with clonal proliferation, one obtained remission after chemotherapy and the other was died after 32 days without chemotherapy. It was concluded that there do exist clonal or malignant proliferation in HPS, so not every case is reactive.
Clone Cells ; Histiocytosis, Non-Langerhans-Cell/*blood ; Histiocytosis, Non-Langerhans-Cell/therapy ; Macrophages/*pathology ; gamma-Globulins/therapeutic use

?AIM:To compare the curative effect of conjoint fascial sheath( CSF) suspension and levator muscle resection for moderate or severe congenital ptosis.?METHODS: Forty - three patients ( 74 eyes ) with moderate or severe ptosis were treated by CSF suspension or levator muscle resection randomly, and followed up for 6mo. The normalization rates of the two operations were then compared by statistical method, and the complications of the two operations were analyzed.?RESULTS: The two operations appeared no significant difference on the normalization rate for moderate congenital ptosis (P>0. 05), while the normalization rate of CSF suspension on severe congenital ptosis was significantly higher than that of levator muscle resection (P<0. 05). Less complication was happened in the CSF suspension group than in the levator muscle resection group.?CONCLUSION:CSF suspension is more effective on the treatment of severe congenital ptosis than levator muscle resection, and has advantages such as less trauma, repeatable, and less complication.

AlM:To discuss the feasibility of microcoria optometry in screening for children ametropia. METHODS: Totally 217 school - age children were selected, included 94 first-grade students ( 6 ~ 8 years old) and 123 fourth-grade students ( 9 ~12 years old ) . Refractive diopter was measured with automatic refractor RM-8000 to evaluate the accuracy of micocoria optometry in screening ametropia.RESULTS: After cycloplegia, both the mean sphere diopter and cylinder diopter in grade one students changed significantly (P<0. 05), the mean sphere diopter in grade four students changed significantly (P<0. 05), while the mean cylinder diopter had no statistical difference ( P>0. 05 ) in grade four students. Different refractive type: before and after mydriasis spherical myopia, spherical equivalent difference was 0. 263 ± 0. 618 and 0.216±0.653D, with statistical significance (P<0.01);ln hyperopia group, spherical myopia, spherical equivalent difference was 0. 947±0. 946 and 1. 039±0. 984D, with statistical significance ( P = 0. 000 ). The lenticular difference between the two groups were not statistically different ( P > 0. 05 ). Choosing small pupil computer optometry for ≤- 1. 00D, ≥- 0. 50D child myopia or hyperopia could get more accurate value of diagnostic cutoffs, Youden index was 0. 672 and 0. 580. CONCLUSlON: Microcoria optometry can be as a effective method of screening of children with ametropia, but if for optometry, school-age children must accept mydriasis.