Objective To investigate the clinical application value, efficiency and safety of precut sphincterotomy in endoscopic retrograde cholangio-pancreatography (ERCP) .Methods From January 2008 to June 2011, 930 patients received ERCP in the department of hepatobiliary surgery of the first hospital of Jilin University.Of them 108 cases (11.6%) were diverted to receive precut sphincterotomy, because selective bile duct cannulation with conventional method was difficult.Inclusion criteria: failure of conventional cannulation or repeating pancreatic duct cannulation for more than 4 times.According to the patient's conditions, the examination and treatment of ERCP was carried out.Observation termination are therapeutic success rate and the incidence rate of complications, and comparative analysis on case data of routine ERCP was made.Statistical analysis was executed by SPSS 13.0 software.Comparison of ratio were determined with χ2 test, a value less than 0.05 was considered as significant.Results Of 108 cases, the success rate of ERCP was 95.4% (103 cases) .The incidence rate of complications was 6.5%, and there are no cases of duodenal perforation and death.Amongst 822 cases of routine ERCP, therapeutic success rate was 97.7%, and the incidence rate of complications was 7.7%.The statistics analysis result indicates that there are no statistical differences between precut sphincterotomy group and routine ERCP groups in the success rate (χ2=2.041, P=0.153) and the incidence rate of complications (χ2=0.141, P=0.707) .Conclusion The precut sphincterotomy in ERCP are safe and obviously effective with less complications compared to routine ERCP.The successful probability of difficult ERCP is improved greatly by using the technique of precut sphincterotomy.But the precut sphincterotomy indication is strictly controlled, and the technique should be performed by experienced endoscopist.

Objective To retrospec the efficacy of percutaneous nephrolithotomy on treatment of urinary tract stones in solitary kidney.Methods From June 2008 to April 2011,percutaneous nephrolithotomy technique was used to treat 20 cases of urinary tract stones,with kidney stone or cast form staghorn calculi in 4 cases,single pelvis,calyceal stones 10 cases,6 cases of upper ureteral calculi;Fourteen cases used the standard channel F24;6 cases used F16 Micro Channel.Among the 20 patients,16 cases performed stage Ⅰ single channel surgery;2 cases performed dual-channel surgery in Ⅰ stage;2 patients with severe infection performed stage Ⅱ single channel surgery.Results The average duration of the operation was 66mins.The stone clearance rate was 88.36％ on average(18/20),without laceration or bleeding of pelvis or renal calyces mucosa or any other complications.Postoperative indwelling nephrostomy tubes were removed 6 -7 days later,without complications found during the follow-up period.For the 6 cases with preoperative renal dysfunction before surgery,the levels of blood Cr decreased at 2 weeks after surgery.Conclusion Compared to open surgery,percutaneous nephrolithotomy is safe and effective with small wound in treatment of solitary kidney with invasive upper urinary tract calculi.

Objective To investigate the causes of postoperative severe infection and other complications of percutaneous nephrolithotomy,and to study the principles of prevention and treatment.Methods Five hundred and sixty three cases of patients underwent percutaneous nephrolithotomy from September 2008 to December 2011 in our hospital,after operation,22 patients were found with serious infection.Data of these 22 cases were analyzed retrospectively according to the causes of the infection,corresponding prevention and treatment.Results The occurrence rate of severe postoperative infection was 3.9％ ( 22/563 ) in this group.The condition of 21 patients improved through adjusting antibiotics and taking other necessary measures in time;the condition of 1 case of septic shock patient was under control by giving anti-infective and anti-shock treatment measures.Conclusion Percutaneous nephrolithotomy is a safe and effective minimally invasive surgery,with a certain incidence of postoperative infection which should be timely and effectively controlled.

Objective: To identify the impact of Urban Resident Basic Medical Insurance (URBMI) on medical service utilization. Methods: Based on data of China Health and Nutrition Survey, matching DID model was used to compare the changes in medical service utilization between residents participated in this system and those not participated in this system in 2009. Results:In initial stage of implementation, URBMI in a certain extent promoted medical service utilization of residents participated in the system, but the impact level was still low. The promoting effect on inpatient service utilization was significant, but very limited on outpatient service utilization. Conclusion:Promoting outpatient service utilization and increasing compensation are future priorities for improving URBMI to implement the system.

Prostate cancer is one of the most common malignant tumors among males, and nearly all patients will inevitably de-velop castration-resistant prostate cancer (CRPC). The prognosis of CRPC patients is very poor. How to implement the individualized treatment plan with minimal side effects and optimum benefit as well as how to prolong the patients' lives have recently become impor-tant issues. Current staging and grading systems fail to provide accurate prognoses of most CRPC, which have complicated biological behaviors. Over the past few years, a host of tumor molecular markers have been discovered and can provide prognostic information for CRPC. This review summarizes the molecular prognostic biomarkers that affect the prognosis of CRPC.

Combined therapy consisting of radiotherapy,chemotherapy and palliative surgery is the primary management for locally advanced pancreatic cancer,with the purpose of prolonging survival and improving life quality.Gemcitabine is the standard chemotherapy at present.Gemcitabine-based combinations show a definite effect,and the combination with targeted drugs also has a certain degree of efficacy.The development of new chemotherapy drugs and targeted drugs provides more ways for the teatment of locally advanced pancreatic cancer.

By collecting literatures on apoplexy recorded in"Database of Basic TCM disease"from 2001 to 2005,we statistically analyzed changes on volume of documents,major authors,major journals,and contents of study in these literatures.

The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

Objective To design a new portable vital signs monitor for family use. Methods TMS320F2812, a kind of digital signal processor, was applied as the main processor to control the functional mod-ules including A/D convertor, LCD display. Bluetooth communication module was introduced to achieve real-time fast transfer of data between the system and the PC. Results Not only can the system monitor electrocardiogram (ECG), breath rate, pulse rate, body temperature and other vital signs accurately, but also it runs stably. Conclusion The features of DSP and Bluetooth were well combined in the design of the family-oriented, easy to use, multi-functional monitor with small size, low power consumption and convenience. A broad application and market prospects can be predicted.

Objective To analyze the current situations of nosoeomial infection tumor and correlated factors,comlnon pathogens and resistance,to provide reference for reasonable clinical use of antibiotics.Methods The specimens of pathogens cultured from 398 Cases of patients with tumor were retrospectively analyzed.Results The rate of the hospital infection oftumor patients was 12.3%,significantly higher than 5.1%,the average infection rate in the 881ne period.The mest common nosocomial infection was in respiratory system.Of the 57 pathogens,Gˉ accounted for 66.7%;G+ 22.8%,and fungus,10.5%.The main bacteria were pseudomonas aeruginosa,Klebsiellapneumonlae,escherichia coli bacteria.Conclusion After nesocomial infections occurred,pathogens should he routinely checked,drugs,susceptibility tested and antibiotics,rationally used.