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 explore the effect of failure mode and effect analysis (FMEA) method in strengthening the management of critical value of blood specimens in hospital. Methods According to the procedures of FMEA, critical values management team were established, drew flow chart of generating test specimens and crisis value, explored the potential failure mode and failure cause, analyzed the severity, possibility and critical value, and formulate and implement countermeasures according to the research outcome. Results The crisis value of the failure mode fell from 1 320 to 151 after the implementation of FMEA, and rate of decline was 88.56%; number of unqualified blood samples decreased from 510 cases to 78 cases, and the difference is statistically significant (χ2=407.27, P<0.05);critical value processing defects decreased from 85 cases (a total of 236 cases) to 3 cases (a total of 229 cases), and the difference was statistically significant (χ2=91.26, P<0.05). Conclusions FMEA method is helpful to improve the accuracy and precision of critical value management of clinical blood samples, so as to ensure the safety of patients in hospitals.

Objective To investigate the expression and clinical significance of bcl-2 and NF-κB/ p65 in different subgroups of diffuse large B-cell lymphoma (DLBCL). Methods Immunohistochemical staining was used to detect the expressions of CD10, bcl-6, and MUM-1 in the DLBCL patients. According to immunohistochemical algorithm of Hans et al. DLBCL were subdivided into GCB and non-GCB/ABC subgroups and the expressions of bcl-2 and NF-κB/p65 were detected. The expressions of bcl-2 and NF-κB/ p65 in GCB DLBCL were compared with that in ABC DLBCL,and the correlation of bcl-2 and NF-κB/p65 expressions with survival in the two major subgroups of DLBCL were analyzed. Results The expression rates of bcl-2 and NF-κB/p65 proteins in DLBCL were 67.1% and 77.1%, and there was significant correlation between them. The expression rates of bcl-2 and NF-κB/p65 were 52.0 % and 56.0 % in GCB DLBCL, but were 75.6 % and 88.9 % in ABC DLBCL. The expression rates of two proteins were higher in ABC DLBCL than in GCB DLBCL. There was no significant correlation between bcl-2 and NF-κB/p65 protein expressions and overall survival within the GCB DLBCL subgroup, but bcl-2 and NF-κB/p65 expressions had a significant effect on overall survival within the ABC subgroup. Conclusion bcl-2 and NF-κB/p65 expressions are associated with poor survival in the ABC subgroup only. Hence, the significance of bcl-2 and NF-κB/p65 protein expressions should be assessed in the context of DLBCL subgroups in the future.

Objective To explore the clinical effect of intranasal dexmedetomidine as premedication on sedation and analgesia during painless electronic colonoscopy in children, and to investigate its optimal dose. Methods Ninety children scheduled for painless electronic colonoscopy were divided into three groups by using a computer?generated randomization schedule, 30 per group. Children were pretreated with 0. 2 mg/kg midazolam ( group A) , 1. 0μg/kg dexmedetomidine ( group B) or 2. 0μg/kg dexmedetomidine ( group C) by nasal drip 30 min before operation. The anesthesia protocol was programmed by propofol in the three groups. After eyelash reflex disappeared, the examination was performed. Mean artery blood pressure ( MAP ) , heart rate (HR), respiratory rate (RR) and oxygen saturation (SPO2) of children were recorded at 10 min before intranasal administration ( T0 ) , 30 min after intranasal administration ( T1 ) , at the onset of eyelash reflex disappearance ( T2 ) and the onset of examination initiating( T3 ) , at lens passing through splenic flexure ( T4 ) , or through hepatic flexure ( T5 ) , at the end of examination ( T6 ) and when patients were fully awake ( T7 ) , respectively. Bispectral index ( BIS) and the observer's assessment of alertness/sedation scale ( OAA/S) were performed at 10 min before intranasal administration ( T0 ) , 10 min, 20 min and 30 min after intranasal administration in the three groups. Mood score at parent?children separation and venipuncture acceptance score were also recorded. The adverse reactions during examination were analyzed. The above observed indices were compared among the three groups. If there was statistical difference ( P<0. 05 ) , pairwise comparison was performed ( P<0. 017) . Results The children's haemodynamics were all stable in the three groups. Compared with group A and group B at the same time point, BIS and OAA/S were all lower ( P<0. 017) in 10 to 30 min after intranasal administration in group C. Compared with group A and group B, mood score at parent?children separation and venipuncture acceptance score were both higher ( P<0. 017) in group C. Compared with group A and B, anesthetic revival time and consumption of propofol were shorter or lower in group C (P<0. 017). Compared with group A and group B, the incidences of intraoperative adverse reactions including hypertension, sinus tachycardia, restless moving and postoperative restlessness were all lower in group C(P<0. 017). The rate of intranasal stimulus in group B and group C were both lower than that of group A( P<0. 017) . The rate of injection pain of group C was lower ( P<0. 017 ) than that of group A and B. Conclusion Intranasal administration of dexmedetomidine can be safely applied to children receiving painless electronic colonoscopy, and it can improve children's compliance effectively and yield to satisfactory anesthetic effect. Moreover, the administering efficacy of dexmedetomidine with the dose of 2. 0μg/kg was superior to 1. 0μg/kg.

AIM To investigate the protective effects of three flavonoids quercetin,rutoside and flavone on the intestinal mucosal injury induced by burn in mice. METHOD The change of injury index of small intestine was assayed and the content of protein and DNA were measured. DTNB method were adopted to measure the GSH content in the intestinal mucosa. The level of DNA damaged were determined by measuring the fluorescence. RESULTS The condition of injury of intestinal mucosa were improved in varying degrees after these favonoids were given introgastrically for 3 days. The injury index of intestinal mucosa decreased and the content of protein,DNA and GSH increased. The degrees of DNA damage were reduced also.Quercetin was the most effective one among these three flavonoids. CONCLUSION The flavonoids of quercetin, rutoside and flavone have obvious protective effects on burn induced intestinal mucosal injury, and the mechanism may be related to its antioxydation function.

Therapies for uveitis include drug treatment and surgery.Medical therapies including proper administration of corticos- teroids,immunosuppressive drugs,nonsteroidal anti-inflammtion drugs and anti-infective drugs are important in management of the in- traocular inflammation and decreasing the risk of complications,furthermore,are the basis for surgical treatment of uveitis.

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 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.

This article has illuminated the importance of strengthening discipline construction to the the local colleges and universities,and why Guangdong Pharmaceutical University should take all kinds of measures to serve the development of territorial economy and improve the characteristic for operating the universities.

SUMMARY Neuroreceptor imaging with radionuclide tracing in vivo has been greatly developed recently.Distribution,density,and activity of receptors in the brain can be visualized by the radioligands labeled for emission computed tomography(ECT),including PET(positron emission tomography)and SPECT(single photon emission computed tomography).The functional and quantitative imaging for several receptors,such as dopamine receptors,serotonin receptors,cholinergic receptors,benzodiazepine receptors,and opioid receptors,has clinical importance.The preparation of receptor imaging agents,foundation of the physio-mathematical model,and the development of nuclear medicine instruments are the main points.In the present review,we will concentrate on introducing the development of brain receptor imaging.