Objective:To discuss the approach of treating the patients who suffered from cystic lesions of the pancreas. Methods:According to the retrospective analysis of all the 127 patients who were diagnosed as cystic lesions of the pancreas by the following methods such as ultrasonography ,CT,MRCP,PET,ERCP,EUS and FNA. Results:48 case of cystic lesions of the pancreas (38%) were selected an initial operation,and 79 of them (62%) selected follow-up visit. Nearly 40% of the patients who chose an initial operation were confirmed to suffer a malignant tumor by pathology. 9 patients(11%) of all the patients in the follow-up accept an operation because of their cystic lesions had a variation. According to the result of the pathology after the resection,3 patients of them had a canceration. The patients in the follow-up whose lesion diameter was smaller than 3cm,not existing a solid lesions,and without signs or symptoms,didn't have a risk in the transition to the malignant mutation. The transition rate was less than 4%,which was similar to the death risk of the patients undergoing resection. Conclusion:It is significant to adopt a careful radioactive follow-up to the surrounding parenchyma of all the patients who had not an initial resection.

Objective To study the homology and clinical distribution of tigecycline-resistant Acinetobacter baumannii (A.baumannii )in a hospital.Methods Multidrug-resistant A.baumannii (MDRAB,n = 88 )from specimens from clinical departments of a hospital in 2013-2014 were collected and detected susceptibility to tigecy-cline;homology of tigecycline-resistant strains were detected by pulsed-field gel electrophoresis (PFGE),clinical characteristics and distribution of infected patients were analyzed.Results 88 patients didn’t use tigecycline before MDRAB were isolated.Of 88 MDRAB strains,4 (4.55%)were resistant to tigecycline,which were No.10,31 , 33,and 87 strains.PFGE results revealed that No.31 ,33,and 87 strains were of the same genotype,and with high homology,which distributed in three different departments;No.31 strain was detected from general intensive care unit (ICU),No.33 strain was detected from emergency ICU,although strains were detected from different depart-ments,patients were transferred before strains were isolated,and were admitted to departments of gastrointestinal surgery and emergency ICU during the same period;No.87 strain was detected from neurosurgical ICU and patient had never been transferred,the detection time was 7-8 months later than No.31 and 33 strains.No.10 strain was isolated from emergency ICU,patient was not transferred.Conclusion Of MDRAB isolated in this hospital,tigecy-cline-resistant strains are low,most strains are homologous,cross infection may be exists in different departments.

Objective To evaluate the efficacy of disinfection and isolation measures in a hospital that received and treated the first case of imported Middle East respiratory syndrome(MERS)in China.Methods The first MERS case in China was admitted in the negative pressure room of the intensive care unit in a hospital on May 28,2015,a series of disinfection and isolation measures were taken for controlling and preventing MERS coronavirus (MERS-CoV)infection.Results One case of MERS confirmed by Guangdong Provincial Center for Disease Control and Pre-vention (CDC)and Chinese CDC were admitted in a hospital at 2:30 of May 28,2015,throat swabs and blood specimens of patients were detected as positive for MERS-CoV by real-time polymerase chain reaction.On the 3rd day,8th day,2 week after admission,and on June 21 ,throat swabs,blood,stool,and sputum specimen culture were negative respectively;before patient’s discharge,throat swabs,sputum,blood,and stool specimen culture were all negative for consecutive two times,there was no fever for 10 consecutive days,clinical symptoms were im-proved,patient finally recovered and was discharged on June 26.Detection of MERS-CoV were all negative for nasal swabs,throat swabs,and blood specimens from all health care workers (HCWs)participated in the treatment for MERS;all HCWs were performed physical examination from June 26 to July 10,none of them felt discomfort, there was no infection occurred among them.On the 7th,13th day of admission,and following terminal disinfec-tion,specimens of environment and object surface were taken and performed detection of MERS-CoV,all were negative.Conclusion Strict implementation of disinfection and isolation measures can effectively cut off the routes of MERS-CoV transmission and protect the safety of HCWs.

Objective:To observe the rehabilitative effect of combining respiratory function training with balloon dilatation for persons with cricopharyngeal achalasia after radiotherapy for nasopharyngeal carcinoma.Methods:A total of 120 nasopharyngeal carcinoma patients with cricopharyngeal achalasia after radiotherapy were randomly divided into an observation group and a control group, each of 60. Both groups were treated with routine functional swallowing training and balloon dilatation, while the observation group was additionally provided with respiratory function training 5 days a week for 8 weeks. Before the treatment and after 4 and 8 weeks of treatment, the swallowing function of both groups was evaluated using video fluoroscopy (VFSS), a functional oral intake scale (FOIS), cricopharyngeal muscle functional status and the M. D. Anderson dysphagia inventory (MDADI).Results:After 4 weeks of treatment the average VFSS, FOIS and MDADI scores of both groups were significantly better than before the treatment, and significant improvement continued over the subsequent four weeks. After 8 weeks of treatment, the average VFSS, FOIS and MDADI scores of the observation group had again improved significantly. Physiology, functioning, and their emotional state were also adjudged to have improved compared with 4 weeks earlier and compared with the control group.Conclusion:Combining respiratory function training with balloon dilatation can improve swallowing and can significantly reduce or delay swallowing disorders among patients with cyclopharyngeal achalasia after radiotherapy.

Objective To compare the clinical choosing principles of sedated colonoscopy with con-ventional colonoscopy. Methods Outpatients who were willing to accept colonoscopy with or without seda-tion were prospectively recruited,which were assigned to sedated colonoscopy group(n=362)and conven-tional colonoscopy group(n=323). All patients and endoscopists were asked to answer a self-administered questionnaire. The colonoscopy completion,operation time,procedure-related discomfort,and questionnaire results of the two groups were compared and statistically analyzed. Results The completion rate was 98. 9%in the sedated colonoscopy group(358/362)and 89. 8% in the conventional colonoscopy group(290/323) ( P=0. 337 ). The operation time of sedated and conventional group were( 5. 60 ± 3. 25 ) minutes and (7. 71 ± 5. 70)minutes respectively(P<0. 001). And the average cost was CNY 886. 54 per patient in se-dated group and CNY 386. 00 per patient in the conventional group. Patient satisfaction score of conventional group and sedated group were 4(3-4)and 3(2-3)points(P<0. 001),while endoscopist satisfaction score was 4(3-4)and 4(4-4)(P<0. 001). A total of 354 patients(97. 79%)in the sedated group and 225 pa-tients(69. 66%)in the conventional group showed willingness to repeat the identical colonoscopy( P <0. 001). Patients who were male(P=0. 035),having no past abdominal operations(P<0. 001),or no ab-dominal pain during colonoscopy( P =0. 015 )in the conventional group preferred to repeat conventional colonoscopy. Conclusion Although the examination time of conventional colonoscopy is longer than sedated colonoscopy,it could reduce anesthesia risk and the cost. Conventional colonoscopy remains an irreplaceable examination of colorectal diseases in developing countries. Physicians should not only focus on patients'com-fort during endoscopy,but also help patients make a decision based on their actual situation and endoscopic indications to make the best of medical resources.