This paper introduces a novel trousers,whose theory is to drive blood by inflated pressure.Being light-weight,small and effective,easy to carry,store and operate,it is postured for first aid and resuscitation of hospital patients with severe shock,and also can be applied to bleeding remission,hemorrhagic as well as fracture immobilization.

Objective To explore the safety and efficacy of endoscopic retrograde cholangiopancreatography(ERCP)by using carbon dioxide for malignant biliary obstruction.Methods A total of 60 patients with malignant biliary obstruction, hospitalized from September 2008 to February 2010, were randomly divided into 3 groups to receive ERCP by using carbon dioxide, contrast agent or magnetic resonance cholangiopancreatography(MRCP)without any agent.The safety and efficacy of 3 contrast methods were compared.Results Successful stent or drainage tube insertion was achieved in all patients.Carbon dioxide was superior to contrast agent in terms of lowering postoperative infection rate(P ＜ 0.05), and it was also superior to MRCP for more effective drainage(P ＜ 0.05).There was no significant difference in occurrence of postoperative pancreatitis and hyperamylasemia between 3 groups.Conclusion Using carbon dioxide during ERCP, safe and effective, is superior to use of contrast agent in less leukocyte increase, and to MRCP in more adequate drainage in patients with malignant biliary obstruction.Furthermore, there is no more risk of pancreatitis and hyperamylasemia.

Objective To explore the efficiency and safety of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosis and treatment of children with pancreaticobiliary diseases.Methods A retrospective study was conducted by data collection from 74 children with biliary and pancreatic diseases undergoing ERCP from January 2012 to December 2016 for observation of therapeutic efficacy and postoperative complications.Results A total of 96 ERCPs were performed on 74 patients.The success rate was 94.8％ (91/96) using 29 operating methods.The complication rate of pancreatitis was 10.8％ (8/74),as well as hyperamylasemia was 13.5％ (10/74) and stress hyperglycemia was 10.8％ (8/74).Conclusion The application of ERCP in children with biliary tract and pancreatic diseases is effective and safe.

Objective To compare therapeutic efficacy and safety of covered and uncovered self-expandable metal stents for malignant biliary obstruction.Methods From October 2010 to August 2012,patients with unresectable malignant biliary obstruction were recruited and divided into 2 groups to receive covered metal stents (group A) or uncovered metal stents (group B).Efficacy and complication of the procedure were compared.Results A total of 81 patients were recruited,with 41 in group A and 40 in group B.Stents were placed successfully in all patients.The median patency time of stent in group A was 182.5 d,which was not significantly different from that of group B (195.0 d,P =0.616).Complications occurred in 3 patients of group A (7.3％) and 4 of group B (10％).Conclusion Covered and uncovered metal stents are both safe and effective for treatment of malignant biliary obstruction with same patency time.

ObjectiveTo explore the efficacy and safety of temporary placement of fully covered metal stent in the treatment of benign biliary strictures.MethodsFully covered metal stents were placed in 36 patients with benign biliary strictures.All patients were followed up every 1-2 months and the stents were removed when adequate biliary drainage was achieved.ResultsResolution of the benign biliary strictures was achieved in 28 of 36 patients (77.8％ ).All fully covered metal stents were removed successfully.Complications were observed in 3 patients (8.3％) after stent placement and in 1 (2.8％ ) after stent removal.ConclusionTemporary placement of fully covered metal stents for benign biliary strictures is safe and efficacious.Further investigation is required to longer follow-up.

Objectiye To evaluate the therapeutic efficacy and safety of (endoscopic sphincterotomy, EST) plus balloon dilation for difficult bile duct stones. Methods Patients with difficult common bile duct stones on endoscopic retrograde cholangiopancreatography (ERCP) from March 2008 to December 2009 were randomly divided into 2 groups to receive EST or EST plus balloon dilation ( EST + EPBD), respectively. The success rate of complete stone removal, number of endoscopic sessions, the rate of using mechanical lithotripsy and the complication rate related to the procedure were compared between the 2 groups. Results Compared with EST alone, EST plus balloon dilation resulted in similar outcomes in terms of overall successful stone removal rate (2/62 vs. 2/61 ) and early complication rate (4/62 vs. 6/61, P ＞0. 05). However,EST group needed more sessions ( EST 15/46 vs. EST + EPBD 5/57, P ＜0. 05) and use of mechanical lithotripsy to achieve complete removal of stones ( EST 12/61 vs. EST + EPBD 4/61, P ＜0. 05 ). Conclusion EST plus balloon dilation is as safe and effective as, but more convenient than EST, for endoscopic removal of common bile duct stones.

Objective To investigate the hemodynamic changes of protosystemic collaterals before and after endoscopic treatment in patients with gastroesophageal varices using 64-row multidetector computed tomograghy portal venography (MDCTPV) so as to evaluate the efficacy of endoscopic treatment in patients with or without para-esoghageal varices and with or without nonvarices portosystemic collaterals before treatment. Methods Twenty-six patients with gastroesophageal varices, who underwent endoscopic variceal ligation (EVL) for esophageal varices and endoscopic N-butyl-2-cyanoacrylate injection (EBC) for gastric varices between Jan.2007 and Dec. 2009, were enrolled. Sixty four-row MDCT was used to examine the changes of portosystemic collaterals 1 week before and 12 months after endoscopic treatment. The reconstructed images of portosystemic collaterals before and after endoscopic treatment were evaluated. Results Excellent quality of portosystemic collateral vessels on CTPV were obtained in all patients. The mean diameter of left gastric vein decreased from (6.7±1.9) mm to (5.0±1.9) mm after endoscopic treatment,with significant difference (P＜ 0.05). There was no significant difference in outcomes between patients with or without para-esoghageal varices (80% vs 72.7%, P＞0.05) and patients with or without non-varices portosystemic collaterals (82.4% vs 66.7% ,P＞0.05). Conclusions Sixty fourrow MDCTPV may provide important information for option of endoscopic treatment and prognosis.

Objective To evaluate the efficacy and safety of Spyglass single-operator cholangioscopy-guided laser lithotripsy for removing difficult bile duct stones.Methods A total of 39 patients with difficult bile duct stones were divided into Spyglass single-operator cholangioscopy-guided group (n =20) and fluoroscopy guided group (n =19) to receive corresponding treatments.The success rates of complete stone removal and the complication rates related to the procedure were compared between the two groups.Results There was no significant difference in success rate of complete stone removal between Spyglass single-operator cholangioscopy-guided group(17/20, 85.0％) and the fluoroscopy guided group(16/19, 84.2％ ,P =0.661) or in rates of procedure related complication (acute pancreatitis P =0.695, infection of bile duct P =1.000).Conclusion Both Spyglass single-operator cholangioscopy-guided laser lithotripsy and fluoroscopy are safe and effective.

Objective To investigate the safety and effectiveness of Glifeet in bowel preparation before colonoscopy.Methods A prospective,single blind,randomized controlled trial of patients undergoing colonos-copy was conducted.A total of 67 inpatients were randomized to the control group,who received a low-residue and semiliquid diet (n =31)and the experimental group,who received Glifeet all day (n =36)before the proce-dure.All patients took polyethylene glycol electrolyte powder 1 000 ml at 7 pm on the day before colonoscopy and 2 000 ml at 8 am on the examination day.Bowel preparation quality was scored using the Boston Bowel Prepara-tion Scale (BBPS).Side effects were also observed.Results The time of the first bowel movement of the experi-mental group was significantly shorter [(77.43 ±54.21)min VS (149.35 ±118.15)min,P =0.002].An in-creased defecating frequency was observed in the experimental group,but there was no significant difference when compared with the control group (11.44 ±6.95 VS 8.74 ±3.58,P =0.055).Patient tolerance and acceptance did not differ.There was no significant difference in BBPS between the two groups.But the bowel preparation quality of the right colon was significantly better in the experimental group (2.56 ±0.50 VS 2.23 ±0.81,P =0.045). Conclusion Glifeet could meet the needs of basic energy in most patients for colonoscopy.Furthermore,Glifeet is well tolerated and can partially improve the quality of bowel preparation.

Objective To evaluate the efficacy and safety of fluoroscopy guided frequency-doubled double-pulsed laser lithotripsy for removing difficult bile duct stones. Methods From March 2008 to December 2009, patients with difficult bile duct stones were divided into cholangioscopy guided group ( n = 21 )and fluoroscopy guided group ( n = 19) to receive corresponding treatments. The success rate of complete stone removal and the complication rate related to the procedure were compared between the two groups.Results There are no significant differences between 2 groups in regarding of either success rate of complete stone removal ( 19/21, 90. 5% in cholangioscopy guided group vs. 17/19, 89. 5% in fluoroscopy guided group, P ＞0. 05 ) or rate of procedure related complication (4/21, 19. 0% in cholangioscopy guided group vs. 3/19, 15. 8% in fluoroscopic guided group, P = 0. 559 ). Conclusion Frequency-doubled doublepulsed laser lithotripsy guided by cholangioscopy or fluoroscopy are both safe and effective.