Objective To investigate the preventive and therapeutic effects of nonsteroidal anti-inflammatory drugs ( NSAIDs) via rectum for hyperamylasemia and pancreatitis after ERCP (endoscopic retrograde cholangiopancreatography).Methods Sixty patients who underwent ERCP for various reasons were randomly divided into preventive and control groups.In addition to routine diazepam (10 mg) and anisodamine (10 mg) given intramuscularly in both groups before ERCP, 100 mg of indometacin suppositories was administered by rectum in preventive group.Serum amylase level was measured before and 6 hours and 24 hours after the procedure.Results Serum amylase levels at 6 hours after ERCP in preventive and control groups were (367.5 ± 268.7 ) U/L and (1034.2 ± 713.5 ) U/L, respectively ( P < 0.05 ), which were (324.9±142.3)U/L and (826.8 ±395.7)U/L, respectively, at 24 hours after ERCP (P<0.05).Conclusion Rectal use of NSAIDs can prevent hyperamylasemia and acute pancreatitis induced by ERCP.

Objective To study the change of diastolic cardiac function in diabetic patients and to determine the diagnostic value of plasma brain natriuretic peptide (BNP) and atria natriuretic peptide (ANP) for diastolic heart failure in patients with type 2 diabetes mellitus.Methods Twelve healthy subjects and seventy-one diabetic patients were included in the study.Plasma BNP and ANP were measured with immunoradiometic assay.Results Plasma levels ofBNP andANP increased significantly with increased severity of diastolic heart dysfunction.The ratio of E/A had significant negative correlation with the plasma levels of BNP (r=0.669,P＜0.001) and ANP (r=0.579,P＜0.01).AUC of ANP and BNP in ROC model was 91.9% and 65.3%,respectively.Conclusions The plasma level of BNP might be a valuable predictor for differential diagnosis of diastolic cardiac function in diabetic patients.

Objective To observe pre-syncopal limited tolerance and cardiovascular responses to head-up tilt combined with lower body negative pressure (HUT/LBNP) following exposure to head-down tilt (HDT, -1 Gz). Method Exposures to HUT/LBNP (-60 mmHg) in control session (without preceding 30 s -1 Gz treatment) and in simulated push-pull effect (PPE) session (with preceding 30 s -1 Gz treatment) were performed in 8 healthy adults. The changes of hemodynamic parameters were monitored by electrical impedance instrument during the experiments. Result The mean endurance time in presyncopal symptom limited HUT/LBNP in control session and in simulated PPE session were 8.4±2.1 min and 4.5±2.4 min, respectively, the two means were significantly different (P< 0.01). In simulated PPE session, as compared with baseline, heart rate (HR) during HDT was significantly lowered (P<0.01), while stroke volume (SV) and cardiac output (CO) were increased significantly (P<0.01). During HUT/LBNP, the increased percentage (relative to baseline) of HR in PPE session was lower than these in control session (P<0.05); the decreased percentages of SV and CO during HUT/LBNP in PPE session were both higher than those in control session (P<0.05). During HUT/LBNP, arterial pulse pressure (PP) of control session was significantly decreased than the value of baseline value (P<0.05); Total peripheral resistance (TPR) of PPE session was significantly increased than baseline value (P<0.05). Conclusion Tolerance time before the appearance of presyncopal symptoms during HUT/LBNP decreases and cardiovascular responses to HUT/LBNP are impaired, preceding exposure to HDT.

Objective To evaluate the therapeutic efficacy and safety of endoscopic sphincterotomy (EST) combined with large balloon dilation for bile duct stones.Methods A total of 83 patients with common bile duct stones were randomly divided into 2 groups to receive standard EST (n =41,EST group) or EST plus large balloon dilation (n =42,EPLBD group),respectively.The number of endoscopic session,operation time,rates of successful complete stone retrieval,mechanical lithotripsy,and procedure related complication were compared between the two groups.Results The rate of early procedure-related complications was similar in 2 groups (9/41 vs.7/42,P ＞0.05),including perforation ( 1/41 vs.0/42,P ＞0.05),bleeding (5/41 vs.2/42,P＞0.05) and pancreatitis (3/41 vs.5/42,P＞0.05).The rate of successful complete stone removal was also similar in 2 groups (39/41 vs.41/42,P ＞ 0.05 ).However,EST group needed more procedure time (38.8 ±4.3 min vs.29.2 ±5.3 min,P ＜0.01 ) and use of mechanical lithotripsy to achieve complete stone removal (9/41 vs.2/42,P ＜ 0.05 ).Only one patient in EPLBD group ( 1/42,2.4％ ) needed a second ERCP to clear bile duct stone,while in EST group,8 patients underwent a second procedure ( 19.5％,P ＜ 0.05 ).Conclusion For endoscopic removal of common bile duct stones,EST combined with larg4e balloon dilation is as safe and effective as EST,while easier in manipulation.

Background:Helicobacter pylori (Hp)infection is correlated with the development of chronic gastritis,peptic ulcer, mucosa-associated lymphoid tissue lymphoma and gastric cancer.Studies showed that Lactobacillus acidophilus could improve the eradication rate of Hp and reduce the occurrence of side-effects.Aims:To evaluate the efficacy of compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy for the treatment of failed eradiction of Hp infection.Methods:One hundred and eighty patients with Hp-positive peptic ulcer in whom standard triple therapy failed were enrolled and then randomly assigned into experimental group and control group.Patients in experimental group received compound Lactobacillus acidophilus tablets 1 g tid for 14 days,followed by rabeprazole 10 mg bid +amoxicillin 1 000 mg bid +furazolidone 100 mg bid +bismuth 300 mg qid for 10 days.Patients in control group received rabeprazole 10 mg bid +amoxicillin 1 000 mg bid +furazolidone 100 mg bid +bismuth 300 mg qid for 10 days.13 C-urea breath test was conducted at least 4 weeks after completion of the course,Hp eradication rate and side-effects were evaluated. Results:No significant differences in PP eradication rate and ITT eradication rate were found between experimental group and control group (PP:81.2% vs.78.2%,χ2 =0.241,P =0.623;ITT:76.7% vs.75.6%,χ2 =0.031,P =0.861).Incidences of nausea and vomiting (2.4% vs.11.5%),diarrhea (0 vs.9.2%)in experimental group were significantly decreased than those in control group (P <0.05).Conclusions:Compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy is efficient for Hp-positive patients with failed standard triple therapy and can reduce side-effects.

Objective To investigate whether IL-24 can inhibit the growth of pancreatic cancer in immune-competent mice,which could be mediated by tumor-targeting oncolytic adenovirus (ZD55-IL-24).Methods Crystal violet staining assay was used to evaluate the anti-proliferative influence of ZD55-IL-24 on Panc02.The tumor growth curve,the tumor formation curve,TUNEL assay,cytotoxic T lymphocyte (CTL) killing assay and serum cytokines detection were used to assess anti-tumor efficacy of ZD55-IL-24 for pancreatic cancer in immune-competent mice.Results ZD55-IL-24 significantly inhibited the growth of pancreatic cancer cells in vitro.Lower tumor formation and slower tumor growth were identified in ZD55-IL-24 group,compared with ZD55-EGFP group or PBS group.ZD55-IL-24 induced pancreatic cancer cells'apoptosis,and mediated anti-cancer immunity by increasing killing responses of CTL to cancer cells and up-regulating serum γ-IFN and IL-6 levels.Conclusion ZD55-IL-24 can induce anti-tumor immunity and suppress pancreatic cancer growth in immune-competent mice.

Objective To observe the clinical efficacy and safety of ticagrelor,a new antiplatelet agent,in patients with ST-Segment elevation myocardial infarction (STEMI) underwent emergency PCI.Methods Selected 174 patients with STEMI receiving emergency PCI treatment from January 2013 to July 2014 in Nanjing General Hospital of Nanjing Military Area Command,and randomly divided into clopidogrel group (preoperative taking 600 mg of clopidogrel,n =88) and ticagrelor group (preoperative taking 180 mg of ticagrelor,n =86).Compared platelet inhibition rate,renal function before and after treatment,major clinical cardiovascular events and bleeding events 30 d after treatment,adverse drug reactions of two groups.Results (1) Arachidonic acid pathway inhibition rate of the two groups were compared,the difference was not statistically significant (P ＞0.05).Compared two groups of patients with adenosine phosphate pathway inhibition rate,ticagrelor group was higher,the difference was statistically significant ((71.82 ± 19.97) ％ vs.(38.96 ± 27.55) ％;t =-7.569,P ＜0.001).(2) Compared major cardiovascular events of ticagrelor group(5 cases) and clopidogrel group (15 cases),ticagrelor group was decreased.There was significant differences (P =0.02) between the two groups.Bleeding events compared to between ticagrelor group (15 cases) and clopidogrel group (11 cases),no statistically significant difference was found(P =0.617).Conclusion Clinical efficacy of ticagrelor in acute ST-segment elevation myocardial infarction treated with primary PCI is superior to clopidogrel in which can reduce the risk of cardiovascular events in patients and without an increase in severe bleeding.

Background and purpose: Carcinosarcoma of the lung is a rare malignant pulmonary neoplasm,which including epithelial and parenchymal malignant structure with a poor prognosis. The purpose of this study was to describe the clinicopathologic characteristics and the survival of pulmonary carcinosarcoma. Methods: From Jan.1980 to Dec. 2006, 64 patients with pulmonary carcinosarcoma who underwent surgical treatment were retrospectively analyzed. Results: The overall 5-year survival rate of the patients was 14.1%. There was significant difference between stage Ⅰ/Ⅱ and stage Ⅲ/Ⅳ disease (28.6% vs 2.8%, P=0.003), respectively. The 5-year survival rates of lobectomy, pneumonectomy and palliative resection were 3 3.3 %, 2.8% and 0% ( P=0.003 ), respectively. Conclusion:p-TNM and operative pattern were correlated with survival. Early diagnosis and radical operation are important to the survival of the patients with pulmonary carcinosarcoma.

Objective To investigate changes of learning ability and somatostatin (SS) changes after positive acceleration (+Gz) exposures. Mehtod Eighty male SD rats were randomly divided into 3groups: control group(Con), +6 Gz/3 min group ( +6 Gz), and +10 Gz/3 min group ( +10 Gz),8 rats in each group. Changes of learning ability in rats were observed at 0 d, 2 d, 4 d and 6 d after + Gz exposure. SS in hippocampus was measured by RIA at 0 d, 2 d and 4 d after + Gz exposures ( there were 8 rats every time, in each group). Result In Y-maze test,number of correct response decreased significantly (P ＜0.01 ), and total reaction time increased significantly(P ＜0.01 ) in +6Gz and +10 Gz groups as compared with control group; number of correct response and total reaction time in +10 Gz group changed significantly at 0 d(P ＜0.01 or P ＜0.05) as compared with +6Gz group. RIA showed that, content of SS in hippocampus declined at 0 d and 2 d(P ＜0.05 or P ＜0.01) in +6 Gz and + 10 Gz groups as compared with control group. Conclusion + Gz exposure could impair learning ability of rats, and inhibit expression of SS in hippocampus.

We investigated the molecular characteristics of the full-length genome of 14 dengue serotype 1 virus (DENV-1)strains isolated in Sino-Myanmar border region in Yunnan Province,China during 2013-2015.Isolation of dengue virus was using C6/36 cell culture method.Viral RNA was extracted from virus isolates,and then the full-length genome was amplified by RT-PCR.The homology and phylogenetic analysis was made on the nucleotide and deduced amino acid sequences by bioinformatics software including ClastalX1.83 and MEGA6 etc.Results showed that fourteen strains of DENV-1 isolated from dengue fever cases,of these,9 strains from Ruili City of Dehong Prefecture,3 from Lincang Prefecture,2 from Kunming City.RT-PCR and sequencing indicated that the full-length genes (10 735 nt) of 14 DENV-1 strains were obtained,and their open reading frame (95-10 271) were coded 3 392 amino acid residues.The genotypes of DENV-1 were revealed by homology and phylogenetic analysis based on structural and non-structural proteins.Thirteen were genotype Ⅰ (G-Ⅰ) (7 from indigenous cases in Ruili and Lincang and 6 from imported case from Myanmar to Ruili,Lincang and Kunming),and 1 G-Ⅲ from imported case from India to Kunming.The phylogenic analysis indicated that the 13 isolates from Yunnan divided into 2 phylogenic subgroups,and they had a closer genetic relationship with the strains isolated from Southeast Asia.The gene sequences of the 13 G-Ⅰ strains have been acquired,the rate of their nucleotide homology and amino acid homology were 97.02 ％-100 ％ and 98.78 ％100 ％ respectively.Compared with 6 strains from Southeast Asia,nucleotide homology and amino acid homology were 96.53％-99.53％ and 97.33％-100％ respectively.Compared with prototype strain (US_Hawaii) of DENV-1,nucleotide homology and amino acid homology were 93.76％-94.45 ％ and 95.86 ％-96.91％ respectively.Compared with US_Hawaii strain,there were 44 and 150 different sites in amino acid of structural and non-structural proteins,respectively.The G-1 of DENV-1 have been popular in Sino-Myanmar border region in Yunnan,2013-2015.They have genetic diversity but multiple transmission sources were from Myanmar,and should strengthen control cross-border spread of dengue fever in this region.It is necessary to further study that change of the amino acid sites of Yunnan strains of DENV-1 is related to its antigenicity and pathogenicity.