Objective To evaluate the efficacy of metal stent placement for the treatment of malignant gastroduodenal obstruction. Methods Medical records of 24 patients with gastroduodenal obstruction secondary to malignant tumors (gastric cancer, 19 patients; pancreatic cancer, 4 patients; postsurgical biliary duct cancer, 1 patient) from October 2002 to November 2004 were reviewed. Under radioscopy, a self-expanding metal stent was placed endoscopically into the stenosis site of the stomach or the duodenum. Results All the metal stents were placed at the expected position. After operation the patients were given fluid diet at 1 day and soft diet at 3 days. No stent-related gastrointestinal perforation or hemorrhage was observed. Follow-up for 1~24 months in 21 patients found re-obstruction in only 2 patients and no migration of metal stents. Conclusions Self-expanding metal stent placement for malignant gastroduodenal obstruction is safe and effective.

Objective To explore the treatment effect on cervical Paiteling cervical high-risk human papiloma virus(HPV) infection outcome.MethodsRandomly selected from our hospital during January 2014 to January 2016 in 120 cases of cervical high-risk HPV infection patients as the research object, of which 40 cases were treated with Paiteling treatment (Paiteling group), 40 patients were treated with foscarnet sodium (foscarnet sodium group).Another 40 patients without intervention (control group).The outcome of HPV infection in three groups was compared.ResultsPatients with negative rate of special spirit (87.50%) and foscarnet sodium group (55.00%) and control group (50.00%) was statistically significant(P<0.05), and the special spirit Group continued the positive rate (2.50%) was significantly lower than the control group (42.50%) and foscarnet sodium group (37.50%).However, there was no significant difference between the groups in the rate of improvement and the incidence of new infections.There was no significant difference between the control group and the positive rate (50.00%) in the control group (42.50%) compared with that in the control group.ConclusionPaiteling treatment of clinical effect of cervical high-risk HPV infection, can effectively improve the symptoms of HPV infection, which can shorten the HPV clearance time, has positive clinical significance.

Application of Multiple-Media and Internet Technology in Teaching of Medicine Ethics can over come the shortcomings of traditional teaching of Medicine Ethics.it has many advantages;Firstly,it is more informational and easier to operate;Secondly,it can improve the efficiency to reach the teaching aims;Thirdly,the teacher and students Can communicate each other,and make the students be the center of teaching.

Objective To explore the mechanism of Huagan Jiedu decoction in treatment of chronic hepatitis B by testing the influence of the decoction on Serum IL-2, IL-4 and IFN-γ of rat models of chronic hepatic injury. Methods The model of Chronic hepatic injury was established by subcutaneously injecting 40% CCl4-olive oil solution in rats according to the ratio of 3ml per kg. of body weight. 60 healthy rats were divided randomly into a normal group, a model group, a low dose of Huagan Jiedu decoction group, a large dose of Huagan Jiedu decoction group, and a control group (Qingre Jiedu tablet group), 15 cases in each group. The Serum IL-2, IL-4 and IFN-γ were detected in each group separately. Results Compared with the normal group, the Serum IL-2 and IFN-γ were decreased (t=2.401, 2.337, P=0.0349, 0.0378) and the Serum IL-4 was increased (t=2.896, P=0.00861 ) in the model group; Compared with the model group, the Serum IL-2 and IFN-γ were increased (t=2.417, 2.344, P=0.0341, 0.0372, P＜0.05; t=3.114, 2.988, P=0.0052, 0.0068) in the large Huagan Jiedu decoction group and the control group, while the Serum IFN-γ was increased (t=3.049, P=0.0062) in the low dose of Huagan Jiedu decoction group and the Serum IL-4 was decreased (t=3.102, 3.017, 2.979, P=0.0061, 0.0065, 0.0069)in both Huagan Jiedu decoction groups and the control group. Conclusion Large dose of Huagan Jiedu decoction has sound therapeutic effects on rats with chronic hepatic injury by decreaseing the content of the Serum IL-4 and increasing IL-2 and IFN-γ, and adjusting th1/th2 balance.

Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2)in pancreatic carcinoma and the relationship between MMP-2 with tumour clinicopatholngical features. Methods The expression of MMP-2 was detected by S-P immunohistochemistry in 36 cases with pancreatic carcinoma and 14 normal pancreat-ic tissues. Results The positive expression rate of MMP-2 was 66.7% (24/36) in pancreatic carcinoma tissue and 14.3% (2/14) in normal pancreatic tissues (χ2 = 3. 587, P < 0.01 ) ;The expression rate of MMP-2 in pancreatic carcinoma tissue with positive-node was 86.7% ( 13/15 ) ,which was higher than that with negative-node,which was 52.4% ( 11/21 ) ( P < 0.05 ) ; As to TNM staging in pancreatic carcinoma, the expression rate of MMP-2 was 41.2% (7/17) with Ⅰ,Ⅱ staging and 89.5% (17/19) with Ⅲ,Ⅳ staging(χ2=9.418,P <0. 01 ) ;The expression rate of MMP-2 was 50.0% (5/10) ,66.7% (10/15) and 72.8% (8/11) in highly,moderately and poorly differentiated pancreatic carcinoma(P > 0.05 ). Conclusions The expression of MMP-2 is strengthened significantly in pancreatic carcinoma tissue and involved in turnout invasion and metastasis features; MMP-2 might be regarded as one more marker for the invasive properties of pancreatic carcinoma.

Objective To apply data mining to risk prediction of sudden deafness, and form the association rules.Methods The clinical data of 517 patients with sudden deafness was collected, including the characteristics of 19 attributes: sex, age, season, hypertension, diabetes, heart disease, hypercholesterolemia, atherosclerosis, long-term smoking, alcoholism, mental tension, insomnia, weakness, bedridden, infection, congenital malformation, trauma, tumour and autoimmune diseases. The source database were cleaned, then mapped for mining database. Minimum support to 0.1 and minimum confidence level to 0.9 were set for analysis of association rules. Results One hundred and six strong association rules were formed, and the rules contained the relation between the incidence of sudden deafness and the characteristics of 19 attributes. Conclusion This method is conducive to make the abstract theory of mathematical statistics into useful association rules to guide the practice of disease prevention and control.

The calcaneus bone strength was assessed by quantitative ultrasonography in 47 postmenopausal women with type 2 diabetes mellitus (T2DM group) and 30 healthy postmenopausal women (control group).Speed of sound (SOS),broadband ultrasound attenuation (BUA) and stiffness index (SI) in T2DM patients were (1 015 ± 170)m/s,(84 ± 14) dB/MHz and 45 ± 8,respectively,which were significantly lower than those of control group (1 403 ± 232) m/s,(111 ± 18) dB/MHz and 66 ± 12 (all P ＜ 0.001).Stepwise multiple regression analysis showed that homeostasis model assessment of insulin resistance (IR) was independently correlated with the parameters of quantitative ultrasonography in T2DM patients.The results suggest that calcaneus bone strength is reduced in postmenopausal women with T2DM.

Objective To study the effect of quality ciecle on improving nurses application ablitiy in operating monitors. Methods Quality circle group was established in the department of general surgery and the circulation of plan-do-check-action was used in the groups for continuous quality control of ECG monitor application.The satisfaction of nurses with ECG monitor management and consuming time of ECG monitor installation were compared between pre-and post-enforcement of quality control circulation. Results After use of quality control circulation,the nurses were more satisfied with the maintenance of ECG monitoring and they knew better about their right storage and disposition and where the monitors were(all P<0.001).Conclusion The quality circle may effectively regulate ECG monitor management,improve applying proficiency of nurses and effectively improve work efficiency,so it is worth clinically applying.

Objective To investigate the variation of fentanyl concentration and the gene expression and activity of rat intestinal cytochrome P450 3A1 in anhepatic phase. Methods The experiment was comprised of 2 steps. Step 1: The rats were randomly divided into experimental group (group A2, underwent occlusion of the hepatic portal) and control group (group A1), with 10 rats in each group. Fentanyl blood concentration was analyzed by LC/MS/MS. Step 2: The rats were randomly divided into group B1 (control), group B2 and group B3 (the rats underwent devascularization of the hepatic portal for 30 or 60 min). The levels of CYP3A1 in rat small intestine were assessed with RT-PCR and the enzymic activity of CYP3A1 was detected by fluorometry. Results Fentanyl concentration in anhepatic phase dropped more slowly in group A2 than group A1 (P

Objective To investigate the value of timely duodenal papilla fenestration for reducing the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).Methods The clinical data of 181 patients with difficult biliary cannulatian during ERCP at the Xinhua Hospital of Shanghai Jiaotong University from July 2006 to December 2009 were retrospectively analyzed.Of the 181 patients,98 patients who received traditional incubation were in the control group,and the other 83 patients who received early duodenal papilla fenestration were in the test group.The success rate of selective incubation and incidence of pancreatitis were compared between the 2 groups.All data were analyzed using the t test,chi-square test or Wilcoxon rank sum test.Results The success rate of incubation,incidences of hyperamylasemia and pancreatitis were 85.7％ ( 84/98 ),7.1％ (7/98) and 10.2％ ( 10/98 ) in the control group,and 94.0％ ( 78/83 ),18.1％ ( 15/83 ) and 2.4％ (2/83) in the test group,respectively,and there were significant differences between the 2 groups (x2 =10.12,5.03,4.41,P＜0.05).The numbers of patients with mild,moderate and severe pancreatitis were 3,5 and 2 in the control group,and 1,1,0 in the test group,respectively,and there was a significant difference between the 2 groups ( Z =- 2.11,P ＜ 0.05 ).Conclusion Timely duodenal papilla fenestration is safe and effective in reducing the incidence of pancreatitis for patients with difficult biliary cannulation during ERCP.