In recent years,endoscopic technique has become a basic procedure for the diagnosis and treatment of biliary and pancreatic diseases,thus the procedure-related complications of ERCP and endoscopic sphincterotomy(EST) become prominent day by day. Post-EST bleeding is one of the most serious complications of the procedure,and its first line treatment involves a variety of endoscopic techniques,such as epinephrine or fibrin glue local injection,electric coagulation and heat probe,clamps and covered metal stents. If these are not successful,transcatheter arterial embolization or surgical operation should be considered. In this article,the above-mentioned treatment modalities of post-EST bleeding were reviewed.

In the paper, 32 lots of intravenous immunoglobulin (IVIG)were tested by an animal model,the hypotensive test of rats. A linear correlation was found between prekallikrein activator (PKA)activity and hypotensive reaction if the inflow of human IVIG was made rapid (r=0.96,n=23). The preliminary observations indicated that it would be satisfactory that the PKA activity was below 35IU/ ml and the size of reduction in blood pressure was not 15% higher than that of control animal's level.The rat model can provide a method for safe usage of the intravenous immunoglobulin and reliable detection of and control over the residual PKA activity in blood products.

Objective To analyse the effect of repaglinide combined with Zhenqi Jiangtang Capsules on βcell function in elderly patients with type 2 diabetes mellitus.Methods 60 elderly patients were collected from harbour branch of Hainan provincial People's hospital, who were diagnosed with type 2 diabetes mellitus .All patients were randomly divided into experimental group and control group, 30 cases in each group, 2 groups of patients were given control diet, moderate exercise, and other conventional adjuvant therapy.Control group was treated with repaglinide orally on the basis of routine adjuvant treatment, 1 mg/times, three times per day,experimental group were given Zhenqi Jiangtang Capsules based on the treatment in control group,4 grains/times,three times per day.Both groups were treated for 4 weeks, after the end of treatment, blood glucose levels,serum insulin levels,βcell function and serum lipids in all patients were detected.ResuIts After treatment, compared with control group, the levels of blood glucose, HbA1c and AUCg in experimental group were significantly lower ( P<0.05 );the insulin levels 30 min,60 min, 120 min after meal were significantly higher (P<0.05);the HOMA-IR of patients was significantly lower(P<0.05);IRG, AUCi and AUCi/AUCg were significantly higher (P<0.05);the serum TC, TG, LDL levels were significantly lower, serum HDL levels were significantly higher(P<0.05).ConcIusion Repaglinide combined with Zhenqi Jiangtang Capsules can significantly reduce the blood glucose and lipid levels in elderly patients with type 2 diabetes, improve the function of pancreatic beta cells, promote postprandial insulin secretion and improve insulin resistance.

OBJECTIVE To observe the therapeutic effectiveness and safety of the indigenous teicoplanin in intensive care unit(ICU) patients with severe infections of Gram-positive(G+) cocci.METHODS Sixty patients with severe Gram-positive bacteria infection received teicoplanin which was produced by Xinchang Pharmaceutical Factory of Zhejiang Medicine Co,Ltd.by infusion for 7-14 d.Dosage was adjusted according to the creatinine clearance rate.Maximum temperature,APACHEⅡ score,indicators of inflammatory response,liver and kidney function,microbiologic examination and adverse reactions were observed before treatment and the end of 7-14 day treatment.RESULTS Seventy-two strains of Gram-positive cocci were isolated from 60 patients,in which meticillin-resistant Staphylococcus aureus(MRSA),meticillin-resistant S.epidermidis(MRSE),Enterococcus faecium,E.faecalis,S.haemolyticus and E.gallinarum accounted for 58.33%,8.33%,16.67%,5.56%,8.33% and 2.78%,respectively.After treatment,59 strains of Gram-positive cocci were eliminated while 13 strains were not eliminated and bacteriological eliminated rate(calculated by strains) was 86.1%;In this group,twenty-eight patients were cured while twenty-two cases were markedly improved.The total bacteriological eliminated rate was 81.94%.The incidence of adverse reactions was low and only a slight increase or decrease in platelet count was observed which didn′t require special treatment interventions.CONCLUSIONS Indigenous teicoplanin has certain therapeutic effectiveness and is safe for severe Gram-positive bacteria infected patients,particularly for septic patients with organ damage in ICU.In patients highly suspected with meticillin-resistant staphylococci or enterococci infection,teicoplanin may be a choice for initial empirical treatment.

Objective To observe critical patients with thrombocytopenia,and exam their coagulation function,so as to diagnose disseminated intravascular coagulation(DIC)in the early stage.Methods Totally 56 critical patients complicated with thrombocytopenia were enrolled in the investigation;complete set of DIC tests were performed.A total of 26 cases were diagnosed as DIC according to the criteria from the International Society of Thrombosis Haemostasis(ISTH).The sensitivity,specificity,accuracy,likelihood ratio,predictive value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),antithrombin Ⅲ and bleeding signs(including petechia and ecchymosia)were calculated by applying fourfold table.Results The specificity of PT prolongation and Fg reduction was 87.0%;the sensitivity of ATⅢ decrease,and each of PT prolongation,Fg reduction,and bleeding(including petechia and ecchymosis)were as high as 96.0%.Conclusion Multi-markers based on thrombocytopenia are likely to improve sensitivity and specificity of DIC diagnosis.

Aim To study the protective effects of dipfluzine against the whole cerebral ischemia and reperfusion injury and its mechanisms.Methods Four-vessel occlusion method was used to make the cerebral ischemia-reperfusion model.In early period of reperfusion,several including LDH,MDA,SOD and brain water content were tested.And in the late period of reperfusion,the delayed neuronal death and amnesia induced by reperfusion were studied.Results The contents of brain water and MDA were increased,and the activities of SOD and LDH were decreased after ischemia and reperfusion injury.The hippocampal structure and memory of rats were also destroyed in the delayed neuronal death.Dip reversed the changes obviously.It had antagonistic effect on brain edema and lipid oxidation,it also protected the neurons of hippocampal CA1 regions from ischemia injury.Conclusion Dip had protective effects on the early stage of reperfusion injury,and delayed neuronal death after the whole cerebral ischemia and reperfusion,which were possibly due to the antagonistic effect on lipid peroxidation.

Objective To analyze the features of normal high-frequency ultrasonography of tarsal tunnel. Methods Forty volunteers (20 males and 20 females) were examined with high-frequency ultrasound (12 MHz). The tendons,nerve and blood vessels in tarsal tunnel were observed from short-axis and long-axis views dynamically. The areas of tarsal tunnel and posterior tibial nerve were measured and com-pared between the males and females. Results High-frequency ultrasonography depicted the anatomical structure of tarsal tunnel,and the tendons,nerve and blood vessels presented different sonographic features that were easy to differentiate. The area of tarsal tunnel: male (7.61 ±1.00) cm2,female (6. 61 ± 1. 07) cm2 (P <0. 01). The area of posterior tibial nerve: male (9. 59 ± 0. 75) mm2,female (8.91 ±0.74) mm2(P<0.01). Conclusion High-frequency ultrasonography can clearly show and accurately measure the tarsal tunnel structure. To be familiar with the normal ultrasonographic anatomy of tarsal tunnel will help to improve the efficacy of ultrasound diagnosis of tarsal tunnel abnormalities.

Objective To study the inhibitory effect of valdecoxib on Lewis tumor and the potential relationship with cyclooxygenase-2(COX-2).Methods HE staining was used to observe lymphocyte infiltration in tumor tissue and the cell structure of the stomach and colon.Western blotting was used to detect the expression of COX-2 in tumor tissue.PGE_2 ELISA kit was used to detect the content of PGE_2 in tumor tissue.Results ① Valdecoxib inhibited the growth of the tumor,and the survival rate was increased.②There was lymphocyte infiltration in treatment group and the content of PGE_2 was decreased.③Valdecoxib did not affect cell structure of stomach and colon,bleeding and clotting time.Conclusion Valdecoxib inhibits the growth of the Lewis tumor and enhances the survival rate.The effect of valdecoxib is related to the inhibition of COX-2.

This study is to explore the activation of the Ca2+/CaM/CaN signal pathway in 5-HT-induced proliferation of rat pulmonary artery smooth muscle cells (PASMCs) and the inhibitory effect of m-nisoldipine (m-Nis) on this pathway. PASMCs were cultured with the explant technique. The proliferation of PASMCs was evaluated by MTT assay. Confocal microscopy was used to measure the change of [Ca2+]i. The mRNA expression of CaM and CaN was evaluated by RT-PCR and the activity of CaN was measured according to the instruction of kits. The results of MTT assay suggested that 5-HT (1 ?mol?L-1) significantly induced the proliferation of rat PASMCs (P

Objective To evaluate the efficacy of STERRAD (r) 100S (low temperature hydrogen peroxide gas plasma sterilization system) by comparing with formaldehyde steam. Methods From 2005.1 to 2005.3, totally sterilization of 2 760 pieces of operating tools were carried out with formaldehyde steam. From 2005.1 to 2005.3, totally sterilization of 4 950 pieces of operating tools in 180 circles were carried out with STERRAD (r) 100S. The instrument damage rate, operating infection rate and satisfaction rate of medical workers of 2 groups were compared. Results All data were in favor of the efficacy of STERRAD (r) 100S. Conclusions STERRAD (r) 100S is a safe, effective, low temperature, and cost-effective sterilization system..