Objective To investigate the influence of endoscopic retrograde cholangiography (ERC), endoscopic retrograde pancreatography (ERP), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and endoscopic biliary stenting on postoperative pancreatitis. Methods 412 patients referred to ERCP were divide into 7 groups, there were both biliary and pancreatic ducts group (ERCP), biliary duct contrast filling group (ERC), pancreatic duct contrast filling group (ERP), ERCP plus biliary stenting group (stent), ERC plus stent, ERCP plus EST and stone extraction (SE) group, and ERC plus EST and SE group. And the differences of postoperative serum amylase in 4 hours and in 24 hours as well as clinical symptoms were compared among different groups. Results The incidence of postoperative hyperamylasaemia in 4 hours and 24 hours were 17.7% and 4.4% respectively. The incidence of postoperative acute pancreatitis was 3.9%, and ERP group had the highest incidence of postoperative acute pancreatitis among the 7 groups. Conclusions Repeated pancreatic duct contrast filling during ERCP manipulation is the main risk factor for postoperative pancreatitis, and therapeutic ERCP such as EST, stent and SE does not increase the incidence of postoperative pancreatitis.

Objective To explore and improve the hospital consumables logistics distribution and cost control system based on consignment mode to solve the current problems in many hospitals for material management.Methods Improvement measures were taken from the aspects of network information system,inventory management,establishing organization architecture and post responsibility as well as introducing IOT technology.Results The system contributed to optimizing consumables management flow and saved hospital cost.Conclusion The hospital consumables logistics distribution and cost control system based on consignment mode is of great value for the management of hospital consumables.

Objective The clinical efficacy of pancreatic stent in treating chronic pancreatitis was summarized. Methods The stents were applied in 14 patients with chronic pancreatitis and ductal stricture manifested clinically and roentgenographically. Postoperative abdominal pain, changes in appetite, body weight and fat in stools were observed in follow－ ups. Results The stents, 5～ 10F in caliber, were successfully placed in all patients with first attempt. They were followed up for 210 days ( ranging 28～ 520 days ). The early (3 months ) results showed that the pain remitted in 13/14 (92.9％ ) and 11/13 (84.6％ ) of cases respectively. While abdominal pain persisted in 2 cases inspite of the stents. Along with pain remission the appetite and presence of fat in stools improved associated with increase in body weight. The stents drainage maintained for a median to 256 days (ranging 90～ 520 days) Transient hyperamylasemia occurred in 3 cases. Translocation and occlusion of the stent was found in 1 occasion each on the 98 and 520 day respectively. No other serious complication was detected. Conclusion It is assumed that pancreatic stent is effective to treat chronic pancreatitis with ductal stricture.

Objective To study the technique of double stent drainage on biliary and pancreatic ducts obstruction,and to assess its clinical effectiveness.Methods Firstly,ERCP was done on all patients to investigate the locus and extent of the stricture or obstruction,in order to choice the stent with suitable diameter and length.Then the stents placed into biliary and pancreatic ducts though the guidewires those was inserted into the ducts already.After the operation,the level of serum amylase and clinical symptoms such as jaundice,abdominal pain and diarrhea were observed to assess the therapeutic effect.Results 14 patients diagnosed as biliary and pancreatic ducts stricture or obstruction were treated successfully with this method(5 patients suffered from ampulla cancer,4 carcinoma of head of pancreas,3 carcinoma of duodenum papilla,2 chronic inflammation of head of pancreas).Thirteen patients were placed with 14 plastic biliary stents in their biliary ducts(each was placed with one stent except one with 2 stents),and one patient was placed with metal stent.At the same time,14 pancreatic stents were placed into pancreatic ducts of these patients.The rate of jaundice extinction in 2 weeks,1 month and 3 months after the operation was 50 percent,71 percent and 93 percent respectively.The rate of abdominal pain remission in 2 weeks after operation was 75 percent.Among 7 diarrhea patients ,the clinical symptoms disappeared in 5 patients and were significantly improved in 2 patients one month after the operation.The obstruction and displacement of stents had not been observed in all patients within 3 months after the operation.The complications related to operation had not been observed in all patients within 3 months after the operation.Conclusions The therapy with double stent drainage in biliary and pancreatic duct stricture is safe and effective.It can relieve jaundice and abdominal pain,decrease biliary pressure and improve the exocrine dysfunction of pancreas.

Objective To investigate the occurrence of early complications of diagnostic and therapeutic ERCP and its treatment .Methods Occurrence,kind,treatment and outcome of early complications of diagnostic and therapeutic ERCP were respectively reviewed in 8 579 cases in our hospital between January 1977 and December 1999.Results 112 cases had early complications(1.31%).In diagnostic ERCP morbidity of early complications was 1.30%(95/7290) and it was 1.32%(17/1289)in therapeutic ERCP.Of them,acute pancreatitis occurred in 38 cases(0.44%),billiary infection 30 cases(0.35%),bleeding of digestive tract 26 cases(0.30%),drug reaction 8 cases(0.09%),stone and basket incarceration 5 cases(0.06)%,intestinal perforation 1 cases (0.01%) and retroperitoneal pneumatosis 1 cases(0.01%).Of them,106 patients were cured by conservative therapy.Operations were performed in 5 patients.1 patient died.Conclusion In diagnostic ERCP acute pancreatitis is the most common complication,which may be related to difficulty of cannulation,repeated developing and inappropriately injecting contrast medium. In therapeutic ERPC bleeding of digestive tract is the most common complication ,which is related to the procedure ,jaundice and diabetes.Most of complications can be cured by conservative therapy,but a minority needs operation.

Objective To evaluate the role of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography(ERCP)in bile duct injury. Methods Thirty-one patients with bile duct injury from March 1999 to March 2004 were managed by ERCP. Patients with indications of endoscopic therapy were treated by endoscopic sphincterectomy(EST)and plastic stent drainage. Results Twenty-two of 31 patients with bile duct injury received endoscopic therapy . The patients included 3 cases of common bile duct transection or ligation, 13 cases of bile duct stricture, and 15 cases of bile leakage. Seven of 13 patiens with bile duct stricture received plastic stent therapy, followed for 8-20 months, 4 cases with satisfaction and 3 cases with poor outcome. Fifteen cases of bile leakage accepted EST and endoscopic nasalbiliary drainage(ENBD) , in the first time,13 cases resulted in healing of the leakage,2 cases were of no effect. Seven cases of bile duct stricture were treated with plastic stent, maintaining for 4-12 months. No procedure related complications. Conclclusions ERCP is helpful not only for diagnosing and localizing localizing bile duct injury, but also for treating it in most of patients with relatively good and safe results.

Objective To summarize the experiences in diagnosing and removing foreign bodies in the upper gastrointestinal tract. Methods Eight hundred and two cases were examined endoscopically for their ingested foreign bodies from 1978 to 2003. Endoscopy and various instruments for grasping the foreign bodies were used. Results Altogether there were 1 198 pieces of foreign bodies, 424 of which were impacted in the esophagus, 662 in the stomach, and 112 in the duodenum. One thousand one hundred and ninity-eight pieces of foreigen bodies were successfully removed from 780 patients without any complications. But removal of 31 pieces in 22 patients failed because the foreign bodies were impacted in the gastrointestinal tract. The success rate was 97.3%. Among all the foreign bodies taken out, the largest one was 20cm in length and 4.2cm in width. Conclusion Endoscopy could be used safely and effectively in patients with ingested foreign bodies.

Objective: To detect the novel apoptosis-related protein PDCD5 expression in granulosa cells of polysystic ovary syndrome(PCOS) and normal ovary, and explore the pathogenesis of PCOS. Methods:The granulosa cells were collected from 30 cases of PCOS and normal ovary in IVF-ET. Expression of PDCD5 was detected by flow cytometry; immunofluorescence and immunohistochemistry. Cell apoptosis was detected by Propidium Iodide (PI) staining. Results: The number of hypodiploidy cells associated with apoptosis in granulosa cells of PCOS was greater than that of the normal control. PDCD5 protein expression in PCOS granulosa cells was significantly higher than that in normal ovary(P

Helicobacter pylori(Hp) infection plays an important role in the development of gastric carcinoma. Colonization of CagA-positive Hp is a great risk for intestinal gastric carcinoma. The mechanism of Hp infection changing the gastric epithelium at the molecular level is complex and through multiple pathways. Animal models can be of great help in exploring the role of Hp infection in gastric cancer development. This paper reviewed the latest studies of epidemiology, animal model and molecular pathogenesis of Hp associated gastric cancer.

Objective To investigate characteristics and alternation of cerebral evoked potentials (CEP) response to esophageal mucosal acid exposure and distention in patients with non-erosive gastro-oesoph- ageal reflux disease (NERD) and in healthy subjects,and to study the mechanism of visceral hypersensitivity in NERD.Methods Twenty-one NERD patients and 10 volunteers were recruited.Mechanical distention stimulation and acid perfusion of the esophagus were performed using the balloon-affixed and polyvinyl multi- lumen catheter.First,maximally tolerated pain thresholds of all subjects were recorded,then esophageal mechanical stimulation with a 75% of maximal tolerated intensity and a frequency of 0.2 Hz was performed altogether 64 times by means of a computer-controlled barostat.The alternation of esophageal CEP was recorded before and after acid perfusion with a multichannel international 10-20 system of electroencephalography. Experimental data was analyzed by student's t-test and one way analysis of variance.Results Esophageal mu- cosal distention may evoke recognizable and reproducible and multi-peak CEP.The latencies for N1,P1 and N2 in volunteers were (246?77),(388?84)and (502?78) ms,CEP morphology of NERD patients was charac- terized by randomly distributed patterns,and the latencies for N1 ,P1 and N2 were (192?46),(293?76) and (440?79)ms,significantly shorter for mechanical stimulation compared with those of control group respectively (all P value