Objective:Endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy (EST) are well accepted as the procedure of choice for diagnostic and therapeutic purposes of pancreaticobiliary disease. The aim of this study is to investigate the curative effect and complication of pancreaticobiliary disease managed by therapeutic ERCP. Methods: A total of 59 patients with common bile duct stone,acute obstructive suppurative cholangitis,malignant bile duct obstruction, acute or chronic pancreatitis,and sphincter of Oddi dysfunction. Each case was confirmed by ultrasonographic examination, diagnostic ERCP and blood amylase test. All patients underwent therapeutic ERCP such as EST, stone extraction and drainage. Results :Of the 59 patients, 16 patients with acute obstructive suppurative cholangitis and severe acute pancreatitis underwent urgent management of endoscopic intervention, stone extraction and endoscopic nasobiliary drainage. The remaining 43 patients underwent diagnostic ERCP,followed by therapeutic ERCP in cases of documented bile duct stone,sphincter of Oddi dysfunciton,or chronic pancreatitis. The success rate of endoscopic procedure was 100% ,and the complication rate was 6. 8% ,without mortality. Conclusion : In patients with pancreaticobiliary disease , therapeutic ERCP provides adequate management and is associated with low complication rates.

Recently,paclitaxel has been used as a new agent on patients with advanced esophageal cancer,and several studies have demonstrated that paclitaxel and paclitaxel-based regimens have significant activity in patients with advanced esophageal cancer and showed highly response rates than the combination of 5-fluorouracil (5-Fu) and cisplatin.However,there have been some problems which need to be solved such as drug-resistance,side effect,and so forth.The new medicament form of paclitaxel can not only depress poison without anti-allergy but also raise medicament curative effect as well as the pharmacal concentration.Although most of the research on the new medicament form of paclitaxel are still limited in the stage of laboratory,it has possessed potential advance in the treatment of advanced esophageal cancer.

Objective To investigate the role of temporary placement of fully covered self-expandable metal stent (cSEMS) for treatment of uncontrolled bleeding after endoscopic sphincterotomy (EST).Methods From January 2000 to present,a total of 3460 cases of EST were performed,and bleeding after the procedure was complicated in 29 (0.84％) of them,in which 4 could not to be stopped by conventional managements.Covered SEMSs were placed across the major papilla in these 4 patients.Results The stents were successfully placed and hemostasis was achieved in all patients.The stent was removed in 1 patient 1 week later,and spontaneous stent dislodgment occurred in 1 patient within 4 weeks.The other 2 patients rejected to remove the stents,and the patency maintained for more than 6 and 12 months respectively.No complication was observed in procedures of placing and removing stents.Conclusion Covered SEMS placement is a safe,effective and simple method for patients with uncontrolled bleeding after EST.

Objective To evaluate the feasibility and safety of peroral direct cholangioscopy (PDCS) by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases.Methods Patients with bile duct dilation underwent standard ERCP and native papilla was dilated using EST and/or endoscopic papillary large balloon dilation,according to the size of the papilla.Then peroral direct cholangioscopy was performed by freehand intubation using routine straight-view endoscope.General data of patients,procedure of ERCP,diagnosis of PDCS and complications were recorded.Results A total of 5 patients underwent PDCS.Indications included common bile duct stones (n =2),intraductal papillary neoplasm of bile buct (n =2) and benign biliary stricture after removable metal stent placement (n =1).The diameter of common bile duct ranges from 1.2 cm to 2.4 cm.EST or/and EPLBD was required in 3/5 patients to facilitate PDCS.Freehand PDCS intubation of the bile duct was successful in all procedures (1 case into distal common bile duct,4 cases into proximal common bile duct).Complications were cholangitis managed with intavenous antibiotics (n =1).No procedure related death occurred.Conclusion Freehand PDCS is technically feasible and safe,and may be clinically useful for diagnostic and therapeutic purposes in managing select biliary tract diseases.

Objective To study the effect of endoscopic treatment in acute severe pancreafitis. Methods EST(endoscopic sphincterepapiilotomy) and ENBD ( endoscopic naso-billary dralnage) or ENPD ( endoscopic naso-pancreatic drainage) were used to treat the acute severe pancreatitis(ASP). Results The recover time of blood dia-stase of the endoscopic therapy group and the contrast group was (3.2±1.5) days, (6.6±1.2) days, respectively (P<0.01) ; the incidence of needing to be operated was 0.7% (1/140), 6.5% (8/124), respectively (P<0.05) ;mortality rate was 0:7% (1/140) ,7. 3% (9/124) ,respectively(P <0. 01 ) ;the incidence of complication was 3.6% (5/140) ,41.9% (52/124), respecfivly(P<0.01). Conclusion EST + ENBD(or ENPD) in treating ASP has cer-tain effect and is the primary therapy to the ASP.

Due to the high incidence and mortality of digestive system malignant tumor,so it is of great significance to make further research for digestive tract tumor.Platinum drugs,one of the traditional drugs which is used for the chemotherapy for digestive system tumor,which has been extensively applied to the chemotherapy for malignant tumor.However,the resistance to the drugs exerts a serious influence on its curative effect.At present,it is believed that the nucleotide excision repair(NER)constitutes one of the most important mechanisms which results in the resistance to platinum drugs,mainly because it causes the twisting of DNA helix by removing large numbers of platinum compounds.The nucleotide excision repair cross complementation group 1(ERCC1)plays an important role in the process of NER.The different expression of ERCC1 in peripheral blood and tumor tissue of patients with digestive sysem tumor has a close connection with therapeutic effect of the platinum-containing chemotherapy.This article aims to provide an overview of the relation between the ERCC1 research development and the curative effect of cisplatin chemotherapy for digestive system tumor.

Objective To explore the clinical value of the insulin pump(CSⅡ) and multiple subcutaneous insulin intensive treat-ment(MDI) for patients with type 2 diabetes and stroke .Methods A total of 80 patients with type 2 diabetes and stroke in Weifang Community Health Service Center from April 2011 to May 2014 were selected as subjects and divided into experimental group and control group according to random number table method ,with 40 cases in each group .Patients in the experimental group were trea-ted with CSⅡ ,patients in the control group were treated with MDI .Glucose level ,therapeutic time ,the number of low blood sugar , insulin dosage ,National Institute of Health Stroke Scale(NIHSS) score ,insulin secretion index(IS) ,insulin resistance index(IR) , hospital costs were compared before and after treatment in the two groups .Results The glucose levels ,therapeutic time ,the num-ber of low blood sugar ,insulin dosage ,NIHSS score ,IS ,IR in the two groups before and after breakfast ,before and after lunch ,be-fore dinner ,after dinner 2 hours before treatment had no significant differences(P>0 .05) ,the glucose levels ,therapeutic time ,the number of low blood sugar ,insulin dosage ,NIHSS score ,IS ,IR after treatment in both groups were significantly decreased at these time points ,but those indicators in the experimental group decreased more significantly ,and had significant differences with those of the control group(P<0 .05) .The cost of hospitalization of patients in the experimental group was significant lower than that in the control group(P<0 .05) .Conclusion CSⅡ treatment for type 2 diabetes and stroke patients ,not only control glucose level well ,re-duce the number of low blood glucose and insulin dosage ,significantly improved IS and IR ,reduce hospital costs ,and also could sig-nificantly improve the neurological disorders of consciousness ,which is an ideal treatment method compared with MDI .

In this study, radioimmunoassay (RIA) was perfomed to measure the contents of opiate peptide in plasma in control group and essential hypertension (EH) group before and after treatment. The relationship between the changes in opiate peptide content and mean artery pressure (MAP) was analysed. The results showed that the contents of ?-endorphin (?-EP) and leuenkephalin (LEK.) in the EH group were lower significantly (P

Melatonin is a bioactive substance primarily secreted by the pineal gland.Increasing evidences indicate that melatonin is effective in reducing breast cancer development.Melatonin exerts its anticarcinogenic actions through a variety of mechanisms.Melatonin suppresses estrogen receptor gene,modulates several estrogen dependent signal transductions,inhibits cell proliferation and impairs the metastatic capacity and so on.It has been suggested that enhanced endogenous melatonin secretion or melatonin treatment is beneficial for breast cancer patients.This review describes the mechanisms of melatonin on breast cancer and its possible application.

Objective To evaluate the influence of extraocular counterpulsation on ocular fundus blood vessels using high-frequency color Doppler ultrasonography. Methods Twenty-one patients with ischemic optic neuropathy were treated with extraocular counterpulsation. During treatment, the Doppler spectra were detected with high-frequency color Doppler ultrasonography. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance retinal index (RI) of central retinal artery and posterior ciliary artery were measured instantly before treatment and 1 min,5 min and 15 min after treatment. Results The instant PSV and EDV of central retinal artery and posterior ciliary artery were significantly increased (P＜0.05) after treatment, then decreased gradually. Fifteen min after treatment ,they returned to the level before treatment. Conclusions We can observe the changes of ocular fundus blood vessels noninvasively on high-frequency color Doppler ultrasonography. The method may be regarded as one of the basis for evaluating the effect of extraocular counterpulsation.