Sphincter of Oddi dysfunction (SOD) refers to a series of clinical syndromes that occurs because of structural or functional disorders involving the biliary and/or pancreatic sphincters.It remains controversial whether endoscopic sphincter manometry (SOM) or sphincterotomy is needed in patients with type Ⅲ SOD.An important problem is that ERCP (with or without SOM) carries significant risks, especially the post-ERCP pancreatitis.The EPISOD trial has updated our knowledge on type Ⅲ SOD.The latest Rome Ⅳ consensus suggested that the classification term type Ⅲ biliary SOD should be abandoned and a new classification of biliary SOD was proposed;also, manometry and sphincterotomy were not recommended for patients with this type of SOD.The goal of this paper is to review recent literatures and elucidate the selected important questions regarding type Ⅲ SOD.

Objective To analyze the genetic mutation patterns and the constituent ratio of α-thalassemia in Luzhou area and to investigate the clinical application value of the gene diagnosis .Methods The PCR method combined with DNA chip hybridization technique was adopted to conduct the gene detection and analysis on 116 cases of suspectedα-thalassemia .Results Among 116 sus-picious cases of α-thalassemia ,39 cases were found with genotypes of α-thalassemia ,the detection rate was 33 .62% .7 kinds of mu-tation genotypes were detected ,in which the deletion type of - -αSEA/ααaccounted for 41 .03% and the deletion type of -α3 .7/ααaccounted for 25 .64% .Conclusion The main gene mutation of α-thalassemia in Luzhou area is the deletion type of - -αSEA/αα. The gene diagnosis is an important criterion for definitely diagnosing α-thalassemia .

OBJECTIVE:To explore the approaches for clinical pharmacists to participate in the treatment for lung cancer. METHODS:Based on the work of oncology department,the content and method of clinical pharmacist participating in clinical drug therapy were introduced in the terms of rationality,drug interaction,pain treatment,etc. RESULTS:Clinical pharmacists could participate in the treatment for lung cancer through paying attention to rationality of antitumor drug and ancillary drug use, drug interaction and pharmaceutical care for pain treatment,conducting special lecture for medical staff,and developing clinical study. CONCLUSION:Clinical pharmacists can provide various pharmaceutical care to promote safe and rational drug use.

Objective To analyze the etiology and clinical features of isolated gastric varices.Methods A retrospectives analysis was carried out in 31 patients with isolated gastric varices between January 2003 and January 2008.The patients records including data of etiology,clinical presentation,imaging studies and therapeutic modalities were reviewed.Results Those who had isolated gastric varices were accounted for 7.38 0A (31/420)of all patients with gastroesophageal varices.The etiologies were left-sided portal hypertension(14 cases,45.2%),liver cirrhosis(8 cases,25.8%),unknown origin(6 eases,19.4%),hepatocellular carcinoma(2 cases,6.5%),portal cavernous transformation(1 case,3.2%).Twenty-one patients(67.7%)had variceal hemorrhage.Splenomegaly was present in 21 cases(67.7%),among which 10 cases(32.3%)had concomitant hypersplenism.Venous involvement was identified in 18 patients(splenic vein obstruction in 9 cases and portal vein involvement in 9 cases).Surgical therapy was performed in 8 cases,selerotherapy in 3 cases,and medical therapy in 20 cases.Conclusions Left-side portal hypertension is responsible for most of the isolated gastric varices,and some of which are also caused by liver cirrhosis.Surgery is the appropriate procedure of choice in management of hemorrhage and recurrence.

In the context of the combination of education for clinical medicine graduates and standardized training of resident doctors,the professional psychological quality of clinical medical postgraduates is confronted with a test.The professional psychological quality education is not only related to the professional development of medical graduate studlents,but also to the realization of the goal of training talents in medical colleges,even to the people's life and health.Medical institutions and relevant teaching hospitals can,through strengthening the psychological education system,promote the occupation education,carry out rich and colorful educational activities,strengthen employment guidance,and improve the security policy to improve the medical personnel quality,and promote the comprehensive reform of the medical and health education.

Objective To observe platelet dynamics in a monkey infected with Plasmodium cynomolgi before and after treatments with antibiotics and antimalarial drug. Methods One experimental monkey was examined for parasite density and platelet count 2 days after parasite inoculation. Observation without treatment continued for 24 days after the parasite was detected in the blood sample of the monkey. Then the monkey was treated with Azithromycin (total 1500 mg) for 3 days. Thirty days after parasite detection in the blood, the monkey was treated with Artesunate for 5 days. Parasite density and platelet count were monitored daily during treatments. The result was compared with that from a healthy monkey as control. Results The experimental monkey's platelet count was 240× 109/L before infection. When parasite density was 2/100 white blood cells (WBC),platelet count increased to 540 × 109/L. During the subsequent period of infection, parasite density fluctuated at (1-60)/100 WBC, and the platelet count reduced to a persistent level of (130-150)×109/L. After the infected monkey was treated with Azithromycin, parasite density reduced initially but subsequently fluctuated at (16-64)/100 WBC. Meanwhile, platelet count was restored to 234.5 × 109/L.The infected monkey was treated with Artesunate and parasite clearance time was 64 hours, and the mean platelet count was 247 × 109/L after treatment. Conclusion Azithromycin and Artesunate treatment have direct influence on the recovery of platelet counts during malaria infection in monkeys.

ObjectiveTo investigate the clinicopathologic features,therapy,and prognosis of primary small cell carcinoma of the pancreas.MethodsDatabases including Chinese Journal Full-text Database,VIP Database for Chinese Technical Periodicals,Medline/Pubmed,and OVID were searched electronically up to April 2012.A systematic review was performed together with one case in our hospital.ResultsTwenty-eight articles fulfilling the criteria consisting of 46 patients with pathologically confirmed diagnosis of primary small cell carcinoma of the pancreas were studied,together with 1 patient in our Drum Tower Hospital,finally 47patients were included.The results of this systematic review showed:( 1 ) Primary small cell carcinoma of the pancreas was more common in men with a median age of 62.The most common clinical presentations were abdominal pain,jaundice and weight loss.Para-neoplastic syndrome was rarely observed.(2)Most cases were found to have abnormally elevated serum levels of neuron-specific enolase.CT displayed heterogeneous,and marked enhancing masses in most cases.The conclusive diagnosis depended on histological confirmation.(3)63.8％ of the cases were found to be associated with metastasis at the time of diagnosis.The overall median survival time was 28 weeks.(4) There was no consensus on the treatment of primary small cell carcinoma of the pancreas. Chemotherapy was currently considered as the treatment of choice among the systematic management for these patients.ConclusionsPrimary small cell carcinoma of the pancreas was a rare and aggressive neuroendocrine tumor with a poor prognosis.

OBJECTIVE: To analyze the therapeutic drug monitoring results of valproic acid( anti- epileptic drug) . METH-ODS: The concentrations of valproic acid in 226 cases in our hospital were determined by fluorescence polarization immunoassay. RESULTS: The results showed that 47. 79% were within the normal referenced concentration range, with average concentration at( 66. 19? 12. 13) ? g? mL- 1, 46. 90% were below the lower limit and 5. 31% were above the upper limit. CONCLUS-ION: The monitoring results are far from satisfactory. It is advisable to adopt individualized administration so as to achieve the goal of treatment.

0.05), but significant difference when compared the older-age group with the young & middle-age group(P