In recent years,with the continuous development of endoscopic and interventional techniques,many new devices and methods have been used in clinical practice,and the application of endoscopic retrograde cholangiopancreatography (ERCP)in biliary and pancreatic diseases has developed rapidly.This paper reviews and summarizes the recent progress in ERCP among patients with biliary and pancreatic diseases,including those with altered gastrointestinal anatomy,pregnant patients,patients with benign and malignant biliary strictures,and patients with pancreatic pseudocysts,as well as the application of SpyGlass,photodynamic therapy,and radiofrequency ablation,the man-agement of ERCP-related duodenal perforation,and the prevention of post-ERCP pancreatitis.All the progress has made a great contribu-tion to the diagnosis and treatment of biliary and pancreatic diseases.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Objective To analyze the effect of calcitonin combined with alfacalcidol on clinical outcome,lumbar vertebrae bone mineral density and safety in patients undergoing internal fixation of humeral shaft fracture.Methods 80 patients with humeral shaft fracture treated with internal fixation in Xunwu county people's hospital from June 2010 to June 2016 were selected,and randomly divided into control group and observation group,40 cases in each groups.The control group was given calcium carbonate D3 tablets and functional exercise therapy,the observation group treated calcitonin combined with alfacalcidol on the basis of control group,analysis and comparison the clinical effects,lumbar spine BMD and safety.Results Compared with before treatment,serum calcium level of two groups increased significantly at treatment 2 weeks and 3 weeks(P<0.05);The control group BMD of lumbar spine was significantly increased in treatment 12 weeks(P<0.05),the observation group BMD of lumbar spine was significantly increased in treatment 4 weeks and 12 weeks(P<0.05).Compared with control group,the level of serum calcium in observation group was higher at treatment 2 weeks and 3 weeks (P<0.05),BMD of lumbar spine was higher at treatment 4 weeks and 12 weeks(P<0.05);The total adverse reaction rate of observation group was 10%,the difference was not statistically significant to control group 15%.Conclusion The combination of calcitonin and alfacalcidol treatment of internal fixation of humeral shaft fractures in patients with significant results, can improve serum calcium levels in patients with and improve bone mineral density, and less adverse reactions.

Objective To explore the application of laparoscopy in non-traumatic acute abdominal emergency. Methods The authors retrospectively analyzed 201 cases of emergency laparoscopy between March 1999 and May 2002. Results All the 201 patients were unequivocally diagnosed during operation. Laparoscopic operations were successfully completed in 190 cases (139 cases of acute appendicitis, 21 cases of acute cholecystitis, 19 cases of upper gastrointestinal tract perforation, 10 cases of intestinal obstruction and 1 case of common bile duct stones accompanied with acute cholecystitis), with a success rate of 94.5% (190/201). The remaining 11 patients underwent a conversion to open surgery. Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal emergency with unknown causes but also simultaneously offer a therapeutic method in at least 90% of cases.

Based on the extensive experience in circuit serving for military medical equipment,problems in managing military medical equipment are discussed and solutions are proposed so as to strengthen management standardization of medical equipment in basic unit army and enhance the support ability of medical equipment.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Paralyses, Familial Periodic ; therapy

AT motif binding factor 1 (ATBF1) gene,is a new tumor suppressor gene,and one of its expression variants by alternative splicing,known as ATBF1-A,can bind to the enhancer AT-rich element of alpha fetoprotein (AFP) and down-regulate the transcription of AFP,which may suppress the development and induce the apoptpsis of some carcinoma cells.In this review,we attempted to analysis the pathway of ATBF1 behaves with other factors and its multiple biological functions;ATBF1 function as a suppressor gene,it was illustrated for the influence on the growth and invasion of breast,prostate or gastric cancer.We also discussed the application of the ATBF1 level function as a cancer predictor,and forecasted the significance to apply ATBF1 for the therapy of cancer.

Objective To establish determination method of luteolin-7-O-glucoside in Compound Luobuma Granule. Methods Phenomenex luna C18 column (4.6 mm×150 mm, 5 μm) was used;aceto-0.5% acetic acid (14∶86) was set as the mobile phase at flow rate of 0.8 mL/min;the detection wavelength was 348 nm. Results The linear range of luteolin-7-O-glucoside was in the range of 0.031 9-0.796 3 μg (r=0.999 6), and the average recovery was 100.85% (n=6). Conclusion The method is specific, simple, and can improve quality standard and increase the controllability of Compound Luobuma Granule.

Clostridium difficile( C. difficile)is a major nosocomial infection pathogen and the principal causative agent of antibiotic-associated diarrhea. The toxigenic C. difficile strains cause colonic injury and inflammation mainly by secreting enterotoxin A( TcdA)and cytotoxin B( TcdB). The severity of C. difficile associated disease( CDAD)is correlated to the toxin level during host infection. However,the toxigenic capacity of C. difficile varies widely among strains,which correlates with the gene regulation involved during toxin production. This article reviewed the regulatory mechanism of C. difficile toxin-associated pathogenic gene and anti-toxin treatment.