Objective To explore how to improve the curative effects and reduce the complications of duodenoscopy in the treatment of bile duct diseases. Methods Clinical data of 292 cases of endoscopic sphincterotomy (EST) and 104 cases of endoscopic nose biliary drainage (ENBD, including 9 post-EST cases) from February 1995 to February 2003 were retrospectively reviewed. Results The success rate of EST was 92.1% (269/292). Among 272 cases of common bile duct calculus, stones were completely taken out in 235 cases (86.4%). Among 15 cases of intrahepatic duct calculus, stones were completely removed in 4 cases. Biliary duct foreign bodies were removed at once in 3 out of 5 cases. EST related complications were found in 16 cases (7 cases of acute pancreatitis, 5 cases of bleeding at the site of incision, 2 cases of severe cholangitis, 1 case of duodenal perforation and 1 case of instrumental break-off), with an incidence rate of 5.5% (16/292). Satisfactory outcomes were achieved in 92 cases receiving ENBD. No death occurred in the study. Conclusions Proper selection of patients and skillful performance of EST is the key to improve its curative effects and reduce its complications.

Purpose　To assess the clinical efficacy and safety of acute cerebral progressive infarction cured with urokinase in combination with heparin sodium. Methods　There were 50 cases in the control group and treated group. The treated group was treated with urokinase 300,000 units/day intravenous for 1～2 days, heparin sodium 12,500 units/day intravenous for 5 days, the control group was treated with heparin sodium 12,500 units/day intravenous for 5 days. All patients were treated within 5 days of onset and the deterioration of neurological deficits within 10 hours. The hypodensity was showed by brain CT scan without hemorrhage, MDS score was given before and after cure 30 days for comparison. Results　The neurological deficits improvement in the treated group was more efficient than the control group and no hemorrhage was found. Conclusion　Middle dose urokinase infusion in combination with heparin sodium intravenous in treatment of acute cerebral progressive infarction was safe and effective and showed obviously clinical valuable.

Objective Objectives To investigate the gender difference affecting the efficacy of cardiopulmonary resuscitation (CPR) in the mouse cardiac arrest (CA) model.Methods CA was induced in 30 Kunming mice (15 male and 15 female) by trans-oesophageal cardiac pacing for 4 minutes.Epinephrine was then administrated intra-artery,and CPR was performed.The time required for restoration of spontaneous circulation (ROSC) was observed,but if ROSC failed to appear at 10 minutes after CPR,resuscitation was discontinued.Blood pressure and electrocardiograms of resuscitated animals were invasively monitored for an additional 60 minutes.Blood pressure,heart rate,the restoration of spontaneous respiration (ROSR) and survival time were observed and recorded.Results All 15 female mice and 14 of 15 male mice had ROSC.There were no significant differences in the time required for ROSC,ROSR,and survival between the two groups [(50±17)svs.(46±12)s; (2.4±1)minvs.(2.5±1)min; 28 (1,72)h vs.16 (3,72)h,P ＞ 0.05)].Moreover,neither blood pressure nor heart rate showed significant differences one hour after ROSC between the two groups.Conclusions Sex differences did not affect the efficacy of CPR,but the precise mechanism is still unclear,and further investigations are required.

Objective To compare the effects between vasopressin and epinephrine during cardiopulmonary resuscitation(CPR)in a mouse model of cardiac arrest(CA).Method Transoesophageal cardiac pacing was performed so as to elicit cardiac arrest in 30 Kunming male mice.Four minutes after the initiation of cardiac pacing,the animals were prospectively randomized into three groups in equal number(n=10/group),namely,control group(saline 0.2 mL intra-arterial),vasopressin group(vasopressin 0.4U/kg intra-arterial)and epinephrine group(epinephrine 0.04 mg/kg intra-arterial),then CPR was initiated.Restoration of spontaneous circulation (ROSC)was observed.If ROSC failed to appear at 10 minutes after CPR,resuscitation was discontinued.Electrocardiogram and blood pressure of resuscitated animals were invasively monitored for an additional 60 minutes.Electrocardiogram and blood pressure.and the restoration of spontaneous respiration and survival time were observed and recorded.Results Rates of ROSC in vasopressin group and epinephrine group were significantly higher than those in saline group(9/10,10/10 vs.3/10,P＜0.05,P＜0.01 respectively),and there was signilieant difference between vasopressin and epinephrine group.All resuscitated mice treated with epinephrine restored sponlaneous respiration after ROSC,while only 4 of 9 animals trealed with vasopressin did(P＜0.05).Survival time of anireals in epinephrine group was longer than that in vasopressin group or in saline group(P＜0.05,P＜0.05,respectively).Conclusions Both vasopressin and epinephrine increase the rates of ROSC.Epinephrine 0.04 mg/kg improved respiratory function and results in a longer survival time compared with vasopressin 0.4 U/kg in this mouse model.and the precise mechanism is not clear and further investigation is required.

Objective To compare the impact of intra-arterial versus intravenous administration of epinephr-ine on the efficacy CPR in mice. Methods Transoesophageal cardiac pacing was performed to induce cardiac arrest for 4 minitues in 20 Kunming male mice. The mice were then randomized to two groups (n = 10 in each group), and received epinephrine of 0.02 mg/kg via either carotid artery (IA-gro) or jugular vein (IV-gro) injection. Chest compression and ventilation were performed; and the rate of restoration of spontaneous circulation (ROSC) and survival time were recorded. CPR was stopped if spontaneous circulation was not restored within 10 minutes. Results There was no significant difference in the rates of ROSC between IA-gro and IV-gro (10/10 vs. 8/10, P>0.05), nor in the time of ROSC or survival time [51 ± 13 s vs. 62 ± 24 s; 8.5 (6.0, 17.0) h vs. 6.5 (2.8, 21.3) h, P > 0.05]. Conclusions Neither intra-arterial nor intravenous administration of epinephrine has no obvious impact on the efficacy of CPR in mice.

Background The pathology of choroidal neovascularization (CNV) is not clear.CD147 plays a critical role in angiogenesis through activating matrix metalloproteinases (MMPs) and degradation of extracellular matrix (ECM).However,the study of CD147 in CNV is rare.Objective This study was to investigate the expression of CD147 and vascular endothelial growth factor (VEGF) in laser-induced rat CNV model.Methods Thirty clean BN rats were divided into normal control group (six rats) and laser group (24 rats) according to the random number table.CNV was induced on laser photocoagulation group rats using 532 nm multiple-wave length photocoagulation.The development of CNV was followed up by fundus fluorescence angiography (FFA) on 1 day,7,14 and 21 days post-photocoagulation.The expression of C D147 protein in retinal pigment epithelium (RPE)-choroidsclera complex was examined by Western blot in normal control group and 1 day,7,14,21 days post-photocoagulation group.The vitreous VEGF concentrations of those groups were detected by ELISA.Results Disk like fluorescein leakage was detected on 7 days after photocoagulation,and CNV was formed on 14 days after photocoagulation.The expressions of CD147 protein were 1.00 ± 0.43,0.97 ± 0.53,0.99 ± 0.45,1.56 ± 0.67 and 2.27 ± 0.54,and the concentrations of vitreous VEGF were (72.96±29.95),(79.36±10.46),(103.82±32.94),(166.05±21.54) and (195.64± 39.90)pg/ml in normal control group and 1 day,7,14,21 days post-photocoagulation group,with significant differences among the groups (CD147:F=10.95,P＜0.01;VEGF:F=304.50,P＜0.01).The expressions of CD147 and VEGF were significantly higher in the 14,21 days post-photocoagulation groups than those in the normal control group (all at P＜0.05).Conclusions The expression of CD147 increases as the induction of CNV,in accordance with the expression of VEGF.CD147 may play an important role in the early development of CNV.

Objective To investigate the effect of mild hypothermia on the myocardial and microcirculation dysfunction induced by epinephrine during early post-resuscitation in a rat model of cardiac arrest and cardiopulmonary resuscitation (CPR).Methods Transesophageal cardiac pacing was performed in order to elicit cardiac arrest for 5 min in SD male rats.Totally 40 rats were randomly (random number) divided into 4 groups (n=10):normothermic control group (N),normothermic epinephrine group (N+E),hypothermic control group (H),and hypothermic epinephrine group (H+E).Chest compression was then initiated.Epinephrine (0.02 mg/kg) or saline was administrated at 1 min during CPR.Restoration of spontaneous circulation (ROSC) was recorded,and the rates of ROSC were observed.Myocardial and microcirculatory function were observed at 1,2,3,and 4 h during early post-resuscitation.Serum lactate level was assessed at baseline and ROSC 4 h.Results The ROSC rates were 10/10 in the H+E group,9/10 in the N+E group,4/10 in the H group,and 1/10 in the N group,respectively.Ejection fraction (EF)and cardiac output (CO) in the H+E group were significantly higher than that of other groups (P＜0.05).Total vessel density,perfused vessel density,proportion of perfused vessels,and microvascular flow index in the H+E group were also significantly higher than those of other groups during early post-resuscitation.The serum lactate level in the H+E group was significantly lower than that in the N+E and H groups..Conclusions Both epinephrine and mild hypothermia can improve the success rate of resuscitation.However,mild hypothermia can improve the epinephrine induced myocardial and microcirculatory dysfunction during postresuscitation in the rat cardiac arrest.

Objective To explore the effects of transitional care based on Wechat in discharged patients with intestinal stoma.Methods A total of 120 inpatients with intestinal stoma in department of stomach,intestine,colon,rectum and anus in China-Japan Union Hospital,Jilin University were recruited in 2015. They were randomly divided into observation group (n=60,routine health education on leaving hospital and transitional care through Wechat provided by members of the Wechat transitional care group for discharged patients,6 months follow-up) and control group (n=60,routine health education on leaving hospital and normally further consultation in outpatient service of stoma,6 months follow-up) according to the order of leaving hospital. The complications rate on intestinal stoma between two groups was compared at the first,third and sixth month after leaving hospital. The depression and satisfaction with nursing care was compared too at the sixth month. Results One month after leaving hospital,the incidence rates of infection in sutures around stoma and mucosa membrane separation in control group were significantly higher than those in observation group (P<0.05). Three months after leaving hospital,the incidence rates of dermatitis,infection in sutures around stoma and granuloma in control group were significantly higher than those in observation group (P<0.05). Six months after leaving hospital,the incidence rates of dermatitis and granuloma in control group were significantly higher than those in observation group (P<0.05). The score of depression in observation group was significantly lower than that in control group (P<0.05). Besides,the satisfaction with nursing care in observation group was higher than that in control group with a significant difference (P<0.05).Conclusions The transitional care based on Wechat has great significance in improving depression,reducing the incidence rates of complications on intestinal stoma and improving the satisfaction with nursing care. It is worth to be used widely.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.