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 conduct prospective randomized controlled clinical observation on patients with nasopharyngeal carcinoma under chemotherapy and radiotherapy using inhaling therapy with recombinant human interleukin 11,and the preventing and curing effect of recombinant human interleukin 11 on radiation-induced pharyngitis is evaluated.Methods 161 cases of newly diagnosed patients with head and neck cancer were selected under the principle of informed consent and these 161 cases were divided into the observation group (87 cases) and the control group (74 cases) based on randomization principle.In the observation group,when the dose reached 20Gy,then recombinant human interleukin-11 inhaling therapy was applied `ll the end of radiotherapy,for the control group,conventional treatment was applied in the event of radioactive throat.RTOG criteria were used during the observation in patients with the occurrence and treatment of radioactive pharyngitis.Results When compared with the control group,the average time for radioactivity to appear was prolonged,the severity decreased and the healing time was shortened in the observation group,those data were statistically significant.Conclusions Recombinant human interleukin-11 inhaling therapy can prevent and cure inhalation of radioactive pharyngitis and this therapy is better than conventional treatment.It's worthy of further study and clinical application.

Objective To investigate the reversal effect of triazole antifungal itraconazole,fluconazole combined with adriamycin on multidrug resistance in leukemia cells.Methods Human chronic myelogenous leukemia adriamycin resistant cell lines K562/ADR cells were incubated with itraconazole,fluconazole,or PSC833 (positive control) combined respectively with adriamycin.CCK-8 assay was used to assess cell proliferation of K562/ADR.The mean fluorescence intensity of intracellular ADR was measured by flow cytometry.The marker of DNA damage γH2AX was detected by Western blot.Results 1 μg/ml itraconazole and 0.5 μg/ml PSC833 can decrease K562/ADR IC50 of adriamycin from 38.30 μg/ml to 8.59 μg/ml and 24.64 μg/ml in a dose-dependent manner.K562/ADR cells were incubated with 1 μg/ml itraconazole or 0.5 μg/ml PSC833 combined respectively with adriamycin for 3 h and 6 h,the mean fluorescence intensity of intracellular ADR were increased 1.54-fold (3 h),1.50-fold (6 h) or 5.97-fold (3 h),5.83-fold (6 h).Itraconazole or PSC833 combined with adriamycin significantly increase the expression of γH2AX in K562/ ADR cells.Conclusion Itraconazole can recover adriamycin sensitivity of K562/ADR by increasing the concentration of intracelullar adriamycin and synergistically increasing DNA damage,but not for fluconazole.

Objective To discuss nursing of patients with esophageal cancer surgery by early feeding of homemade non-factor enteral nutrition.Methods 70 patients of esophageal cancer surgery were accepted homemade non-factor enteral nutrition.Results We got better results in nitrogen balance recovery and the enteral function in intestinal nutrition group than those in apenteric nutrition group after the operation.Conclusion The nutritional status of patients had been markedly improved by application of homemade non-factor feeding after carefully nursing of nasal feeding tube and other tubes,reasonable preparation,maintaining the pipeline opening,observation of illness,oral care,complications of observation and caring etc.The complications have been reduced the quality of life of the patients wag significantly improvad.

Objective To establish inductively coupled plasma mass spectrometry(ICP-MS) method and determine the migration contents of twelve elements in clevidipine injectable emulsion direct contact with packaging materials.Methods Clevidipine injectable emulsion were digested by carbonization-oxidation.Based on internal standard method, migration contents of twelve elements in digested sample solutions were analyzed by ICP-MS.Results The linear correlative coefficients for twelve elements were higher than 0.9995.The accuracy, precision and stability of the method were detected, all of which conformed to the analysis standard.The recoveries were in the range of 81.3%~119.0%.Conclusion The packaging materials have good compatibility with injectable emulsion, and migration contents of Na、K、Sb and Ba of twelve elements meet the requirements.

The postoperative pathological status of head and neck cancer is the determining factor for the use of radiotherapy. It is still unknown whether the interval between operation and postoperative radiotherapy has any impact on local control of the disease.However, from the radiobiological point of view, early postoperative radiotherapy is preferred, especially for patients with high-risk factors. Research has shown that concurrent chemoradiotherapy could improve the local control rate、overall survival rate and disease-free survival rate for head and cancer without surgery. Concurrent chemoradiotherapy was also recommended to the postoperative patients even though the acute toxicities might be increased significantly, but no evidence showed that it would aggravate late injuries including second primary neoplasm. The role of modern radiation technology and targeted therapy in adjuvant treatment of head and neck cancer needs to be further clarified.