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.

Neuronal nicotinic acetylcholine receptors(nAChRs) are widely distributed in the central nervous system,and they participate in complex neuronal signal transduction and regulation in the brain.The high Ca~(2+) permeability of nAChRs,plays a pivotal role in shaping nAChRs-induced neuromodulatory effects.The nAChRs-mediated Ca~(2+) signals may regulate diverse neuronal activities such as the improvement of learning and memory,and are closely related to drug addiction or neuroprotection mechanism.

Purpose: To study the influence of the manual manipulations on the reversal ability of the skull space in the patients with vertigo due to proprioceptive disturbance of the neck. Methods: By motor surveyor of skull three-dimensional space, the changes in the reversal ability of the skull space before and after the treatments with manual manipulations were observed in 72 cases of the patients with vertigo due to proprioceptive disturbance of the neck. Besides, 51 cases of vertigo due to insufficient blood supply of the cervical artery and 138 normal adults were selected as the control group. Results:After the treatments with manual manipulations, the deviation degree of the skull space in the three motor axes were all obviously decreased in the proprioceptive group, more obviously in the flexing and extending direction. The deviation degree of the skull space was also decreased in the ischemic group in the flexing and extending direction. Conclusion: Manual manipulations have the instant function to improve the proprioceptive function of the neck, and the factor of the proprioceptive disturbance also exists in the clinical onset of vertigo in pattern of insufficient blood supply of the cervical artery.

Objective To analyze the influence of different operation film drape styles on incision infection in cesarean section . Methods 396 patients of cesarean section in this hospital were divided into two groups from October 2011 to April 2012 .There were 198 patients in group A and 198 in group B .The operation film was pasted after operation sheet draped in group A ,the opera-tion film was pasted before operation sheet draped in group B .Subcutaneous tissue fluid was dipped after skin incision and before skin suture in every patient ,and the tissue fluid was bacterial cultured .Observed dressing infiltration degree after operation ,and fol-low up wound healing of incision after 5 to 7 d .Results The preoperational tissue fluid after skin incision had no bacterial growth in two groups (P>0 .05) .The dressing infiltration in group B (47 cases) was higher than in group A (16 cases) (P<0 .05) .The postoperative tissue fluid had one bacterial growth in group A ,and 4 in group B .The bacterial growth rate in group B was higher than in group A ,but there was no statistically significant (P>0 .05) .There was no postoperative infection happened in group A , and one in group B ,the difference was no significant between two groups (P>0 .05) .Conclusion Two operation film drape styles in cesarean section have no influence on postoperative incision infection ,but the dressing infiltration degree is different .So compre-hensive prevention and control is important to prevent postoperative incision infection .

Objective To investigate the dose distribution and radiation risk of Varian thoracic cone beam computed tomography (CBCT) with default parameters with reference to Monte Carlo simulation and International Commission on Radiological Protection (ICRP) report 110.Methods EGSnrc/BEAMnrc code was used to simulate the material, thickness, and geometry of the kV CBCT source (kVS) to establish the kVS model.A benchmarked MCSIM code was applied to calculate the dose distribution in the ICRP phantom after the scan with the standard thoracic parameters (110 kV, 20 mA, and 262 mAs), and the conversion coefficient of absolute dose was obtained in a spherical phantom following the TG-61 protocol.The results of Monte Carlo simulation were validated by PDD and Profile in a water phantom and the measurement of the absolute dose in the computed tomography dose index (CTDI) phantom and Alderson phantom.The models including BEIR VⅡ were used to evaluate the radiation risks.Results With reference to the criterion of 3%/1 mm, the uncertainties of PDD and Profile were less than 2%.The difference between the measured and calculated values was<2.9% in the CTDI phantom and ≤0.05 cGy in the Alderson phantom.In the ICRP110 phantom, the doses to the left lung, right lung, left breast, right breast, heart, thyroid, trachea, cancellous bone, and cortical bone were 1.28, 1.39, 1.74, 1.80, 1.46, 0.48, 0.88, 0.85, and 1.84 cGy, respectively.The relative risks of ischemic heart disease, breast cancer, lung cancer, thyroid cancer, and tracheal cancer in a standard scan were1.001 , 1.009, 1.019, 1.000, and 1.008, respectively. Conclusions The accumulated dose and long-term risks of CBCT during image-guided thoracic radiotherapy cannot be neglected and should be effectively controlled.

Objective To detect the changes of gastric emptying function by gastroenteric contrastenhanced ultrasonography and to offer the evidence for the diagnosis and treatment of diabetic gastroparesis.Methods The gastric emptying function was measured by gastroenteric contrast-enhanced ultrasonography in 35 cases of diabetic gastroparesis (DGP,DGP group) and 35 volunteers (control group).The gastric emptying rate(GER) and emptying time(ET) after taking orally gastroenteric ultrasound developer in DGP group were observed and compared with control group.Results The GER in DGP group was lower than that in control group [(27.05 ± 11.32)％ vs.(45.38 ± 15.08) ％] (P ＜ 0.05).The ET in DGP group was longer than that in control group[(102.43 ± 15.76) min vs.(75.31 ± 11.52) min] (P ＜ 0.05).Conclusions The method of gastroenteric contrast-enhanced ultrasonography is a simple,and repeatable imaging method,which can be used to make a real-time assessment on the gastric dynamic changes,but don't influence gastroenteric function and can provide a dependent and noninvasive examine means for clinical physician to test the gastric emptying function in DGP.

Objective:To investigate the onset mechanism of cervical vertigo from the proprioceptive sensation and provide clinical basis for its treatment.Methods:Among the 121 cases that conformed to the diagnostic criteria of cervical vertigo,70 cases who presented with negative neck-rotation test and cervical vertigo without obvious vascular factors by transcranial Doppler(TCD)were assigned to the observation group,while 51 cases who presented with positive neck-rotation test and cervical vertigo due to spasm of vertebral basal artery or insufficient blood supply by TCD were assigned to the control group.The cases in the two groups were treated once every day,5 days make up one treatment course and the resuIts were statistically analyrzed after one treatment course.Results:The skull triaxial spatial offset of the cases in the two groups were significantly reduced after the treatment (P<＜0.01).However, there was no statistically significant difference between the skull triaxial spatial offset between the two groups (p＞0.05).It is not conclusive that the therapeutic effect in the two groups was significantly different after one treatment course.Conclusion:Tuina manipulation therapy can improve the skull spatial ofrset repositioning ability of the Patients.

Objective To scrutinize the positioning accuracy and reproducibility of the cone-beam computed tomography system in combination with the six-degree couch table (Hexapod Robot Treatment Table, HRTT). Methods The mechanical stability of the X-ray volume imaging (XVI) system was tested,in terms of the reproducibility. And the influence of the moveable parts, including the KV panel and the source arm, on the accuracy of the XVI image registration was analyzed. The accuracy between the bone and grey value registration was compared using a head-and-neck phantom. The accuracy of the HRTT for translational, rotational, and a combination of translational and rotational corrections was investigated in consecutive measurements. Results The performance of XVI system itself was stable with translational and rotational error of below 0. 4 mm and below 0. 3°, respectively. The mean position accuracy of the XVI system in combination with the HRTT summarized over all measurements was below 0. 6 mm and below 0. 4° for translational and rotational corrections, respectively. The grey value match was more accurate than the bone match. Conclusions The XVI image acquisition and registration procedure were highly reproducible.Both translational and rotational positioning errors can be corrected very precisely with the HRTT. The HRTT is therefore well suited to complement CBCT to take full advantage of position correction in six degrees of freedom for image guided radiotherapy.

Objective To discuss the role of EPI-DWI unite ASSET in the detection of hepatic colorectal micrometastasis. Methods 29 patients with hepatic colorectal metastasis were examined with EPI-DWI unite ASSET and EPI-DWI. Results In a lesion detection analysis,the overall detection rate was 93% (58/63) for ASSET-EPI-DWI,and 81% (51/63) for diffusion-weighted MR imaging. ASSET and EPI-DWI was more sensitive than diffusion-weighted MR imaging(P = 0.01 1). Conclusion ASSET-EPI-DWI is superior to diffusion-weighted MR imaging in the detection of hepatic colorectal micrometastasis.