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.

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 .

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.

ObjectiveTo analyze the clinicopathologic characteristics and survival of ethnic minority female patients with triple negative breast cancer (TNBC) from Xinjiang Uygur Autonomous Region.Methods The clinicopathological characteristics,including age at diagnosis,size of tumor mass,lymphnode involvement,adjuvant therapy,recurrence of disease and survival of patient,of 48 ethnic minority patient cases with TNBC negative for estrogen receptor (ER),progesterone receptor (PR) and human epidermal growth factor receptor-2 (Her-2) were analyzed,whom were treated in our hospital from January 2001 to December 2005,including age at diagnosis,size of tumor mass,lymph node involvement,adjuvant therapy,recurrence of disease and survival of patients.ResultsOf the 48 patients,median age was 47 years,and 83.3 ％ (39 cases) of patients had stage Ⅱ or Ⅲ disease.The majority(85.4 ％,41 cases)of pathological types were grade Ⅱ or Ⅲ invasive ductal carcinomas,and lymph node involvement was detected in 56.2 ％ (27 cases) of these patients at initial diagnosis.46 patients were followed and had adjuvant therapy.Tumor-free survival and overall survival at 5 years were 43.5 ％ (20/46) and 52.2 ％ (24/46),respectively.Patients with lymph node involved had only 38.5 ％ (10/46) of overall survival at 5 years.ConclusionThe incidence of triple negative breast cancer of female patients in Xinjiang multiple minority groups is similar to domestic study,and the rates of over all survival is lower than that in Han Chinese patients. The female patients with TNBC in Xinjiang Uygur Autonomous Region multiple minority groups showed higher lymph node involvement at initial diagnosis and more distal metastasis.Patients with lymph node involved had poor survival.

Objective To investigate the methods and strategies of therapeutic ERCP in patients with duodenum stricture.Methods Endoscopic procedure,success rate and complications in patients with duodenum stricture who underwent ERCP were retrospectively analyzed.Results In 7276 patients who underwent therapeutic ERCP,duodenum stricture was found in 158 (2.17％),patients with malignant tumor infiltration in 120 and benign stricture in 38.The total success rate of ERCP and biliary drainage was 84.2％,with posture change or guidewire leading method in 96 patients,stylolitic water sac dilation in 33and duodenum metal stent placement before biliary drainage in 4.The procedure was failed in 25 patients.Minor bleeding occurred in 5 patients and no major complication including massive bleeding or perforation was observed.Conclusion ERCP is safe,effective and feasible for patients with duodenum stricture,which can be performed by posture change or guidewire leading method in mild stricture,and stylolitic water sac dilation or duodenum metal stent placement in severe stricture.

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

Cardiac toxicity is found in frequently used chemotherapeutic agents.There are many factors related to the cardiac toxicity caused by chemotherapeutic agents.The common cardiovascular complications include heart failure,ischemia,hypertension,hypotension,edema,QT prolongation,pleural effusion,pericardial effusion,bradyarrhythmia and thromboembolism.It is necessary to monitor the left ventricular function before and after chemotherapy and take effective measures to protect myocardium.

AIM: To estabolish the method for quality control of Anxinkang Dripping Pills(Radix Sophorae Flavescentis,Radix Astragali,etc.) METHODS: Using TLC to identify the dripping pills,matrine and oxymatrine in dripping pills were determined by RP-HPLC.Using C_(18) column,the mobile phase was made from the acetone methanol-H_3PO_4(3∶7∶90),the detection wavelength was at 210 nm. RESULTS: The herbs could be(identified) by TLC.For matrine,the linear range was from 0.05-0.50 ?g,and the average recovery was 97.3%,and for oxymatrine,the linear range was from 0.1-1.0 ?g,and the average recovery was 97.6%. CONCLUSION: The method is simple,reliable,accurate and can be applied to the quality control of the Anxinkang Dri-(pping) Pills.

Objective: To identify the mutation points of Cu/Zn superoxide dismutase(SOD1) gene in an amyotrophic lateral sclerosis(ALS) family with a unique phenotype,and to compare the value of single strand conformation polymorphism(SSCP) and denaturing high performance liquid chromatography(DHPLC). Methods: Five exons of SOD1 gene were amplified by PCR. The difference of these products were analyzed by PCR-SSCP and DHPLC.DNA sequencing was used to examine the mutation. Results: ①Mutations were found in exons 2 and 5 in several family members.DNA sequencing revealed that a base pair insertion occurred in the codon area of exon 2 and in the non-codon area of exon 5.②The results of DHPLC tests proved double peaks in one member with ALS symptoms(Ⅲ1),which indicated the possibility of mutation in SOD1 exon 4.DNA sequencing revealed that there was a heterozygote,with a mutation of GAA to GGA in exon 4 in the member with double peak. Conclusion: ①The mutations in exons 2,4,5 were proved.Insertion of exon 2 may be responsible for the disease of the ALS family in Chongqing.②Compared with PCR-SSCP,DHPLC technique has been proven to be a rapid and reliable method for screening mutation site in large samples.