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 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.

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 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.