Objective To understand the vibrio vulnificus pollution condition in marine products in Zhuhai region and the drug resistance situation to provide the basis for further study of vibrio vulnificus and clinical medication .Methods 89 samples were col-lected from the marine products wholesale market ,pedlars′market and supermarkets in Zhuhai region and the method published by the US Food and Drug Administration (FDA) was adopted to perform the qualitative detection of vibrio vulnificus .The identifica-tion of bacteria and the drug sensitivity test were performed by using the ATB instrument .Results In 89 samples of marine prod-ucts ,vibrio vulnificus was detected in 39 samples ,the total positive rate was 43 .82% .The detection rate of oyster was as high as 60 .87% (28/46) ,followed by marine fish (39 .13% ,9/23) and marine shrimp (20 .00% ,2/10) .The drug sensitive test showed that vibrio vulnificus had the resistant strains to cephalosporins and aminoglycoside drugs .Conclusion The seafood vibrio vulnificus pollution in Zhuhai region can not be ignored .The monitoring of vibrio vulnificus in the marine products and the drug resistance a-nalysis should be strengthened for effectively preventing the outbreak of vibrio vulnificus .

AIM:To reveal the characteristics and patterns of mental activity in the cerebral cortex of patients with attention deficit hyperactivity disorder (ADHD) and explore the pathogenetic characteristics of ADHD.METHODS: The ADHD patients were asked to record their mental activity, general health condition and obsessions before the onset of pathological symptoms by means of psychological introspective reports.RESULTS: The direct cause of attention distraction and failure of attention focus is the patients' inability to perform cognitive tasks (including perception, memory and recollection, imagination, association and thought)in a continuously ongoing manner in relaxation. The frequent stagnancy and pause during the course of recognition precipitated the patients in a stressful state, which contributed to the onset of various hyperactivities and also resulted in the acquisition of "silent verbal thinking". This is an important psychopathological phenomenon long been neglected. All theses abnormalities caused the patients much discomfort, which was naturally relieved by means of impulsive and irritable behaviors.CONCLUSION: A series of clinical symptoms of ADHD arises from the same pathogenic factor of difficulty in mental activity and inability to carry out the activities in the cerebral cortex in a relaxed manner. The difficulty in mental activity is the key problem of ADHD and the source of various synptoms, which should be ;reated for the first place. The cause of this key problem is possibly lowered metabolism of the cerebral cortex, and the effect of "instinct" can not be neglected in the attempt to explain the pathogenesis of ADHD.

Objective To investigate the factors that related to acute biliary pancreatitis including size and the location of the common bile duct stone. Methods Clinical data from 3497 patients with common bile duct stone admitted to the hospital between Jan. 2002 and Dec. 2008 were retrospective analyzed. All patients were grouped according to the size and the location of the bile duct stones. The incidence of acute pancreatitis was compared among groups. Results In patients with common bile duct stone accompanying the acute pancreatitis,common symptoms were fever, bellyache and jaundice, as well as elevated serum amylase. There was a negative correlation between size of the common bile duct stone and the severity of acute hiliary pancreatitis, which was easily induced by the stone in the Vater's ampullar or distal common bile duct. Conclusion Early endoscopic treatment should be carried out in patients with microlith located in the Vater's ampullar or distal common bile duct in order to prevent the acute biliary pancreatitis.

Objective To discuss the safety of endoscopic sphincterotomy (EST) in treatment of choledocholithiasis in patients over 80 years.Methods From 2005 to 2007,893 patients with choledocholithiasis were divided into group A (n= 148,aged over 80 years) and group B (n=745,aged below 60 years).The clinical data,complications and EST successful rate were retrospectively reviewed between two groups.Results ① The important chronic concomitant diseases were significantly higher in group A than those in group B ( 29.3 % vs 8.1 % ,P＜0.01).② The EST successful rate in group A and B was 95.6% and 96.5%,respectively ( P＞0.05).③ Sixteen patients in group A had complications including 13 caused by EST itself,3 related with EST and one died of aspiration pneumonia.While in group B,41 complications were caused by EST itself and no EST related complications.There was a statistically difference in EST related complications between two groups (P < 0.01 ).In complications caused by EST itself,there was no difference between two groups (P 0.05 ).④ The average hospital stay was ( 7.2 ± 2.2) days in group A and (5.1 ± 1.4) days in group B with no significant difference (P 0.05),Conclusion The EST is safe and effective in treatment of patients over 80 years.

Objective To explore the long-term efficacy of endoscopic sphincterotomy (EST) for choledocholithiasis and to evaluate the necessity of cholecystectomy after EST. Methods Two hundred and fifty seven patients who underwent EST for choledocholithiasis in 2006 were followed up for an average period of 34. 8 months (26-48 months). According to the existence of cholecystolithiasis, the patients were divided into group A (combined with cholecystolithiasis, n = 151) and group B (without cholecystolithiasis, n = 106) , and group A was further divided into group A1 as undergoing cholecystectomy after EST (n =56) and group A2 as not having cholecystectomy after EST ( n = 95). Results Of the 257 patients, late complications occurred in 31 patients (12. 1% ) , including recurrent choledocholithiasis in 25 (9.7% ), cholangitis in 27 (10. 1% ) , acute pancreatitis in 2 (0. 8% ) and cholangiocarcinoma in 1 (0.4% ). The rates of late complications and recurrent choledocholithiasis were significantly higher in group A2 than those in group A1 (P<0.05). Conclusion EST is safe and effective for choledocholithiasis. Cholecystectomy after EST is necessary in patients with cholecystolithiasis.

Objective To estimate the long-term efficacy of endoscopic sphincterotomy (EST)in treatment of choledocholithiasis and to analyze the potential risk factors for disease recurrence.Methods A total of 154 patients with choledocholithiasis,who underwent EST between January 2006and December 2006, were enrolled. Multivariate analysis was used to evaluate the association of clinical features and experimental parameters with recurrence of choledocholithiasis. Results Longterm complications developed in 22 patients (14.29%) including recurrent choledocholithiasis (18/154,11.69 % ) and combined cholangitis (16/154). Cholangitis without calculi was found in 1 case (0.65%), acute pancreatitis in 2 cases (1.30%) and cholangiocarcinoma in 1 case (0.65%). High body mass index and serum cholesterol were proved to be risk factors for recurrence of choledocholithiasis. Whereas the incision size (0.5 cm-1.5 cm) of vater's papilla was the protective factor for recurrence of choledocholithiasis. Conclusions Body mass index, serum cholesterol and the incision size of vater's papilla are related to recurrence of choledocholithiasis.

To analyze the reasons of injuries during surgical practices and explore the hazards and the corresponding preventive measures. The surgical interns don't receive enough training of injury prevention. They don't pay enough attention to the occupational prevention and are not skilled in operation, which causes high rate of sharp edged instrument injuries. Therefore, a perfect plan of education, training and treatment must be made to reduce the occupational injuries and blood sourced diseases.

Objective To analyze the MR imaging features of pyocephalus. Methods MR imaging features!of pyocephalus in 5 cases with clinically proved were analyzed retrospectively. All patients were undergone no-contrast MR imaging. 3 patients received diffusion weighted-imaging(DWI). Results In all five patients,the debris and pus with pus-fluid level were shown inside the lateral ventricle.The debris or pus was slightly hyperintense on T1WI, slightly hypointense on T2WI relative to cerebrospinal fulid(CSF). On DWI, the debris was hyperintense in 1 case and isointense in 2 cases.Conclusion The features of MR imaging of pyocephalus is specific. MR imaging is valuable in the diagnosis of pyocephalus.

Objective To study the clincial effectiveness and safety of endoscopic sphincteropapillotomy combined with balloon dilation for decompensated cirrhosis accompanied with choledocholithiasis.Methods Data of 79 cases of decompensated cirrhosis patients with choledocholithiasis who underwent limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD,the ESBD group) and 42 cases who underwent endoscopic papillary balloon dilation(EPBD,the EPBD group)were retrospectively analysed and compared for complete stone clearance rate,one-time stone clearance rate and complications.Results The rate of complete stone clearance and one-time stone clearance were 94.9％ (75/79) and 77.2％ (61/79)in ESBD group,and those were 88.1％ (37/42) and 59.5％ (25/42) in EPBD group respectively.The rate of complete stone clearance was a little higher in ESBD group than that in EPBD group.In ESBD group,ERCP-related bleeding occurred in 3 patients (3.8％),post-ERCP hyperamylasemia in 3 (3.8％)and post-ERCP pancreatitis in 2 (2.5％) ; while in EPBD group,post-ERCP hyperamylasemia occurred in 8 patients(19.0％),post-ERCP pancreatitis in 6(14.3％) and ERCP-related bleeding did not occur.There were no significant difference in ERCP-related bleeding between ESBD group and EPBD group (P =0.551).However,the rates of post-ERCP pancreatitis and hyperamylasemia in ESBD group were significantly lower than those in EPBD group(P ＜ 0.05).Conclusion ESBD is a safe and effective procedure for choledocholithiasis accompanied by decompensated cirrhosis,with several advantages over EPBD in terms of higher one-time stone clearance rate,reduced risk of post-ERCP pancreatitis and hyperamylasemia,and without noticeable increase in the risk of bleeding related to ERCP.

ObjectiveTo explore the safety and efficacy of endoscopic treatment for choledocholithiasis in patients with decompensated cirrhosis.MethodsA total of 104 cases of choledocholithiasis with decompensated cirrhosis were treated by ERCP in our hospital between January 2001 and March 2011.ChildPugh grading and model for end stage liver diseases (MELD) were investigated pre-ERCP and 2 weeks post-ERCP.Complication and mortality during the follow-up were recorded.ResultsThe success rates of complete stone retrieval was 92.3％ (96/104),and plastic stent was placed in other 8.Major complications ineluded post-ERCP bleeding in 9 cases (8.7％) and pancreatitis in 8 (7.7％ ).MELD score valuated 2weeks after ERCP ( 10.1 ± 6.3 ) was significantly lower than that of pre-ERCP ( 1 1.9 ± 6.2,t =2.22,P ＜0.05).The Child-Pugh grading before ERCP of 104 patients were 28 in grade A (26.9％ ),52 in grade B (50.0％ ) and 24 in grade C (23.1％ ),which was significantly different from those of 2 weeks after ERCP (40/52/12).No death was recorded during hospital stay for choledocholithiasis,and 2 patients of Child-Pugh grade C died in 3 months after discharge.ConclusionERCP is an effective method for choledocholi-thiasis in patients with decompensated cirrhosis.The main severe complication was post-ERCP bleeding.Those patients with decompensated cirrhosis would benefit from ERCP if we took effective measures.