Endoscopic retrograde cholangiopancreatography (ERCP)has become an important method for the diagnosis and treatment of cholangio -pancreatic duct diseases.Post -ERCP pancreatitis (PEP)is the most common complication and its incidence has increased up to 40% in recent years.The prevention of PEP has always been a hot topic in clinical research.This article reviews the research advances in the pharmacological prevention of PEP and points out that controlled clinical trials with a large sample size are still needed to investigate the effect of preventive drugs,and further studies should focus on optimal medication time,route of administration,and dose.In addition,de-mographic features of populations from different countries and different age groups should be taken into consideration.

Objective To sequence and analyze the complete genome of two human coronavirus NL63 (HCoV-NL63) strains collected from Beijing Children Hospital .Methods Eighteen pairs of primers were designed according to the gene sequences of HCoV-NL63 reference strain ( HCoV-NL63_Amsterdam 1) and used to amplify the target fragments covering the complete genome of HCoV-NL63 strains.Rapid ampli-fication of cDNA ends ( RACE) and RT-PCR assays were used to amplify the full length genome of HCoV-NL63 strains.Phylogenetic analysis was conducted by using Mega 5.0 software.Results The complete ge-nome sequences of the two HCoV-NL63 strains were 27 538 bp in length, showing a homology of 99.1%in nucleotide sequences .There were 15 consecutive bases deleted from 1a region.The systematic phylogenetic analysis demonstrated that four genotypes of NL 63 virus including A , B, C and D have been identified , and two domestic strains were belonged to the new genotype D .Conclusion The complete genome sequences of two domestic HCoV-NL63 isolates were identified for the first time .This study provided evidence for further investigation on molecular epidemiology of HCoV-NL63 in China .

Objective:To purify and characterize the major antigenic components of sand swimming crab,and provide theoretical evidences for the research of standardization of allergenic vaccine.Methods:The crude extract of Linnaeus was prepared using classical method, and electrophoresis of SDS-PAGE was used to separate the proteins of each group. The allergen proteins of 26 crab were identified using Western blot. To distinguish between the primary allergen proteins and secondary allergen proteins, FPLC(Gel Chromatography and ion exchange chromatography) was used to filtrate and identify the allergen protein.Results:SDS-PAGE analysis revealed that sand swimming crab proteins were composed of at lease 9 discrete protein bands, which molecular weight ranging from 13 000 to 90 000. Major bands were of 20 900, 24 200, 27 100, 29 200, 33 700, 38 900, 48 700, 74 700, 89 100 respectively. Western blot assay indicated that the crude extract reacted with sera obtained from 26 crab allergenic subjects and contained 5 allergen bands altogether, and the bands of 74 400 and 48 700 were the major allergenic components. The positive rates of the two major allergen proteins were both 100%, indicating the allergenic components maintained the immunocompetence after yielding from chromatography.Conclusion:The 74 400 and 48 700 bands are the major allergens of sand swimming crab. The major allergen proteins can be purified by chromatography.

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This study discussed the dual affiliated institutions of one author in a scientific paper.This issue could give rise to troubles such as the dispute over signature rights, dispute over intellectual property rights, etc. Moreover, it could bring negative effects on the development of science. In addition, some suggestions were put forward to deal with this issue.

Objective To investigate the diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones.Methods The retrospective cohort study was conducted.The clinical data of 460 patients with gallbladder stones who were admitted to the Affiliated Hospital of Zunyi Medical College from June 2012 to June 2016 were collected.Of 460 patients,106 combined with asymptomatic secondary common bile duct stones and 354 with gallbladder stones were allocated into the common bile duct stone group and gallbladder stone group,respectively.The serum liver function test was applied to the 2 groups,including alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil),direct bilirubin (DBil),glutamyltransferase (GGT) and alkaline phosphatase (ALP).The receiver operating characteristic (ROC) curve was built using significant statistical indicators,and correspondent cut-off value,sensitivity and specificity were calculated according to ROC curve.Observation indicators:(1) comparison of serum liver function indicators (ALT,AST,TBil,DBil,GGT,ALP) between the 2 groups;(2) analysis result of ROC curve.Measurement data with normal distribution was represented as x±s.The comparison between groups was evaluated with the independent-sample t test.The comparison of count data were analyzed using the chi-square test.The ROC curve analysis was done for significant statistical indicators.Results (1) Comparison of serum liver function indicators between the 2 groups,the levels of ALT,AST,TBil and DBil were (32±8)U/L,(35±8)U/L,(12.8±2.5)μmol/L,(2.6±0.4)μmol/L in the common bile duct stone group and (30±7)U/L,(32±7)U/L,(12.2± 2.4)μmol/L,(2.5 ±0.4)μmol/L in the gallbladder stone group,respectively,with no statistically significant difference (t=0.891,0.786,0.924,1.026,P＞0.05).The levels of GGT and ALP were (162±43) U/L and (145±37) U/L in the common bile duct stone group and (36± 10)U/L and (128±23) U/L in the gallbladder stone group,respectively,with significantly statistical differences (t =20.859,2.483,P＜0.05).(2) Result of ROC curve showed that areas under the curve of GGT and ALP were respectively 0.963 [95％ confidence interval (CI):0.938-0.988] and 0.621 (95％CI:0.561-0.684).The correspondent cut-off value of diagnostic accuracy,sensitivity and specificity of GGT and ALP were 92.5 U/L and 139.5 U/L,91.6％ and 50.7％,95.7％ and 76.5％,respectively.Conclusion The abnormally elevated levels of serum GGT have major diagnostic value for patients with gallbladder stones combined with asymptomatic secondary common bile duct stones,with an advantage of convenient and fast operation,and it is worth to be applied and popularized.

ObjectiveTo find out the risk factors and the incidence of lithiasis. MethodsA questionnaire was formulated by the National Biliary Surgical Group. It was sent to the medical staff of all levels of hospitals in the Zunyi Region, Guizhou to fill in on surgically proven cases of cholelithiasis. The clinical data were collected and analyzed using SPSS 13.0. ResultFor lithiasis, the gender ratio was 1∶ 1.78; the peak age was 41-year and 51-year respectively. The proportion of cholecystolithiasis (n =4456 ; 86.76 ％) and choledocholithiasis (n =554;10.79 ％ ) was comparatively higher than in other regions in China. ConclusionsThe commonest type of lithiasis in Zunyi was cholecystolithiasis. There was an increasing tendency for lithiasis to develop in young people. Lithiasis was closely associated with factors such as gender, food and occupation.

Objective To systematically compare the efficacy of three-dimensional conformal radiotherapy (3D-CRT) versus intensity-modulated radiotherapy (IMRT) in the treatment of prostate cancer (PCa).Methods Clinical comparative studies of IMRT and 3D-CRT in the treatment of PCa were collected from PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang Data after two independent researchers developed the strategy and inclusion and exclusion criteria for the literature search.Articles published up to February 2017 were searched for, and the languages of publications were restricted to English and Chinese.Clinical meta-analysis of the data from the relevant studies was performed using the RevMan5.3 software.Results A total of 15 relevant retrospective cohort studies were collected from the databases in strict accordance to the search strategy and inclusion and excluding criteria.There were 4608 PCa patients, including 2229 in the IMRT group and 2379 in the 3D-CRT group.IMRT and 3D-CRT had similar adverse effects in terms of early-stage (odds ratio[OR]=0.77, 95% confidence interval[CI]:0.43-1.40, P=0.390) and late-stage (OR=0.75, 95%CI:0.55-1.04, P=0.080) urinary tract injury.However, IMRT led to reduced early-stage (OR=0.47, 95%CI:0.27-0.82, P=0.008) and late-stage (OR=0.52, 95%CI:0.35-0.78, P=0.001) intestinal injury compared with 3D-CRT.Meanwhile, the biochemical recurrence-free survival rate was also significantly higher in the IMRT group than in the 3D-CRT group (OR=1.87, 95%CI:1.51-2.32, P=0.000).Conclusions IMRT is more protective against intestinal injury with a higher biochemical recurrence-free survival rate compared with 3D-CRT during the treatment of PCa.

OBJECTIVETo make clear the burden of injury in residents living in countryside of Dongying, Shandong Province.

METHODSA retrospective questionnaire survey was conducted among 15,276 residents in 20 villages of Dongying Municipality of Shandong Province with a multiphase cluster randomly sampling on cases of injury from March 1, 2002 to February 28, 2003. The injury was decided with three principles which had been carried out through the nation. The standardized incidence and mortality rates were calculated on base of the population data of Shandong Province in 2000. The burden of injury was evaluated by incidence rate, mortality rate, years of potential life lost (YPLL) system, disability adjusted life year (DALY), direct and indirect economic costs, et al.

RESULTSTotally 902 were injured cases in which the crude incidence rate was 5.90%, and the standardized incidence rate was 5.93%. It was shown higher in men (7.79%) than in women (4.03%). The crude death rate was 12.438 per million. And the standardized death rate was 11.257 per million. 27 cases were crippled. The years, the working years and the valued years of the potential life lost were 24, 19.6 and 8.7 years respectively for each death case. Disability adjusted life years was 566.61 years. Direct economic cost for medical expenses of all cases was 816.3 thousand RMB Yuan and 200.1 thousand RMB Yuan for else costs. Indirect economic cost was 5,492.9 thousand RMB Yuan according to DALY.

CONCLUSIONInjury was common incidence in rural residents in Dongying which caused a heavy burden on them. Prevention and control of injuries would be enhanced.

Accidents, Traffic ; economics ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; Cost of Illness ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Rural Population ; Surveys and Questionnaires ; Wounds and Injuries ; economics ; Young Adult

In China's new healthcare reform, the pilot local governments explore the practice of establishing a new model of hierarchical diagnosis and treatment system.Zhejiang Province has adopted a special policy of effectively allocating hospital resources and human resources, and efficiently improving primary healthcare institution capability and patient satisfaction(hereinafter referred to as double allocation, double improvement), focusing on the implementation of the 'Healthcare Talents Project', in order to fill a vacancy of human resources in primary healthcare institutions.This paper uses system dynamics modeling and the WISN method of WHO to estimate the gap in physician supply in primary healthcare institutions.After building the system dynamics model of 'Healthcare Talents Project', this paper simulates the influence of the policy on the vacancy of doctors in primary healthcare institutions and analyzes the sensitivity of regulatory factors.The simulation results show that, there are a big gap in physician supply of about 14,000 to build the hierarchical diagnosis and treatment system.The project can gradually increase the number of primary doctors, and the policy may fill the vacancy by 2021.However, if the efficiency of the hospital doctors who give assistance to primary institutions is increased by 10%, the targeted training and recruitment 100% achieve the policy plans and objectives, the project goal may be achieved by 2020.Therefore, this project can effectively adjust the human resources structure quickly and reasonably, and it can be used as reference for the reform of hierarchical diagnosis and treatment system.