Objective To improve the successful rate of endoscopic biliary drainage. Methods The experience of biliary drainage with duodenoscope for biliary obstruction from January 1998 to September 2001 was reviewed retrospectively. Endoscopic naso -biliary drainage (ENBD) , endoscopic retrograde biliary drainage (ERBD) and endoscopic metal biliary endoprothesis (EMBE) were performed in 242 cases, 43 cases and 35 cases respectively. Results Of 320 cases with biliary obstruction, 305 received successful drainage under endoscopy and 15 cases failed. Ten cases with ENBD failed but got successful drainage after modulating the site of naso-biliary tube or reinserting another tube. For 3 cases failed with ERBD, we chose plastic stents with appropriate length for 2 cases to achieve fluent drainage and percutaneous transhepatic biliary drainage (PTBD) was managed for another case after endoscopic management failed. For 2 cases with EMBE failed, one stent couldn' t exceed the tumor stricture site and one was obstructed by tumor implantion at one month after EMBE. Either a metal stent or a plastic stent was replaced through previous prothesis in these two failed cases. Conclusions The effect of endoscopic biliary drainage for biliary obstruction is definite. Mostly the drainage failure can be avoided as early as possible by analyzing the causes and taking some corresponding measures to correct it.

Objective To evaluate the value of endoscopy in etiological diagnosis and treatment of post - cholecystectomy syndrome. Methods Three hundred and twenty - six patients with post -cholecystectomy syndrome received ERCP. To reveral the etiology of post - cholecystectomy syndrome. For those with choledocholithiasis and those with papillary inflammatory stricture EST or EPBD were given those with papillary diverticulum and SOD EPBD were given, those with papillary tumor and hepatobiliary carcinoma EMBE were given and for those with bililary stricture in middle part of bile duct, purulent cholangitis, chloedocholithiasis(stones not excluded in one time)and bile leakage ENBD were used. Results ERCP was succeeded in 315 cases(96. 6%), 24 cases had no abnormal endoscopic findings view. 191 cases of choledocholithiasis 186 were totally get rid of stone after one to three times of opretion EST or EPBD was successfully given to 39 cases of 39 had papillary inflammatory stricture. Nine had papillary diverticulum which oppressed the papillary orifice, 7 had SOD, all of them were dealt with EPBD. Sixteen had stricture in the middle portion of bile duct, 11 of which were treated with ENBD. In 6 cases of papillary tumor and 5 hepatobiliary carcinoma patients jaundice improved significantly after received EMBE. Residual stones in cholecystic duct were seen in 4 cases. In 2 cases of bile leakage after cholecystectomy, ENBD was successfully carried out to avoid another operation. Complications were noted in 15 cases(4. 8%) of them. pancreatitis 11 cases, cholangitis 3 eases and hemorrhage of upper gastrointestinal tract one ease. Conclusion ERCP can find out the defenite cause of post - cholecystectomy syndrome at early stage and take corresponding endoscopic therapeutic measures. The complications of ERCP can be avoided by skillful operator.

Objective To summarize the clinical feature and treatment of 34 cases with closed abdominal trauma and craniocerebral trauma. Methods 34 patients with closed abdominal trauma and craniocerebral trauma were analyzed retrospectively. Results 4 cases died in hospital. Conclusion For the patients with closed abdominal trauma and craniocerebral trauma, shock and acute intracranial hypertension should be dealt with in time. Early diagnosis and operation is important to avoid secondary brain injury and to reduce the death rate.

Objective To investigate whether gemcitabine (GEM) could enhance radiosensitivity of human non-small cell lung cancer cells and its related mechanism.Methods Clonogenic assay was used to analyze radiosensitivity enhancement by GEM on p53 mutant human lung adenocarcinoma cell line 973.Alterations of cell cycle distribution and apoptosis were measured by flow cytometry.Results Mild radiosesitizing effect was observed when 10 nmol/L GEM was administrated before or after irradiation.Marked radiosesitizing effect was demonstrated when 100 nmol/L GEM was administrated before or after irradiation, with much stronger effect of pre-irradiation GEM treatment.Mutation of p53 gene affected cell cycle redistribution and cell apoptosis, but had no relationship with radiosensitivity enhancement of GEM.Conclusions 100 nmol/L GEM could significantly enhance radiosensitivity of human lung cancer cells.However, this effect may not be associated with p53 gene mutation, cell cycle redistribution or cell apoptosis.

Objective To investigate and compare the killing effect of photodynamic therapy (PDT)induced by hematoporphyrin derivative (HpD),hematoporphyrin monomethyl ether (HMME) and photocarcinorin (PsD007) on human leukemia cells K562 in vitro.Methods Human leukemia cells were cultured with serial concentrations of photosensitizers followed by irradiation of different dosage of laser light,then MTT colorimetric assay was applied to measure the relative survival rate of PDT for the cells.Results Significant difference in the inhibitory between the PDT group and control group was observed (P＜0.05).The survival rate of PDT for the cells elevated along with the increase in the concentration of sensitizer and dose of laser light.When the photosensitizer concentration was bigger (25 μg/ml) or the energy density was bigger (7.2 J/cm2),the effect of PsD007 was better than HMME,and they were significantly better than HpD (P＜0.05).Conclusion PDT has significant killing effect on human leukemia cells K562,and its relative inhibitory rate appears to be correlated with the dose of sensitizer and laser light irritation.The effect of PDT is related to the photosensitizers.The effect of HpD-PDT is not as effective as PsD007 and HMME.On the conditions of higher energy density and larger photosensitizer concentration,the effect of PsD007-PDT is better than HMME-PDT.

An analytical method of fluorescent dye-labeled oligonucleotides was established by ion pair reversed phase high performance liquid chromatography(IP-RP-HPLC) which was improved by optimizing the effects of triethylamine-acetic acid(TEAA)(0-0.15 mol/L), pH(4.5-7.0) and gradient. Comparing the retention of 5, 10 and 15-mer unlabeled oligonucleotides with that of 5'-carboxyfluorescein(5'FAM) labeled oligonucleotides, the mechanism of fluorescent dye-labeled oligonucleotides retention was studied. In addition, TaqMan~(TM) probes as wellas other common fluorescent dye-labeled oligonucleotides were concerned. The results showed that the best resolution of different length fluorescent dye-labeled oligonucleotides was observed under the condition of 0.01 mol/L TEAA and pH 7.0. The retention behavior of fluorescent dye-labeled oligonucleotides was different from that of unlabeled oligonucleotides significantly, and therefore they can be separated completely. The results indicated that the retention of unlabeled oligonucleotides enhanced with the increase of the length of molecule. In contrast, the retention of fluorescent dye-labeled oligonucleotides was reduced with the increase of the length of molecule. For the hydrophobicity of fluorescent dyes made a great impact on the retention, a longer retention time the labeled oligonucleotides would take while the hydrophobicity of fluorescent dyes was higher. However, the effect of the hydrophobicity was limited as the length was increased to a certain level.

Objective To evaluate the feasibility and clinical value of endoscopic decompression with metal stent and colorectal tube for acute malignant colorectal obstruction. Methods With the aid of fluoroscopy, 26 cases with acute malignant colorectal obstruction were treated. Their obstructive sites consisted of rectum(n=14), sigmoid colon(n=8), descending colon(n=2) and transverse colon(n=1). Results In 18 of 26 patients, metal stents were successfully inserted (18/20, 90%), in 6 cases colorectal tube were successfully inserted(6/6, 100%), the total technical success rate was 92. 3% (24/26). Thereafter, 1 patient has no effect, 23 patients showed relief of obstructive symptoms within 1-2 days, the clinical success rate was 88.5% (23/26). Permanent metal stent placements were performed in 13 cases for palliative treatment, 10 underwent subsequent elective surgical resection after 7 ~ 10 days, without complications, such as anastomotic leakage and intraperitoneal infection. One case was failed in recurrent rectal carcinoma after resection, one case with widespread metastatic sigmoid colon carcinoma occurred colon perforation and received immediate Hartmann operation. Recurrent obstruction was detected in one patient with distal stent migration within 6 weeks, and second stent were placed to solve the problems. Stent occlusion from stool impaction was found in one patient 1 month after stent insertion, and was solved by endoscpic interventions. Conclusion Endoscopic decompression with metal stent and colorectal tube can alleviate the acute malignant colorectal obstructive sympotoms with high success rate. It is a simple, safe, effective and well tolerated method, and can obviate colostomy, prominently reduce trauma and agony, and increase the living quality of patients.

Objective To investigate the effect of fetal hemoglobin( HbF) in improving anemia of women who were β‐thalasse‐mia carriers at childbearing age .Methods 289 cases of women at childbearing age diagnosed as β‐thalassemia carriers in Shenzhen City were enrolled in this study .The high performance liquid chromatography (HPLC) was uesed for quantitative analysis of HbF , and the red blood cell parameters were detected by using the LH750 Automatic blood cell analyzer .The differences of red blood cell parameters between the HbF normal group and the HbF increased group were compared ,and the relationship between the high HbF expression rates and gene mutations were also analyzed .Results Comapred with the HbF normal group ,the hemoglobin (HGB) levels ,mean corpuscular volume (MCV) and the mean corpuscular hemoglobin (MCH) increased significantly ,while the red blood cell (RBC) count reduced ,there were significant differences between the two groups (P<0 .05) .No significant differ‐ences of the mean corpuscular hemoglobin concentration (MCHC) and RDW coefficient of variation (RDW‐CV) between the two groups were found(P>0 .05) .There were no significant differnces of rates of HBF high expression between different types of β‐globin gene mutations and the overall rate of HBF high expression (P>0 .05) .Conclusion Compared with the HbF normal group , anemia may improve more significantly in cases of women diagnosed as β‐thalassemia carriers at childbearing age in the HbF in‐creased group ,and there may be no relationship between gene mutations and high expression of HbF .

OBJECTIVE To approach whole environment dynamic monitoring of the cross infection in operation department.METHODS To learn the experience of planning,construction and infection′s monitoring and managing of domestic and abroad operation departments,in combination with own work practice of reforming and infection management.RESULTS There were straight relations between planning,plane disposition,flow-sheet,construction quality,managing way and cross infection.CONCLUSIONS The whole environment dynamic monitoring of cross infection in operation department is very important.Of the total,the monitoring of planning design,the efficiency,rationality and safety of disposition,and flow-sheet of operation department at the beginning stage of construction is the premise of preventing and controlling cross infection there.The monitoring of construction quality at intermediate stage is the foundation of monitoring cross infection.The dynamic monitoring of alive human flow(patients,staff),logistic flow(articles during pre-operation,in-operation,and post-operation) and air current at later stage is the key point of preventing and controlling cross infection.

Objective To investigate the related factors of infection post ventricle-peritoneal shunt and explore some preventive measures.Methods 85 cases after ventricle-peritoneal shunt for normal pressure cranial hydrocephalus were analysed retrospectively. The effect of intensive prevention was observed. Results The overall infection rate was 7% after ventricle-peritoneal shunt. There was significant difference between the patients with or without infection post-operation in some factors, such as preoperative infection (pneumonia, urinary tract infection, intracranial infection, biliary infection); the operator; activities of daily living. It was 9.8% (6/61) under routine aseptic operation,and was 0 (0/24) under intensive management. Conclusion Infection after ventricle-peritoneal shunt is associated with many factors, especially the susceptibility and contact to infection. Intensive management can significantly prevent the infection.