Objective To investigate the role of endoscopic color Doppler ultrasonography (ECDUS) in the preoperative localization of insulinomas. Methods Seven patientsd woman) with biochemically diagnosed insulinoma underwent abdominal US, spiral CT and ECDUS in an attempt to precisely localize the tumor before surgery. Surgical and pathological results were considered as the definite localization of tumor. The role of ECDUS in the preoperative localization of insulinomas was compared with that of abdominal US and spiral CT. Results Ten tumors were detected by surgery and pathology. The sensitivity of ECDUS in identifying insulinomas was 8/10 compared with 1/10 for CT and 0/10 for abdominal US. Two tumors not detected by ECDUS had a size below 0. 5cm. Conclusions ECDUS is superior to spiral CT or abdominal US, and should be served as the first choice in the detection of pancreatic isulinomas. ECDUS identification depends on the size of the tumor and 'is hard to detect the tumors smaller than 0. 5cm.

Objective To analyze correlation of drug with acute drug-induced liver injury in 83 patients. Methods According to the international consensus criteria and Danan's causality assessment of a drug in the case of acute liver injury, 83 cases which had been clinically diagnosed as acute drug-induced liver injury were analyzed. Results Among the 590 inpatients of acute hepatitis, 83 (14.07%) were acute drug-induced liver injury, in whom 53 patients had liver cell damage (63.86%), 22 with cholestasis (26.5%), and 8 with mixed type (9.64%). In 34 patients, it was drug related (40.96%), undefined in 37 cases (44.57%), and unrelated in 12 cases (14.47%). Conclusion The international consensus criteria standardized the diagnosis of drug-induced liver injury and are helpful in differential diagnosis, but it needs improvement for actual implementation.

Objective To compare the diagnostic accuracy of intraductal ultrasonography(IDUS) and endoscopic retrograde cholangiography(ERC) on extrahepatic bile duct stones. Methods 30 patients with suspected extrahepatic bile duct stones by B Ultrasonography, CT,or MRI,were allocated into this study. ERC was performed first by the use of Fujinon duodenal endoscopy ( ED-410XT, ED-410XU) and then followed IDUS by inserting the Fujinon miniprobe (PL2220-15 or PL2226-15) through endoscopic working channel to detect extrahepatic bile duct, finally the substance in extrahepatic bile duct was proved by endoscopic sphincterotomy(EST)and stone extraction. Results Among 30 cases, the diagnoses by ERC were stone 26 cases,floccule 1 cases and misinterpreted 2 cases so the accuracy and sensitivity of ERC were 26/30(86.7%) and 26/28(92.9%)respectively. For IDUS, the diagnoses were totally in accordance with the results of EST and stone extraction.So the accuracy and sensitivity of IDUS in the diagnosis of extrahepatic bile duct stones were 30/30(100%) and 28/28(100%) respectively. Conclusion (1) IDUS was superior to ERC in the diagnosis extrahepatic bile duct stones. (2) IDUS can compensate the misinterpretation of ERC on extrahepatic bile duct stones.

Objective To investigate the rule of changes in endoscopic and endoscopic ultrsonic findings after endoscopic variceal sclerotherapy in the follow-up period. Methods Patients suffered from esophagogastric variceal bleeding and received endoscopic variceal sclerotherapy were investigated. Patients with liver cirrhosis after viral heptitis and their varices eliminated or reduced to grade Ⅰor Ⅱ after sclerotherapy entered this study for at least 5 years' follow - up. Endoscopic and endoscopic ultrsonic findings were recorded to find its course of transformation. Results Lumens of varices were occluded by thrombus and eventually replaced by white fibrous tissue after endoscopic sclerotherapy. Vessels reappeared within e-sophageal wall gradually after a lot of time in the form of formation of new venules (93. 8% ) or re-vascular-ization (6. 2% ) . Newly formed varices within gastric wall after sclerotherapy were seen in 5. 3% of the cases and some cases of duodenal varices were also found rarely in the follow-up. Endoscopic ultrasonic finding confirmed the revascularization and dilatation of vessles after sclerotherapy. Conclusion From the follow-up results it indicates that varices would reappear gradually after endoscopic sclerotherapy, regular re-examination and appropriate treatment in time are the most important measure to assure its long term effect.

Objective To evaluate the efficacy of scle rotherapy (EVS) for esophageal variceal bleeding. Methods Retrospective analysis was made in 1 010 patients with es ophageal variceal bleeding who underwent sclerotherapy, among them 850 patie nts were cirrhosis and 160 patients were hepatocellular carcinoma. The total num ber of procedures of sclerotherapy were 3 203, including 602 for emergency scler otherapy and 2 601 for selective sclerotherapy. Supplementary sclerotherapy was performed in 502 cases. Average procedures of sclerotherapy for initial treatme nt were 3.18?1.1 in 710 cirrhotic patients. Follow-up was made in 579 cirrhosi s patients for 3-157 months, with an average follow-up period of (42.47?32.78) months. Results 1. The hemostasis rate in the whole group was 97.0%, the c omplication rate was 13.4%, and the mortality was 1.8%. 2. Rate of complete and nearly complete elimination of esophageal varices in cirrhotic patients was 84 .1 %, and long term rebleeding rate was 23.7%. Survival rates were (95.8?0.8)% 、(86.1?1.6)%、(74.5?2.4)%、(53.6?3.8)% at 1,3,5 and 10 year according to t he Kaplan-Meier analysis. Conclusions EVS is an important method of treatment for esophageal variceal bleeding.

Objective To investigate the current status of health education among nursing undergraduates,to analyze the existing problems and to bring up corresponding strategies for improving the health education ability for nursing undergraduates.Methods Totally 381 nursing undergraduates were recruited and investigated with a self-designed questionnaire.Aspects of students' cognition of health education,influencing factors of health education and the implementation of health education in clinic were investigated.Data were processed using SPSS 12.0 and percentages were calculated.Resuits 98.75％ students understood the importance of heath education in nursing work.However,systemic training courses of health education for nursing undergraduates were insufficient in both colleges and hospitals.Meanwhile,clinical teachers' ability of health education was limited.Only 15.59％students provided health education for patients independently.Conclusions Nursing colleges and practicing hospitals should strengthen health education consciousness of nursing undergraduates,enhance faculty construction and should set up related courses to train the health education skills.

Objective To determine Oligl transcription factor expression in periventricular tissue of day 2 newborn rat of periventricular leukomalacia (PVL) and to explore the relation with remyelination.Methods PVL newborn rat model was successfully established through bilateral common carotid artery ligation,followed by 8% oxygen exposure for 30 min. On day 0,day 7 and day 14 after operation,Oligl expression was examined through in situ hybridization, oligodendrocyte precursor cells and oligodendrocytes were detected via immunohistochemistry method and mRNA levels of MBP, PLP, MAG in control and PVL group were examined with quantitative real-time PCR. Results Oligl positive cells of control group were 115 ± 15/mm2. On day 0 and day 7 after operation,oligl positive cells were 72 ± 20/mm2and 75 ± 12/mm2 ,and there was significant difference as compared with control group (P both ＜ 0. 05), however the oligl positive cells on day 14 after operation(146 ± 1 1/mm2) significantly increased with comparison to control group (P ＜0. 05). Compared to control group, GST-Ⅱ positive oligodendrocytes and O4 positive oligodendroglial progenitor cells of PVL group were significantly decreased on day 0, day 7 after operation (P both ＜ 0. 05), and these cells both increased on day 14 after operation ,however there was no difference as compared with control group (P ＞ 0. 05). Compared to control group, mRNA levels of MBP, PLP, MAG all significantly decreased on day 0,day 7 after operation(P all ＜ 0. 05), and these levels slightly increased on day 14 after operation (P ＞ 0. 05). Conclusion Oligl transcription factor may be essential in the remyelination and repair of myelin in PVL.

Objective To assess the efficacy and safety of interventional techniques for the management of symptomatic portal vein (PV) and superior mesenteric vein (SMV) thrombosis. Methods Six patients with thrombosis of the PV and SMV were treated by transjugular intrahepatic portosystemic (TIPS) approach. Contrast PV SMV venography was carried out to verify the access to the PV branch. Then a 8F large bore catheter was used to aspirate thrombus. A J shaped guide wire and pig tail catheter were used to fragment the thrombus. Local thrombolysis with urokinase (UK) was delivered through a catheter in the SMV. An 4 French multiple side hole catheter was put into the SMV and UK was continuously infused for 3 to 13 days.Results The procedure was successful in all cases. One patient died of intra abdominal sepsis 12 days after. Five patients were followed up by color Doppler ultrasonography for 4～36 months with confirmed patency of the PV and SMV in all these patients. Conclusions This procedure is both safe and effective in the treatment of symptomatic PV and SMV thrombosis.

Objective To evaluate the effect of oxycodone preconditioning on liver injury induced by intestinal ischemia-reperfusion (I/R) in rats and the role of different opioid receptors.Methods Fiftyfour adult male Sprague-Dawley rats, weighing 200-300 g, were randomly divided into 9 groups (n =6 each) using a random number table: sham operation group (group S), group I/R, oxycodone preconditioning group (group OP) , μ receptor antagonist CTOP group (group CTOP) , δ receptor antagonist naltrindole group (group NTD), κ receptor antagonist nor-binaltorphimne group (group BNI), CTOP + oxycodo ne preconditioning group (group CTOP+OP) , naltrindole + oxycodone preconditioning group (group NTD+ OP) , and nor-binaltorphimne + oxycodone preconditioning group (BNI+OP).The model of intestinal I/R was established by occlusion of the superior mesenteric artery for 45 min followed by 2 h reperfusion in anesthetized rats.The superior mesenteric artery was only exposed, but not occluded in group S.In OP,COTP+OP, NTD+OP and BNI+OP groups, oxycodone 0.5 mg/kg was injected intravenously at 10 min prior to ischemia.COTP 1 mg/kg and naltrindole 5 mg/kg were injected intravenously at 20 min prior to ischemia in COTP+OP and NTD+OP groups, respectively.Nor-binaltorphimne 5 mg/kg was injected intravenously at 25 min prior to ischemia in group BNI+OP.In CTOP and NTD groups, the corresponding doses of CTOP and naltrindole were injected intravenously at 10 min prior to ischemia.In group BNI, the corresponding dose of nor-binaltorphimne was injected intravenously at 15 min prior to ischemia.The rats were sacrificed at 2 h of reperfusion, and left hepatic lobes were removed for microscopic examination and for detection of apoptosis in liver cells (using TUNEL).The apoptosis index (AI) was calculated.Results Compared with group S, the AI was significantly increased in the other groups (P＜0.05).Compared with group I/R, the AI was significantly decreased (P＜0.05) , and the pathological changes of livers were reduced in OP, COTP+OP, NTD+OP and BNI+OP groups, and no significant change was found in AI and pathological changes of livers in CTOP, NTD and BNI groups (P＞0.05).Compared with group OP, the AI was significantly increased (P＜0.05), and the pathological changes of livers were aggravated in COTP+ OP, NTD+OP and BNI+OP groups.There was no significant difference in AI and pathological changes of livers among groups COTP+OP, NTD+OP and BNI+OP (P＞0.05).Conclusion Oxycodone preconditioning can mitigate liver injury induced by intestinal I/R in rats, and μ, δ and κ receptors mediate the role with comparable effects.

Objective To evaluate the effects of different doses of oxycodone on renal ischemiareperfusion (I/R) injury in rats.Methods Forty adult male Sprague-Dawley rats, weighing 220-300 g, aged 10-13 weeks, were randomly divided into 5 groups (n =8 each) using a random number table: sham operation group (group S), group I/R, and low, medium and high doses of oxycodone groups (OL, OM and OH groups).After the rats underwent right nephrectomy, the renal I/R was induced by occlusion of the left renal artery and vein for 45 min with atraumatic microclips followed by 3 h reperfusion in I/R, OL, OM and OH groups.In group S, right nephrectomy was performed, and the left renal artery, vein and ureter were isolated without occluding blood flow.In OL, OM and OH groups, oxycodoue 2, 4, and 6 mg/kg were infused intravenously, respectively, immediately after onset of ischemia.At 3 h of reperfusion, blood samples were taken from the abdominal aorta to determine the concentrations of serum blood urea nitrogen (BUN) and creatiniue (Cr) concentrations.After blood sampling, the animals were sacrificed, and the left kidneys were removed for determination of tumor necrosis factor-alpha (TNF-α) , interleukin-6 (IL-6) and IL-8 and IL-10 contents (by using enzyme-linked immunosorbent assay), and malondialdehyde (MDA) content (by thiobarbituric acid method), and superoxide dismutase (SOD) activity (using xanthine oxidase method).Results Compared with group S, the serum BUN and Cr concentrations, and contents of TNF-α, IL-6, IL-8 and MDA in renal tissues were significantly increased, and the IL-10 content and SOD activity in renal tissues were decreased in the other four groups (P＜0.05).Compared with group I/R, the serum BUN and Cr concentrations, and contents of TNF-α, IL-6, IL-8 and MDA in renal tissues were significantly decreased, and the IL-10 content and SOD activity in renal tissues were increased in OL, OM and OH groups (P＜0.05).The serum BUN and Cr concentrations, and contents of TNF-α,IL-6, IL-8 and MDA in renal tissues were gradually decreased, and the IL-10 content and SOD activity in renal tissues were gradually increased with increasing dosage of oxycodone in OL, OM and OH groups (P＜ 0.05).Conclusion Oxycodone 2, 4, and 6 mg/kg can alleviate renal I/R injury in a dose-dependent manner in rats, and the mechanism is related to inhibition of inflammatory responses and oxidative stress response.