Objective To investigate the clinical application value, efficiency and safety of precut sphincterotomy in endoscopic retrograde cholangio-pancreatography (ERCP) .Methods From January 2008 to June 2011, 930 patients received ERCP in the department of hepatobiliary surgery of the first hospital of Jilin University.Of them 108 cases (11.6%) were diverted to receive precut sphincterotomy, because selective bile duct cannulation with conventional method was difficult.Inclusion criteria: failure of conventional cannulation or repeating pancreatic duct cannulation for more than 4 times.According to the patient's conditions, the examination and treatment of ERCP was carried out.Observation termination are therapeutic success rate and the incidence rate of complications, and comparative analysis on case data of routine ERCP was made.Statistical analysis was executed by SPSS 13.0 software.Comparison of ratio were determined with χ2 test, a value less than 0.05 was considered as significant.Results Of 108 cases, the success rate of ERCP was 95.4% (103 cases) .The incidence rate of complications was 6.5%, and there are no cases of duodenal perforation and death.Amongst 822 cases of routine ERCP, therapeutic success rate was 97.7%, and the incidence rate of complications was 7.7%.The statistics analysis result indicates that there are no statistical differences between precut sphincterotomy group and routine ERCP groups in the success rate (χ2=2.041, P=0.153) and the incidence rate of complications (χ2=0.141, P=0.707) .Conclusion The precut sphincterotomy in ERCP are safe and obviously effective with less complications compared to routine ERCP.The successful probability of difficult ERCP is improved greatly by using the technique of precut sphincterotomy.But the precut sphincterotomy indication is strictly controlled, and the technique should be performed by experienced endoscopist.

Five medicines for prevention and treatment of osteoporotic fractures were introduced.They are bisphosphonates,calcitonin,selective estrogen-receptor modulator,estrogen and active vitamin D.The pharmacologic effects,safety,application and causions were explained according to principles of evidence-based medicine.

Objective To achieve the software automatic updates and maintenance in the local area network which is developed based on the C/S structure. Methods Based on the existing software and hardware development platform,we use PowerBuilder to exploit and compile a program which can determine whether the software need to update automatically or not under the premise of unchanging the existing LAN software system. Results When the user terminal in the local area network runs this program,they can update it automatically whenever they need. Conclusion This method will greatly reduce the later maintenance software,upgrade works and also improve the work efficiency and accuracy.

BACKGROUND: Silicon nanowire field effect transistor electronic biosensors (SiNW-FETs) have attracted enormous interest in the biosensing field and have made rapid progress in protein detection.OBJECTIVE: To review the progress in protein detection by using silicon nanowire biosensors.METHODS: PubMed, CNKI, Baidu Scholar, Google Scholar were searched by the first author for the articles related to protein detection, microfluidic channels and silicon nanowire biosensors published from 2005 to 2016.RESULTS AND CONCLUSION: SiNW-FETs, with the merits of high sensitivity, target selectivity, real-time recording and label-free character, have been confirmed to have broad application prospects.

Different diagnostic criteria are existed nowadays in grading the dysplasia of gastric mucosa in clinical practice. Novel endoscopic techniques and molecular markers could facilitate the pathologic grading of dysplasia. As to the treatment strategy,it is debatable whether to choose endoscopic dissection or conservative follow-up. Here,we reviewed the diagnostic grading and therapeutic options with regard to the dysplasia of gastric mucosa.

The abdomen is an indispensable site of cardiopulmonary resuscitation,and combination with the chest for sustaining artificial circulation is the future research direction for precision medicine.This paper elaborates on the importance of abdomen in cardiopulmonary resuscitation,and analyzes the resuscitation mechanism of the chest,abdomen and thoracic abdominal combination for heart and lung recovery.The respective advantages and complementary points of chest and abdomen compression for cardiopulmonary resuscitation were also discussed.

[Summary] Endometrial carcinoma is one of the most common malignant tumors in female reproductive system .The treatment is given priority to with surgery .As a kind of minimally invasive surgery , the da Vinci robot surgical technique has become more and more mature in the past ten years and played an increasingly important role in gynecological oncology .As compared with the traditional laparoscopic surgery , the main advantages of the da Vinci robotic surgery system are as follows: improved three-dimensional surgical field, improved operation dexterity by mechanical wrist , and improved accuracy of operation by tremor filtering system .These innovations can help gynecological oncologists complete difficult surgery , especially for patients diagnosed of endometrial cancer with severe obesity.This article summarized the application of the da Vinci robotic surgery system in the treatment of endometrial carcinoma and compared it with the open surgery and traditional laparoscopic surgery .The new robot surgery system , innovation, applicable people and the learning curve were also involved .

Objective To study the therapeutic efficacy of cryoprecipitate in the treatment of disseminated intravascular coagulation(DIC).Methods 28 healed cases of DIC from 2006 to 2007 were enrolled in the study.The changes of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fbg)were compared and analyzed before and after cryoprecipitate infusion.Results The therapeutic efficacy of 28 cases was satisfactory after cryoprecipitate treatment,and the findings of TT,PT,APTT and Fb were improved.Conclusion The cryoprecipitate plays an important role in the treatment of DIC.Cryoprecipitate offers various kinds of blood coagulation factors for control of DIC,provides the opportunity of successful remedy,and improves the treatment achievement ratio.

Objective To study the effect of estrogen on cardiac injury and cardiomyocyte apoptosis of rat induced by isoprotere-nol by modeling cardiac inj ury induced by bilateral ovariectomized (OVX)and isoproterenol (ISO).Methods Fifty female SD rats with bilateral ovariectomy and sham operation (Sham)were randomly divided into 5 groups:sham operation group (Sham group), bilateral ovariectomy group (OVX group),cardiac injury group (OVX+ISO+Vehi group),low dose estrogen treatment group (OVX+ISO+E2 a group,4μg·kg-1 ·d-1 ),high dose estrogen treatment group (OVX+ISO+E2 b group,40μg·kg-1 ·d-1 ). these status were separately measured:rats′general features,hemodynamics parameters monitored of carotid artery,morphological observation and cardiomyocyte contraction change of single-cardiomyocyte separate cultured,cardiomyocyte apoptosis protein ex-pression were detected by immunoblotting.Results ISO significantly reduced myocardial pump function,increased hypertrophy and apoptosis of cardiomyocytes,reduced contractility of single cardiomyocytes (P<0.05).High-dose estrogen (40μg·kg-1 ·d-1 ) replacement therapy significantly improved ISO induced cardio inj ury and cardio functions decreasing,also inhibited Bax expression and caspas-3 activation and decreased myocardial hypertrophy and cardiomyocytes apoptosis through increasing Bcl-2 expression (P<0.05),significantly.while low dose estrogen (4μg·kg-1 ·d-1 )treatment showed marginally protection effects on ISO in-duced cardio inj ury with no statisticly significance.Conclusion Appropriate dose estrogen replacement therapy can decrease cardio-myocyte apoptosis,improve cardiomyocytes contractility,so as to protect ISO-induced cardiomyocyte apoptosis.

Insulin resistance and islet ? cell dysfunction are well-identified pathogenesis of type 2 diabetes. The generation of a great quantity of mitochondrial reactive oxygen species (ROS) impairs the function of mitochondria and induces oxidative stress during metabolic process of hyperglycaemia and hyperlipemia. Oxidative stress blocks insulin action pathway and induces insulin resistance; inhibit expression of insulin gene; decrease insulin secretion and impair ? cell function. In this paper, the mechanism of the ROS generation, insulin resistance and ? cell dysfunction induced by oxidative stress are reviewed.