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.

Objective:To evaluate the clinical efficacy of Shiwei-Jinghuang Ointment combined with Chinese herbal external washing prescription in the treatment of acute paronychia. Methods:A total of 126 patients with acute paronychia in Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to December 2019, who met the inclusion criteria, were divided into 3 groups according to the random number table method (42 in each group). The treatment group was treated with Shiwei-Jinghuang Ointment combined with Chinese herbal external washing prescription. The control group 1 and group 2 were simply applied with Chinese herbal external washing prescription and mupirocin ointment, respectively. All groups were treated for 2 weeks and followed up 2 months. Serum CRP level was determined by ELISA method, and neutrophil percentage (NEU%) was measured by automatic hematology analyzer. The subsided time of red swelling and inflammatory exudation in nail groove of the paronychia patients were observed and recorded. Results:The total effective rate was 90.5% (38/42) in the treatment group, 71.4% (30/42) in the control group 1 and 66.7% (28/42) in the control group 2. The statistical difference were significant among three groups ( χ2=7.350, P=0.025). After treatment, the serum CRP level and NEU% in three groups were decreased ( P<0.01), and the serum CRP and NEU% level in treatment group were significantly lower than those in the control group 1 and group 2 ( F values were 6.482, 33.619, respectively, all Ps<0.001). After 2 months of follow-up, the incidences of chronic paronychia were 50.0% (6/12) and 57.1% (8/14) in control group 1 and group 2, respectively, but no chronic paronychia occurred in the treatment group. The difference among three groups was statistically significant ( χ2=9.355, P=0.009). Conclusion:The combination of Shiwei-Jinghuang Ointment and Chinese herbal external washing prescription can promote paronychia red swelling, reduce the inflammatory exudation time and the incidence of chronic paronychia, effectively improve the in vivo decrease inflammation index and clinical efficacy.

Therapies for uveitis include drug treatment and surgery.Medical therapies including proper administration of corticos- teroids,immunosuppressive drugs,nonsteroidal anti-inflammtion drugs and anti-infective drugs are important in management of the in- traocular inflammation and decreasing the risk of complications,furthermore,are the basis for surgical treatment of uveitis.

AIM To investigate the protective effects of three flavonoids quercetin,rutoside and flavone on the intestinal mucosal injury induced by burn in mice. METHOD The change of injury index of small intestine was assayed and the content of protein and DNA were measured. DTNB method were adopted to measure the GSH content in the intestinal mucosa. The level of DNA damaged were determined by measuring the fluorescence. RESULTS The condition of injury of intestinal mucosa were improved in varying degrees after these favonoids were given introgastrically for 3 days. The injury index of intestinal mucosa decreased and the content of protein,DNA and GSH increased. The degrees of DNA damage were reduced also.Quercetin was the most effective one among these three flavonoids. CONCLUSION The flavonoids of quercetin, rutoside and flavone have obvious protective effects on burn induced intestinal mucosal injury, and the mechanism may be related to its antioxydation function.

The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

EML4-ALK fusion oncogene represents a new molecular target which appears mainly in lung adenocarcinoma.EML4-ALK is detected more frequently in young non-small-cell lung cancer patients who never or light smoke.ALK inhibitors(crizotinib)for the treatment of the EML4-ALK-positive non-small cell lung cancer has a high response rate.This finding can improve the individual treatment of non-small cell lung cancer.

Objective: To identify the impact of Urban Resident Basic Medical Insurance (URBMI) on medical service utilization. Methods: Based on data of China Health and Nutrition Survey, matching DID model was used to compare the changes in medical service utilization between residents participated in this system and those not participated in this system in 2009. Results:In initial stage of implementation, URBMI in a certain extent promoted medical service utilization of residents participated in the system, but the impact level was still low. The promoting effect on inpatient service utilization was significant, but very limited on outpatient service utilization. Conclusion:Promoting outpatient service utilization and increasing compensation are future priorities for improving URBMI to implement the system.

Combined therapy consisting of radiotherapy,chemotherapy and palliative surgery is the primary management for locally advanced pancreatic cancer,with the purpose of prolonging survival and improving life quality.Gemcitabine is the standard chemotherapy at present.Gemcitabine-based combinations show a definite effect,and the combination with targeted drugs also has a certain degree of efficacy.The development of new chemotherapy drugs and targeted drugs provides more ways for the teatment of locally advanced pancreatic cancer.

Ultra-wide-field fluorescein angiography (UWFA) is a novel breakthrough in ocular fundus imaging technology, which can capture a single, high-resolution, 200° wide image of the ocular fundus that traditional fluorescein angiography cannot reach. This technology has important impacts on the screening, diagnosis, staging, treatment and follow-up of vascular diseases involving peripheral retina (such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, uveitis and so on).