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 retrospec the efficacy of percutaneous nephrolithotomy on treatment of urinary tract stones in solitary kidney.Methods From June 2008 to April 2011,percutaneous nephrolithotomy technique was used to treat 20 cases of urinary tract stones,with kidney stone or cast form staghorn calculi in 4 cases,single pelvis,calyceal stones 10 cases,6 cases of upper ureteral calculi;Fourteen cases used the standard channel F24;6 cases used F16 Micro Channel.Among the 20 patients,16 cases performed stage Ⅰ single channel surgery;2 cases performed dual-channel surgery in Ⅰ stage;2 patients with severe infection performed stage Ⅱ single channel surgery.Results The average duration of the operation was 66mins.The stone clearance rate was 88.36％ on average(18/20),without laceration or bleeding of pelvis or renal calyces mucosa or any other complications.Postoperative indwelling nephrostomy tubes were removed 6 -7 days later,without complications found during the follow-up period.For the 6 cases with preoperative renal dysfunction before surgery,the levels of blood Cr decreased at 2 weeks after surgery.Conclusion Compared to open surgery,percutaneous nephrolithotomy is safe and effective with small wound in treatment of solitary kidney with invasive upper urinary tract calculi.

Objective To investigate the causes of postoperative severe infection and other complications of percutaneous nephrolithotomy,and to study the principles of prevention and treatment.Methods Five hundred and sixty three cases of patients underwent percutaneous nephrolithotomy from September 2008 to December 2011 in our hospital,after operation,22 patients were found with serious infection.Data of these 22 cases were analyzed retrospectively according to the causes of the infection,corresponding prevention and treatment.Results The occurrence rate of severe postoperative infection was 3.9％ ( 22/563 ) in this group.The condition of 21 patients improved through adjusting antibiotics and taking other necessary measures in time;the condition of 1 case of septic shock patient was under control by giving anti-infective and anti-shock treatment measures.Conclusion Percutaneous nephrolithotomy is a safe and effective minimally invasive surgery,with a certain incidence of postoperative infection which should be timely and effectively controlled.

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).

Objective To evaluate the curative effect of Keli-Paoxi power for the treatment of acute paronychia. Methods A total of 144 patients with acute paronychia were randomly divided into a Keli-Paoxi power group, a mupirocin ointment group and an ethanol soaking group, 48 in each group. All patients were treated for 3 weeks and followed-up for 2 months. The time to regression of redness and swelling in the nail groove was recorded. The Visual Analogue Scale (VAS) was used to assess tenderness. The curative effects were evaluated, and recurrence of paronychia was recorded. Results The time to regression of redness and swelling in the nail groove in the Keli-Paoxi power group (2.2 ± 0.6 d) was significantly shorter than that in the mupirocin ointment group (8.1 ± 1.7 d) or ethanol soaking group (7.9 ± 1.2 d; F=344.597, P<0.01). The VAS Scores in the Keli-Paoxi power group (1.2 ± 0.2) was significantly lower than that in the mupirocin ointment group (3.2 ± 0.3) or ethanol soaking group (3.1 ± 0.3; F=831.273, P<0.01). The total effective rate in the Keli-Paoxi power group (100.0%, 48/48) was significantly higher than that in the mupirocin ointment group (83.3%, 40/48) or ethanol soaking group (81.3%, 39/48; χ2=9.700, P=0.008). The recurrence rate of paronychia in the Keli-Paoxi power group (2.1%, 1/48) was significantly lower than that in the mupirocin ointment group (16.7%, 8/48) or ethanol soaking group (14.6%, 7/48; χ2=6.000, P=0.049) at 2 months follow-up. Conclusions Keli-Paoxi power can alleviate tenderness, shorten the time to regression of redness and swelling in the nail groove, decraese recurrence in patients with acute paronychia. The curative effect of Keli-Paoxi power is superior to mupirocin ointment and ethanol soaking in the treatment of acute paronychia.

OBJECTIVE:To discuss the application of Prescription Automatic Screening System (PASS) in the examination of clinical medical orders. METHODS: The level and type of caution and the modification rate of medical orders in our hospital between April 2005 and April 2006 were analysed statistically, and the conformity between PASS cautions of medical orders and clinical medications was evaluated. RESULTS: A total of 10 982 160 medical orders were monitored by PASS, of which, 11 146 were with black cautions and in which 2 861(25.67%) were modified, 51 504 were with red cautions and in which 10 357 (20.0%) were modified, 339 449 were with yellow ones and in which 66 022 (19.45%) were modified. In PASS monitor process, inconformity between feasible clinical medical orders and cautions of PASS was noted in a few cases. CONCLUSION: The examination of medical orders using PASS is convenient and rapid and the PASS can help improve clinical rational drug use level, however, its function of remains to be updated and optimized.

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.

Objective To analyze the current situations of nosoeomial infection tumor and correlated factors,comlnon pathogens and resistance,to provide reference for reasonable clinical use of antibiotics.Methods The specimens of pathogens cultured from 398 Cases of patients with tumor were retrospectively analyzed.Results The rate of the hospital infection oftumor patients was 12.3%,significantly higher than 5.1%,the average infection rate in the 881ne period.The mest common nosocomial infection was in respiratory system.Of the 57 pathogens,Gˉ accounted for 66.7%;G+ 22.8%,and fungus,10.5%.The main bacteria were pseudomonas aeruginosa,Klebsiellapneumonlae,escherichia coli bacteria.Conclusion After nesocomial infections occurred,pathogens should he routinely checked,drugs,susceptibility tested and antibiotics,rationally used.