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 explore the effect of failure mode and effect analysis (FMEA) method in strengthening the management of critical value of blood specimens in hospital. Methods According to the procedures of FMEA, critical values management team were established, drew flow chart of generating test specimens and crisis value, explored the potential failure mode and failure cause, analyzed the severity, possibility and critical value, and formulate and implement countermeasures according to the research outcome. Results The crisis value of the failure mode fell from 1 320 to 151 after the implementation of FMEA, and rate of decline was 88.56%; number of unqualified blood samples decreased from 510 cases to 78 cases, and the difference is statistically significant (χ2=407.27, P<0.05);critical value processing defects decreased from 85 cases (a total of 236 cases) to 3 cases (a total of 229 cases), and the difference was statistically significant (χ2=91.26, P<0.05). Conclusions FMEA method is helpful to improve the accuracy and precision of critical value management of clinical blood samples, so as to ensure the safety of patients in hospitals.

Objective To develop a questionnaire for factors influencing the quality of nursing interns.Methods The factors influencing the quality of nursing interns were formulated through literature review,interview and expert consultation.The pre-questionnaire was developed after modification.Exploratory factor analysis and correlation analysis were used to examine the reliability and validity of this questionnaire.Results Six common factors were extracted by exploratory factor analysis.Factor loading ranged from 0.487 to 0.889 for each item.The Cronbach α of the total scale was 0.814,and that of subscales ranged from 0.802 to 0.863.Retest-reliability coefficient of the total scale was 0.863,and that of subscales ranged from 0.794 to 0.931.Conclusions The self-designed questionnaire for factors influencing the quality of nursing interns has good reliability and validity,and can be used to measure the influencing factors for nursing interns.

Objective To investigate the expression and clinical significance of bcl-2 and NF-κB/ p65 in different subgroups of diffuse large B-cell lymphoma (DLBCL). Methods Immunohistochemical staining was used to detect the expressions of CD10, bcl-6, and MUM-1 in the DLBCL patients. According to immunohistochemical algorithm of Hans et al. DLBCL were subdivided into GCB and non-GCB/ABC subgroups and the expressions of bcl-2 and NF-κB/p65 were detected. The expressions of bcl-2 and NF-κB/ p65 in GCB DLBCL were compared with that in ABC DLBCL,and the correlation of bcl-2 and NF-κB/p65 expressions with survival in the two major subgroups of DLBCL were analyzed. Results The expression rates of bcl-2 and NF-κB/p65 proteins in DLBCL were 67.1% and 77.1%, and there was significant correlation between them. The expression rates of bcl-2 and NF-κB/p65 were 52.0 % and 56.0 % in GCB DLBCL, but were 75.6 % and 88.9 % in ABC DLBCL. The expression rates of two proteins were higher in ABC DLBCL than in GCB DLBCL. There was no significant correlation between bcl-2 and NF-κB/p65 protein expressions and overall survival within the GCB DLBCL subgroup, but bcl-2 and NF-κB/p65 expressions had a significant effect on overall survival within the ABC subgroup. Conclusion bcl-2 and NF-κB/p65 expressions are associated with poor survival in the ABC subgroup only. Hence, the significance of bcl-2 and NF-κB/p65 protein expressions should be assessed in the context of DLBCL subgroups in the future.

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.

SUMMARY Neuroreceptor imaging with radionuclide tracing in vivo has been greatly developed recently.Distribution,density,and activity of receptors in the brain can be visualized by the radioligands labeled for emission computed tomography(ECT),including PET(positron emission tomography)and SPECT(single photon emission computed tomography).The functional and quantitative imaging for several receptors,such as dopamine receptors,serotonin receptors,cholinergic receptors,benzodiazepine receptors,and opioid receptors,has clinical importance.The preparation of receptor imaging agents,foundation of the physio-mathematical model,and the development of nuclear medicine instruments are the main points.In the present review,we will concentrate on introducing the development of brain receptor imaging.

Leptin,a proteohormone primarily made by adipocytes,directly interacts with the hypothalamus for energy balance regulation.It plays an important role in the morbility of obesity.The soluble leptin receptor(sOb-R) is one of the leptin receptor isoforms.The examination of the sOb-R concentration is valuable because of its function in the regulation of leptin concentration.Leptin shows a great potential as a childhood obesity biomarker,and its concentration could be used in assessing the responsiveness of obese children to intervention programs.

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.

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 study the changes in the expression of GABA and its receptors in the dorsal horn of rat spinal cord induced by hind paw formalin injection. Methods Twelve healthy male SD rats weighing 300-325 g were randomly divided into two groups: (A) control group (n=6) and (B) peripheral inflammatory hyperalgesia group in which 5% formalin 50?l was injected subcutaneously into the plantar region of right hind paw to produce persistent pain(n=6). The animals were killed 24h after formalin injection. L_(4-6) segment of the spinal cord was removed. The number of GABA immuno-reactive cells was examined by immuno-cytochemistry technique and the exprpession of GABA_(A?3) and GABA_(B1) receptor mRNA in the spinal dorsal horn were determined by in situ hybridization. Results In control group(A), GABA immuno-reactive cells and GABA_(A?3) and GABA_(B1) receptor mRNA were observed throughout the lumbar spinal dorsal horn. The density of GABA immuno-reactive cells and GABA_(B1) receptor mRNA was highest in the superficial laminae Ⅰ-Ⅲ; while the GABA_(A?3) receptor mRNA was evenly distributed in the spinal dorsal horn. In group B, 24h after formalin injection there was a significant increase in the GABA immuno-reactive cells in the ipsilateral spinal dorsal horn. The expression of GABA_(A?3) and GABA_(B1) receptor mRNA were significantly increased in bilateral dorsal horn compared to group A. The three parameters were positively correlated and their locations in the spinal dorsal horn were not significantly different from those in group A. Conchusion GABA and its receptors may play an important role in nociceptive modulation.