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.

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.

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.

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 design a new portable vital signs monitor for family use. Methods TMS320F2812, a kind of digital signal processor, was applied as the main processor to control the functional mod-ules including A/D convertor, LCD display. Bluetooth communication module was introduced to achieve real-time fast transfer of data between the system and the PC. Results Not only can the system monitor electrocardiogram (ECG), breath rate, pulse rate, body temperature and other vital signs accurately, but also it runs stably. Conclusion The features of DSP and Bluetooth were well combined in the design of the family-oriented, easy to use, multi-functional monitor with small size, low power consumption and convenience. A broad application and market prospects can be predicted.

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.

By collecting literatures on apoplexy recorded in"Database of Basic TCM disease"from 2001 to 2005,we statistically analyzed changes on volume of documents,major authors,major journals,and contents of study in these literatures.

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.

[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 .