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 investigate the protective effects of polysaccharide from Radix Codonopsis Lanceolatae on acute alcoholic hepatic injury in mice.Methods The model of CCl4-induced acute hepatic injury was set up in mice, and then treated with polysaccharide from Radix Codonopsis Lanceolatae to observe the activities of ALT, AST and TG in serum and the levels of SOD, GSH and MDA in hepatic tissue and Observed the pathological changes in the liver of mice.Results Compared with model control group, the lance asiabell root polysaccharide liver injury in mice all dose groups in the activity of serum ALT(97.5 ± 22.12 U/L, 108.8 ± 22.15 U/L, 125.2 ± 19.68 U/Lvs. 152.3 ± 17.32 U/L), AST (72.5 ± 21.3 U/L, 89.2 ± 17.47 U/L, 104.3 ± 19.34 U/Lvs.1215 ± 22.31 U/L) and TG(0.75 ± 0.32 mmol/L, 0.80 ± 0.22 mmol/L, 0.96 ± 0.21 mmol/L vs.1.44 ± 0.23 mmol/L) reduce, can increase the liver damage the activity of SOD(215.6 ± 22.68 U/mg, 203.2 ± 22.18 U/mg, 186.2 ± 18.34 U/mgvs.164.3 ± 17.54 U/mg), GSH(17.74 ± 2.12μmol/g, 14.84 ± 1.12μmol/g, 13.93 ± 2.15μmol/gvs.12.23 ± 2.09μmol/g) in liver tissue of mice, decrease the activity of MDA(6.22 ± 2.12 nmol/mg, 6.22 ± 2.12 nmol/mg, 8.36 ± 1.84 nmol/mgvs.9.35 ± 1.68 nmol/mg) in liver tissue, showing significant differences (P<0.05), and there was certain dose dependent, and can improve the pathological injury of liver tissue.Conclusion Polysaccharide from Radix Codonopsis Lanceolatae had protective effects on acute liver induced by acute alcoholic hepatic injury in mice.

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.

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.

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.

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.

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.