Objective To determine how endoscopic retrograde cholangiopancreatography (ERCP) compared with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of pancreaticobiliary diseases. Methods A total of 40 patients with suspected pancreaticobiliary diseases underwent both MRCP and ERCP. Images obtained from ERCP and MRCP were compared. Results Pictures of both the examinations in the 40 patients had come out satisfactorily revealing the pancreatic duct and the biliary tree. The sensitivity, specificity and accuracy were 87% (34/39), 100% (1/1) and 88% (35/40) in MRCP and 100% (39/39), 100% (1/1) and 100% (40/40) in ERCP, respectively, without significant differences between the two examinations. Conclusions Although MRCP offers a diagnostic means equivalent to ERCP, it cannot take the place of the latter as regards identification of biliary obstruction.

Objective To investigate whether IL-24 can inhibit the growth of pancreatic cancer in immune-competent mice,which could be mediated by tumor-targeting oncolytic adenovirus (ZD55-IL-24).Methods Crystal violet staining assay was used to evaluate the anti-proliferative influence of ZD55-IL-24 on Panc02.The tumor growth curve,the tumor formation curve,TUNEL assay,cytotoxic T lymphocyte (CTL) killing assay and serum cytokines detection were used to assess anti-tumor efficacy of ZD55-IL-24 for pancreatic cancer in immune-competent mice.Results ZD55-IL-24 significantly inhibited the growth of pancreatic cancer cells in vitro.Lower tumor formation and slower tumor growth were identified in ZD55-IL-24 group,compared with ZD55-EGFP group or PBS group.ZD55-IL-24 induced pancreatic cancer cells'apoptosis,and mediated anti-cancer immunity by increasing killing responses of CTL to cancer cells and up-regulating serum γ-IFN and IL-6 levels.Conclusion ZD55-IL-24 can induce anti-tumor immunity and suppress pancreatic cancer growth in immune-competent mice.

Objective To investigate the effects of interleukin-18 ( IL-18 ) on M cells of intestinal mucosa in acute pancreatitis (AP) in rats. Methods Seventy SD rats were divided into seven groups: AP 6 hour group, 12 hour group, 24 hour group, IL-18 6 hour group, 12 hour group, 24 hour group, and control group at random. The models of AP were established. Serum, pancreatic tissue, and ileal mucosa were harvested. Serum amylase, glutamate pyruvate transaminse, total bilirubin, endotoxin, IL-27, and TNF-α were detected. Pathologic changes of pancreatic tissue and ileal mucosa were observed. The protein with reverse transcription-polymease chain reaction (RT-PCR). Results The level of serum TNF-α increased obviously in IL-18 6 hour group, 12 hour group, and AP group. The level of serum IL-27 increased in IL-18 6 hour group and AP group and back to normal in IL-18 24 hour group. The in IL-18 group than AP group (P < 0. 05 ). Conclusions IL-18 may affect M cells function and play important roles in intestinal barrier in acute pancreatitis.

As a mature management method, the matrix management model has been embraced by various sectors at large. This article introduced the practice of a tertiary general hospital in combining hospital ethics with medical administration and code of conduct for medical service, leveraging the matrix management mode in hospital ethics construction. By sorting out the risk exposure in hospital ethics, the hospital identified specific responsibilities and departments involved. On such basis, eight stable matrix-based ethics working groups were established, namely hospital ethics training, hospital ethics publicity, hospital ethics interview, prevention against prescription statistics for drug rebate, patient rights protection, management of physician practice in other medical facilities, academic cooperation, and hospital ethics tour inspections. Matrix-based management meets the characteristics of hospital ethics development as it not only enables multi-department management needs, but also improves the efficiency. With the advancement and connotation enrichment of hospital ethics development, matrix management can become a regular management mode.

Health service is an important part of the integrated development of the Yangtze River Delta. Taking the cooperation practice between Shanghai Tenth People′s Hospital and Suzhou Yinshanhu Hospital as an example, this article introduced the multi-agent cooperation mode of the loose medical alliance including the government, urban hospitals and cross provincial grassroots medical institutions. Among them, the local government provided policy, fund guarantee and guidance, the urban hospital exported management ideas, medicine talents and technologies, and the primary hospital conducted dual training by inviting in and going out to achieve double growth. Through the high gap cooperation between tertiary hospital and primary hospital, Yinshanhu hospital had been comprehensively developed. The loose medical alliance with multi subject coordination and cross region could give full play to the advantages of the loose healthcare alliance mode, achieve multi-win, and have reference significance for promoting the regional integration of medical and health services in the Yangtze River Delta.

The cross regional loose medical alliance is an important carrier in the current integrated development process of medical services in the Yangtze River Delta region. Smith policy implementation process model was used to analyze the development difficulties of cross regional loose medical alliances from idealized policies, policy implementation institutions, policy target groups, and policy implementation environment. Such medical alliances were formed under the background of integrated development in the Yangtze River Delta, with Shanghai′s tertiary public hospitals as leading units and medical institutions in Jiangsu, Zhejiang, and Anhui provinces as member units. Analysis showed that the policies for such medical alliances development had not yet clearly defined the organizational management mode, operational mechanism, and implementation path, and the corporate governance structure of medical alliance was immature; The policy implementation agencies were relatively lagging behind in the support of special funds and the formulation of related supporting policies; Participation of policy target groups was insufficient and their incentive mechanisms was imperfect; There were problems in the policy implementation environment, namely inconsistent medical and health service regulations and systems in different regions, different health financing capabilities of local governments, insufficient coordination of medical institution management concepts, and a lack of unified standards in information systems. Based on the above difficulties, this study proposed to strengthen the development planning and layout of cross regional loose medical alliances, and improve the corporate governance structure; To strengthen the government′s main responsibility and improving policy implementation capabilities; To improve the internal cooperation and operation mechanism of cross regional loose medical alliances, and enhance the sense of identity of the target group; To optimize the policy implementation environment and implement various support measures, so as to provide references for further promoting the coordinated development of high-quality medical resources in the Yangtze River Delta region.