Objective To determine the effectiveness of ETCD ( endoscopic transpapillary cyst drainage) in treatmen! of pancreatic pseudocysts. Methods Twenty-six patients with pancreatic pesudocysts were selected. They are presented some indications for treatment and the pesudocyst were ranged in size from 1.5 to 15 cm. Of 23 cases 38 sessions of ETCD were performed. In two of thirty-eight cases the cyst bulges were invisible in the stomach or duodenum due to its compression. In one case ETCD was employed after percutaneous drainage of the pseudocyst, the other one was treated after combination therapy of plastic stent ing because of jaundice. Results Improvement of abdominal pain, changes in appetite, body weight and fat in stool were recorded in follow-ups of 60 ~ 850 days. There was only one asymptomatic recurrence. One case was complicated with pancreatic abscess. There was no mortality related to the procedure. Surgical intervention became necessary in three cases because of inadequate drainage or complication. Conclusion ETCD treatment of symptomatic pancreatic pseudocysts with ductal communication, the transpapillary pancreatic duct stenting is a safe, effective modality and should be considered as the first line therapy; on the other hand for those pancreatic pseudocyst without communication to the main pancreatic duct it is not effective.

opping drinking. They were not influenced by gender, smoking and drinking histories. They could serve as monitoring indexes for recent drinking status on healthy individuals.

Objective To monitor the changes of resting energy expenditure in ventilated critically ill children,to compare the results of standard equations and indirect calorimetry (IC) in predicting energy expenditure,and to investigate the possible influence factors of the metabolic status of the critically ill children.Methods From September 2012 to September 2013,56 critically ill children on assisted ventilation and fitting the requirements of IC in pediatric intensive care unit of Shanghai Children's Medical Center were enrolled in this prospective study.IC measurements were performed using metabolic cart on day 1,4,7,10 after trachea intubation.General clinical data of these children were recorded.Results 130 IC measurements were performed in the 56 children.The measured resting energy expenditure (MREE) did not exhibit significant differences among day 1,4,7,and 10 (P =0.379).Although there were no significant differences between MREE and energy expenditure predicted with Schofield and WHO equations (P =0.917,P =0.995),the agreement was poor between the measured and predicted values (R2 =0.185,R2 =0.322).The metabolic status of the children on day 1 of ventilation was only correlated with age (P =0.000) and height (P =0.027),not with severity of underlying diseases or clinical outcomes.Conclusions MREE of IC method in ventilated critically ill children did not significantly change over time in this study.A poor agreement was observed between equationpredicted energy expenditure and MREE.IC measurement of resting energy expenditure is recommended for guiding individual nutritional support among critically ill children so as to improve clinical outcome.

Type 2 diabetes is a metabolic disease with increasing prevalence,which causes great socioeconomic burden.Intestinal flora is the microbiota located in the human intestines,which are participating in human growth and development,physiological procedures,or even pathogenesis as a closely connected environmental factor.There have recently been rapid progresses in the research on the relationship between intestinal flora and type 2 diabetes in the field of endocrinology and metabolism.In this article,we reviewed the overall framework and research progress in the relationship between intestinal flora and type 2 diabetes,aiming to shed some light on the future research about this topic.

Objective To study and contruct competency characteristic evaluation models of nursing supervisors in secondly hospitals.Methods Using the matron semi-structured interviews,literature review,questionnaire survey and expert questionnaires to discuss the competency of nursing supervisors in secodary hospitals.Results We found that the competency model of nursing supervisors in secondary hospitals could better reflect the competency of nursing supervisors.The model had 16 competencies which included knewleage skills.management and individual characters.Conclusions Through the study of the model of competency nursing supervisors in secondary hospitals,we form a set of standard for nursing supervisor selection based on their competency.The standard can help to select the most suited nursing supervisors who have great potentials.

Objective To investigate the expression of hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor C(VEGF-C) in colon carcinoma,and their relation with clinical pathological parameters and prognosis. Methods Immunohistochemistry was used to detect the expression of HIF-1α and VEGF-C in 65 tissues of colon carcinoma. Results In all cases,the expression of HIF-1α had a positive correlation with the expression of VEGF-C(r= 0.638,P＜0.01).The expressions of HIF-1α and VEGF-C had significant correlation with clinical stage and nodal metastasis(P＜0.05) ,but had no relationship with sex,age and tumor size(P＞0.05). Conclusion The expression of HIF-1α and VEGF-C was correlated with nodal metastasis, tumorigenesis and prognosis of colon/carcinoma.

Objective To evaluate the diagnostic value of the recombinant protein Sj_Ts4 in immunodiagnosis of Schistosomiasis japonica.Methods Seventy-four blood samples of schistosomiasis japonica patients(acute, chronic and advanced)were used for evaluating the sensitivity.Blood samples from 24 Clonorchiasis patients,8 patients with hookworm infections and 30 normal persons from the areas without Schistosomiasis were used ror patients.Results The positivity rates were 97.1%(33/34),100.0%(16/16),87.5%(21/24)in rSj-Ts4-ELISA and 100%(34/34),100.0%(16/16),75.0%(18/24)in SjAWA-ELISA in acute,chmnic and advanced Schistosomiasis. respectively.Statistical analysis revealed no significant difference in sensitivity(X2=1.23,P＞0.05)between both recombinant and crude antigens.The false positive reaction was found to be 6.7%(2/30)in rSj-Ts4-ELISA and 3.3%(1/30)in SjAWA-ELISA when detected in 30 cases of normal control sera.but no statisticallv significant difference was noted(x2=0.35,P＞0.05).Twelve point five percent(3/24),20.8%(5/24)and 12.5%(1/8),37.5% (3/8),of cross-reactions were observed between rSj-Ts4-ELISA and SjAWA-ELISA for detecting the sera of patients with clonorehiasis and hookworms.There was no significant difference of cross-reaction in two parasitic infections (x2=0.60,1.33,P＞0.05)with the two tests.Conclusions The rSj-Ts4 antigen shows higher sensitivity and specificity for the diagnosis of Schistosomiasis japonica,which is helpful in the serological diagnosis of Schistosomiasis japonica in endemic areas.

Objective To evaluate the feasibility and efficacy of subfascial endoscopic perforator surgery in treating varicose ulcer after great saphenous vein stripping.Methods Between July 2008 and July 2013,152 limbs of venous ulceration after great saphenous vein stripping were divided into two groups (conservative therapy and subfascial endoscopic perforator surgery therapy) and followed up at least for 2 years,respectively compared symptoms and signs improvement,ulcer healing time,ulcer healing and ulcer recurrence rate after healing for 6,12,24 months.Results No patient underwent the surgery occured pulmonary embolism or death,2 limbs appeared hematoma.Conservative and subfascial endoscopic perforator surgery group's symptoms and signs improvement rates were 81.9％ (59/72) and 86.3％ (69/80) (not significant,P =0.528),while the ulcer healing time,ulcer healing and ulcer recurrence rate respectively were 65.3％ (47/72) and 78.8％ (63/80),(73 ±15.7) d and (41 ± 12.6) d,34.0％ (16/47) and 14.3 ％ (9/63) (significantly different,P ＜ 0.05).According to the three time-points' (6,12,24 months) follow-up,the non-recurrence rate were 89.4％ (42/47) and 96.8％ (61/63),P=0.135;72.3％ (34/47) and 92.1％ (58/63),P=0.006;66.0％ (31/47) and 85.7％ (54/63),P =0.014.Conclusions Subfascial endoscopic perforator surgery is a reliable,safe and minimally invasive surgery,and has a long-term effect in treating varicose ulcer after great saphenous vein stripping.

Objective We observe the ?-aminobutyric acid(GABA)′s variation in the visual cortex of Royal College of Surgeons Rat(RCS rat)′s retina following the photoreceptor cell transplantation. Method The healthy Wistar rats′photoreceptor cells were grafted into the sub-retinal space of the left eye of the RCS rat by outer-path way.Two weeks later,host animals were sacrificed.Both sides of visual cortex were processed for light microscopic analysis.So did the 74 days Wistar rats and 74 days RCS rats.Then immunocytochemistry was used to determine the localization of the amino acid neurotransmitters(?-aminobutyrate,GABA).Results After two weeks of transplantation,the transplanted photoreceptor cells survived.On the opposite side of the visula cortex in the grafted RCS rats,GABA-like immunoreactivity was intensely stained.But the same side of the visual cortex in the grafted RCS rats,GABA-like immunoreactivity could not be observed.Conclusion These results suggest that we can rebuild the visual pathway by transplanting the photoreceptor cells.In the visual cortex of the grafted RCS rats, GABA- like immunoreactivity may indicate that the visual cortex had reflection to the stimulation after photoreceptor cells had been grafted.

Objective We observe the grafted Wistar rat's photoreceptor cell labeled by Horse\|radish peroxidase (HRP) in the receptor. Methods The healthy Wistar rat's photoreceptor cells were labeled and grafted into the sub\|retinal space of the left eye of the Royal College of Surgeon (RCS) rat by outer\|path way. Two weeks later, the eyes of the RCS rats were stained by cyto\|chemistry method and processed for light microscopic. Results After two weeks of transplantation, the transplanted photoreceptor cells survived. HRP\|labeling photoreceptor cell was stained brown and ranged orderly.Conclusion\ These results suggest that we can observe the grafted Wistar rat's photoreceptor cell in the RCS rat's retina by transplanting the HRP\|labeling photoreceptor cells.\;[