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.

ObjectiveTo investigate the expression characteristics of Caspase-8 in gastric carcinoma tissues and its correlation with clinical pathological features.Methods The mRNA and protein of Caspase-8 in gastric carcinoma and its surrounding tissues were detected by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry,respectively.ResultsThe Caspase-8 mRNA in gastric carcinoma tissues was obviously lower than that in its surrounding ones (0.154±0.065 vs 0.394±0.107,t =14.04,P ＜0.01),which was correlated with lymph node metastasis,tumor stage,differentiation grade (P＜0.01).The Caspase-8 protein in gastric carcinoma tissues was also significantly lower than that in its surrounding ones (31.48％ vs 85.19％,x2 =32.04,P ＜ 0.01),which was correlated with tumor stage,differentiation grade (P＜0.05).ConclusionsCaspase-8 is low-expressed in gastric carcinoma,which may play an important role in the occurrence and progression of gastric carcinoma.

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 investigate the prevalence and related factors of sexual dysfunction (SD) in patients with Parkinson's disease.Methods A total of 411 patients with Parkinson' disease in Nanjing Brain Hospital were analyzed retrospectively.The ICD-10 diagnostic criteria for SD was used to evaluate SD.The Unified Parkinson's Disease Rating Scale (UPDRS) part Ⅲ, Hoehn and Yahr (H&Y) staging, Non-motor Symptoms Questionnaire (NMS-Quest), Parkinson's Disease Sleep Scale (PDSS), Hamilton Anxiety Rating Scale (HAMA), Hamilton Rating Scale for Depression (HRSD) and Montreal Cognitive Assessment (MoCA) were used to evaluate patients.Results SD was found in 145 (35.3 ％) patients and the prevalence was higher in male than in female.Patients with SD had older age, longer duration, severer motor symptoms, and higher scores of UPDRS-Ⅲ, HAMD, HAMA and NMS-Quest (all P＜0.05).In male patients, SD was positively associated with age, duration of disease, UPDRS-Ⅲ , H-Y stage, HAMD, HAMA and NMS (r=0.127, 0.303, 0.240, 0.236, 0.181, 0.221 and 0.302, all P＜0.05).In female patients, SD was positively associated with duration of disease, HAMD, HAMA and NMS (r=0.194, 0.163, 0.189 and 0.178, all P＜0.05).The forward binary Logistic regression analysis indicated that female gender (OR=0.539, P＜0.05), duration of disease (OR=1.133, P＜0.05), NMS (OR=1.104, P＜0.05) and history of exposure to heavy metals (OR=5.268, P＜0.05) were associated with SD.Conclusions SD is a common complication in patients with Parkinson's disease, and a great attention should be paid to its screening and diagnosis.

Objective To evaluate the diagnostic value of 18F-FDG PET-CT in looking for tumor primary lesion with multiple bone metastasis.Methods 84 patients with suspected bone metastases were detected by routine imaging (X -ray,CT,MRI)in our hospital from May 2012 to September 2014 were selected,18F -FDG PET/CT were used to find the primary lesion.The final diagnosis were confirmed by tissue pathology or by clinical imaging follow -up.The diagnostic sensitivity,specificity and accuracy on tumor bone metastasis of 18F -FDG PET/CT were recorded.Results In 84 patients,primary tumor was found in 49 cases,of which 46 cases (54.8%)confirmed pri-mary tumor by operation or pathology,the other 3 cases were false positive;35 patients were diagnosed as non meta-static bone tumor by PET/CT,in which 34 cases were finally confirmed as non metastatic bone tumor by pathology and follow -up;accuracy,sensitivity,specificity of 18F -FDG PET/CT were 54.8%(46 /84),93.9% (46 /49)and 95.2%(80 /84);18 cases of lung cancer,9 cases of prostate cancer,7 cases of breast cancer,5 cases of lymphoma, 4 cases of renal cell carcinoma,2 cases of liver cancer,1 cases of Uterine sarcoma were included in 46 primary tumors.Conclusion 18F -FDG PET/CT has a higher specificity,accuracy as well as higher detection rate in search of multiple bone metastases,thus it is beneficial to the clinical therapy.

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.