Objective To study the preventive effects of selective bile ductal cannulation using an aqua-coat tipped Metro tracer guidewire on pancreatitis and hyperamylasemia after ERCP. Methods A total of 291 patients with biliary disease were enrolled in the study. The patients were randomized into the guidewire group (n= 149) and the control group (n= 142). In the guidewire group, the bile duct was first accessed by insertion of an aqua-coat tipped Metro tracer (diameter 0. 029 inch) guidewire through a 5.5Fdouble channel ERCP-tube to judge the bile duct by the direction of guidewire. As soon as cannulation was accomplished, the guidewire was removed to allow injection of contrast medium and other therapeutic manipulation. In the control group, the bile duct was opacified by the traditional method of cannulation of the biliary tree followed by single ERCP-tube cannulation, judgment of the bile duct by injection of contrast medium and performance of other therapeutic procedures. The incidences of post-ERCP pancreatitis and hyperamylasemia were compared between the 2 groups. Results The selective bile ductal cannulation was successfully conducted in 145 patients in the guidewire group and 138 in the control group. The incidences of post-ERCP pancreatitis and hyperamylasemia were significantly lower in the guidewire group than in the control group. Pancreatitis tended to be less severe for patients in the guidewire group. Conclusion Using the Double-Crossing method in selective bile ductal cannulation with an aqua-coat tipped Metro tracer guidewire reduced not only the frequencies of post-ERCP pancreatitis and hyperamylasemia but also the severity of post-ERCP pancreatitis.

Objective: To study the effect of Maitork (a sodium chloride injection containing Ginkgo bioba extract and ligustrazine phosphate) on plasma levels of fibrinogen (Fg), platelet granule membrane protein 140 (GMP-140), tissue plasminogen activator (tPA) after focal cerebral ischemia-reperfusion in rats. Methods: Eighty male SD rats were randomly allocated into groups 3-day (n=40) and 7-day (n=40) after operation. Then each group was divided into 4 subgroups: sham-operation, ischemia control, Ginaton and Maitork. The focal cerebral ischemia model was established in rats. The activities of GMP-140 and tPA were measured by chromogenic substrate assay, and the level of Fg was measured by gel plaque assay. Results: The level of Fg in the Ginaton group was significantly higher than that in the ischemia control group, and the 7-day group was also significantly higher than that in the Maitork group (P

Objective:To mutate the codons which code the lysine at loci ? 99 ,? 82 in human hemoglobin gene to the codons which code the cystein.Methods:The objective gene to be mutated was cloned into pAlter Ex2 plasmis and then was mutated with the site directed mutagenesis mediated by oligonucleotide.Results:The sequencing of clones obtained by preliminary screening showed that the anticipated results were reached without any unexpected mutation.Conclusion:The results lay a foundation for the further development of research on expression and purification of recombinated mutant human hemoglobin gene.

Objective To make an attempt to express serialy the human ?,? globin in Escherichia Coli in order to carry out the research on blood substitute based on the genetic recombination of hemoglobin.Methods The routine molecular biology technology was used.Results The serial genetic fragment of ?,? globins containing the hemoglobin was amplified by PCR.The genetic sequencing showed that there was no unexpected mutation.And then,the serial genes were cloned into the pBV220 expression carrier.Undergoing thermal inducement,the expression product could reach about 20% of total bacterial protein.The expression product assumed the form of inclusion body,and it was vertified by Western Blotting.Conclusion This much can lay the solid foundations for further launching the research on expression and pruification of recombinant human hemoglobin genes.

Objective To evaluate the effect of detailed disease management model in community management of hyperuricemic patients.Methods One hundred and fifty patients with primary hyperuricemia were randomly divided into detailed management group and conventional group from April to June 2012,patients in two groups were managed by different models for 1 year.The weight,height,biochemical indexes including blood uric acid and serum lipids were measured and a questionnaire survey was conducted with the items of disease awareness score,smoking,drinking,diet,standard treatment,satisfaction of treatment etc.before and after management.Results One hundred and thirty six patients completed the study including 68 in detailed management group and 68 in conventional group.After one year management,the blood uric acid,triglyceride,low density lipoprotein (all P ＜ 0.01) were statistically lower than baseline in detailed management group,while there were no statistical differences of these indexes in conventional group (P ＞ 0.05).The disease awareness score increased from (65.4 ±5.4) to (82.7±4.2) (Z=-10.2,P＜ 0.01),high purine diet rate fell from 47.1％ to 7.4％ (x2 =33.6,P ＜ 0.01),the standard treatment rates increased from 10.3％ to 85.3％ (x2 =76.6,P ＜0.01),treatment satisfaction rate increased from 51.5％ to 88.2％ (x2 =21.8,P ＜0.01) in detailed management group.In detailed management group,the blood uric acid (Z =-7.4,P ＜ 0.01),total cholesterol (Z =-0.01,P ＜ 0.01),triglyceride (Z =-2.4,P ＜ 0.01) and low density lipoprotein (Z =-3.2,P =0.03) and high purine diet rate were lower (x2 =27.1,P ＜ 0.01),the standard treatment rate (x2 =70.6,P ＜ 0.01) and treatment satisfaction rate were higher (x2 =5.6,P =0.02) than those in conventional group after 1 year management.Conclusion Detailed disease management is an applicable and effective model for community management of hyperuricemic patients.

Objective To evaluate the clinical effect and safety of homemade biodegradable drug eluting stents(Excel stents)in patients with coronary heart disease.Methods Two hundred and twelve patients who received Excel stents implantation during February,2006 to March 2007 were included in the study.Procedural success rate and complications during hospitalization were monitored and all the patients were followed up clinically up to 8-21 months after discharge.Results The procedural success rate was 99.1%(210/212).A total of 420 Excel stents were implanted while direct stenting was applied in 125 patients(29.8%).Sudden cardiac death happened in 1 patient during hospitalization.Two hundred and six patients finished their clinical follow up and among them,6 patients had recurrant angina.Fifty patients received CAG examination 6-9 months after PCI and 2 patients reached the criteria of restenosis(stenosis ≥50%)and required revascularization.Conclusion Homemade biodegradable drug eluting stents(Excel stents)are safe and effective for PCI in coronary heart disease patients.

Objective To investigate the effects of painless ward standardized pain management on pain control and postoperative recovery of patients with inguinal hernia after surgery.Methods From January 2015 to January 2016,44 cases of inguinal hernia in Department of General Surgery,First People's Hospital of Huainan,control group (22 cases) and observation group (22 cases) were retrospectively studied.The patients in observation group underwent painless ward standardized pain management and those in control group underwent traditional pain mnanagement model.Pain score after surgery,time for get out of bed after surgery,postoperative intestinal exhaust time,duration of night sleep,and satisfaction degree for pain-control were comparrd between two groups of patients.Results For pain score after surgery,the observation group 3 h after operation,postoperative 1 d,2 d pain score respectively (3.46 ± O.56),(2.72 ± O.21),(2.20 ± O.43) points,the control group 3 h after operation,postoperative 1 d,2 d pain score respectively (4.48 ± 1.52),(3.55 ± 0.40),(2.80 ± 0.40) points,there were significant difference between two groups (P ＜ 0.05).For sleep time,the observation group on the day of surgery,postoperative 1 d,2 d sleep time respectively (5.23 ± 0.98) h,(6.57 ± 0.54) h,(7.50 ± 0.54) h,the control of sleep time of 2 d group on the day of surgery,postoperative 1 d,respectively (4.35 e 1.28) h,(5.17 ± 0.45) h,(6.72 ± 0.61) h,there were significant difference between two groups (P ＜ 0.05).The satisfaction rate of pain control in the observation group was 86.3％,which was higher than that of the control group 50.0％ (P ＜ 0.05).The observation group first ambulation time,anal ventilation time,hospital stay were (10.5 ± 2.0) h,(16.8±2.1) h,(6.6±1.4) d,the control group for the first time,ambulation time,anal ventilation time,hospital stay were (15.9 ± 3.O) h,(22.6 ± 3.3) h,(7.5 ± 1.2) d,there were significant difference between two groups (P ＜ 0.05).However,there was no difference between the two groups in the total cost of hospitalization.Conclusions Application of painless ward standardized pain management for patients with inguinal hernia after surgery can shorten time for get out of bed after surgery,postoperative intestinal exhaust time,prolong duration of night sleep,improve satisfaction degree for pain-control during hospitalization.

Objective To evaluate the efficacy and complication of endoscopic dense ligation for bleeding esophageal varices(EV). Methods 128 cases of EV experienced varcies ligation, and 16～22 points(average 18.8 points) of the varices were ligated by using dense ligation, while only 5～6 points were ligated in common ligation (common method) for varices. All patients got one to two times of ligation therapy. Results In dense ligation group, the rate of prompt hemostasis was 96.9%, rate of elimination of EV was 92.2% with one therapy, and 96.9% with twice therapy, while the rate of bleeding was 0.8%. In common method the rates were 95.7%, 42.6%, 64.7% and 7.1% respectively. Between the two groups, the rate of elimination of EV and rebleeding had significant difference (P

Objective Pericardiocentesis and drainage are the common measures for the treatment of cardiac temponade and massive pericardial effusion. In this issue, the complications of pericardiocentesis and drainage were discussed. Methods 5 in-hospital cases of cardiac temponade or massive pericardial efiusion who had complications of pericardiocentesis and drainage were reported and analyzed. Results The complications were 2 cases with neural mediated syncope, 1 case with pleural efiusion, 1 case dead of acute right ventricular dilation, and 1 case with acute pulmonary edema and effusion leaking into the subcutaneous tissue. Conclusion The importance of hemodynamic change during pericardiocentesis and drainage could not be over-emphasized, and the patients whose hemodynamic status were unstable should be monitored by bedside hemodynamic monitoring or echocardiography. Also we should pay more attention to the drainage catheter per se, which may cause the complications.

Objective To summarize the clinical features,neuroimaging findings and pathological characteristics of demyelinating pseudotumors(DPT)of the brain,and to differentiate it from glioma. Methods The clinical features,neuroimaging findings and pathological characteristics of 35 patients with demyelinating pseudotumors of the brain were summarized,and the diagnosis for 18 of them was confirmed by bioscopy.Results Demyelinating pseudotumors affected adults of both sexes.The onset age of patients ranged from 9 to 69 years old.There was no definite antecedent,and the clinical syndromes were atypical. Neuroimaging scans showed multiple lesions in cerebral hemisphere,while the lesion in brain stem and spinal cord was single.The symptom and neuroimaging were not parallel.While with many or large lesions, the symptoms and signs were less.The lesions were not enhanced on CT scan,but appeared round or patch enhancement on MRI scan.Nine patients with DWI all appeared high density.The myelin basic protein was useful for diagnosis.The typical pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis.The Creutzfeuldt cells were also found in these patients.The lesions might become small or disappear after treatment,but could not serve as the criterion to exclude brain neoplasm. Conclusions DPT is a distinct demyelination disease entity,which is confusable with brain neoplasm.It is difficult to distinguish DPT from brain neoplasm with the clinical features and conventional neuroimaging scan.But DWI scan is useful.The pathological changes accord with demyelination,and Creutzfeuldt cells are also found.It is important to apply corticosteroid treatment or biopsy rather than being anxious to excise the lesions.