Objective To characterize the spectrum of adult choledochal cyst and to determine suitable surgical procedures for this disorder.Methods The medical records of 169 patients who were treated for choledochal cyst from July 1977 to October 2008 in our Department were retrospectively reviewed.The cysts were classified using Todani's classification as type Ⅰ in 110 patients (65.1％),type Ⅱ in one patient (0.6％),and type Ⅳ in 56 patients (33.1％).The choledochal cysts in two patients could not be classified because of the lack of clinical data.163 patients received surgical treatment,which included cystectomy (n=119),cystenterosotmy (n=33),T-tube drainage following bile duct exploration (n=5),surgical exploration/biopsy (n =5),and endoscopic sphincterotomy (n =1).Results There was an increase in the number of patients in the 1980s which became stable at round 30 patients per every four years since the late 1990s.The proportion of patients presenting with a history of biliary surgery decreased and accounted for about 25％ of patients in the past decades.The rate of cyst malignancy dropped from 16.5％ in 1977=1995 to 9.7％ in 1996=2008.Of the 163 patients who received surgical treatment,long-term complications included anastomotic strictures and intrahepatic bile ductal stones presenting with repeated cholangitis.Conclusions The incidence of adult congenital choledochal cysts had become stable following years of rapid increase.The rate of cancer progression had gradually decreased.The use of different surgical treatments based on the condition of the proximal bile duct helped to prevent postoperative stenosis of biliary anastomosis.

Objective To compare the effect of different sutures and suture method on corneal neovascularization ( CNV) in rabbit models. Methods NV was induced by placing sutures at the corneal periphery of rabbits (n = 45). To observe the NV status, 45 rabbits were randomly divided into 5 equal groups. Group A applied 8-0 absorbable suture (A1 single loop parallel suture, A2 single loop vertical suture). In group B, 10-0 nylon suture was used (B1 double loop parallel suture, B2 double loop vertical suture, B3 three loop radial suture). The development of CNV was observed with slit lamp microscope and photographed. Therefore the effective model for neovascularization induction was selected. Histological examination, immunofluorescent staining and ELISA analysis for the vascular endothelial growth factor( VEGF) were performed before suture, 7 and 14 days after suture. Results Sutures fell off and CNV gradually atrophied in group Al and A2; At the 14th day after suture, Sparse or short cluster CNV grew into the corneal margin in group B1 and B2, while CNV was vigorous and grew in bundles in group B3. The expression of VEGF in aqueous humor increased in B3 group after suturing, and increased in 14 days as compared with 7 days after suture. Corneal edema, neovascularization and little immunofluorescence staining for VEGF were detected in group B3 after 7 days suture. More neovascularization and immunofluorescence staining for VEGF were detected in group B3 after 14 days suture. Conclusion Corneal NV can be induced successfully in rabbit model by suturing. The method of 10-0 thread with three sets of circular seams (B3) is stable and effective.

This paper is a summary of the three types of faults that have occurred in the recent years in the Carestream DR7500:hardware failure, software failure, and communication failure. The specific cases of three types of faults are introduced in a case-by-case basis.
Equipment Failure ; Maintenance ; Radiographic Image Enhancement

Humans ; Neoplasms/therapy* ; Echocardiography ; Heart Diseases/diagnostic imaging*

The coverage rate of HPV vaccination in China is still very low,and the main reason may be related to people's confusion about the choice of vaccine types,the best age of vaccination,vaccination procedures and prices and other factors.This paper briefly describes the etiology of cervical cancer,the approval of HPV vaccine,the application status of HPV vaccine in foreign countries,and the current situation and challenges in the use of cervical cancer vaccine in China,and advocates that obstetrics and gynaecology experts/disease control experts actively promote the prevention and control of cervical cancer,so that young girls and their parents understand the knowledge related to cervical cancer and HPV vaccine,and young girls can be vaccinated with HPV vaccine as early as possible,so as to improve the coverage rate of HPV vaccination and eliminate cervical cancer.

Objective: To investigate a mass incident of bromadiolone poisoning and analyze related clinical data. Methods: An investigation was performed for a mass incident of bromadiolone poisoning in a place in Shandong, China in December 2015, and related clinical data were analyzed and summarized. Results: This incident was a mass incident of bromadiolone poisoning caused by spreading poison. The poisoned patients had major clinical manifestations of bleeding and coagulation disorder and all of them were cured after comprehensive rescue, especially after intravenous drip of vitamin K1. Conclusion Bromadiolone poisoning can cause severe visceral hemorrhage and coagulation disorder, and intravenous drip of vitamin K1 has a good therapeutic effect.

Cranial Nerves ; Humans ; Lymphoma ; Nervous System Malformations

Endocarditis ; Humans ; Syncope

Objective: To investigate the cognitive level and practice status of nursing ethics of clinical nurses in Shandong Province. Methods: 3 205 nurses from 20 tertiary hospitals and 10 secondary hospitals were investigated using clinical nursing ethics cognition and practice questionnaire, with the aid of the special committee of nursing ethics in Shandong province. All data were analyzed by SPSS 17.0 software. Results: The total score of nursing ethics in Shandong Province was (16.65±3.25), and the total score of ethical practice was(40.10±6.72). Univariate analysis showed that there were differences in ethical cognitive level among nurses of different age, education, working years, professional title, marital status, income and working department (t=49.880, F=5.470-65.006, P<0.01); and there were differences in ethical practice level among nurses of different gender, age, education, working years, professional title, marital status, income and working department (t=36.037, 103.510, F=37.267-132.710, P<0.01). Multiple linear regression analysis showed that different age, working years and professional title have statistically significant influence on the nursing ethical cognitive level; and different gender, working years, professional title, education, income and marital status have statistically significant influence on the nursing ethical practice level. Conclusion The ethical cognition of clinical nurses in Shandong province was in the middle level. Although nurses were aware of the importance of ethics, there were some weak points in ethical practice. The influencing factors include hospital management, society, patients, nurses 'own factors, and national policies. It is recommended to improve ethical cognition and practice status by carrying out continuing education, reducing nurses′ workload, strengthening positive publicity, and strengthening management learning, etc, thus improving nursing quality.