Objective To investigate the diagnosis and treatment of injury in choledocho-pancreatico-duodenal junction. Methods The clinical data of 6 patients with injury in choledocho-pancreatico-duodenal junction who had been admitted to Beijing Hospital from January 2000 to January 2008 were retrospectively analyzed. Results Of the 6 patients, 4 were diagnosed according to the intraoperative findings, cholangiography and fiber cholangioscopy. The 4 patients were cured after suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage. Two patients developed severe abdominal and retroperitoneal infection and other complications after operation, and were diagnosed by cholangiography and fiber cholangioscopy. Of the 2 patients, 1 was cured and 1 died after multiple drainage procedures and debridement. Conclusions Diagnosis and treatment in the early stage are crucial for the curative purpose. Cholangingraphy and fiber cholangioscopy are effective in the diagnosis of injury in choledocho-pancreatico-duodenal junction. The suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage should be chosen for patients who are diagnosed during primary operation. For patients with abdominal and retroperitoneal abscess and cellulitis, drainage and debridement should be performed, and biliopancreatic diversion and duodenal diverticularizatian are applied to patients when necessary.

Objective To investigate the therapeutic effect of injectingPSby Scalp needle-induced tra-cheal catheter on treatment of neonatal hyaline membrane disease.Methods 26 cases were chosen as control group who were treated in our hospital NICU department during January,2013 to December,2013;the other 31 cases as improved group during January,2014 to January,2015.After administration therapy of drug,the injection time,chest X-ray and blood gas analysis were researched as observation indexes respectively.Results The amelioration of chest X-ray:29 cases in the improved group and 19 cases in the control group after 48 hours treatment,χ2 =4.457, P=0.035;The amelioration of blood gas analysis:pH:(7.38 ±0.08) in improved group and (7.26 ±0.04) in the control group,t=4.981,P=0.030;PaCO2 (mmHg):(39 ±6) in the improved group and (50 ±10) in the control group,t=5.897,P=0.019;PaO2(mmHg):(77 ±6) in the improved group and (67 ±10) in the control group,t=8.026,P=0.006.Conclusion The therapeutic effect of improved group is obviously better than the control group.

Objective To investigate the effect of dexamethasone combined with clomiphene on serum sex hormone levels in patients with polycystic ovary syndrome. Methods 80 pregnancies with polycystic ovary syndrome treated in our hospital from January 2013 to December 2015 were selected and they were randomly divided into observation group and control group with 40 cases in each group. The observation group was given dexamethasone combined with clomiphene, while the control group was given simple clomiphene. Compared the curative effect and the change of the levels of progesterone and estradiol before and after treatment for three months. Results After treatment, the total effective rate of the observation group was 95.00%, higher than the total effective rate of the control group was 72.50%, the difference was statistically significant (P<0.05), compared the levels of progesterone(P), estradiol(E2), luteinizing hormone(LH) and LH/FSH in the observation group and the control group, the difference was statistically significant (P<0.05), after treatment, both levels were higher than before treatment. The total ovulation rate of the observation group was 90.00%, higher than the total ovulation rate of the control group was 72.50%, the difference was statistically significant (P<0.05). The level of progesterone and estradiol in serum of polycystic ovary syndrome treated by dexamethasone combined with clomiphene had a obvious positive correlation (r=0.746, 0.812, 0.731 and 0.796, P<0.05). Conclusion Dexamethasone combined with clomiphene treatment of polycystic ovary syndrome than using only clomiphene treatment is good, which can also improve serum hormone levels in patients, effectively improve the patient's endocrine abnormalities.

Objective To study the curative effect of arthroscopic debridement in the treatment of knee osteoarthritis with moderate-to-severe degenerative cartilage. Methods Arthroscopic knee debridement combined with postoperative rehabilitation exercise was carried out in 17 cases (21 knee joints) of knee osteoarthritis with moderate-to-severe degenerative cartilage. Results The operation time was 55~100 min (mean, 75 min). No surgical complications occurred. The postoperative hospital stay was 15~ 20 days (mean, 13 days). The passive range of motion of the knee joint during the surgery was 0?~120? and the range of motion after the surgery, 0?~110?. Follow-up was conducted for 5~36 months (mean, 21 months). The curative effect was classified as “good” in 6 cases (8 joints), “fair” in 9 cases (11 joints) and “poor” in 2 cases (2 joints). The range of motion of the knee was 0?~ 120?. Conclusions Arthroscopic debridement is an effective option for the treatment of knee osteoarthritis with moderate-to-severe degenerative cartilage.

Bibliometrics ; China ; Pneumoconiosis

Objective To investigate the characteristics of department distribution and antibacterial resistance of multidrug‐re‐sistant(MDR) pathogens in hospital ,and take specific measures for the prevention ,treatment and infection cntrol .Methods Data of 1 816 MDR isolates detected in the hospital from January to December in 2014 were analyzed retrospectively .Results Among the 1 816 MDR strains ,extended‐spectrum β lactamases(ESBLs) producing Escherichia coli ranked first(665 strains ,36 .62% ) ,fol‐lowed by methicillin‐resistant Staphylococcus aureus(387 strains ,21 .31% ) ,MDR Acinetobacter baumannii(295 strains ,16 .22% ) , MDR Pseudomonas aeruginosa(195 strains ,10 .74% ) ,carbapenem‐resistant Enterobacteriaceae(144 strains ,7 .92% ) ,ESBLs pro‐ducing Klebsiella pneumoniae(130 strains ,7 .16% ) .MDR strains were mainly distributed in general department of urology surgery (384 strains ,21 .14% ) ,burn unit(325 strains ,17 .90% ) ,intensive care unit(ICU )(266 strains ,14 .52% ) and department neurosur‐gery(110 strains ,6 .04% ) .Vancomycin and linezolid resistance were not found in methicillin‐resistant Staphylococcus aureus ;less than 2 .9% of the ESBLs producing Escherichia coli and Klebsiella pneumonia strains were resistant to carbapenems .The resistance of carbapenem‐resistant Enterobacteriaceae to amikacin ,sulfamethoxazole‐trimethoprim ,meropenem and tetracycline were relatively low (39 .6% -60 .7% ) .The resistance of MDR Acinetobacter baumannii to levofloxacin ,tetracycline ,sulfamethoxazole‐trime‐thoprim and cefoperazone‐sulbactam were relatively low (48 .9% -76 .5% ) .The resistance of MDR Pseudomonas aeruginosa to amikacin ,ceftazidime ,gentamicin and ciprofloxacin were relatively low(45 .3% -66 .7% ) .Conclusion The MDR pathogens should be monitored in high‐risk department ,preventive measures should be taken ,and antibiotics should be used according to the results of drug susceptibility tests .

Objective: To construct and identify a lentiviral vector harboring RNAi sequence targeting the human high mobility group A1(HMGA1) gene.Methods: The effective sequence of siRNA targeting the HMGA1 gene confirmed in our previous study,the complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed,synthesized and cloned into the pGCL-GFP vector diced by the restriction enzyme of HpaⅠ and XhoⅠ,which contained the U6 promoter and green fluorescent protein(GFP).The resulting lentiviral vector containing HMGA1 shRNA was named LV-sh HMGA1 and confirmed by PCR and DNA sequencing.A total of 293T cells were cotransfected with LV-sh HMGA1,pHelper 1.0 and pHelper 2.0.All the virus stocks were produced by Lipofectamine2000-mediated transfection.The titer of the virus was tested according to the expression level of GFP.Results: PCR analysis and DNA sequencing demonstrated that the RNAi sequence targeting the human HMGA1 gene was successfully inserted into the lentiviral vector.The titer of the recombinant lentiviral vector was 5?107 TU/ml.Conclusion: The successful construction of the lentiviral vector of HMGA1 has prepared the ground for further studies on the functions of the HMGA1 gene with the RNAi technique.

Objective To explore the pattern of lymph node metastasis in patitsen with squamous cell carcinoma of the thoracic esophagus and its significance in lymphadenectomy.Methods The clinical data of 230 patients who received radical esophagectomy with three-field lymphadenectomy was analyzed.The metastatic sites of lymph nodes were correlated with tumor location by chi-square test.Logistic regression was used to analyze the relationship between clinic pathoingical factors and lymph node metastasis.Results Lymph node metastases were found in 133 of the 230 patients(57.8%).The average number of resected lymph nodes was 25.3? 11.4 per patient(range 11～71).The rates of lymph node metastasis were 41.6%,19.44%and 8.3%in the neck,thoracic medi- astinum and abdominal cavity for patients with upper thoracic esophageal carcinoma,33.3%,34.7%and 14%for patients with mid- die thoracic esophageal carcinoma and 36.4 %,34.1%and 43.2 %for patients with lower thoracic esophageal carcinoma.No signifi- cant difference in cervical or thoracic metastatic rate was observed among upper,middle and lower thoracic carcinoma.The difference in lymph node metastatic rate for nodes in the abdominal cavity was significant among upper,middle and lower thoracic carcinoma. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity.Logistic-regression showed depth of tu- mor invasion and angiolymphatic invasion were factors influencing lymph node metastasis.Conclusion Cervical and mediastinal node dissection should be performed independently from tumor location.Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancer than of other locations.Patients with greater tumor grade,depth of tumor invasion and angiolymphatic invasion were more prone to develop lymph node metastasis.

Objective To investigate the protective effects of daidzein (DD) on myocardial hypertrophy and fibrosis induced by pressure overload in rats and to study its mechanism. MethodsMyocardial hypertrophy and fibrosis model of rats induced by pressure overload was prepared by constricting abdominal aorta. The operated rats were randomly divided into sham operated control group, aorta-constricted model group, and three DD groups (30, 60, and 120 mg/kg). Four weeks later, the heart-weight (HW), left ventricular weight (LVW), the ratio of HW/BW and LVW/BW (LVI), and the cardio-myocyte diameters (MD) after dying by HE color were measured. The content of collagen and nitric oxide (NO), the activity of calcineurin (CaN) and Na+, K+-ATPase, Ca2+-ATPase in the left ventricle were quantified with spectrophotometry. The angiotension Ⅱ (AngⅡ) in the left ventricle was messured with radioimmunoassay. Results In aorta-constricted model group, the ratio of HW/BW, LVI, and MD as well as the content of collagen and AngⅡ, the activity of CaN in the left ventricle was significantly increased, and Na+, K+-ATPase, Ca2+-ATPase activity and NO content in the left ventricle were obviously decreased. After treatment of the left ventricular with DD, NO content, Na+, K+-ATPase, Ca2+-ATPase activity were significantly increased, the content of collagen and of AngⅡ and the activity of CaN in the left ventricle and the ratio of HW/BW, LVI, and MD were significantly reduced. ConclusionDD has protective effects on ventricular remodeling in rats with myocardial hypertrophy and fibrosis induced by pressure overload and its mechanism may be related to raising NO content and reducing the level of AngⅡ and the activity of CaN.

Objective To study the methods and skill of vena cava filter placement via the antecubital access. Methods Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF (Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access.