Objective To investigate the safety and efficacy of endoscopic duodenal papillary muscle small incision(EST)combined with duodenal papillary balloon dilation(EPBD)in the treatment of elderly patients with bile duct stones.Methods 100 elderly patients with bile duct stones were treated with endoscopic stone removal. Among them,55 patients were treated with SEST combined with EPBD(EPBD group),45 patients were treated with a single EST(EST group),the rate of stone removal,the occurrence rate of lithotripsy and the incidence of complications were compared between the two groups.Results The SEST +EPBD group at a time calculi clearance rate,postopera-tive hyperamylasemia,post pancreatitis,cholangitis were 98.2%,7.3% and 3.6%,1.8%,the EST group were 97.7%,6.7%,6.7%,3.6% and the difference between the two groups had no significant(all P >0.05).The SEST+EPBD group of gravel formation rate was 3.6%,lower than 13.3% in the EST group,the difference was statistically significant(χ2 =9.647,P <0.05).The SEST +EPBD group had no bleeding,bleeding in EST group incidence rate was 11.1%,the difference was statistically significant(χ2 =11.235,P <0.05);The recurrence rate of the SEST +EPBD group was 1.8%,which was lower than 11.1% in the EST group,the difference was statistically significant (χ2 =10.113,P <0.05 ).Conclusion EST combined with EPBD in the treatment of elderly common bile duct stones is safe and effective,which can significantly reduce the incidence of debris and bleeding,reduce the recurrence rate of common bile duct stones.

Objective:To summarize the ultrasound features of renal arteriovenous fistula(RAVF)under various ultrasound imaging modes,so as to avoid missed diagnosis of RAVF on initial ultrasound examination.Methods:The clinical data of 6 patients with RAVF,including the ultrasound evidence,the timing of ultrasound diagnosis,the modes of ultrasound diagnosis, and the agreement between ultrasound diagnosis and selective renal arterial angiography,were retrospectively analyzed.Results: 2D ultrasound had 1 case of correct diagnosis,1 case of misdiagnosis and 4 cases of missed diagnosis.Color Doppler and spectral Doppler both had all the 6 cases correctly diagnosed.Ultrasound angiography in 3 cases demonstrated that the contrast agent reached the renal veins earlier than reached the renal parenchyma;large fistula lumen was associated with ischemia of downstream areas.3D ultrasound vividly reflected the structure of fistula lumen volume,and provided us with the profiles of blood signal in fistula at different planes and angles,improving our knowledge of blood flow on the fistula.Conclusion: Ultrasound is the first line screening method for RAVF.Color Doppler plays a decisive role in the diagnosis of RAVF and pulsed spectral Doppler plays a synergetic role and contributes to differential diagnosis.Contrast-enhanced ultrasound may help to discover the abnormality of venous circulation and the ischemic parenehyma area due to shunting.2D ultrasound has a poor diagnostic value and is liable to lead to misdiagnosis and missed diagnosis.

AlM: To observe the treatment efficacy of eyelid herpeszoster with external use ganciclovir ophthalmic gel.METHODS:A total of 77 patients were randomly divided into treatment group and control group. ln the treatment group, ganciclovir ophthalmic gel was topical coated on the basis of antiviral drugs, while the control group was coated with conventional acyclovir ointment and antiviral treatment.
RESULTS: The cure rate was 95% in the treatment group, and the control group was 83% after 10d treatment. The difference was significant.
CONCLUSlON: The efficacy of ganciclovir ophthalmic gel treated eyelid herpes zoster is obvious.

Objective To determine the efficacy of glucose-loweringtreatment by proton magnetic resonance spectroscopy (1H-MRS).Methods Bilateral frontal lobes of 45 male patients with type 2 diabetes mellitus (T2DM) underwent 1 H-MRS separately bythe time it was first diagnosed.Among them,30 were treated with insulin,15 were rejected.The bilateral frontal lobes of all patients were re-examined with 1 H-MRS after 6 months.The ratios of metabolites in the frontal lobe were recorded and compared,and observing whether the lactate(Lac) peak appeared or not.Results Significantly higher values of the N-acetylaspartate (NAA)/creatine (Cr)ratio and NAA/choline (Cho) ratio after 6 months (2.414 2± 0.206 6 and 2.244 2±0.341 5) were found in bilateral frontal lobes compared with pre-therapy (1.905 3±0.135 7 and 1.906 0±0.322 1)(P＜0.05).Significantly lower values of the NAA/Cr ratio and NAA/Cho ratio in the refuse treatment group(1.504 2 ± 0.262 4 and 1.510 0± 0.220 8) were found in bilateral frontal lobes compared with pre therapy (1.960 0±0.175 0 and 1.880 8±0.297 0)(P＜0.05).Lac peak was not detected in the all experiments.Conclusion 1 H-MRS provides valuable information in the assessment and evaluation of clinical efficacy and prognosis of T2DM by detecting the changes of brain metabolism.

Objective: Extracting ephedrine and berberine from the water extract of Ephedra Herba and Rhizoma Coptidis. Methods: Modified PVA was used as separating membrane and separated alkaloids. Results: A colorless ephedrine aqueous solution was obtained when extraction time was less than 8 hours; while a three constitution solution was obtained when time of extraction is over 8 hours. So is Rhizoma Coptidis. The membrane is hardly fouled. Conclusion: Purity of alkaloids from Herba Ephedra and Rhizoma Coptidis by membrane separation is Superior to that by alcoholic sediment but amount of alkaloids is reverse.

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.

This study aims to explore the differences of event-related potential (ERP) between attention deficit hyperactivity disorder (ADHD) and normal children, so that these differences provide scientific basis for the diagnosis of ADHD. Eight children were identified to be ADHD group by the diagnostic criteria of DSM-IV (diagnostic and statistical manual of mental disorders-IV), and the control group also consisted of 8 normal children. Modified visual-continuous performance test (CPT) was used as the experiment paradigm. The experiment included two major conditions, i. e. Go and NoGo. All the 16 subjects participated in the study. A high density EEG acquisition instrument was used to record the EEG signal and processed these EEG data by means of ERP and spectrum analysis. P2-N2 peak-peak value and spectral peak around 11 Hz were analyzed between ADHD subjects and those in the control group, and then statistical tests were applied to these two groups. Results showed that: (1) Under the condition of Go, ADHD group had a significant lower P2-N2 peak-peak value than the values in the control group (P < 0.05); but under the condition of NoGo there was no significant difference in between. (2) Compared with the control group, the ADHD group had significant lower spectral amplitude around 11 Hz under the condition of NoGo (P < 0.05). However, under the condition of Go the difference was insignificant. In conclusion, there is certain cognitive dysfunction in ADHD children. P2-N2 peak-peak value and spectral peak around 11 Hz could be considered as clinical evaluation indexes of ADHD children's cognitive function. These two objective indexes provide an early diagnosis and effective treatment of ADHD.
Attention Deficit Disorder with Hyperactivity ; diagnosis ; physiopathology ; Brain ; physiopathology ; Case-Control Studies ; Child ; Cognition Disorders ; diagnosis ; physiopathology ; Electroencephalography ; Evoked Potentials ; Humans

Objective To discuss the surgical treatment for huge hepatoblastoma in children,and the technique of hepatectomy without blockade of the blood supply to the remained liver lobes.Methods We reviewed 12 cases of huge hepatoblastorna who had been operated from July 2001 to January 2009 in our hospital.The mean age of the children was 3.2 years(range,11 months to 12 years).The diameter of the tumor was from 10 to 23 cm.3～7 cycles of chemotherapy was routinely administrated before operation.When the tumor reduced to a certain size that radical resection could be performed safely,regular hepatectomy was conducted.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes was performed in every patient.Results The operations were successfully accomplished in all the 12 children.5 cases received right trihepatectomy (segment Ⅳ,Ⅴ～Ⅷ),4 cases received right hemihepatectomy(segment Ⅴ～Ⅷ),and the other 3 cases received Ⅳ,Ⅶ,Ⅷ segmentectomy,right Ⅴ,Ⅵ segmentectomy,and left hemihepatectomy respectively.The intraoperative hemodynamic parameters were stable,and there was no perioperative mortality.Postoperative chemotherapy wag routinely administrated.The follow-up period varied from 2 to 92 months.11 children survived and were disease free,among those 6 children have survived for more than 5 years.One child had brain and lung metastasis 5 months post operation,and died 7 months post operation. Conclusion Preoperative chemotherapy administrated to children with huge hepatoblastoma can reduce the tumor size and render tumor reseetable.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes is a safe and feasible surgical technique.

Acute Disease ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infusions, Intravenous ; Male ; Theophylline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

Objective To evaluate the effect of non-linear blending function for dual-energy CT on image of pulmonary angiogra-phy.Methods 27 patients underwent dual energy CT pulmonary angiography(CTPA).Data obtained with 100 kVp,140kVp,and non-linear blending were divided into group A,B,and C respectively.CT value of emboli were measured.Corresponding signal to noise ratio(SNR )and contrast to noise ratio(CNR)were calculated.One-way Anova analysis and Friedman test were used to ana-lyze statistical significance among these values.Results On quantitative analysis of 27 patients,there was no statistical difference for CT value of CTPA among the three groups(P >0.05).For the noise,CNR and SNR,there were statistically significant among the three groups(P <0.05).Conclusion The non-linear blending function has certain advantages in improved image signal-to-noise ratio and it can be used in CT pulmonary angiography examination for patients suspected pulmonary embolism clinically .