Objective To explore the application of plastic pancreatic stents and/or nasal biliary drainage for choledocholithiasis patients having DSBC during Endoscopic Retrograde Cholangiopancreatography (ERCP).Methods Retrospective analysis on clinical data of 57 ERCP cases aiming at choledocholithiasis patients having DSBC from January 2010 to December 2015 has been carried out. According to the guide wire cannulation in an operation, patients are divided into three groups, i.e. plastic pancreatic stents group, nasal biliary drainage group, and plastic pancreatic stents + nasal biliary drainage group, so as to observe the success rate of operation and the occurrence rate of postoperative complications, such as pancreatitis or hyperamylasemia, as well as to compare the differences between the three groups.Results Out of the 57 patients receiving ERCP, 13 patients are in the plastic pancreatic stents group, with two successful operations (15.4%), one case of hyperamylasemia (7.7%), two cases of postoperative pancreatitis (15.4%), one case of fever (7.7%) and one case of hemorrhage (7.7%); 20 patients are in the nasal biliary drainage group, with 20 successful operations (100.0%), no occurrence of hyperamylasemia or postoperative pancreatitis or other complications including hemorrhage and fever; 24 patients are in the plastic pancreatic stents + nasal biliary drainage group, with 19 ERCP operations succeeded at the first attempt (79.2%) and 5 ERCP operations succeeded at the second try (20.8%), as well as 4 cases of hyperamylasemia (16.7%), 2 cases of hemorrhage (8.3%) , no occurrence of fever cases and postoperative pancreatitis. In comparison between the three groups, the occurrence of postoperative pancreatitis and successful rate of operation show a significant difference.Conclusion By adopting plastic pancreatic stents and/or nasal biliary drainage for patients having a dififcult selective biliary cannulation during ERCP, the success rate of operation can be improved, and the occurrence of pancreatitis can also be reduced.

Objective To examine the levels of fractional exhaled nitric oxide in bronchial asthma and the cor-relation between fractional exhaled nitric oxide and pulmonary function tests as well as the value of pulmonary function tests in curing the children with bronchial asthma. Methods Seventy - two asthmatic children came from Guiyang Ma-ternal and Child Health Hospital were studied. They were divided into 2 groups:mild - to - moderate asthma group(36 cases)and serious asthma group(36 cases). Fractional exhaled nitric oxide level and the lung function were measured and the correlation analysis was analyzed by SPSS 13. 0 software. Results The fractional exhaled nitric oxide concen-tration of the serious asthma group was significantly higher than that of the mild - to - moderate asthma group[(47 ± 26)ppb vs(29 ± 15)ppb,t = 3. 543,P ﹤ 0. 01],1 - second rate,maximum mid - expiratory flow(MMEF),and peak expiratory flow(PEF)in mild - to - moderate asthma group were significantly higher than those in serious asthma group[(99. 74 ± 9. 81)% vs(87. 17 ± 13. 30)% ,(87. 12 ± 35. 61)% vs(68. 90 ± 30. 88)% ,(99. 97 ± 10. 83)% vs (94. 31 ± 17. 69)% ](P ﹤ 0. 01,0. 05,0. 05). No correlations were found between fractional exhaled nitric oxide level and the lung function parameters,including forced expiratory volume in 1s(FEV1),1 - second rate,MMEF and PEF in the mild - to - moderate asthma group(r = 0. 073,0. 087,0. 242,0. 326,all P ﹥ 0. 05). However the level of fractional exhaled nitric oxide was negatively correlated with the lung function parameters,including FEV1,FEV1 / FVC,MMEF and PEF in serious asthma group(r = - 0. 354,- 0. 573,- 0. 478,- 0. 471,P ﹤ 0. 05,0. 001,0. 005,0. 005),respec-tively. Conclusions Monitoring of fractional exhaled nitric oxide and the lung function parameters can effectively indi-cate the state of illness of asthmatic child,which plays a key role in the treatment.

Objective To investigate pathological characteristics and differential diagnosis of desmoplastic melanocytic nevus.Methods Four cases of desmoplastic melanocytic nevus were analyzed based on the clinical manifestations and histological,immunohistochemical and fluorescence in situ hybridization (FISH) features.Results Of the 4 cases,2 were male and 2 were female.Their age ranged from 19 to 30 years with the average age being 26.5 years.The skin lesions were located on the extremities in 3 cases,on the vulva in 1 case.Histologically,the lesions were bilaterally symmetrical intradermal nevus.Nevus cells appeared epithelioid and/or fusiform,some were clustered or scattered in the proliferative fibrous tissue.None of lymphocyte aggregation,necrosis or ulceration was observed.Immunohistochemical examination showed positive staining for S100 and Melan A in 3 cases,positive staining for P16 in 2 cases,Ki-67-1abeling index less than 5％ in all the 4 cases,and negative staining for factor XⅢ (FXⅢ) and CD34 in 2 cases.FISH assay showed no copy-number variations in gene loci 6p25 (RREB1),6q23 (MYB),6p11.1-q11.1 (Cep6) and 11q13 (CCND1) in desmoplastic nelanocytic nevus.Conclusion Desmoplastic melanocytic nevus is a kind of histologically unique,benign melanocytic nevus,and immunohistochemical staining for Ki-67,S-100,Melan A and FXmand FISH assay on melanoma can be helpful for the differential diagnosis between cutaneous fibrous histiocytoma and melanoma.

Objective To determine the activity concentration of radionuclides for 137Cs and 40K in edible wild mushrooms,and to evaluate the extent of radioactive contamination and ingestion doses to adults from consumption of these wild mushrooms.Methods A total of 33 samples for 18 edible wild mushroom species were collected from natural forest Mangshi,Yunnan province.The activity concentrations of 137Cs and 40K were analyzed by using high-purity germanium (HPGe) gamma spectrometry.Results Except.for one sample that was below the MDA,137Cs artificial radionuclides were detected in other 32 samples,with activity concentration of 137Cs in the range of 0.45-339.58 Bq/kg (dry weight) and an average of 25.47 Bq/kg (dry weight).In regards to 40K in edible mushrooms,all species presented the activity concentrations for this radionuclide and the levels varied from 453.4 to 1 882.6 Bq/kg (dry weight),with an average of 815.1 Bq/kg (dry weight).After species of mushroom with only one sample were eliminated,there was significant difference for 137Cs(F =21.13,P ＜ 0.05) among 6 species of mushroom named Gomphus floccosus (Schw.) Sing.,Boletus edulis bull,Boletus edulis bull,Tylopllus bolloul (Peck) Sing.,Lentinus edodes (Berk.) Sing.and Boletus brunneissimus W.F.Chin,but without significant difference for 40K.Conclusions These 6 different mushroom species have different capacity to retain radionuclides of 137Cs in soil.These wild mushrooms,such as Gomphus floccosus (Schw.) Sing.and Lentinus edodes (Berk.) Sing.have large affinity ability for radionuclides137Cs.The effective dose to adults attributable to consuming these kinds of mushrooms is small and below the level that could cause harm.

Objective To test a full range of processes of sample collection,preparation,measurement and analysis by conducting the intercomparison of gamma-ray spectrometry measurement and analysis of radionuclides among key laboratories,so as to facilitate the development of gamma-ray spectrometry measurement and analysis technology.Methods To complete the collection and preparation of soil samples by Chinese Center for Disease Control and Prevention (CDC) laboratory and to measure and analyze the content in two soil samples of 214Pb,214Bi,208TI,228Ac,40K and 137Cs by three laboratories using gamma-ray spectrometry.Results The value calculated by any two laboratories were less than 1 in terms of assessment standards agreed by these three laboratories and based on the activity concentrations and the total uncertainty reported from them.The measurement results from our lab were acceptable.Conclusions Measurement results from these three laboratories are in agreement to some extent.This intercomparison activity has tested the analytical ability of the three laboratories and raised the level of our laboratory in testing homogeneity of sample preparation.

The professional quality training ofthree orientedpersonnel training mode is one of the three core, which requires medical students to have lifelong learning ability. This study mainly describes the proposed concept of lifelong learning ability, expounds the necessity of lifelong learning ability, and analyzes the connotation, objective and strategies of improving the medical students'!lifelong learning ability under the framework of three oriented medical talents training mode. The training strategy has been discussed mainly from five aspects such as strengthening medical humanistic education, creating a lifelong learning atmosphere in campus, optimizing teaching methods, reform the course of career development and employ-ment guidance, reforming the course of career development and employment guidance, reforming the teaching of medical literature retrieval course and establishing the personal growth archives.

of NB4 cells at S phase was lower than those in control group (P <0.05),and the number of NB4 cells at G1 phase was increased (P <0.05).The expression levels of Bcl-2 in ICA groups were significantly lower than that in control group (P < 0.05 ), while the expression levels of Bax were higher than that in control group (P < 0.05 ). Conclusion ICA can induce the apoptosis of NB4 cells via inhibiting the expression level of Bcl-2 and up-regulating the expression level of Bax.

[ ABSTRACT] AIM:To explore the effects of eplerenone on the expression and activity of aortic endothelial nitric oxide synthase ( eNOS) in high salt-induced hypertensive rats .METHODS: Male Wistar rats (4 week old, weighting 50~60 g) were randomly divided into control group , high-salt diet group and eplerenone group .The rats in control group were fed with ordinary rodent animal diet , the rats in high-salt group and eplerenone group were exposed to 5%salt diet for 16 weeks and administrated with the same dosage of saline or eplerenone (40 mg? kg-1? d-1 ) by gavage for 4 weeks, re-spectively.Systolic blood pressure (SBP) was measured by tail-cuff every 2 weeks.The rats were sacrificed after 16 weeks and the thoracic aorta was collected .The aldosterone content in the aorta was measured by ELISA .The protein levels of mineralocorticoid receptor (MR) and eNOS were determined by Western blot.The activitie of constitutive NOS (cNOS) was measured by chemocolorimetry .The protein localization of eNOS , neuronal nitric oxide synthase ( nNOS) and MR was observed by immunohistochemistry .RESULTS: A process of 8-week high-salt diet increased SBP gradually .SBP in the rats exposure to high salt for 16 weeks was significantly higher than that in control group ( P<0.05 ) .After 4 weeks of eplerenone treatment, SBP in the rats was significantly lower than that before treatment (P<0.05).Compared with control group, the aldosterone content in the aorta were significantly increased in high-salt diet group and eplerenone group ( P<0.05), the expression level of MR also increased significantly (P<0.05).Compared with control group, both eNOS pro-tein expression (P<0.05) and cNOS activity in high-salt diet group were significantly decreased (P<0.05).The protein expression of eNOS as well as cNOS activity in aorta increased significantly in eplerenone group compared with high -salt diet group (P<0.05).CONCLUSION:Aldosterone content in aorta of high-salt-induced hypertensive rats increases signifi-cantly .Aldosterone attenuates the protein expression of eNOS and reduces the enzyme activity through the activation of min -eralocorticoid receptor .The selective mineralocorticoid receptor antagonist eplerenone enhances the protein expression of eNOS and its activity , thereby improves eNOS function .

OBJECTIVETo explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds.

METHODSNinety patients of burn injury were randomized into 3 groups, 30 cases in each one. In the group A, fentanyl citrate injection was used at corresponding injury area, jiaogan (AH6a, sympathetic nerve), fei (CO14, lung), neifenmi (CO18, endocrine) on ear, 0.25 mL at each point. In the group B, fentanyl citrate injection was applied subcutaneously in the deltoid muscle, 1 mL. In the group C, 0.9% sodium chloride injection was applied subcutaneously in the deltoid muscle, 1 mL. The visual analogue scale (VAS) was used to evaluate the analgesic effect before, during and 10 min after dressing change in the patients of the three groups separately.

RESULTSIt was not different in VAS score before dressing change among the three groups (P> 0.05). Compared with that before dressing change, the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A (both P>0.05), but the score in the patients of the group B and C was different significantly (all P<0.05). The VAS score during and after dressing change in the group A was lower than that in the group B and C (all P<0.05), and the score in the group B was lower than that in the group C (P<0.05).

CONCLUSIONFentanyl injection of small dose at auricular points achieves definite analgesic effect on procedural pain in dressing changes of burn wounds, superior to subcutaneous injection of fentanyl.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Burns ; complications ; therapy ; Female ; Fentanyl ; administration & dosage ; Humans ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Pain Measurement ; Young Adult

Objective To investigate the functional changes of dendritic cells (DC) in elderly patients with sepsis. Method Elderly patients (n = 20), ages 75 to 86 years, treated in the department of internal medicine for cadres and the medical intensive care unit (MICU), were selected to participate in the study. Patients with ma-ligoant tumors, hematological diseases, immune diseases, or a history of receiving drugs known to interfere with immune functions were excluded. Using the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) definition of sepsis, the patients were categorized into four groups: non-sepsis (group A) (n = 5) ; sepsis (group B) (n = 5) ; severe sepsis (group C) (n = 5) ; and septic shock (group D) (n = 5). The peripheral blood mononuclear cells (PBMCs) of each patient were isolated and cultured with human re-combinant granuloceyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) in vitro for 10 days. The cells were examined under an inverted microscope, scanning electron microscopy, and flow cytometry. The MTT colorimetric assay was used to observe the abilities of the dendritic cells to stimulale an allogeneic T lym-phocyte response in vitro. Paired t -test was used to compare changes in the surface markers among the different groups, Results The PBMCs in the four groups of patients differentiated into cells with typical dendritic configura-tions after in vitro cuhure with combined cytokines. The CD40, CD80, CD86, and HLA-DR expressions on the cell surfaces increased after culture,with (43.2±12.5)%/(27.3±9.3)%, (31.4 ± 10.1)%/(22.5 ± 8.7)%, (39.3±15.7)%/(21.9±7.7)%, and (75.4±25.6)%/(58.7±16.7)%, respectively. The stimulation index (the abilities of the dendritic cells to stimulale the allogeneic T lymphocyte response in vitro) in the four groups of patients after culture were (23.3±7.9) in group A, (18.9±8.3) in group B,(11.4±5.1) in Group C,and (5.5 ± 3.7) in Group D. Conclusions The immune functions of the dendritic cells of elderly patients with sepsis decrease in a linear manner with the severity of their septic state.