Objective To investigate the clinical application value, efficiency and safety of precut sphincterotomy in endoscopic retrograde cholangio-pancreatography (ERCP) .Methods From January 2008 to June 2011, 930 patients received ERCP in the department of hepatobiliary surgery of the first hospital of Jilin University.Of them 108 cases (11.6%) were diverted to receive precut sphincterotomy, because selective bile duct cannulation with conventional method was difficult.Inclusion criteria: failure of conventional cannulation or repeating pancreatic duct cannulation for more than 4 times.According to the patient's conditions, the examination and treatment of ERCP was carried out.Observation termination are therapeutic success rate and the incidence rate of complications, and comparative analysis on case data of routine ERCP was made.Statistical analysis was executed by SPSS 13.0 software.Comparison of ratio were determined with χ2 test, a value less than 0.05 was considered as significant.Results Of 108 cases, the success rate of ERCP was 95.4% (103 cases) .The incidence rate of complications was 6.5%, and there are no cases of duodenal perforation and death.Amongst 822 cases of routine ERCP, therapeutic success rate was 97.7%, and the incidence rate of complications was 7.7%.The statistics analysis result indicates that there are no statistical differences between precut sphincterotomy group and routine ERCP groups in the success rate (χ2=2.041, P=0.153) and the incidence rate of complications (χ2=0.141, P=0.707) .Conclusion The precut sphincterotomy in ERCP are safe and obviously effective with less complications compared to routine ERCP.The successful probability of difficult ERCP is improved greatly by using the technique of precut sphincterotomy.But the precut sphincterotomy indication is strictly controlled, and the technique should be performed by experienced endoscopist.

By collecting literatures on apoplexy recorded in"Database of Basic TCM disease"from 2001 to 2005,we statistically analyzed changes on volume of documents,major authors,major journals,and contents of study in these literatures.

Objective To analyze the current situations of nosoeomial infection tumor and correlated factors,comlnon pathogens and resistance,to provide reference for reasonable clinical use of antibiotics.Methods The specimens of pathogens cultured from 398 Cases of patients with tumor were retrospectively analyzed.Results The rate of the hospital infection oftumor patients was 12.3%,significantly higher than 5.1%,the average infection rate in the 881ne period.The mest common nosocomial infection was in respiratory system.Of the 57 pathogens,Gˉ accounted for 66.7%;G+ 22.8%,and fungus,10.5%.The main bacteria were pseudomonas aeruginosa,Klebsiellapneumonlae,escherichia coli bacteria.Conclusion After nesocomial infections occurred,pathogens should he routinely checked,drugs,susceptibility tested and antibiotics,rationally used.

The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

EML4-ALK fusion oncogene represents a new molecular target which appears mainly in lung adenocarcinoma.EML4-ALK is detected more frequently in young non-small-cell lung cancer patients who never or light smoke.ALK inhibitors(crizotinib)for the treatment of the EML4-ALK-positive non-small cell lung cancer has a high response rate.This finding can improve the individual treatment of non-small cell lung cancer.

Objective To retrospec the efficacy of percutaneous nephrolithotomy on treatment of urinary tract stones in solitary kidney.Methods From June 2008 to April 2011,percutaneous nephrolithotomy technique was used to treat 20 cases of urinary tract stones,with kidney stone or cast form staghorn calculi in 4 cases,single pelvis,calyceal stones 10 cases,6 cases of upper ureteral calculi;Fourteen cases used the standard channel F24;6 cases used F16 Micro Channel.Among the 20 patients,16 cases performed stage Ⅰ single channel surgery;2 cases performed dual-channel surgery in Ⅰ stage;2 patients with severe infection performed stage Ⅱ single channel surgery.Results The average duration of the operation was 66mins.The stone clearance rate was 88.36％ on average(18/20),without laceration or bleeding of pelvis or renal calyces mucosa or any other complications.Postoperative indwelling nephrostomy tubes were removed 6 -7 days later,without complications found during the follow-up period.For the 6 cases with preoperative renal dysfunction before surgery,the levels of blood Cr decreased at 2 weeks after surgery.Conclusion Compared to open surgery,percutaneous nephrolithotomy is safe and effective with small wound in treatment of solitary kidney with invasive upper urinary tract calculi.

Combined therapy consisting of radiotherapy,chemotherapy and palliative surgery is the primary management for locally advanced pancreatic cancer,with the purpose of prolonging survival and improving life quality.Gemcitabine is the standard chemotherapy at present.Gemcitabine-based combinations show a definite effect,and the combination with targeted drugs also has a certain degree of efficacy.The development of new chemotherapy drugs and targeted drugs provides more ways for the teatment of locally advanced pancreatic cancer.

Objective To study the changes in the expression of GABA and its receptors in the dorsal horn of rat spinal cord induced by hind paw formalin injection. Methods Twelve healthy male SD rats weighing 300-325 g were randomly divided into two groups: (A) control group (n=6) and (B) peripheral inflammatory hyperalgesia group in which 5% formalin 50?l was injected subcutaneously into the plantar region of right hind paw to produce persistent pain(n=6). The animals were killed 24h after formalin injection. L_(4-6) segment of the spinal cord was removed. The number of GABA immuno-reactive cells was examined by immuno-cytochemistry technique and the exprpession of GABA_(A?3) and GABA_(B1) receptor mRNA in the spinal dorsal horn were determined by in situ hybridization. Results In control group(A), GABA immuno-reactive cells and GABA_(A?3) and GABA_(B1) receptor mRNA were observed throughout the lumbar spinal dorsal horn. The density of GABA immuno-reactive cells and GABA_(B1) receptor mRNA was highest in the superficial laminae Ⅰ-Ⅲ; while the GABA_(A?3) receptor mRNA was evenly distributed in the spinal dorsal horn. In group B, 24h after formalin injection there was a significant increase in the GABA immuno-reactive cells in the ipsilateral spinal dorsal horn. The expression of GABA_(A?3) and GABA_(B1) receptor mRNA were significantly increased in bilateral dorsal horn compared to group A. The three parameters were positively correlated and their locations in the spinal dorsal horn were not significantly different from those in group A. Conchusion GABA and its receptors may play an important role in nociceptive modulation.

SUMMARY Neuroreceptor imaging with radionuclide tracing in vivo has been greatly developed recently.Distribution,density,and activity of receptors in the brain can be visualized by the radioligands labeled for emission computed tomography(ECT),including PET(positron emission tomography)and SPECT(single photon emission computed tomography).The functional and quantitative imaging for several receptors,such as dopamine receptors,serotonin receptors,cholinergic receptors,benzodiazepine receptors,and opioid receptors,has clinical importance.The preparation of receptor imaging agents,foundation of the physio-mathematical model,and the development of nuclear medicine instruments are the main points.In the present review,we will concentrate on introducing the development of brain receptor imaging.