Objective To explore skills and values of needle-knife in difficult papillosphincterotomy.Methods 222 cases underwent needle-like fenestration(NKF),and other 194 cases directly underwent needle-knife papillotomy(NKP) using needle-knife.Results The success rate of operation in the NKF Group and NKP Group was 75.2%(167/222) and 97.9%(190/194) respectively,with total success rate 85.8%(357/416).Infections of biliary tract occurred in 5 cases(1.2%) after operation,in which 3 cases were treated by surgical biliary tract drainage,2 cases were placed drainage tubes under endoscope once again and administrated antibiotics for controlling infection.Pancreatitis occurred in 24 cases(5.8%) postoperatively,in which 1 case of acute severe pancreatitis was cured with abdominal paracentesis drainage in 3 sites,other 23 cases were given medical conservative treatment.1 cases had massive bleeding of incision and was cured by injecting sclerosing agent under endoscope.Conclusions Using niddle-knife can make papillotomy successful in most of standard EST or pre-cut failure.The success rate of NKP is significantly higher than that of NKF,and re-NKP can improve the success rate without increasing severe complications and death mortality,but NKP should be restricted to duodenal hypo-papilla and stenotic terminal of common bile duct.

Objective To establish the animal model with stress ulcer(SU) and probe the relationship between the gastric mucosal injury and lasting stress time,the dynamic structural changes of pH of gastric juice.Methods Twenty-four SD young rats were randomly divided into 4 groups:control group,45 min(groupⅠ),90 min(groupⅡ),3 h(groupⅢ)groups under water immersion restraint stress(WRS).The change of gastric mucosal ulcer index(UI),pH of gastric juice were observed.Results Acute gastric mucosal damage was induced by WRS,with the WRS time prolonged,UI increased gradually and pH of gastric juice remarkably decreased in experimental rats.UI was positively rela-ted with stress time(r=0.957 P

Polymerase chain reaction (PCR) is one of the common techniques in molecular biology, which can amplify nucleic acids through the cycle of denaturation, annealing and extension. Based on the principle of common PCR, rapid PCR is to realize the amplification of nucleic acids in less time without affecting the specificity, sensitivity and fidelity of the reaction. A lot of research work in this field has been going on in recent years. This article will make a review of the development of rapid PCR with emphases on the improvement of DNA polymerase, the choice of additives and the improvement of thermocyclers.

Background Currently,the recommendation when treating acute biliary or pancreatic disease during pregnancy is to perform endoscopic retrograde cholangiopancreatography (ERCP) without radiation exposure,either empirically (with no radiographic guidance) or with ultrasound guidance.However,few published studies compared these two ways.This study aimed to compare ultrasound-guided ERCP with the procedure without radiographic guidance in the treatment of acute pancreaticobiliary disease in pregnant patients.Methods The clinical data of 68 pregnant patients with acute pancreaticobiliary disease admitted to our hospital between January 2004 and May 2010 were reviewed retrospectively.ERCP was performed without radiographic guidance in 36 cases (group A) and with ultrasound guidance in 32 cases (group B).Data on the following variables were compared between the two groups:surgical success rate,rate of complete stone removal,time to resolution of clinical manifestations and laboratory indicators,length of hospital stay,complications,outcome and differences in efficacy of ERCP during different stages of pregnancy.Results In group A,the rates of surgical success and complete removal of stones were 69％ and 60％,respectively; the corresponding values were 91％ and 89％ in group B (P ＜0.05).Postoperatively,clinical manifestations improved rapidly in all patients; there was no statistically significant difference between the groups (P ＞0.05).Leukocyte counts and liver function had improved significantly after one week in all patients; they recovered more quickly in group B ((8.64±1.83)days vs.(14.57±3.74) days,(14.29±4.64) days vs.(20.00±5.40) days,P ＜0.01).The hospital stay was shorter in group B ((16.28±7.25) days vs.(28.00±6.83) days,P＜0.001).The complication rate was 14％ in group A and 3％ in group B (P ＜0.05).There were no significant differences between the two groups in the procedure's efficacy during different stages of pregnancy.Conclusions In the treatment of acute pancreaticobiliary disease during pregnancy,ultrasound-guided ERCP is safer and more effective than performing the procedure empirically without radiographic guidance when performed by experienced practitioners.Its more widespread use is recommended.

ObjectiveTo study the clinical features, arterial involvement, therapeutic strategies and outcomes of Takayasu arteritis (TA). MethodsThe clinical symptoms, arterial images, inflammatory parameters and follow-up information of 173 patients with TA were retrospectively studied. Comparisons between groups were performed by t-test. ResultsThere were 136 female and 37 male patients in this study. The mean age at onset was(26±11 ) years. Hypertension, pulse deficit or asymmetrical pulse, and fever were present in 46.6％, 41.1％, 28.7％ of patients, respectively. The distribution of arterial involvement were 64.7％in aorta, 9.8％ in pulmonary artery, 19.1％ in innominate artery, 65.9％ in common carotid arteries, 65.3％in the subclavian artery, 36.2％ in the renal artery, 12.1％ in the vertebral artery, and 5.8％ in coeliac axis.Elevated erythrocyte sedimentation rate(ESR) was found in 61.0％ patients. Active tuberculosis or history of tuberculosis was implicated in 45 patients(26.0％). Ten patients(5.8％) were hepatitis B virus carriers.Among 105 followed-up patients, 98 patients(94.2％) achieved persistent remission, 17 patients relapsed when corticosteroids were tapered. ConclusionCorticosteroids combined with or steroid alone, supplemented with endovascular intervention procedures or surgical bypass procedures when necessary, can effectively control the clinical symptoms and inflammatory parameters and improve the quality of life of patients.

Age Factors ; Cardiac Output ; physiology ; Cardiography, Impedance ; methods ; Child ; Child, Preschool ; Electric Impedance ; Female ; Heart ; physiology ; Humans ; Male ; Stroke Volume ; physiology ; Tomography ; methods

Objective To evaluate the effect of propofol on noise-induced hearing loss in guinea pigs.Methods Forty-eight healthy adult male guinea pigs,aged 3 months,weighing 400-500 g,were randomly divided into 4 groups (n =12 each) using a random number table:control grotup (C group),propofol group (P group),noise-induced hearing loss group (N group),and propofol + noise-induced hearing loss group (P + N group).A loading dose of propofol 5 mg/kg was infused intravenously over 5 min,followed by infusion at 20 mg· kg-1 · h-1 for 115 min in P and P + N groups,while the equal volume of normal saline was given in N group.N and P+ N groups were exposed to the noise of 4 kHz center frequency and 118-122 dB sound pressure level for 120 min.Distortion product otoacoustic emission (DPOAE) was measured before noise exposure (T1) and at 1 h after the end of noise exposure (T2) and the amplitudes were recorded at the frequencies of 2,4,6 and 8 kHz.After the second measurement of DPOAE,all the animals were sacrificed and organs of Corti were harvested for determination of cochlear 8-isoprostaglandin F(2alpha) (8-iso-PGF2α) content (by ELISA assay) and out hair cell (OHC) count.The rate of OHC lesions was calculated.Results The DPOAE amplitude was significantly lower at frequencies of 4,6 and 8 kHz at T2 than at T1 in N and P + N groups (P ＜ 0.05).Compared with C group,the DPOAE amplitude was significantly decreased at frequencies of 4,6 and 8 kHz at T2,while the cochlear 8-isoPGF2α content and rate of OHC lesions were increased in N and P + N groups (P ＜ 0.05).Compared with N group,the DPOAE amplitude was significantly increased at frequencies of 4,6 and 8 kHz at T2,while the cochlear 8-iso-PGF2α content and rate of OHC lesion were decreased in P + N group (P ＜ 0.05).Conclusion Propofol can reduce noise-induced hearing loss in guinea pigs possibility through decreasing oxidative stress response-induced damage to cochlear OHCs.

Objective To determine the effect of bacille Calmette-Guerin-polysaccharide nucleic acid (BCG/PSN)on 2,4-dinitrochlorobenzene(DNCB)-induced atopic dermatitis-like skin lesions in Nc/Nga mice.Methods Fifteen mice were randomly and equally classified into 3 groups,i.e.,control group receiving topical acetone on foot pad and abdomen and intraperitoneal injection of physiological saline,model group receiving topical 5% DNCB solution and intraperitoneal injection of physiological saline,treatment group receiving 5% DNCB solution and intraperitoneal iniection of BCG/PSN,and all drugs were used every other day for 7 weeks.Further more,0.1% DNCB was topically applied on the ear and neck of Nc/Nga mice once a week from week 2 to week 7.The effects of BCG/PSN were evaluated by ear thickness,skin histopathology and immunological parameters.Results Repeated application of DNCB caused the development of eczematous dermatitis in mice.Mice in model group chnieally manifested skin dryness,erythema,edema and erosion with histopathological changes including dermal and epidermal thickening,hyperkeratosis,and inflammatory infiltration.The serum levels of IL-4 and IrE in model group were significantly higher than those in control group[(174.72±12.64)μg/L vs (17.32±3.56)μg/L,(91.49±6.32)ng/L vs (83.95±6.63)ng/L,both P<0.05].Increased serum IL-12 and IFN-γ and decreased serum IgE were observed in treatment group compared with the model group[(122.10±4.64)ng/L vs (20.14±6.15)ng/L(73.89±2.39)ng/L vs (51.53±3.45)ng/L, (84.27±9.35)μg/L vs (174.72±12.64)μg/L, all P<0.05].Conclusion BCG/PSN might be beneficial for the treatment of atopie dermatitis-like skin lesions in Nc/Nga mice by enhancing the secretion of IL-12 and IFN-γ and suppressing the synthesis of IgE.

Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Language Development ; Sampling Studies

Adult ; Boronic Acids ; therapeutic use ; Bortezomib ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; POEMS Syndrome ; therapy ; Pyrazines ; therapeutic use