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.

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.

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

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.

Objective To investigate the reliability of a novel rating scale, unified multiple system atrophy rating scale, section Ⅰ(UMSARS-Ⅰ) in the evaluation of illness severity in patients with multiple system atrophy (MSA). Methods A retrospective analysis and a prospective follow-up study were conducted by using UMSARS-Ⅰ in 46 patients with MSA, and the Schwab and England scale was employed and illness severity was graded. The reliability, validity and sensitivity to change of UMSARS-Ⅰ in evaluating the illness severity of MSA were estimated. Results UMSARS-Ⅰ enjoyed high internal consistency (standard Crohnbach's ?=0.88) and sound content, criterion-related, construct and discriminant validity in the evaluation of illness severity of MSA, and a moderate sensiti-vity to change was found(effect size=0.61). Conclusion UMSARS-Ⅰ is a reliable and multidimensional semi-quantitative scale in the measurement of severity and progression of impairment in MSA.

Objective To examine the relationship between plasma homocysteine level and status of congestive heart failure. Methods Plasma homocysteine level was determined in 106 patients with congestive heart failure(CHF).Among them,40 patients were diagnosed as having recent onset of CHF(group 1) and the remaining 66 were receiving conventional treatment(group 2).Thirty healthy subjects were served as a control group. Results(The plasma) homocysteine levels in group 1,group 2 and the control group were(14.87?5.22),(13.25?5.45) and((7.52)?1.73) ?mol/L,respectively.The plasma homocysteine level was significantly higher in group 1 and group 2 than in the control group(P

AIM: To explore the effect of hypertonic sugar eyes drops with local to the oxygen therapy for severe corneal edema after cataract surgery.METHODS: Totally 68 patients (68 eyes) with severe corneal edema after phacoemulsification were selected from January 2014 to December 2015 in our hospital, who were aged 53-80(64.45±4.24), including 30 males and 38 females.According to different treatment, they were divided into treatment group (34 cases) given conventional therapy + hypertonic sugar eyes drops with local to the oxygen therapy, the control group (34 cases) given conventional treatment + hypertonic sugar eyes drops.Visual acuity and corneal situation were observed during the treatment.RESULTS: Corneal edema fade time of treatment group was 11.62+0.53d, that of control group was 15.23±0.62d, the difference between the two groups was significant (P<0.05).Preoperative best corrected visual acuity (BCVA) and corneal endothelial cell count had no significantly difference between the two groups while the corneal endothelial cell count were significantly different compared with postoperative of the two groups (P<0.05).At 7d after treatment, the BCVA and corneal endothelial cell count had significantly difference between the two groups (P<0.05), which did not have significant difference at 1mo after treatment (P>0.05).The effective rates of the two groups was significantly different (P<0.05).CONCLUSION: Hypertonic sugar eyes drops with local to the oxygen therapy is effective for severe corneal edema after cataract surgery.

AIM: To compare the measurement of anterior chamber depth(ACD) inclusive of corneal thickness using intrao-cular lens(IOL) master and ultrasound biomicroscopy (UBM) and evaluate the repeatability of each method.METHODS: Two consecutive measurements of ACD were prospectively performed using IOL master and UBM in 60 eyes in 60 individuals. Mean values were compared using the paired t test. For each individual, ACD measure-ments was performed 5 times to estimate the repeatability of each method by a coefficient of variation(CV).RESULTS: The mean ACD was 2.95±0.25mm with the IOL master and 2.96±0.22mm with the UBM. This diffe-rence was not statistically significant (P=0.631).The coefficient of variation (CV) was 0.56%±0.26% and 0.65%± 0.36% in IOL master and UBM, respectively.CONCLUSION: The mean ACD of IOL master was the same as UBM. The repeatability of IOL master is better than UBM.

AlM: To investigate and evaluate the prevalence of xerophthalmia among aerospace science and technology staff and its influencing factors for the eye health guidance.
METHODS: The staff underwent physical examination in our examination center from September 2013 to June 2014 were preliminary screened, and those patients with symptoms of dry eye were investigated with questionnaires and diagnosed by basic lacrimal secretion test ( Schirmer l ) , breakup time of tear film ( BUT ) test and fluorescein ( FL) staining test .
RESULTS: There were 606 complaints of dry eye symptoms of the 1 000 premiers, distributed in random (60. 6%), and 432 employees were diagnosed (43. 2%). The positive rate of dry eye was 71. 3%. The causes of xerophthalmia, besides of gender, age, also include a variety of factors such as air-conditioner, heating, video terminals, sleep time, etc.
CONCLUSlON: Dry eye, an epidemic disease, has a variety of symptoms and complex etiology, the main causes of aerospace science and technology staff with dry eye is working environment and some local factors. We can give appropriate health guidance according to the different factors. Meanwhile the relevant series of dry eye screening should also be taken as a routine examination in ophthalmic examination.