In recent years,endoscopic technique has become a basic procedure for the diagnosis and treatment of biliary and pancreatic diseases,thus the procedure-related complications of ERCP and endoscopic sphincterotomy(EST) become prominent day by day. Post-EST bleeding is one of the most serious complications of the procedure,and its first line treatment involves a variety of endoscopic techniques,such as epinephrine or fibrin glue local injection,electric coagulation and heat probe,clamps and covered metal stents. If these are not successful,transcatheter arterial embolization or surgical operation should be considered. In this article,the above-mentioned treatment modalities of post-EST bleeding were reviewed.

Objective To analyse the effect of repaglinide combined with Zhenqi Jiangtang Capsules on βcell function in elderly patients with type 2 diabetes mellitus.Methods 60 elderly patients were collected from harbour branch of Hainan provincial People's hospital, who were diagnosed with type 2 diabetes mellitus .All patients were randomly divided into experimental group and control group, 30 cases in each group, 2 groups of patients were given control diet, moderate exercise, and other conventional adjuvant therapy.Control group was treated with repaglinide orally on the basis of routine adjuvant treatment, 1 mg/times, three times per day,experimental group were given Zhenqi Jiangtang Capsules based on the treatment in control group,4 grains/times,three times per day.Both groups were treated for 4 weeks, after the end of treatment, blood glucose levels,serum insulin levels,βcell function and serum lipids in all patients were detected.ResuIts After treatment, compared with control group, the levels of blood glucose, HbA1c and AUCg in experimental group were significantly lower ( P<0.05 );the insulin levels 30 min,60 min, 120 min after meal were significantly higher (P<0.05);the HOMA-IR of patients was significantly lower(P<0.05);IRG, AUCi and AUCi/AUCg were significantly higher (P<0.05);the serum TC, TG, LDL levels were significantly lower, serum HDL levels were significantly higher(P<0.05).ConcIusion Repaglinide combined with Zhenqi Jiangtang Capsules can significantly reduce the blood glucose and lipid levels in elderly patients with type 2 diabetes, improve the function of pancreatic beta cells, promote postprandial insulin secretion and improve insulin resistance.

In the paper, 32 lots of intravenous immunoglobulin (IVIG)were tested by an animal model,the hypotensive test of rats. A linear correlation was found between prekallikrein activator (PKA)activity and hypotensive reaction if the inflow of human IVIG was made rapid (r=0.96,n=23). The preliminary observations indicated that it would be satisfactory that the PKA activity was below 35IU/ ml and the size of reduction in blood pressure was not 15% higher than that of control animal's level.The rat model can provide a method for safe usage of the intravenous immunoglobulin and reliable detection of and control over the residual PKA activity in blood products.

Objective To observe critical patients with thrombocytopenia,and exam their coagulation function,so as to diagnose disseminated intravascular coagulation(DIC)in the early stage.Methods Totally 56 critical patients complicated with thrombocytopenia were enrolled in the investigation;complete set of DIC tests were performed.A total of 26 cases were diagnosed as DIC according to the criteria from the International Society of Thrombosis Haemostasis(ISTH).The sensitivity,specificity,accuracy,likelihood ratio,predictive value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),antithrombin Ⅲ and bleeding signs(including petechia and ecchymosia)were calculated by applying fourfold table.Results The specificity of PT prolongation and Fg reduction was 87.0%;the sensitivity of ATⅢ decrease,and each of PT prolongation,Fg reduction,and bleeding(including petechia and ecchymosis)were as high as 96.0%.Conclusion Multi-markers based on thrombocytopenia are likely to improve sensitivity and specificity of DIC diagnosis.

OBJECTIVE To observe the therapeutic effectiveness and safety of the indigenous teicoplanin in intensive care unit(ICU) patients with severe infections of Gram-positive(G+) cocci.METHODS Sixty patients with severe Gram-positive bacteria infection received teicoplanin which was produced by Xinchang Pharmaceutical Factory of Zhejiang Medicine Co,Ltd.by infusion for 7-14 d.Dosage was adjusted according to the creatinine clearance rate.Maximum temperature,APACHEⅡ score,indicators of inflammatory response,liver and kidney function,microbiologic examination and adverse reactions were observed before treatment and the end of 7-14 day treatment.RESULTS Seventy-two strains of Gram-positive cocci were isolated from 60 patients,in which meticillin-resistant Staphylococcus aureus(MRSA),meticillin-resistant S.epidermidis(MRSE),Enterococcus faecium,E.faecalis,S.haemolyticus and E.gallinarum accounted for 58.33%,8.33%,16.67%,5.56%,8.33% and 2.78%,respectively.After treatment,59 strains of Gram-positive cocci were eliminated while 13 strains were not eliminated and bacteriological eliminated rate(calculated by strains) was 86.1%;In this group,twenty-eight patients were cured while twenty-two cases were markedly improved.The total bacteriological eliminated rate was 81.94%.The incidence of adverse reactions was low and only a slight increase or decrease in platelet count was observed which didn′t require special treatment interventions.CONCLUSIONS Indigenous teicoplanin has certain therapeutic effectiveness and is safe for severe Gram-positive bacteria infected patients,particularly for septic patients with organ damage in ICU.In patients highly suspected with meticillin-resistant staphylococci or enterococci infection,teicoplanin may be a choice for initial empirical treatment.

Aim To explore the effect of m-Nisoldipine(m-Nis) on 5-HT-induced proliferation,migration of rat PASMCs and to study the mechanisms.Methods PASMCs were cultured with the explant technique,and were divided into 6 groups:control group,5-HT(1 μmol·L~(-1)) group and m-Nis(10~(-5),10~(-6),10~(-7),10~(-8) mol·L~(-1))group.MTT assay was used to evaluate the proliferation of PASMCs,and transwell chambers were used to detect the migration of PASMCs.In addition,the expression of PCNA and the phosphorylation of ERK1/2 were evaluated by Western blot analysis.Results m-Nis inhibited the proliferation(P<0.05 or P<0.01)and migration(P<0.01)of rat PASMCs induced by 5-HT obviously.Similarly,Western blot analysis of PCNA indicated that the expression of PCNA was significantly higher in 5-HT group than that in control group(P<0.01).Whereas,in four m-Nis treated groups,the level of PCNA was markedly decreased(P<0.05 or P<0.01).Meanwhile,m-Nis 10~(-5),10~(-6) and 10~(-7) mol·L~(-1) pretreatment also reduced 5-HT-induced phosphorylation of ERK1/2 obviously(P<0.05 or P<0.01).Conclusion m-Nis inhibits 5-HT-induced proliferation and migration of rat PASMCs obviously,which may be related to the inhibition of PCNA expression and the blockage of ERK1/2/MAPK signal pathway.

Effect of new calcium antagonist m-nisoldipine (m-Nis) on MCT-induced PH in rats and its mechanisms were investigated. Rats were injected with a single doxe(60mg·kg-1)of MCT subcutaneously to induce PH. Pulmonary haemedynamic measurement and lung tissue morphological investigations were undertaken. The MDA production and SOD activity in the serum were tested. PCNA,ERK1 and p-ERK expressions were analyzed by Western blotting. The expressions of 5-HT and PCNA were observed with immunohistochemistry. Results suggested that the PAP, right ventricular index and the degree of muscularization of small pulmonary artery were elevated markedly in MCT group, which was attenuated by m-Nis treatment. A significant reduction in MDA production and an increase in the SOD activity in the serum were also observed in all three m-Nis groups. The number of PCNA and 5-HT positive smooth muscle cells increased significantly in MCT group, and m-Nis treatment attenuated the expression obviously. Western blotting results suggested that the protein expression of PCNA and the ratio of p-ERK/ERK1 increased markedly in MCT group and decreased by m-Nis. In conclusion, m-Nis protected against MCT-induced PH by decreasing PAP, right ventricular index, PAMSCs proliferation and pulmonary artery remodelling, which may be related to the reduction of 5-HT and the suppression of the ERK/MAPK signal pathway.

To train health supervision talents , one of the scarce talent cultivation plans of National Health and Family Planning Commission, the undergraduate of health supervision was set up by Harbin Medical University and approved by the Ministry of education in 2012. According to the problems of personnel training, the competency model of health supervision was established through empirical research, which covered six aspects and 33 factors, and based on the model, the personnel training model was developed to cultivate the compound health supervision talents to meet the demand of health supervision, and the curriculum system covered medical, law, supervision and management courses. In order to realize the target of talent training, some viable measures were taken such as re-forming the traditional teaching methods, establishing comprehensive teachers, strengthening teacher training, and so on.

Objective To evaluate the efficacy of STERRAD (r) 100S (low temperature hydrogen peroxide gas plasma sterilization system) by comparing with formaldehyde steam. Methods From 2005.1 to 2005.3, totally sterilization of 2 760 pieces of operating tools were carried out with formaldehyde steam. From 2005.1 to 2005.3, totally sterilization of 4 950 pieces of operating tools in 180 circles were carried out with STERRAD (r) 100S. The instrument damage rate, operating infection rate and satisfaction rate of medical workers of 2 groups were compared. Results All data were in favor of the efficacy of STERRAD (r) 100S. Conclusions STERRAD (r) 100S is a safe, effective, low temperature, and cost-effective sterilization system..

Objective To study the inhibitory effect of valdecoxib on Lewis tumor and the potential relationship with cyclooxygenase-2(COX-2).Methods HE staining was used to observe lymphocyte infiltration in tumor tissue and the cell structure of the stomach and colon.Western blotting was used to detect the expression of COX-2 in tumor tissue.PGE_2 ELISA kit was used to detect the content of PGE_2 in tumor tissue.Results ① Valdecoxib inhibited the growth of the tumor,and the survival rate was increased.②There was lymphocyte infiltration in treatment group and the content of PGE_2 was decreased.③Valdecoxib did not affect cell structure of stomach and colon,bleeding and clotting time.Conclusion Valdecoxib inhibits the growth of the Lewis tumor and enhances the survival rate.The effect of valdecoxib is related to the inhibition of COX-2.