Objective To discuss the implication of ectopic opening of the pancreaticobiliary duct in the performance of cholangiopancreatography (ERCP) and the diagnosis and treatment of cholangio-pancreatic disease. Methods We summarize the data of 1000 cases of ERCP in the past four years. Five patients were found with ectopic opening of the pancreaticobiliary duct. The positions, characteristics of ectopic opening and the characteristics of the mucosa disease around the ectopic papilla and cholangio-pancreatic disease were analyzed. Results In the 5 patients with ectopic opening of the papilla, one had the opening in the pyloric channal, two in the duodenal bulb, the other two in the distance of the descending part of duodenum. Mucosa erosion was found in the patients with ectopic opening in the pyloric channal and in the duodenal bulb. Conclusion The ectopic opening of the pancreaticobiliary duct may affect the finding of the papilla, but may not affect the performance of ERCP. The incidence of the cholangiopancreatic disease and the mucosa disease around the ectopic papilla will increase in the patients with ectopic opening.

Objective To observe the effect of SIRT1 on the proliferation of ovarian cancer CAOV3 cells and its possible mechanism. Methods Ovarian cancer CAOV3 cells were transfected the Lipofectamine 2000 and were divided into normal control group,negative control group and SIRT1-siRNA group.The mRNA and protein expression levels of SIRT1 were detected by RT-PCR and Western blot.MTT method was used to detect the proliferation of RNA interference at 24h,48h and 72h,respectively.The distribution of CAOV3 cell cycle phase after RNA interference of SIRT1 for 72 hours was detected by flow cytometry.SIRT1,p53,p21 protein expression and p53 acetylation status were detected by Western blot with RNA interference of SIRT1 after 72 hours.The interaction between SIRT1 and p53 protein was verified by immunoprecipitation in CAOV3 cells.Results Compared with negative control group,the expression of mRNA and protein of SIRT1 in SIRT1-siRNA group decreased after transfection of SIRT1 for 72 hours.The survival rate of CAOV3 cells in SIRT1-siRNA group decreased significantly at 48 hours and 72 hours (P<0.01).The proportion of Sphase cells in CAOV3 cells transfected with SIRT1-siRNA for 72h was significantly decreased (P<0.01),while the G1 phase cells were significantly increased (P<0.01),and the cells arrested in the G1 phase.The expression of p53 and p21 proteins were significantly increased and the p53 was in higher acetylation status after transfection with SIRT1-siRNA for 72 hours ( P<0.01 ) .SIRT1 was interacted with p53 protein in CAOV3 cells confirmed by co-immunoprecipitation. Conclusion Downregulation of SIRT1 expression can inhibit the proliferation of ovarian cancer CAOV3 cells, which maybe connected with p53 at high acetylation status,and enhancing p53-dependent p21 transcriptional activation,thus blocking the cell cycle and inhibiting the cell proliferation.

Objective To apply failure mode and effect analysis (FMEA) to reduce nursing risk of peripherally inserted central catheter (PICC).Methods 100 patients with PICC in central hospital of Minxing District of Shanghai were named as the experimental group,failure mode and effect analysis were performed in this group to obtain the value of risk priority number (PRN) and array them according to the RPN value to work out improved plan systematically and put it into practice to guide the clinical operation and nursing care.98 PICC patients in Xinzhuang health service center and Tumor Hospital of Minhang district were set as the control group,which were subjected to traditional nursing.All statistical analysis were done by SPSS 11.0 software package,the differences of the incidence of PICC-related nursing risk between the two groups due to the implementation of FMEA was analyzed by X2 test.Results Application of FMEA could reduce the nursing risk of PICC,After the application of FMEA,the incidence of PICC-related complications such as focal or systemic infection,puncture site oozing and bleeding,skin allergies,mechanical phlebitis,too deeply placed catheter,catheterization into cervical veins and reflexed into axillary vein,catheter occlusion,catheter migration,difficult removal of catheter,puncture failure in the experimental group decreased obviously,the differences had statistical meaning.Conclusions The application of failure mode and effects analysis can reduce the nursing risk of PICC,decrease medical disputes,alleviate the suffering of patients,reduce medical costs caused by PICC-related complications,and improve the satisfaction degree of patients and the quality of nursing care.

AIM:To evaluate the effect of bFGF on the apoptosis and the expression of glucose regulated protein 78(GRP78) in ovarian cancer CAOV3 cells.METHODS:Starvation induced cell apoptosis was conducted.After treatment with bFGF,the cell cycle and apoptosis were determined by FACS analysis and Annexin V/PI staining,respectively.The expression of protein kinase B(PKB) and GRP78 were detected by Western blotting and RT-PCR.RESULTS:Compared to starvation group,the cells treated with bFGF were still viable and increased activation of PKB and high expression of GRP78 were observed,which were prevented by PKB inhibitor wortmannin effectively(P

Objective To investigate the influence of endoscopic retrograde cholangiography (ERC), endoscopic retrograde pancreatography (ERP), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and endoscopic biliary stenting on postoperative pancreatitis. Methods 412 patients referred to ERCP were divide into 7 groups, there were both biliary and pancreatic ducts group (ERCP), biliary duct contrast filling group (ERC), pancreatic duct contrast filling group (ERP), ERCP plus biliary stenting group (stent), ERC plus stent, ERCP plus EST and stone extraction (SE) group, and ERC plus EST and SE group. And the differences of postoperative serum amylase in 4 hours and in 24 hours as well as clinical symptoms were compared among different groups. Results The incidence of postoperative hyperamylasaemia in 4 hours and 24 hours were 17.7% and 4.4% respectively. The incidence of postoperative acute pancreatitis was 3.9%, and ERP group had the highest incidence of postoperative acute pancreatitis among the 7 groups. Conclusions Repeated pancreatic duct contrast filling during ERCP manipulation is the main risk factor for postoperative pancreatitis, and therapeutic ERCP such as EST, stent and SE does not increase the incidence of postoperative pancreatitis.

Objective To investigate the localization and mRNA expression of dopamine receptor subtype D_4 and D_5 mRNA in human stomach and duodenum by in situ hybridization. Methods The oligonucleotide probe was synthesized and labeled with digoxin, and then hybridized with human gastric and duodenal samples, which were stored in liquid nitrogen, fixed in hypothermia, and embedded in paraffin. The results were recorded and quantitatively analyzed using the pathological image computer analysis system. Results Dopamine receptor subtype D_4 and D_5 mRNA both expressed in human stomach as well as duodenum. They distributed mainly in the interstitial of mucosal glands and the lamina propria near lamina muscularis mucosa. The mRNA expression value of D_4 was higher than that of D_5 in both stomach and duodenum. In stomach, the number of positive target cells was 41.29?5.06 vs. 26.25?5.82 ( P

Objective To explore effective methods of nursing quality evaluation. Methods Guided by human-centered thinking,the new DRG quality indicators were formulated based on clinical investigation,literature review and expert consulta-tion. Then,the standards of the new indicators for radical masteetomy were identified by Delphi method and the reliability and validity were tested in 30 patients with radical mastectomy. Results The two new quality indicators were illness observation and health education. The Cronbach'α was 0.82 and 0.88 respectively. The results of expert consultation showed high content validity. Moreover,the new quality indicators got high commend by involved nurses. Conclusion The new quality indicators will lead nursing work to illness observation and health education,which will more benefit to reflect the true work of nurses and improve the internal quality of nursing.

Asian Continental Ancestry Group ; Hepatitis B virus ; Hepatitis B, Chronic ; immunology ; Humans ; Killer Cells, Natural ; immunology

According to the characteristics of low cost, high performance, high integration and long battery life of wearable medical devices, the mainstream low-power microcontroller(MCU) series were compared, and came to the conclusion that the MCU series based on ARM Cortex-M0+ architecture were suitable for the development of wearable medical devices. In aspects of power consumption, operational performance, integrated peripherals and cost, the MCU series based on Cortex-M0+ architecture of primary semiconductor companies were compared, aimed at providing the guides of MCU selection for wearable medical devices.
Durable Medical Equipment ; Electric Power Supplies ; Monitoring, Ambulatory ; instrumentation

BACKGROUND:Acute myeloid leukemia after liver transplantation is a rare complication with high mortality. OBJECTIVE:To study the clinical features of acute myeloid leukemia after liver transplantation. METHODS:One case of acute promyelocytic leukemia after liver transplantation was reported, and literatures were reviewed. RESULTS AND CONCLUSION:Case presentation was post-odontectomy bleeding with associative abnormal coagulation test at 85 months after liver transplantation. Routine blood test, bone marrow test and chromosome analysis and examination diagnosed as acute promyelocytic leukemia and promyelocytic leukemia/RARαpositive chimeric gene, and clearly diagnosed as acute promyelocytic leukemia combined with disseminated intravascular coagulation. The patient received fresh frozen plasma transfusion to correct the abnormal coagulation, and then received induction chemotherapy with retinoic acid, arsenic trioxide and daunorubicin to obtain bone marrow complete remission. The patient was treated with daunorubicin combined with cytarabine and mitoxantrone combined with cytarabine regimens after remission induction to consolidate the chemotherapy for two courses of treatment, and then subsequently subjected to arsenous acid chemotherapy, and the bone marrow was sustained for remission. During chemotherapy, the dose and type of immunosuppressive agents were adjusted, and the patient had stable liver function without serious infection or complications. The results indicate that acute myeloid leukemia is common and often occurs after liver transplantation. When the patient displays hematological abnormality, acute promyelocytic leukemia should be considered. Early diagnosis and treatment can reduce the mortality.