Objective:To evaluate the value of Cook MOB-15 system in guiding wire insertion during endoscopic retrograde cholangiopancreatography (ERCP). Methods: The clinical data of 51 patients who received Cook MOB-15 system-guided wire insertion during ERCP between Jan. 2005 to Dec. 2007 were retrospectively analyzed. Forty patients who received conventional ERCP catheter for malignant jaundice between Jan. 2002 and Dec. 2004 were taken as control. The successful insertion rates were compared between the 2 groups. Results: The successful insertion rate was 90.2% (46/51) in the Cook MOB-15 system group and 72.5% (29/40) in the conventional group; there was significant difference between the 2 groups (P

OBJECTIVE To investigate the incidence and pathogens of infection in 1659 consecutive cases in single center hematological unit.METHODS The incidence,pathogen,and outcome of infection in 1659 hospitalized patients with hematological disorders from 1999 to 2006 were retrospectively analyzed.RESULTS The overall incidence of infection was 24.4% according to the person-times of hospitalization,which included 22.1% of nosocomial infection and 2.3% of community acquired infection.Most of the pathogenic bacteria of the nosocomial infection were Gram-negative.The most common bacteria in the sputum samples included Enterobacter cloacae(19.3%) and Pseudomonas aeruginosa(14.8%).The most common bacteria in the blood samples were coagulase negative Staphylococcus(CNS,39.3%),the next was Pseudomonas aeruginosa and Escherichia coli.There were 4.21% bacteria resistant to most of antibiotics in nosocomial infection.There were 114 fungi isolated.Candida albicans was accounted for 35.1%.The mortality due to nosocomial infection was 7.4%.CONCLUSIONS The patients in hematology ward are susceptible to infection.The pathogens of nosocomial infection are most likely G-bacteria.Some bacteria are resistant to almost all antibiotics.The incidence of fungal infection is increasing in the near 8 years.

Objective To explore the clinical characteristics,therapy reactions and prognosis of the elderly patients with idiopathic thrombocytopenic purpura(ITP). Methods A total of 43elderly ITP patients(age≥60 years old)including 16 men and 27 women were reviewed and further followed up for 1 month to 15 years. Results Until June 2007,35 elderly ITP patients survived,platelet counts were sustained(30-50)×109/L in 7 cases,but no significant bleeding was found.Thirty-six patients had adrenocorticosteroid therapy first, 25 patients were sensitive to adrenocorticosteroid therapy,4 patients underwent splenectomy,and 3 patients achieved a normal platelet count. Immunosuppressive agents(vinscristine,cyclophosphamide, azathioprine and Cyclosporin A)treatments were held in 5 6 case-times,Cyclosporin A and azathioprine were more effective than vinscristine and cyclophosphamide.The refractory rate was 13.9%.One patient progressed to monoclonal gammopathy of unknown significance and 1 to lymphoma.Eight patients died.1 patient died of brain bleeding after trauma,3 patients died of malignant neoplasm,4 patients died of heart failure induced by infection. Conclusions The clinical features of elderly ITP patients are atypical.the mortal bleeding in them was rare,treatment strategy should be individualized tO each elderly patient.

Objective To investigate the prevalence by age,response to different therapies and outcome in newly diagnosed idiopathic thrombocytopenic purpura(ITP). Methods ITP patients who were hospitalized from July 1992 to December 2006 and followed uD with telephone were retrospectively analyzed.Results 103 patients with ITP were investigated. The time of follow-up was between 2 months to 15years.to adrenocorticosteroid and 4 patients under going splenectomy achieved a normal platelet count. In those immunosuppressive agents:including vincristine,cyclophosphamide,azathioprine and cyclosporin A(CsA)used in the present series. CsA was shown to be more effective. It could increase the platelet count when given together with prednisolone,the effective rate was 81.3%(26/32). Severe side effects like kiney function failure were not found in CsA treated patients so the use of geug in ITP would be recommended.There were 2,1 and 1 ITP patients progressing respectively to Sjogren's syndrome,systemic lupus erythematosus and lymphoma. 7 patients died,1 patient died of cerebral bleeding,2 brain infarction,3 malignant neoplasm and 1 nephrosis The refractory rate of ITP is 17.2%(10/58). Conclusions The morbidity in older people is high. The mortal bleeding in ITP is low. Treatment should be tailored to the individual patient.

Objective To assess the effects of fenofibrate on myocardial remodeling in obese rats by echocardiography.Methods Twenty-six SD rats were fed with high fat chow to establish twenty obese rats models,which were randomly divided into two groups:obesity group (OB group,n =10) and fenofibrate group(F group,n =10).The same week-old SD rats group (n =10) was also randomly selected as normal control group.F group was given fenofibrate 60 mg · kg-1 · d-1 for 8 weeks,the other groups were given normal saline.Echocardiographic scan was performed in each group at the beginning and ending of the experiment.Twenty-four weeks later,all rats were executed and the cardiac muscle was used to histological inspect.Results After the experiment,compared with the control group,the body weight,the ventricular thickness,interventricular septal thickness and the left ventricular mass in OB group were significantly increased than those of control group(P ＜0.01),the E/A ratio was significantly decreased(P ＜0.01).Histological detection showed that myocardial structure was disordered,and that interstitial collagen was deposited in the myocardium.Compared with OB group,the parameters all above in F group were significantly improved (P ＜0.01).Left ventricular mass from echocardiography correlated well with the results from pathologic specimen (r =0.98,P ＜0.01).Conclusions Fenofibrate has beneficial effects on preventing myocardial remodeling.By general echocardiography,the effects can be assessed comprehensively and accurately.

Objective To find out the status of prevention and control of iodine deficiency disorders and evaluate the iodine nutritional status of Jinan residents,to explore appropriate iodine level in drinking water,and to provide a scientific basis for adjustment of intervention strategies.MethodsAccording to the Monitoring Program of the National Iodine Deficiency Disorders (Trial),qualified iodized salt consumption rate,drinking water iodine content and urinary iodine levels of women of childbearing age were determined in iodine deficiency areas from 2003 to 2010.Salt iodine was detected by direct titrimetry,urinary iodine by As-Ce catalytic spectrophotometric assay and iodine in drinking water by cerous sulfate catalytic spectrophotometric method.Results Intake rate of qualified iodized salt was up to 90％ and above from 2003 to 2010,median water iodine was 13.65 μg/L in the 10 counties(cities,districts),of which less than 100 μg/L accounted for 79.82％(4560/5713 ) and ＞ 150 μg/L accounted for 12.73％(727/5713).With the increase of water iodine(0 ～ ＜ 10,10 ～ ＜ 50,50 ～ ＜ 100,100 ～ ＜ 150,150 ～ ＜ 300 and ≥300 μg/L),urinary iodine levels of women of childbearing age increased successively(median 156.56,175.81,267.04,349.00,524.22,583.20 μg/L,respectively,x2 =121.20,P ＜ 0.05),while the ratio of urinary iodine ＜ 100 μg/L was significantly lower.The ratio of urinary iodine between 100 and 300 μg/L was decreased gradually,but the ratio of great than 300 μg/L was gradually increased.ConclusionsIodine deficiency areas in Jinan have reached the standard of elimination of iodine deficiency disorders.We should insist to carry out our measures to suit local conditions,classified guidances and scientific principals of iodine supplementation.

AIM: To analyze the effect factors of trabeculectomy combined with intraoperative application of mitomycin C in the treatment of neovascular glaucoma.
METHODS: Fifty patients (50 eyes) with neovascular glaucoma collected from January 2013 to August 2015 in our hospital were treated by trabeculectomy combined with intraoperative application of mitomycin C. Single factor and multi factor variables analysis were used for effect factors of trabeculectomy combined with intraoperative application of mitomycin C in the treatment of neovascular glaucoma.
RESULTS: By results of single factor variable analysis,< 50 years old, preoperative intraocular pressure ( IOP) was ≥45mmHg and postoperative occurrence of anterior chamber hemorrhage were risk factors for treatment failure ( P < 0. 05 ), and gender, proliferative diabetic retinopathy and previous cataract surgery and prior photocoagulation were not the risk factors for failure (P>0. 05 ). By multivariate analysis, < 50 years old and postoperative occurrence of anterior chamber hemorrhage were risk factors for treatment failure ( P < 0. 05 ), and preoperative IOP≥45mmHg was not a risk factor (P>0.05). CONCLUSION: For patients < 50 years old with neovascular glaucoma, should be careful on the selection of surgical treatment. For high- risk patients, we should strengthen the monitoring and give timely intervention, which are helpful to improve the prognosis.

Objective To investigate the correlation between hemoglobin level and health status of the elderly living in communities in Beijing.Methods A random cluster sampling method was used to select residents living in communities of Beijing city,and a cross-sectional study was carried out by questionnaires,scene testing and blood sample collection.WHO-formulated criteria were applied for diagnosing anemia.The health indicators in questionnaires included visual impairment,physical disability,decreased health,self-care,fatigue,anorexia,independent walking distance,exercise frequency,intelligence status and computing power.Results Complete information was obtained in a total of 1 948 elderly people,including 790 cases of male and 1 158 cases of female,with an average age of(73.9±6.1)years and a median age of 74 years(65-100).The mean level of hemoglobin in the 1 948 people was(135.65 ± 14.48) g/L,with (142.56 ± 15.56) g/L in male and (130.95 ± 11.53) g/L in female.Hemoglobin level was significantly lower in female than in men (t =54.739,P＜ 0.01).Hemoglobin level was decreased with aging,and negatively associated with appetite,physical strength,walk assistance,visual acuity and physical ability(r=-0.055,-0.067,-0.071,-0.114,-0.095;P =0.022,0.005,0.004,0.000,0.000),while positively associated with health status,activities in daily life,athletic ability,exercise frequency and intelligence (r =0.073,0.126,0.122,0.066,0.124;P =0.002,0.000,0.000,0.006,0.000).Conclusions The hemoglobin level of the elderly decreases with aging and is associated with health status and quality of life in the elderly,which should be taken care seriously.

Objective To explore the clinical and biological characteristics and treatment effect of acute myeloid leukemia (AML) in elderly patients. Methods The clinical data of 62 patients over 60 years old with AML were retrospectively analyzed, and they were compared with those of 60 younger adult patients (18-59 years old) at the same period. Results In elderly patients, the complete remission (CR) rate was 27. 7% and the overall effective rate was 44.7%, which were lower than those of younger adult patients (74.1% and 87.9 %, 1-espectively, P＜0.01). The early death rate was 19.0% and the mortality rate during the first two induction chemotherapy was 29. 3% in the elderly, which were higher than those of younger adult patients (3. 3% and 6.7%, 1-espectively,P＜0.01). The 27.4% of elderly patients were diagnosed as myelodysplastic syndrome (MDS)-transformed AML, which were more than that of younger adult patients (10.0%, P＜0.05), and they had lower CR rate than those without MDS (P＜0. 05). The 28.2% of elderly patients had lymphoid antigen positive AML and 71.8% of patients showed CD34+ which were higher than those of younger adult patients (8. 1% and 48.6%, respectively, P＜0. 05), and they had lower CR rate than those of lymphoid antigen negative and those of CD34- AML (P＜0. 05). Elderly patients had less favorable and more unfavorable karyotypes than younger adult patients (45.7 % and 15.4 %, P＜0. 05). Conclusions The elderly patients with AML have more unfavorable prognostic factors than younger adult patients. They have lower CR rate and higher mortality rate. There are many specialties in elderly patients and the treatment strategy should be made more individually.

Acetaminophen (APAP, also known as paracetamol)-induced liver injury is the leading cause of drug-induced liver injury in the world. Wuzhi Tablet (WZ, an ethanol extract of Schisandra sphenanthera) is widely used in clinical practice to protect liver function. Our previous studies have shown that pretreatment with WZ for 3 days can significantly protect against APAP-induced liver injury; however, the effect of different intervals between APAP and WZ treatment on APAP-induced liver injury remains unclear. In this study, the change in liver injury indexes, APAP metabolites, and the activity of cytochrome P450 (CYP450) enzymes after treatment with WZ and APAP at different intervals were determined. The animal experiment was reviewed and approved by the Animal Ethics Committee of Sun Yat-sen University. The results show that 0 h, 0.5 h, and 2 h pretreatment with WZ significantly protected against APAP-induced liver injury in mice, as evidenced by a significant decrease in biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malonaldehyde (MDA). WZ inhibited the metabolic activation of APAP mediated by CYP450 enzymes and reduced the formation of APAP metabolites. This study further demonstrates that pretreatment with WZ at different intervals (0 h, 0.5 h, and 2 h before APAP dosing) exerts a significant hepatoprotective effect against APAP-induced liver injury, and a single-dose of WZ inhibits the activity of CYP450 enzymes related to APAP metabolic activation, thereby protecting against APAP-induced hepatotoxicity.