A method for the quantitative monitoring of sulfadiazine (SD) residues in pork was established by molecular imprinted column coupling with high performance liquid chromatography (HPLC).The molecular imprinted column was selected as an extraction device.To obtain the optimum extraction efficiency,several parameters related to the molecular imprinted column,including column solvent,flow-rate,eluent of the sample matrix and eluent volume,were investigated.The sample solution was directly injected into the device for the extraction after simple extraction.Under the optimum conditions,the relative standard deviations (RSD) was ≤6.1％ and the recoveries for SD were higher than 75.6％.In comparison with the AL-SPE column,the MIP-SPE column had good reusability and extraction efficiency.This method was successfully applied to the determination snlfadiazine residues in pork.

Objective To investigate the efficacy of pancreatic duct stent in preventing post-ERCP pancreatitis (PEP) of difficult bile duct cannulation.Methods A total of 120 patients who underwent difficult bile duct cannulation during routine ERCP were randomized to receive pancreatic duct stent placement (S group) or not (NS group),and the incidence of PEP,hyperamylasemia and scores of abdominal pain were analyzed.Results There were 15 cases of hyperamylasemia and 5 cases of PEP occurred in S group,but no severe PEP was observed.The score of abdominal pain was (3.82 ± 1.48) in S group.There were 18cases of hyperamylasemia and 14 cases of PEP occurred,including 2 severe PEP in NS group.The score of abdominal pain was (7.48 ± 1.93) in NS group.There was no significant difference in the incidence of hyperamylasemia between the two groups (P ＞ 0.05).The incidence of PEP,severe PEP and the scores of abdominal pain were lower in the S group (P ＜ 0.05).Conclusion Placement of pancreatic duct stent can reduce the PEP rate of difficult bile duct cannulation and relieve the abdominal pain.

Objective To investigate the risk factors of post-ERCP pancreatitis( PEP). Methods Data of 4,234 patients who underwent ERCP in Nanjing Drum Tower Hospital were retrospectively analysed. Information of patients and operations,including age,gender,operation history,major disease history,labora-tory examination before operation,abdominal ultrasound,CT,MRCP,detailed ERCP operation process,com-plications and treatment were carefully recorded. Then Chi-square test was used for univariate analysis,and stepwise multivariate Logistic regression for variate analysis. Linear correlations between risk factors were de-tected. Results There were totally 226 PEPs,with 5. 3% incidence rate. Univariate analysis showed that the female(χ2 =9. 715,P=0. 002),young( <60 years)(χ2 =6. 108,P=0. 013),chronic pancreatitis(χ2 =14. 703,P=0. 001),initial ERCP(χ2 =14. 899,P=0. 000),hypertension(χ2 =4. 489,P=0. 034),nor-mal bilirubin levels before operation(χ2 =19. 159,P =0. 000 ),difficult cannulation(χ2 =45. 824,P =0. 000),pancreatic guide wire(χ2 =30. 223,P=0. 000),papillary pre cut(χ2 =45. 928,P=0. 000),pan-creatography(χ2 =20. 170,P=0. 000)may be risk factors for PEP. Non conditional Logistic regression analy-sis showed that female(OR=1. 449,P=0. 011),initial ERCP(OR=1. 745,P=0. 003),normal bilirubin levels before operation(OR=1. 917,P=0. 000),difficult cannulation(OR=3. 317,P=0. 000)and pancre-atography(OR=1. 823,P=0. 004)were independent risk factors for PEP. Linear correlation analysis sugges-ted that pancreatic duct guide wire and papillary precut were related to the difficult cannulation,and the corre-lation coefficients were -0. 788 and -0. 699. Conclusion Female,young(<60 years),chronic pancreati-tis,initial ERCP,hypertension,normal bilirubin levels,difficult cannulation,pancreatic duct guide wire,pa-pillary precut,pancreatography may induce PEP. Female,normal bilirubin levels before operation,initial ER-CP,difficult cannulation and pancreatography are independent risk factors for PEP,while pancreatic duct guide wire,papillary precut are not,as they were linear correlated to difficult cannulation.

Objective To assess feasibility and advantages of the improved endoscopic resection of duodenal major papillary.Methods A total of 56 cases were collected in Drum Tower Hospital from October 2007 to December 2012, which were diagnosed as duodenal major papillary adenoma or carcinoma in situ, where tumor didn't extend to the biliary or pancreatic duct by the endoscopic ultrasonography, intraductal ultrasonography or histology of biopsy specimens.The diameters of these adenoma ranged from 0.3 cm to 5.0 cm.Twenty-four lesions were resected by routine endoscopic method and 32 lesions were removed by modified endoscopic method.All patients underwent ERCP and biliary and/or pancreatic stents were placed.Results En bloc resection rate was significantly higher in modified group(87.5％ ,28/32) than that in routine group (60.9％, 14/23, P ＜ 0.05).There were no significant differences in complete resection rates (93.8％ ,30/32 VS 87.0％, 20/23;P ＞0.05), or in the amount and difficulty of pancreaticobiliary stenting(P ＞ 0.05)between modified group and routine group.Short-term complication occurrence in modified group was lower than that of the routine group(15.6％ ,5/32 VS 41.6％, 10/24, P ＜ 0.05), but long-term complication occurrence showed no significant difference.There was no significant difference in recurrence rate between two groups[7.1％ (2/28) VS 15.0％ (3/20) ,P ＞0.05].Conclusion Endoscopic resection of duodenal major papillary adenoma with a modified method shows more therapeutic effect.

Objective To explore the nutritional risk factors in patients with chronic hepatitis C (CHC), who have been accepted pegylated interferon (IFN) and ribavirin (RVB) therapy (PR). Methods A total of 175 CHC patients treated with PR were included in this study. Data of heights, body weights, and calculated body mass index (BMI) were recorded in patients. At the same time, patients were evaluated nutritional risk with Nutritional Risk Screen 2002 (NRS 2002), and divided into risk group (n=35) and non-risk group (n=140). Results There were significant differences in age, HCV genotype (1b type and not 1b), clinical type (CHC/cirrhosis), the length of treatment time and the tolerance degree for PR therapy between two groups (P<0.05). Logistic regression analysis showed that age (OR=16.068,β=2.777), IFN dosage (OR=3.096, β=1.130), RVB dosage (OR=3.382, β=1.219) and clinical type (OR=5.092, β=1.628) were nutritional risk factors. The HCV genotype (OR=0.384; β=-0.957) was protective factors for nutritional risk. Conclusion There is higher occurrence rate of nutritional risk for CHC patients accepted PR therapy. The dependant nutritional risk factors are advanced age, intolerance for PR therapy and cirrhosis associated CHC. HCV without genotypes 1b is not a nutritional risk factor.

Objective To increase externally-assigned response, improve energy response of CR39 and develop positive fast/thermal neutron personal dosimeter applicable for occupational exposure in oil and gas field logging by using pre-recoil layer.Methods The externally-assigned response of CR39 detector was improved through increasing the track density by using the α particle induced by the reaction of 10B(n,α) 7Li with the BN as pre-recoil layer, and the increase was vilified by using both Monte-Carlo simulation and experiment exposed by standard neutron source.Results Fast/thermal neutron personal dosimeter's neutron flux sensitivity and neutron dose equivalent sensitivity were 3.46 × 10-4 track per 0.013 and 52.8 mSv.According to theoretical derivation and experiment of standard 241 Am-Be neutron source, detecting efficiency and energy response of CR39 were effectively improved, and quantitative measurement of dose contributed by thermal neutron was realized.Conclusions CR39 fast/thermal neutron personal dosimeter of high sensitivity is applicable to oil and gas field logging environment and of potential development.

Objective To assess the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for children with pancreaticobiliary diseases. Methods Data of children under 14 years old who have underwent ERCP in Nanjing Drum Tower Hospital between September 2007 and August 2016 were reviewed for completion, complications and therapeutic methods. Results A total of 41 children underwent 68 ERCP, including 6(8. 8%) diagnostic and 62(91. 2%) therapeutic procedures. All procedures were performed under deep sedation. Cannulation failed in only 1 child with anomalous junction of pancreaticobiliary duct. The procedure success rate was 98. 5%( 67/68 ) . There were 8 adverse events, including 7 mild post?ERCP pancreatitis and 1 fever. Incidence of adverse event was 11. 8%( 8/68) . There was no such severe adverse event as bleeding, perforation, death, or other anesthesia related adverse event. Thirty?two children ( 78. 0%) had follow?up, ranging from 2 month to 6 years. Children followed lived well with no long?term adverse event. Conclusion ERCP is an effective and safe procedure for the diagnosis and treatment of pancreaticobiliary diseases in children.

Air embolism is a rare complication of upper endoscopy and potentially causes life-threatening events. A 67-year-old man with a history of surgery of cardiac carcinoma and pancreatic neuroendocrine tumor underwent painless upper endoscopy because of tarry stools. During the procedure, air embolism developed, which caused decreased pulse oxygen saturation and delayed sedation recovery. He recovered with some weakness of the left upper limb in the intensive care unit without hyperbaric oxygen therapy. The etiology, clinical manifestations, and treatments of air embolism are discussed based on the literature reports. Although air embolism is uncommon in endoscopic examinations, the patients’ outcomes could be improved if clinicians are alert to this potential complication, and promptly start proper diagnostic and therapeutic measures.
Aged ; Embolism, Air ; Endoscopy ; Heart Neoplasms ; Humans ; Hyperbaric Oxygenation ; Intensive Care Units ; Neuroendocrine Tumors ; Oxygen ; Upper Extremity

OBJECTIVE: To investigate relationship between anti-endothelial cell antibody(AECA) and response to dexamethasone in sudden hearing loss(SHL). METHOD: Forty-eight SHL patients and thirty normal controls with SHL were recruited in present study. AECA was detected by ELISA in serum of all normal controls and SHL patients as well as pure-tone average was examined by electronic audiometry during treatment in SHL patients. Both AECA-positive and -negative subjects received 10 mg/d venous dexamethasone for 5 days followed by gradual tapering of dose of 5 mg/d for another 5-day. Then pure-tone average was reexamined. Differences in hearing recovery between AECA-positive and -negative subjects and relationship between AECA level and hearing recovery were analyzed. RESULT: The prevalence of AECA detection was 68.75% (33 of 48 patients) in SHL patients, with significant difference compared with control subjects with 23.33% (7 of 30 controls) (P<0.01). After treatment, rates of response to dexamethasone in AECA-positive and -negative SHL patients were 81.8% (27 of 33 patients) and 33.3% (5 of 15 patients), respectively. Meanwhile, there was a significant difference in cure, excellent recovery, partly recovery and invalid between AECA-positive and -negative groups [21.2% (7/33), 33.3% (11/33), 27.3% (9/33) and 18.2% (6/33) versus 0, 13.3% (2/15), 20.0% (3/15) and 66.7% (10/15), P<0.01]. Except 5 subjects with AECA level more than 263 microg/L, hearing recovery was correlated to pretreatment AECA level (r=0.8084, P<0.01). CONCLUSION In sudden HL patients treated with dexamethasone, AECA might represent a serological marker of prognosis.
Adolescent ; Adult ; Aged ; Audiometry, Pure-Tone ; Autoantibodies ; blood ; Case-Control Studies ; Child ; Dexamethasone ; therapeutic use ; Female ; Hearing Loss, Sudden ; blood ; drug therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Young Adult

Objective To investigate the diagnostic value of intraductal ultrasonography ( IDUS ) with or without brush cytology on distinguishing malignant from benign biliary stricture. Methods The data of patients with biliary stricture, who underwent endoscopic retrograde cholangiography( ERC) and IDUS in Drum Tower Hospital from September 2007 to October 2015 were retrospectively analyzed. Features of IDUS images and results of brush cytology were compared with postoperative histological results to evaluate the diagnostic yield of IDUS and brush cytology on differential diagnosis of malignant biliary stricture. Results A total of 230 patients with biliary stricture underwent ERC and IDUS, and 206 patients meanwhile received brush cytology, including 84 cases of malignant biliary stricture. Of the 230 patients, 87 cases underwent surgery, and 75 revealed malignant results, including 65 cases of cholangiocarcinoma, 8 cases of pancreatic adenocarcinoma, and 2 cases of periampullary adenocarcinoma. Using postoperative pathologic results as the gold standard, 72 malignant and 9 benign biliary strictures were correctly diagnosed by IDUS. The sensitivity, specificity, positive predictive value, and negative predictive value of IDUS for diagnosis of malignant biliary stricture was 96. 0％, 75. 0％, 96. 0％, and 75. 0％, respectively. Sixty-five patients underwent IDUS with brush cytology during ERC before surgery, and 56 out of 65 showed malignant results. Thirty-one malignant and 9 benign biliary stricture were correctly diagnosed by brush cytology. The sensitivity, specificity, positive predict value, and negative predict value of brush cytology for diagnosis of malignant biliary stricture was 55. 4％, 100％, 100％, and 26. 5％, respectively. If brush cytology combined with IDUS to diagnose malignant biliary stricture, the sensitivity rose up to 94. 6％, while the specificity went down to 77. 8％, and the positive and negative predictive value was 96. 4％ and 70. 0％, respectively. Conclusion IDUS exhibited excellent sensitivity and specificity, while brush cytology revealed perfect specificity and positive predictive value on diagnosis of malignant biliary stricture. If IDUS combined with brush cytology, the sensitivity and negative predictive value could rise significantly, while the specificity and positive predictive value mildly went down, which suggested that IDUS remained a certain degree of over judgment and false positive rate.