The principle of Endoscopic Ultrasonography (EUS) is similar to abdominal ultrasonography. The difference between them is the installment of a high-frequency ultrasound miniature probe at the tip of the endoscope for real-time ultrasound scanning. The pancreas is a retroperitoneal organ. The insertion of the ultrasonic endoscope into the stomach and duodenum can clearly demonstrate the structure of the pancreas on ultrasound scanning. With the extensive application of EUS and development of endoscopic accessories, EUS is becoming more important and it plays an important role in the minimally invasive treatment of pancreatic diseases. EUS-FNA and injection technique, EUS-CPN,EUS-guided radiation seed implantation, endoscopic ultrasound-guided puncture and drainage of pancreatic pseudocyst broaden the application of EUS techniques. EUS will become another important minimally invasive endoscopic treatment for pancreatic diseases following ERCP.

A probe into the management of outpatient medical records written by rural doctors:Such a record is indispensible for technical appraisal of medical accidents; yet writing of such a record might involve illegal medical practice or go beyond the scope of practice.It is recommended to normalize the behavior of rural doctors in their writing of outpatient medical records,stipulating that the Basic Regulations on Medical Records do not apply to rural doctors at present.It is also recommended that separate regulations for rural doctors be formulated,along with a promotional period before these regulations are in practice.An alternative would be clarifying that Article 28 of the Regulations of Medical Malpractice Settlement do not apply to rural doctors.

AIM:To explore the clinical effect of capsule membrane phacoemulsification and capsular bag in phacoemulsification in treatment of hard nuclear cataract with high myopia.
METHODS:A total of 297 patients(322 eyes) with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus) and high myopia were selected from Mar. 2014 to Mar. 2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes) and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test.
RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P<0. 05). The phacoemulsification time and energy parameters of the observation group were significantly lower than that of the control group( P<0. 05 ). One month after operation, the postoperative visual acuity in two groups was significantly higher than the visual acuity at 1d after operation(P<0. 05). But there was no statistical significance on the visual acuity at 1mo after operation between two groups ( P> 0. 05 ). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation ( P < 0. 05 ). But there was no statistical significance on the density of corneal endothelial cell after operation between two groups ( P > 0. 05 ). The intraoperative complication rate of observation group was significantly lower than that of the control group ( P<0.05 ) , but there was no statistical significance on postoperative complication rate between two groups ( P>0. 05). CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.

OBJECTIVE: To optimize the extraction technology of ardicrenin from Ardisia crenata.METHODS: The content of ardicrenin was determined by RP-HPLC. The extraction technology was optimized by orthogonal experiment with the extraction rate of ardicrenin as evaluation index and with the volume fraction of ethanol,the extraction temperature,extraction time and extraction times as factors.RESULTS: The optimum extraction technology was determined as follows: 80%ethanol was used as solvent;the extraction temperature was 80 ℃;the extraction time was 20 min and the extraction was conducted for 3 times.The extraction rate of ardicrenin was 6.04%.CONCLUSION: The optimized extraction technology is feasible and reproducible,and it provides theoretical basis for mass extraction of the ardicrenin from A.crenata.

As the key phase for medical students to be doctors,clinical internship plays a vital role in the whole medical education process.Interns in the department of gastrointestinal surgery face series of difficulties,such as wide variety of diseases and emergence of new technology and new concepts.In addition,because of the uneven levels of teachers and low enthusiasm of interns,the result of clinical practice teaching is not satisfactory.Based on the above-mentioned problems,measures have been introduced during the process of clinical practice teaching,including selection of typical diseases and surgical procedures,construction of clinical practice teaching team,adoption of pluralistic teaching methods,reinforcement of participation of interns during the clinical practice.Finally,the quality of teaching in our department has been irmproved significandy.

Peripheral T-cell lymphoma (PTCL) is a relatively common subtype of non-Hodgkin lymphoma in China. PTCL is clinically highly aggressive, and it progresses rapidly. The current treatment methods are ineffective and the overall prognosis is poor. The 62nd American Society of Hematology Annual Meeting reported on the progress of PTCL molecular targeted therapy and immunotherapy, including programmed death receptor 1/programmed death receptor ligand 1 antibodies, JAK inhibitors, brentuximab vedotin, etc. These novel drugs bring a better prospect for patients.

Acupuncture Therapy ; Adult ; Female ; Humans ; Labyrinth Diseases ; therapy

Congenital Abnormalities ; diagnosis ; therapy ; Ear, External ; abnormalities ; Ear, Middle ; abnormalities ; Humans

To compare the chemical change of Paeoniae Radix Alba (PRA) after vinegar-baking processing, as well as the effect of vinegar types exerted on the processing, 1H NMR-based metabolomic approach combined with multivariate statistical analysis was used to investigate the different metabolites between the raw and two vinegar-baked PRA. More than thirty metabolites were identified in the 1H NMR spectrum of PRA, and the multivariate statistical analysis showed that raw and two vinegar-baked PRA could be separated obviously. After vinegar-baking, the contents of isoleucine, lactate, alanine, arginine, albiflorin, and 5-hydroxymethyl furfural (5-HMF) elevated, while those of sucrose, paeoniflorin and its analogues (calculated by benzoate) decreased. The chemical compositions of two vinegar-baked PRA were also different. Shanxi vinegar- baked PRA showed higher levels of leucine, isoleucine, valine, and albiflorin, while rice vinegar-baked PRA contained more sucrose and paeoniflorin's analogues (calculated by benzoate). And the chemical changes in Shanxi vinegar-baked PRA were greater than those of rice vinegar-baked PRA. The results revealed the chemical differences between raw and vinegar-baked PRA, as well as the influence of vinegar type on processing, in a holistic manner, the results obtained suggested that the correlations between the chemical change and the drug action after processing, as well as the vinegar type used in processing, should be further studied.
Acetic Acid ; Benzoates ; Bridged-Ring Compounds ; Cooking ; Drugs, Chinese Herbal ; Furaldehyde ; analogs & derivatives ; Glucosides ; Metabolome ; Metabolomics ; Monoterpenes ; Paeonia ; chemistry ; Plant Roots ; chemistry

Objective:To investigate the expression of tissue factor pathway inhibitor-2 (TFPI-2) and synuclein gamma (SNCG) in esophageal cancer and their correlation with local invasion, lymph node metastasis and apoptosis. Methods:The expression of TFPI-2, SNCG, and matrix metalloproteinase-9 (MMP-9) was detected by immunohistochemical SP methods in 82 cases of esophageal cancer tissues, 20 cases of atypical hyperplasia tissues, and 54 cases of para-cancerous tissues. The apoptosis of esophageal cancer cells was detected by TUNEL staining and apoptosis index (AI) was calculated. Results:The positive rates were 30.4%, 60.0%, and 87.0% for TFPI-2 protein and 63.4%, 30.0%, and 3.7% for SNCG protein in the tumor tissues, atypical hyperplasia tissues,and tumor-adjacent normal tissues, respectively. There was a significant difference between the three groups(P<0.01). The positive expression of TFPI-2 and SNCG correlated with the lymph node metastasis, invasion depth, TNM staging, and differentiation degree of esophageal cancer (P<0.01), but did not correlate with age at surgery, gender, tumor location, and pathologic classification(P>0.05). The expression of TFPI-2 and MMP-9 was negatively correlated (r=-0.636, P=0.000). The expression of SNCG and MMP-9 was positively correlated(r=0.393,P=0.000). AI was related with TFPI-2 and SNCG expression (P<0.05). Conclusion:TFPI-2 not only inhibited the expression of MMP-9 but also induces apoptosis of esophageal cancer to prevent tumor invasion and metastasis, however, SNCG plays a contradictory role in cancer development. TFPI-2 and SNCG might serve as new tumor markers and the new targets for tumor gene therapy.