OBJECTIVE To analyze the nosocomial infections among dead cases with cancer and explore the relationship between death and nosocomial infections.METHODS Totally 309 dead cases with cancer were investigated and analyzed in 2004-2005.RESULTS From them 64 with 72 times accompanied by nosocomial infections(20.71%,23.30%),the rate was 5.85 times higher than the total nosocomial infection rate in the hospital.Of 64 cases with nosocomial infections,48(75%) were led to death directly by nosocomial infections.The average hospitalization time of these 64 dead cases with nosocomial infections was 63.94 days,which was 20.98 days longer than the whole average hospitalization time(29.21 days).Cases with tumors related to immune system were more often accompanied by nosocomial infections than with other tumors(P

Objective To evaluate the safety and diagnostic accuracy of preoperative endoscopic ultrasound-guid﹣ed fine-needle aspiration in patients with pancreatic cancer. Methods 256 patients with pancreatic cancer from Jan﹣uary 2010 to December 2014, 82 were considered resectable on the basis of cross-sectional imaging findings. Of these patients, 54 underwent EUS-FNA before surgery (FNA+group) and 28 underwent surgery without preoperative EUS-FNA (FNA- group), the diagnosis result of EUS-FNA and the survival time of the two groups were observed. Results All 54 lesions were visible on EUS, and all 54 attempts at FNA were technically successful. The diagnostic accuracy according to cytology and histology findings was 94.44 % (51/54) and 88.89% (48/54), respectively, and the total accuracy was 94.44 % (51/54). Two patients developed mild pancreatitis and two hemorrhage after EUS-FNA but were successfully treated by conservative therapy. No severe complications occurred after EUS-FNA. In the FNA+and FNA- groups, the median relapse-free survival (RFS) was 282 and 265 d, respectively (P>0.05), and the median overall survival (OS) was 568 and 557 d, respectively (P>0.05). RFS and OS were therefore not inferior in the FNA+group. These data indicate that the usage of EUS-FNA did not influence RFS or OS, nor did it increase the risk of other complications. Conclusions Preoperative EUS-FNA is a safe and accurate diagnostic method.

Water soluble extract (WSE) is an important index for the quality evaluation of Astragali Radix (AR). In this study, the WSE of the wild AR from Shanxi province (SX) and the cultivated AR from Gansu Province (GS) were compared. The WSEs of two types of AR were determined according to the appendix of Chinese pharmacopoeia. Then the WSEs were subjected to NMR analysis, and the obtained data were analyzed using HCA, PCA, OPLS-DA, microarray analysis, and Spearman rank analysis. In addition, the Pearson correlation of differential metabolites were also calculated. The results showed that the WSE content of GS-AR (37.80%) was higher than that of SX-AR (32.13%). The main constituent of WSE was sucrose, and other 18 compounds, including amino acids, organic acids, were also detected. Multivariate analysis revealed that SX-AR contained more choline, succinic acid, citric acid, glutamate, taurine and aspartate, while GS samples contained more sucrose, arginine and fumaric acid. In addition, the Pearson correlations between different metabolites of the two types of AR also showed apparent differences. The results suggested that the WSE of two types of AR differs not only in the content, but also in the chemical compositions. Thus, the cultivation way is important to the quality of AR. This study supplied a new method for the comparison of extract of herbal drugs.
Arginine ; analysis ; Aspartic Acid ; analysis ; Choline ; analysis ; Citric Acid ; analysis ; Drugs, Chinese Herbal ; analysis ; chemistry ; Fumarates ; analysis ; Glutamic Acid ; analysis ; Magnetic Resonance Spectroscopy ; Multivariate Analysis ; Phylogeography ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Succinic Acid ; analysis ; Sucrose ; analysis ; Taurine ; analysis

Objective To evaluate safety and efficacy of EUS-FNA for occupying pancreatic lesions.Methods Data of 62 patients with occupying pancreatic lesions,who underwent EUS-FNA between June 2011 and June 2014,were analyzed for completion and complications,with surgery and clinical follow-up as the golden standard.Accuracy,sensitivity and specificity of EUS-FNA were calculated.Results A total of 62 patients with pancreatic lesions successfully underwent EUS-FNA and median puncture number was 4.2(3 to 8).Success rate of puncture was 100％ and sampling satisfaction rate was 90.3％ (56/62).No complications such as fever,infection,bleeding,perforation,severe pancreatitis or death were found.With the final diagnosis as the golden standard(39 malignant lesions and 23 benign lesions),overall diagnostic accuracy of EUS-FNA was 88.7％(55/62).The cytology diagnostic accuracy was 69.4％ (43/62),significantly higher than that of the tissue pathology of 30.6％ (19/62,P＜0.01).Sensitivity and specificity of the procedure were 87.2％(34/39) and 91.3％(21/23) respectively.Conclusion EUS-FNA is an effective and safe procedure in diagnosis of occupying pancreatic lesions.

Objective To explore for the effect of endoscopic treatment on biliary leakage and biliary duct stricture. Methods All patients with biliary leakage and biliary duct stricture were treated by endo scopic sphincoterotomy and endoscopic nasobiliary drainage ( ENBD) during abdominal cavity drainage. EN-BD was removed when biliary leakage healed and abdominal cavity drainage ceased for 1-2 weeks were confirmed. Plastic stents were implanted to distend the biliary duct stricture for 2-3 months. Results Twenty two patients with biliary leakage were cured 3-4 weeks after ENBD. Ten out of 13 patients implanted with plastic stent were recovered uneventfully after stent removed, and 2 patients also recovered after installation of double-stents for 3 months, while another case with calculus and stricture of left hepatic duct in spite of implantation of simple-stent suffered repeatedly from biliary tract infection. Conclusions Endoscopic therapy is the first choice in treating biliary leakage or secondary biliary duct stricture.

Objective To explore the strategies for diagnosis and treatment of anomalous junction of pancreaticobiliary duct (AJPBD) complicated by acute pancreatitis. Methods The clinical dataof 22 patients with abnormal pancreaticobiliary junction were analyzed retrospectively. Results The incidence of acute pancreatitis in this series was 31.8 % (7/22), thereinto, 5 cases(71.4%) in C-Ptype (the common bile duct joining the pancreatic duct) and 2(28.6%) in P-C type (the pancreatic duct joining the common bile duct). Seven patients underwent ERCP+ EST+ ENBD. Two patients with common bile duct stones were treated with stone basket and cholecystectomy was performed in two cases with gallstone. All patients were successfully treated. The follow-up for l year showed that there was no recurrence of pancreatitis. Conclusion Acute pancreatitis usually occurs in patients with AJPBD, especially in C-P type or with gallbladder stone or common bile duct stone. ERCP+EST+ENBD and prophylactic cholecystectomy are effective to prevent and treat acute pancreatitis.

Objective To investigate the litholytic effect of stirring by plastic stem inside biliary tract in large common bile duct (CBD) stone. Methods Forty-five patients with large CBD stones were included in this study (8 with the distal bile duct stricture and 5 with too-small Vater's papilla).Plastic stent of 8.5Fr was inserted into the CBD under the guidance of guide wire in all the 45 patients. Results In 10 of the 45 patients, ERCP showed that there was no stone in CBD 3 months later after stent placement. In 22 cases, repeated ERCP revealed that the stone had become smaller to the extent of more than a half or became stone fragments that were easily extracted by baskets or balloon dilation. Thirteen patients continued to have large stone at the second time ERCP treatment, and a new stent was replaced and follow-up performed by B mode ultrasonography of abdominal region per month. Further endoscopic treatment was performed immediately when the stone became small enough. The percentage of 95.6% (43/45) of large CBD stone were eventually cleared after endoscopic treatment for an average of 2.4 times. There were no severe complications related to ERCP or stent placement. Conclusion Placement of plastic biliary stent is a convenient and effective measure for the treatment of large CBD stones. It is especially appropriate for aged patients of CBD stone of high risk.

Objective To study the therapeutic effect of EUS-guided rendezvous (EUS-RV) when ERCP failed in patients with malignant obstructive jaundice. Methods 12 cases of malignant obstructive jaundice patients were underwent EUS-RV after unsuccessful ERCP. The operation success rate, liver function recovery 1 week and 1 month after operation, complication rates, hospital stay and patient survival were observed. Results All 12 patients were successfully operated and placed stents by endoscopic ultrasound puncture following by ERCP: 8 patients by the stomach, 4 patients by duodenum, the operation success rate was 100.00%; There were significant difference between the liver function recovery of preoperative and postoperative one week or postoperative one week and postoperative one month (P < 0.05). 1 bleeding occurred and were improved after conservative treatment, the complications rate was 8.33%; the hospital stay was (20.68 ± 5.76) d; the average survival time of patients was 224 d. Conclusion EUS-guided rendezvous may be the alternative treatment due to the diminutive trauma and good effect when ERCP failed in patients with malignant obstructive jaundice.

Objective To compare the curative effect of internal fixation treatment between reconstruction-type intramedullary nailing and long anatomic proximal femoral locking plate for patients with ipsilateral femoral proximal and shaft fractures. Methods Twenty-six patients with ipsilateral femoral proximal and shaft fractures were selected, among whom 12 patients were treated with reconstruction-type intramedullary nailing internal fixation treatment (group A), and 14 patients were treated with long anatomic proximal femoral locking plate internal fixation treatment (group B). The fracture to operation time, operation time, intraoperative blood loss, fracture healing time and hip joint function according to Majeed function score were compared between 2 groups. Results The fracture to operation time, operation time, intraoperative blood loss, proximal femoral fracture healing time, femoral shaft fracture healing time and Majeed function score in group A were (6.65 ± 4.11) d, (131.08 ± 20.70) min, (470.83 ± 96.43) ml, (17.83 ± 2.70) weeks, (20.08 ± 3.97) weeks and (83.83 ± 8.13) scores, and those in group B were (7.13 ± 4.56) d, (141.86 ± 27.30) min, (553.57 ± 127.80) ml, (18.29 ± 5.12) weeks, (21.55 ± 4.19) weeks and (83.21 ± 9.58) scores, and there were no statistical differences (P>0.05). According to Majeed function score, in group A excellent was in 7 cases, good in 4 cases, and general in 1 case; in group B excellent was in 9 cases, good in 3 cases, and general in 2 cases. Conclusions A fixation device fixes two fracture is preferred. Both treatment methods used in the present study could achieve satisfactory curative effect, and should be chosen according to the fracture type of the patients and the surgeon′s familiarity for the methods of internal fixation chosen. The proximal femoral fracture should preferably be reduced and stabilized first. A delay of 5 - 6 d would not affect the ultimate curative effect.

Objective To improve the method of blood collection from external jugular vein in rats,so as to repeatedly obtain blood samples of high quality and to meet the special requirements of the experiment.Methods The experimental rats were anesthetized by intraperitoneal anesthesia,and the jugular vein was fully exposed with special fixed method.Whereafter,the blood samples were collected by disposable vacuum blood vessels.Results This method had little traumatic effect.The blood samples were collected from 60 rats at an interval of 14 days with 1.8 to 2.5 mL each time.The success rate was above 95％,and the normal activities of the rats were not apparently affected.This vacuum blood collection method guaranteed the quality of serum,and the veracity of blood detection and analysis were also significantly improved.Conclusion On the basis of the principle of animal welfare,the improved rat jugular vein blood collection method has the advantages of simple operation,less trauma,large blood collection,high blood sample quality aod so on,which can ensure the effect of the special experiment.