Objective To evaluate the efficacy and clinical application value of endoscopic transpapillary cyst drainage(ETCD)on huge pancreatic pseudocysts(HPP)and pancreatic abscess.Methods According to unification standard from 2003 Jun to 2006 Jun,to select 10 disquisitive cases,in which patients with uninfected HPP were 8 cases and that with infected HPP was 1 case,and pancreatic abscess was 1 case.ETCD was adopted in all cases.The clinical treatment process and the change of relative investigation subjects were retrospectively studied.Results Endoscopic transpapillary treatment failed in 1 case,postoperative infection of HPP occurred in 2 cases and acute pancreatitis was found in 1 case.Mean follow-up was 16.5 months in 8 cases.Finally,four patients had complete resolution of HPP,3 cases had partial resolution,and the remains cavity of HPP was formed in 1 caes.Acute grave pancreatitis were cured in 2 cases and Chronic pancreatitis had resolution in 6 cases.Conclusion ETCD was safe and efficient in HPP and pancreatic abscess.Postoperative infection of HPP was the familiar complication,and obstruction of drainage path of HPP was major cause.So the crux of complications precaution and treatment was that the drainage path of HPP was unhindered.

OBJECTIVE:To evaluate the effects of clinical pharmacist participating in clinical consultation,and to provider ref-erence for clinical pharmacists participating in clinical practice. METHODS:436 cases/times of clinical consultation in which clini-cal pharmacists participated in Zhengzhou Seventh People’s Hospital from 2012 to 2015 were analyzed statistically. RESULTS:2012-2015,the number of clinical consultation in the hospital showed rising tendency;23 departments applied the consultation, among which top 5 were endocrinology department,gynaecology department,neurosurgery department,neurology department and orthopedics department. The reasons for consultation mainly were the formulation of therapy plan (430 cases/times,accounting for 97.95%). The consultation suggestions were adjusting drug types(303 cases/times,69.17%). Consultation suggestions were adopt-ed completely in 405 cases/times(92.89%). There were 307 cases/times of effective outcome,with effective rate of 75.80%(307/405). CONCLUSIONS:Clinical pharmacists participated in clinical consultation is helpful to optimize therapy plan,play a positive play on the safety of drug use. Clinical pharmacists should further learn clinical medical and pharmaceutical knowledge and summa-rize the experience of clinical practice to improve the quality of consultation.

Objective To evaluate the clinical value of endoscopy for the treatment of acute obstructive suppurative cholangitis. Methods Data of 182 patients suffering from acute obstructive suppurative cholangitis, in whom endoscopic treatment was undertaken, were retrospectively analysed. Results All patients received endoscopic sphincterotomy (EST). Among them, 25 patients underwent endoscopic retractor-biliary drainage (ERBD), 140 patients received endoscopic naso-biliary drainage (ENBD), and in 17 cases endoscopic metal retractor-biliary drainage (EMBD) was done. The treatment was successfully in all patients. The clinical findings were markedly improved after treatment in all of them. Conclusion Endoscopic treatment was a fast, safe, effective and economic method for the treatment of acute obstructive suppurative cholangitis.

Objective To evaluate the clinical curative effects of pancreatic stents on chronic pancreatitis.Methods 18 cases of chronic pancreatitis were diagnosed by clinical symptoms,by lab tests and by relative examinations.All cases had received pancreatic stents endoscopic treatment,and were followed up postoperatively about the change of the clinical symptoms and the lab tests.Results All cases were placed successfully pancreatic stents.Abdominal pain relieved completely within one month.The remissive rate of abdominal pain was a hundred percent.The clinical symptoms such as marasmus and fatty diarrhea were markedly improved.The serum amylase level recovered to the normal range within 1 to 14 days,except one case in which the serum amylase level recovered slowly for the dysfunction of pancreatic external secretion.The stent was replaced in 1 case after 10 days because of obstruction.Conclusion Pancreatic stents endoscopic treatment of chronic pancreatitis is a preferred method which is secure,low-traumatic,low-expenditure,convenient and effectual,and it is of prominent clinical application value.

Objective To investigate the drug resistance genes of Acinetobacter baumanii in some areas of Nanjing City,and to explore the molecular epidemiology characteristics of different antibiotic resistant strains.Methods A total of 75 strains of Acinetobacter baumanii were isolated from three hospitals of Nanjing city from May 2015 to May 2016 and the strains were identified by microbial identification system.Drug resistances of the strains were determined by KB method.The genotypes of strains were analyzed by pulsed field gel electrophoresis,and PCR was used to amplify the resistance genes.The molecular epidemiology of Acinetobacter baumanii was studied.Results Seventy five strains of Acinetobacter baumanii all had high drug resistance to antibiotics except tigecycline and colistin.The rates of resistance to cefepime,ceftazidime,cefotaxime,ciprofloxacin,cefotaxime,tetracycline were all higher than 90％.The strains were mainly divided into 5 types,and the proportion of A type and B type accounted for 42.67％ and 37.33 ％.The positive rates of genes OXA-23,OXA-24,TEM,SHV,CTX-M,IMP-1,IMP-2 and VIM-2 were 81.33 ％,9.33％,66.67％,10.67％,42.67％,26.67％,16.00％ and 21.33％ respectively.Conclusion A type and B type of the Acinetobacter baumanii are the most popular in hospitals of Nanjing,and the strains are multiple drug resistance.The expression of main resistance genes OXA-23 and TEM strains may be the main mechanism for the higher resistance of the bacteria to antibiotics and β-amide antibiotics.

Objective To investigate the effectiveness of micro assistant teaching in physiology teaching . Methods A total of 112 students from the rehabilitation Class 1 and 2 of Grade 2016 in Hubei University of Medicine were selected as the subjects. Class 1 was the control group and Class 2 was the ex-perimental group . The control group adopted the traditional teaching method . The experimental group adopted micro assistant teaching method for physiology teaching. At the end of the course, the learning outcomes were evaluated by using descriptive analysis and t test (α=0.05) based on the final examination and questionnaire. Results There were significant differences in the final exam results between the exper-imental group and the control group [(81.46±7.63) vs. (68.21±10.27), t=-7.769, P=0.000]. There are also statistically significant between two groups according to the scores of Chapter 4 [(15.76±1.28) vs. (9.34± 1.96), t=-20.595, P=0.000], Chapter 8 [(8.31±0.86) vs. (6.28±1.22), t=-10.207, P=0.000] and Chapter 10 [(15.99±1.14) vs. (11.19±1.81), t=-16.856, P=0.000]. The questionnaire survey of teaching effect showed that in experimental group 56 students (98.24％) felt it could help to enhance interactive communication, 51 students (89.47％) believed it could help to organize the classroom discipline, 43 students (75.43％) believed it could increase learning interest, and 55 students (95.26％) believed it could help to accurately solve the various difficult points of knowledge. Conclusion Micro assistant teaching can improve the teaching effect of physiology teaching, which is worthy of promotion.

Objective Compare the efficacy of transvaginal cesarean scar pregnancy debridement surgery(treatment group) and the uterine artery embolization company with the curettage(control group) in the treatment of cesarean scar pregnancy and ana-lyze the related factors of the failure of the surgery .Methods Postoperative vaginal bleeding ,incidence of postoperative scar preg-nancy again ,and time of hospital stays after surgery were compared in two groups .Relationships between gestational age ,cesarean section ,the value of serum HCG ,B-mass size ,live births and surgical success rate were discussed .Results The mean amount of blood bleeding during operation of the treatment group was(85 .38 ± 13 .27)mL ,the rate of continue pregnancy after surgery was 2 .56% ,mean time of hospital stays was(5 .13 ± 0 .77)d ,Significantly lower than the control group[(163 .11 ± 34 .87)mL ,11 .90% , (8 .12 ± 1 .88)d ,all P< 0 .05] ;Blood HCG value ,B-mass size ,and live births were related with surgical success rate(P< 0 .05) ,But times of cesarean section and gestational age had no significant relationship with the surgical success rate(P> 0 .05) .Conclusion Tansvaginal cesarean scar pregnancy debridement surgery showed less damage on the treatment of cesarean scar pregnancy ,and re-duced the recurrence rate of the patient ,who had high blood HCG levels ,embryo survival and larger volume .

Objective To evaluate the effects of endoscopic treatment on chronic pancreatitis. Methods 33 cases with chronic pancreatitis having received endoscopic treatment in a 2 years' period were retrospectively analyzed. The diagnosis was confirmed in all the patients by clinical examination, lab tests, CT, ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP). According to the patients' condition, various treatment measures including endoscopic pancreatic sphincterotomy (EPS), endoscopic papillo-sphincterotomy (EST), pancreatic stenting (PS), pancreatic stone extraction, naso-pancreatic drainage (ENPD), pancreatic duct stricture dilation, etc, were used individually or jointly. Results 18 cases received EPS and 27 underwent EST. Pancreatic duct stone extraction by basket or balloon was performed in 6 cases, PS in 13, ENPD in 5, and pancreatic duct dilatation in 9 cases. The endoscopic drainage by transgastric placement of a stent was done in a patient with a huge pseudocyst. Abdominal pain disappeared or markedly relieved in 29 cases after treatment. Marked improvement after treatment was shown by lab examination and imaging. Conclusion The combined application of various treatment measures for chronic pancreatitis through endoscopic approach is a safe, minimal-invasive and effective procedure.

Gelastic epilepsy is a special refractory epilepsy accompany with ictal laughing and/or crying which can be divided into cortical induced gelastic epilepsy and hypothalamic hamartomas induced gelastic epilepsy according to their epileptogenic focus.Currently, domestic scholars had lack of systematic understanding of the mechanism and clinical treatment involved in gelastic epilepsy.Recently, foreign scholars had achieved great progress in the research of gelastic epilepsy which included the ictal laughing mechanism in gelastic epilepsy, the primary molecular mechanism in hypothalamic hamartomas induced gelastic epilepsy, the secondary epileptogenesis mechanism in hypothalamic hamartomas induced gelastic epilepsy and the clinical treatment of gelastic epilepsy.Now, the study progress of pathogenesis and clinical treatment of gelastic epilepsy were reviewed.

Traditional Chinese medicine considers that the final purpose of acupuncture treatment for disease is to harmonize yin and yang. Acupuncture redresses a balance between yin and yang by transmitting information to acupoints and then to corresponding visceral tissues and organs and the brain through the meridian system or the nervous system. In recent years, scholars at home thoroughly studied heart rate variability (HRV) analysis for acupuncture treatment of diseases and found that the regulating effect of acupuncture on visceral organs was closely related to autonomic nerves and acupuncture could restore a balance between sympathetic and parasympathetic nerves. Many scholars explored the effect of acupuncture on diseases related to autonomic nervous dysfunction by HRV frequency domain or time domain analysis and gained a certain achievements. This article summarizes recent years’ domestic studies on HRV-based analysis of acupuncture for diseases with autonomic nervous dysfunction and reviews the close relationship between autonomic nerves and diseases and the related mechanism of acupuncture action.