Objective To investigate the role of ERCP in geriatric population (≥70 yr) with biliary obstruction.Methods 218 geriatric patients (≥70 yr) and 189 non-geriatric ones ( ＜70 yr) admitted during 2001.1～2007.12 who had undergone biliary drainage by ERCP were retrospectively studied.Results The mean ages in geriatric and non-geriatric group were 79±9 and 56±7 yr,respectively.The success rates of biliary drainage were 96.8% (211/218) and 97.4% (184/189) in geriatric and non-geriatric group,respectively.The procedure time of ERCP was (55±30)rain and (58±34)min in geriatric and non-geriatric group,respectively.The complication rates were 16.1% (35/218) and 13.8% (26/189),respectively.The mortality rates were 1.83% ( 4/218 ) and 1.06% ( 2/189 ),respectively.There were no statistically significant differences between the two groups.However,the re-intervention rates were 16.1% (35/218) in geriatric group,which was significantly higher than that of 5.8% (11/189) in non-geriatric group.Conclusions ERCP was a less invasive,safe and effective treatment option for geriatric patients with bile duct obstruction.

Objective To discuss the application effect of health care failure mode and effect analysis in quality control of polysomnngraphy.Methods The health care failure mode and effect analysis were applied to analyze the process of polysomnngraphy,process reengineering was carried out according to potential risk factors and causes affecting the results of polysomnography in order to ensure the continuous improvement of quality of polysomnography.Results After the improvement of the key link affecting the quality of polysomnography,the number of the patients underwent polysomnography increased from 345 in 2007 to 657 in 2010,the success rate increased from 93％ to 98％ and the doctors' trust level about polysomnography increased from 90％ to 96％.Conclusions Applying the health care failure mode and effect analysis to analyze of key link affecting the quality of polysomnography prospectively and adopting the pertinent countermeasures can effeetively improve the quality of polysomnngraphy.

Objective To evaluate the application effect of psychological intervention of husband and wife for the center to patients with in vitro fertilization and embryo transfer. Methods Eighty infertile couples with in vitro fertilization and embryo transfer were selected and divided into intervention group and control group with 40 cases in each group according to the document order numbers, the two groups were given conventional health education of in vitro fertilization and embryo transfer, in addition,the patients in the intervention group received psychological intervention of husband and wife for the center, the intervention time was 5 weeks. Questionnaire investigation about Self- rating Depression Scale (SDS), Self- rating Anxiety Scale (SAS),Coping Style Scale and Subjective Feeling of Marriage Scale were conducted before and after the intervention. Results The scores of SDS and SAS were (30.43±8.92), (33.48±9.92) points after the intervention in the intervention group, and (40.26±9.54), (41.51±7.24) points in the control group,and there were significant differences (t=7.611, 6.245, P<0.01).The scores of help seeking, self- accusation, fantasy, wince and rationalization in Coping Style Scale were (0.63±0.19), (0.25±0.21), (0.41±0.22), (0.43±0.24), (0.42±0.21) points after the intervention in the intervention group, and (0.51±0.21), (0.38±0.22), (0.51±0.19), (0.55±0.23), (0.55±0.22) points in the control group, and there were significant differences(t=3.008-3.668, P < 0.05). The scores of subjective feelings of marriage and family relationship were (64.79±9.75), (34.37±5.12) points after inntervention in the intervention group, and (58.09±11.42), (29.23±4.97) points in the control group, and there were significant differences (t=7.212, 3.463, 15.234, P < 0.05). Conclusions Applying psychological intervention of husband and wife for the center to patients with in vitro fertilization and embryo transfer can improve the psychological state, reduce depression and anxiety, adopt positive coping style, increase the quality of marriage.

The principle and function of FluoViewTM FV500 laser scanning confocal microscope are expatiated.Suggestions are put forward in the selection of fluorescence probe,sample preparation,selection of parameters and environment requirment in using laser scanning confocal microscope.

Objective To observe the clinical effect of blood transfusion on earthquake victims from Wenchuan earthquake area, Sichuan province.Methods The blood routine, electrolyte and coagulation function of earthquake victims were detected.Results A total of 41(27.5%) victims received blood transfusion. The average volume of blood transfusion was 1 233 ml, and the average volume of plasma was 1 550 ml. No patient was found to have adverse transfusion reaction. There was no significant difference between the electrolytes before and after the transfusion.Conclusion Blood transfusion is important in the care of earthquake victims.

Objective To observe the effects of Shenmai injection on cardiac hemodynamics of isolated heart in rats of myocardial infarction model. Methods 30 myocardial infarction rat models created by ligation of left anterior descending coronary artery were randomly divided into a model group, a captopril group and a Shenmai group. 24 hours after successfully setup the models, all rat models were executed and their hearts were taken. Langendorff isolated heart perfusion method was adopted, and each group was perfused with 0.05mol/L amount of corresponding medicine, the model group was perfused with KH nutritive medium. left ventricular peak pressure(LVSP)and left ventricular ejection fraction(LVEF), left ventricular pressure increase/decrease rate(dp/dtmax±LV)(mmHg/s)and left ventricular end systolic diameter(LVESD)(%)and left ventricular end diastolic diameter(LVEDD)(%) was observed 5 min before the perfusion and 0.5 h, 1 h, 2 h after the perfusion. Results LVSP(9.47%± 0.15%vs. 3.34%± 0.05%),(11.25%± 1.31%vs. 3.79%± 0.04%) and LVEF reducing rate (7.44%± 0.10%vs. 4.94%± 0.04%), (10.24%± 0.31%vs. 5.34%± 0.05%) were elevated, and ±dp/dtmax(5 011 ± 253 mmHg/s vs. 5 827 ± 227 mmHg/s), (4 732 ± 212 mmHg/s vs. 5 837 ± 254 mmHg/s);(3 139 ± 127 mmHg/s vs. 4 722 ± 231 mmHg/s), (2 997 ± 125 mmHg/s vs. 4 793 ± 241 mmHg/s) was reduced in the Shenmai group 1 and 2 hours after the administration, which showed statistical difference compared to the model group (P<0.05). Conclusions Shenmai injection reduce myocardial contractility and intraventricular pressure of isolated heart o myocardial infarction rat models.

Objective:To explore the functions of cytokines and TM in the pathogenesis of acute cerebral infarction.Methods:The levels of IL-1、IL-6 、TNF and TM were detected by ELISA in 55 patients with acute cerebral infarction.Results:The levels of IL-1、IL-6 、TNF and TM were increased significantly in the patients with acute cerebral infarction in comparision with the controls ( P

Objective To discuss the clinical effect of normal saline flushing and heparinized saline flushing in invasive arterial blood pressure monitoring in the critical patients. Methods A total of 140 critical patients were randomly divided into the experimental group and the control group with 70 cases in each group according to the envelope method. The experimental group used normal saline for tube flushing, the control group used heparinized saline (5 U/ml) for tube flushing. The incidence of complications and coagulation index were compared between two groups. Results There was no statistically difference in the incidence of the catheter jam and local infection (P>0.05). The incidence of bleeding events was 14.3% (10/70) in the control group, which was higher than 2.9% (2/70) of the experimental group. The difference was statistically significant(χ2=4.466, P<0.05). The activated partial thromboplastin time, prothrombin time of the control group were (32.22 ± 4.22) s, (11.56 ± 2.12) s, which were longer than (29.84 ± 3.64) s, (10.66 ± 1.48) s of the experimental group. And international normalized ratio of the control group was 1.12±0.14, which was higher than 1.03±0.20 of the experimental group. The difference was statistically significant (t values were-3.573,-2.912,-3.084, P <0.05). Conclusions The normal saline flushing liquid was more safer and reliable in the invasive arterial blood pressure monitoring.

Objective:To analyze the curative effect of discectomy under Quadrant expandable channel associated with annulus repair for the treatment of adolescent lumbar disc herniation (ALDH).Methods:10 ALDH patients received discectomy under Quadrant expandable channel associated with annulus repair (annulus repair group) and 12 patients received discectomy (control group) in Clinical Medical College of Yangzhou University from January 2013 to December 2017 were retrospectively collected. The length of skin incision, amount of intraoperative bleeding, operation time and duration of hospitalization were compared. The degree of pain was assessed by visual analogue scale (VAS) before operation, 24 h, 1 week and 1 year after operation, and the lumbar function was assessed by Oswestry disability index (ODI) before operation, 1 week and 1 year after operation. At the last follow-up, the curative effect was evaluated by MacNab Scale, and the recurrence of lumbar disc herniation during the follow-up was recorded.Results:There were no significant differences in the amount of intraoperative bleeding, operation time and duration of hospitalization between the two groups ( P>0.05). The skin incision length of the annulus repair group was less than that of control group ( P<0.05). The postoperative VAS score and ODI score at each follow up time point in both groups were significantly improved when compared with the preoperative ones ( P<0.05). There were no statistically significant difference between the two groups in the VAS score and ODI score 1 week postoperative and 1 year postoperative ( P>0.05). According to the MacNab criteria, there was no statistically significant difference between the two groups in the excellent and good rate (annulus repair group: 9/10, control group: 10/12; P>0.05). There was no recurrence case in the annulus repair group, but two cases of recurrence (one recovered by conservative treatment, the other needed second operation) in the control group ( P<0.05). Conclusions:Discectomy under Quadrant expandable channel associated with annulus repair can achieve early satisfied outcome, reduce surgery related trauma, pain in the early period postoperative and recurrence rate after operation in the treatment of ALDH.

Institutions and management for some key processes in medical equipment management are described. Desired effect is achieved in practice. Good and efficicent medical equipment management is one of the important factors to guarantee medical quality in hospital. Medical equipment management should be improved with the equipment development.