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Objective To evaluate aggressive hydration with lactated Ringer′s solution for prophylaxis of post-ERCP pancreatitis ( PEP ) during the perioperative period. Methods CNKI, VIP, Wangfang,Pubmed,Embase and Cochrane Library were searched for randomized controlled trials( RCTs) on aggressive hydration with lactated Ringer′s solution for preventing PEP published from the setup time of databases to June 2018. According to the inclusion and exclusion criteria, RCTs were selected by two researchers,data were extracted and methodological quality was assessed independently. Revman 5. 3 was used to perform the meta-analysis.The heterogeneity among the included RCTs was analyzed by using the Q test and the chi-square test. The funnel plots,the risk of bias graph and the risk of bias summary were used to evaluate publication bias. Results A total of 10 RCTs with 1727 patients were included. Meta-analysis showed that 10 RCTs had no significant heterogeneity ( P=0. 10, I2 =39％) , aggressive hydration with lactated Ringer′s solution could reduce the incidence of PEP(OR=0. 37,95％CI:0. 26-0. 53,P<0. 00001). Hyperamylasemia incidence was included in 6 RCTs,and the results showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of hyperamylasemia ( OR=0. 41, 95％CI:0. 27-0. 64, P<0. 00001 ) . A total of 4 RCTs compared the incidence of abdominal pain after ERCP between the experimental group and the control group. Meta-analysis showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of abdominal pain ( OR=0. 32, 95％CI: 0. 15-0. 68, P=0. 003) . Conclusion Aggressive hydration with lactated Ringer′s solution can effectively prevent PEP and other complications.
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Objective To approach the correlation between preoperative detection of serumal carcinoembryonic antigen (CEA ) and carbohydrate antigen 19‐9(CA19‐9) and primary tumor/regional lymph nodes/distant metastasis(TNM) staging ,clinicopatho‐logic staging and clinical features of patients with colorectal cancer (CRC) ,and to explore their clinical significance .Methods The dates of 231 patients with CRC treated in the First Affiliated Hospital of Chongqing Medical University from April 2011 to January 2013 were gathered .Then ,the relationship between detection of CEA and CA19‐9 and TNM staging ,clinicopathologic staging and clinical features of patients with CRC were analyzed . Results The positive rate of CEA in patients with CRC was 51 .5%(119/231) and the positive rate of CA19‐9 in patients with CRC was 46 .3% (107/231) .The positive rates of CEA and CA19‐9 were positively correlated with the TNM staging and clinicopathologic staging of CRC (P<0 .05) .Conclusion The positive rate of CEA and CA19‐9 were associated with the tumor progress and metastasis ,so the detection of CEA and CA19‐9 could be used as one of important serumal marker for clinicopathologic staging of CRC .Also ,detection of CEA and CA19‐9 could be used for prog‐nosis judgment and therapeutic schedule institution .
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Diagnostics is an important professional medical course concerning basic theory,basic skill and basic approach of diagnosis.Using standardized patients in clinical scene can relieve the shortage of clinical teaching resources and strained doctor-patient relationship as well as improve the clinical skills and doctor-patient communication of students.However,there were many problems in using the standardized patient;therefore,discussions were needed to find a better solution.
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With the increasing confrontation between doctors and patients and the increasing number of medical conflictions, case reports, as convincing evidence, have played a more and more important role. How to improve medical students’ capability of writing case reports and avoid the occurrence of some medical conflictions turns out to be a problem that has to be solved. This article makes a tentative exploration in this respect.
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Objective With the increasing number of medical disputes,it is urgent to train the interns'skills. Methods Interns improved their doctor-patient communication skills by enhancing awareness on the doctor-patient communication,learning a variety of medical laws and regulations,improving clinical skills,training good medical ethics to master some communication skills. Results Through such training,medical disputes due to interns never happened during the internship period. Conclusion Our training program is practicable.
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Objective:To clone the recombinant plasmid affecting gene DNMT1 expression by RNA interfering and transfect it into AGS in order to further search its effects on the cell cycle of gastric cancer AGS.Methods:Two DNA sequences containing short hairpin structure was designed and synthesized.The complement form was obtained by annealing and inserted into vector pTZU6+1.The recombinant plasmid was transfected into AGS.Finally the cell cycle was evaluated through flow cytometer.Results:The S cycle cells of the transfected AGS dropped dramatically.And the G2-M cycle cells increased significantly.Conclusion:Successful cloning and transfecting the recombinant make it possible to search new gene therapy for the tumors.
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Special weight has been laid on young teachers in the buildup of teaching staff in medical universities.Aimed at promoting their active and creative involvement in exploring their potentials and helping them develop into qualified teachers in the current new era,this article performs some tentative research on approaches to their self-improvement.
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Objective:To clone the recombinant plasmid affecting gene DNMT1 translation by RNA interfering and analyze the nucleic acid sequence of the recombinant for further searching new gene therapy method of tumor.Methods:Two DNA sequences containing small hairpin structure were designed and synthesized.The complement form was obtained by annealing and inserted into vector pTZU6+1,and the recombinant plasmid was transformed into Jm109 strain.Finally the plasmid identified by restriction enzyme was used for sequence analysis.Results:The recombinant was cloned and the aim sequence was obtained.Conclusion:Successful cloning of the recombinant helps to search new gene therapy method of tumor.