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Objective:To evaluate the safety and efficacy of endoscopic resection in the treatment of patients with primary non-ampullary duodenal early cancer.Methods:A total of 20 cases with primary non-ampullary duodenal early cancer receiving endoscopic resection were collected from Jan 2015 to Dec 2019 at the Department of Endoscopy, the First Affiliated Hospital of Shandong First Medical University.Results:The size of lesions ranged from 0.3-2.5 cm (0.9±0.5)cm.The size of removed membrane samples ranged from 1.5-3.5 cm (2.5±0.7)cm. The edges were all negatiue pathologically. Duodenal perforation occurred in 2 cases, and all were successfully clipped by endoscopy. The follow-up time was from 4-42 months (20.4±11.4)m and no recurrence was found.Conclusion:Endoscopic resection is a safe and effective method for primary non-ampullary duodenal early cancer.
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Objective:To evaluate the clinical efficacy and safety of SpyGlass-guided laser lithotripsy for large common bile duct (CBD) stones with diameter>2 cm.Methods:From August 2015 to August 2018, a total of 157 patients with large CBD stones at the First Affiliated Hospital of Shandong First Medical University who met the inclusion criteria were randomly divided into SpyGlass group ( n=78, underwent SpyGlass-guided laser lithotripsy) and laparoscopic common bile duct exploration (LCBDE) group ( n=79, underwent LCBDE) by using random numbers. Non-inferiority test was used for rates of one-time stone removal and total stone removal, and the non-inferiority margin was set to 10%. The transform rate, incidence of short-term complications, hospital stay, and quality of life (assessed by the gastrointestinal quality of life index) were compared between the two groups. Results:The total success rates of stone clearance were 92.3% (72/78) and 96.2% (76/79) in the SpyGlass group and LCBDE group, respectively ( P=0.023), with valid non-inferiority hypothesis. The one-time stone removal rates were 83.3% (65/78) and 96.2% (76/79), respectively ( P=0.124), with invalid non-inferiority hypothesis. There were no significant differences in the incidence of transform [7.7% (6/78) VS 3.8% (3/79), P=0.294] or short-term complications [5.1% (4/78) VS 10.1% (8/79), P=0.246] between the two groups. Compared with the LCBDE group, the SpyGlass group had a shorter hospital stay (5.65±0.94 d VS 8.84±1.54 d, P=0.001) and higher scores of gastrointestinal quality of life index (1 month after operation: 99.85±4.36 VS 91.51±5.47, P=0.001; 3 months after operation: 131.24±3.32 VS 112.32±7.77, P=0.001). Conclusion:For large CBD stones, the efficacy of SpyGlass-guided laser lithotripsy is not inferior to LCBDE, and it is less invasive. In the future, SpyGlass-guided laser lithotripsy could be an important option for the treatment of large CBD stones.
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Objective:To compare the effects of repetitive transcranial magnetic stimulation (TMS) at three different relatively high frequencies on neuropathic pain so as to find the best frequency.Methods:One hundred Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a TMS group and a control stimulation group. The TMS group was further divided into a 5Hz group, a 10Hz group, and a 20Hz group. The rats in the model, control stimulation and TMS groups received constriction injury of the sciatic nerve, while the rats in the sham group were given a sham version of the operation. On the third day after the operation the rats in the TMS group and the control stimulation group began to receive TMS treatment. Neuropatic pain was evaluated on the day before the operation, and on the 3rd, 5th, 7th, 10th and 12th days after the operation. The evaluations included the paw withdrawal thermal latency (PWTL) and the paw withdrawal mechanical threshold (PWMT).Results:The average PWTLs and PWMTs in all of the TMS groups increased with the TMS treatment. Those of the 10Hz and 20Hz groups were significantly higher than the 5Hz group′s average, while there were no significant differences between the 10Hz group and 20Hz group.Conclusions:High-frequency TMS at different frequencies has different effects on neuropathic pain, at least in rats. The treatment efficacy at 10 and 20Hz is superior to that at 5Hz.
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Brain-derived neurotrophic factor (BDNF) exerts its survival-promoting effects on photoreceptors and retinal ganglion cells, however, delivery systems with little-to-no side effect are needed to sustain its controlled release and long-term efficacy. Our previous studies demonstrated that adipose-derived stem cells (ADSCs) are ideal delivery systems for gene therapy; moreover, ADSCs present unique properties like migration to damaged tissue sites, immunomodulation and anti-inflammation. Herein, we propose to employ ADSCs as the BDNF gene delivery vehicle. Different Analyses like flow cytometry, differentiation and cell proliferation assays etc demonstrated that BDNF were successfully transduced into ADSCs and the stemness of ADSCs was maintained even with the transduction. Real Time PCR and Western blot were used to measure mRNA and protein expressions of the BDNF-transduced ADSCs. The results demonstrated that the BDNF expression level of the lentiviral-BDNF transduced ADSCs is significantly increased and, moreover, enhanced the expression of other neurotrophic and downstream signaling factors. The data suggest that ADSCs are a reliable delivery vehicle for BDNF and could be used for the treatment of various diseases.
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Objective:To investigate the effect of paired associative stimulation (PAS) on the recovery of neurological function after cerebral infarction, and to explore whether any such effect is associated with autophagy in the ischemic penumbra.Methods:Sixty adult male Sprague-Dawley rats were randomly divided into a sham operation group ( n=20) and an experimental group ( n=40). The rats of the experimental group underwent 90 minutes of right middle cerebral artery occlusion (MCAO), while the sham group received a sham operation. The experimental group was subsequently divided into a model group ( n=20) and a PAS group ( n=20). The PAS group received 14 days of paired associative stimulation (PAS) beginning 24 hours after the operation. Neurological dysfunction was evaluated with a modified neurological severity scale (mNSS) and the elevated body swing test (EBST) on the 1st, 7th and 14th day after the MCAO. The rats were then euthanized and the expression of LC3Ⅰ, LC3Ⅱ, Beclin1, and Cathepsin B in the ischemic penumbra were detected using Western blotting, while the distribution of LC3 in neurons was detected using double immunofluorescent staining. Results:Compared with the sham group, the average mNSS scores and EBST values of the model and PAS groups were both higher on the 7th and 14th day after the MCAO, with those of the PAS group significantly lower than those of the model group on those days. The average mNSS score on the 14th day was significantly lower than on the 7th day. Compared with the sham group, the average LC3Ⅱ/Ⅰ values, Beclin 1 and Cathepsin B levels of both the model group and the PAS group were significantly higher on the 7th and 14th day after the MCAO, with the LC3Ⅱ/Ⅰ values of the PAS group significantly lower than those of the model group at both time points. The PAS group also had significantly lower Beclin1 and Cathepsin B levels on day 14. On the 7th and 14th days after the MCAO, the average number of LC3-positive cells and the ratio of LC3-positive neurons to total neurons in the model and PAS groups were significantly greater than the those of sham group, with the PAS group′s values significantly lower than those of the model group at each time point.Conclusion:PAS can significantly promote neurological recovery after stroke. The beneficial effects may involve inhibition of neuronal autophagy in the ischemic penumbra.
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Objective@#To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).@*Methods@#The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.@*Results@#Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.@*Conclusions@#TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Objective:To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).Methods:The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.Results:Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.Conclusions:TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Objective@#To analyze the research hotspots of domestic narrative nursing and explore its related research trends which provide reference and guidance for its application and development in China.@*Methods@#Wanfang, CNKI, VIP, CBM and other databases were retrieved from inception until October 2018. Word frequency analysis and graph cluster analysis were performed on the main information using Excel, Bicomb, Ucinet, Netdraw and gCLUTO software.@*Results@#A total of 649 articles were included. The result of visual analysis showed that the annual amount of publications showed an upward trend. The articles distributed abroad in many different journals which educational journals account mostly. The study regions were distributed in 34 provinces except Taiwan of China, Hainan, Tibet, and Macao Special Administrative Regions where mainly concentrated on East China and North China. The cooperation among authors and institutions both were not close; A total of 25 high-frequency key words were intercepted,and three hotspots of narrative nursing research in China were obtained,which respectively were: (1) The application of narrative medicine and the cultivation of narrative ability; (2) The application research of narrative therapy in humanistic care; (3) The application of narrative nursing in nursing practice.@*Conclusions@#Narrative nursing has attracted the attention of domestic scholars, but the depth and breadth of research still need to be improved. It is necessary to strengthen cooperation between inter-regional institutions, individuals and scientific research groups and pay attention to research hotspots in this field. Also,there is a need to conduct more high quality studies to verify the significance of narrative nursing.
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Objective: To analyze the ultrasonic appearances of sclerosing angiomatoid nodular transformation (SANT) of the spleen. Methods: Ultrasonic features of 8 cases of SANT confirmed by pathology were retrospectively analyzed. The location, size, shape, boundary, echo of lesions and blood flow information were observed in comparison of the pathological appearances. Results: Totally 9 lesions of 8 cases were observed, and 7 lesions protruded from the splenic surface. Most lesions were circular and clear margined, with the mean maximum diameter of (5.48±1.69)cm. Lesions displayed iso-echoic or slightly hypoechoic accompanying with hyperechoic bands and absent blood flow, but no apparent cystic changes nor calcification. The pathological findings of SANT in the spleen included lesions with clear boundaries, within which surrounded fibrous hard tissue and separated aneurysm-like nodules could be observed. Conclusion: SANT of the spleen has certain ultrasonic appearances.
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Objective To explore the sonographic features of primary testicular lymphoma(PLT).Methods The sonographic features of 16 PLT patients confirmed by surgery and pathology were retrospectively analyzed.Results Sixteen PLT patients were typed into 3 ultrasonic patterns:①The diffuse homogeneous echo type:2 cases,the ultrasonic features were homogeneous sieve-like hypoechoic echo,the blood flow signal was rich and radially distributed,with interstisial fibrosis inapparently under-microscope.②The diffuse uneven homogeneous echo type:9 cases,the ultrasonic features lobulated or map-like heterogeneous hypoechoic features,the blood flow signal was rich in linear distribution,and interstisial fibrosis proliferated to form fibrous septa under-microscope.③The focal nodular pattern echo type:5 cases,the ultrasonic features were homogeneous hypoechoic nodules,the blood flow signal was few,interstisial fibrosis hyperplasia surrounding the tumor under-microscope.Conclusions Ultrasonic appearances of primary testicular lymphoma are closely related to its pathologic characteristics,the recognization of their relations contributes to improve the diagnostic value of ultrasound.
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Objective@#To explore the sonographic features of primary testicular lymphoma(PLT).@*Methods@#The sonographic features of 16 PLT patients confirmed by surgery and pathology were retrospectively analyzed.@*Results@#Sixteen PLT patients were typed into 3 ultrasonic patterns: ①The diffuse homogeneous echo type: 2 cases, the ultrasonic features were homogeneous sieve-like hypoechoic echo, the blood flow signal was rich and radially distributed, with interstisial fibrosis inapparently under-microscope. ②The diffuse uneven homogeneous echo type: 9 cases, the ultrasonic features lobulated or map-like heterogeneous hypoechoic features, the blood flow signal was rich in linear distribution, and interstisial fibrosis proliferated to form fibrous septa under-microscope. ③The focal nodular pattern echo type: 5 cases, the ultrasonic features were homogeneous hypoechoic nodules, the blood flow signal was few, interstisial fibrosis hyperplasia surrounding the tumor under-microscope.@*Conclusions@#Ultrasonic appearances of primary testicular lymphoma are closely related to its pathologic characteristics, the recognization of their relations contributes to improve the diagnostic value of ultrasound.
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Objective@#To observe the effects of paired associative stimulation (PAS) on synaptic ultrastructure, neuron apoptosis and BDNF in rats with cerebral infarct, and explore the possible underlying mechanisms.@*Methods@#Forty-five male Sprague-Dawley rats were randomly divided into three groups: a sham operation group, a model group and a PAS group, with 15 rats in each. All the rats underwent a surgical operation for transient middle cerebral artery occlusion (MCAO) on the right side to model focal cerebral ischemia, with those in the sham operation group left without real occlusion. PAS treatment was given to rats in the PAS group 24h after MCAO model was successfully established, while no special intervention was given to those in the sham operation group and model group. After 28 days of treatment, transmission electron microscopy was used to investigate the ultrastructure of the ischemic penumbra, TUNEL was used to observe the apoptosis of cortex neurons, and real time-PCR to investigate BDNF mRNA expression.@*Results@#It was found that after 28 days treatment: ①The synaptic curvature, the synapse length and the post-synaptic density (PSD) decreased significantly in the rats of model group in contrast to those of the sham control group (P<0.05). And compare to model group, the synaptic curvature, the synapse length and the PSD increased significantly in the rats of PAS group (P<0.05). ②Compare to sham control group, the apoptosis rate of model group and PAS group increased significantly (P<0.05). And the apoptosis rate of PAS group decreased significantly in contrast to those of model group (P<0.05). ③Compare to sham control group, BDNF mRNA expression of the PAS group increased significantly(P<0.05), while BDNF mRNA expression of the model group decreased significantly(P<0.05). BDNF mRNA expression of the PAS group increased significantly in contrast to those of model group (P<0.05).@*Conclusion@#PAS promotes neural plasticity and inhibits apoptosis of cortex neurons of the ischemic penumbra in rats with ischemic cerebral infarction. One of the underlying mechanisms might be related to the up-regulation of BDNF mRNA expression.
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Objective To explore the effects and the underlying mechanisms by which paired associative stimulation ( PAS) of tibial nerve electrostimulation and M1 cortex transcranial magnetic stimulation ( TMS) in pro-moting the recovery of forelimb dysfunction in rats with cerebral ischemic stroke. Methods Resting motor thresholds of left extensor carpi radialis muscle ( ECR) were determined 5 min before and 5 min, 30 min, 60 min after PAS,respectively, in 8 male Sprague-Dawley ( SD) rats. Then 48 male SD rats were divided into a sham group ( n=16) subject to sham surgery, an experimental group (n=32) which was further divided into a MCAO group (n=16) and a PAS group (n=16) after cerebral ischemic stroke model was established successfully by occluding the right middle cerebral artery. 24 hours after surgery, PAS consisting of left tibial nerve stimulation and right M1 cortex area TMS was applied to PAS group once daily for 7 consecutive days. The corner tests and grip strength tests were per-formed before and after 7 days of PAS treatment in each group. The RMTs of left ECR were determined, metabolites of the left area tissue of cervical spinal cord were measured by nuclear magnetic resonance spectrum, and expressions of Bcl-2 and Bax of left and right area tissue of cervical spinal cord enlargement were detected by Western Blot tech-nique after 7 days of intervention. Results The average RMTs of left ECR at 5 min, 30 min, 60 min after PAS were significantly lower than those at 5 min before PAS ( P<0.05) . All rats in experimental group showed significant higher turning scores and lower grip strength when compared with sham group (P<0.001 or P<0.01). After PAS interven-tion, PAS group demonstrated lower turning scores, higher grip strength and lower RMT of left ECR as compared with MCAO group ( P<0.05 or P<0.01) . The expression of GABA of left cervical enlargment was significantly decreased in MCAO group when compared with the sham group ( P<0.05) , and there was no significant difference between MCAO group and PAS group. Meanwhile, other metabolites showed no significant difference among the three groups. The av-erage expression level of Bcl-2 and Bax proteins in both sides of cervical spinal cord enlargment showed no significant difference among three groups either. Conclusions Tibial nerve-M1 cortex area PAS may increase the excitability of motor cortical representation of forelimbs in rats, by which PAS promotes the recovery of forelimb dysfunction in rats with cerebral ischemic stroke.
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Objective To discuss the value of color Doppler ultrasound in the diagnosis and differential diagnosis of ovarian granulosa cell tumor (OGCT) . Methods Fourteen cases were diagnosed as OGCT by pathology postoperatively had been examined by color Doppler ultrasound check-up before the surgery . In image appearance ,the tumors were divided into cystic mass ,solid mass or mixed cystic-solid mass respectively according to their own pathological features . Additionally ,the blood flowing signal of OGCT was labeled from 0 to 3 grade with Adler standard based on the blood flowing imaging observed by color Doppler flow imaging ( CDFI) . The CDFI results were compared with the pathological diagnosis . Results Ultrasound image appearance of OGCT varied in the 14 cases .Two of them could be characterized as cystic mass ,5 solid mass and 7 mixed cystic-solid mass . The mixed cystic-solid OGCT contained solid mass in multiple cystic degeneration area . There was a significant difference in the diameter among three kinds of OGCT ( P = 0 .0006) . The more visible cystic lesion indicated the longer diameter of OGCT . According to the CDFI ,4 ,5 ,3 and 2 cases were 0 ,1 ,2 ,3 grade respectively in Adler standard . No significant difference was found among the four standards groups ( P =0 .056) . The localization diagnosis accordance rate of the Doppler imaging in OGCT was 71 .4％ (10/14) and the qualitative diagnosis accordance rate was 35 .7％ (5/14) . Conclusions The color Doppler ultrasonography can be the first-line preoperative imaging investigation in the diagnosis and differential diagnosis of OGCT ,as well as in the long-term following after surgery . It can provide more details and evidences for the treatment and prognosis assessment of OGCT .
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Aim Tostudytheanalgesiceffectofoxyso-phoridine (OSR)on GABA transporter-1 (GAT-1 )mR-NA expression and its influence on GAT-1 expression inmice.Methods Formalintestwasusedtodetectthe analgesic effect of OSR(iv).Immunohistochemis-try was taken to inspect the expression of GAT-1 in cerebral cortex and thalamus in mouse brain. The quantitative real-time PCR method was used to inspect the influence of OSR on GAT-1 mRNA expression of braininmice.Results OSR(500,250,125mg· kg-1 ,iv ) could significantly increase the foot-licking latency.OSR(500 mg·kg-1,ip)could significantly decrease the number of GAT-1 immuopositive cells incerebral cortex and thalamus in mouse brain,and re-duce GAT-1 mRNA expression in brain(P<0. 01,P<0.05)intheformalintest.Conclusion OSRhasa significant analgesic effect,and its analgesic mecha-nism is related to the GAT-1 expression in mouse brain.
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Objective To study the relationship between gestational glucose,lipid metabolism parameters and fetal distress.Methods Retrospectively,82 cases of primipara with fetal distress and 246 cases of primipara without any obstetric complications were analyzed.The latter were treated as control group.All the patients were from the same hospital between January,2014 and January,2016.Factors as fasting plasma-glucose (FPG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein (HDL-C),low-density lipoprotein (LDL-C) parameters during early pregnancy,blood glucose of fasting,1 hour and 2 hours in 75 g oral glucose tolerance test (OGTT),at 24 to 28 weeks of gestation,hemoglobin and blood pressure parameters during ante partum were recorded for all the cases while parameters as glucose and lipid,hemoglobin,blood pressure and cesarean section rate were compared between the 2 groups.Results FPG during early gestation,blood glucose of fasting,1 hour and 2 hours 75 g OGTT during mid gestation,systolic blood pressure and diastolic blood pressure during late gestation in the 'fetal distress' group were significantly higher than that of the control group.Hemoglobin during late gestation in the fetal distress group was lower than that of the control group,with statistically significant difference (P＜0.05).The rate of cesarean section in the fetal distress group was higher than that in the control group (x2=4.489,P=0.034).Conclusions High BMI at pre-pregnancy,high blood glucose during early and mid-gestation,high blood pressure and anemia during late gestation were related to the fetal distress group.Cesarean section rate was high for pregnancy women with fetal distress.
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Objective To study the relationship between gestational glucose,lipid metabolism parameters and fetal distress.Methods Retrospectively,82 cases of primipara with fetal distress and 246 cases of primipara without any obstetric complications were analyzed.The latter were treated as control group.All the patients were from the same hospital between January,2014 and January,2016.Factors as fasting plasma-glucose (FPG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein (HDL-C),low-density lipoprotein (LDL-C) parameters during early pregnancy,blood glucose of fasting,1 hour and 2 hours in 75 g oral glucose tolerance test (OGTT),at 24 to 28 weeks of gestation,hemoglobin and blood pressure parameters during ante partum were recorded for all the cases while parameters as glucose and lipid,hemoglobin,blood pressure and cesarean section rate were compared between the 2 groups.Results FPG during early gestation,blood glucose of fasting,1 hour and 2 hours 75 g OGTT during mid gestation,systolic blood pressure and diastolic blood pressure during late gestation in the 'fetal distress' group were significantly higher than that of the control group.Hemoglobin during late gestation in the fetal distress group was lower than that of the control group,with statistically significant difference (P＜0.05).The rate of cesarean section in the fetal distress group was higher than that in the control group (x2=4.489,P=0.034).Conclusions High BMI at pre-pregnancy,high blood glucose during early and mid-gestation,high blood pressure and anemia during late gestation were related to the fetal distress group.Cesarean section rate was high for pregnancy women with fetal distress.
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Objective To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of urinary tract urothelial carcinoma (UTUC).Methods Color Doppler ultrasonography exam was practiced in 84 UTUC patients preoperatively.According to ultrasound characteristics,lesions was classified into nodular type,wall thickening type and solid mass type,which were confirmed by pathology in all cases postoperatively.Results In the total of 84 cases (76 transitional-cell carcinoma,5 adenocarcinoma and 3 epidermoid carcinoma),lesions infiltrated laminae propria and surrounding tissue in 65 cases.In the nodular type of UTUC,there were nodules raising into lumen.Wall thickening type of UTUC was characterized by irregularly wall thickening,lumen narrowing,truncating and breaking.Similarly,obstruction broke off the ureteral lumen suddenly in solid mass type of UTUC.A clear demarcation could be found between the pipe wall and surrounding tissue in nodular type.However,such clear demarcation could not be found in wall thickening type and solid mass type.The accordance rate of ultrasonographic located diagnosis were 92.9 ％ (78/84),with 6 missed diagnosis cases.The accordance rate of qualitative diagnosis were 89.7％ (70/78).Conclusions As result of color Doppler ultrasonography,there were different relationship between lesion and the peripheral tissue in different types of UTUC.In types of wall thickening and solid mass,the demarcation was unclear and it is easier to violate the surrounding tissue.Color Doppler ultrasonography can provide more effective information for diagnosis and therapy UTUC.
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Objective To investigate the efficacy of prophylactic pancreatic stent placement and nonsteroidal antiinflammatory drugs( NSAIDs) for the prevention of post?endoscopic retrograde cholangiopan?creatography(ERCP) pancreatitis(PEP). Methods A total of 623 patients with high risk factors for PEP were treated with prophylactic pancreatic stent placement ( 145 patients, group A) or rectal NSAIDs( 478 pa?tients, group B) for PEP prevention by using the propensity score matching( PSM) analysis. Incidence of PEP, moderate and severe PEP were investigated. According to risk factors of PEP, indications of prophy?lactic pancreatic stent placement were analysed. Results Of 623 patients with high risk factors, 145 pairs were generated after PSM.Pancreatitis occurred in 32 patients,10 (6?9%) in group A and 22 (15?2%) in group B( P<0?05 ) . Moderate?to?severe pancreatitis developed in 5 ( 3?4%) patients in group A and 14 (9?7%) patients in group B(P<0?05).Risk factors of post?ERCP PEP were cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and history of ampullectomy. Conclusion Although the NSAIDs represent an easy, inexpensive treatment, prophylactic pancreatic stent placement is still a better prevention strategy for PEP.Prophylactic pancreatic stents should be recommended to those with risk factors including cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and ampullectomy.