Objective To evaluate the safety and efficacy of simultaneous endoscopic bilateral placement of selfexpandable metal biliary stents in malignant hilar biliary obstruction． MethodFrom May 2007 to December 2010, a total of 24 patients with hilar malignancy of Bismuth type Ⅱ to Ⅳ underwent endoscopic retrograde cholangiopancreatography (ERCP) and bilateral metal stent placement. Technical success rate, functional success rate, ERCP related complications, stents’ patency time, and patient’ survival time were recorded and reviewed． Results Twentyone of 24 patients were followedup for average 39 months. Technical success rate was 100%, the average operation time was （36.2±13.9） min, the functional success rate was 95.45%. Mild cholangitis occurred in 2 cases and there was no ERCP related pancreatitis, bleeding, perforation, and death. Stents dysfunction occurred in 7 within followup period. Amonge them, plastic stents were inserted through the metallic stents in 4 cases, PTCD was required in 1 case, and conservative therapy was given in the other 2 cases. The median stent’ patency time and median patient’ survival time were 253 d (95% CI: 199.79-306.21) and 229 (95% CI : 154.53-303.47）, respectively, with no significant differences between Bismuth classification types. ConclusionEndoscopic simultaneous bilateral biliary metal stent placement is technically feasible, safe, and effective to malignant hilar obstruction.
ObjectiveTo analyze the 2023 learning society construction project in order to provide references for researchers in this field. MethodsExcel 2021 software was used to summarize and comb the list of key tasks for the construction of a learning society in 2023 (field of higher continuing education) published on the official website of the Chinese Ministry of Education, and to visually analyze the research topics of key tasks in the medical field and the distribution of applicants. ResultsThe analysis found that a total of 250 projects were shortlisted in the cultivation and construction list, including 100 teaching reform and innovation tasks of continuing education for academic degrees, 100 reform and innovation tasks of non-academic education, and 50 tasks to explore the path of coordinated innovation of the three education. The project involved digital transformation, education and teaching reform, ideological and political education, etc. There were 17 medical projects, accounting for 6.8% of the total number of key tasks. The 17 medical key task declaration units were distributed in 12 provinces (regions), which were mainly concentrated in East China, and the construction of "non-double first-class" universities as the main force; The results mainly focused on personnel training and education and teaching reform. ConclusionThe analysis results of the key task list of 2023 learning society construction (field of higher continuing education) provide important references and enlightenment for the researchers in the field of education, and provide guidance and references for the future development of higher continuing education.