Objective:To evaluate the effectiveness of endoscopic minimally invasive treatment for submucosal tumors of the esophagus.Methods:Included in the study were 33 patients with esophageal submucosal tumors,male 23 and female 10 cases,aged 34-85 years(average 51.2).The lesions were removed by means of endoscopic mucosal resection(EMR),or stripping-resection method,i.e.,first stripped by a needle knife and followed by "injection and cut".Results:All the lesions were resected completely by endoscopic minimally invasive methods.Of 33 lesions,15 cases were undertook EMR,and 18 cases were treated by stripping-resection method.Except 5 cases of treatable bleeding,and 6 cases of post-operative substernal pain,no other complications were found.Pathological exam and immunohistochemical study showed that 25 cases were esophageal leiomyoma,3 cases of stromal tumor,2 cases of lipoma,2 cases of haemangioma and 1 case of submucoal cyst.No recurrence was found during the follow-up of 2-30 months. Conclusion:Endoscopic minimally invasive therapy is effective and safe for the treatment of esophageal submucosal tumors.

The diagnosis and monitoring of inflammatory bowel disease mainly depend on clinical presentation , endoscopical , histopathological and imaging findings .It has been demonstrated that fecal inflammatory biomarkers can be potential markers to replace endoscopy diagnosed disease activity .Calprotectin is a binding protein of calcium and zinc , which is mainly derived from neutrophils and macrophages .Calprotectin is an accurate noninvasive biomarker in diagnosing and monitoring inflammatory bowel disease in clin -ics.This paper reviews the progress of fecal calprotectin in the diagnosis, disease activity evaluation, clinical monitoring and prognosis of inflammatory bowel disease .

Mannan binding lectin (MBL) is an innate immune mediator belonging to the collectin family known to bind to the surface of many viruses, bacteria and fungi. Many researches show that MBL is associated with many autoimmune diseases. Inflammatory bowel diseases (IBD) including ulcerative colitis and Crohn's disease are related with innate individual immunity. This article reviews the recent researches on the association of MBL with IBD.

objective The consequences of macroscopic classification for early colorectal cancer(CRC),carried out by clinicians from China and Japan,were compared.Methods The endoscopic color photos and related materials of 7 selected patients with early CRC were distributed to each of 5 endoscopists from China and Japan to present everyone's own idea on classification.Results Some lesions assumed as typeⅡ (flat pattern) by Japanese were considered as typeⅠ (elevated pattern)by Chinese.While the lesions having protrusion with central depression were depicted by physicians of both sides according to the ratio of areas with different outlook,namelyⅡ a＋Ⅱ c orⅡ c＋Ⅱ a.Some new terms have been adopted currently by Japanese only,such asⅡ a＋ depression,LST(laterally spreading tumor).Conclusion Regarding the macroscopic classification indices for early CRC discrepancies exist between Sino-Japanese doctors.More comments and cooperation seem necessary to set up an unified criterion.

Objective To design a kind of suitable equipment to collect the specimens from endoscopic mucosal resection (EMR),and observe the effect of the collector on clinical application. Methods The six-hole rotating collector was made from transparent glass,in which the specimens could be aspirated through the channel and remained in a mental net. A total of 813 cases with 1254 lesions in esophagus,stomach and large intestine were included in the study. All the cases were male 516,female 297,age in 7-90 years old (average 53.2 years). The collector was used for receiving these EMR specimens that less than 1cm in diameter. The final diagnoses were proved by histopathologic examination. Results The rotating collector was named as Transparent 6-hole Rotating Eodoscopic Specimen Collector,and registered as national patent. The collector was a round column type,about 160g in weight and 56 mm?60 mm in size,which was light,clear and easily cleaned,and worked well during clinical application. The total collecting success rate for specimen receiving is 93.3%. All the specimen samples kept undamaged and good for histological analysis. Conclusion The rotating specimen collector is useful and economic for endoscopic mucosal resection.

Objective To further study the effectiveness of endoscopic mucosal resection (EMR) for the treatment of early cancer and precancerous lesions on colon and rectum. Methods A total of 58 patients with 70 lesions were included in this study. EMR were performed by means of " injection and cut " method. Results All the lesions were resected completely by EMR. All the diagnoses were proved by pathology as follows: mucosal cancer 3 cases, adenoma with mild to severe dysplasia 53 cases, and inflammatory polyps 14 cases. No recurrence was found during the follow up survey for 1 23 months. Except 3 cases of treatable hemorrhage, no other complications were found. Conclusion The results of this study further confirm that EMR is effective and safe for the treatment of early cancer and precancerous lesions on colon and rectum

Background:Intestinal permeability plays an important role in the development of ulcerative colitis. Sugar molecular probes is a safe and non-invasive method to measure intestinal permeability,and its correlation with inflammatory factors and claudin-8 is not clear. Aims:To explore the correlation of sugar molecular probes with TNF-α,CRP and claudin-8 in intestinal permeability in colitis rats. Methods:Twenty-four rats were assigned randomly to model group and normal control group. Colitis model was induced by DSS solution. Expressions of TNF-α,CRP were determined by ELISA,and expression of claudin-8 was determined by immunohistochemistry. Sugar molecular probes were determined by high performance liquid chromatography. Correlations of inflammatory factors and claudin-8 with sugar molecular probes were analyzed. Results:Compared with normal control group,expressions of colonic tissue TNF-α and CRP were significantly increased while expression of claudin-8 was significantly decreased in model group(P < 0. 01);secretion of lactulose and sucrolose,ratio of lactulose/ mannitol( L/ M)were significantly increased( P < 0. 01)while mannitol secretion was significantly decreased(P < 0. 01). Secretion of lactulose and sucrolose were positively correlated with expressions of TNF-α and CRP(P < 0. 01),but negatively with expression of claudin-8(P < 0. 01). L/ M ratio and mannitol secretion were negatively correlated with expressions of TNF-α and CRP(P < 0. 01),but positively with expression of claudin-8(P <0. 01). Conclusions:Sugar molecular probes and expressions of TNF-α,CRP,claudin-8 have similar results in predicting intestinal permeability in rats. Sugar molecular probes can be used as a potential method to measure intestinal permeability.

Objective To explore the expression of transcriptional regulation factor FHL 1 in pancreatic fibrosis of chronic pancreatitis (CP) and clinical significance.Methods Serum samples from 20 CP patients treated in the Department of Gastroenterology , Nanjing General Hospital and 20 healthy controls in the corresponding period were collected .The level of FHL1 in the serum was detected by ELISA .Twenty male Wistar rats were randomly divided into control group and CP group according to the body weight .The CP rat model was established by injecting dibutyltin dichloride ( DBTC) through tail vein .All the rats were killed at 28 days after injection and the pancreas was collected , which was observed using hematoxylin and eosin ( HE) staining to investigate pathological changes . The expression of FHL1 in pancreas was measured by immunohistochemistry (IHC) and Western blotting (WB).Results The average of serum FHL1 level in two groups were (0.86 ±0.22)g/L and (1.18 ±0.22)g/L, respectively.The level of FHL1 in serum of CP patients was significantly lower than that of healthy cases , and the difference was statistically significant (t=10.54, P=0.001).Damaged pancreatic lobular structure , acinar atrophy and the obvious fibrous hyperplasia were observed in CP rats .The pathological score of abnormal structure , acinar atrophy, fibrosis, and inflammatory cell infiltration in the pancreas of the CP group was (2.2 ±0.4),(2.0 ±0.7),(2.4 ±0.3) and (2.8 ±0.6), respectively, but was all 0 in control group.The difference between two group was statistically significant ( t value =17.24, 9.01, 25.22 and 14.75, respectively, all P<0.001).The expression of FHL1 in the pancreatic tissue of CP group were less than that of normal group , and the difference was statistically significant (IHC:15 798 ±3 247 vs 37 570 ±9 254, t=2.438,P=0.016;WB:0.44 ±0.11 vs 0.89 ±0.03, t=4.289, P=0.002).Conclusions The protein of FHL1 was in low expression in the pancreas of CPs , indicating that FHL1 may participate in the formation of pancreatic fibrosis .

Objective To observe the change of comprehensive agitating coefficient in the intracerebral hem -orrhage( ICH) patients monitoring by non-invasive cerebral edema and dynamical method ,and to find out dynamical change of cerebral edema in patients with ICH ,and to evaluate the specificity and sensitivity of non-invasive dynami-cal brain edema monitor in ICH treatment .Methods The change of comprehensive agitating coefficient in 130 patients was detected by non-invasive dynamical brain edema monitor at day 1,3,5 and 7 from ICH onset.Results The comprehensive agitating coefficient in focus side was lower than the unaffected side in both groups at the first day .The coefficient in the focus side was higher than the unaffected side at the third day ,and then became approximately equal at day 5 and basically normal at day 7.The comprehensive agitating coefficients in focus side were significantly differ-ent to unaffected side at day 3,5(P<0.01),and quite different at day 1,7(P<0.05).Conclusion The compre-hensive disturbance coefficient takes on dynamical changes in the ICH and reflects the course of edema formation . Cerebral edema monitoring by non-invasive and dynamical method can evaluate the course of cerebral edema ,and has a guiding role to the therapy of the ICH .

Purpose　The aim is to study the effects of solubl e chit osan on antitumor factors and NK cell activity in rats.Methods　The level of NO、TNF produced by peritoneal macrophages,IFN-γ production and NK ce ll activity of spleen was detected,after different concentrations of chitosan we re injected into the sarcoma 180 rats peritoneally.Results　Th e cont ents of NO、TNF、IFN-γ and NK cell activity in sacroma 180 rats were significa ntly higher in the chitosan groups than those in the control group (P＜0.01) .Conclusion　Chitosan could impove the immune function in rats .