Objective To evaluate the therapeutic effects of microwave coagulation and balloon dilatation on benign esophageal stenosis. Methods The location and degree of esophageal stenosis was diagnosed by endoscopy. Balloon dilatation or microwave coagulation plus balloon dilatation were selected to treat esophageal stenosis according to the severity of esophageal stenosis. Results 87 cases of esophageal stenosis were caused by esophageal anastomosis after esophagectomy (n=37), radiotherapy(n=25), chemical damage(n=22) and unclear causes(n=3) respectively. 66 cases of esophagostenosis were treated by balloon dilatation and 21 cases were treated by microwave coagulation plus balloon dilatation. 78 cases of esophageal stenosis were significantly improved, 8 cases were improved, and 1 case happened esophageal perforation. Conclusion Endoscopic therapies including balloon dilatation or microwave coagulation plus balloon dilatation were efficacious to esophageal stenosis caused by various causes.

Objective: To investigate the effects of Interlukin- 4(IL-4) on the invasiveness and the expression of several cell surface antigens related to invasive and metastatic potentials of human hepatocellular carcinoma QGY-7701 cell line in vitro. Methods: QGY-7701 cells were incubated with high concentration of IL-4 or low concentration of IL-4 in different time. The expression of ICAM-1, CD44 and HLA-I was determined by fluorescence-activated cell sorter (FACS) analysis, the tumor cell binding affinity to extracellular matrix (ECM) components was measured by cell attachment assay, the degree of homotypic aggregation was quantified by cell aggregation assay. Results: IL-4 pretreatment can enhance the expression of ICAM-1 and HLA-I, suppress the expression of CD44 on hepatocellular carcinoma cell line and decrease the binding affinity to ECM components and the degree of homotypic aggregation of hepatocellular carcinoma cells. Conclusoin: IL-4 can inhibit the invasive and metastatic potentials of hepatocellular carcinoma cells.

Objective To explore the clinical characteristics of posthepatitic cirrhosis accompanied with peptic ulcer (called as hepatogenic ulcer, HU) and the effect of quadruple therapy in this event Methods A total of 105 cases of PU were subjected in this study, and 126 patients with simple peptic ulcer (PU) served as control Endoscopy was carried out to observe the peptic ulcer, bleeding, and healing after treatment Urease testing was employed to detect Helicobacter pylori (Hp) in gastric mucosa All patients were followed up for 2 years Results Most cases of PU were confirmed to have duodenal ulcer The positive rate of Hp was 72 4% in HU group before treatment Ulcer healing rates of quadruple therapy were 65 7% and 88 5% respectively in HU group and PU group During the follow up, the rates of recurrence and rebleeding were 68 4% and 30 2% in HU group, and 48 9% and 16 6% in PU group,with very significant difference between them ( P

Objective To investigate neoplastic lesions in gastrointestinal tract treated by endoscop-ic mucosal resection (EMR). Methods The properties, extent and infiltrating depth of the neoplastic lesions in gastrointestinal tract were detected by chromoendoscopy, magnifying videoscopy and endoscopic ul-trasonograpy. The tumors in niucosa or its muscular layer including the early cancer, precancerous lesion, submucosal tumors, polyps in laterally development, large polyps with or without peduncle were removed by EMR or transparent plastic cap EMR. Results Thirty-one submucosal tumors and four early cancers (esoph-ageal cancer 2, cardiac carcinoma 1 , early colonic carcinoma 1 ) and moderate or severe gastric dysplasia 2 were treated by EMR or transparent plastic cap EMR, no recurrence happened within 3-18 months follow-up. Laterally spreaded 13 polyps and 21 subpedunculated or sessile typed large polyps were resected by the procedures of EMR and Endoscopic Piecemeal Mucosal Resection ( EPMR). Five (7. 04% ) cases were complicated with bleeding during the procedure, and cured under endoscopies. One patient with villus adenoma ( 1. 41% ) recurred three months after EMR. Conclusion Under the guidance of chromoendoscopy, magnifying videoscope and endoscopic ultrasoundgraphy, EMR is a safe and effective endoscopic therapy for early cancers, submucosal tumors and large polyps in gastrointestinal tract.

Objective To evaluate the safety and efficacy of resection (EMR) of gastrointestinal tumors by EUS assisted with high-frequency probe EUS (HFPE). Methods EMR assisted with HFPE was attempted in 30 patients with gastrointestinal tumors with 0. 5 - 3. 5 cm in diameter. Complications such as bleeding and perforation were carefully monitored. The entire resected specimen received histopathological examination. Follow-up was regularly taken in outpatient clinic. Results In 28 (93. 3% )out of 30 patients tumors were successfully resected by EMR. 95. 2% cancerous and 85. 7% tumorous lesions were resected satisfactorily. No severe bleeding or perforation occurred nor had any recurrences be observed when follow-up of 2 ~ 13 months. Conclusion EMR assisted with HFPE is a safe and desired measure in the treatment of early small gastrointestinal tumors.

Objective The aim of this study was to reveal the clinical features of colorectal polyps by investigating its endoscopic features using a magnifying videoscope. Methods One hundred and five colorectal polyps presented in colonoscopy were included in this study. A magnifying videoscope with a zoom ranging from ? 1 to ? 100 magnification combined with indigocarmine dye was employed to observe the pit pattern of colorectal polyps. Pit pattern was analyzed according to Kudo' s modified classification as follows; (1) type Ⅰ ; round pit; (2) type Ⅱ; asteroid; (3) type Ⅳs; tubular or round pit, which is smaller than the normal pit (type Ⅰ ) ; (4) type ⅢL: tubular or round pit, which is larger than the normal pit (type Ⅰ ) ; (5 ) type Ⅳ : dendritic or gyrus - like pit; ( 6 ) type Ⅴ : irregular or amorphous pit; and ( 7 ) mixed type. Types Ⅰ and Ⅱ represented the pit pattern of nonneoplastic polyps and types Ⅲ L , Ⅲs, Ⅳ , Ⅴ , and mixed type represented the adenomatous polyps represented neoplastic polyps. Results In all samples of polyps, 17 were of the pedunculated type, 40 subpedunculated type and 48 sessile type. Among the 17 pe-dunculated type, 12 were type Ⅰ ,Ⅱ pit pattern. In those subpedunculated types, type Ⅰ , Ⅱ pit pattern were found in 15. 0% (6/40) , type ⅢL , Ⅲs , Ⅳ, and Ⅴ were detected in 85. 0% (34/40) . Type Ⅰ ,Ⅱ pit pattern were found in 41. 7% (20/48), type Ⅰ,ⅢL, ⅢS, Ⅳ, and V were in 58.3% (28/48) in sessile type. Of all polyps 88 (83. 8% ) were situated between the splenic flexure and rectum , but'no correlation was found between pit pattern and location of polyps. The incidences of neoplastic changes in the lesions with pit pattern Ⅰ,Ⅱ ,ⅢL, Ⅲs,Ⅳ, Ⅴ , and mixed type were 0% , 11. 8% , 77. 3% , 75. 0% , 100. 0% , 100. 0% , and 70. 0% , respectively. The diagnostic sensitivity of neoplastic and nonneoplastic polyps were 96. 7% and 80. 0% , and specificity were 86. 6% and 94. 7% . The overall diagnostic accuracy in differentiating neoplastic from nonneoplastic polyps was 89. 5% . Conclusions The pit pattern analysis of colorectal polyps by magnifying colonoscopy combined with indigocarmine staining is a useful and objective tool fur differentiating nonneoplastic lesions from adenomas or invasive carcinoma of the large bowel. There-fore it may be possible to determine, at the lime of colonoscopy, which lesions require treatment or not, and which one should be removed by endoacopy, or by surgery.

Objective To analyze and investigate endoscopic and pathological characteristics in the diagnosis of early esophageal carcinoma. Methods The clinical data of 62 patients with early esophageal carcinoma who had been admitted to Southwest Hospital from January 2003 to December 2007 were retrospectively analyzed. Results Of all patients, 8 had upper esophageal carcinoma, 42 had middle esophageal carcinoma and 12 had lower esophageal carcinoma. The tumor growth patterns included surface diffusion growth (n = 30), bidirectional growth (n = 11), intracavitary growth (n = 9), intra-esophageal wall growth (n = 7) and mixed growth (n = 5). The diameter of lesions ranged from 1.0 cm to 2.9 cm in majority. Surgical resection was done in 38 patients, endoscopic mucosal resection in 23 patients and endoscopic submucosal dissection in 1 patient. Postoperative pathological examination showed that 13 patients had in situ carcinoma, 22 had intramucosal carcinoma and 27 had submucosal carcinoma. The lymph node metastatic rate of intramucosal carcinoma and submucosal carcinoma were 5% (1/22) and 15% (4/27), respectively. The numbers of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma carcinoma and spindle carcinoma were 57, 2, 1, 1, 1, respectively. ConelusionsEarly esophageal carcinoma tends to appear in the middle part of esophagus, and with surface diffusion growth type. Most of the early esophageal carcinoma are squamous cell carcinoma. Endoscopy combined with lugol's iodine and methyleneblue staining is effective in detecting early esophageal carcinoma.

Objective To evaluate the value of double vital staining with both iodine and methylene blue in diagnosing early esophageal carcinoma. Methods Lugol' s iodine was sprayed on the esophageal lesions first, then methylene blue. The results before or after staining with mythylene blue were compared. The tumor infiltrative depth in the esophagus was assessed by gastric endoscopy and endoscopic ultrasonography (EUS). The tumors were resected surgically or under endoscopy. Results After Lugol's iodine spray it stained the normal esophageal squamous epithelium brown-black, whereas the lesions did not. In 10 cases with 11 lesions, 9 cases (81. 8% ) showed the margin of lesions fairly clear. After spray of methylene blue it stained all the lesions in blue color with clear margin. The mucosal resection was done in one case under endoscopy and surgical resection in 8 cases. All of the 9 cases were diagnosed pathologically squamus carcinoma including mucosal carcinoma, 6 lesions and submucosal carcinoma, 4 lesions. The pathological diagnostic accuracy in differentiating mucosal cancer from submucosal cancer by endoscopy or EUS was 80% ; by both endoscopy and EUS in conjunction was 90%. Conclusion Double vital staining with both iodine and methylene blue is very useful in revealing the area and infiltrative depth of early esophageal cancer.

Objective To assess the potential diagnostic value of the potential of flexible image col-or enhancement system(FICE)with magnifying endoscopy for superficial esophageal lesions by observing the intrapapillary capillary loops(IPCL)in esophageal mucosa. Methods IPCL in patients with esophageal diseases were studied with Fujinon EG-590ZW FICE endoscopy. The relationship between changes of IPCL in 31 cases of superficial esophageal lesions and pathological findings was studied. Results The vascular patterns of IPCL were analyzed and classified as follows: Type Ⅰ,often seen in normal esophagus,were e- venly distributed with regular forms. TypeⅡ,protracted,often occured in esophagitis. Type Ⅲ showed two or three of such four changes as,dilatation,wave-like inflection,irregular caliber and deformity,which was mainly seen in dysplasia. While Type Ⅳshowed all the four changes mentioned above and frequently ap- peared in esophageal cancer. Of the 17 cases of esophagitis,fifteen cases were TypeⅡIPCL and the others Type Ⅲ. Of the 10 cases of dysplasia,eight were Type Ⅲ IPCL and two high-grade dysplasia showed Type Ⅳ IPCL. One sml early esophageal cancer showed Type Ⅲ IPCL and all three advanced esophageal cancer showed TypeⅣ IPCL. Conclusion The esophageal microvessels can be clearly seen by FICE with magnif- ying endoscopy,and the differentiation of superficial esophageal lesions can be fairly performed with the ob- servation of IPCL,it gives an important practical siginificance in diagnosing tumorous lesions.

Objective To explore the diagnosis value of narrow-band imaging magnifying endoscopy (NBI-ME) in the early esophageal cancer and precancerous lesions while estimating the quality,depth and treatment strategy.Methods One hundred and eleven cases of patients with suspected early esophageal cancer and precancerous lesions,who underwent ESD treatment,were selected as the study subjects.To estimate the diagnosis value of NBI-ME in the quality,depth and treatment strategy with pathological histology as gold standard.Results While estimating quality,there was no low grade intraepithelial neoplasia(LGIN) cases with NBI-ME.A total of 33 cases were diagnosed as high grade intraepithelial neoplasia(HGIN),including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,and the other 78 cases were diagnosed as early esophageal cancer,including 5 cases of LGIN,22 cases of HGIN,and 51 cases of early esophageal cancer.Compared with the pathology results,the quality consistency of NBI-ME is general:K=0.498.While estimating depth,there was no LGIN cases with NBI-ME.A total of 33 cases were diagnosed as HGIN,including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,67 cases were diagnosed as intramucosal carcinoma,including 5 cases of LGIN,22 cases of HGIN,30 cases of intramucosal carcinoma,and 10 cases of submucosal carcinoma after ESD treatment,and 11 cases were diagnosed as submucosal carcinoma.Compared with the pathology results,the depth consistency of NBI-ME is general:K=0.469.Most of the patients shoud be treated by ESD except 8 cases of LGIN.Conclusion The study shows general diagnosis value of NBI-ME in estimating quality,depth and treatment strategy of early esophageal cancer and precancerous lesions.