Objective To evaluate the effects of pantoprazole on patients with upper gastrointestinal bleeding and its safety, as compared with omeprazole. Methods Ninety patients with non variceal upper gastrointestinal bleeding were randomly assigned to two groups. Sixty patients were in the group of pantoprazole, including 24 patients with gastric ulcer, 33 duodenal ulcer and 3 erosive gastritis; 30 patients were in the group of omeprazole, including 9 patients with gastric ulcer, 15 duodenal ulcer and 5 erosive gastritis.Treatment schemes:either pantoprazole or omeprazole 80 mg were added into 250 ml 5% glucose respectively and then infused intravenously. The clinical signs of the patients including the amout of bleeding were observed. Results After the treatment, the symptoms and sings improved significantly in both groups( P 0.05). Both the total effective rate of pantoprazole and omeprazole on upper gastrointestinal bleeding was 96.7%. The rates of side effects were 1.7% in pantoprazole group and 3.4% in omeprazole group. Conclusion Pantoprazole is also an effective and safe drug for the non variceal upper gastrointestinal bleeding.

By using antr-ras P21 mouse monoclonal (MoAb), SCI-Oncogema 1, the authors examined immunohistochemica! staining in pancreatc adeocarcinoma. The percentage of positive staining was 24/43 (558%). Furthermore it was indicated that the positive staining rate of antr-ras P21 MoAb was related to either histopathological grade or clinical stage. Upon statistical analysis of the correlation between the staining of anti-ras P21 and patient prognosis with Kaplan-Meier curve and Log-rant test, the positive staining cases showed comparatively better prognosis than the negative ones. Our study suggests that ras P21 expression may be important in the early stage of pancreatic carcinoma.

With the method of endoscopic ultrasonography (EUS) and Color scale ultrasound, 156 patients with stomach and gallbladder diseases were examined, The features revealed by the EUS and color scale ultrasound for these diseases were compared with the pathological changes. The findings were that:the mean color quantity scale of benign gastric ulcer was higher than that of gastric cancer(p<0.01).The gallbladder stone was two color quantity scales higher than did polypoid lesions of gallbtadder(p<0.01).The color scale ultrasound can improve the clear degree of lesion pictures.The correct rates of diagnosis were no significant differences between color scale ultrasound and grev scale ultrasound.

Objective To study the technique of double stent drainage on biliary and pancreatic ducts obstruction,and to assess its clinical effectiveness.Methods Firstly,ERCP was done on all patients to investigate the locus and extent of the stricture or obstruction,in order to choice the stent with suitable diameter and length.Then the stents placed into biliary and pancreatic ducts though the guidewires those was inserted into the ducts already.After the operation,the level of serum amylase and clinical symptoms such as jaundice,abdominal pain and diarrhea were observed to assess the therapeutic effect.Results 14 patients diagnosed as biliary and pancreatic ducts stricture or obstruction were treated successfully with this method(5 patients suffered from ampulla cancer,4 carcinoma of head of pancreas,3 carcinoma of duodenum papilla,2 chronic inflammation of head of pancreas).Thirteen patients were placed with 14 plastic biliary stents in their biliary ducts(each was placed with one stent except one with 2 stents),and one patient was placed with metal stent.At the same time,14 pancreatic stents were placed into pancreatic ducts of these patients.The rate of jaundice extinction in 2 weeks,1 month and 3 months after the operation was 50 percent,71 percent and 93 percent respectively.The rate of abdominal pain remission in 2 weeks after operation was 75 percent.Among 7 diarrhea patients ,the clinical symptoms disappeared in 5 patients and were significantly improved in 2 patients one month after the operation.The obstruction and displacement of stents had not been observed in all patients within 3 months after the operation.The complications related to operation had not been observed in all patients within 3 months after the operation.Conclusions The therapy with double stent drainage in biliary and pancreatic duct stricture is safe and effective.It can relieve jaundice and abdominal pain,decrease biliary pressure and improve the exocrine dysfunction of pancreas.

Objective To investigate the occurrence of early complications of diagnostic and therapeutic ERCP and its treatment .Methods Occurrence,kind,treatment and outcome of early complications of diagnostic and therapeutic ERCP were respectively reviewed in 8 579 cases in our hospital between January 1977 and December 1999.Results 112 cases had early complications(1.31%).In diagnostic ERCP morbidity of early complications was 1.30%(95/7290) and it was 1.32%(17/1289)in therapeutic ERCP.Of them,acute pancreatitis occurred in 38 cases(0.44%),billiary infection 30 cases(0.35%),bleeding of digestive tract 26 cases(0.30%),drug reaction 8 cases(0.09%),stone and basket incarceration 5 cases(0.06)%,intestinal perforation 1 cases (0.01%) and retroperitoneal pneumatosis 1 cases(0.01%).Of them,106 patients were cured by conservative therapy.Operations were performed in 5 patients.1 patient died.Conclusion In diagnostic ERCP acute pancreatitis is the most common complication,which may be related to difficulty of cannulation,repeated developing and inappropriately injecting contrast medium. In therapeutic ERPC bleeding of digestive tract is the most common complication ,which is related to the procedure ,jaundice and diabetes.Most of complications can be cured by conservative therapy,but a minority needs operation.

70 patients with gastric carcinoma were studied by EUS prior to surgery. The results were correlated with the histology of resected specimens according to the new TNM classification. EUS was accurate in assessing the depth of tumor infiltration, the overall accuracy of EUS was 74.3%. The cancerous ulcer and obstruction are the main causes of over- and understaging, respectively. EUS was relatively accurate in the assessment of lymph node metastasis, the overall accuracy was 57.1%. However, negative-predictive rate is lower, about 42.9%. It is difficult to distinguish between inflammatory and metastatic lymph nodes. EUS was not reliable in diagnosing distant metastasis, due to its limited depth of penetration. In our experience, in staging the gastric carcinoma, greater accuracy would be achieved if we use EUS for T and N factors, and CT for M factor.

4 and the area under the curve of intragastric pH was increased to 7.18?1.06, (93.41?8.43)% and 6.20?10 5?0.90?10 5, respectively ( P

Objective To determine the role of endogenous NO in gastric mucosal tolerant cytoprotection under stress and its possible mechanism. Methods SD rats were exposed to WRS repeatedly during which L NAME, a non selective NOs inhibitor, and L Arg, a substrate for NO synthesis, were administered to inhibit or promote the synthesis of NO, GMBF was measured using LDF 3 flowmeter, NO levels in gastric mucosa were tested by Griess reaction and gastric mucosal lesions were evaluated by ulcer index (UI). Results Gastric tolerant cytoprotection was accompanied by increased GMBF and NO levels in gastric mucosa. Inhibition of endogenous NO synthesis by L NAME worsened mucosal lesions induced by WRS. After repeated WRS, adaptive increase of GMBF was abolished and NO content in gastric mucosa significantly reduced. In contrast, enhancement of endogenous NO synthesis by L Arg attenuated mucosal erosions caused by WRS. GMBF and NO content in mucosa increased. After 4th WRS, mucosal lesions could be negligible. Conclusion By regulating GMBF, endogenous NO might play an important role in the gastric mucosal tolerant cytoprotection under stress. Inhibition of NO synthesis delayed the induction of tolerant cytoprotection, while increase NO synthesis will ptomote the induction of tolerant cytoprotection.

Objective To investigate the influence of endoscopic retrograde cholangiography (ERC), endoscopic retrograde pancreatography (ERP), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and endoscopic biliary stenting on postoperative pancreatitis. Methods 412 patients referred to ERCP were divide into 7 groups, there were both biliary and pancreatic ducts group (ERCP), biliary duct contrast filling group (ERC), pancreatic duct contrast filling group (ERP), ERCP plus biliary stenting group (stent), ERC plus stent, ERCP plus EST and stone extraction (SE) group, and ERC plus EST and SE group. And the differences of postoperative serum amylase in 4 hours and in 24 hours as well as clinical symptoms were compared among different groups. Results The incidence of postoperative hyperamylasaemia in 4 hours and 24 hours were 17.7% and 4.4% respectively. The incidence of postoperative acute pancreatitis was 3.9%, and ERP group had the highest incidence of postoperative acute pancreatitis among the 7 groups. Conclusions Repeated pancreatic duct contrast filling during ERCP manipulation is the main risk factor for postoperative pancreatitis, and therapeutic ERCP such as EST, stent and SE does not increase the incidence of postoperative pancreatitis.

Objective To investigate diagnostic significance of detecting p53 protein in cytologic specimens by endoscopic pancreatic duct brushing for pancreatic cancer. Methods p53 protein in cytologic specimens was detected by immunohistochemistry, and the resules were compared with cytologic specimens by HE staining. Results Sensitivity, specificity, and accuracy of HE staining for pancreatic cancer is 53%, 100% and 70% respectively. Sensitivity, specificity, and accuracy of detecting p53 protein for pancreatic cancer is 59%, 100%, 74% respectively. Sensitivity, specificity, and accuracy of HE staining and detecting p53 protein for pancreatic cancer is 71%, 100%, 81% respectively. Conclusions HE staining combined with detecting p53 protein in cytologic specimens by endoscopic pancreatic duct brushing is a useful stool for diagnosis of pancreatic cancer. It is helpful to differentiate benign diseases of pancreas from malignant tumor of pancreas.