Objective To discuss the operational technique and clinical effect of metallic stent placement in treating malignant gastroduodenal obstruction.Methods Metallic stent placement under fluoroscopic monitoring and endoscopic direct vision was performed in 47 patients with malignant gastroduodenal obstruction.A total of 54 metallic stents was used.Results The procedure was successfully completed in all 47 patients.During the follow-up period,all the patients could take liquid or ordinary diet and were markedly relived of vomiting.The living quality was much improved and no serious complications occurred.Conclusion Under fluoroscopic monitoring and endoscopic direct vision,stent placement is a safe,effective,technically-simple and time-saving procedure for the treatment of malignant gastroduodenal obstruction with less sufferings to the patient.Therefore,it is definitely worth popularizing this technique in clinical practice.

Objective:To investigate the efficacy and characteristics of subarachnoid xenogenetic adrenal medullary transplants on neuropathic pain. Method: Eighty rats were assigned to 4 different groups before their right sciatic nerves were tied according to the method described by Bennet. Each rat received subarachnoidly xenogenetic medullary pieces or isolated chromaffin cells according to the groups. The basal pain thresholds to thermal and electrical stimuli were determined before nerve ligations,and the analgesiometric tests were repeated at weekly intervals following transplantation for 10 weeks. Behavioral indications of spontaneous pain were recorded concomitantly. The effects of naloxone, phentolamine and fentanyl on the antinociception of chromaffin cells were evaluated. Result:The pain thresholds to noxious thermal and electrical stimuli increased after transplantation of medullary pieces or isolated chromaffin cells subarachnoidly. The Behavioral indications of spontaneous pain and hyperalgesia to thermal and electrial were also eliminated after the transplantation. These antinociceptive effects can be reversed by naloxone and phentolamine. Conclusion:Transplanting xenogenetic chromaffin cells into subarachnoid space can reduce neuropathic pain effectively,and this antinociception is conducted via adrenoreceptors and opiate receptors.

Objective To evaluate the safety and therapeutic effect of covered expandable metallic stent placement combined with interventional chemotherapy in treating malignant esophago-tracheal fistulae. Methods A total of 60 patients with esophago-tracheal fistula were enrolled in this study. The patients were randomly divided into control group (n=28) and study group (n=32). Patients of the control group were treated with covered stent implantation only, while patients of the study group were treated with combination use of covered stent implantation and interventional chemotherapy. All the patients were followed up regularly, the short-term and long-term results were determined, and the effect rate, median survival time and complications were statistically analyzed. Results Among the 60 patients, successful obstruction of the fistula was obtained in 58 with a success rate of 96.7%. The median survival time of the 58 patients was 5.8 months. The median survival time of the control group and the study group was 3.6 months and 8.7 months respectively, the difference between the two groups was statistically significant (P<0.05). The one-month, 3-month and 6-month effect rates were 78.1%, 68.8% and 62.5% respectively. The incidence of esophageal stent re-stenosis in the study group was much lower than that in the control group. Conclusion The combination use of covered stent implantation and interventional chemotherapy can effectively improve the median survival time of patients with malignant esophago-tracheal fistula, and reduce the occurrence of stent-related complications. Therefore, covered expandable metallic stent placement combined with interventional chemotherapy is an effective and safe treatment for malignant esophago-tracheal fistulae.