Objective: To itvestigate the effect of Antidepressant on refractory irritable bowel syndrome(IBS).Methods: A self-control study of subclincal dosage of antidepressants therapy(fluoxetine 10mg/d or paroxetine 10mg/d) for 12 weeks in 46 patients with refractory IBS was performed.The clinical outcomes were evaluated by indexs of symptom severity and symptom frequency and the score of Hamiton depession scale(HAMD) and Hamiton anxiety(HAMA).Results: All 46 cases completed the therapy.After the course of treatment,indexes of symptom severity and symptom frequency and the scores of HAMD and HAMA were significantly lower than those before treatment(P

0.05),but the rate of recurrent bleeding in EBL group was significantly lower than that in EIS group (6.3% vs. ~40.0% , P0.05). Conclusions EBL is an effective and safe ~endoscopic treatment for hemorrhagic Dieulafoy's lesion.

0.05), but the rate in eradicating varices after the first treatment session was significantly higher(66.7% vs. 10.0%, P 0.05); the comparison of the Kaplan Meier estimate of survival did not show any statistically significant differences in the two groups. Conclusions The sandwich method leads to longer retention of sclerosant in varices and is far superior to EVL alone with respect to the rate in eradicating varices after the first treatment session and prevention of rebleeding and variceal recurrence. The study shows the sandwich method is the optimal endoscopic method for the treatment of EVB.

Objective To analyze the expressions of p27 and PCNA and cell apoptosis in ulcerative colitis and colon cancer.Methods The expressions of p27 and proliferation cell nuclear antigen(PCNA)proteins in colorectal cancer,ulcerative colitis and normal colon were analyzed by StrptAvidin-Biotin Enzyme Complex immunohistochemical methods.The apoptosis was detected using terminal uridine deoxynucleiotide nick end labeling(TUNEL) histochemistry.Results The level of PCNA expression in colorectal cancer and ulcerative colitis was markedly higher than that in normal colon(P

Gastrointestinal benign stricture is a common disease with symptoms of dysphagia,abdominal pain and difficult defecation,which severely impair the quality of life for patients.Endoscopic intervention is the first-line treatment,and the available methods include balloon dilation,local drug injection and stent insertion,etc.Endoscopic incision was first used for the treatment of Schatzki's rings,and later it was used for the treatment of other gastrointestinal benign strictures,and the promising results were achieved.

Objective To explore the effect of recombinant pEGFP-N3-APC vectors carrying various APC functional domains on the expression of β-catenin in human colorectal cancer cells HT-29.Methods The recombinant plasmids were transfected into HT-29 cells mediated by lipofectamine~(TM) 2000, and detected by green fluorescence and RT-PCR. Western blot was applied to detect β-catenin expression level in HT-29 cells after transfection, and gray scales of electrophoresis strips were analyzed by SPSS 13.0.Results Green fluorescence and RT-PCR made clear that all 5 recombinant plasmids were successfully expressed in HT-29 cells. Western blot showed that β-catenin expression level in HT-29 cells was not affected after being transfected with pEGFP-N3-APC1, pEGFP-N3-APC2 and pEGFP-N3-APC3, and was distinctly affected after being transfected with pEGFP-N3-APC4 and pEGFP-N3-APC5, especially the later one. Conclusion The selected APC5 gene fragment with 15-amino acid repeats and SAMP repeats, which is relatively short, can degrade β-catenin level in HT-29 cells and may be applied in the gene therapy.

Background:Hepatic veno-occlusive disease( HVOD) is a disease characterized by hepatomegaly,jaundice, ascites,weight gain and lack of effective treatment currently. Our prophase research showed that ligustrazine had therapeutic effect on Sedum aizoon induced HVOD in mice. Aims:To investigate the mechanism of therapeutic effect of ligustrazine on Sedum aizoon induced HVOD in mice. Methods:A total of 115 mice were randomly divided into 4 groups:mice in group A were intragastrically administrated with 30 mg·kg-1 ·d-1 Sedum aizoon to induce HVOD and served as model group;mice in group B were given 30 mg·kg-1 ·d-1 Sedum aizoon + 100 mg·kg-1 ·d-1 ligustrazine and served as low dose ligustrazine intervention group;mice in group C were given 30 mg·kg-1 ·d-1 Sedum aizoon + 200 mg·kg-1 ·d-1 ligustrazine and served as high dose ligustrazine intervention group;mice in group D were given 30 mg·kg-1 ·d-1 PBS and served as normal control group. After 30 days,all the mice were sacrificed. HE staining and Masson staining were performed for histological examination. The mRNA and protein expressions of tissue factor(TF),nuclear factor(NF)-κBp65 and early growth response factor( Egr)-1 in liver tissue were determined by RT-PCR and Western blotting, respectively. Results:HE staining and Masson staining histological examination showed that ligustrazine could obviously ameliorate the pathological injury of liver tissue in HVOD mice. Compared with group D,the mRNA and protein expressions of TF,NF-κBp65,Egr-1 were significantly increased in group A( P < 0. 05). After intervention with ligustrazine,the mRNA and protein expressions of TF,NF-κBp65,Egr-1 were significantly decreased( P < 0. 05), especially in group C,and no significant differences were found between group C and group D(P > 0. 05). Conclusions:Ligustrazine has therapeutic effect on HVOD,the possible mechanism is that ligustrazine could interrupt the activation of coagulation system by reducing the expression of TF via down regulating the expressions of NF-κBp65 and Egr-1,especially in high dose ligustrazine group.

Background:There have been several studies about peroral endoscopic myotomy( POEM)for treating esophageal achalasia( EA). Although the feasibility,safety and effectiveness of POEM have been demonstrated,comparative studies of full-thickness and circular muscle myotomy were rare. Aims:To evaluate the efficacy and safety of POEM for treating patients with EA. Methods:A total of 216 patients with EA admitted from Aug. 2011 to Nov. 2013 at the Second Xiangya Hospital of Central South University were treated with POEM,of whom 133 received full-thickness myotomy and 83 received circular muscle myotomy. Data about Eckardt ’s score, diameter of esophageal lumen, intra- and post-operative complications and recurrence before and/or during periodical follow-up were collected,and the efficacy of full-thickness and circular muscle myotomy was compared. Results:All the 216 patients successfully underwent POEM with an average operation time of 59. 1 minutes. Average length of tunnel and myotomy were 13. 3 cm and 10. 1 cm,respectively. Symptoms remitted in all of the 216 patients,Eckardt’s score decreased significantly,diameter of esophageal lumen was reduced(pre-treatment vs. 6 months after treatment,53. 7 mm vs. 30. 8 mm,P<0. 001),and complications occurred in 13. 0%(28/216)of the cases. Success treatment was achieved in 99. 1%(214/216)of the cases with a follow-up of 3-30 months( mean 13. 8 months),no recurrence was noted. The operation time,efficacy and complications were comparable between full-thickness and circular muscle myotomy(P>0. 05). Conclusions:POEM is an effective and safe method for treating EA. Full-thickness myotomy did not increase the operation time and procedure-related complications, however,its long-term efficacy and complications need to be further assessed.

Objective To evaluate the efficacy and safety of peroral endoscopic full-thickness myotomy for patients with severe esophageal achalasia.Methods A total of 64 patients with severe achalasia,whose Eckardt's score ≥6,esophageal diameter ≥6 cm or with S-type esophagus,were treated by peroral endoscopic full-thickness myotomy.Data of Eckardt's score,complications,recurrence,gastroscopy and esophageal barium radiography were collected before and during periodical follow-up.Results All the 64 patients underwent peroral endoscopic myotomy (POEM) successfully,mean operation time was 55 minutes,average length of tunnel and myotomy were 14.1 cm and 10.6 cm respectively,and full-thickness myotomy was performed beyond 6 cm near esophagogastric junction.Symptoms remitted in all patients.Eckardt's score decreased significantly [pre-treatment VS post-treatment,(7.4 ± 1.5) VS (0.6 ± 0.8),P ＜ 0.001],the diameter of esophageal lumen reduced[pre-treatment VS post-treatment,(59.7 ± 13.0) mm VS (31.4 ±3.3) mm,P ＜ 0.001),and the diameter of cardia increased [pre-treatment VS post-treatment,(15.6 ± 10.1) mm VS (33.4 ± 8.9) mm,P ＜ 0.001].Complications occurred in 9.4％ (6/64) of the cases,gas-related complications was 6.3％ (4/64).Treatment success was achieved in 98.4％ cases (63/64) with a follow-up of 6 ～20 months (median 12.3 months),with no recurrence cases.Conclusion Peroral endoscopic full-thickness myotomy is an effective and safe method for severe achalasia.Long-term efficacy and complications need further assessment.