Objective:To discuss the clinical use of endoscopic Sphincterotomy(EST)and endoscopic nosalbiliary drainage(ENBD) in the treatment of severe acute pancreatitis.Methods:77 patients were divided into the endoscopic treatment group and contol group.EST plus ENBD were performed in patients of the endoscopic treatment group 24h after hospitalization.The control group were treated with the combination of treatment.Blood was drawn in each group the day and 48h following hospitalization for amylase measurement.The time of bellyache relief.the morbidity rate and hospital stay were also observed.Results:48h after hospitalization amylase measurement was significiantly lower in endoscopic treatment group 982?mol/L?24?mol/L than that in control group(1576?mol/L?31?mol/L,P

Objective:To study the effect of hypoxia on the invasion ,metastasis,and angiogenesis of gastric cancer in vitro. Methods: MTT was used to study the effects of viability durng hypoxia on SGC-7901,The Boyden Chamber membrane invasion culture system was used to study invasion,metastasis,and angiogenesis. Immunocy tochemical staining was used to observe the change of TGF-?1. Resuts: In the membrane invasion culture system,the numbers of invading and migrating SGC-7901 cells were significantly higher in hypoxia group than in the control group (P

Objective:To study the clinical treatment for esophageal malignant stenosis or esophageal fistula with stent implantation under the supervision of gastroscope.Methods:Eighteen operation-intolerant patients with late esophageal cancer accompanied by stenosis or fistula were selected and administered nickel-titanium coil stent under the supervision of gastroscope.Results:The symptoms of dysphagia and esophageal fistula disappeared and the stent was setup properly.Conclusion:The technique of implanting the nickel-titanium coil stent is an effective palliative treatment for the late esophageal malignant stenosis or fistula.And it is simple and reliable to implant the esophageal stent under the supervision of gastroscope.

0.05 and P

Objective:To study the inhibitory effects of soybean isoflavones and its induction of apoptosis of human gastric cancer cell SGC-7901.Methods:MTT,FCM and electron microscope were used to study the effects of soybean isoflavones on SGC-7901.Results:MTT showed that the soybean isoflavones inhibited SGC-7901 growth.It could arrest the cell in G2/M,electron microscope showed soybean isoflavones could reduce apoptosis.Conclusion:Soybean isoflavones inhibits SGC-7901 cells growth via apoptosis reduction.

Objective To investigate the preventive role of somatostatin in acute pancreatitis and hyperamylasemia induced by endoscopic retrograde cholangiopancre aticography (ERCP) in different periods .Methods 570 cases were divided into four groups , the preoperative group(127 cases) ,the postoperative group(153 cases) ,the whole group(189 cases) and the control groups(101 ca-ses) ,and occurrences of acute pancreatitis and hyperamylasemia were observed .6 h before the operation ,the preoperative group was given 3 mg somatostatin per 12 h by microdosis venous pump .In 12 h after the operation ,the postoperative group was given 3 mg somatostatin per 12 h by microdosis venous pump ,the whole group was given somatostatin 6 h before and 12 h after the operation , the control group was injected normal saline .Measurement of hyperamylasemia was made in 24 h after ERCP ,and clinical manifes-tations of acute pancreatitis were also observed .Results The incidences of PEP and hyperamylasemia were 4 .04% ,23 .86% ,re-spectively .The incidences of hyperamylasemia among the four groups were 23 .62% ,21 .57% ,13 .23% and 47 .52% ,and the inci-dences of PEP were 3 .15% ,4 .58% ,1 .59% ,8 .91% .The incidences of hyperamylasemia and PEP in somatostatin used groups were statistical lower than the control group(P<0 .05) .Compared with the preoperative group and the postoperative group ,the incidence of hyperamylasemia in the whole group had significant difference(P<0 .05) .Compare witn the postoperative group ,the incidence of PEP in the whole group also had significant difference(P<0 .05) .Conclusion Use of somatostatin can reduce the incidence of PEP and hyperamylasemia ,and the use of somatostatin before and after the operation have a better preventive effect .

Objective To investigate the efficacy and significance of endoscopic sphincterotomy(EST)and endoscopic nasobiliary drainage(ENBD)combined with the continuous blood purification(CBP)in the treatment of severe acute pancreatitis(SAP).Meth-ods The clinical data of 179 patients with SAP treated in our hospital over a period of ten years were retrospectively analyzed.The cases were divided into four groups according to the treatment methods.The conventional group was treated with the routine meth-od,the CBP group received the CBP therapy combibed with routine methods,the endoscopic group was given EST and ENBD on the basis of the routine methods and the combined group was treated with CBP,EST and ENBD.The patients′vital signs,WBC,CRP, APACHE Ⅱ score,abdominal signs change,incidence of complications,mortality and hospitalization days were compared among 4 groups.Results Compared with the conventional group,the clinical indicators,WBC,CRP,APACHEⅡ scores,blood amylase lev-el,incidence of local complications,mortality and hospitalization days in the rest three groups were decreased significantly(P<0.05),the total effective rate of abdominal signs relief was significantly increased(P<0.05);compared with the rest groups,the to-tal effective rate of abdominal signs relief in the combined group was increased(P<0.05),the blood amylase level,incidence of local complications and hospitalization days were decreased significantly(P<0.05),the mortality was significantly lower than that in the conventional group(P<0.05),however there was no difference between the CBP group and the endoscopic group(P>0.05).Con-clusion CBP combined with EST and ENBD in treating SAP has the active and effective role for improving the disease condition, reducing complications and the mortality,and shortening the hospitalization time.

Sentinel lymph node (SLN) is the first group of lymph nodes to receive breast lymph nodes and the first group of lymph node metastasis. It can accurately predict the metastatic status of axillary lymph nodes, which is an important reference factor in the diagnosis and treatment of breast cancer. It has become the first choice for early breast cancer staging. The rapid and accurate intraoperative localization and diagnosis of SLN is of great significance for the choice of operation mode and the improvement of therapeutic effect. SLN location and diagnostic methods are still needed to be investigated. This article reviews various methods in clinic recently.

Objective To systematically assess the values of B-ultrasound(US),computed tomography(CT),magnetic resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP)in diagnosing cholangiocarcinoma(CCA).Methods All published literatures on bile duct cancer were collected from the literature databases of PubMed,Medline,Embase,CNKI and Wanfang.Then the patients with bile duct cancer suspected by US,CT,MRCP and ERCP were performed the systematic review.The evaluation indicators included sensitivity and specificity.The summary receiver operating characteristic(SROC)curve was adopted to obtain the area under the curve(AUC)and Q values.The diagnostic values of 4 kinds of method were analyzed.Results Forty-four articles were included,involving 4 364 patients.The pooled sensitivities of US,CT and MRCP were 0.75,0.82 and 0.85 respectively,the specificities were 0.72,0.80 and 0.87 respectively(sensitivity and specificity of ERCP cytology and image were 0.62,0.98;0.88,0.84),the Q values were 0.690 8,0.787 8 and 0.841 7(0.846 1,0.833 2 in ERCP cytology and image).Conclusion The accuracy of CT,MRCP and ERCP for diagnosing bile duct cancer is similar and higher than that of US,which is an effective assisted examination method when compared with US.The pooled specificity of ERCP cytology is obviously higher than that of other examination method and has high clinical diagnostic value in the patients with highly suspected bile duct malignant tumor.

Objective To study the mechanisms and effect of soybean isoflavone on esophageal carcinoma cell ECa109 during the normoxia and hypoxia. Methods The environment of hypoxia was established by GasPak method. The ECa109 cells were assigned into normal control group, soybean isoflavones group, hypoxia group, and soybean isoflavones plus hypoxia group. The effect of soybean isoflavones was determined by MTT, and FCM was used for detecting the apoptosis and cell cycle of ECa109. Electron microscope was used to observe the ultrastructural changes of ECa109 induced by soybean isoflavone. Immunohistochemistry was used to detect the changes of HIF-1? and Fas. Results Soybean isoflavone could inhibit significantly the growth of ECa109 cells in a concentration-dependent manner, and arrest the cells in G_2/M phase during normoxia and hypoxia. The inhibitory effect was elevated significantly during hypoxia, and the cell apoptosis and necrosis were observed by electron microscope. The Fas expression was elevated by soybean isoflavone during the normoxia and hypoxia, and the HIF-1? expression was down-regulated during hypoxia. Conclusion Soybean isoflavone can inhibit ECa109 cells growth by delaying the progress of cell cycle, up-regulating the Fas expression. Soybean isoflavone can inhibit the expression of HIF-1? that was increased during hypoxia, which may be the mechanism that the inhibitory effect was enhanced significantly during hypoxia.