Patients with long-standing history of ulcerative colitis have an increased risk of developing colitis-associated colorectal cancer.The risk factors include longer duration of colitis,greater anatomic extent of colitis,degree of inflammation of the bowel,family history of colorectal callcer,the presence of primary sclerosing cholangitis.etc.The two kinds of molecular pathogenesis that contribute to colon carcinogenesis are chromosomal instability and microsatellite instability.In order to reduce cancer morbidity,colonescopic surveillance and chemoprevention should be carried out in patients with ulcerative colitis especially in those high risk patients.New endoscopic techniques increase the sensitivity and shed a new light on tumor surveillance.

With the development of endoscopic techniques in recent years,therapeutic endoscopic retrograde cholangiopancreatography has replaced surgery as the first approach to the extraction of common bile duct stones.Endoscopic sphincterotomy and endoscopic papillary bal-loon dilation have become established endoscopic techniques for stone removal.However,it remains a challenge for endoscopists to remove large common bile duct stones.Emerging endoscopic modalities,such as endoscopic papillary large balloon dilation and cholangioscopy-guided laser or electrohydraulic lithotripsy,have been shown to be safe and effective for management of large common bile duct stones.This paper reviews recent advances in the endoscopic management of large common bile duct stones.

The β-adrenergic receptor has close relationship with the occurrence and development of tumor.The β-adrenergic receptors were expressed in a variety of tumors.Its activation can stimulate tumor growth by promoting cell proliferation,inhibite apoptosis,promote angiogenesis,and enhance tumor invasion and metastasis.The β-adrenergic receptor blockers can suppress the tumor growth,which may become one of the effective methods of cancer prevention and treatment.

Assessing the stage of live fibrosis and cirrhosis has direct clinical implications for patient treatment options.Liver biopsy is typically considered as the gold standard, but it has limited clinical utility due to its invasiveness.In recent years, with the rapid development of CT hardware and software, CT has made important progress in the non-invasive evaluation of liver fibrosis and cir-rhosis at home and abroad.This review focuses on clinical application of of contrast-enhanced CT, CT perfusion imaging, dual-energy CT and CT molecular imaging for liver fibrosis and cirrhosis.

Objective To investigate the infection status of Helicobacter pylori (Hp) in a Lhasa hospital.Methods A retrospective survey of Hp infection from 2009 to 2013 was conducted in Lhasa People's Hospital.The data of 14C-urea breath test and gastroscopy were analyzed.Results A total of 2 908 patients were enrolled,1 518 (52.20％) were Hp positive,including 1 061 males (1 061/1 939,54.72％) and 457 females (457/969,47.16％).The Hp infection rate in males was higher than that in females (x2 =14.788,P =0.000).The Hp infection rate by years from 2009 to 2013 was 55.97％ (267/477),49.79％ (239/480),54.66％ (375/686),52.06％ (291/559) and 49.15％ (347/706),respectively.The infection rate in 2013 was significantly lower than that in 2009 and 2011 (P =0.021,0.040).There were no significant differences in Hp infection rates among Tibetan,Han and Hui ethnic groups.In 2020 cases who underwent endoscopic examination,1 098 had Hp positive (54.36％).The Hp infection rate in chronic superficial gastritis group(39.91％) was significantly lower than that in erosive gastritis (x2 =30.143,P =0.000),gastric ulcer (x2 =22.434,P =0.000),gastric polyps (x2 =9.627,P=0.002),gastric cancer (x2 =9.506,P =0.002),duodenal ulcer (x2 =54.158,P =0.000),duodenitis (x2 =14.966,P =0.000) and compound ulcer groups (x2 =8.582,P =0.003).The Hp infection rate in duodenal ulcer group (68.42％) was significantly higher than that in chronic superficial gastritis (x2 =54.158,P =0.000),erosive gastritis (x2 =6.733,P =0.009),atrophic gastritis (x2 =21.496,P =0.000) and gastric ulcer groups (x2 =8.940,P =0.003).Conclusion Hp infection rate appears a decreasing trend in Lhasa area in last 5 years; among various gastro-duodenal diseases patients with duodenal ulcer have a highest Hp infection rate.

Purpose:To eveluate the effect of liver function after TIPSS.Materials and methds:Ananalysis of 17 cases with laboratory data to study the liver function changes after TIPSS (transjugular intrahepatic portosystemic stent shunts).Results:There were 35 percent of cases whose liver function were worse than before,the others showed no change or better after TIPSS. Couclusion:It was important to choose the cases strictly before TIPSS so as to reduce the compli- cation and improve the survival rates.Although some cases liver function went worse after TIPSS but only temporarily.TIPSS can reduce bleeding retes effectively,thus simultaneously seve the lives.It is worthy to extend this procedue.

The techniques for endoscopic diagnosis and treatment of biliary and pancreatic diseases mainly include endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography,which have achieved great progress in recent years.Meanwhile,new techniques including combined therapy with endoscopy and laparoscopy and natural orifice transluminal endoscopic surgery have gradually been applied in clinical practice.In the future,it is necessary to cultivate interdisciplinary experts in the field of endoscopy who master various endoscopic techniques and integrated talents with experience in both transluminal operation and gastrointestinal surgery outside lumens.At present,there are still controversies over the application of new techniques in the treatment of biliary and pancreatic diseases.The diagnosis and treatment of biliary and pancreatic diseases can be further improved by promoting the application of biliary and pancreatic endoscopy and standardization,accumulating experience and improving devices,evaluating clinical research,and promoting the bench-to-bedside translation of new techniques.

Objective To investigate the attention bias characteristics of first-episode depressive patients.Methods Forty two patients in our hospital from June 2011 to May 2014 with first-episode depressive and 42 healthy people for physical examination were selected.The reaction time and error number were recorded.Results The reaction time in observation group was significantly longer than control group.Difference between negative and neutral words of observation group was showed (P ＜ 0.01).Conclusions First-episode depressive patients have obviously attention bias in negative related stimulation.

Objective To evaluate the value of narrow band imaging(NBI) in the diagnosis of early squamous esophageal cancer and precancerous lesions.Methods Four thousand and fifty-six patients were examined by routine endoscopy,NBI and iodine chromoscopy,one hundred and fourteen lesions in 82 patients were screened.Of all lesions were detected by NBI with magnification and targeted biopsy.The differences among routine endoscopy,NBI and iodine chromoscopy,and the consistency between IPCL and histological findings were assessed.Results Compared to NBI and iodine chromoscopy,especially flat lesions,there was a high missed diagnosis rate in diagnosis of early squamous esophageal cancer and precancerous lesions by routine endoscopy.With NBI and iodine chromoscopy,the incidence rate of lesions was 78.0% and 79.8%,respectively.For iodine staining,85.7% Grade Ⅰ was high grade intraepithelial neoplasia(HGIN),and 66.0% Grade Ⅱ/Ⅲ was low grade intraepithelial neoplasia(LGIN).For NBI,80.4% Grade Ⅰ was HGIN,but there was no specificity in diagnosis LGIN.In appearance of IPCL,92.9% Type Ⅳ/Ⅴ was HGIN,89.4% Type Ⅱ/Ⅲ was LGIN,and it has a relatively better consistency in IPCL with histological findings.Conclusion There is a high detection rate in diagnosis of early squamous esophageal cancer and precancerous lesions by Lugoul's iodine staining and NBI endoscopy.It's probably that IPCL patterns by NBI with magnification can provide scientific basis for both the endoscopic theraphy of early esophageal cancer and the omen of postoperative recurrence.

Objective To observe the clinical effect of different doses of simethicone on the colonoscopy bowel preparation.Methods One hundred and fifty outpatients who received colonoscopy were randomly divided into three groups:group A1 (PEG plus 5 ml simethicone),group A2 (PEG plus 10 ml simethicone) and group B (PEG =polyethylene glycol electrolyte).The colonic cleaness,effect of removing bubbles,total procedure time,patients' satisfaction and tolerance were observed during the examination.Results The satisfaction with bubbles removal were 98.0％ (49/50),100.0％ (50/50) and 80.0％ (40/50) with significant difference(x2 =17.855,P =0.000).However,there was no difference in cleaness (x2 =1.500,P =0.472),total procedure time (Z =-0.333,P =0.765),patients' satisfaction (x2 =6.303,P =0.178) and tolerance (x2 =8.238,P =0.083).Conclusion Simethicone is of benefit for colonoscopic bowel preparation in removing air bubbles,which can enhance visibility.Five ml dose of simethicone can meet the basic need of removing air bubbles,and 10 ml dose of simethicone can exert better effects.