Objective To analyze the incidence and pathological characteristic of gastric cancer in young patients and to explore the possibility of screening and preventing hereditary gastric cancer. Methods 68 young patients with gastric cancer under 35 years of age were retrospectively analyzed about their sex, endoscopes datum, clinic representation,pathology and expression of c-erbB-2 protein. Results The hemoglobin was lower in the female group (94. 5 ±21.7) g/L than male group(126. 2 ± 12. 8) g/L(t =4. 502 ,P ＜0.05) ;The malignant pathology was significant difference(P ＜0.05) in young female group than the male' s;The expression of c-erbB-2 protein has no significant difference(P ＞ 0.05). Conclusions Gastric cancer in young patients was diagnosed later, misdignosed more,and move highly malignant. The prognosis is poor. Those phenomena was obviously in female.

Objective To investigate the curative effect of Oryz-Aspergillus Enzyme and Pancreatin Tablet (Combizym) combined with esomeprazole Magnesium Enteric-coated Tables (Esomeprazole) in the treatment of gastroesophageal reflux disease with dyspepsia.Methods 133 patients with gastroesophageal reflux disease and dyspepsia symptoms were randomly divided into two groups.Group A received esomeprazole 20mg once a day and Combizym 1 pill three times a day,while group B only received esomeprazole 20mg once a day.The symptoms integral,curative effect and adverse reaction in the two groups after treatment for 2 weeks and 4 weeks were compared.Results Compared with group B,the symptoms of abdominal distension and satiety significantly relieved after 2 weeks treatment in group A (abdominal distension x2 =4.516,P =0.038 ;satiety x2 =4.630,P =0.041),and one more symptom:loose stools relieved after treatment for 4 weeks in group A (abdominal distension x2 =5.317,P =0.025 ;satiety x2 =5.036,P =0.027 ; Loose stools x2 =4.989,P =0.030),while other symptoms didn t relieve (P ＞ 0.05).The total effective rate was 85.2％ vs 68.1％ (x2 =8.917,P =0.030) and 93.4％ vs 69.4％ (x2 =17.526,P =0.001)in gourp A and B after treatment for 2 weeks and 4 weeks respectively.The symptoms integral reduced notably no matter after 2 or 4 weeks treatment and decreased more significantly in group A (2 weeks t =6.355,P =0.000 ;4 weeks t =5.450,P =0.000).The total effective rate increased more significantly in group A,without serious adverse reaction in both two groups.Conclusion Combined combizym with esomeprazole can better improve the symptoms of gastroesophageal reflux disease with dyspepsia without obvious adverse reaction.

Objective To evaluate the safety and effectiveness of conscious sedation and intravenous anesthesia used to endoscopic retrograde cholangio pancreatiography (ERCP) in treatment of extrahepatic bile duct stones.Methods A total of 100 cases of extrahepatic bile duct stones patients in treatment of ERCP were encoded by the group order,50 cases of odd used intravenous anesthesia (intravenous anesthesia group),intravenous injection of propofol; 50 cases of even used conscious sedation (conscious sedation group),muscle injection of diazepam and pethidine.Intraoperative reaction (extubation behavior,own postural changes),changes in vital signs,operating time,the success rate of stone and complication were observed in two groups.Results The incidence of intraoperative extubation behavior and own postural changes in conscious sedation group were significantly higher than those in intravenous anesthesia group [24％ (12/50) vs.2％ (1/50),18％ (9/50) vs.0],and the differences were statistically significant (P ＜ 0.01).The heart rate and mean artery pressure in two groups were decreased at 5 minutes after administration than that before operation,and the difference was statistically significant (P ＜ 0.05),but there was no statistical significance at 10 min after entering the mirror and postoperative awake compared with before operation (P ＞ 0.05).Pulse oxygen saturation between two groups had no statistical significance (P ＞0.05).The success rate of stone in two groups were 98％ (49/50).Operating time in intravenous anesthesia group was obviously shorter than that in conscious sedation group [(38.2 ± 6.3) min vs.(49.1 ± 9.9) min] (P ＜ 0.01).The complications between two groups had no statistical significance (P ＞ 0.05).Conclusion Conscious sedation and intravenous anesthesia can be used to ERCP in treatment of extrahepatic bile duct stones,but intravenous anesthesia can obviously reduce patients discomfort,shorten the operation time.

Objective To compare the clinical efficacy of ilaprazole standard triple therapy with omeprazole standard triple therapy in the treatment of patients with Helicobacter pylori ( Hp ) positive duodenal bulb ulcer. Methods 100 patients with Hp positive duodenal bulb ulcer were randomly divided into the two groups by lottery, given ilaprazole standard triple therapy and omeprazole standard triple therapy respectively.After 5 weeks of the course,take gastroscopy and the enzyme 13C-urea breath test,and the Hp eradication rate,clinical efficacy,ulcer heal-ing rate and adverse reactions were observed.Results The Hp eradication rate is better than the omeprazole group (92%vs 78%,χ2 =3.853,P<0.05),while the ulcer healing rate were no significant (96%vs 90%,χ2 =1.561, P>0.05).Conclusion It is a good method in the treatment of Hp positive duodenal bulb ulcer for ilaprazole stand-ard triple therapy.

Objective To investigate the relationship between the expression of c-erbB-2 and rim23, and their clinical significance in gastric cancer. Methods The expression of c-erbB-2 and nm23 were detected by using immunohistochemical (SP) method in 85 surgi-cally removed specimens from patients with gastric cancer. Results The expression rate of c-erbB-2 and nm23 were 74.1% (63/85),52.9% (45/85). c-erbB-2 was positively correlated with the location, size and depth of invasion of gastric cancer, but not related with the histological types and lymph node metastasis. The expression rate of nm23 in patients without lymph node metastasis (85.7%) and in stage Ⅰ+Ⅱ (72.7%) was higher than that in patients with lymph node metastasis (42.2%) and in stage Ⅲ + Ⅳ (46.0%). The depth of inva-sion and clinical stage between the patients with c-erbB-2 over-expression and nm23 low-expression were positively related(P<0.01 or P<0.01). Conclusion c-erbB-2 promoted growth and invasion of gastric cancer, and nm23 restrained metastasis of gastric cancer. Both c-erbB-2 and nm23 could be served as predictors for biological behavior of gastric cancer.

OBJECTIVETo retrospectively compare combined endovascular intervension with traditional bypass operation for the treatment of Budd-Chiari syndrome (BCS).

METHODSFrom July 1989 to June 2001, 49 patients undergoing surgery for BCS were studied. 32 operations were performed by traditional bypass (from superior mesenteric vein or inferior vena cava to right auricle), and 17 by combined endovascular operation.

RESULTSThe data demonstrated a high incidence of perioperative complications, longer hospital stay, and expensive cost in the former group than in the latter group (P < 0.01). The mid-term effects were significantly better in the latter than in the former (P < 0.05). Severe complications occurred in the bypass group included hepatoencephalopathy, obtinacy ascites, cardiac dysfunction, and embolization of vascular grafts.

CONCLUSIONSCombined endovascular intervention and shunting are the treatment of choice for BCS, with different combination according to its clinical type. This approach is simple, safe, effective, and economic.

Adult ; Budd-Chiari Syndrome ; surgery ; Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Length of Stay ; Male ; Mesenteric Veins ; surgery ; Middle Aged ; Vena Cava, Inferior ; surgery