Objective To investigate the characteristic findings of intestinal metaplasia revealed by magnifying endoscopy, and clarified their relationship with histopathological features. Methods One hundred and nine patients underwent magnifying endoscopy between March 2003 and November 2003. Patients with gastric adenocarcinoma, esophogeal and/or gastric varices, history of gastric surgery were excluded. Endoscopic examination was performed with a high-resolution magnification endoscope after methylene blue (1 % ) spraying. According to the differences in color and mucosal pattern, forms of endoscopic images were defined, and biopsies were taken (n = 115). Results Six patterns of endoscopic images were defined according to the microscopic findings. Pattern-4 and -5 were related to intestinal metaplasia. Histological features were used as the key standard. Conclusion High-resolution magnifying endoscopy is useful in detecting intestinal metaplasia of gastric mucosa pits from its normal shape changed into oval shape or villous like pattern. This procedure may improve the follow-up of individuals at high-risk of gastric cancer.

Objective To investigate the gastric mucosal characteristics of Helicobacter pylori(Hp)-associated gastritis under high-resolution magnifying endoscopy. Methods Fujinon EG 485 ZH 850k CCD high-resolution electronic magnifying endoscopy was performed. Fifty patients were inspected by regular endoscopy with high-resolution magnifying function. Particular inspection was given on the collecting venules, the pit patterns of the gastric antrum and gastric body. Four pieces of biopsy specimen were taken, 1 each in antrum and body for RUT and the other two for pathologic examination as well as W-S stain. Both of the W-S stain and RUT being positive were confirmed as Hp infection. The Hp-positive patients received the triple therapy. Endoscopy with biopsies was repeated 4 weeks after the course of eradication treatment ended. The results were assessed by SPSS 8. 0 statistical package. Results Twenty-six patients were Hp-positive and 24 patients Hp-negative. In comparing with the results of W-S stain and RUT , the high-resolution magnifying endoscopy features and regular endoscopy findings had different outcomes. The sensitivity was 69. 23% Vs 34. 62% ; the accuracy 78.00% Vs 58. 00% respectively; the positive likelihood ratio and the negative likelihood ratio were 5. 54 Vs 2. 08 and 0. 35 Vs 0. 78 respectively. The Kappa value in high-resolution magnifying endoscopy was 0.563 whereas in regular endoscopy was 0. 176. Conclusions The advantage of high-resolution magnifying endoscopy relies on its ability to observe the fine gastric mucosal patterns. The gastric mucosal features of Hp-associated gastritis can be described as followings: collecting venules are irregular or disappeared; the gastric pits are enlarged or reddened, the sulciolar are deepened. Compared with regular endoscopy, the high-resolution magnifying endoscopy is better in sensitivity, accuracy and likelihood ratio. A high degree of interobserver agreement was obtained with the Kappa value. The pathologic findings get better soon after the eradication therapy, while the endoscopic changes are not prominent.

Objective To investigate the endoscopic feat ures and endoscopical treatment of gastric carcinoid tumors.Methods The clinical and endoscopic materials of 18 patients w ith gastric carcinoid tumors was retrospectively reviewed.Results Five of the 18 patients were benign and 13 were maligna nt. Benign gastric carcinoid tumors were found by biopsy at endoscopy ,and were resected by endoscopic mucosal resection(EMR).Their endoscopic appearance was mu ltiple polypoid masses. 13 malignant patients were confirmed by surgery. Their e ndoscopic appearance was ulcerating and infiltrating lesions.Conclusion Gastroscopy remains to be valuable to set correct di agnosis of gastric carcinoid tumors. EMR may be the first choice for benign gast ric carcinoid tumors.

Objective To select a practical and reliable method in cleaning and disinfecting endo-scope, and to investigate the efficacy of endoscope disinfection. Methods A study was done on the disinfection efficacy using or not using enzyme cleaning plus 2% glutaraldehyde immersion, and disinfection efficacy of automated washer/disinfectors for endoscopes at tertiary hospitals in Beijing. Results In 301 cases of en-doscopes cleaned with enzyme ( Epizyme rapid multi enzyme cleanse) and immersed in 2% glutaraldehyde for 7 minutes, culture was negative in 283 cases (94. 02% ) ; in 155 cases without enzyme cleaning but with immersion for 7 minutes in 2% glutaraldehyde, culture was negative in 137 cases (88. 39 % ). Taking 20 or less bacteria per endoscope as the eligibility criterion, there were 298(99.00% ) and 147(94. 84% ) cases eligible in enzyme treated and enzyme untreated group respectively , P

Objective To study the effects of three kinds of endoscopic therapy on gastric varices. Methods In this study, the efficacies of endoscopic band ligation ( EVL) , endoscopic injection of tissue adhesives (histoacryl) and sclerotic agent (EIS) for gastric varices were assessed. Forty consecutive, non-randomized patients with gastric varices were prospectively studied. EVL was done for 11 cases, Histoacryl 15 cases, and EIS 14 cases, to control and prevent relapse of bleeding. Results In the following-up ( six months) period, the effective rate of EVL, histoacryl and EIS were 100. 0% , 100. 0% and 72. 7% ; the e-radicative rate 25. 0% , 30. 8% ,0 (P

Objective To compare the differences between antrum and corpus in endoscopic and histological diagnosis in non-ulcer dyspeptic patients.Methods 132 cases from out-patient department who had been ordered to undergo gastroendoscopy for dyspepsia were enrolled in the study.After endoscopy,different signs including redness,erosion,intramural bleeding and rugal atrophy were described.Histological diagnosis was defined according to the classification of chronic inflammation,polymorphonuclear neutrophil activity,glandular atrophy,intestinal metaplasia,helicobacter pylori and dysplasia.The differences between antrum and corpus in endoscopic and histological diagnosis were analyzed.Results Redness and erosion under endoscopy,glandular atrophy and chronic inflammation in histological diagnosis were found more frequently in antrum than in corpus.P values were less than 0.001,0.01,0.001 and equaled to 0.025 respectively.Conclusion In functional dyspeptic patients,there are differences in the endoscopic and histological findings between antrum and corpus.Redness and erosion in endoscopic diagnosis,glandular atrophy and chronic inflammation in histological diagnosis are more common in antrum when compared with that in corpus.

Objective To analyze and determine the clinical chatacteristics and treatment of suqerior mesenteric venous thrombosis.Methods We reviewed the medical records of all 32 patients who were diagnosed as with SMVT in Peking Friendship Hospital from 1985 to 2005.Results Thirty-two patients were diagnosted as SMVT,11 patients were with chronic superior mesenteric venous thrombosis(median age 46.6 years,ranging 32～78 years),without acut abdomen;22 cases were acute superior mesenteric venous thrombosis(median age 45.9 years,range 19～64 years).The main symptoms at the presentation were abdominal pain(100%),abdominal distension(100%),acute abdomen(100%),vomiting(68.2%,15/22),an fever(36.4%,8/22).Misdiagnosis rate 59.1%(13/22),death rate 31.8%(8/22).Conclusion The presentations of ASMVT have some relatively characteristics.The clinical diagnosis of ASMVT can be confirmed on the basis of abdominal CT and selective superior mesenteric arteriography in early phase.

Objective To assess the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary diseases in children. Methods Data of 9 patients younger than 14 years who underwent ERCP at between November 2004 and May 2010 were indentified through a computer database search. Therapeutic methods, success rate and procedure-related complications were evaluated.Results A total of 9 patients underwent 17 ERCP procedures under anesthesia, including 16 therapeutic and 1 diagnostic procedure. The success rate was 94. 1% (16/17) and the complication rate was 11.8%(2/17), including 1 mild pancreatitis and 1 peri-pancreatic infection. Conclusion ERCP is an important tool with high safety and efficacy for diagnosis and treatment of pancreaticobiliary diseases in children.

Objective To systematically review the Helicobacter pylori eradication efficacy with ranitidine bismuth citrate(RBC) and two antibiotics,and to conduct a meta-analysis of randomized clinical trials comparing the efficacy of proton pump inhibitor(PPI)vs RBC with two antibiotics for 1 week.Methods Selection of studies:studies evaluating RBC plus two antibiotics were considered.For the meta-analysis,randomized controlled trials comparing PPI vs.RBC plus two antibiotics for 1 week were included.Data Source:RCTs were identified from CBM,handsearching,and personal contact with pharmaceutical companies.Inclusion criteria:data were extracted independently by two reviewers.The methodological quality of trials was assessed by the Jadad-scale.Statistics analysis was managed by using RevMan 4.2.Results Twelve randomized clinical trials including 1254 patients were included.The meta-analysis showed comparable efficacy with RBC and PPI (OR=1.30,95% CI:0.94～1.81,P=0.12).Conclusion The efficacy of RBC and PPI-based triple regimens were comparable.