Objective To evaluate the clinical efficacy of endoscopic variceal ligation (EVL) combined with injection of tissue adhesive for esophageal and gastric varices bleeding.Methods Data of 452 patients with esophageal and gastric varices bleeding who received EVL and injection of tissue adhesive were retrospectively studied.Results The instant hemostatic rate was 100.0％ (145/145).Early rebleeding rate was 1.8％ (8/452).Incidence of early adverse reactions was 50.0％ (226/452).The total incidence rate of complications was 12.4％ (56/452).Efficiency and effectiveness of EVL were 32.5％ (145/446)and 40.4％(180/446) respectively.Efficiency and effectiveness of injection of tissue adhesive were 32.5％ (136/419) and 27.4％ (115/419) respectively.With an average of 18 months' follow-up (ranging from 9 to 37 months),the rate of rebleeding was 10.1％ (43/426),six-month and one-year survival rate was 97.9％ (417/426) and 89.9％ (383/426) respectively.Conclusion EVL combined with injection of tissue adhesive for esophageal and gastric varices is effective,convenient,and less invasive.They can be used not only for emergency hemostasis but also for secondary prophylaxis.

AIM:To investigate the effect of RNA interference (RNAi)-mediated insulin-like growth factor 1 receptor ( IGF1R) gene silencing on the growth , migration, and invasion of hepatocellular carcinoma cells .METHODS:The most effective siRNA targeting IGF1R gene was designed and screened .After lentiviral expression vector pLVX-shR-NA2-IGF1R carrying the most effective siRNA sequence was constructed , it was transfected into 293T cells and packed into pLVX-shRNA2-IGF1R lentivirus.Huh7 and Hep3B cells were infected with the pLVX-shRNA2-IGF1R lentivirus to screen the positive clone Huh7 cells and Hep3B cells with the lentivirus .These Huh7 cells and Hep3B cells were cultured to ana-lyze the mRNA level of IGF1R, cell proliferation, cell cycle, cell apoptosis, cell migration/invasion, and the protein levels of IGF1R, Ki-67, p-AKT, p-ERK1, Gli1,β-catenin, cyclin D1, p21 and BCL-XL.RESULTS:The mRNA expression of IGF1R in Huh7 cells and Hep3B cells with pLVX-shRNA2-IGF1R lentivirus was significantly reduced .The proliferation of these cells was remarkably inhibited , and the number in G 1 phase was increased significantly .The percentages of apop-totic cells were increased markedly , and the number of cell migration/invasion was decreased markedly .The protein levels of IGF1R, Ki-67, p-AKT, p-ERK1, Gli1,β-catenin, cyclin D1, p21 and BCL-XL were decreased significantly compared with the blank control group and negative control group .CONCLUSION:The RNAi-mediated IGF1R gene silencing sig-nificantly suppresses the growth and the malignant biological characteristics of Huh 7 cells and Hep3B cells, which may be involved in the reduced protein levels of the above genes induced by down -regulation of IGF1R expression.