Objective To investigate the clinic and endosoopic features of left-sided portal hypertension ( LSPH). Methods Eight patients with left-sided portal hypertension were analyzed retrospectively. Results The main manifestations of patients with LSPH were hematemesis, hematochezia, splenomegaly and hypersplenism. The patients have the features of pancreatic disease, but without the evidences of hepatic disease. Solitary gastric varices account for 62. 5% , both gastric and esophageal varices account for 37. 5% . The patients with features of LSPH often mislead to diagnose as blood diseases or portal hypertension resulted from hepatic cirrhosis. Conclusions Pancreatic diseases may lead to portal hypertension, solitary gastric varices were the important evidence of left-sided portal hypertension.

Objective To compare the effectiveness and adverse effects among three groups of patients with esophageal achalasia treated with small balloon dilation and/or intrasphincteric injection of botulinum toxin. Methods Forty-eight patients were divided randomly into three groups, A, B, and C, treated with small balloon dilation, intrasphincteric injection of botulinum toxin, and combination of these two respectively. At 1 week, 3 months and 1 year after treatment, the clinical scores, lower oesophageal sphincter-ic pressure, and lower oesophageal sphincteric relax rate in three groups were compared. Results At 1 week, 3 months and 1 year after treatment, the effective rates and gaps of pre - and post - treatment LESP and LESRR were higher in group B and C than those in group A. There were no differences between BT group and combination group at 1 week and 3 months, but in 1 year after treatment the effective rates and gaps of LESP and LESRR in combination group were higher than those in BT group. Complications never happened in all groups. Conclusion The combination of small balloon dilation and intrasphincteric injection of botulinum toxin was the effective procedure with the advantages of lasting longer time, less complications and milder chest pain.

Objective To evaluate the clinical responses and side effects of non sealed colloidal 32 P internal radiation and macroaggregate albumin (MAA) for hepatocellular carcinoma (HCC). Methods Twenty six patients with HCC underwent ultrasound guided intratumoral injection therapy of 32 P colloid and MAA. The clinical responses and toxic effects were analyzed on basis of clinical manifestions and laboratory data, including the tumor size, histopathological changes, serum alpha fetoprotein (AFP) estimation, blood routine, hepatic and renal functions and immunocompetence assays before and after treatment. Results Clinical responses: alleviation of symptoms, decreased AFP levels, fibrosis and complete or partial necrosis within tumor lesions (CR 2, PR 13, MR 2, SD 7 and PD 2). The total response rate was 57.7% and the median survival period was 16 months. Hepatic lesions became resectable in 5 patients for whom successful operation was performed. The 1 ,2 and 3 year survival rates were 88.5%, 76.9% and 38.5%, respectively. No evidence of non sealed radionuclide induced toxic reactions or complications were observed. Conclusions The treatment of internal radiation with 32 P colloid and macroaggregate albumin is effective, simple, safe and applicable with wide indications for primary hepatic carcinoma.

Objective:To investigate the role of soluble Fas ligand (sFasL) in the mechanism of immune escape and counterattack of colorectal cancer.Methods:ELISA was used to detect the level of sFasL in the sera of colorectal cancer patients and the supernatant of SW480. Transmission electron microscopy (TEM), flow cytometry (FCM) analysis and fluorescence microscopy were used to examine the apoptosis of Jurkat induced by the sera of colorectal cancer patients and the supernatant of SW480. The apoptosis was also studied after pretreatment of Jurkat by Fas blocking antibody ZB4. The supernatant of African green monkey cell line Vero was used as control.Results:The concentration of sFasL in sera of colorectal cancer patients was 12.21?1.14 ?g/L before treatment, the concentration decreased significantly after treatment(P

[Abstract] Objective To evaluate the clinical and endoscopic manifestations of abdominal type allergic purpura in adult patients as the evidences in reaching early diagnosis. Methods The clinical and endoscopic manifestations of 32 patients with abdominal type allergic purpura were analyzed retrospectively. Re-SllltS All the patients complained of paroxysmal abdominal colic, 59. 4% patients complained of nausea and vomiting, 50% patients had hematochezia and haematemesis, the occult blood test was positive in all patients, and 25% patients had elevated level of amylase in the blood and urine. Purpura was found in 2-10 days after the presentation of abdominal pain. Endoscopy found hyperaemia, edema, bleeding spots, erosion and ulcer in gastroenterologic mucosa. Duodenal, ileum and caecum had more severe mucous lesions, but the esophageal mucosas in all patients were normal. The clinic and endoscopic misdiagnosis rates were 87.5% and 85.7% respectively. Glucocorticoids were the especially effective medicine in its treatment, while those agents for relieving spasm or antacids were ineffective. Conclusion Many scattered bleeding spots and snow flower-like ulcers on the gastrointestinal mucosa are the most important findings in adult abdominal type allergic purpura patients. Clinic manifestations of these patients are very severe abdominal colic in indefinite sites and merely with mild abdominal objective signs is the important characteristic feature.

AIM Fas system plays an important role in the mechanism of immune escape and counterattack of colon cancer cells. This study was to investigate the influence of anti-tumor drugs on Fas, Fas ligand expressions on colon cancer cells. METHODS MTT method was used to get the inhibition concentration 50%(IC_ 50 ) of 5-fluorouracil (5-Fu), mitomycin (MMC), cisplatin (CP) to SW480. The concentrations of anti-tumor drugs were 0, 0.5 IC_ 50 , IC_ 50 , 2 IC_ 50 , respectively. Immmunocytochemical staining and flow cytometry analysis were used to detect the expression rates of Fas and FasL on SW480 cells before and after 5-Fu, MMC, CP treatments. In situ hybridyzation was used to observe Fas, FasL mRNA in SW480 cells before and after treatments. RESULTS IC_ 50 of 5-Fu, MMC, CP to SW480 were 11.70, 3.12, 3.40 mg?L -1 , respectively. Both immmunocytochemical staining and flow cytometry analysis found that without drug treatments SW480 expressed high FasL and low Fas, after the treatment of 5-Fu, Fas expression rates on SW480 increased but FasL remained unchanged; both Fas and FasL increased after the treatment of MMC or CP. In situ hybridization showed that after the treatment of 5-Fu and Fas mRNA on SW480 increased while FasL mRNA remained unchanged; both Fas mRNA and FasL increased after the treatment of MMC or CP. CONCLUSION Anti-tumor drugs can change the expression of Fas system on SW480 cells in different ways. MMC and CP can increase the sensitivity of colon cancer cells to apoptosis signals; at the same time, they possibly facilitate immune escape of tumor cells. However, 5-Fu does not have influence on immune escape of colon cancer cells. The target point is at the level of transcription or above it.-

Objective To investigate the clinical features, diagnosis and treatment of heterotopic pancreas in gastrointestinal tract. Methods A total of 60 cases of heterotopic pancreas in gastrointestinal tract diagnosed through endoscopic ultrasonography and pathological examination were treated in our hospital in the recent 10 years. Their data were retrospectively analyzed. Results Among all the 60 patients, the lesions were located in duodenal bulb cavity in 3 cases, in duodenal descendent in 2 cases, in gastric angle in 3 cases,in the junction of gastric antrum and corpus ventriculi in 2 cases and in gastric antrum in 50 cases. All of the 60 patients were definitely diagnosed through endoscopy, endoscopic ultrasonography and pathological examination. 28 patients were treated by endoscopic high-frequency electronic resection, 2 patients were treated by endoscopic mucosal resection (EMR), 30 patients were treated by surgical operation; no operative complication was found, and satisfactory clinical effects had been observed in these patients. Conclusions Endoscopic ultrasonography has great value in the diagnosis and endoscopic therapy of heterotopic pancreas in gastrointestinal tract. It can provide the guide for the choice of treatment. Minimally invasive endoscopic treatment is safe and effective for heterotopic pancreas and has great clinical value.

Objective To study the efficacy and safety of oral calcium carbonate suspension and proton pump inhibitors (PPI) in symptoms relief of acid related diseases.Methods The multi-center,randomized and controlled study was carried out.A total of 400 acid-related diseases patients from 14 to 70 years old with at least one of moderate or severe symptoms such as acid regurgitation,epigastric pain,epigastric discomfort,upper abdominal burning or distension were equally divided into two groups and treated with oral calcium carbonate suspension or omeprazole enteric-coated tablets.The onset of symptoms relief of all patients of the first time after taking medicine was observed.The relief of clinical symptoms at the third day and seventh day after taking medicine was also observed.The adverse events were recorded.Analysis of variance was performed for statistical analysis.Results The onset of symptoms relief of oral calcium carbonate suspension group in acid regurgitation,epigastric pain,epigastric discomfort,upper abdominal burning or distension of the first time after taking medicine were significantly faster than those of PPI group (F=4.866,8.142,41.366,6.955,35.252; all P＜0.05).At the third day after taking medicine,the treatment efficiency of oral calcium carbonate suspension group and PPI group were 69.50％ and 72.50％,and at the seventh day the treatment efficiency of oral calcium carbonate suspension group and PPI group were 92.00％ and 96.50％.There was no significant difference in treatment efficiency and comprehensive efficacy between two groups at day three and seven after taking medicine (both P＞ 0.05).There were 14 cases of mild adverse events and two cases of moderate adverse events in oral calcium carbonate suspension group.There were 10 cases of mild adverse events in PPI group.There was no significant difference between two groups (P＞0.05).Conclusion Oral calcium carbonate suspension provides faster symptom relief than PPI and can effectively improve the symptoms of acid-related diseases.

Objective To analyze the application of quality control cycle (QCC) in reducing the false negative rate of minimal residual disease (MRD) of flow cytometry in patients with acute myeloid leukemia (AML). Methods In AML patients with abnormal fusion gene detected in hematology laboratory of Changhai Hospital during the year of 2014, the prevalence of AML-MRD detected both by flow cytometry (FCM) and real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) were analyzed retrospectively. The possible causes of false negative rate of flow cytometric MRD referring to PCR were further deeply analyzed, and the improvement measures were adapted from January 2015 to December 2015 and further judged all according to the QCC methods. Results Pareto diagram showed that the dilution and coagulation of the specimen, the improper analysis strategy and the incomplete combination of the MRD index [composition ratio:83.3 % (60/72)] were the main factors leading to the leakage of FCM MRD in 2014. The QCC group devised measures to reduce the dilution probability of bone marrow and develop a standard operating procedures (SOP) for sampling and testing, strengthen the maintenance of the flow instrument and more importantly, focused on optimizing the antibody panels and gated strategies referring to the current two main kinds of MRD detection combination modes on the basis of the latest advances published in 2015. Finally, the undetected rate of AML-MRD was reduced by FCM from 14.8 % (72/486) in 2014 to 2.6 % (16/620) in 2015. Conclusions The QCC can effectively reduce the leakage rate of flow cytometric AML MRD, improve the ability of laboratory quality control and the ability to solve problems. Solving problems with QCC is thus worthy of being popularized.

OBJECTIVETo evaluate the effect of endogenous nitric oxide (NO) on the ability of 5-fluourouracil (5-FU) to induce apoptosis in the liver carcinoma Bel7402 cell line, and to observe the anti-tumor mechanism and effective adjuvant of 5-FU.

METHODSCells were cultured under routine conditions with Dulbecco's modified Eagle's medium (DMEM) without L-Arginine (L-Arg). We observed the expression of inducible nitric oxide synthase (iNOS) and apoptosis of cells induced by 5-FU with L-Arg added to the medium. The production of nitric oxide was determined by the cell expression of iNOS detected by immunohistochemical staining, and by the concentrations of nitrite and nitrate in the supernatant.

RESULTS5-fluourouracil significantly increased the iNOS expression to 0.1687 +/- 0.01968 (P < 0.05, vs control group), and the concentration of nitric oxide to 213 +/- 30.2 micromol/L (P < 0.05, vs control group). The apoptotic cell rate increased significantly to 17.85 +/- 0.78%, while the necrotic cell rate decreased to 3 2.99 +/- 0.83% (P < 0.05,compared with the 5-FU group). N(omega)-nitro-L-Arginine methyl ester (L-NAME), the antagonist of L-Arg, can block the apoptotic effects of endogenous nitric oxide.

CONCLUSIONS5-FU had a synergistic effects with L-Arg by increasing the production of endogenous nitric oxide. Endogenous nitric oxide plays an important role in the process where 5-FU induces apoptosis in liver carcinoma cells. L-Arg may be a good adjuvant for chemotherapy with 5-FU.

Antimetabolites, Antineoplastic ; pharmacology ; Apoptosis ; drug effects ; Arginine ; pharmacology ; Fluorouracil ; pharmacology ; Humans ; Immunohistochemistry ; Liver Neoplasms ; pathology ; Nitric Oxide ; biosynthesis ; Nitric Oxide Synthase ; analysis ; Nitric Oxide Synthase Type II ; Tumor Cells, Cultured