Gastrointestinal bleeding is a severe,complicated and commonly seen disease in Department of Digestive Diseases,the frequent etiology is peptic ulcer,acute gastric mucosal lesion,esophageal gastric varices and digestive tract tumors. In recent years,clinicians gradually noticed a kind of disease characterized by acute,recrudescent and life-threatening bleeding,that is the non-variceal vascular originated gastrointestinal hemorrhage. The guidelines and scholars have not paid enough attention to this problem. However,non-variceal vascular originated gastrointestinal hemorrhage is not uncommon,and is difficult and tricky in its management for clinicians. Therefore,clinicians should pay sufficient attention to the characteristics and therapeutic principles of non-variceal vascular originated gastrointestinal hemorrhage.

Objective To explore the effects of TNF alpha on the expression of sterol-regulatory element binding protein-1c, SREBP-1c mRNA and the content of triglyceride (TG) in the models of cultured steatosis hepatocytes. Methods Steatosis models of hepatocytes were established by adding oleic acid to the growing L-02 cells, and then cultured in present with TNF alpha or its antibody. The expressions of SREBP-1c and fatty acid synthetase (FAS) mRNA were measured with RT-PCR, lipid droplets in the hepatocytes were observed with oil red staining and the TG contents in hepatocytes were measured with analyzed kit. Results SREBP-1c mRNA was upregulated in the TNF alpha treatment group in comparison with the normal control group(P

Objective To discussion the efficacy and safety of single channel and double chinese -made biliary stent in high biliary malignant hilar obstructive jaundice .Methods We reviewed the clinical data of 24 malignant hilar obstructive jaundice patients treated with single channel and double chinese -made biliary stent from October 2012 to December 2013 retrospectively.Of which 9 cases(study group)were used for single channel and double stenttreatment,and 15 cases(control group)were treated by the bilateral channel;We compared the number of intraoperative percutaneous puncture hepatic duct , radiation exposure doses , operation time , drainage effectiveness and complication rates in the two groups .Results The average number of percutaneous puncture hepatic duct in the study group was 1.44 ±0.53 times,which was significantly lower than the control group (3.73 ±0.70 times).The fluoroscopy time and radiation exposure dose of study group was 1152.22 ±335.61 s and 653.22 ±207.02 mGy,which was slightly less than the control group (1236.93 ±463.43 s and 727.00 ±348.52 mGy),the difference was not statistically significant (P=0.638;P=0.572).Liver function was tested after 4 W, the drainage effectiveness of study group and the control group were 88.9%(eight-nineths),86.7%(thirteen-fifteenths),the difference was not statistically significant .One case occurred bile leakage in the study group ,2 pa-tients with hemobilia in control group ,both groups showed no serious complication .Conclusion The single chan-nel and double chinese -made biliary stent to treat high biliary malignant hilar obstructive jaundice is minimally injured and effective ,which can be selectively applied to treat patients with hepatic hilum malignant obstructive jaundice .

Objective To screen the HBV SPⅡ promoter DNA-binding protein, and to investigate its potential role in the regulation of replication and expression of HBV DNA. Methods By using HBV SPⅡ biotinylated promoter DNA as a selective molecule, the T7 select human liver cDNA library was biopanned and the positive clones were selected. After screening, amplification of positive plaques was performed for inserted DNA fragment and then they were cloned into the pGEM-Teasy vector. Results Four positive plaques were chosen for DNA sequencing. The binding protein of HBV SPⅡ promoter was demonstrated as nicotinamide adenine dinucleotide (NADH) dehydrogenase 4 by BLAST. Conclusion The result suggests that this approach may provide a new tool for the study of replication and expression mechanism of HBV DNA.

Objective To evaluate the role of esophageal visceral sensitivity in the pathogenesis of different subtypes of nonerosive reflux disease (NERD), erosive esophagitis (EE), and observe the characteristics and differences of nerve fiber endings of lower esophageal sphincter (LES) to explore the mechanism for peripheral sensitization in mediating the esophageal hypersensitivity. Method 31 NERD patients, 13 EE patients and 12 healthy volunteers were enrolled in the present study. The perception thresholds including the initial perception threshold (IPT) and the maximally tolerated pain threshold (MPT) were determined using the step-wise intraesophageal balloon distention (IEBD) protocol by esophageal barostat. The ultrastructures of nerve fiber endings of various types of synaptic vesicles were investigated with transmission electron microscope (TEM). Results IPT in NERD-H patients was significantly lower than that in NERD-N and controls (P

Objective To investigate the effect of nociceptin/orphanin FQ (N/OFQ) on crossorgan sensitization and bladder function disorders in rat model with visceral hypersensitivity. Methods The model of cross-organ sensitization was induced by basic OVA-sensitization combined with colon mustard oil instillation in 44 female SD rats. All rats were then divided into control group (n= 14,infusion with 0.9% NaCl solution), model group (n= 14) and N/OFQ group (n= 16, infusion with N/OFQ). The anti-nociceptive effect of N/OFQ were evaluated by using the visceromotor response (VMR) to grade bladder distention (0. 5～2.0 ml, 20 s). Bladder function was evaluated with the cystometry by measuring voiding pressure and micturition frequency. Results The rats in model group had a significant increase of VMR response at 1.0 ml, 1.5 ml and 2.0 ml of pressure when compared to those in control group (P=0. 006,0. 015 and 0. 0331, respectively). However, N/OFQ treatment was able to reverse the increased VMR response in N/OFQ group at 1.5 ml and 2.0 ml of pressure (P=0. 016 and 0. 031, respectively). It was showed that mustard oil significantly reduced bladdervoiding pressure (P＜0. 01) and significantly increased micturition frequency (P＜0.01)in model group when compared to control group. The N/OFQ reversed the decrease of voiding pressure (P=0. 0038) and the increase of micturition frequency in N/OFQ group( P = 0. 001). Conclusions These findings indicate that the rat model of cross-organ sensitization was able to be established successfully by the basic OVA-sensitization combined with colon mustard oil instillation. N/OFQ has an antinociceptive effect on cross-organ hypersensitivity and attenuates changes in bladder urodynamic function.

Objective:To detect the expressions of COX-2 protein and BCL-2 protein in transitional mucosa adjacent to rectal carcinoma,and determine whether the transitional mucosa was the cancer precursor event.Methods:Mucin histochemical method was employed to detect the distal mucosa 2 cm away from rectal tumor and the transitional mucosa was found in 54 cases of rectal carcinoma.Immunohistochemical method was used to investigate the expressions of BCL-2 and COX-2 protein in the specimen of rectal carcinoma mass,transitional mucosa and non-transitional mucosa,and 20 cases of normal rectal mucosa,and the points of the expressions of COX-2 protein and BCL-2 protein were counted.Results:35.19%(19/54)of distal mucosa were characterized as the transitional mucosa.The expressions of COX-2 and BCL-2 protein were detected in carcinoma mass and distal mucosa.Significant difference was observed in carcinoma mass and transitional mucosa(p<0.01).But there were no significant differences between the expressions of those in transitional mucosa and non-transitional mucosa(p>0.05),as well as transitional mucosa and normal mucosa(p>0.05).Conclusion:The performance of transitional mucosa was not the cancer precursor event,but the non-specificity reaction of carcinoma or inflammation.

AIM:To observe the effect of spironolactone on myocardial fibrosis of spontaneously hypertensive rats(SHR).METHODS:Sixteen fourteen-week-old male SHRs were randomly assigned to spironolactone and SHR group equivalently(n=8).Rats in each group were given 30 mg ? kg-1 ? d-1 spironolactone and equal sodium chloride respectively for 12 weeks by gavage.Eight fourteen-week-old male SD rats were as control group.Connective tissue growth factor(CTGF),transforming growth factors beta-1(TGF?1),collagenⅠand Ⅲ were measured by qualitative and semiquantitative immunohistochemical staining and semiquantitative reverse transcription polymerase chain reaction.Masson staining was used to determine total collagen in left ventriculum.Alkaline hydrolysis method was used to detect the concentration of hydroxyproline(Hypro)in the myocardium of left ventricle.RESULTS:Left ventricular index(LVI),collagen volume fraction(CVF),Hypro and the expression of TGF?1,CTGF,collagenⅠand Ⅲ in SHR group were significantly higher than those in SD group(P

Objective Retrospectively analyzed the data of patients with delayed bleeding after colorectal polypectomy,summarized the risk factors and treatment methods of bleeding patients,and provided the basis for further prevention and treatment of postoperative delayed bleeding.Methods Collected the clinical data of 1 243 patients who were admitted into the department of gastroenterology of third affiliated hospital of the third military medical university and accepted polypectomy with colonoscopy from January 2014 to December 2016.Divided these patients into the bleeding group and the non-bleeding group according to whether there was delayed bleeding after surgery.The age,size of polypus,location of polypus,postoperative pathology of the two groups were compared and the postoperative treatment of bleeding was evaluated.Results Among the 1 243 patients underwent colorectal polypectomy,there were 14 cases of delayed bleeding,and the incidence was 1.13%.In the bleeding group,there was 1 case of secondary delayed bleeding and 2 cases of bloody stool after hemostasis for the delayed bleeding.Delayed bleeding occurred at (4.73±2.49)days after surgery.The predilection site of of polypus was rectum in the bleeding group (7/14,50%), and the diameter of polypus was (16.65±4.91)mm in the bleeding group,which was lager than (8.07±4.23)mm in the non-bleeding group with statistical difference (P<0.05).The proportion of hypertensive and diabetic patients in the bleeding group was significantly higher than that in the non-bleeding group (P<0.05).Juvenile polyps and tubular adenoma with high grade intraepithelial neoplasia were more common in the bleeding group(P<0.05).The bleeding group achieved good hemostatic effect by purse suture,hemostatic clip,electrocautery or injection hemostasis.Conclusion Older age,hypertension and diabetes,lager size of polypus,rectum polypus,juvenile polyps and tubular adenoma with high grade intraepithelial neoplasia were risk factor for delayed bleeding.In the event of delayed bleeding,different choice of purse suture,hemostatic clip,electrocautery or injection hemostasis according to different wounds can achieve the desired effect.

ObjectiveTo research a way to verify whether the stomach duct is misplaced into the trachea.MethodsThe air pressure of the stomach duct placed in the stomach or in the trachea were measured using a water bottle.ResultsThe air pressure of the stomach duct was (1±0.45)cmH2O When it was put in the stomach, and was (7±2.03)cmH2O when it was put in the trachea(P<0.01).ConclusionsWhen it is impossible to draw out acerbic substances from the stomach to verify whether the stomach duct is placed in the stomach or misplaced in the trachea, measure the air pressure stomach duct by a water bottle can be used as substitute, which is reliable and convenient.