Objective Acute esophageal variceal bleeding is one of the most dreadful complications of cirrhotic portal hypertension.This study evaluated a modified gastro-esophageal decongestion (MGED) procedure in the management of acute variceal bleeding that could not be controlled by drugs and/or endoscopic therapy.Methods A MGED procedure was performed in 136 patients with uncontrollable acute variceal bleeding by drugs and/or endoscopic therapy.The perioperative and long-term outcome of these patients were retrospectively studied.Resluts Immediate control of variceal bleeding was achived in 97.8％ (133/136) patients.Perioperative mortality occurred in 5.1％ (7/136) patients.The 3-year and 5-year rebleed rate was 7.0％ (9/129) and 13.2％,respectively.The 3-year and 5-year overall survival rate was 91.5％ (118/129) and 79.8％ (103/129),respectively.Conclusions In this study,the MGED procedure was an effective life-saving procedure in controlling acute esophageal variceal bleeding for its safe,simple and less time-consuming advantages.

Objective To evaluate a modified Suguira procedure for the treatment of variceal bleeding.Methods A modified Suguira procedure was performed in 62 patients with acute variceal bleeding (11 cases) that could not be controlled by endoscopic therapy or with a history of massive bleeding (51 cases) after endoscopic therapy.Results Perioperative mortality occurred in 2％ (1/62) patients.Esophageal anastomotic leak occurred in 2％ (1/62) patients,and anastomotic stenosis developed in 5％ (3/62) patients.Twelve months after operation,esophageal varices disappeared in 79％ (48/61) patients,diminished in size in 18％ (11/61),remained unchanged in 3％ (2/61) ; Fundal gastric varices disappeared in 98％ (60/61) patients,diminished in size in 2％ (1/62).The rebleeding rate was 3％ (2/61) and 8％ (5/61) in 3 years and 5 years,respectively.Conclusions The modified Suguira procedure is safe and effective for long-term control of variceal bleeding after a failed endoscopic therapy.

Selective occlusion of tumor vasculature has proven to be an effective strategy for cancer therapy. Among vascular coagulation agents, the extracellular domain of coagulation-inducing protein tissue factor, truncated tissue factor (tTF), is the most widely used. Since the truncated protein exhibits no coagulation activity and is rapidly cleared in the circulation, free tTF cannot be used for cancer treatment on its own but must be combined with other moieties. We here developed a novel, tumor-specific tTF delivery system through coupling tTF with the DNA aptamer, AS1411, which selectively binds to nucleolin receptors overexpressing on the surface of tumor vascular endothelial cells and is specifically cytotoxic to target cells. Systemic administration of the tTF-AS1411 conjugates into tumor-bearing animals induced intravascular thrombosis solely in tumors, thus reducing tumor blood supply and inducing tumor necrosis without apparent side effects. This conjugate represents a uniquely attractive candidate for the clinical translation of vessel occlusion agent for cancer therapy.