Objective To evaluate the effects of pantoprazole on patients with upper gastrointestinal bleeding and its safety, as compared with omeprazole. Methods Ninety patients with non variceal upper gastrointestinal bleeding were randomly assigned to two groups. Sixty patients were in the group of pantoprazole, including 24 patients with gastric ulcer, 33 duodenal ulcer and 3 erosive gastritis; 30 patients were in the group of omeprazole, including 9 patients with gastric ulcer, 15 duodenal ulcer and 5 erosive gastritis.Treatment schemes:either pantoprazole or omeprazole 80 mg were added into 250 ml 5% glucose respectively and then infused intravenously. The clinical signs of the patients including the amout of bleeding were observed. Results After the treatment, the symptoms and sings improved significantly in both groups( P 0.05). Both the total effective rate of pantoprazole and omeprazole on upper gastrointestinal bleeding was 96.7%. The rates of side effects were 1.7% in pantoprazole group and 3.4% in omeprazole group. Conclusion Pantoprazole is also an effective and safe drug for the non variceal upper gastrointestinal bleeding.

With the method of endoscopic ultrasonography (EUS) and Color scale ultrasound, 156 patients with stomach and gallbladder diseases were examined, The features revealed by the EUS and color scale ultrasound for these diseases were compared with the pathological changes. The findings were that:the mean color quantity scale of benign gastric ulcer was higher than that of gastric cancer(p<0.01).The gallbladder stone was two color quantity scales higher than did polypoid lesions of gallbtadder(p<0.01).The color scale ultrasound can improve the clear degree of lesion pictures.The correct rates of diagnosis were no significant differences between color scale ultrasound and grev scale ultrasound.

By using antr-ras P21 mouse monoclonal (MoAb), SCI-Oncogema 1, the authors examined immunohistochemica! staining in pancreatc adeocarcinoma. The percentage of positive staining was 24/43 (558%). Furthermore it was indicated that the positive staining rate of antr-ras P21 MoAb was related to either histopathological grade or clinical stage. Upon statistical analysis of the correlation between the staining of anti-ras P21 and patient prognosis with Kaplan-Meier curve and Log-rant test, the positive staining cases showed comparatively better prognosis than the negative ones. Our study suggests that ras P21 expression may be important in the early stage of pancreatic carcinoma.

In order to evaluate the use of transendoscopic miniature ultrasonic probe (TEMP) in the diagnosis of gastric submucosal tumor, 18 patients were investigated. The results obtained by TEMP were compared with those of gastroscopy, and endoscopical ultrasonography (EVS). The result showed that among those 18 patients, gastric submucosal leiomyomas, were common and accounted for 88.9％. Most of them were intramural. The diagnostic accuracy of TEMP for the size of tumor and gastric submucosal tumor was 88.9％ and 100％ respectively. Which were much higher than those of gastroscopy (33.3％ and 61.1％ respectively). The sonogrophic characteristics of gastric submucosal tumors in TEMP imaging were related to the nature of the tumors, hut the common manifestations were that all the tumors were hypoechoic under the hyperechoic mucosal layer with clear bell shaped origin, and usually appeared as round or nearly round intragastric eminence. It is concluded that the selective use of TEMP has great value in the diagnosis of gastric submucosal turmor, especially for those lesions which were small and difficult to be detected by EUS.

Objective Helicobacter pylori (H. pylori )contains more than 30 genes and many of them in cag pathogenicity island (cag PAI) composed of cag Ⅰ and cag Ⅱ are involved in eliciting the transcription of interleikin 8 (IL 8) and the induction of IL 8 protein secretion in gastric epithelial cells, although some genes are not involved. This study was designed to observe the effect of ORF10 of H. pylori cag Ⅱ on the transcription of IL 8 in gastric epithelial cells and to test the possibility that certain genes in the cag PAI also downregulate (modulate) the transcription and expression of IL 8 in gastric epithelial cells. Methods Three strains of H. pylori mutants with deletion of ORF10 gene (ORF10, namely 28 1, 28 2, 28 3) and L5F11 cells containing IL 8 reporter gene were constructed. The constructed L5F11 cells were co cultured with the above strains and the luciferase activity (IL 8 transcription) was measured in a scintillation counter and the concentration of IL 8 protein was assayed by enzyme linked immunosorbent assay (ELISA). Results The activities of luciferase induced by 3 strains of H. pylori mutants with deletion of ORF10 gene were much higher than that of the mother strain 26695 [ 28 1:(1.49 ? 0.27)?10 6 cpm vs. (0.67 ? 0.08 )? 10 6 cpm, P

A vector for a mutant Chinese Helicobacter pylori (Hp) strains knock out pathogenicity island (PAI) was constructed, which was the basis to establish a Chinese Hp mutant deleting pathogenicity island. Genetic engineering techniques such as polymerase chain reaction, plasmid extraction, agarose gel electrophoresis, restriction analysis, ligation, preparation of competence cell and transformation were used to make two cloning fragments containing two end regions of PAI and a selectable chloramphenicol resistance marker between them, and then engineering the recombined fragments into pBluescript plasmid. The result showed that restriction analysis demonstrated that the engineering mutant vector had been recombined. It suggested that we constructed an engineering mutant vector which targeted to delete the PAI in Chinese Hp strains. It will be useful for addressing the role of PAI in the pathogenesis of Hp infection.

Objective The clinical efficacy of pancreatic stent in treating chronic pancreatitis was summarized. Methods The stents were applied in 14 patients with chronic pancreatitis and ductal stricture manifested clinically and roentgenographically. Postoperative abdominal pain, changes in appetite, body weight and fat in stools were observed in follow－ ups. Results The stents, 5～ 10F in caliber, were successfully placed in all patients with first attempt. They were followed up for 210 days ( ranging 28～ 520 days ). The early (3 months ) results showed that the pain remitted in 13/14 (92.9％ ) and 11/13 (84.6％ ) of cases respectively. While abdominal pain persisted in 2 cases inspite of the stents. Along with pain remission the appetite and presence of fat in stools improved associated with increase in body weight. The stents drainage maintained for a median to 256 days (ranging 90～ 520 days) Transient hyperamylasemia occurred in 3 cases. Translocation and occlusion of the stent was found in 1 occasion each on the 98 and 520 day respectively. No other serious complication was detected. Conclusion It is assumed that pancreatic stent is effective to treat chronic pancreatitis with ductal stricture.

Objective To determine the cleaning and the shortest disinfectant time for gastroscope Methods 1? g/ml HBsAg and 3? 108/ml bacteria of Aureus Staphylococci(ATCC 6538),Escherichia coli(ATTC 8099),Bacterium earuginosum(ATCC 27853)were artificially spreaded on the body of gastroscope ,biopsy hole and biopsy clamp.The gastroscope was routinely cleaned and disinfected.HBsAg and pathogens in the samples,which collected before and after cleaning the gastroscope and 3min,5min,10min after disinfection,were tested by using ELISA and bacteria culture,respectively.Results Pathogen and HBsAg can be detected before cleaning the gastroscope.Pathogen can also be detected,but HBsAg disappears after cleaning.Both HBsAg and pathogen was negative 3 min after gastroscope was immersed in glutaraldehyde.Conclusion The tests for pathogens and HBsAg can be negative after gastroscope was cleaned and immersed in 2％ glutaraldehyde for 3 min.

Objective To evaluate the usefulness of cytologic examinations of pancreatic duct brushing obstained during ERCP in diagnosis of pancreatic neoplasms. Methods In 27 patients with suspected manlignancy, cytologic examinations of pancreatic duct brushing during ERCP were performed. Results The positive rate of brush cytology was 55.6%.The results were affected by the location of lesion, correct cytodiagnoses of cancer were 69.2% in cancer at the head of the pancreas and 60% in cancer of the body. The accuracy rate of ERCP was 77.8%.However, by combining these 2 methods, the accuracy rate rose to 100%. Conclusion Our results confirm the significance,safety,and usefulness of the cytologic specimens obtained at the time of ERCP for the diagnosis of pancreatic neoplasms.

Objective To study the technique of double stent drainage on biliary and pancreatic ducts obstruction,and to assess its clinical effectiveness.Methods Firstly,ERCP was done on all patients to investigate the locus and extent of the stricture or obstruction,in order to choice the stent with suitable diameter and length.Then the stents placed into biliary and pancreatic ducts though the guidewires those was inserted into the ducts already.After the operation,the level of serum amylase and clinical symptoms such as jaundice,abdominal pain and diarrhea were observed to assess the therapeutic effect.Results 14 patients diagnosed as biliary and pancreatic ducts stricture or obstruction were treated successfully with this method(5 patients suffered from ampulla cancer,4 carcinoma of head of pancreas,3 carcinoma of duodenum papilla,2 chronic inflammation of head of pancreas).Thirteen patients were placed with 14 plastic biliary stents in their biliary ducts(each was placed with one stent except one with 2 stents),and one patient was placed with metal stent.At the same time,14 pancreatic stents were placed into pancreatic ducts of these patients.The rate of jaundice extinction in 2 weeks,1 month and 3 months after the operation was 50 percent,71 percent and 93 percent respectively.The rate of abdominal pain remission in 2 weeks after operation was 75 percent.Among 7 diarrhea patients ,the clinical symptoms disappeared in 5 patients and were significantly improved in 2 patients one month after the operation.The obstruction and displacement of stents had not been observed in all patients within 3 months after the operation.The complications related to operation had not been observed in all patients within 3 months after the operation.Conclusions The therapy with double stent drainage in biliary and pancreatic duct stricture is safe and effective.It can relieve jaundice and abdominal pain,decrease biliary pressure and improve the exocrine dysfunction of pancreas.