Objective To compare the efficacy and safety of endoscopy and laprotomy for gastric stromal tumor,and to evaluate the clinical value of endoscopy.Methods A retrospective analysis was made based on the clinical data of 142 patients with gastric stromal tumor(diameter＜3 cm with clear boundary),with 83 patients who underwent endoscopic resection assigned to the endoscopy group,and 59 patients who underwent laprotomic resection to the operation group.The clinical and pathological data in both groups were analysed and the safety,perioperative situation and prognosis of two groups were compared.Results Compared with the laprotomy group,the endoscopy group required the same time,[(88.25±12.18) min VS (90.15±10.25) min,P=0.367],yielded to less intraoperative blood loss[(42.15±22.13) ml VS (140.55±35.66) ml,P＜0.01],early postoperative feeding[(2.30± 1.20) d VS (5.40± 1.28) d,P＜0.01],and shorter postoperative hospital stay [(5.43± 1.78) d VS (9.42± 1.65) d,P＜0.01].Follow-up was performed in two groups for 5-55 months (median,30 months),with no recurrence or metastasis.Conclusion Compared with surgery,endoscopic therapy is safe and effective for the gastric stromal tumor,whose diameter is less than 3 cm with clear boundary.

Objective To evaluate the therapeutic effectiveness and safety of endoscopic submucosal dissection(ESD)for early colorectal carcinoma and its precancerous lesions. Methods The clinical pathologi-cal characteristics,en bloc resection rate,curative resection rate,complications and follow-up results of 21 pa-tients with early colorectal carcinoma or precancerous lesions,who were treated by ESD,were retrospectively analyzed. Results Most lesions were located in left colon,which accounted for 80. 9%(17/ 21).The most com-mon macroscopic morphology(TypeⅠ)was protrusion type(61. 9%,13/ 21),while flat type was the least (14. 3%,3/ 21). The mean procedure time was 79(35-120)min. The en blot resection rate was 100. 0%(21/ 21),and curative resection rate was 85. 7%(18/ 21). Postoperative hemorrhage occurred in 1 patient (4. 7%,1/ 21)and postoperative infection occurred in 1(4. 7%,1/ 21)and no perforation was recorded. Tubu-lar adenoma with high-grade intraepithelial neoplasia(LGIEN)was the most occurence(33. 3%,7/ 21),villous adenoma with LGIEN was the least(4. 7%,1/ 21). No local recurrence or metastasis was observed during follow-up of 3-20 months. Conclusion ESD is safe,effective,minimal invasive for early colorectal carcinoma and its precancerous lesions,with optimistic prospect of clinical application.

Objective To investigate the efficacy and safety of SB( stag beetle) knife in peroral en?doscopic myotomy( POEM) for achalasia( AC) . Methods A total of 58 cases of AC treated with POEM at department of gastroenterology of the People′s Hospital of Wuhan University from January 2013 to December 2014 were randomly divided into two groups,SB knife group and Dual knife group by using random number table, 29 patients in each group. The complications and therapeutic effects were analyzed. Results All 58 patients with achalasia successfully completed POEM. There were no significant complications in SB knife group such as subcutaneous emphysema, perforation or bleeding.But there were 4 cases of subcutaneous em?physema and 4 cases of bleeding occurred in Dual knife group.The overall incidence of complications was sig?nificantly lower in SB group than that in Dual knife group[0 VS 27?6%(8/29), P<0?05]. The operation time of SB group was(36?32±5?87)mins, which was significant less than that in Dual knife group(56?20± 14?41)mins(P<0?05). The symptom scores significantly increased(P<0?05) and the sphincter resting pressure decreased significantly( P<0?05) after POEM treatment compared with before in the two groups, and there was no statistical significance between the two groups(P>0?05). Conclusion SB knife is safe and effective for achalasia with POEM, which can effectively shorten the operation time and reduce the inci?dence of complications.

Objective To investigate the status of fragile histidine triad (FHIT) gene in human esophageal, gastric and colorectal carcinomas. Methods Ninety six samples of digestive tract cancer (including 21 esophageal carcinomas, 43 gastric carcinomas and 32 colorectal carcinomas) tissues and their adjacent non carcinoma tissues and 18 samples of normal tissue were examined by nested RT PCR for FHIT gene alteration. Results Aberrant transcripts were observed in 33.3% esophageal cancers, 51.7% gastric cancers and 31.3% colorectal cancers. In the adjacent esophageal,gastric and colorectal non carcinoma tissues the rate of aberrant transcripts were 4.8%,20.9% and 9.4%, respectively ( P

0.05). The expression levels of Akt and pAkt proteins in cancerous tissues were 2.7-fold (P

Objective To investigate the effect of activation of protein kinase B(PKB) and Caspase-9 signal transduction pathway of human gastric cancer cells on the cell growth and chemosensitivity to etoposide.Methods The gastric cancer cells SGC7901 were treated with etoposide or etoposide plus PKB inhibitor Wortmannin at different time.The growth rates of gastric cancer cells SGC7901 and their sensitivity to etoposide were examined by 3-(4,5-dimethylthiazol-2,1)-2,5 diphanytetrazolium(bromide) assay.Apoptosis of gastric cancer cells was(detected) by flow cytometry.PKB activity was measured by(immunoprecipitation.) Caspase-3 expression and Caspase-9 activity were determined by Western bolt analysis.Results Etoposide induced apoptosis of SGC7901 cells and inhibited its survival effectively,which was much(weaker) 12 h after treatment.PKB(activity) became higher gradually,and Caspase-3 expression,Caspase-9(activity) significantly reduced at 12 h treated with etoposide.(Conversely),after pretreated with Wortmannin,PKB activity remarkably(reduced,) and Caspase-3(expression),Caspase-9 activity markedly increased.(Wortmannin) suppressed growth and potentiated (apoptosis) caused by etoposide.Potentiation of apoptosis by Wortmannin(correlated) with etoposide-induced PKB and Caspase-9 phosphorylation.Conclusions PKB and Caspase-9 signal transduction pathway promotes(human) gastric cancer cells survival and resistance to(chemotherapy.) PKB inhibitor can enhance sensitivity of gastric cancer cells to chemotherapy.

3. 0 cm in diameter). Methods During last 10 years, fifteen giant and symptomatic gastrointestinal lipomas were resected under endoscopy in our hospital. Of them, two giant lipomas with small stalk (

Objective To investigate the correlation between phosphatidylinositol-3kinase(PI3′K)/serine/threonine kinase(Akt)/Forkhead like 1(FKHRL1)signaling pathway and chemoresistance in human gastric cancer cell line SGC7901.Methods From Jan.2004 to sep.2005,cells were exposed to doxorubicin with or without Wortmannin(a special inhibitor of PI3′K/Akt pathway)in Department of Gastroenterology the people's Hospital of when University.Cytotoxicity was assessed by determining cell survival with MTT.By Western blot analysis,the phosphorylation levels of FKHRL1 was evaluated in SGC-7901 cell.Results It was found that doxorubicin caused reduction of cell viability of SGC-7901 and induced phosphorylation of FKHRL1 in a time-dependent manner.Wortmannin enhanced the cell inhibitory efficiency of doxorubicin.Phosphorylation levels of FKHRL1 was significantly induced by Doxorubin in a time-dependent manner and was blocked by wortmannin.Conclusion Doxorubin may activate PI3′K/Akt signaling pathway and then induce phosphorylation of FKHRL1 in a time-dependent manner,which affects the chemoresistance of gastric cancer cell .However,Wortmannin enhances the chemotherapy sensitivity by suppressing this pathway.

Objective To investigate the expression of cellular FLICE/caspase-8 inhibitory protein(c-FLIP) in gastric cancer and its possible implications. Methods Forty-eight gastric cancer specimens and their normal counterparts were obtained. Western blot and immunohistochemistry were used to detect protein expression of c-FLIP. Semi-quantitative RT-PCR and TUNEL were used to measure c-FLIP mRNA levels and tissue apoptotic index, respectively. Results Mean levels of c-FLIP mRNA were significantly higher in gastric can-(cer) tissues than those in matched normal tissues (0.59?0.16 vs 0.24?0.13, P

Objective To identify the possible risk factors for esophageal delayed bleeding after endoscopic submucosal dissection ( ESD ) of early esophageal carcinoma and precancerous lesions. Methods Data of 281 patients with early esophageal carcinoma and precancerous lesions treated by ESD were reviewed. Risk factors for esophageal delayed bleeding were investigated by univariate analysis and logistic multivariable regression analysis. Results Esophageal delayed bleeding occurred in 22 patients ( 7. 83%) . Univariate analysis showed there was significant difference between delayed bleeding group and non?delayed bleeding group in regard of age ( P=0. 046 ) , lesion size ( P=0. 013 ) , and lesion infiltration depth( P<0. 001 ) . Together with three factors above, the intraoperative bleeding ( P=0. 068 ) was also analyzed by Logistic multivariable regression analysis which showed only infiltration depth was the independent risk factor of early esophageal carcinoma and precancerous lesions treated by ESD( P=0. 002, OR=6. 88,95%CI:1. 07?39. 28) . Conclusion Patients older than 60 years and diameters more than 3 cm might be prone to delayed bleeding, but the direct factor is infiltration depth. The deeper lesions infiltrate, the delayed bleeding is more likely to occur.