Objective To investigate the role of temporary placement of fully covered self-expandable metal stent (cSEMS) for treatment of uncontrolled bleeding after endoscopic sphincterotomy (EST).Methods From January 2000 to present,a total of 3460 cases of EST were performed,and bleeding after the procedure was complicated in 29 (0.84％) of them,in which 4 could not to be stopped by conventional managements.Covered SEMSs were placed across the major papilla in these 4 patients.Results The stents were successfully placed and hemostasis was achieved in all patients.The stent was removed in 1 patient 1 week later,and spontaneous stent dislodgment occurred in 1 patient within 4 weeks.The other 2 patients rejected to remove the stents,and the patency maintained for more than 6 and 12 months respectively.No complication was observed in procedures of placing and removing stents.Conclusion Covered SEMS placement is a safe,effective and simple method for patients with uncontrolled bleeding after EST.

Background and purpose:Studies have shown that renin-angiotensin system (RAS) is closely associated with tumor progress. angiotensinⅡ (AngⅡ) is the most important component of RAS. This study aimed to investigate the possible mechanism by which AngⅡ affected the cell proliferation in human breast cancer cell line MCF-7.Methods:CCK-8 was used to investigate the cell proliferation alteration of MCF-7 cells after treatment of AngⅡ at different dose and time. The inlfuence of losartan (an AT1R inhibitor) and PD98059 (a MAPK inhibitor) in AngⅡ-enhanced cell proliferation was detected by CCK-8. Protein expression was analyzed by Western blot.Results:AngⅡ stimulated the growth of breast cancer cells in a dose- and time-dependent manner. The maximal proliferation effect on MCF-7 cells was obtained with 10-7 mol/L AngⅡ and 24 h, respectively (P<0.000 1). Losartan signiifcantly decreased the level of AngⅡ-induced proliferative effects (P<0.05). Western blot showed that AngⅡ caused rapid activation of p-ERK. In addition, PD98059 could signiifcantly suppress AngⅡ-promoted cell proliferation.Conclusion:AngⅡ can promote MCF-7 cell proliferation through AT1R/ERK/MAPK pathway activation, which could be reversed by losartan or PD98059. Therefore, targeting AngⅡ/AT1R/MAPK signaling could be a novel therapeutic for breast cancer.

Objective To discover the features of biliary obstruction in hepatocellular carcinoma (HCC) and evaluate the effectiveness of therapeutic ERCP in the management of such patients. Methods Two hundred and ninety two patients (male 234 and female 58) suffering from HCC with obstructive jaundice underwent 358 times of ERCPs between May 2000 and March 2003. The mean (SD) age and mean (SD) total serum bilirubin of these patients were 51. 9 ?10. 6 yrs and 232 ? 158?mol/L respectively. The profiles of cholangiographic changes were recorded. Two hundred and sixty cases received treatment under endosco-py. Then therapeutic techniques including sphinclerotomy and debris removal, naso-biliary drainage, plastic or metal stent placement or several procedures in combination were given to all patients except 32 cases in far advanced condition. The body temperature, amount of bile drained and changes in liver function test were observed within two weeks post-procedure and based on these data the therapeutic effectiveness was evaluated. Results According to the features of radiographic finding, five types of biliary obstruction were classified as: type Ⅰ - intrahepatic stricture or occlusion (5.9%); type Ⅱ - perihilar stricture or occlusion (19. 0% ) ; type Ⅲ - extrahepatic stricture or occlusion (18. 4% ) ; type Ⅳ - hilar intraductal tumor em-bolus (49. 4% ) ; and type Ⅴ - intraductal floating tumor debris (7. 3% ) . In 267 patients/times under follow-up, the symptomatic jaundice was improved in 82. 0% of the patients with significant reduction of serum bilirubin in 65. 5%. Conclusion ERCP plays an important role in both diagnosis and palliative management of the HCC patients with obstructive jaundice.

15 mm in length or the contractile segment distal to the union of the biliary and pancreatic ducts. When common bile duct appeared to join the main pancreatic duct, it was denoted as B-P type. While th e main pancreatic duct appeared to join the common bile duct, it was denoted as P-B type.Results Fifty-four patients had been proven to have gallbladde r carcinoma histopathologically. Seven of them (men 3, women 4) had APBDJ (P-B union 6, B-P union 1). The mean (SD) common channel was 21 0 mm ?11 2 mm in length (range 12 mm to 45 mm), among them there was one case with associated ear ly cystic dilation of bile duct. Three other patients had APBDJ: one was associ ated with a choledochal cyst and two with normal biliary trees. The overall prev alence of APBDJ was 0 9% (10/1082 cases). The incidence of APBDJ was significan tly higher in patients with gallbladder carcinoma (P

Objective To investigate the effects of 860MHz microwave on the formation and extinction of context conditioned fear in mice. Methods The mice were exposed to 860MHz continuous microwave ( power density were 380 μW/cm2 or 550 μW/cm2, respectively) for 30 min or 2 h, which then were divided in to 5 groups.Each group consisted of 15 animals. Footshocks were used to induce context conditioned fear by 75 voltages. The frequency and time of freezing after irradiation were investigated. Results When 24 h after foot shocking, the values of freezing time: control group was 2.31 ±4. 17 , two groups of the microwave irradiation 2 h were 3.93 ±6.99 and 2.47 ± 3.34, the Nemenyi test results (P = 0.004): control group was 32.63333, while two groups of the microwave irradiation 2 h were 52.46667 and 39.76667; and the values of freezing frequency: control group was 0.73 ± 1.16 , two groups of the microwave irradiation 2 h were 0.86 ± 1.41 and 1.07 ± 1.16, the Nemenyi test results of (P=0. 014): control group was 33. 26667, while two groups of the microwave irradiation 2 h were 50. 76667 and 40.90000. Conclusion The mice receiving relatively longer period of microwave irradiation showed more stable memory of the context conditioned fear.

Objective To identify the point mutation of Cu/Zn superoxide dismutase(SOD1) gene in an amyotrophic lateral sclerosis(ALS) family and observe the value of denaturing high performance liquid chromatography(DHPLC). Methods DHPLC and DNA sequencing were used to examine SOD1 gene of the ALS family which had not been found mutation by PCR-SSCP. Results DHPLC tests proved double peaks in one member(Ⅲ_1), Which indicated the possibility of mutation in SOD1 exon 4. DNA sequencing revealed that there was a heterozygote,with mutation of GAA to GGA in exon 4, and with a substitution of glutacid by glycine. Conclusion As compared with PCR-SSCP, DHPLC technique has proved to be a rapid and reliable method for screening mutation site in large samples.

Objective To investigate the genotype-phenotype correlation between TSC1 and TSC2 associated tuberous sclerosis complex(TSC).Methods Nineteen infants with TSC were enrolled in the study.Their clinical manifestations and mutations of TSC gene were analyzed by chip capturing and next-generation sequencing.Results Among the total of 19 patients with TSC,13 TSC2 mutations and 4 TSC1 mutations were detected.The ratio of TSC2/TSC1 mutation-positive cases was 3.4/1.Six mutations were novel.There were epilepsy in 10 cases carrying TSC2 mutations,including 4 cases (31％) with refractory to antiepileptic treatment,and 3 cases carrying TSC1 mutations,including 1 case (25 ％)with refractory to antiepileptic treatment.The incidence and severity (grade 2)of epilepsy,brain imaging were not different in TSC2 and TSC1 patients(P =0.480 7,0.462 2).Compared with clinical manifestations,incidence of mental retardation (grade 1 or grade 2) was higher in TSC2 patients (85 ％,11/13 cases) than TSC1 patients (50 ％,2/4 cases).Also,the incidence of moderate and severe mental retardation (grade 2) was higher in TSC2 patients (54％,7/13 cases) in comparison with TSC1 patients(25％,1/4 cases).Compared with the phenotype of TSC2 and TSC1 patients,the frequencies of skin,renal and cardiac lesions were significantly higher in TSC2 patients than TSC1 patients.Conclusions TSC2 mutation may be the prominent molecular pathogenesis in Han population with TSC.TSC2 patients have much profound muhisystemitc leisions than TSC1 patients,including mental retardation,epilepsy,facial angiofibromas and renal angiomyolipomas etc,which should be confirmed further in domestic multicenter and large samples.

Objective To evaluate the efficacy of narrow-band imaging (NBI) in diagnosis of color-ectal neoplasm. Methods A total of 96 colorectal neoplasm from 78 patients were observed under NBI, and the findings were compared with those from magnifying chromo-endoscopy and pathologic examinations. Re-suits The sensitivity of conventional colonoscopy in diagnosis of polyps was 78. 7%, which was increased to 99% (P < 0. 05) under NBI, with the clear identification of the shape and boundary of the lesions. Magnif-ying NBI colonoscopy provided images of pit patterns similar to those from chromo-endoscopy in diagnosis of type Ⅱ , ⅢL, Ⅳ and ⅤN, which showed better recognition than conventional colonoscopy, but less sensitiv-ity than chromo-endoscopy. Superficial vascular morphologic features could be better classified with NBI, with sensitivity of 100% and specificity at 87. 8%, which was superior to conventional colonoscopy but infe-rior to chromo-endoscopy. Conclusion Both chromo-endoscopy and NBI colonoscopy have better sensitivity and specificity in detection of colon polyps, while chromo-endoscopy reveals clear superficial structure of le-sion and pit pattern, and NBI demenstrates capillary morphology, which can distinguish neoplasm from non-neoplasm colorectal lesions. NBI, easy and convenient to switch, is an effective technique to make early di-agnosis of colorectal neoplasm.

Objectives To evaluate the performances of transcranial Doppler (TCD) and vessel-encoded arterial spin labeling MRI perfusion imaging (VE-ASL) in the evaluation of collateral circulation of cerebral arteries. Methods Thirty patients with unilateral ICA or MCA stenosis diagnosed by TCD and carotid duplex ultrasound and confirmed by MRA underwent VE-ASL. Peak systolic velocity (PSV) of bilateral MCA in the same depth, distal to the stenosis site, was recorded. Cerebral blood flow (CBF) in bilateral MCA territories was measured by VE-ASL. The detection rates of collater-al flow using TCD and VE-ASL were compared. Results TCD revealed that PSV in the ipsilateral and contralateral MCA were (31.6 ± 10.5) cm/s and (83.1 ± 9.2) cm/s, respectively. VE_ASL revealed that CBF in the ipsilateral and contralateral MCA territory were (22.5±9.8) mL·min-1·100g-1 and (31.7±8.3) mL·min-1·100g-1, respectively. The PSV ratio of the ipsi-lateral/contralateral MCA was significantly lower than the CBF ratio of the ipsilateral/contralateral MCA(0.37 ± 0.173 vs. 0.66±0.141, P=0.001). The detection rates of collateral flow using TCD were lower than those using VE-ASL. The detec-tion rate was 26.7% vs. 70% on TCD vs. VE-ASL in anterior collateral circulation (P=0.001), was 16.7% vs. 60% (P<0.001) on TCD vs. VE-ASL in posterior collateral circulation. The total display rate of collateral flow was 36.7%vs. 86.7%on TCD vs. VE-ASL (P<0.001). Conclusions TCD is inferior to VE-ASL in evaluating the collateral circulation because of the limitations including the anatomical variations of the circle of Willis and formation of leptomenigeal anastomoses.

Objective To establish HPLC method for the simultaneous detgrmination of 9 effective components ofTanreqing injection.Methods The Agilent TC-C18 (2) (250 mm×4.6 mm, 5μm) column was used, the mobile phase consisted of acetonitrile (A) acetonitrile-0.1% formic acid aqueous solution (B) in a gradient mode, the flow rate was 1.0 ml/min,the column temperature was 30℃, the injection volume was 10μl, and the detecting wavelength was at 280 nm.Results All the 9 effective components showed a good linear relationship. TheRSDof the precision, reproducibility and stability tests were less than 2%. The average recoveries of the 9 effective components were in the range of 99.3%-103.1%.Conclusion This analysis method is simple, accurate and has a good specificity, which can be suitable for controlling the quality of Tanreqing injection.