To measure esophageal manometric parameters in liver cirrhosis, patients with different liver function grades were chosen. In the normal control group ( n =72) gastrointestinal disease history and symptoms, abdominal surgery and injury history were all negative. In liver cirrhosis group ( n =94) liver cirrhosis was diagnosed by clinical picture or pathology, and their liver function in Child grade was: grade A, 38 cases and 8 had ascites; grade B, 37 cases and 20 had ascites; grade C, 19 cases and 18 had ascites. Taking no motility medicines within seven days before measurement, esophageal motility parameters of these subjects were taken by a Biolab System made by Sandhill Company. The data were analyzed with SAS statistical software. The results showed that from Child grade A to C, LESP in cirrhosis group reduced, relaxation pressure increased, and relaxation percentage become lower successively; from Child grade A to C, onset peristaltic wave velocity in upper esophageal body became slower, peristaltic contraction reduced, and abnormal contraction increased; from Child grade A to C, peristaltic wave amplitude reduced in lower esophageal body, and velocity of onset peristaltic wave velocity became slower, peristaltic contraction reduced, and abnormal contraction increased. It suggests that more severe injury in liver function, more serious impact in esophageal motility. At the same time complications of portal vein hypertention such as esophageal varices and ascites behave synergetically.

Objective To compare the diagnostic accuracy of intraductal ultrasonography(IDUS) and endoscopic retrograde cholangiography(ERC) on extrahepatic bile duct stones. Methods 30 patients with suspected extrahepatic bile duct stones by B Ultrasonography, CT,or MRI,were allocated into this study. ERC was performed first by the use of Fujinon duodenal endoscopy ( ED-410XT, ED-410XU) and then followed IDUS by inserting the Fujinon miniprobe (PL2220-15 or PL2226-15) through endoscopic working channel to detect extrahepatic bile duct, finally the substance in extrahepatic bile duct was proved by endoscopic sphincterotomy(EST)and stone extraction. Results Among 30 cases, the diagnoses by ERC were stone 26 cases,floccule 1 cases and misinterpreted 2 cases so the accuracy and sensitivity of ERC were 26/30(86.7%) and 26/28(92.9%)respectively. For IDUS, the diagnoses were totally in accordance with the results of EST and stone extraction.So the accuracy and sensitivity of IDUS in the diagnosis of extrahepatic bile duct stones were 30/30(100%) and 28/28(100%) respectively. Conclusion (1) IDUS was superior to ERC in the diagnosis extrahepatic bile duct stones. (2) IDUS can compensate the misinterpretation of ERC on extrahepatic bile duct stones.

Objective To investigate the correlated factors concerning esophago-gastric variceal bleeding and sclerotherapy in liver cirrhosis. Methods Twenty-six factors were selected for 670 patients with liver cirrhosis and esophagogastric variceal bleeding and received sclerotherapy in our hospital. Spearman relationship analyses were performed on factors concerning esophagogastric variceal bleeding and sclerotherapy. Results Duration and number of episodes of bleeding were not related to grade of esophagogastric varices, diameter of portal vein and hepatic function but negatively related to ascites and hypersplenism.Severity of bleeding was not related to all of the above parameters. Esophageal varices related to gastric varices while neither of them related to diameter of portal vein. Result of sclerotherapy related to grade of esophageal varices, and negatively related to number of operations in first-period sclerotherpy, supplementary sclerotherpy and total number of operations as well as to amount of scleroant of first-period sclerotherpy and total amount of scleroant. Types of sclerosant had no relationship with result of sclerotherapy. Conclusion Esophagogastric variceal bleeding is affected by multiple factors. Diameter of portal vein is not the only factor. Result of sclerotherapy is affected by number of operations and amount of scleroant and has nothing to do with types of sclerosant.

Objective To investigate the role of endoscopic color Doppler ultrasonography (ECDUS) in the preoperative localization of insulinomas. Methods Seven patientsd woman) with biochemically diagnosed insulinoma underwent abdominal US, spiral CT and ECDUS in an attempt to precisely localize the tumor before surgery. Surgical and pathological results were considered as the definite localization of tumor. The role of ECDUS in the preoperative localization of insulinomas was compared with that of abdominal US and spiral CT. Results Ten tumors were detected by surgery and pathology. The sensitivity of ECDUS in identifying insulinomas was 8/10 compared with 1/10 for CT and 0/10 for abdominal US. Two tumors not detected by ECDUS had a size below 0. 5cm. Conclusions ECDUS is superior to spiral CT or abdominal US, and should be served as the first choice in the detection of pancreatic isulinomas. ECDUS identification depends on the size of the tumor and 'is hard to detect the tumors smaller than 0. 5cm.

Objective To investigate the rule of changes in endoscopic and endoscopic ultrsonic findings after endoscopic variceal sclerotherapy in the follow-up period. Methods Patients suffered from esophagogastric variceal bleeding and received endoscopic variceal sclerotherapy were investigated. Patients with liver cirrhosis after viral heptitis and their varices eliminated or reduced to grade Ⅰor Ⅱ after sclerotherapy entered this study for at least 5 years' follow - up. Endoscopic and endoscopic ultrsonic findings were recorded to find its course of transformation. Results Lumens of varices were occluded by thrombus and eventually replaced by white fibrous tissue after endoscopic sclerotherapy. Vessels reappeared within e-sophageal wall gradually after a lot of time in the form of formation of new venules (93. 8% ) or re-vascular-ization (6. 2% ) . Newly formed varices within gastric wall after sclerotherapy were seen in 5. 3% of the cases and some cases of duodenal varices were also found rarely in the follow-up. Endoscopic ultrasonic finding confirmed the revascularization and dilatation of vessles after sclerotherapy. Conclusion From the follow-up results it indicates that varices would reappear gradually after endoscopic sclerotherapy, regular re-examination and appropriate treatment in time are the most important measure to assure its long term effect.

0.05). 7 cases were complicated with early rebleeding in each group, 3 cases died in the EVL group, and no patient died in the EVS group. During the follow up period of 1 year, the rate of recurrent varices was 39.4%(26/66) in the EVL group, versus 21.3% (13/61) in the EVS group, showing statistically significant difference between the two groups ( P 0.05).

Biopsies were randomly taken from 160 patients through endoscopy. Among them 46 patients suffered from chronic superfacial gastritis, 39 patients from chronic atrophic gastritis, 39 patients from gastric ulcer, and 36 patients from gastric cancer. Ras, p16, and p53 genes were analysed with polymerase chain reaction single strand conformation polymorphism (PCR SSCP). Helicobacter pylori (HP) was examined with RUT. Result: ① the positive rates of ras and mutant p53 in gastric cancer were significantly higher than that in gastritis and gastric ulcer( P

To evaluate the influences of sclerotherapy and band ligation on esophageal motility, EVS and EVL were measured before and after treatment respectively. After sclerotherapy, lower esophageal sphincter pressure (LESP)and residual pressure were decreased while relaxa tion was increased , relaxation duration became shorter; band ligation only influenced LESP.After EVS, the amplitude of motor waves in the sites of EVS and lower esophagus body was reduced ,and peristaltic wave duration was prolonged ,velocity of propagating contractions became faster , band ligation made the peristaltic wave duration in the sites of EVS and lower esophagus body become shorter, abnormal contractions increased. After EVS, antiacid medicine should be ased to reduced pH of gastric and raised LESP, and drugs to increase esophageal motility should be used after band ligation.

Crohn disease (CD) is a relatively infrequent disease in China. CD and intestinal tuberculosis (IT) are lack of specific clinical manifestations and are generally identified by endoscopic and histological examination. However, it is sometimes difficulty to distinguish them by endoscopy and histology. Their characteristics were investigated to offer more evidences and data for their differential diagnosis. The records of inpatients were reviewed from 1980～2001 in our hospital, all enrolled subjects were verified by endoscopy(or operation) and histology. The characteristics and key points of differential diagnosis of 28 CD cases and 14 IT cases were comparatively analyzed. The results showed that abdominal pain, mass, and hematochezia occurred more significantly in CD than in IT ﹙ P

Objective To investigate the incidence of hepatocellular carcinoma (HCC) among patients with esophageal varices bleeding previously treated with endoscopic sclerotherapy, and to evaluate the factors influencing prognosis of HCC patients.Methods The clinical data of patients (from April 1987 to May 2003) who had received sclerotherapy for esophageal varices bleeding, and also that of HCC patients who had had sclerotherapy for esophageal varices bleeding were retrospectively reviewed. The survival rates of HCC patients were evaluated with Wilcoxon-Gehan method. Sixteen risk factors for HCC were assessed by multivariate analysis (Cox model). Results A total of 934 cases were treated with sclerotherapy, among which 109 patients suffered from HCC while 825 patients did not. In 22 HCC patients with esophageal varices bleeding sclerotherapy was not given. 31 out of 825 patients (3.76%) developed HCC during the follow-up period. 17 out of 31 patients received regular follow-up while 14 cases did not. The median surviving time of 31 patients was 13 months. The survival rate of patients with HCC under regular follow-up was significantly higher than that of patients under irregular follow-up(P=0.0002); risk factors, i.e. Child-Pugh classification, age and regular or irregular follow-up, were significantly related to the prognosis of patients with HCC(P=0.039、0.029 and 0.021, respectively). Conclusion Surveillance of patients with decompensated liver cirrhosis may increase the diagnostic rate of small HCC and prolong life expectancy; sclerotherapy can lower the incidence of HCC and it may play an active role in decreasing the incidence of HCC.