In recent years,endoscopic technique has become a basic procedure for the diagnosis and treatment of biliary and pancreatic diseases,thus the procedure-related complications of ERCP and endoscopic sphincterotomy(EST) become prominent day by day. Post-EST bleeding is one of the most serious complications of the procedure,and its first line treatment involves a variety of endoscopic techniques,such as epinephrine or fibrin glue local injection,electric coagulation and heat probe,clamps and covered metal stents. If these are not successful,transcatheter arterial embolization or surgical operation should be considered. In this article,the above-mentioned treatment modalities of post-EST bleeding were reviewed.

Objective:To compare the survival of resected gastric cancer patient treated with oxaliplatin, 5-fluorouracil, and leu-covorin (FOLFOX6) with those treated with oxaliplatin and capecitabine (XELOX). Methods:A total of 147 resected gastric cancer pa-tients accepted the treatment. Among them, 99 were treated with FOLFOX6 and 48 were treated with XELOX. Adverse events and sur-vival rates of the two groups were compared. Results:Incidence of leukopenia and hepatic dysfunction in the FOLFOX6 group was sig-nificantly higher than that of the XELOX group (P<0.05), whereas hand-foot syndrome in the XELOX group was significantly higher than that of the FOLFOX6 group (P=0.016). By contrast, the incidence of other adverse events, such as anemia, thrombocytopenia, nau-sea and vomiting, diarrhea, kidney dysfunction, peripheral neurovirulence, and oral mucositis, was not significantly different (P>0.05) between the two groups. After 1, 3, and 5 years, disease-free and overall survivals between the two groups were not significantly differ-ent (P>0.05). Conclusion:The effects of FOLFOX6 and XELOX adjuvant chemotherapies on long-term survival of resected gastric cancer patients were found to have no significant difference.

Objective To evaluate the preventive effect of compound matrine injection on hepatic lesion caused by chemotherapy. Methods 178 patients after gastric and colorectal cancer resection were enrolled into three groups randomly. 56 patients in group A received MFOLFOX6 regimen treatment only, 62 patients in group B received both normal treatment and combined compound matrine injection,60 patients in group C received both normal treatment and glutathione. The change of liver function were observed. Results There was no the hepatotoxicity of Ⅲ-Ⅳ degree in all groups;the incidence of bilirubin and transaminase increasing in group B and C was significantly lower than that group A(P ＜0.05), but the incidence of ALP/GGT increasing showing no significant difference among the three groups; 72.7 % of the incidence of hepatic lesion in group A happened firstly before the seventh cycle,it was 27.3 % and 33.3 % respectively in group B and group C, the time of the emerging of hepatotoxicity in group B and C was markedly delayed than that group A (P ＜0.05); there was not significant difference between group B and group C in both bilirubin and transaminase increasing and the time of the emerging of hepatotoxicity (P ＞0.05). Conclusion Compound matrine injection can prevent and postpone the happening of hepatic lesion caused by adjuvant chemotherapy after digestive tract cancer resection, The result is equal to glutathione. Compound matrine injection also has antineoplastic effects, so the clinical superiority is more obvious.

Objective To explore whether dexmedetomidine(Dex)could mitigate acute lung in-jury induced by hind limb ischemia reperfusion(I/R).Methods One hundred and twenty SD rat weigh-ting 250-300 g were allocated to receive hind limb I/R,I/R plus Dex (25 μg/kg Dex was intraperitoneal in-jection 30 min before ischemia)and norm control group,and each group was further divided into five sub-groups:before operation and 4 h ischemia followed by 0,1,3 and 6 h reperfusion.After euthanization,lung W/D weight ratio,PaO2 ,SOD,MDA and TNF-α were determined.Results Compared with group C, hind limb I/R injury significantly increased serum TNF-α concentration and W/D ratio,with significantly decreasing PaO2 level at any time of reperfusion in the group I/R,the concentration of MDA increased and the SOD activity decresed at 1,3,6 h of reperfusion.Conversely,W/D ratio as well as the concentration of TNF-αin the serum of the I/R plus group Dex were significantly lower than those of the I/R at 6 h of reperfusion,PaO2 level increased respectively;the concentration of MDA decresed at 1,3,6 h of reperfusion and the SOD activity increased at 3,6 h of reperfusion in I/R plus group Dex.Conclusion Dex mitigates a-cute lung injury induced by unilateral hind limb I/R in rats.The mechanisms may involve attenuating oxida-tive stress and inhibiting inflammatory response.

Objective To explore the effects of psoralen (PSO) and long wave ultraviolet A (PUVA) on apoptosis and expression of Fas in HL-60,K562 and NB4 leukemia cells.Methods The cells were incubated with PSO in different concentrations irradiated with or without UVA.The changes of ultrastructure of cells were observed under the electron microscope.The expression of Fas gene was detected by fluorescent quantitation PCR.The apoptosis ratio and the expression of Fas protein were detected through the flow cytometry.The factorial design and analysis of variance were used to analyze the interaction among the factors.Results There were obvious ultrastructure changes about apoptosis in leukemia cells after treated with PUVA.PSO,UVA and PUVA all increased the apoptosis ratio and expression of Fas gene and protein,and the effects of PUVA were stronger than the other two (P

Objective To study the changes of Caspase8 and Caspase3 protein in HL-60 cells during apoptosis induced by psoralen (PSO) plus ultraviolet A (UVA). Methods HL-60 cells were treated with PSO, extracted from Chinese medicine psoralea fruits in different concentrations, plus UVA of wave length 360 nm in different irradiation time. The apoptosis ratios, ultrastructure changes and the expression of Caspase8 and Caspase3 protein were detected. The factorial design and analysis of variance were used to analyze the interaction among the factors. Results PSO, UVA and PUVA all increased the apoptosis ratios and up-regulated the expression of Caspase8 and Caspase3 protein, but the effects of PUVA were the strongest. There were obvious changes about apoptosis under the electron microscope after treatment with PUVA. Conclusions PUVA can induce the apoptosis of HL-60 cells and activate Caspase8 and Caspase3 gene.

Objective To compare the clinical efficacies of electroacupuncture plus rehabilitation training versus electroacupuncture alone in treating lumbar intervertebral disc herniation and evaluate the therapeutic effect of electroacupuncture plus rehabilitation training. Method Seventy-two patients with lumbar intervertebral disc herniation were randomly allocated to a treatment group of 36 cases and a control group of 36 cases. The control group received electroacupuncture at Huatuo jiaji(Ex-B2) points. In addition to electroacupuncture, the treatment group received lumbodorsal muscle stretch training according to the outcome (forward flexion and backward extension) obtained using the Turgunmed testing and evaluating system. Isokinetic muscle strength and the activity were measured and the ODI lumbago score and the VAS pain score were recorded before and after treatment. Result There were statistically significant differences in isokinetic muscle strength and the VAS pain score (P<0.01,P<0.05) but no in the activity and the ODI lumbago score (P>0.05) between the treatment and control groups. Conclusion Electroacupuncture plus rehabilitation training is more effective than electroacupuncture alone in improving isokinetic muscle strength and the VAS pain score in patients with lumbar intervertebral disc herniation.

Objective:To investigate the clinical efficacy of microscopic myringoplasty versus endoscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media. Methods:The clinical data of 91 patients with tympanic membrane perforation caused by chronic suppurative otitis media who received treatment in Jiaxing Second Hospital, China between February 2017 and March 2019 were retrospectively analyzed. These patients were divided into a control group ( n = 45) and an observation group ( n = 46) according to different surgery methods. The control group was given microscopic tympanoplasty, while the observation group was given endoscopic tympanoplasty under the otoendoscope. Results:Blood loss in the observation group was significantly lower than that in the control group [(7.2 ± 2.0) mL vs. (13.7 ± 3.1) mL, t = 11.912, P < 0.001]. Operation time in the observation group was significantly shorter than that in the control group [(59.4 ± 5.4) min vs. (91.5 ± 11.2) min, t = 17.474, P < 0.001]. Postoperative pain score in the observation group was significantly lower than that in the control group [(2.9 ± 0.7) points vs. (4.8 ± 1.3) points, t = 8.707, P < 0.001]. Hospital stay in the observation group was significantly shorter than that in the control group [(4.3 ± 1.0) d vs. (6.5 ± 1.5) d, t = 8.249, P < 0.001]. Pure tone hearing thresholds at 1, 2 and 4 kHz frequencies in the observation group were significantly higher than those in the control group (all P < 0.05). Patient satisfaction regarding the aesthetic effect of the surgical incision in the observation group was significantly higher than that in the control group [97.8% (45/46) vs. 77.8% (35/45), χ2 = 8.604, P = 0.003]. Conclusion:Endoscopic myringoplasty has the advantages including shorter operation time, less blood loss, lower degree of pain, better hearing improvement and higher patient satisfaction over microscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media.