Objective To review the results of minimally invasive intervention on acute suppurative cholangitis(ASC);the effects of intervention was analyzed.Methods ASC patients had been admitted to our hospital from 2001,6 to 2005,6,and their data was analyzed;35 cases were selected according to the ASC diagnosis criteria,among whom 28 cases were treated by intervention;the data change of WBC and ratio of N before and after treatment were analyzed by T test.Results Twenty-two cases were treated by therapeutic ERCP only;all of them were cured after intervention,among whom 9 cases were drained by therapeutic ERCP for biliary duct obstruction.The effects of 5 cases who suffered from extrohepatic duct obstruction were better than those of 4 cases who suffered from hepatic duct obstruction,but the symptoms of all cases were released after drainage;4 cases were cured by combination of therapeutic ERCP and PTCD;2 cases were treated by PTCD only,among whom one was cured and one was released after treatment.No obvious complication occurred.Conclusion The minimally invasive methods of therapeutic ERCP,PTC and combined therapeutic ERCP and PTCD are good methods for ASC.

0.05), as well as in the predicted fatality rate based on Ranson score. Conclusion ERCP is safe for the biliary pancreatitis patients, and it does not increase the fatality rate of acute pancreatitis.

Objective To evaluate the efficacy and safety of the covered retrievable metal stent in the treatment of refractory benign esophageal stricture. Methods Six patients with refractory benign esophageal stricture who failed in endoscopic dilation were selected. There were 3 cases of stricture after caustic chemical ingestion, 2 cases of anastomotic stricture after surgery, and 1 case of re-stricture after metal stenting. The shape and diameter of the covered stent were individually designed. Stent was placed across the esophageal stricture. Symptoms after stenting, mucosal hyperplasia at the ends of stent and symptoms after retrieval of stent were followed up. Results Stent placement was performed successfully in all patients. After the stent placement, dysphagia was resolved, and all patients could consume soft food. Three to six months after stenting, all the stents were removed successfully by endoscopy. No mucosal hyperplasia and re-stricture occurred. In 4 cases, after stent had been removed, followed up for 2 to 12 months, symptoms of dysphagia were resolved persistently, and no further treatment was necessary. In the other 2 cases, the stent migrated, and dysphagia recurred within 1 month after removal of the stent. Besides one case of retrostemal pain after stenting, no other complication was noted. Conclusion Individually designed covered retrievable metal stent is a safe and effective way to treat refractory benign esophageal stricture.

AIM　To study the features of cell death induced by the anticancer antibiotic lidamycin (LDM) in human hepatoma BEL-7402 cells. METHODS　Chromatin condensation was observed by co-staining with fluorescent dyes, hoechst 33342 and propidium iodide. “G1 sub-peak” was detected by flow cytometry and DNA ladder was observed using agarose gel electrophoresis. The caspase-3, 6 activities were measured with kits specific for them. RESULTS　Typical apoptotic chromatin condensations appeared when the BEL-7402 cells were treated with the conventional antitumor agent mitomycin C 30 μmol.L-1 for 12 h. However, an abnormal type of chromatin condensation occurred when the cells were treated with LDM 1 μmol.L-1 for 6 h, which was characterized with keeping the completeness of nuclear membrane and not forming apoptotic bodies. The DNA ladder patterns were observed using agarose gel electrophoresis. The “G1 sub-peak” occurred only in the cells treated with LDM for 24 h, though chromatin condensation was earlier detected in treatment with LDM for 6 h. The caspase-3, 6 activities were increased about 5 and 4 folds, after the cells were treated with LDM 1 μmol.L-1 for 6 h, as did mitomycin C. The time of initiating chromatin condensation was earlier than that of the high peak activities of caspase-6. CONCLUSION　The characterization of cell death induced by lidamycin in the human hepatoma BEL-7402 cells differs from typical apoptosis. The results make it helpful to explain the molecular mechanism of the highly potent cytotoxicities of lidamycin toward tumor cells.

Objective To explore the value of autoantibodies and biochemical markers in the diagnosis of autoimmune hepatitis (AIH),and to provide the basis for clinical diagnosis.Methods AIH patients as AIH group(n=35),viral hepatitis as viral hepatitis group (n=30,including 9 cases of hepatitis A,15 cases of hepatitis B and 6 cases of hepatitis C),the other 33 healthy volunteers were selected as healthy control group,indirect immunofluorescence assay was used to detect ANA,ASMA,AMA.Western blot was used to detect SLA/LP,LC-1,LKM,AMA-M2 and biochemical examination means ALT,AST,ALP,gamma-GT,T-BIL,D-BIL,TBA.Results The test results of autoantibodies were tested by chi square test.The positive rate of ANA,ASMA,AMA and AMA-M2 in AIH group was significantly higher than that in viral hepatitis group and healthy control group (P<0.05).The results of biochemical test by rank sum test,ALP,gamma-GT in the AIH group was significantly higher than the other two groups (P<0.05).The results of D-BIL detection in viral hepatitis group were significantly higher than those in the other two groups (P<0.05).Conclusion The combination of autoantibodies and laboratory biochemistry could help clinical diagnosis of AIH.

Objective To study the related prognostic factors influencing rectal neuroendocrine tumor prognosis.Methods We retrospectively reviewed tumor clinical and pathology material of 183 cases with rectal neuroendocrine in our hospital during recent 10 years and reclassified them according to the 2010 WHO pathology classification.Single factor and multivariate analysis were performed to find related prognostic factors.Results Single factor analysis showed that tumor size (＜ 1 cm,1-2 cm,＞2 cm,98.77％ vs 78.57％ vs 28.57％,x2 =71.4793,P =0.0001),pathological grading (G1,G2,G3,98.73％ vs.76.19％ vs 25.00％,x2 =56.5121,P =0.0001) and the stage (stage Ⅰ,Ⅱ,Ⅲ,Ⅳ period,99.40％ vs 50.00％ vs 60.00％ vs 16.67％,x2 =105.0383,P =0.0001) among the three variables survival difference was statistically significant.Multivariate analysis (Cox regression) indicated that the tumor stage were independent factors affecting the prognosis,regression coefficient was 1.277 (B),Wald value of 28.145,Exp (B) a value of 3.586,95％ CI:2.237-5.747.Conclusion Tumor staging is an independent risk factor of survival,without considering other factors,different tumor size and pathologic grade also have different prognosis.Clinicians in making treatment plan should fully consider the above factors before choosing the appropriate follow-up plan.

Objective To investigate the clinical features and prognosis of rectal neuroendocrine neoplasms (NENs) in different pathological grades.Methods The clinical data of 183 patients with rectal NENs who were admitted to the PLA General Hospital from January 2001 to April 2012 were retrospectively analyzed.All the clinical and pathological data of the patients who received endoscopy and (or) surgical resection were retrieved from the work station and the database of the endoscopic center.Based on the 2010 WHO pathology classification of digestive tumors,the pathological data were ranked according to the mitotic count.The prognosis of the patients was learned by re-examination or phone call.The follow-up ended till July 2014 or at the death of patients.Data were analyzed using the chi-square test.Results A total of 183 patients were enrolled in this study including 120 males and 63 females.The median age of the patients was 48 years (range,14-83 years).Seventy-four patients had the symptom of hemafecia,9 patients had abdominal pain and change in bowel habit,and 70 patients were diagnosed by body examination.Other symptoms included increased level of tumor markers and abdominal distension.Carcinoid syndrome was not detected in all the patients.Fourteen patients were complicated with polyp of intestine,5 with tubular adenoma,3 with colorectal adenocarcinoma and 1 with small cell lung cancer.The diameters of the tumor under 1 cm were detected in 162 patients,the diameters of the tumors ranged between 1 cm and 2 cm in 14 patients,and the diameters of the tumors above 2 cm in 7 patients.The mean distance between the tumor and the anus was (5-± 3)cm.Of the 183 patients,130 received endoscopic treatment,43 received surgical treatment and 10 received clamping because the tumor was misdiagnosed as polyps.There were 158 patients in grade1 (154 in stage Ⅰ,1 in stage Ⅱ,1 in stage Ⅲ and 2 in stage Ⅳ),21 in grade2 (13 in stage Ⅰ,3in stage Ⅱ,3 in stage Ⅲ and 2 in stage Ⅳ),4 in grade 3 (1 in stage Ⅰ,1 in stage Ⅲ and 2 in stage Ⅳ).Six patients had liver metastasis and 9 had lymph node metastasis.Fourteen patients died (4 in grade 1,6 in grade 2 and 4 in grade 3).The 5-year survival rate of patients was 92.35％ (169/183).There were significant differences in the gender,tumor diameter,tumor staging,lymph node metastasis distal metastasis and 5-year survival rate among patients with rectal NENs in different pathological grades (x2=60.949,71.587,32.135,55.486,56.512,P ＜ 0.05).Conclusions Rectal NENs lacks the specific clinical manifestation and is more likely to happen in males,and it often locates at the middle-lower rectum.Most of the rectal NENs belongs to stage Ⅰ and grade 1 and is less than 1 cm in size.The prognosis of patients with rectal NENs in different pathological grades is different.The 2010 WHO pathology classification of digestive tumors is useful to asses the prognosis of rectal NENs.Different grades of rectal NENs could be taken into account when designing the treatment plan.

Objective To study the application of implantable telemetry and whole-body plethysmography to observe the changes of circadian rhythm in conscious rats and evaluate the pharmacological safety of doxofylline, and to provide a basis for the future application of this technological system for drug safety evaluation.Methods Eight healthy SPF Sprague-Dawley rats were used in this study, 4 males and 4 females.The rats were implanted with telemetry transmitters by surgery to establish a telemetry system combined with plethysmography to observe the changes of 24 h physiological parameters and circadian rhythm in conscious rats at 14 d after operation, including heart rate (HR), blood pressure, the time interval from the Q wave to point A in the ECG of the aortic pressure wave (QA interval), respiration, activity, body temperature and pulmonary function parameters.The rats were divided into 3 groups: normal control group, doxofylline 40 mg/kg and 80 mg/kg groups, and the performance was validated by aerosolizing saline, doxofylline 40 mg/kg and 80 mg/kg inhalation, respectively, to observe the changes in physiological parameters after the drug administration.Results The physiological parameters of rats showed obvious changes in circadian rhythms at 14 d after operation.Compared with the normal control group, the doxofylline 40 mg/kg-treated group showed significantly increased changes of HR, tidal volume (TV), minute ventilation (MV), 50% expiratory flow (EF50), peak inspiratory flow (PIF) and peak expiratory flow (PEF) (P<0.01), significantly decreased respiratory frequency, QA interval and enhance pause (Penh) (P<0.05, P<0.01), but no significant differences in the blood pressure, activity and body temperature (P>0.05).Compared with the normal control group, the group treated with doxofylline 80 mg/kg had significantly increased HR, blood pressure, TV, MV, EF50, PIF and PEF (P<0.01), significantly decreased respiratory frequency, QA interval and Penh not (P<0.01), but not significantly changed activity and body temperature (P>0.05).Conclusions The application of implantable telemetry and whole-body plethysmography in this study does not obviously affect the circadian rhythm, and can sensitively monitor the relevant cardiovascular and respiratory parameters in conscious rats.It can be used in drug safety pharmacological research of cardiovascular and respiratory systems in conscious rats.

A fast method composed of the quick, easy, cheap, effective, rugged and safe ( QuEChERS) and temperature-assisted ionic liquid dispersive liquid-liquid microextraction ( TA-IL-DLLME) sample preparation coupled with high performance liquid chromatography ( HPLC ) for the analysis of 5 dyes residues in navel orange was developed. The QuEChERS sample preparation involved the quick extraction with acetonitrile in the presence of anhydrous MgSO4 and NaCl and the purification with primary secondary amine ( PSA ) sorbent. The TA-IL-DLLME sample preparation was processed using 1 mL of the extract obtained by QuEChERS as dispersive solvent and 60 μL of 1-octyl-3-methylimidazolium hexafluorophosphate as extractive solvent under 55 ℃ of water-bath temperature and 12 min of water-bath time. The ultimate solution was detected by HPLC-UV and the contaminated sample was further confirmed by UPLC-MS/MS under multiple reactions monitoring (MRM) mode. The recoveries of five dyes were in the range from 70. 3% to 93. 6% at two spike levels of 0. 01 and 0. 05 mg/kg, the relative standard deviations (RSDs) were between 3. 5% and 9. 2% and the limits of quantification (LOQs) were between 1. 1 and 2. 8 μg/kg.

ObjectiveTo investigate the procedure,effect and complication of endoscopic submucosal dissection (ESD) in the management of early gastrointestinal tumors and precancerous lesions.MethodsESD was performed in 28 patients with 29 lesions of early cancer and precancerous lesions in esophagus,stomach,colon and rectum.First we made marks around the lesion 3-5 mm away from the margin with a needle knife or APC,then injected solution into submucosa to elevate the lesion,and cut the mucosa and submucusa along the margin with a needle knife or IT knife.The submucosa was carefully dissected until the lesions were completely removed with IT knife.Bleeding was stopped with thermocoagulation forceps,argon plasma coagulation or clip.The samples were collected for pathological examination.All patients were followed up with endoscopy as scheduled.ResultsOf the 29 lesinas,22 were en bloc resected,6 were piecemeal resccted,and 1 was partial removed.The resection rate of antral lesion was 100% (12/12),and that of lesions between angulus and cardia was 5/7,that of esophageal lesions was 3/5 and that of colorectal ncoplasmns was 2/5.Delayed bleeding occured in 1 patient.The mean operation time for the antral lesions was 48 minutes.Twenty patients were followed up for 1 to 12 months.No residue or recurrence of the lesions was found.ConclusionThe major advantage of ESD is that the resection area can be determined by the size and shape of the lesion,and resection can be achieved en bloc even in a large neoplasm.