Objective To evaluate the effective of emergent endoscopic injection sclerotherapy ( EIS) for lethal bleeding from esophagogastric varices. Methods In this study, endoscopic injection of 5% sodium morrhuate was used to control esophagogastric variceal bleeding in 176 patients. In all 209 cases, 181 cases suffered from acute lethal bleeding from esophagogastric varices received endoscopic variceal sclerotherapy under the modified Senstaken-Blakemore tube compression. Results The exact bleeding site at the first procedure could be visualized in 166(94. 3% ) patients. The effective rate of EIS was 96. 2% . Multiple procedures were required in the 21 cases of relapsed bleeding. Complications of EIS occurred in 15 cases (8. 5% ) , of which 3(1. 7% ) died. Conclusion Endoscopic injection sclerotherapy under the modified Senstaken-Blakemore tube compression is relatively safe and effective procedure in the treatment of lethal bleeding from esophagogastric varices.

To investigate the distribution of Hepatitis B virus (HBV) genotypes among the population of Dai nationality in Xishuangbanna, Yurman Province HBV genotypes of the Serum samples were tested by PCR-RFLP. This is the first time to discover the B+E genotypes in China. This finding provides new information for understanding the distribution of HBV genotype in China and a provides a basis for establishing a Chinese gene bank.

Objective To investigate the causes, clinical features, treatment and prognosis of gastrointestinal bleeding (GIB) patients in emergency department.Methods To analyze prospectively the clinical data of 168 GIB patients admitted to the emergency department of Peking Union Medical College Hospital during 2006.1-2006.12.Results (1) General data; male: female = 1.75:1 ( 107: 61) , mean age 13-87(56.5 ±17.8) years with a peak in 60-69 years.The percentage of old patients was significantly higher than that of young and middle age ( 52.4% vs 19.6% and 28.0% , P = 0.000 ).( 2 ) The incidence of acute gastric mucosal lesion in patients taking non-steroidal antiinflammatory drugs ( NSAIDs) ( 18.5% ) was significantly higher than that in patients not taking( 0.7% , P = 0.000 ).( 3 ) 86.9% ( 146/168 ) of the patients had anemia.(4) More patients who took emergency gastroscopy could be diagnosed than those patients who did not (89.4% vs 58.5% , P =0.000), while no significant difference could be seen between patients who took emergency enteroscopy and patients who had non-emergency gastroscopy (20.0% vs 57.9% , P =0.315).(5)The hemostatic ratio in GIB patients due to peptic ulcer was obviously higher than that in GIB patients due to other causes (86.0% vs 40.7% ,P =0.000).The rate of emergency operation for GIB patients was 1.8%.Conclusions Most of the GIB patients admitted to tertiary general hospitals are elderly males.NSAIDs administration is one of the most important causes of upper GIB.Upper GIB patients should have gastroscopy as soon as possible, while emergency coloscopy is of little significance in cases with lower gastrointestinal hemorrhage.

Objective: To explore the effect of transgenic metallothionein (MT) mushroom on anti-radiation ability of mice. Method: Dried power of transgenic MT mushroom was mixed into the feed of ICR mice. After being fed for 23 d, they were irradiated by 5.0Gy 60Co-?rays. Then their anti-radiation ability was determined after being fed 7 d again. Results: Transgenic MT mushroom can evidently alleviate the injury of platelet and spleen induced by radiation, and apparently increase SOD activity and reduce MDA content in irradiated mice’s serum. Conclusion: Transgenic MT mushroom can improve anti-oxidation ability of irradiated mice.

Occupational Medicine ; education

Objective To verify the effects of different conc entrations of auecifemine on the function of osteoblast cell expression and oste ogenic ability in vitro . Methods Iliac spongy bone specimens were obtained from twel ve adult patients scheduled surgery. After the bone pieces were treated with col lagenase-trypsin, osteoblasts were obtained from cancellous bones. Then the ost eoblasts were purified and cultivated. They were cultured in medium with various concentrations(1?10 -11 , 1?10 -9 , 1?10 -7 , 1?10 -6 , 1 ?10 -5 , 5?10 -5 mol?L -1 ). The alkaline phosphatase (ALP) acti vity, osterocalcin and osteogenic ability were examined by biochemical assay and radioimmunologic assay (RIA), respectively. Results The co rrelation of auecifemine of different concentrations with ALP activity and osteo calcin secretion was positive. Auecifemine of lower concentrations (1?10 -11 mol?L -1 , 1?10 -9 mol?L -1 and 1?10 -7 mol?L -1 ) s howed the stimulating effect on osteogenic ability and but not higher concentrat ion. Conclusion Estrogen can increase osteoblast ALP activi ty, osteocalcin production, and osteogenic ability.

To investigate the distribution of hepatitis B virus (HBV) genotypes and subgenotypes among the Bai nationality in Dali, a total of 100 serum samples from patients with chronic HBV-infection were collected for the detection of HBV genotypes and subgenotypes by genotype-specific primers and restriction fragment length polymorphism (RLFP), respectively. Among the 100 samples, the proportions of genotype B, C and mixed genotype (B+C) were 41%, 25% and 34%, respectively. All the genotype B strains belonged to subgenotype Ba. In genotype C, 84% were Subgenotype Cs and 12% were subgenotype Ce. The distribution of genotypes B, C and B+C showed no significant difference between male and female patients (P=0.182) and among the age groups of patients (P=0.812). The rates of HBeAg/HBeAg positivity were no significantly different among genotypes B, genotype C and mixed genotype (B+C) (P=0.077/P=0.663). In Dali, genotypes B, B+C and C existed among Bai nationality with chronic HBV-infection, and genotype B was the major genotype. Subgenotypes Ba and Cs were the predominant strains in patients with HBV genotype B/C infection. The most prominent characteristic was the higher prevalent rate of mixed genotype (B+C) in patients.

Objective To evaluate the efficacy and safety of transarterial chemoembolization (TACE)combined with sonographically guided percutaneous microwave coagulation therapy(PMCT)for hepatic carcinoma with diameter＞5.0 cm.Methods We retrospectively reviewed 68 cases of hepatic carcinoma with diameter＞5.0 cm under treatment of TACE combined with PMCT.CT,USG and correlated laboratory tests of hepatic carcinoma were carried out.Results Among 68 cases,complete ablation were 5 cases(5/68),tumor ablation area more than 50% or tumor shrinkage less than 30% were 59 cases(59/ 68),tumor ablation area less than 50% or tumor shrinkage more than 30% were 6 cases(6/68).Forty five cases with high AFP descended more than 50% after the procedure in 42 eases(93.33%).Thirty seven cases and 29 cases with increase of CEA and CA19-9 decreased to 28(75.97%)and 23(93.10%)cases with corresponding index decreasing more than 50% respectively.Survival time reached 4-6 months in 3 cases, more than 6 months for 31 cases,more than 12 months of 34 cases.Two cases among them showed no recurrence up to now after stoppage of treatment for 24 months and finally no correlative mortality occurred. Conclusion TACE combined with sonographically guided PMCT for hepatic carcinoma with diameter more than 5 cm is safe and effective.

Objective To investigate the treatment of intractable bile duct stones. Methods Of the total 149 cases of biliary stones, some are multiple bile duct stones,large stones,stones obstructed in the duodenal ampulla or residuary stones after T-tube surgery, others are associated with small papilla or papilla with neighoring diverticulum. All the stones were extracted with several endoscopic methods, such as choledochoscopy during or after operation, mechanical lithotripsy after EST(endoscopic sphincterotomy), biliary mother-baby endoscopy, ENBD(endoscopic nasobiliary drainage) or biliary-duodenum internal drainage. Results In general, extrahepatic bile duct stones were effectively removed in 94. 6% cases. In 19 out of 20 cases, stones were completely removed with choledochoscopy during operation; In 35 out of 40 cases stones were fully extracted through T-tube endoscopy, and in 72 of 76 cases stones were thoroughly removed with mechanical lithotripsy after EST. Conclusion The intractable bile duct stones can be effectively managed with combined endoscopic therapy, which is attributed to the high success rate in removing biliary stones and should be popularized in this field.