Objective To investigate the feasibility and safety of endoscopic ultrasonography (EUS) guided interstitial chemotherapy for the pancreas in canine model. Methods A therapeutic 19gauge needle was inserted into the pancreas with EUS guidance,and seeds with sustained release of 5-iluorouracil were implanted into the tissue. After 14 days of clinical observation,the animals were sacrificed and the tissue response to local chemotherapy was examined. Results All the seeds were implanted successfuUy and no migration was observed. Chemotherapy induced tissue fibrous necrosis was localized in the pancreas without significant complications. The apoptotic index of tissue within 1 cm of the seeds increased.Biochemical parameters were normal in all the dogs. Conclusion EUS-guided implantation of seeds is a safe,simple and minimally invasive technique for interstitial chemotherapy in the pancreas.

Objective To investigate the differences of EUS images between stromal tumors and leiomyoma in esophagus and cardia. Methods EUS image of 13 cases of stromal tumors and 11 cases of leiomyoma diagnozed immunohistochemically were collected. Information of gray scale including mean value and dissociation of lesions and submucosal layer were analyzed. Gray scale values of lesions were calibrated according to that of the submucosal layer. Results The mean value of corrected gray scale of stromal tumors was 0. 285, which was significantly different from that of leiomyoma (0. 185, P ＜ 0. 05). Dissociation of gray scale of stromal tumors was 8. 14, which was also significantly different from that of leiomyomia (4. 59,P ＜0. 05). Conclusion In esophagus and cardia, stromal tumors exhibits higher and more inhomogeneous ultrasound echo than leiomyoma.

Objective To evaluate the diagnostic value of endoscopic ultrasonic elastography in lymph node staging of gastrointestinal tumors.Methods Thirty-nine abdominal lymph nodes and 26 mediastinal lymph nodes of 35 patients with gastric cancer or esophageal carcer were examined by endoscopic ultrasonic elastography of five-point elastic score.Lymph node at 1-3 points was regarded as negative(benign),while 4-5 points as positive(malignant).The diagnostic value of EUS elastography was determined by comparing the results with pathological findings.Results Of all the 65 lymph nodes,49 were diagnosed as positive and 16 negative.The sensitivity and specificity of EUSE in the diagnosis of malignant lymph nodes were 91.1%and 60.0%.respectively.Conclusion EUSE is helpful for diagnosis of malignant metastasic lymph nodes.

Objective To evaluate the clinical effects and safety of double-channel forward-view endoscopy for lower-position biliary obstruction after Billroth-Ⅱ gastrectomy.Methods A total of 18 patients with lower-position biliary obstruction after Billroth-Ⅱ gastrectomy were enrolled and treated with doublechannel forward-view endoscopy.The process and the outcomes were recorded.Effectiveness and safety were evaluated.Results Double-channel forward-view endoscopic treatment was successfully performed in 13 of the 18 patients (72％),with stone removal or stents implantion to resolve biliary obstruction.The procedure failed in 5 patients,who were transferred to surgery or underwent percutaneous transhepatic cholangial drainage.Delayed bleeding occurred in 1 patient,and pancreatitis in 2,who were cured after standard treatments.Conclusion Double-channel forward-view endoscopy is effective and safe for lower-position biliary obstruction in patients after Billroth-Ⅱ gastrectomy.

Objective To investigate whether preoperative proton pump inhibitor (PPI) would increase the risk of bacteremia after endoscopic ultrasonography guided fine needle aspiration (EUS-FNA).Methods Dogs were randomly divided into experimental group ( n = 8) to take 20mg of omeprazole orally twice a day for 3 days before EUS-FNA, and control group (n = 10) to take placebo.EUS-FNA was performed to puncture the pancreas, and blood was collected before and after the procedure for culture.Bacteremia incidence of the two groups were compared.Results Bacteria culture was positive in 11 edogse.After excluding contamination, 1 dog in experimental group and 3 in control group were authentical bacteremia.There was no significant difference on the incidence of bacteremia between 2 groups based on Fisher test ( P = 0.383).Conclusion Aplication of PPI before EUS-FNA is not likely to increase the incidence of bacteremia.

ObjectiveTo assess the diagnostic value of EUS for pancreatic neuroendocrine tumors.MethodsClinical data of 26 patients with final diagnosis of pancreatic neuroendocrine tumors,who had underwent EUS and EUS-FNA,were retrospectively analyzed.Results On EUS,pancreatic neuroendocrine tumors presented as hypoechoic masses with clear margins and rich blood flow.Of the 26 pancreatic lesions,3 were in the head,2 in unicate process,2 in neck,11 in body and 8 in tail.The tumors presented with function in 16 ( mean size 9 mm),and on function in 10 ( mean size 29 mm).EUS-FNA yeilded positive results in 22 patients and negative in 4.The accuracy rate of EUS for preoperative localization was 100％ in 23 patients who underwent surgery.ConclusionEUS can provide accurate preoperative localization and pathologic evidence for pancreatic neuroendocrine tumors.

Objective To evaluate the therapeutic value of endoscopic band ligation in gastric stromal tumors.Methods Twenty-nine patients with small gastric stromal tumors(diameter<12mm)underwent endoscopic band ligation,and were followed up with routine endoscopy and EUS.Results Twentyeight patients recovered completely,with the surface healing up 4-6 weeks(average 4.8 weeks)thereafter.The neoplasm did not slough off in one patient,so he underwent a second ligation.Hemorrhage occurred in one patient three days after ligation,but was successfully managed with hemoclips.Other patients showed no complications.All the patients were followed up for 36 to 51 months,and there was one case of recurrence.Conclusion Endoscopic band ligation is an effective and safe treatment for small GISTs of less than 12 mm.

OBJECTIVETo examine the protective effect of Ginkgo biloba leaf extract (GbE) on learning and memory deficit induced by aluminum chloride (AlCl(3)), and explore its mechanisms.

METHODSThe rat models with learning and memory deficit were induced by administering via gastrogavage and drinking of AlCl(3) solution. And the model rats were treated with GbE at the dose of 50, 100, 200 mg/kg every day for 2 months accompanied with drinking of AlCl(3) solution, respectively. Their abilities of spatial learning and memory were tested by Morris water maze, and the acetylcholinesterase (AChE) activity in serum was assayed with chemical method, the AChE expression in hippocampus was observed by immunohistochemistry assay, and then quantitative analysis was done by BI 2000 image analysis system.

RESULTSLearning and memory deficit of rats could be induced by AlCl(3) solution (P < 0.01), and AChE expressions in rats hippocampus were increased (P < 0.01); GbE ameliorated learning and memory deficit and reduced AChE expression in rats hippocampus in a dose-dependent manner, while GbE significantly increased serum AChE activity at the dose of 200 mg/kg each day (P < 0.05).

CONCLUSIONGbE can ameliorate learning and memory deficit induced by AlCl(3), which may be due to its inhibition of the AChE expression in hippocampus.

Acetylcholinesterase ; metabolism ; Aluminum Compounds ; toxicity ; Animals ; Chlorides ; toxicity ; Dose-Response Relationship, Drug ; Ginkgo biloba ; Hippocampus ; enzymology ; Immunohistochemistry ; Male ; Maze Learning ; drug effects ; Memory Disorders ; chemically induced ; prevention & control ; Neuroprotective Agents ; therapeutic use ; Phytotherapy ; Plant Extracts ; therapeutic use ; Plant Leaves ; Plant Structures ; Rats ; Rats, Wistar ; Reaction Time

Objective To investigate the optimal time for double balloon enteroscopy (DBE) in patients with obscure gastrointestinal bleeding (OGIB).Methods Data of 78 patients with OGIB who underwent DBE from January 2009 to November 2013 were retrospectively analyzed.They were classified into two groups:emergency DBE and non-emergency DBE.The demographic and clinical features and outcomes of DBE,the time of examination and complications were compared.Results The overall diagnostic yield of DBE was 48 lesions (61.54 ％).The overall diagnostic yield of emergency DBE group was 77.14％,which was significantly higher than that in non-emergency DBE group (48.83％) (P =0.019).The time of examination in emergency group was shorter than that of non-emergency group with significant difference (P =0.031).Conclusion Emergency DBE takes less time and yields a higher rate of detection.Patients withOGIB should receive DBE as soon as possible.

ObjectiveTo study the state of oxidative injury induced by sodium arsenite(NaAsO2) in SV-40-immortalized normal uroepithelial (SV-HUC-1 ) cells.Methods SV-HUC-1 cells were exposed to different concentrations of NaAsO2[0(control),1,2,4,8,10 μmol/L] for 24 h,intracellular reactive oxygen species (ROS) was determined by flow cytometry,and the content ofintracellular nitrotyrosine(NT) and the 8-Hydroxydeoxyguanosine (8-OHdG) levels of cell culture medium were detected by enzyme linked immunosorbent assay (ELISA).Results After 24 h treatment,ROS levels(81.76 ± 4.91,95.23 ± 2.17,126.61 ± 17.95,126.74 ± 27.77,114.18 ± 9.65) of SV-HUC-1 cells in the 1,2,4,8,10 μmol/L NaAsO2 exposure groups were significantly higher than those of the control group (69.84 ± 1.28,P ＜ 0.05 or ＜ 0.01 ),ROS levels and exposure dose were positively correlated significantly(r =0.818,P＜ 0.01); the content of NT in the 10 μmol/L NaAsO2 exposure group[(919.66 ± 206.33) μg/L] was significantly higher than that in the control group[ (238.19 ± 38.28)μg/L,P ＜ 0.01 ],NT content and dye concentrations of arsenic also had dose-response relationship (r =0.617,P ＜ 0.01); after 24 h the cells were treated with arsenic,no significant difference of 8-OHdG content in the culture medium was observed(F =2.127,P ＞ 0.05 ).ConclusionNaAsO2 can cause SV-HUC-1 cell oxidative damage.