Objective To evaluate the value of percutaneous endoscopic gastrostomy (PEG) in the treatment of amyotrophic lateral sclerosis (ALS) patients with dysphagia. Method Sixty-five ALS patients underwent PEG from April 2005 to July 2010 were analysed retrospectively. Results All the 65 patients underwent PEG,and 2 patients failed because of dyspnea. Totally 63 patients were intubated successfully,the successful rate was 96.9%(63/65). The operation time was 8-17 min. Two patients had local infection.After 3 months, the body mass index was increased from (18.3 ± 1.0) kg/m2 to (19.7 ± 1.2) kg/m2(t = 15.8,P ＜ 0.01), without peritonitis, migration of the gastrostomy tube and other complications. Conclusions PEG is a safe method with a low complication for ALS patients to get enteral nutrition. Dyspnea is the main reason of failure.

Chronic Disease ; Forkhead Transcription Factors ; Hepatitis, Viral, Human ; Humans

Humans ; Practice Guidelines as Topic ; Rectal Neoplasms ; surgery

Colorectal Neoplasms ; pathology ; Humans ; Neoplasm Staging

Humans ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; surgery

Combined Modality Therapy ; Evidence-Based Medicine ; Humans ; Rectal Neoplasms ; therapy

Objective To evaluate the therapeutic effect and safety of forward-viewing,doublechannel endoscope in the process of ERCP in patients with bile duct diseases after Billroth-Ⅱ gastroenterostomy.Methods ERCP was applied to 46 patients with bile duct diseases using forward-viewing,doublechannel endoscope.All patients had the history of Billroth-Ⅱ gastroenterostomy.The success rate of selective cannulation,complication rate and the outcome of all the patients were recorded.Results The procedure succeeded in 38 patients with a success rate of 82.6％,and failed in 8.Of all the failing cases,the afferent loop couldn't be accessed in 6,failure in biliary cannulation in 2.Of 38 successful cases,bile duct stones were successfully removed in 31,metal stents placed for malignant bile duct obstruction in 4,and endoscopic balloon dilation for benign common bile duct stricture in 3.All patients recovered without complications of perforation,delayed bleeding or pancreatitis.Conclusion For patients with history of Billroth-Ⅱgastroenterostomy,ERCP with forward-viewing,double-channel endoscope yields to a higher success rate and lower complication rate.

[Objective]To investigate the effect of Luteolin on mRNA expression ,protein expression and enzyme activity of 11β-Hydroxysteroid Dehydrogenase (11β-HSD) in rats.[Methods]Twenty-four rats were randomly divided into 4 groups and orally administrated with vehicle(1 % CMC-Na solution)or Luteolin(5,10 or 20 mg/kg daily)for 14 days. Gene expression of 11β-HSD I and 11β-HSD II in liver and kidney was determined with quantitative RT-PCR method. Protein expression was deter-mined with quantitative Western Blot method. The enzyme activity was expressed as the production rate of metabolites of prednisone and prednisolone.[Results]Luteolin significantly induced gene expression of 11β-HSD I and inhibited gene expression of 11β-HSD II in liver tissues ,significantly inhibited gene expression of 11β-HSD I and induced gene expression of 11β-HSD II in kid-ney tissues. Luteolin obviously up-regulated protein expression of 11β-HSD I and down-regulated protein expression of 11β-HSD II in liver tissues ,down-regulated protein expression of 11β-HSD I and up-regulated protein expression of 11β-HSD II in kidney tissues. Luteolin significantly induced activity of 11β-HSD I in liver and11β-HSD II in kidney.[Conclusions]Luteolin could change the activity of corresponding enzyme through affecting gene expression ,protein expression and enzyme activity of 11β-HSD I and 11β-HSD II in liver and kidney tissues in rat ,and affect in vivo activation of glucocorticoids and hormone level in liver and kidney.

Objective To investigate the characteristics of etiology,efficacy of endoscopic management for recurrent idiopathic pancreatitis (RIP).MethodsThe clinical data of 58 cases of RIP diagnosed in our hospital from April 2005 to April 2011 were retrospectively analyzed.All the patients underwent endoscopic retrograde cholangiopancreatography (ERCP),and patients with suspected sphincter of Oddi dysfunction received manometry.According to the clinical and ERCP manifestations,the etiologies of RIP were determined and individualized endoscopic treatment was applied.The patients were followed-up postoperatively about the improvement of abdominal pain and recurrence of RIP.ResuItsFifty-eight patients (29 males,29 females) were suffered from acute pancreatitis from 3 to more than 10 times.The etiologies were as follows:29 cases of biliary microlithiasis,19 case of sphincter of Oddi dysfunction ( 16 cases of pancreatic type,3 cases of mixed type),4 cases of anomalous arrangement of the pancreaticobiliary duct,and 6 cases of normal manifestations at ERCP.Biliary sphincterotomy alone was performed in 33 patients,while both biliary and pancreatic sphincterotomy was performed in 8 patients,and pancreatic sphincterotomy alone was performed in 17 patients,after sphincterotomy,pancreatic stent insertion was performed in 24 patients.The follow-up data was obtained from 41 out of 58 patients,the follow-up period ranged from 3 ～ 67 months ( average 33 months).During this period,9(22.0％ ) patients suffered from RIP,and the treatment efficiency was 78％.ConclusionsBiliary microlithiasis and sphincter of Oddi dysfunction are the main causes of RIP.Drink could induce RIP.ERCP has definite treatment efficacy for RIP.

Objective To investigate the effects of exogenous hydrogen sulfide on brain edema and injury and their mechanisms. Methods Sixty male SD rats were randomly divided into a sham operation group, an ischemia-reperfusion group, a 30 ppm hydrogen sulfide group, and a 60 ppm hydrogen sulfide group (n =15 in each group; 1 ppm =1 mg/L). A model of focal cerebral ischemia for 2 h and reperfusion for 24 h was induced by middle cerebral artery occlusion. The neurological scores were observed after 24 h cerebral ischemia-reperfusion. The cerebral infarction volume, the degree of brain edema, and the changes of blood-brain barrier permeability were measured. Western blotting was used to detect the expressions of occludin and zonula occludens-1 protein (ZO-1) in ischemic penumbra. Results Compared with the ischemia-reperfusion group, the neurological function scores in the 30 ppm and 60 ppm hydrogen sulfide group significantly increased in a dose-dependent manner (al P <0.05) and the neurological deficits and infarct volume reduced (al P < 0.05), and the
brain edema aleviated (al P < 0.05). The content of Evans blue in the ischemic brain tissue in the ischemia-reperfusion group increased significantly compare with the sham operation group (0.74 ±0.14 μg/100 mg vs. 0.19 ±0.06 μg/100 mg; P <0.05). The content of Evans blue in the brain tissue in the 30 ppm hydrogen sulfide group (0.55 ±0.10 μg/100 mg ) and the 60 ppm hydrogen sulfide group (0.35 ±0.08 μg/100 mg ) decreased significantly compared with the ischemia-reperfusion group (al P < 0.05), among them the 60 ppm hydrogen sulfide group was significantly lower than the 30 ppm hydrogen sulfide group (P <0.05). Western blot analysis showed that expression levels of occludin in penumbra (0.621% ±0.101% vs.0.787% ±0.087% vs.0.453% ± 0.127%; P <0.05) and ZO-1 (0.602% ±0.118% vs.0.778% ±0.805% vs.0.426% ±0.146; P <0.05) in the 30 ppm and 60 ppm hydrogen sulfide groups increased significantly compared with the ischemia-reperfusion group, among them, the expression levels of occludin and ZO-1 in the 60 ppm hydrogen sulfide group were significantly higher than those in the 30 ppm hydrogen sulfide group (al P < 0.05). Conclusions Inhalation of exogenous hydrogen sulfide can significantly attenuate brain edema after ischemia-reperfusion in a dose dependent manner, reduce infarct volume, and improve neurological function.Their mechanisms may be associated with inhibiting the downregulated expressions of occludin and ZO-1 and maintaining the integrity of the blood-brain barrier.