Humans ; Hydrocarbons, Chlorinated ; poisoning ; Propane ; poisoning

Humans ; Infant ; Milk, Human ; chemistry ; Paraquat ; poisoning ; Poisoning ; diagnosis

0. 05), but was higher than that of 1 h-stress group (P

AIM: To evaluate the dynamic changes of the function and ultrastructure of gastric parietal cells under stress and their relation with acute gastric mucosal lesions. METHODS: Thirty-two male SD rats were randomly divided into four groups, which were control group and 1,2,4 h groups under water restraint stress (WRS). The gastric fluid pH value and gastric mucosal ulcer index(UI) were measured. The ultrastructural changes of parietal cells were observed by transmission electronic microscopy (TEM). RESULTS: The study demonstrated that gastric acid secretion increased and gastric fluid pH value decreased gradually and significantly under WRS compared with control group( P

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD)in treatment of patients with early gastric cancer(EGC).Methods A total of 4 3 consecutive patients with EGC were treated with ESD at Changhai Hospital from July 2007 to July 2008.The data referred to one-piece resection,histologically complete resection,operation time,complications,the post-ESD ulcer-healing and local recurrance were retrospectively analyzed.ResultsEn bloc resection was achieved in 97.7 0A(4 2/43)lesions in one-piece resection.The histologically complete resection rate was 95.3%(41/43).Only one patient had acute minor bleeding during the ESD procedure(2.3%,1/43)and one patient had delayed bleeding(2.3%,1/43).Post-ESD epigastric pain was found in 2 2 patients(51.2%).There was no complications such as acute major bleeding,perforation,requiring surgical treatment and death.The median operation time was 60.4 miutes.The post-ESD ulcer-healing was achieved in 100%(42/42)8 weeks after esomeprazole treatment.During follow-uP of 10.3 months(ranged from 8 to 1 8 months),no residual or local recurrence of EGC was seen.Conclusion ESD has the advantages of increasing one-piece resection and histologically curative resection rates.It is a safe and effective procedure in treatment of EGC.

Objective To compare the yield of endoscopic ultrasonography guided fine needle aspira-tion (EUS-FNA) with 3 different sample processing methods. Methods The clinical data of 118 patients, who underwent EUS-FNA performed by one physician from February 2005 to September 2008, were retrospectively analyzed. The FNA sample processing methods included liquid-based cytology, on-site cytology and smear method. The pathological diagnosis was classified as definite, suspicious malignancy, dissatisfying sampling and indefinite. Results The success rate of obtaining samples through on-site cytological procedure was 95.2% (40/42), which was significantly higher than that of conventional smear (32/47, 68%, P <0. 05), and was higher than that of liquid-based cytological method (26/29, 89. 7% ), but without significant differ-ence (P>0.05). The yield of definite diagnosis with liquid-based cytology and on-site cytology were 82.8% (24/29) and 78. 6% (33/42), respectively, which were both significantly higher than that of smear method (57. 4%, 27/47, P <0. 05). The sensitivity and accuracy of on-site cytology were higher than those of smear method and liquid-based cytology, but without significant differences (P >0. 05). Conclusion Compared with conventional smear method, an-site cytology and liquid-based cytology yield more results from EUS-FNA.

ObjectiveEndoscopic suhmucosal dissection (ESD) is a new diagnostic and therapeutical technique for early gastric cancer (EGC).The aim of this study was to evaluate the efficacy and safety of ESD for EGG.MethodsThe data of patients who underwent ESD for EGCs from July 2007 to December 2007 were analyzed retrospectively.One-piece resection rate,histologically complete resection rate (the lateral and vertical margins were free of cancer),operation time,complications,post-ESD ulcer-healing rates and local recurrence were assessed.ResultsA total of 21 EGCs in 20 consecutive patients were treated with ESD.The median age was 56.4 years (range 37-75 years) and the male/female ratio was 1.9(13/7).Out of 21 lesions,20 (95.2%) were resected in one piece.The rate for one-piece resection with tumor-free margins was 90.5% (19/21).Acute minor bleeding during the ESD procedure occurred in 4.8% (1/21).Post-ESD epigastric pain rate was 76.2%(16/21).No acute major bleeding, delayed bleeding and perforation occurred.The median operation time was 50.4 min (range 45-200 min).The pest-ESD ulcer-healing rates was 100% after 8 weeks of oral esomeprazole.After a follow-up with median time of 9.2 months (range 8-12 months),none of the patients experienced residual/local recurrence of early gastric cancer.Conclusion ESD has the advantage of increasing one-piece resection rate and histologically curative resection rates.ESD is a safe and effective treatment for EGC.

Objective To evaluate the efficacy and salty of endoscopic ultrasonography-guided celiac plexus neurolysis (EUS-CPN) in the treatment of pain due to pancreatic cancer and celiac metastatic carcinoma.Methods Thirty-three patients with celiac carcinoma were selected for EUS-CPN. Among whom 15 pateints were received chemotherapy before procedure . Using endoscopic ultrasounography,transgastric injection of the celiac plexus with bupivacaine and 98% dehydrated absolute alcohol was accomplished.The abdominal pain was evaluated by the numeric pain intensity scale before and at 24,48,72 hours and one week after the precedure.The successful rate of precedure,the complication and the relief of the pain were observed. Results All procedures were performed successfully . No serious complications such as pancreatitis by trauma,pancreatic fistula,bleeding and celiac infection was found.Compared with baseline,pain was significantly relieved at 12,24,72 hours and 1 week after EUS-CPN (100%,98%,90% and 88%,respectively).The pain remission at 24,48,72 hours and one week in patients who received chemotherapy before procedure were 100%,100%,980% and 98%,respectively,while in those who had not treated chemically were 100%,98%,95% and 90%,respectively.The complete%relief of pain in chemotherapy group was significantly higher than that in nonchemotherapy group (75 % vs 56 %,P%0.05).Conclusions EUS CPN is a safe and effective method for relieving pain with low complications.It can raise the quality life of the patients and chemical therapy may be helpful in pain control.

Objective To investigate the safety and efficiency of 125I radioactive stents for advanced extra-hepatic cholangio-carcinoma.Methods We retrospectively reviewed data of 15 consecutive patients with advanced and un-resectable extra-hepatic cholangiocarcinoma,who were treated by radioactive stents.Postoperative complications,patency time of stents,and survival of the patients were assessed.Results Fifteen patients underwent 32 endoscopic sessions of radioactive stents placement.Successful operations were achieved in all patients,and there were no life-threatening complications including perforation,bleeding or bone marrow depression.The average patency time of radioactive stents was 117 ± 105 days (8-295 days).The actual radiation dose was 56.55 ± 17.42 Gy (7.86-82.48 Gy).The median survival time was 420 days (90-1175 days) and survival of 6 patients exceeded 12 months.Conclusion The 125I radioactive stent is safe and effective for patients with advanced unresectable extra-hepatic cholangio-carcinoma.

Objective To analyse the clinical characterization of intraductal papillary mucinous neoplasm of pancreas (IPMNs) and to improve the understanding of IPMNs.Methods Three hundred and sixty-one patients with IPMN at Shanghai Changhai Hospital between 1993 and 2012 were retrospectively analyzed.Results Among 361 cases of IPMNs,241 were men and 120 were female,with a female to male ratio of 2.6∶1.Mean age of the patients was 62 years old (16 ～ 87 years old).The duct type included the main duct in 102 patients (28.3％),a branch duct in 109 (30.2％),and mixed ducts in 150 (41.6％).The most common symptom at presentation is pancreatitis,which occur in 167 patients (46.3％).The sensitivity for the detection of IPMN was 80.2％ by ERCP,76.9％ by MRCP,63.9％ by CT,and 50.5％ by EUS.One hundred and twenty-nine patients (35.7％) were operated and diagnosed with 87 (67.2％) IPMA,21 (16.4％) IPMB,10(8.2％) IPMC(CIS) and 10 (8.2％) had invasive carcinomas.The 5-year survival rates of IPMA,IPMB,IPMC,and invasive carcinomas were 100％,100％,66.5％,and 44.7％,respectively.Conclusions IPMNs were fregrently occured is 60 years old,half of patients had acute pancreatitis history and the frequtly attack,mixed type is most anatomy type,and the outcome after surgery is good.