Objective To develop a new silicone coating iodine-125 (s-125I) radioactive stent, and to compare it with the traditional titanium coating iodine-125 (t-125I) radioactive stent.Methods Medical silicone solution was mixed with 125I solution, evenly applied to specific locations of stents to make the silicone-coated 125I stents.The total radioactivity of 125I solution was 24mCi, by which 20 silicone-coated 125I stents were made.A total of 20 traditional titanium stents of the same radioactivity were collected, and the utilization rate of the radionuclides of the two types of stents were compared.Results With the same amount of radioactivity, the s-125 I stent showed a higher utilization rate of nuclide [91.2％ (21 878/24 000) VS 50.1％ (12 031/24 000)] (P ＜ 0.05).Conclusion The s-125I stent has a high utilization rate of nuclide,which can save the cost and energy largely.However, the application of the s-125I stent still needs further research.

Objective To investigate the effect of antiulcer agents Omeprazole, Misoprostol and Talcid on the gastric mucosa lesion by analyzing the gastric mucosa cell apoptosis and proliferation and CX43 transcriptional expression. Methods Mucosa lesion were evaluated by UI, 32 mice were randomly divided in equal numble into Omprazole (O), Misoprostol (M), Talcid (T), Comparison (C). Apoptosis cells in gastric mucosa were quantitated by terminal deoxynucleatidyl transferase mediared dUTP nick and labelling (TUNEL) techniques, while the expression of PCNA proteins were detected by immunohistochemical staining, CX43 mRNA was detected by In situ hyberdization. at 2h after WRS. Results We found that in comparison with control group, the group of pretreatment with Omeprazole, Misoprostol and Talcid showed a significant reduction in damaged mucosa and epithelial cell apoptosis and increase in the expression of PCNA proteins, and the effect of Omeprazole and Misoprostol was better than Talcid. All three antiulcer agents increased CX43 mRNA expression, the effect of Misoprostol and Talcid was better than Omeprazole. Conclusions Omeprazole, Misoprostol and Talcid can attenuate the multiple gastric mucosa lesion induced by WRS. It may be the ultimate way to prevent and cure stress ulcer by exerting direct cytoprotective effect to improve the cell ability and inhibit stress injury.

Objective To study the expression of EGF and EGFR in restenosis tissue of animal e-sophagus after several times of stenting in esophagus, and their relation with esophageal restenosis . Methods Animal models of esophageal stenosis after stenting were made from 16 adult healthy dogs, and allocated into 4 groups to take restenosis tissue as experimental samples at week 1,2,4 and 8. In addition, other 6 normal dogs served as control. To study the expression of EGF and EGFR at protein and mRNA level in these samples by immunohistochemistry ( SABC) and RT-PCR. Results At week 1 and 2, EGF and EGFR clearly expressed, the expressing level increased greatly as compared with the normal controls, the expression of EGF and EGFR existed almost in all the tissues. At week 4 the expression lessened greatly, and finally at week 8 disappeared. The positive cells for EGF were mainly macrophages, some vascular endothelial cells and smooth muscle cells, the positive cells for EGFR were mainly macrophages, lymphocyte and Fb. Conclusion After esophageal stenting, lymphocyte, macrophage and Fb in the local tissues were closely related to restenosis, and served as the important regulatory cells in the pathogenesis of restenosis.

Objective To study the changes of collagen content in the esophageal tissue after stenting. Methods To select healthy adult dogs as experimental subjects.Esophageal stent was installed by the method of “autogenous fascia lata femoris transplantation and fixation",the dogs were killed at the end of 1,2,4 and 8 weeks,and the esophageal tissues with stent were taken out and studied by gross observation,light microscopy and electromicroscopy. The bulk density and distribution of collagen fiber were studied by special staining and computer technology.The content of P I CP and PⅢNP in restenosis tissue were measured by radio immunoassay(RIA).The contents of hydroxyproline and total amino acid(AA) in restenosis tissue were measured by amino acid analyser. Results At week 1 and 2 the inflammatory reaction occurred evidently in stenting esophagus with granulation and fibrosis,in some sites the esophageal tissue began to proliferate towards the lumen where the fibroblasts were in the state of active proliferation and secretion .The contents of hydroxyproline and total amino acid were significantly higher in the esophageal tissue within 1 and 2 weeks of stenting than those in normal esophagus.At week 4 and 8 esophageal lumen narrowed conspicuously,with a lot of fibrotic tissue and a little of inflammatory cells.The staining density of collagen elevated gradually within 4 weeks,there after the content of collagen was stabilized.The change of P I CP and PⅢNP accorded with that of collagen staining.The content of AA at week 4 increased significantly compared with that at week 2,its level was similar to that between 4 and 8 weeks. Conclusions Re-stenosis mainly expressed as fibrosis. At week 4,8 the fibrosis stabilized gradually with the lessening of inflammatory reaction. The content of collagen in re-stenosis tissue elevated within 4 weeks,and stablilized after week 4,it was in accordance with the pathological changes of re-stenosis.

To observe the changes in mucosal blood flow and permeability after esophageal "Z"stenting, 12 adult healthy dogs were divided into two groups, and an esophageal stent was placed in each dog. Mucosal blood flow was measured with Dopplar blood flowmeter. Two hours after stenting PEG400 was instilled into the esophagus continuously under a constant pressure for two hours in the first group. The amount of PEG400 in the stented tissue was measured with gas liquid chromatography.In the second group the same experiment was carried out 24 hours after stenting. The mucosal structure was examined with electron microscope after stenting. It was found that the mucosal blood flow decreased evidently, and the amount of PEG400 was much greater in tissue after being stented as compared with that in normal esophagus. Electron microscopy revealed that the number of desmosome of epithelium decreased, and it was disrupted significantly after stenting. The interval epithelial cells were enlarged, basement membrane was damaged. Stenting might lead to evident decrease of esophageal mucosal blood flow, which significantly impaired the junction of epithelial cells and mucosal structure, and the permeability for PEG400 was increased significantly. All these findings demonstrate that stenting might impair the esophageal mucosa.

To determine the effect of CX43 expression on gastric mucosa apoptosis and proliferation under stress conditions, a water immersion-restraint stress(WRS) model was performed with SD rats. Apoptotic cells were quantitated in gastric mucosa by terminal deoxynucleatidyl transferase-mediated dUTP nick and labelling (TUNEL) techniques. Cell proliferation was detected by immunohistochemical staining for proliferating cell nuclear antigen (PCNA). The expression of CX43 mRNA was detected by in situ hybridization. The results revealed that in control rats not exposed to WRS, apoptotic cells were seen only occasionally at the surface epithelium, The PCNA cells occurred in the proliferation zone of the gastric glands. The CX43 mRNA predomination occurred in the zone of the gastric glands. In contrast, the apoptotic quantities rose significantly 2h to 5h after the termination of WRS and reach a peak gradually, while PCNA proteins and the CX43 mRNA decreased significantly. At 8～12h after WRS the apoptotic cells gradually declined, while the PCNA cells increased to reach a peak. The CX43 mRNA almost returned to normal level and then increased to reach a peak. At 24h after WRS, the apoptotic cells remained significantly higher than normal level while the expression of PCNA proteins and CX43 mRNA returned to the values observed in the intact rats.These results suggested the expression of CX43 might associate with cellular differentiation, proliferation and the stabilization of glandular zone and affect the apoptosis of the surface epithelium.

ObjectiveTo establish a new model of biliary peffusion in vitro,and to explore the feasibility of comparative biliary studies with the model.MethodsA set of ten-text-area model of biliary peffusion was designed in vitro.Saline,glycerol and pig bile were put into this model.The outflow of the first tube was set at 8 drops/min,and these liquids were collected through the ten sample test areas and measured at 0.5 hour,1.0 hour,1.5 hours,2.0 hours,12.0 hours and 24.0 hours.Equality of liquid amount was evaluated from each sample test area.Rods containing delayed release EDTA of ten different levels were placed in the test areas.The liquid was collected and EDTA concentrations were evaluated from the ten tubes at 24.0 hours.EDTA concentrations of the same rod in the three liquids were compared.ResultsA(1) the same time point,the amounts of saline,glycerol,pig bile flowing through the ten sample test areas showed no significant difference (P ＞ 0.01 ) ; but EDTA concentrations of the same liquid at 24.0 hours were significantly different (P ＜ 0.01 ) ; and EDTA concentrations of the same rod in the three liquids were also obviously different ( P ＜ 0.01 ).ConclusionThe same liquid flow rates and the same experimental environment can be achieved.Different test results can be obtained from different test areas in different experiments.The test results of the same kind of sample change with the changes of experimental conditions,which simulates biliary duct.

Objective To compare and analyze the kinetics changes of lower esophageal sphincter (LES) and esophageal body of achalasia after treated by simple dilation, dilation with botulinum toxin injection and stenting under endoscope. Methods The 99 clinical diagnosed achalasia cases were divide into simple dilation group, dilation with botulinum toxin injection group and stenting group, which were treated with simple dilation, dilation with botulinum toxin injection and stenting respectively. The resting pressure of LES, relaxing ratio, the percentage of concordant and discordant contraction of esophageal body and the contraction range at 10 cm above LES were tested. The variation of each indicator was compared and analyzed before and after the operation. Results Before treatment, the value of the resting pressure of LES, the percentage of discordant contraction,contracting amplitude of esophageal body was higher than normal, while the relaxing ratio of LES and percentage of concordant contraction of esophageal body was lower. There was no significant difference between 3 groups. One week after the treatment, there was no statistic difference in the variation of each indicator compared with pre-operation in 3 groutps. Six months after the treatment, theimprovement of LES resting pressure, relaxing rate and contracting amplitude of esophageal body in dilation with injection group and stenting group were better than those of dilation group (P was 0.041,0.006,0.037and 0. 029,0.004,0.033 respectively). However there was no statistic difference between dilation with injection group and stenting group. Twelve months after treatment, the improvement of LES resting pressure, relaxing ratio, the percentage of concordant contraction and contracting amplitude of esophageal body in stenting group were better than those of dilation group (P was 0.035,0.028, 0. 008, and 0. 007 respectively). However there was no statistic difference between dilation with injection group and simple dilation group. Conclusion Simple dilation, dilation with botulinum toxin injection and stenting are effective methods of achalasia treatment. The effect in near future is significant, while the long-term recurrence is in rising trend as time extension. The effect of stenting is better than the other two methods in the long-term.

Objective To investigate the factors predicting endoscopic stone extraction complications during operation and 1 week within operation. Methods The clinical data of 136 patients with common duet stones during endoscopic procedures and 1 week within procedures were collected, and the impacts of the number, size of stones, and the first-attack versus recurrent-attack stone, with or without cholangeitis on the complications during operation and 1 week within operation were analyzed, and the effect of nasobiliary drainage was investigated. Results The success rate in single-stone group was high, the incidences of complications during endoscopy including sphincter hemorrhage, cardiac laceration, hyperamylasemia, acute pancreatitis were significantly lower than those in the multi-stones group ( P < 0. 05 ). The group of < 2 cm stone also had high success rate of stone extraction, the incidences of complications including sphincter hemorrhage, stone impaction, cardiac laceration, hyperamylasemia, acute pancreatitis were significantly lower than those in the ≥2 cm group. The first-attack group had low success rate of stone extraction, the incidences of complications including sphincter hemorrhage, stone impaction, hyperamylasemia, acute pancreatitis and biliary infection were significantly higher than those in the recurrent-attack group. The patients with cholangeitis had low success rate of stone extraction, the incidences of complications including sphincter hemorrhage, hypoxemia, hyperamylasemia, acute pancreatitis and biliary infection were significantly higher than those without cholangeitis. After nasobiliary drainage, the incidences of hyperamylasemia, acute pancreatitis and biliary infection significantly decreased while the incidence of sphincter hemorrhage significantly increased. Conclusions The number, size of stones, and the first-attack versus recurrent-attack stone, symptoms with orwithout cholangeitis could predict the complications of stone extraction;post-ERCP nssobiliary drainage could decrease the complications, but increase the possibility of sphincter hemorrhage.

Background: Early diagnosis and staging of liver fibrosis are important for the prognosis and evaluating the survival of patients.Aims: To systematically assess the diagnostic value of transient elastography (TE) for staging of liver fibrosis in patients with chronic liver disease.Methods: PubMed,Embase,Cochrane Library,CNKI,Wanfang and VIP from Jan.2001 to Dec.2015 were retrieved to collect the articles with staging of liver fibrosis in patients with chronic liver disease by TE.Data extraction was conducted.Article quality was evaluated by quality assessment of diagnostic accuracy studies 2 (QUADAS2).Meta-analysis was conducted by Stata 12.0 software.Results: Twenty articles involving 5 748 patients were included.Meta-analysis showed that the combined sensitivity,specificity and AUC of TE for diagnosing significant fibrosis (≥F2) were 0.78 (95％ CI: 0.73-0.82),0.85 (95％ CI: 0.80-0.88) and 0.88 (95％ CI: 0.85-0.91),respectively.The combined sensitivity,specificity and AUC for advanced fibrosis (≥F3) were 0.89 (95％ CI: 0.86-0.91),0.88 (95％ CI: 0.85-0.91) and 0.94 (95％ CI: 0.92-0.96),respectively.The combined sensitivity,specificity and AUC for cirrhosis (F4) were 0.91 (95％ CI: 0.86-0.95),0.89 (95％ CI: 0.87-0.92) and 0.95 (95％ CI: 0.93-0.97),respectively.Conclusions: TE technique has a good diagnostic value in assessing significant fibrosis,advanced fibrosis and cirrhosis in patients with chronic liver disease,especially for advanced fibrosis and cirrhosis.