Objective To evaluate the clinical results from different endoscopic treatments of patients with chronic pancreatitis. Methods Thirty-seven cases of chronic pancreatitis had accepted endoscop-ie treatments were analvzed retrospectively. Results All cases were diagnosed clearly by ERCP showing different degree of pancreatic duct dilatation. Among them 21 cases had pancreatic duct stricture, 9 cases pancreatie duet ealeification. EPS in 18 cases and EST in 37 cases, basket extraction pancreatic duct stones in 6 eases, PDSD in 17 cases, NPD in 5 cases were conducted. The abdominal pain in 34 cases disappeared or markedly relieved alter treatment. Conclusion Endoseopie treatments have the advantages of safe, less-trauma and effectiveness. The combination of different endoscopic treatments improved evidently the current state of chronic pancreatitis treatment, thereby the therapeutic results.

ObjectiveTo study the diagnostic value of double balloon endoscopy (DBE) for gastrointestinal disease.MethodsClinical data of 53 patients with suspected intermediate gastrointestinal diseases who underwent DBE procedures were retrospectively analyzed for detection rate,complications and the incidence of adverse reactions.ResultsAll of 53 patients underwent successful DBE,Procedures were performed via mouth ( n =26),anus ( n =9 ) and the combined routes ( n =18 ).And definite diagnosis was made in 46 cases (86.79％),including upper gastrointestinal (above ligament of Treitz) disease in 3 cases (5.66％),intermediate gastrointestinal disease in 41 cases (77.36％ ) and lower gastrointestinal disease in 2 cases (3.77％).All 53 patients were tolerant to the operation and anesthesia.No severe complications like bleeding,perforation,intestinal torsion,mesenteric tear,pancreatitis or anesthetic accident occured.Several patients showed abdominal flatulence,transient abdominal pain.Some patients in oral route reported slight throat discomfort or slight nasal bleeding.Incarceration occurred in 1 case due to friction of endotracheal intubation and the silicone tube,which was released after deflation and removed out.2 patients showed mild diarrhea with low fever,and the symptoms were self-healing without special treatment in 48 h.ConclusionDBE is of high diagnostic value for gastrointestinal diseases with a high safety.

Objective To investigate the role of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment of adult biliary ascariasis.Methods Clinical data of 19 cases of adult biliary ascariasis diagnosed and treated with ERCP during Jan 2005 to Dec 2012 were retrospectively analyzed.Results Among the 19 adult patients with biliary ascariasis,11 were male,and the mean age was (62.7± 10.8) years.Eight cases lived in the countryside,7 cases in the integration of urban and rural area,and 4 cases in urban area.All cases had histories of eating raw fruits and vegetables.Living worms were found in 9 cases.Four cases were complicated with common bile duct stones.Petrification of residual dead worms in the common bile duct was found in 10 cases.All ascariasis and residual bodies were removed successfully by ERCP.There were no postoperative complications except for 3 cases of hyperamylasemia.Conclusions Adult biliary ascariasis commonly occurs in the elderly,and is frequently complicated with common bile duct stones.ERCP is efficacious in treating biliary ascariasis.

Objectives It was constructed that the replication defective adenoviral vectors carried the short hairpin sequences of mouse SCP2.And we will make a further study of mechanism between SCP2 gene and cholesterol stone in gallbladder.Methods The short hairpin sequences of mouse SCP2 were cloned by two-step PCR,and connected together with the plasmid pDC312.The Admax Adenoviral Vector System was used to generate the replication defective adenoviral vectors,which were purified by CsCl method.The processes of TCID50 were applied to detect the titers of the adenoviral vectors.Furthermore,Protein levels of SCP2 were determined by Western blot analysis,and the levels of SCP2、CYP7A1、HMGCR mRNA from the hepa1-6 cell of mouse were measured by the usage of RT-PCR.Results SCP2mRNA and SCP2 protein were down-regulated by the replication defective adenoviral vectors carried the SCP2-shRNA.With the decreasing SCP2mRNA,the levels of HMGCRmRNA were down-regulated at same the time,while CYP7A1mRNA were up-regulated.Conclusions The replication defective adenoviral vectors carried SCP2-shRNA were constructed successfully.The lower levels of SCP2 could affect the activities of HMG-CoA reductase and CYP7-a enzyme,which caused the variations of cholesterol metabolism and then decreased the formation of cholesterol stone.

Objective To evaluate the clinical value of endoscopic palliative stents drainage in patients with unresectable carcinoma at pancreas head.Methods Endoscopic stents placement was Derformed in 197 patients with unresectable pancreas head carcinoma,from August 2003 to August 2007,and the clinieal data was studied retrospectively.Results Bile duct obstruction was present in all patients.in which 126 were accompanied with dilation of distal pancreatic duct,91 with atrophy of pancrea body and tail. Stent placement in pancreatic duct Was performed in 108 patients with a Success rate of 96.4%,and placement in bile duct was performed in all patients with a success rate of 99.0%.In 195 patients with successful stent placement,jaundice dissolved after the procedure.Of 101 patients who had abdominal pain,complete pain alleviation Was achieved in 98,partially alleviation achieved in 3. Serum amylase level increased after the operation in 24 cases,which resumed tO normal value after corresponding managements.All Datients received a lifelong follow-up at mean duration of 373.57±157.35 days,with a longest survival time of 842 days.Conclusion Endoscopic palliative stents drainage is safe and effective in patients with unresectable Dancre.atie carcer,which miight increase survival rate and improve life quality.

Objective To investigate the clinical value of endoscopic biliary stent drainage for obstructive jaundice due to hepatic portal metastatic carcinoma. Methods Patients with obstructive jaundice arising from hepatic portal metastatic carcinoma were selected and treated with consent by plastic endoscopic bile duct stents since 2006. Success rate and survival were evaluated. A total of 38 patients with obstructive jaundice were treated and analyzed. Hepatic portal metastatic carcinoma included 13 cases of liver cancer, 3gallbladder carcinoma, 14 gastric carcinoma, 2 esophageal carcinoma, 1 ileum adenocarcinoma and 5 pancreatic carcinoma. Results Stents were successfully placed in all patients and jaundice rapidly subsided after the endoscopic procedure. Follow-up life span was 92-521 days, mean 264. 42 ± 104. 41 days. During follow-up, biliary stents were replaced in 5 patients in 3-14 months ( mean 8. 6 ± 4. 1 months) because of stent displacment in 1 case, biliary stone obstruction in 2 cases and carcinomatous obstruction in 2 others.Conclusion For patients with obstructive jaundice arising from hepatic portal metastatic carcinoma, endoscopic biliary stent drainage is effective and can prolong life span to some degree.

Objective To study the effects of restructuring tissue inhibitor of matrix metatloproteinase-3 (rhTIMP-3) in combination with cisplatin (DDP) on the growth and apoptosis of A549 lung cancer cell line.Methods We made individual and combined use of different concentrations of rhTIMP-3 and DDP on A549 cells.Methyl thiazoyl terazolium (MTT) colorimetry was used to analyze cell growth inhibition,and flow cytometry technique was used to determine the cell cycle distribution and apoptosis rate.Results rhTIMP-3 and DDP both could inhibit the proliferation of A549 cells.rhTIMP-3 exerted its effect in the time-and concentration-dependent manners while DDP did so in the concentration-dependent manner;both induced the apoptosis of A549 cells.rhTIMP-3 could make the cells stay in S and G2/M phases,and DDP made the cells stay in S phase.The combination of them obviously strengthened the inhibition of A549 cell growth,and had obvious synergy in inducing apoptosis.Conclusion Both rhTIMP-3 and DDP can inhibit the proliferation of A549 cells and induce their apoptosis.The combined use of them not only can increase the inhibition of cell growth but also has synergy in inducing cell apoptosis.

Objective To evaluate the efficacy and safety of biliary stent loaded with 125I seeds in treatment of hilar cholangiocarcinoma with malignant obstructive jaundice.Methods Totally 43 patients with malignant obstructive jaundice caused by cholangiocarcinoma were included.All the patients underwent percutaneous transhepatic puncture of the left and right side branch of the bile duct.In the hilar stenosis,the biliary stent with 125I seeds were implanted,and the biliary drainage tube had been kept in 3 to 5 days after procedures.The drainage tube was removed and the puncture road was closed after the patency of stents were confirmed by cholangiography.The changes of liver function before and after procedures were recorded,and the survival time was observed.Results Five biliary stents loaded with 125I seeds were implanted in type I (n=5),36 in type Ⅱ (n=18),8 in type Ⅲ (n=4) and 25 in type Ⅳ (n=16).The serum total bilirubin and direct bilirubin of patients before procedures were (145.54 ± 65.35) μmol/L and (124.73 ± 35.04) μmol/L,respectively,and (65.91±29.43)μmol/L and (35.50±15.12)μmol/L respectively after procedures.Compared with preoperative,the total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,C-reactive protein and gamma glutamic transaminase decreased significantly (all P＜0.05).The lactate dehydrogenase had no significant difference before and after operation (P=1.050).The median survival time was 13 months (3.0 to 22.5 months).The serious complications such as biliary puncture,pancreatitis,severe biliary tract infection or biliary bleeding were not occurred.Conclusion Biliary stent loaded with 125 I seeds is an effective therapy to alleviate symptoms of jaundice and prolong the survival time of patients with malignant obstructive jaundice caused by hilar cholangiocarcinoma.

Objective To investigate the therapeutic effects of endoscopy for palliative treatment of advanced pancreatic cancer. Methods A typical case of un-resectable advanced pancreatic cancer was reviewed, who underwent obstruction of upper gastrointestinal tract, obstructive jaundice and alimentary tract hemorrhage subsequently. The patient received multiple placement of intestinal tract stents, common bile duct stents and hemostatic treatment endoscopically. Because of the obstruction of upper gastrointestinal tract, jejunalostomy and retrograde endoscopy through the orificium fistulae were performed to place bile duct stents. Results The patient survived for 10 months with good life quality after diagnosis, obstruction of upper gastrointestinal tract, obstructive jaundice and alimentary tract hemorrhage were cured and didn't recur till death.Conclusion Therapeutic endoscopy, safe and effective, is the first choice for advanced pancreatic cancer complicated with obstruction of digestive tract (including gastrointestinal tract, bile duct and pancreatic duct).

Objective To evaluate the diagnostic and therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) in biliary papillomatosis. Methods Data of 6 patients, who underwent ERCP and diagnosed as biliary papillomatosis from 2000 to 2008, were retrospectively analyzed. Results There were 3 males and 3 females, with the mean age of onset at 72.8 years (range 52-83 years). Recurrent cholangitis and jaundice were common presentations in all patients, with 5 patients having right upper abdominal pain and 3 others exhiting fever and algor. History of partial hepatectomy was observed in 2 patients. Endoscopic findings included dilated papillary orifice with mucin discharge in 5 patients and papillary-occupying lesion in 1 patient. Multiple filling defects in the lumen of the biliary system in dilated common bile duct were detected in all patients, accompanied with extra-hepatic ducts dilatation in 3, right intra-hepatic duct dilatation in 1, and major pancreatic duct dilation in 1. Of 6 patients, 5 underwent multiple ERCP, inclucling stents and endoscopic nasobiliary drainage (ENBD), and have survived for 10-30 months. Another 83-year-old patient underwent palliative endoscopic treatment with balloons, baskets and ENBD, but died of cholangitis 10 days after the procedure. Conclusion This case series reports the typical endoscopic findings of biliary papiliomatosis. For inoperable or postoperative recurrent patients, endoscopic palliative treatment is a safe, convenient and effective procedure.