Objective To observe and evaluate clinical feasibility and efficacy of endoscopic metal stenting and combined radiotherapy in treatment of medium and late stages of esophageal carcinoma. Methods 34 cases of medium and late stages of esophageal carcin oma were treated with endoscopic stent implantation and in combination with sten t and radiotherapy. Evaluation of CES stainless metal stent on rad iation effect, clinical symptom alleviation and complication rates and survival rates in both groups was made. Results 1) CES stainless stent had no effect on radiation dosage distribution; 2) Dysphagia was markedly alleviated in both groups and no differe nce in complication rates was observed between two groups; 3) The survival rates of 6,9,12 months in patients treated with combined therapies were significantly higher than those in simple stent implantation patients. Conclusions Endoscopic metal stenting in combination with radiothe rapy was a feasible and practical management in treating medium and late stages of esophageal carcinoma, which was superior to simple metal stent implantation.

Objective To investigate the value of sulindac in chemoprevention and treatment of human hepatocellular carcinoma. Methods The hepatocellular carcinoma cell(HCC) lines (SMMC 7721 and HepG 2) were used in this study. Antiproliferation effects was measured by MTT assay, and apoptosis, cyclooxygenase 2 (COX 2) and Bcl 2 were detected by Western dot blotting. Results The growth inhibition and apoptosis of HCC cells could be induced by sulindac in a dose and time dependent manner. The effects of growth inhibition and apoptosis induction were different between 2 cell lines. After 24 hours of incubation with sulindac at the concentration of 2 mmol/L and 4 mmol/L, the expression of COX 2 and Bcl 2 were markedly reduced. Conclusions Sulindac could inhibit the growth of two HCC cell lines effectively in vitro by induction of apoptosis, which were associated with the inhibition of COX 2 and Bcl 2 expression.

Objective To investigate the relationship between insulin like growth factor (IGF Ⅰ)、IGF Ⅱ and IGFBP 3 and Child Pugh classification in patients with liver cirrhosis and to determine the potential clinical markers of functional hepatic reserves. Methods Forty four patients with posthepatitic cirrhosis were divided into 3 groups according to disease severity (Child Pugh Score) and 38 healthy subjects severed as controls. Serum levels of IGF Ⅰ, IGF Ⅱ and IGFBP 3 were measured in these groups by immunoradiometric assay. Results Baseline IGF Ⅰ, IGF Ⅱ and IGFBP 3 levels were significantly lower in patients with cirrhosis than in controls, and the serum concentrations of IGF Ⅰ, IGF Ⅱ and IGFBP 3 were associated with the marked changes of liver function due to Child Pugh score. They all showed a significant correlation with the degree of hepatic dysfunction and dropped markedly during the progression of liver failure. The sensitivity of IGF Ⅱ is much higher than that of IGF Ⅰ and IGFBP 3. It was found that IGF Ⅰ

Objective To evaluate the clinical efficacy and safety of endoscopic metal stenting in lef t colon malignant obstruction as decompression bridging therapy and palliative t herapy. Methods Twelve pathologically confirmed and surgically indicated patients with left colo n malignant obstruction underwent metal stent placement as decompression treatme nt. Permanent metal stent placement was performed in 5 left colon cancer obstru ction patients without surgical indication. The successful rate of stent deploym ent, procedure-related complication, stent patency and long-term complication were observed in treated patients. Results ①Stent placement was successful on the first occasion in 15 of 17 (88%) cases, and total successful rate was 100%. No severe procedure-related complication wa s found. ②The mean duration of placed stent in bridging cases was 6.1 days(4-9 days), and all patients were transferred to one-stage tumor resection after d ecompression by bridging stent and bowel preparation without complications of fi stula development and intraperitoneal infection. One case developed colon perfor ation 4 days after stent insertion and received immediate operation. ③ The mean effective patency duration of placed stent in palliative cases was 81.7 days(61 -119 days). Tumor ingrowth and reobstruction were noticed in 2 cases, within 62 and 119 days respectively. Stent migration within 61 days in 1 patient was deve loped. Conclusions As an effective and safe bridging palliative therapy, decompression metal stent p lacement may be applied to unresectable and metastatic left colon malignant canc er patients without surgical indication.

Objective To investigate the effect of specialized human tel omerase antisense oligodeoxyribonucleotides (AS-ODN) on the growth inhibition o f well, moderate and poor differentiated gastric cancer cell lines, and to explore its inhibitory mechanism and the correlation between the inhibition ratio of gastric cancer cells and differentiation of the tumor cells. Methods Under the given circumstances, three distinct differentiated gastric cancer cell lines were treated with AS-ODN. The telomerase a ctivities were measured by modified telomeric repeat amplification protocal assa y. The cell viability was detected by Trypan blue test, and the cell apoptosis was determined by cell morphological observation under light and electromicroscope, flow cytometry an d TUNEL assay. Results The telomerase activity and cell growth were apparently suppressed in MK N45 and SGC7901 cells, under defined concentrations of AS-ODN. Whilst, in MKN28 cells, only telomerase activity was suppressed at same concentration . There were no obvious changes in non-antisense oligomers treated group. The apoptotic features of MKN45 and SGC7901 were noticed by microscopic observa tion, TUNEL assay, after three distinct gastric cancer cell lines being continuo usly exposed to 10 ?mol/L AS-ODN for 96 h. Furthermore, the flow cytometric analy sis verified that the average apoptotic rate of MKN45 and SGC7901 was 44.75% and 33.56% respectively, but there were no obvious changes in non-antisense oli gomers treated group (P

Objective To investigate the difference of gene expression in two human gastric adenocarcinoma cell lines, 5-fluorouracil resistant cell line SGC7901/R and its parental cell line SGC7901, and to screen related genes of JAK/STAT signaling pathway by gene chip. Methods The mRNAs of two cell lines were extracted and purified. The two cDNA probes were made from these two mRNAs which were labelled by (biotin-)16-dUTP, hybridized with human JAK/STAT signaling pathway gene array and scanned for intensity, respectively. The acquired images were analyzed by software. Different expression genes were then screened out. The mRNA expressions of Stat3, NF-?B1 and bcl-x were analyzed by semi-quantitative RT-PCR, (respectively.) Results A parallel comparison between the gene profiles of JAK/STAT signalling pathway in two cell lines showed that a total of 70 genes were screened out whose expressive level was more than 2 folds in 5-flurouracil resistant cell line SGC7901/R and its parental cell line SGC7901. Among these genes, 40 were upregulated and the other 30 were down-regulated. The results of RT-PCR were consistent with those of microarray scanning. Conclusions The knowledge of gene expression profile of JAK/STAT signaling pathway, which was changed in 5-fluorouracil resistant cell line of human gastric adenocarcinoma, has proven to be useful for illustrating the multi-drug resistance mechanisms of gastric cancer.

To investigate the relationship between gene p1 7 0 expression of human gastric carcino- ma tissues and histological types of the gastric carcinoma . 80 human gastric carcinoma tissues were taken from endoscopies and postoperations , and detected the p1 70 gene expression by peroxidase immuno- chemical stain method(Kit from US) . According to depth of yellow to brown stain on tumor cell mem- brane and/or cytoplasm ,if no colour stain indicated no p170 gene expression rif 70% stained 3+. The positive rate of p170 gene overexpression in gas- tric carcinoma tisaues by endoscopic . and postoperation were 66 % and 7 1% respectively. These histopathological types of gastric carcinomas with p 1 70 expression rate were 83% ( 5/6 ) in early carcino- mas ; 76% (26/34) in tubular adenocarcinomas ;64% (14/22) of undifferetiated adenocarcinomas ; 62% (5/ 8 ) in mucinous adenocarcinomas and 50% (2/4) in signet rign-form carcinomas. This study showed that p 1 70 gene overexpression gresented in human gastric carcinoma tissues and significantly in the group with metastatic lymph nodes. We considered that p 1 70 gene might be a new tumor marker for detection of gastric carcinoma.

Objective To evaluate the effect and safety of the argon plas ma coagulation (APC)a non－ touched technique via endoscopy. Methods Various po wer setting (40 W,60 W,80 W) at increasing exposure time (1 sec,3 sec,5 sec) wer e used during application of APC to different mucosa (gastric body and autrum) o f fresh stomaches gotten from 5 pigs.Histologic appearance and measurement of de pth and diameter of tissue necrosis area were examined through light microscope. Results Under the same power,the depth and the diameter were increased with th e exposure time increasing(P

0.05. No marked side effects and complication were found. The obliterate rate of needles for D-TH direct injection is lower than that of Histoacryl sandwich method. Conclusion Tissue adhesive D-TH injection for hemostasis of acute esophagogastric varices bleeding was an effective treatment and was easy to perform without side effects, and could be served as a recommended application in clinics.

Objective To study the effect of Smad4 gene on angiogenesis related factors in human gastric cancer cell line.Methods Recombinant eukaryotie expressing plasmid pcDNA3.1 (-)-Smad4 containing Smad4 gene and empty vector pcDNA3.1 (-) were introduced into human gastric cancer cell line MKN28 using lipofectam and selected by G418,respectively.Two cell lines were obtained as follows:Smad4+-MKN28 cell line which was MKN28 transfected with a stable hybrid containing Smad4 gene and Smad4--MKN28 cell line with empty plasmid as control.The transcription and expression of VEGF and TSP1 were investigated by RT-PCR and Western blot.Results The mRNA expression of TSP1 in Smad4+-MKN28 cells was higher (P＜0.05) than that in control cells,while VEGF was lower(P＜0.05).Western blot showed the consistent results as measurement by RT-PCR.Conclusion Smad4 restoration in gastric cancer cells reduced angiogenesis rates through down-regulation of angiogenesis activitor and up-regulation of angiogenesis inhibitor.