Objective:To investigate expression of cyclinD1 and p21WAF1 and their relationship with multistage process of colon carcinogenesis.Methods:Immunohistochemical staining was performed with SP assay on archival materials from 40 colorectal carcinomas,28 colorectal adenomas,and 14 normal mucosa,cyclinD1 and p21WAF1 expression were compared.Results:The positive staining rate for cyclinD1 in colorectal adenomas and carcinomas is 92.9% and 67.5% respectively,which are both higher than that in the normal mucosa (35.7%) (Padenoma＜0.01，Pcarcinoma＜0.05) and the expression of cyclinD1 is not correlate with differentiation and lymph node metastasis of colorectal carcinoma.The positive stainimg rate for p21WAF1 in normal mucosa (92.9%) is higher than that in colorectal carcinoma(37.5%) (P＜0.01) and the expression of p21WAF1 is correlate with differentiation and lymph node metastasis of colorectal carcinonma.Conclusions:The aberrant expression of cyclinD1 and p21WAF1 is a common event during multistage process of colon carcinogenesis.

Sump syndrome is a rare complication of side-to-side choledochoduodenostomy (CDD) and occasionally occurs after spontaneous gallbladder-bile duct-digestive tract fistula or end-to-side choledochojejunostomy.Before the development of minimally invasive surgery,conventional surgical operation used to be the most important treatment method.This article reviews the research advances in sump syndrome in recent years and points out that endoscopic retrograde cholangiopancreatography is the major diagnostic method for this disease,and endoscopic sphincterotomy combined with bile duct debridement is the most simple and effective measure for the treatment of sump syndrome.Meanwhile,this article briefly reviews sump syndrome with reference to related literature and clinical practice,in order to raise the awareness for sump syndrome.

Objective This study was designed to investigate the relationship between COX-2 and VEGF-C in human gastric carcinomas and discuss the significance of COX-2、VEGF-C in lymph mode metastasis.Methods Forty-two gastric carcinoma tissues and twenty adjacent noncancerous specimens were obtained from surgical resections.COX-2,VEGF-C protein expression was evaluated by immunohistochemical analysis.Results (1)COX-2 was overexpressed in 25 of 42 carcinoma tissues (59.5%) and VEGF-C was 27 of 42(64.3%),which were significantly higher than those in noncancerous tissues (P0.05).(3)There was positive correlation between the expression of COX-2 and VEGF-C(r=0.425,P

Objective To assess the effect of anti- Helicobacter pylori (Hp) treatment on patients with chronic idiopathic thrombocytopenic purpura (cITP). Methods Fifty-nine patients with cITP and positive-Hp were divided into two groups by random digits table:Hp eradication group (30 cases,given a standard anti-Hp treatment) and placebo controlled group (29 cases,received a placebo). The platelet response of two groups was compared after three months' follow-up. Result The platelet response in Hp eradication group (63.3%, 19/30) was significantly higher than that in placebo controlled group (27.6%,8/29 )(χ2 = 7.59, P ＜ 0.05 ), and the increasing level of platelet count in Hp eradication group [ (33.5 ± 21.6)× 109/L] was higher than that in placebo controlled group [(12.6 ± 19.5) × 109/L] (t = 5.52,P ＜0.05).Conclusion Hp eradication treatment can promote the platelet recovery in mild and moderate cITP patients with positive-Hp.

ObjectiveTo evaluate Fuji intelligent color enhancement (FICE) chromoendoscopy for diagnosis of early gastric cancer. MethodsFrom February 2010 to March 2011 ,a total of 67 patients with suspected gastric mucosal lesions were enrolled in this study. The lesions were observed with magnifying endoscopy, FICE, magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy.Suspected gastric mucosal pit patterns and microvascular morphology were compared. Targeted biopsy was performed on suspected locations. Sensitivity, specificity and pathological consistency were compared between the 3 procedures. ResultsOut of 67 patients, 17 were diagnosed as having early gastric cancer.There was no difference among magnifying endoscopy, FICE magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy in pit pattern findings,however, FICE magnifying chromoendoscopy was superior to other 2 procedures in displaying capillary loop. The sensibility, specificity and pathological accordance rate of FICE magnifying chromoendoscopy were 94. 1％ ( 16/17 ), 98. 0％ (49/50) and 97.0％(65/67), which were higher than those of the magnifying endoscopy [58.8％ ( 10/17), 84％ (42/50)and 77.6％ ( 52/67 )] ( P ＜ 0. 05 ), and were not different from those of indigo-carmine-magnifying-chromoendoscopy [88.2％ (15/17), 96％ (48/50) and 94.0％ (63/67)] (P ＞0.05). Conclusion FICE magnifying chromoendoscopy provides rather clear images of gastric mucosa and intrapapillary capillary, thereby improving the accuracy of endoscopic biopsy and then imporving the diagnosis rate of early gastric cancer.

ObjectiveTo evaluate the Fuji intelligent chromo endoscopy (FICE) in the diagnosis of Barrett esophagus (BE).MethodsFrom September 2010 to March 2011,a total of 180 patients with suspected reflux esophagitis were examined successively by FICE,magnifying FICE,acetic dyeing endoscopy and magnifying acetic dyeing endoscopy.The diagnosis was made out under the observation of lesion extensions,superficial mucosa contrast ratio,pit patterns and capillary forms of BE.The endoscopic diagnosis was made and compared with the pathologic diagnosis,and the consistency of the diagnosis was evaluated by Kappa value.ResultsBE was confirmed in 35 patients ( 19.4％ ) pathologically.The consistency rates of diagnosis under FICE and acetic dyeing endoscopy were 81.7％ and 72.8％ ( P ＜ 0.05 ).The consistency rates of diagnosis under magnifying FICE and magnifying acetic dyeing endoscopy were 97.8％ and 85.6％,respectively (P ＜ 0.05).FICE magnifying endoscopy revealed better mucosal structures of capillaries than magnifying acetic dyeing endoscopy did ( P ＜ 0.05 ),but there was no significant difference in revealing of duct openings (P ＞ 0.05).The specificity,sensitivity,positive predictive value,negative predictive value and Kappa value of FICE in diagnosis of BE were 82.1％,80.0％,51.9％,94.4％ and 0.52,respectively,which were 73.2％,71.4％,39.1％,91.4％ and 0.34 of acetic dyeing endoscopy,98.6％,94.3％,94.3％,98.6％ and 0.93 of magnifying FICE,and 88.3％,74.3％,60.5％,93.4％ and 0.58 for magnifying acetic dyeing endoscopy.ConclusionAs a neotypical endoscopic system,magnifying FICE could exhibit clearly the pit patterns and microvascular structures of esophagus mucosa,and it can capture the optimal images of Barrett's epithelium.FICE could improve the diagnosis of BE in vivo.

AIM: To investigate and optimize the technology of ultrasonic-assisted extraction of arctiin and arctigenin from Fructus arctii.METHODS: The effects of ultrasonic power,particle size,ratio of liquid to solid,extraction time,extraction temperature and duty factor on the extraction rates of arctiin and arctigenin were investigated,and optimized with orthogonal experiments.RESULTS: The results showed that the optimal extraction conditions were as follows: particle 80 ～ 100 mesh 14 mL/g,ratio of liquid to solid 400 W ultrasonic power,50 ℃ of extraction temperature,and 10 min of extraction time.CONCLUSION: The optimized conditions are reasonable and reliable.

Objective To evaluate the efficacy and side effects of arsenic trioxide (ATO) combined with thalidomide in the treatment of relapsed/refractory multiple myeloma (MM). Methods 35 patients with relapsed/refractory MM were treated with ATO (10 mg/d) and Vit C (2 g/d) for 14 days,28 days per cycle.Meanwhile they were orally administered thalidomide 50 mg/d,and then one week later orally thalidomide was added to 100-150 mg/d. After 3 cycles of treatment, response and the side effects were evaluated. Patients responsed to the regimen were continued the treatment of thalidomide and were followed up to estimate the PFS. Responses were assessed according to the criteria of the EBMT.Adverse events were graded according to the criteria of the WHO.Results The overall response Was 71.43 ％ (25/35),CR 5.71％ (2/35),PR 34.29 ％ (12/35),MR 31.43 ％ (11/35).After a median follow-up of 11 months,the median PFS was 9 months.The major adverse reactions were digestive tract reaction,leukocytopenia,liver function damage,peripheral neuropathy.They were mild,and could be tolerated.Conclusions The combination of ATO and thalidomide is a feasible and active regimen in treatment of relapsed/refractory MM with better compliance in general.

Objective To evaluate the efficacy and safety of ureteroscopic endo-incision and drainage in the treatment of renal cysts.Methods Thirty cases(19 females and 11 males)of renal cysts(1 1 parapelvie cysts,15 simple cysts.and 4 multiple cysts)were treated with ureteroscopic endo-incision and drainage.The renal cysts were located in renal pelvis,and opened and decompressed by electrotme with ureteroscope.Double J stent was placed afterwards.Urinary and blood biochemistry were tested post-operatively.Results All the operations were successfully completed with no severe complication.The cyst managing time ranged from 15 tO 45 min.Urinary biochemistry(urinary protein and glucose)turned normal 1 2 days after the surgery.Patients were followed up for 3 to 9 months.Renal cysts disappeared in 24 cases,diminished in 4 cases,and recurred in 2 cases.Conclusion Application of ureteroscopic technique in the treatment of renal cyst is safe,effective and minimally invasive.

Objective This study was designed to evaluate the safety ,tolerability and efficacy of intravenous caspofungin for treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .Methods This was a non-controlled ,multicenter ,candidiasis .All the 63 patients were included in the safety set (SS) and the full analysis set (FAS) .In the SS ,19 SAEs occurred in 14 patients .All these SAEs were unrelated to caspofungin .There were 73 caspofungin-related non-serious AEs in 31 patients (49 .2% ) .Five patients (7 .9% ) had both clinical AEs and laboratory abnormalities .Eight patients (12 .7% ) had clinical AEs (mainly rashes) ,and 27 patients (42 .9% ) had laboratory abnormalities ,mainly increases in liver enzymes alanine transaminase and aspartate transaminase and reduction in blood potassium .About 91 .7% of the clinical AEs were mild to moderate .Treatment was discontinued in 1 patient (1 .6% ,1/63) due to AEs .The overall efficacy was 58 .1% (36/62) in the FAS and 70 .0% (35/70) in the per-protocol set (PPS) .In the FAS ,the therapeutic efficacy was 57 .6% (34/59) for invasive candidiasis and 66 .7% (2/3) for esophageal candidiasis .In the PPS , the therapeutic efficacy was 68 .8% (33/48 ) for invasive candidiasis and 100% (3/3 ) for esophageal candidiasis .Conclusions The AEs of caspofungin were mostly mild to moderate in the treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .Only one patient terminated therapy due to drug-related AE .Caspofungin is safe and effective for the treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .