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AN OBSERVATION OF THE THERAPEUTIC EFFECTS ON 126 CASES OF DUODENAL BULBAR ULCER BY COMBINED TREATMENT WITH OMEPRAZOLE AMOXIL AND EPIDERMAL GROWTH FACTOR

Shen QU ; Yanxia XIE ; Fengxiang CHI

Chinese Journal of Digestive Endoscopy.1996;0(04):-.

Observe under endoscope the effect s of raising effective rate on the treatment of duodenal bulbar ulcers by the addition of epidermal growth factor. The control group , 1 08 cases , was randomized from 234 cases of active duodenal bulbar ulcer. Oral omeprazole , 20 mg , in the murning , and amoxil , 0. 5g , t. i. d. were administered for 4 weeks. The treatment group , 1 26 cases , in addition to the above mentioned 2 drugs , epidermal growth factor , 20 ml ( 40?g) , was added orally each morning for 4 weeks , followed by en- doscopy. The therapeutic effect of treatment group was better than that of the control with very significant difference. The effective rate of control group was 84 . 26% , and that of the treatment group , 96. 03% , X~2 = 9. 82 ,P

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ENDOSCOPIC TREATMANT ANASTOMOTIC CICTRICIAL STENOSIS AFTER RESECTION OF ESOPHAGEAL CANCER BY ENDOTHERN KNIFE.

Heyuan GAO ; Zhangshu CHENG ; Jie ZHANG

Chinese Journal of Digestive Endoscopy.1996;0(04):-.

Anastomotic cicatricial stenosis after resection of esophageal cancer were treated by self- making electric knife through endoscipe.Fifty two cases were located in upper segment while 37 cases in middle-lowere part.Anastomotic diameter of 40 cases were less than 2.0mm,17 cases less than 3.0mm. Sixteen cases more than 3.0mm. Anastomotic stoma were incarcerated by food in 16 cases.The operatic procedure:First,the cicatricial stenosis was resected and became"*"shape by electric knife,then dilated by baloon catheter and by endoscope.sitytwo cases of stenosis were unobstrated(can swallow solid food)after one time treatment ; 11 cases each needed 2 and 3 times;1 case each needed 4 , 5 , 12 , 43and 81 times ,respec- tively. The last 2 cases were treated repeatly every 1- 3 months. The authors think that this procedure is ef- fective and safe. The technique is mastered easily and could be wildely used.

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THE ENDOSCOPIC ULTRASONOGRAPHY ASSESSMENT IN THE PREOPERATIVE STAGING FOR CARCINOMA OF AMPULLA OF VATER AND EXTRAHEPATIC BILE DUCT

Qilian ZHANG ; Weidong NIAN ; Lanbo ZHANG

Chinese Journal of Digestive Endoscopy.1996;0(04):-.

In order to investigate the lesion' s extention and the infiltrated deepth and the metastasis of the tumors preoperatively ,endoscopic ultrasonography (EUS) was performed in 28 patients with ampullary carcinoma and 18 patients with extrahepatic bile duct carcinoma. forty six patients underwent surgical ex- plorations. A radical resection with detailed pathological study was done for 22 resectable cases of ampullary carcinoma and all the 18 cases of extrahepatic bile duct carcinoma. Carcinoma of ampulla of Vater and ex- trahepatic bile duct were assessed and staged preoperatively according to the TNM staging system. The re- sults of EUS were compared with surgical explorations and pathological findings for evaluating the accuracy of preoperative staging of EUS. The accurate rate of EUS in assessing the extent of cancer invasion was 8l.8% for ampullary carcinoma, 72. 2% for extrahepatic bile duct carcinoma. The accuracy of EUS in pre- dicting regional lymph node metastasis was 59% for ampullary carcinoma , and 61.6% for extrahepatic bile duct carcionoma. invasion of portal vein was correctly predicted by EUS in 2 out of 3 patients of ampullary carcinoma. All the 3 cases of liver metastasis were not detected by EUS. EUS is a more accurate diagnostic method in judgement of invasive extent of ampullory carcinoma and extrahepatic bile duct carcinoma preop- eratively , but less accurate for metastasis of the tumors.

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STUDY ON p170 GENE EXPRESSION IN HUMAN GASTRIC CARCINOMA

Ping XU ; Chijun YIN ; Yunlin WU

Chinese Journal of Digestive Endoscopy.1996;0(05):-.

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.

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CLINICAL VALUE OF PULSE AND BLOOD OXYGEN SATURATION MONITORING IN ESOPHAGOGASTRODUODENOSCOPY

Jun CHEN ; Jinhua ZHANG ; Zongshun CHEN

Chinese Journal of Digestive Endoscopy.1996;0(05):-.

The purpose of this study was to reseach the relationship between the upper gastroin- testinal endoscopy and heart rare and blood oxygen saturation (SaO2 ) , 62 patients were examined by (esophagogastroduodenoscopy , EGD ) and monitored with a transcutaneous pulse oximeter simultane- ously. The mean age was 44. 5 years (range 21 - 68) , 30 males and 32 females. No sedative drugs and at- ropin were used. The mean pulse and SaO2 value before endoscopy were 94. 12/min and 97. 68%. During the ECD SaO2 was slightly decreased by a mean of 1 . 61% ( P 100/min accounted for 61 . 3%, it was more than preendoscopy (P

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FIVE YEAR SURVIVAL RATE AND PROGNOSTIC FACTORS OF PATIENTS WIT HEARLY CARCINOMA OF THE ESOPHAGUS AND THE GASTRIC CARDIA TREA -TED WITH ENDOSCOPIC LASER

Guanrui YANG ; Liqun ZHAO ; Shanshan LI

Chinese Journal of Digestive Endoscopy.1996;0(05):-.

In order to evaluate the factor. which affect the five year survival rate and prognosti c factors of the early carcinoma of the esophagus and the gastric cardia treated with endoscopic Nd : YAG laser therapy , thirty-three patients were followed. Of the 33 patients , 32 ( 97% ) cases were cured , resul- ting in the disappearance of the cancer cells. They were followed up for 3 3- 78 months , with a mean of 55. 3 months. The survival rate of the 32 patients treated with endoscopic laser was computed with the Product limit estimate method ,and was compared with the natural history of early superficial carcinoma . of the esophagus and the gastric cardia. The five year survival rate was in 97% of the 32 patients treated with laser therapy ,in contrast to 67% (P

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RELATIONSHIP BETWEEN GASTRIC JUICE AMMONIA CONCENTRATIONS AND SEVERITY OF INFLAMMATION IN HELICOBACTER PYLORI ASSOCIATED GAS- TRITIS

Zhanmin SHANG ; Yiqing LIU ; Shongliang QIU

Chinese Journal of Digestive Endoscopy.1996;0(06):-.

In order to investigate the relationship between gastric juice ammonia concentrations and severity of inflammation in helicobacter pylori (Hp ) associated gastritis. Gastric juice ammonia concen- trations were measured in 39 cases Hp -positive and 23 cases Hp -negative chronic gastritis patients .at the same time , the severity of inflammation in gastric untral mucosa was also evaluataed by the method of polymorphonuclear (PMN) and mononuclear (MN ) count. The results showed : gastric juice ammonia concentration in Hp -- positive gastritis group (84.10?33. 07mg/L)was significantly higher than that in the negative group (22. 59?13. 12mg/L) (P

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EXPERIENCE OF 1 257 ERCP

Junhua LU ; Daiyun ZHOU ; Biao GONG

Chinese Journal of Digestive Endoscopy.1996;0(06):-.

In order to obtain more experience of endoscopic retrograde cholangiopancreatography (ERCP) ,and in this way, more correct diagnosis and much more effective treartment were received ,we studied 1 257 cases of ERCP we had performed in last two years . The results were: In 1 25 7 cases of ERCP,1 229 cases(97. 77% ) were successful and 435 cases (34. 61% ) received treatment. Ninety-four cases received papillotomy and extraction, 309 cases received biliary drainage in therapeutic ERCP. lt in- dicated that the importance of gallbladder visualization and biliary drainage should be emphasised.

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ABNORMAL CHANGE OF p53 GENE IN GASTRIC CANCER AND PRECANCER- OUS LESIONS AND APC GENE IN GASTRIC CARCINOMA AND NEAR TISSUES

Yin HAO ; Jinkun ZHANG ; Cuiqiong YI

Chinese Journal of Digestive Endoscopy.1996;0(06):-.

p53 gene mutation (exon4 , 5 , 6 . 7 . 8 and intron6) in gastric cancer and precancerous le- sions and p53 gene (exon4 and intron6) .APC gene deletion in gastric carcinomas were studied by PCR/ SSCP and PCR/RFLP. Results showed: mutation rate of p53 in intestinal metaplasia ,dysplasia and gas- tric carcinoma was 37. 5% (3/8) ,42. 1 % (8/19) , 53. 3% (16/30) ,respectively. There was significant dif- ference between groups of metaplasia、dysplasia、cancer and that of normal control. We found there were no exon8 mutation in metaplasia and dysplasia , but 4 cases in cancer group. lt is suggestted that exon8 mutation occurs at the late stage of gastric cancer , but exon 5 , 6 , 7 mutation occur in the course of pre- cancerous lesions to cancer. Loss of heterozygosity (LOH) of exon4 . intron6 . APC was 47. 4 % ( 9/19) . 8. 7%C2/23).16. 7%(3/18) ,respectively. There are some relationship between LOH of exon4 and poor- ly differentiation , lymph node metastas , depth of invasion. LOH of exon4 may be one of prognostic marker of gastric cancer. We concluded that p53 gene mutation is an early event and perhaps has syner- gism with ras oncogene in gastric carcinogenesis

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ERCP for narrow－ winding cystic duct and surgical treatment

Zeli YU ; Lijun ZHANG ; Jie LI

Chinese Journal of Digestive Endoscopy.1996;0(05):-.

Objective The value of endoscopic retrograde choledocho－ pancreatography( ERCP ) to detect narrow－ winding cystic duct and the effect of surgery were studied .Methods The clinical presentations, pathogenesis, diagnostic procedures and outcome of surgery were collected and analysed in 17 patients with this change. All had preoperative ERCP as well as intraoperative cholangiography. The operation was simple cholecystectomy. Results Satisfaction was obtained througthout the followup period for 2～ 5 years . Conclusion Narrow－ winding cystic duct is not a rare biliary disorder with high rate of confirmation by ERCP and fine result following cholecystectomy.

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