Objective We examined the Grp78, ERK1/2 and phospho-ERK1/2 expressions in hepatocellular carcinoma(HCC) tissue samples in vitro, we interfered the expression of Grp78 in SMMC-7721 cells to explore whether Grp78 is involved in ERK1/2 signal pathway. Methods The Grp78, ERK1/2 and phospho-ERK1/2 expressions were detected by immunohistochemistry and confirmed by Western blotting in 47 HCC tissue samples. The Grp78 expression in SMMC-7721 cells was interfered by plasmid transfection and siRNA, ERK1/2 phosphorylation and expression were determined by Western blotting. Results The Grp78 expression was significantly correlated with ERK1/2 and phospho-ERK1/2 in HCC tissue samples. Overexpression of Grp78 promoted ERK1/2 phosphorylation in SMMC-7721 cells and the increased ERK1/2 phosphorylation was inhibited by Grp78 knockdown. Conclusion Grp78 is involved in the regulation of ERK1/2 signal pathway and might be a potential target for the comprehensive therapy of HCC.

0.05).The incidence of adverse events was low and similar in each group. CONCLUSIONS Rifaximin is a safe and effective alternative to ciprofloxacin in the treatment of acute infectious diarrhea in adults.

OBJECTIVETo evaluate the efficacy of endoscopic variceal sclerotherapy (EVS) for esophago gastric variceal bleeding.

METHODSA retrospective analysis was made on 1010 patients with esophagogastric variceal bleeding who underwent sclerotherapy, among whom there were 834 patients with cirrhosis, 160 with hepatocarcinoma, 12 with Budd-Chiari syndrome and 4 with congenital liver fibrosis. Totally, 3203 sessions of sclerotherapy were performed, including 602 sessions of emergency sclerotherapy and 2601 of selective surgery. The average number of sessions of sclerotherapy for the initial treatment in 710 cirrhosis patients who received continuous sclerotherapy was 3.2 +/- 1.1 times. Follow-up was done in 579 cirrhosis patients for 3-157 months, with an average period of 42.5+/- 32.8 months.

RESULTSThe rate of emergency hemostasis in the whole group was 97.0%. The rate of complications was 13.4%, and the mortality rate was 1.8%. The rate of complete eradication and basically complete eradication of esophagogastric varices in cirrhosis patients was 84.1%. The late rebleeding rate was 23.7%, and the survival rates were 95.8% +/- 0.8%, 86.1% +/- 1.6%, 74.5% +/- 2.4%, 53.6% +/- 3.8% at 1, 3, 5 and 10 years, respectively, according to Kaplan-Meier analysis.

CONCLUSIONEVS is an important method for the treatment of esophagogastric variceal bleeding.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Esophageal and Gastric Varices ; therapy ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sclerotherapy

Objective To explore a method for development of carbon tetrachloride-induced cirrhotic model in rabbit and establish a portal vein delivery system in this model.Methods Male New Zealand white rabbit was subcutaneously injected carbon tetrachloride twice weekly,and the liver pathology and hepatic hydroxyproline content were examined after 12 weeks of injection.Portal vein catheterization was introduced through the terminal branch of mesostenium vein.The injection end of the catheter was embedded subcutaneously in the abdominal wall of the animal.The portal delivery was implemented by percutaneous puncture of the injection cap.Results After 12 weeks' of carbon tetrachloride administration,the rabbit liver developed typical pseudo lobule,and the liver hydroxyproline content increased 3.5 times compared to normal control.The portal vein delivery system could be maintained as long as 12 weeks.Conclusion A successive method to induce rabbit liver cirrhosis is developed,and a simple and economic animal portal vein delivery system is introduced.

Objective To compare the diagnostic accuracy of intraductal ultrasonography(IDUS) and endoscopic retrograde cholangiography(ERC) on extrahepatic bile duct stones. Methods 30 patients with suspected extrahepatic bile duct stones by B Ultrasonography, CT,or MRI,were allocated into this study. ERC was performed first by the use of Fujinon duodenal endoscopy ( ED-410XT, ED-410XU) and then followed IDUS by inserting the Fujinon miniprobe (PL2220-15 or PL2226-15) through endoscopic working channel to detect extrahepatic bile duct, finally the substance in extrahepatic bile duct was proved by endoscopic sphincterotomy(EST)and stone extraction. Results Among 30 cases, the diagnoses by ERC were stone 26 cases,floccule 1 cases and misinterpreted 2 cases so the accuracy and sensitivity of ERC were 26/30(86.7%) and 26/28(92.9%)respectively. For IDUS, the diagnoses were totally in accordance with the results of EST and stone extraction.So the accuracy and sensitivity of IDUS in the diagnosis of extrahepatic bile duct stones were 30/30(100%) and 28/28(100%) respectively. Conclusion (1) IDUS was superior to ERC in the diagnosis extrahepatic bile duct stones. (2) IDUS can compensate the misinterpretation of ERC on extrahepatic bile duct stones.

Objective To investigate the correlated factors concerning esophago-gastric variceal bleeding and sclerotherapy in liver cirrhosis. Methods Twenty-six factors were selected for 670 patients with liver cirrhosis and esophagogastric variceal bleeding and received sclerotherapy in our hospital. Spearman relationship analyses were performed on factors concerning esophagogastric variceal bleeding and sclerotherapy. Results Duration and number of episodes of bleeding were not related to grade of esophagogastric varices, diameter of portal vein and hepatic function but negatively related to ascites and hypersplenism.Severity of bleeding was not related to all of the above parameters. Esophageal varices related to gastric varices while neither of them related to diameter of portal vein. Result of sclerotherapy related to grade of esophageal varices, and negatively related to number of operations in first-period sclerotherpy, supplementary sclerotherpy and total number of operations as well as to amount of scleroant of first-period sclerotherpy and total amount of scleroant. Types of sclerosant had no relationship with result of sclerotherapy. Conclusion Esophagogastric variceal bleeding is affected by multiple factors. Diameter of portal vein is not the only factor. Result of sclerotherapy is affected by number of operations and amount of scleroant and has nothing to do with types of sclerosant.

Objective To evaluate the efficacy of scle rotherapy (EVS) for esophageal variceal bleeding. Methods Retrospective analysis was made in 1 010 patients with es ophageal variceal bleeding who underwent sclerotherapy, among them 850 patie nts were cirrhosis and 160 patients were hepatocellular carcinoma. The total num ber of procedures of sclerotherapy were 3 203, including 602 for emergency scler otherapy and 2 601 for selective sclerotherapy. Supplementary sclerotherapy was performed in 502 cases. Average procedures of sclerotherapy for initial treatme nt were 3.18?1.1 in 710 cirrhotic patients. Follow-up was made in 579 cirrhosi s patients for 3-157 months, with an average follow-up period of (42.47?32.78) months. Results 1. The hemostasis rate in the whole group was 97.0%, the c omplication rate was 13.4%, and the mortality was 1.8%. 2. Rate of complete and nearly complete elimination of esophageal varices in cirrhotic patients was 84 .1 %, and long term rebleeding rate was 23.7%. Survival rates were (95.8?0.8)% 、(86.1?1.6)%、(74.5?2.4)%、(53.6?3.8)% at 1,3,5 and 10 year according to t he Kaplan-Meier analysis. Conclusions EVS is an important method of treatment for esophageal variceal bleeding.

Objective To investigate the rule of changes in endoscopic and endoscopic ultrsonic findings after endoscopic variceal sclerotherapy in the follow-up period. Methods Patients suffered from esophagogastric variceal bleeding and received endoscopic variceal sclerotherapy were investigated. Patients with liver cirrhosis after viral heptitis and their varices eliminated or reduced to grade Ⅰor Ⅱ after sclerotherapy entered this study for at least 5 years' follow - up. Endoscopic and endoscopic ultrsonic findings were recorded to find its course of transformation. Results Lumens of varices were occluded by thrombus and eventually replaced by white fibrous tissue after endoscopic sclerotherapy. Vessels reappeared within e-sophageal wall gradually after a lot of time in the form of formation of new venules (93. 8% ) or re-vascular-ization (6. 2% ) . Newly formed varices within gastric wall after sclerotherapy were seen in 5. 3% of the cases and some cases of duodenal varices were also found rarely in the follow-up. Endoscopic ultrasonic finding confirmed the revascularization and dilatation of vessles after sclerotherapy. Conclusion From the follow-up results it indicates that varices would reappear gradually after endoscopic sclerotherapy, regular re-examination and appropriate treatment in time are the most important measure to assure its long term effect.

Objective To assess the efficacy and safety of interventional techniques for the management of symptomatic portal vein (PV) and superior mesenteric vein (SMV) thrombosis. Methods Six patients with thrombosis of the PV and SMV were treated by transjugular intrahepatic portosystemic (TIPS) approach. Contrast PV SMV venography was carried out to verify the access to the PV branch. Then a 8F large bore catheter was used to aspirate thrombus. A J shaped guide wire and pig tail catheter were used to fragment the thrombus. Local thrombolysis with urokinase (UK) was delivered through a catheter in the SMV. An 4 French multiple side hole catheter was put into the SMV and UK was continuously infused for 3 to 13 days.Results The procedure was successful in all cases. One patient died of intra abdominal sepsis 12 days after. Five patients were followed up by color Doppler ultrasonography for 4～36 months with confirmed patency of the PV and SMV in all these patients. Conclusions This procedure is both safe and effective in the treatment of symptomatic PV and SMV thrombosis.

0 05). No adverse reaction was seen in all patients. Our results suggest that intravenous Pantoloc is a good proton pump inhibitor in patients with duodenal ulcer combined with upper gastrointestinal bleeding, and it is similar to Losec in effectiveness and safety.