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 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.

Objective To analyze correlation of drug with acute drug-induced liver injury in 83 patients. Methods According to the international consensus criteria and Danan's causality assessment of a drug in the case of acute liver injury, 83 cases which had been clinically diagnosed as acute drug-induced liver injury were analyzed. Results Among the 590 inpatients of acute hepatitis, 83 (14.07%) were acute drug-induced liver injury, in whom 53 patients had liver cell damage (63.86%), 22 with cholestasis (26.5%), and 8 with mixed type (9.64%). In 34 patients, it was drug related (40.96%), undefined in 37 cases (44.57%), and unrelated in 12 cases (14.47%). Conclusion The international consensus criteria standardized the diagnosis of drug-induced liver injury and are helpful in differential diagnosis, but it needs improvement for actual implementation.

To evaluate the influences of sclerotherapy and band ligation on esophageal motility, EVS and EVL were measured before and after treatment respectively. After sclerotherapy, lower esophageal sphincter pressure (LESP)and residual pressure were decreased while relaxa tion was increased , relaxation duration became shorter; band ligation only influenced LESP.After EVS, the amplitude of motor waves in the sites of EVS and lower esophagus body was reduced ,and peristaltic wave duration was prolonged ,velocity of propagating contractions became faster , band ligation made the peristaltic wave duration in the sites of EVS and lower esophagus body become shorter, abnormal contractions increased. After EVS, antiacid medicine should be ased to reduced pH of gastric and raised LESP, and drugs to increase esophageal motility should be used after band ligation.

Crohn disease (CD) is a relatively infrequent disease in China. CD and intestinal tuberculosis (IT) are lack of specific clinical manifestations and are generally identified by endoscopic and histological examination. However, it is sometimes difficulty to distinguish them by endoscopy and histology. Their characteristics were investigated to offer more evidences and data for their differential diagnosis. The records of inpatients were reviewed from 1980～2001 in our hospital, all enrolled subjects were verified by endoscopy(or operation) and histology. The characteristics and key points of differential diagnosis of 28 CD cases and 14 IT cases were comparatively analyzed. The results showed that abdominal pain, mass, and hematochezia occurred more significantly in CD than in IT ﹙ P

To measure esophageal manometric parameters in liver cirrhosis, patients with different liver function grades were chosen. In the normal control group ( n =72) gastrointestinal disease history and symptoms, abdominal surgery and injury history were all negative. In liver cirrhosis group ( n =94) liver cirrhosis was diagnosed by clinical picture or pathology, and their liver function in Child grade was: grade A, 38 cases and 8 had ascites; grade B, 37 cases and 20 had ascites; grade C, 19 cases and 18 had ascites. Taking no motility medicines within seven days before measurement, esophageal motility parameters of these subjects were taken by a Biolab System made by Sandhill Company. The data were analyzed with SAS statistical software. The results showed that from Child grade A to C, LESP in cirrhosis group reduced, relaxation pressure increased, and relaxation percentage become lower successively; from Child grade A to C, onset peristaltic wave velocity in upper esophageal body became slower, peristaltic contraction reduced, and abnormal contraction increased; from Child grade A to C, peristaltic wave amplitude reduced in lower esophageal body, and velocity of onset peristaltic wave velocity became slower, peristaltic contraction reduced, and abnormal contraction increased. It suggests that more severe injury in liver function, more serious impact in esophageal motility. At the same time complications of portal vein hypertention such as esophageal varices and ascites behave synergetically.

Objective To investigate the indication and therapeutic effect of endoscopic pancreatic stent insertion. Meth-ods 13 procedures of endoscopic sphincter incision,2 procedures of endoscopic pancreatic stone picking,3 procedures ofendoscopic papilla adenoma or carcinoma resection. 10 procedures of endoscopic stenosis dilatation and 20 procedures ofendoscopic pancreatic stent insertion were performed on 9 cases of chronic pancreatis (in which 3 cases had pancreaticstone), 1 case of acute recurrent pancreatis.4 cases of pancreatic cancer and 3 cases of papilla adenoma or carcinoma.The duration of stent preserve was 2 weeks to 8 months, average 3. 43 months. Results Remission of abdominal pain,improvement of appetite and digestive function was found in 16 cases. 12～35 months (average 26. 17 months) of follow-up was performed on patients of pancreatitis after the stents were removed. 7 cases had no recurrence of abdominal pain,3 patients still often had upper abdominal pain. Complications:3 cases had mild elevation of serum amylase and lipase. 1case had obstructive jaundice. Conclusion Endoscopc pancreatic stent insertion and drainage is suitable for pancreaticduct obstruction caused by chronic pancreatitis or cancer. It can alleviate symptoms and has reliable therapeutic effect andgood security.