Risk factors of major intraoperative bleeding and postoperative bleeding associated with endoscopic submucosal dissection for gastric neoplasms

Background: Endoscopic resection bleeding (ERB) classification was proposed by the authors’ team to evaluate the severity of intraoperative bleeding (IB) during endoscopic submucosal dissection (ESD). This study aimed to evaluate the application of ERB classification and to analyze the risk factors of major IB (MIB) and postoperative bleeding (PB) associated with ESD for gastric neoplastic lesions.Methods: We retrospectively enrolled a total of 1334 patients who underwent ESD between November 20...     

Identification of metastasis associated gene G3BP by differential display in human cancer cell sublines with different metastatic potentials G3BP as highly expressed in non-metastatic

Objective　To investigate genes involved in cancer metastasis, mRNA differential display was used to compare the levels of gene expression in two cell sublines derived from human giant cell carcinoma of lung (PG) which had different metastatic potentials. Methods　Using in vivo tumorigenicity and a spontaneous metastasis assay in nude mice, two sublines (BE1, LH7) from human giant cell carcinoma of lung (PG) with different metastatic potentials were isolated and characterized. mRNA differential display was used to compare the levels of gene expression between them and the obtained results were confirmed by Northern hybridization. Results　One differentially expressed band was nearly identical (99% homology) to Ras-GTPase-Activating protein SH3 domain binding protein (G3BP). G3BP displayed a strong expression in LH7 (non-metastatic in recipient nude mice) and a very weak expression in BE1 (100% metastatic frequency). The same different expression level of G3BP was detected in Northern hybridization with another panel of cell sublines with different metastatic potentials (established in our lab) derived from human prostate carcinoma cell line PC-3M. Conclusion　Our results indicate that G3BP was implicated in cancer metastasis because of its differential expressions in the two panels of cell sublines with different metastatic potentials.     

Difference of Gene Expression Profiles between Barrett＇s Esophagus and Cardia Intestinal Metaplasia by Gene Chip

The difference of gene expression profile changes in Barrett＇s esophagus （BE） and cardia intestinal metaplasia （CIM） epithelium was studied and the novel associated genes were screened in the early stage by cDNA microarray. The cDNA retro-transcribed from equal quantity mRNA from BE and CIM epithelial tissues were labeled with Cy3 and Cy5 fluorescence as probes. The mixed probe was hybridized with three pieces BiostarH-40s double dot human whole gene chip. The chips were scanned with a ScanArray 4000. The acquired images were analyzed using GenePix Pro 3.0 software. It was found a total of 141 genes were screened out that exhibited differentially expression more than 2 times in all three chips. It was identified that in gene expression profiles of BE, 74 genes were up-regulated and 67 down-regulated as compared with CIM. The comparison between the difference of gene expression profile changes in BE and CIM epithelia revealed that there existed the difference between BE and CIM at gene level. 141 genes with the expression more than two time were probably related to the occurrence and development of BE and the promotion or progress in adenocarcinoma.     

Low doses of ethanolic extract of Boldo （Peumus boldus） can ameliorate toxicity generated by cisplatin in normal liver cells of mice in vivo and in WRL-68 cells in vitro,but not in cancer cells in vivo or in vitro

OBJECTIVE： Use of cisplatin, a conventional anticancer drug, is restricted because it generates strong hepatotoxicity by accumulating in liver. Therefore its anticancer potential can only be fully exploited if its own toxicity is considerably reduced. Towards this goal, ethanolic extract of the plant, Boldo （Peumus boldus）, known for its antihepatotoxic effects, was used simultaneously with cisplatin, to test its ability to reduce cisplatin＇s cytotoxicity without affecting its anticancer potential. METHODS： The cytotoxicity of Boldo extract （BE） and cisplatin, administered alone and in combination, was determined in three cancer cell lines （A549, HeLa, and HepG2） and in normal liver cells （WRL-68）. Drug-DNA interaction, DNA damage, cell cycle, apoptosis, reactive oxygen species （ROS） and mitochondrial membrane potential （MMP, Aψ） were also studied. Hepatotoxicity and antioxidant activity levels were determined by alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase and glutathione assays in mice. The cytotoxicity of related proteins was tested by Western blotting. RESULTS： Co-administration of BE and cisplatin increased viability of normal cells, but had no effect on the viability of cancer cells. Boldo protected liver from damage and normalized different antioxidant enzyme levels in vivo and also reduced ROS and re-polarized MMP in vitro. Bax and cytochrome c translocation was reduced with caspase 3 down-regulation. Further, a drug- DNA interaction study revealed that BE reduced cisplatin＇s DNA-binding capacity, resulting in a reduction in DNA damage. CONCLUSION： Results indicated that a low dose of BE could be used beneficially in combination with cisplatin to reduce its toxicity without hampering cisplatin＇s anticancer effect. These findings siqnify a potential future use of BE in cancer therapy.     

Endoscopic trans-minor papilla biliary drainage： a case report

In normal physiological anatomy, common bile duct opens in the major papilla and does not communicate with the minor papilla directly. There is little chance to cannulate biliary system via the minor papilla. There was no report of trans-minor papilla biliary drainage in the literature. We presented a case with malignant obstructive jaundice that underwent trans-minor papilla biliary drainage. A 5F super slim nasobiliary tube was inserted into common bile duct successfully through minor papilla during endoscopic retrograde cholangio-pancreatography (ERCP). The patient did not complain abdominal pain or any discomfort after procedure. Biliary drainage was effective (500-800 ml per day). The patient’s jaundice relieved significantly during follow-up.     

Long-term outcomes of additional surgery versus non-gastrectomy treatment for early gastric cancer after non-curative endoscopic submucosal dissection: a meta-analysis

Background: Endoscopic resection is increasingly used in the treatment for early gastric cancer (EGC); however, about 15% of endoscopic submucosal dissection (ESD) cases report non-curative resection. The efficacy of different remedial interventions after non-curative ESD for EGC remains controversial. This meta-analysis aimed to compare the long-term outcomes of additional surgery and non-gastrectomy treatment for EGC patients who underwent non-curative ESD.Methods: All relevant studies publish...     

Study on the preventive effects of different drugs on reflux esophagitis inrats

Objective: To observe the damage of mixed reflux to the rat esophageal mucosa, and investigate the preventive effects of cisapride, nabumetone and hydrotalcite on the damaged esophageal mucosa. Methods: Three hundred sixty-eight Sprague-Dawley rats were treated as esophagoduodenostomy and divided into four groups in random. Group Y:operation + saline as positive controls; Group P: operation + cisapride; Group R: operation + nabumetone; Group D: operation + hydrotalcite. Different drugs were perfused in the 1st week after operation. The lesions of esophageal mucosa were observed in the 5th, 9th, 13th, 17th, 22nd, 28th, 35th and 40th week respectively, and evaluated the preventive effects of these drugs. Results: The lesions of esophageal mucosa in group Y were more severe than other three groups in different time ( P < 0.05), and the incidence of Barrett' s esophagus(BE), severe atypical hyperplasia and esophageal adenocarcino-ma (EAC) in group Y were higher than others. After 22 weeks, the lesions in gro     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究:津液辨证(英文)

Intraditional Chinese medicine (TCM),the so-called津液refers to all the fluid and liquid flowingand maintaining inside the human body.In Chineselanguage,津液is a phrase composed of twoChinese characters which describes two differentkinds of fluid or liquid in the human body .According to the theory of TCM,津refers to thepart of fluid that is thin in texture and flowss moothly inside the body while液refers to thepart of fluid that is thick in texture and mainlymaintains in the joints of the body to nourish andlubr...     

Malate and Lactate Dehydrogenases of a Freshwater Catfish: Impact of Endosulfan

A sublethal concentration of technical grade endosulfan (END) inhibited 35 to 55% of the activities of cytoplasmic malate dehydrogenase (cMDH), mitochondrial malate dehydrogenase (mMDH), and lactate dehydrogenase (LDH) in the liver and the skeletal muscle of a freshwater catfish, Clarias halrachus, after 7 days of exposure. The activity remained in the inhibited state up to 28 days. The withdrawal of END from the medium after 1 week of exposure gradually restored the activities to control levels within 21 days in the skeletal muscle and 28 days in the liver. The administration of actinomycin D or cycloheximide between the 14th and the 21st day of the withdrawal of END almost completely inhibited the withdrawal-dependent recovery in the activities of all the three enzymes. This indicates de novo synthesis of the enzymes during the recovery period. A conjoint treatment of END and triiodothyronine (T_3) raised the activities of cMDH, mMDH, and LDH in the liver and the skeletal muscle up to the control levels. This shows that the inhibitory effect of END may be relieved in presence of T_3. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed few changes in the pattern of cytoplasmic proteins of the liver and the skeletal muscle in response to exposure to END. 1990 Academic Press. Inc.     

射频联合埃索美拉唑镁铝镁加混悬剂治疗Barrett食管32例临床疗效观察

目的观察内镜下射频联合药物治疗Barrett食管疗效和应用价值。方法对经过内镜及病理检查确诊为Barrett食管32例采取内镜下射频治疗,术后应用埃索美拉唑镁20 mg早晚饭前30 min口服,铝镁加混悬剂15 ml每餐饭后1 h口服,连续4周,4周后改为埃索美拉唑镁20 mg,1次/d,再治疗4周。并于治疗后第1、6、12个月对患者复查胃镜和（或）病理检查。结果 32例Barrett食管中有24例1个疗程获痊愈,3例2个疗程获痊愈,5例经过2个疗程治疗后病灶面积缩小。结论内镜下射频联合药物治疗Barrett食管疗效好,不良反应少,易于临床推广。     

Differences of risk factors and clinical presentations in male and female Taiwanese individuals with Barrett's esophagus

Background

Barrett's esophagus (BE) is a disorder more often found in obese men. Differences between the two genders are not known in the Asian countries. Here, we studied their gender differences in the Taiwanese population in terms of risk factors and clinical presentations.

江苏地区Barrett’s食管患病率的内镜研究

目的探讨江苏地区接受内镜检查的人群中Barrett’s食管（BE）患病率及其变化趋势,以及同期同人群中食管腺癌的患病情况。方法以我院近4年接受内镜检查的患者为研究对象,对内镜疑诊的BE患者取活检,病理标本见到真性杯状细胞确诊为BE。分别研究4年间BE的总体患病率、各年度病例患病率及各年龄组患病率,同时研究BE的内镜下形态和同期食管腺癌的患病情况。结果上消化道内镜检查的69544例中,共检出BE105例,BE的总体患病率为1．51‰（95％CI1．27‰～1．75‰）,其中男性和女性分别为55例及50例,两者在平均年龄和患病率间均无差异。近四年的年度病例患病率分别为2．15‰、1．23‰、1．41‰及1．39‰,各组间差异无显著性（P=0．18,X2=4．92）。随着年龄增长,BE的患病率呈逐渐增加的趋势,且各个年龄组间患病率差异有显著性（X2=6．07,P〈0．01）。除典型的内镜下表现外,部分BE患者可表现为食管炎、食管溃疡等。BE的内镜下形态以岛形最多见（51．35％）,舌形次之（35．14％）,全周形最少（13．51％）。食管腺癌占同期所有食管癌的比例仅为4．68％,且近四年该比例并未明显升高。结论近4年江苏地区所有接受上消化道内镜检查者中BE总体患病率约为1．51‰,该比例在过去四年间并没有明显升高,但随着年龄增长其患病率逐渐增加。食管腺癌占所有食管癌的比例仍很低且相对稳定。     

内镜诊断技术在Barrett食管中的应用及进展

Barrett食管(BE)诊断主要依赖于内镜及组织病理学检查。提高BE的诊断水平,为及早治疗及干预其向食管腺癌的发展具有重要的意义。近年来,BE诊断技术得到进一步发展,普通内镜、胶囊内镜、染色内镜、染色放大内镜、增强放大内镜、荧光内镜技术、超声内镜、共聚焦荧光内镜、窄带光照内镜技术在诊断BE中具有不同特点。现对BE诊断标准、不同内镜诊断技术特点进行综述。     

TMSG-1基因转染对肿瘤转移表型的影响

目的：研究肿瘤转移抑制基因TMSG-1对肿瘤转移表型的影响。方法：将含TMSG-1全长开放阅读框架的1.5kb cDNA克隆于pcDNA3，构建正义及反义TMSG-1 cDNA真核表达载体，以脂质体转染人肺巨细胞癌PG的高转移亚系BE1，挑选G418抗性克隆，RT-PCR检测正义或反义TMSG-1cDNA在转染细胞中的表达，进行转染细胞体外肿瘤生物学行为检测。结果：RT-PCR显示正义TMSG-1cDNA转染的BE1细胞（BE1-S）中TMSG-1表达明显高于BE1及空载体对照细胞，反义TMSG-1cDNA转染细胞（BE1-AS）中TMSG-1表达低于空载体对照细胞。与BE1及空载体对照细胞（BE1-V）相比，BE1-AS细胞体外生长较快，软琼脂克隆形成能力明显增强；而BE1-S细胞体外生长能力没有显著改变，但其穿越Matrigel的能力及软琼脂克隆形成能力明显减弱。流式细胞仪分析结果显示BE1-S的G0、G1期的细胞较BE1-V细胞比例增多，并且BE1-S出现了细胞凋亡峰。结论：实验结果表明反义TMSG-1基因转染可增强BE1细胞的体外生长、体外侵袭能力及克隆形成能力。而正义TMSG-1基因转染则使BE1细胞的侵袭能力及软琼脂克隆形成能力减弱，而对细胞体外生长能力无明显影响。结论支持TMSG-1是一个肿瘤转移抑制基因。     

CK7、CK20及CDX2在不同病理类型Barrett食管中的表达及意义

目的分析CK7、CK20及CDX2在不同病理类型Barrett(BE)食管中的表达意义,探讨3种不同组织病理类型的BE食管在分子生物学方面的变化。方法选取病理诊断明确的胃底型BE组22例,贲门型BE组20例,特殊肠化型BE组18例。应用免疫组化法检测不同类型BE食管黏膜组织中CK7、CK20及CDX2的表达率及表达强度,并以正常食管黏膜、正常贲门黏膜及反流性食管炎作为对照。结果 CK7在各型BE及正常贲门黏膜中均有较高的表达率,分别为肠化型BE 100%、胃底型BE 86.36%、贲门型BE 95.00%及正常贲门黏膜100%,4组之间差异无统计学意义;而与正常食管黏膜及食管炎组相比差异均有统计学意义(P<0.01);CK20在肠化型、胃底型及贲门型BE中的表达率分别为100%、81.81%及50.00%,差异均有统计学意义(P<0.01);CDX2在肠化型、胃底型及贲门型BE中的表达率分别为100%、59.09%及15.00%,3组BE组织中的CDX2的表达均有统计学意义(P<0.05);CDX2与CK20在各组BE中的表达有明显相关性,两者的表达强度均为肠化型BE>胃底型BE>贲门型BE(rs=0.819,P<0.01)。结论 CK7在各型BE中表达均有较高的敏感性,但缺乏特异性,而CDX2及CK20均可作为肠化型BE的敏感指标。胃底型和贲门型BE虽未在病理组织中见到杯状细胞,但具备了一定的肠化特征。     

Barrett's食管组织中环氧合酶-2的表达及食管动力学测定

目的:探讨Barrett's食管(BE)食管运动功能、环氧合酶-2(COX-2)的表达及其发病机制。方法:收集62例经内镜和病理确诊的BE患者的资料,对其中21例的食管动力学检查结果进行分析;采用免疫组化SP法检测其中37例食管黏膜组织中COX-2蛋白的表达。以20例同期健康体检者和23例反流性食管炎(RE)患者作对照。结果:BE组下食管括约肌(LES)压力低于RE组及健康对照组,BE组食管远端收缩波幅较RE组及对照组降低(P均<0.05),而食管近端收缩波幅3组间差异无统计学意义(P>0.05)。正常十二指肠上皮组织中COX-2无表达,而20/24无不典型增生BE肠化黏膜、12/13不典型增生BE肠化黏膜表达COX-2蛋白,且2者间表达差异无统计学意义(P<0.05)。结论:LES功能失调是BE主要发病机制,COX-2蛋白的表达是BE发生的早期事件。     

Barrett食管血浆内皮素及降钙素基因相关肽的水平

目的:观察Barrett食管(BE)血浆内皮素(ET)及降钙素基因相关肽(CGRP)水平.方法:对确诊为BE 38例患者,26例反流性食管炎(RE)及健康检查者18例,用放射免疫法测定空腹静脉血中ET和CGRP含量.结果:BE患者血浆ET水平明显高于RE及健康检查者(P＜0.05,P＜0.01),RE ET水平明显高于健康检查者(P＜0.05);CGRP水平明显低于RE及健康检查者(P＜0.05,P＜0.01),RE CGRP水平明显低于健康检查者(P＜0.05).结论:BE患者血浆中ET和CGRP含量有显著变化,ET和CGRP可能参与BE的病理生理过程,其含量的变化可能与疾病的发展有关.     

共晶技术提高黄芩素溶出度及生物利用度的研究

采用混悬液结晶法制备1∶1物质的量比的黄芩素-咖啡因(BE-CA)共晶,以提高BE的溶出度及口服生物利用度。差示扫描热分析、X射线粉末衍射法、傅里叶红外光谱法等分析表明所制备的共晶为区别于BE及CA的一种长针状晶体新物质。溶出试验表明BE-CA共晶的溶出度均显著高于BE晶体及其与CA的晶体混合物。大鼠体内药代动力学研究表明,与BE相比,BE-CA共晶缩短BE及其活性代谢物黄芩苷(BI)的达峰时间(t_max),并显著提高了BE及BI的峰浓度(c_max)及血药浓度-时间曲线下面积(AUC),极大地提高了黄芩素口服生物利用度。     

Barrett食管的临床表现与病理类型分析

目的了解Barrett食管（BE）的内镜检出情况及分型特点,研究不同内镜分型的临床及病理特征。方法通过胃镜检查,对可疑BE黏膜钳取病检进行病理组织学检查;对确诊为BE的51例患者,记录其一般状况、主要临床表现、内镜分型及病理分型,同时记录同期检出的257例反流性食管炎（RE）患者的主要临床表现及内镜分型。结果内镜检查中BE检出率为1．76％,RE检出率为8．86％;BE内镜分型：岛型23例,舌型10例,全周型18例;RE合并BE7．O％,BE合并RE45．1％,BE不同内镜分型合并反流性食管炎的几率有明显差异,全周型BE明显高于其他两型,P〈0．05。结论不同内镜分型的BE临床特征、病理类型存在差异。