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Objective: To establish the method of percutaneous endoscopic gastrostomy(PEC) and percutaneous endoscopic jejunostomy (PEJ) for enteral nutrition. Methodes: PEG tubes were placed in 114 patients with Pull method. On the foundation of PEG, PEJ tubes were placed in 26 patients by pushing endoscopy to send tubes through Treitz ligment with usingthe the clip. Results: All PEG insertion was performed successfully. PEJ tubes were placed successfully with a new method in 26 patients. 15 patients had a little blooding and 8 patients had slight infection. 21 patients had respiratory tract infection and had been cured by using antibiotic. There was no severe complication. Conclusion: PEG is simple、safe、efficient. The new method of PEJ is feasible.
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Objective To investigate the clinical and histopathologic features of patients with primary gastrointestinal malignant lymphoma ( PGIML). Methods The clinical and histopathologic data of 22 patients with PGIML were reviewed and analyzed retrospectively. All cases were confirmed with histological specimen obtained from endoscopic biopsies or surgery. Results Abdominal pain was the most common presenting symptom, seen in 15 of 22 patients (68.2% ). The incidence of PGIML was highest in stomach, seen in 12 of 22 patients (54. 5% ). Modularity of the mucosal surface was the most common endoscopic finding, seen in 15 of 21 patients (71. 4% ). The positive rate of endoscopic biopsy for the diagnosis of PGIML was 52. 6% (10/19 biopsy cases). All cases were non-Hodgkins lymphomas ( NHL). Twenty cases were muco-sa associated lymphoid tissue (MALT) lymphoma, and 13 of 20 cases were extra-nodal marginal zone B-cell lymphoma of MALT. Conclusions Abdominal pain is the most common symptom and the stomach was the most common location in PGIML. Extra nodal marginal zone B-cell lymphoma of MALT is the main histopathologic feature. The prognosis of PGIML is related to the surgical procedure and the post operative chemotherapy.
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Objective To evaluate the accuracy of RUT for the diagnosis of H. pylori infection before and after eradication therapy using bacterial culture and histological examination as gold standard. Methods A total of 250 patients undergoing gastroendoscopy, including 127 and 123 patients with or without previous H. pylori eradication therapy respectively were randomly selected. Each of the biopsy specimens was taken from the antrum and body of stomach for RUT, culture, and histological examination. The data of positive culture and/or positive histology were defined as H. pylori infection. It was judged H. pylori negative or eradication of the bacteria only when the results of culture and histological examination were both negative. Results In cases before eradication therapy, RUT correctly diagnosed in 84 of 86 H. Pylori-positive cases, and 34 of 37 H. Pylori-negative cases. The overall accuracy was 95.9%. The sensitivity and specificity of RUT before eradication were 97. 7% and 91. 9% respectively. In cases after eradication therapy, RUT gave correct diagnoses in 18 of 28 H. pylori - positive cases and in 98 of 99 H. pylori-negative cases with sensitivity 64. 3% and specificity 99. 0% . However, when RUT was used more than 6 months after the end of eradication therapy, both the sensitivity and specificity increased to 100%. Conclusions RUT is highly accurate for the diagnosis of H. pylori infection in untreated and treated patients who were examined more than 6 months after the completion of therapy.
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AIM: To clarify the effects of specific and non-specific cyclooxygenase-2 (COX-2) inhibitors on gastric epithelial cell proliferating and gastric healing following acid-induced damage. METHODS: Male Sprague-Dawley rats were given 1 mL of 0.6 mol/L hydrochloric acid (HCl) into the stomach. Ten minutes after the administration of the acid,the animals were given NS-398 (COX-2 inhibitor) or indomethacin. Levels of COX-1 and COX-2 in the gastric mucosa before and after HCl-administration were analyzed using western blotting and immunohistochemical staining. Proliferating cell nuclear antigen (PCNA) was detected using immunohistochemistry for epithelial cell proliferation. Gastric lesion index (LI) was assessed using planimetry. RESULTS: Expression of COX-2 was enhanced mainly in surface epithelial cells and neck cells following HCl-administration. At 24 h following acid administration,PCNA labeling index (PCNA-LI) was (22.72?4.33) % and (21.98?5.18) % in the groups treated with 40 mg/kg of NS-398 and indomethacin respectively,which was significantly lower than that in the control group [ (34.46?3.61) %,P
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AIM: To clarify the effects of gastrin on t he expression of cyclooxygenase (COX) and several growth factors in rat gastric mu cosa. METHODS: Male Sprague Dawley rats were fasted for 24 hours and s ubcutaneously injected with saline or gastrin 17 at doses of 1 ?g/kg, 10 ?g/kg and 100 ?g/kg, respectively. The expression of COX-1, COX-2, heparin-binding e p idermal growth factor-like growth factor (HB-EGF) and hepatocyte growth factor ( HGF) in the gastric mucosa were examined using Western blotting and immunohistoc hemical staining. Effects of a potent gastrin receptor antagonist YM022 on the e xpression of COX-1, COX-2, HB-EGF and HGF in gastric mucosa were also evaluated. RESULTS: Gastrin dose-dependently increased the expression of C OX-2 and HB-EGF in rat gastric mucosa while the expression of COX-1 and HGF did not change significantly after treatment with gastrin. However, pretreatment wit h YM022 dose-dependently abolished the up-regulation of COX-2 and HB-EGF express ion induced by gastrin. CONCLUSIONS: This study demonstrates that gastrin up-regulates C OX-2 and HB-EGF expression in rat gastric mucosa, indicating that COX-2 and HB-E GF are involved in pathogenesis of the gastrin-related gastric mucosal hyperplas ia and carcinoma of stomach.