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To investigate the clinical efficacy, feasibility and safety of new "three tubes" method in the treatment of spontaneous esophageal rupture. A total of 22 patients with spontaneous esophageal rupture were retrospectively analyzed. Through the new "three tubes" method of treatment, patients achieved leak cured with reduced hospital stay, less medical expenses and early resumption of oral diet. The new "three tubes" method for spontaneous esophageal rupture has the advantages of easy handling, minimal invasion, few complication and exact curative effect.
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Objective To investigate the risk factors of pathological upgrading in gastric mucosal lesions with low-grade intraepithelial neoplasia (LGIN) after endoscopic submucosal dissection (ESD).Methods From January 2010 to December 2016,the complete clinical data of 326 patients pathologically diagnosed with gastric LGIN lesions before ESD were retrospectively analyzed.Single factor analysis of variance and multiple factor Logistic regression analysis were performed to analyze the risk factors of pathological upgrading after ESD.Results A total of 326 patients with gastric LGIN lesions diagnosed by preoperative biopsy before ESD were enrolled.Among them the postoperative pathological diagnosis of 244 cases (74.85％) were still LGIN,while the postoperative pathological diagnosis of 82 cases (25.15 ％) were upgraded,of which 61 cases (18.71％) were upgraded to high-grade intraepithelial neoplasia and 21 (6.44％) were upgraded to gastric early cancer.The results of single and multiple factor analysis indicated that lesion size≥2.0 cm,deep depressed-type,surface erythema,lesion mucosa with ulceration and lesions with spontaneous bleeding were the risk factors of pathological diagnosis upgrading after ESD (F=5.37,6.44,4.56,7.56 and 7.78,respectively;all P＜0.01),odds ratio (OR) value and 95％ confidence interval (CI) were 4.086 (2.035 to 10.786),7.435 (2.845 to 19.862),3.205 (1.535 to 8.541),8.668 (3.365 to 21.457) and 7.056 (2.732 to 18.355).The age,gender and location of the lesion were not the risk factors.Conclusions Pathological upgrading is common in gastric lesions with LGIN after ESD.The lesions with high risk factors should be alerted and treated more actively.
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Objective To investigate the risk factors of pathological upgrading in gastric mucosal lesions with low-grade intraepithelial neoplasia (LGIN) after endoscopic submucosal dissection (ESD).Methods From January 2010 to December 2016,the complete clinical data of 326 patients pathologically diagnosed with gastric LGIN lesions before ESD were retrospectively analyzed.Single factor analysis of variance and multiple factor Logistic regression analysis were performed to analyze the risk factors of pathological upgrading after ESD.Results A total of 326 patients with gastric LGIN lesions diagnosed by preoperative biopsy before ESD were enrolled.Among them the postoperative pathological diagnosis of 244 cases (74.85％) were still LGIN,while the postoperative pathological diagnosis of 82 cases (25.15 ％) were upgraded,of which 61 cases (18.71％) were upgraded to high-grade intraepithelial neoplasia and 21 (6.44％) were upgraded to gastric early cancer.The results of single and multiple factor analysis indicated that lesion size≥2.0 cm,deep depressed-type,surface erythema,lesion mucosa with ulceration and lesions with spontaneous bleeding were the risk factors of pathological diagnosis upgrading after ESD (F=5.37,6.44,4.56,7.56 and 7.78,respectively;all P＜0.01),odds ratio (OR) value and 95％ confidence interval (CI) were 4.086 (2.035 to 10.786),7.435 (2.845 to 19.862),3.205 (1.535 to 8.541),8.668 (3.365 to 21.457) and 7.056 (2.732 to 18.355).The age,gender and location of the lesion were not the risk factors.Conclusions Pathological upgrading is common in gastric lesions with LGIN after ESD.The lesions with high risk factors should be alerted and treated more actively.
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Objective To evaluate the role of Akt and nuclear factor (NF)-κB pathway in the development of chemoresistance in gastric cancer and the relation between Akt and NF-κB.Methods SGC-7901 cells were exposed to chemotherapeutic drugs (doxorubicin and etoposide ) or chemotherapeutic drugs combined with Wortmannin or MG-132.The cell growth was detected using MTT method.The apoptosis of SGC-7901 cells was measured by TUNEL and Annexin V/PI methods.The protein level of NF-κB was analyzed by immunocytochemical staining.Electrophoretic mobility shift assay (EMSA) was used to confirm the increased nuclear translocation of NF-κB/P65.chemotherapeutic drugs could obviously inhibit the growth of SGC-7901 cells in time-dose-dependent manner.Pretreatment of SGC-7901 cells with Wortmannin or MG-132 could promote this inhibitory κB in a dose-dependent manner.Wortmannin or MG-132 pretreatment could enhance the apoptosis of NF-κB was found in SGC-7901 cells stimulated with Wortmannin,but no activation of Akt was noted in those treated with MG-132.Conclusions The chemotherapeutic drugs can both induce apoptosis and activate Akt and NF-κB in SGC-7901 cells.The efficacy of chemotherapeutic drugs can be increased via inhibiting activation of Akt or NF-κB.