AIM To evaluate the usefulness of ultrasound monitoring acute fluid accumulation in acute pancreatitis.METHODS Six hunclred and twenty-seven patients with acute pancreatitis were undergone ultrasonographicexamination. All examinations were performed by the attending doctors. The first scans were performed onthe first or second day after admission to our hospital, if there were acute fluid accumulation inperipancreatic spaces including the lesser sac, pararenalspaces, peritoneal cavity, or even thoracic cavity,then the follow-up scans were routinely performed 3 - 7 days following the initial scan and this interval wasdependent upon the severity of acute pancreatitis, and partieulanly noticed the changes of pancreas and thefluid mentioned above. Continuous variables were analyzed by t test, Discrete variables were analyzed by the,x2 test and rank sum test using SPSS, P<0.05 was considered significant.RESULTS Acute fluid accumulation was fouad in 57.5% of 627 patients among them 14.4% evolved intocomplications and 85.6% resolved spontaneously. The most frequent sites of fluid accumulation are theperitoneal cavity and the left hemithorax, followed by the lesser sac and right hemithorax (x2 = 738,P<0.0001); the hospital stay was longer as the quantity of acute fluid accumulation increased (P<0.0001, t = 2.2 - 4.2 ). There was no fluid accumulation in mild AP and more than 2 sites in severe AP (P<0.0001, x2 = 147.8).CONCLUSION The number of sites as well as the duration of fluid accumulation are proportional tohospital stay and the severity of AP.

AIM To study the relationship among typing of Traditional Chinese Medicine (TCM) and Helicobacterpylori infection, expression of oncogene and tumor suppresser genes in gastric cancer and precancerouslessions.METHODS According to TCM typing, 120 patients with chronic superficial gastritis, intestinal metaplasia,atypical hyperplasia and gastric cancer were divided into 4 groups: 21 patients with coexistence of cold andheat syndrome (group R), 22 patients with in coordination between the liver and the spleen (group U), 29patients with deficiency of the spleen-yin (group I) and 48 patients with insufficiency of the spleen-yang(group H). Protein expression of c-myc, p21 and p53 were detected immunohistochemically, and Hp wereconfirmed by modified Giemsa method.RESULTS The Hp infection of the group H was significantly higher (72.9%) than that of group R(38.1%, P<0.01) and group U (40.9%, P<0.01). Expression of c-myc, p21 and p53 were significantlyrelated to Hp infection and severity of gastric mucosa lesions (group H>group I>group U>group R).CONCLUSION Hp infection, expression of oncogene and tumor suppresser genes were related to TCMtyping. These parameters were helpful in identification of symptoms and signs and TCM differentiationdiagnosis.

AIM To study the comprehensive prevention and treatment of gastric cancer among high-risk population inthe high risk areas.METHODS A gastrocarcinoma mass screening was performed in 16 villages of Zhuanghe region. About50 000 population were involved and 3033 cases aged above 35 suffering from gastric diseases, and/or hadfamily history of gastric cancer were screened. Clinical epidemiological investigation, double-contrast X-ray,serum pepsinogen monitor, gastroscopic biopsies and histopathologic examinations were adopted in thescreening.RESULTS The ratio of the examined patients with gastric disorder reached up to 82% and 32 patients withgastric cancer were detected (1.06%) and 18 cases were early gastric cancer (56.25%). Patients with gastriccancer were treated successively. Aside from gastric cancer, several gastric lesions were also detected, whichlaid a good foundation for further interventional treatment. It was also found in the examination that93.97% of the local residents were addicted to salted pork and more than 60% of the residents had Hpinfection.CONCLUSION Gastric diseases, Hp infection of gastric mucosa and eating salted pork are very common inZhuanghe region. These are very dangerous factors causing gastric cancer. It is feasible to quit eating saltedpork and eradicate Hp infection and cure precancerous diseases.

AIM In order to evaluate the diagnostic parameters of characteristic pathologic change in the liver biopsyspecimens, we developed a numerical scoring diagnostic standard.METHODS Ten of the eleven categories of characteristic pathologic lessions appearing in acute hepatitisand 11 categories in chronic hepatitis were selected. Each of them was graded 3 scales, then the essentialscore and scale score were set up. Adding up to all the numerical scores of individual components, formed thetotal scores of histological chronic activity index (HCAI) and histological acute activity index (HAAI). Onethousand and eight patients with various liver dieases were studied,and compared with conventional readingsand Knodell'HAI through F analysis and q test.RESULTS The HAAI of acute, subacute, and chronic severe hepatitis was 43.56±9.08, 51.63±12.13,and 65.45±17.51 respectively. There was significant difference between each other (P<0.01). TheirHCAI was 14.44±8.31, 57.39±10.98, and 58.14 12.24 respectively. HAAI of mild, moderate, andsevere chronic hepatitis was 18.57±7.00, 26.43±7.49, and 35.58±11.47 respectively (P<0.01), andHCAI was 13.2±6.90, 40.29±10.99, and 50.02±9.78 respectively. There was signficant difference(P<0.01). The HAAI of active liver cirrhosis and silent liver cirrhosis was 64.96±16.60 and 31.17±9.07respectively, the difference being significant (P < 0.01), and HCAI was 66.00±9.62 and 69.84±8.93, withno significant difference (P >0.05).CONCLUSION The diagnostic standard of histological activity index that we set up, was more useful aseither an alternative or supplement to the conventional terminology and KnodellHAI.

AIM To study the expression of cathepsin B in gastric carcinoma and its relationship with pathologic type.METHODS The cathepsin B expression in 54 specimens of human gastric adenocarcinoma was studied byimmunohistochemistry.RESULTS The cathepsin B expression was detected in 33/54 (61.1%) specimens of human gastriccarcinoma and in 3/54 (5.6%) of normal tissue (P<0.01). There was no obvious correlation between theexpression of cathepsin B and pathologic type of gastric adenocarcinoma.CONCLUSION There is a high expression of cathepsin B in human gastric adenocarcinoma.

AIM To probe into the feasibility and theoretic basis for the treatment of chronic hepatitis with hyperbaricoxygenation (HBO).METHODS Sixty cases of chronic hepatitis were randomly distributed into an experimental group (n=30)and a control group (n =30). The experimental group was treated with HBO for 6 courses. The controlgroup was treated with commonly used drugs in clinic for 60 days. The function and blood stream graph ofliver were examined and the liver biopsies were made before and after treatment. The routine paraffin slidesof liver tissue were cut, stained with HE, and observed under optical microscope. The ultrathin slides fromparaformaldehyde and glutaraldehyde fixed liver tissue were cut, stained with lead citrate, and observedunder transmission electric microscope. The HBsAg and HBcAg in the experimental group were detected bythe ABC immunohistochemical method before and after treatment.RESULTS In the experimental group the ALT, SB, γ-GT, AKP, IgG and IgM in blood (P< 0.05) and thedegeneration and necrosis of hepatocytes (P<0.05) were remarkably decreased, the mean contractive waveof blood stream in the liver (P<0.05) and the blood stream in the right ramus of janitrix (P<0.05) weresignificantly increased, and the swelling of mitochondria, the increased lysosomes, the generation of Kupffer's cells, the infiltration of lymphocytes in portal area and the capillary generation were remarkably alleviated(P<0.05), but the fibrosis and fat-storing cells did not reduce (P>0.05) in the liver, and the expression ofHBsAg and HBcAg in the liver was not lowered (P<0.05) after the treatment with HBO.CONCLUSION The treatment with HBO for chronic hepatitis was effective and recommendable.

AIM To find out if there is any difference in human primary liver carcinogenesis between Han and minorityethnic patients in Xinjiang.METHODS Expression of p53, c-erbB-2, H-rasp21 protein and proliferating cell nuclear antigen (PCNA)in tumor tissues of 50 patients (Hah 38, minorities 12) with primary hepatic carcinoma (HCC) was detectedby immunohistochemistry (LSAB).RESULTS The positive frequency of p53, c-erbB-2, H-rasp21 and PCNA expression was 46.0% (23/50,70.0% (35/50), 68.0% (34/50) and 82.0% (41/50) in tumor tissues; 4.0% (2/50), 22.0% (11/50),64.0% (32/50) and 52.0% (26/50) in peritumor respectively with a significant difference, except for H-rasp21 (P<0.05) between tumor and non-tumor tissues. Combined the three oncogenes alteration, 26%(13/50) tumor tissues had positive immunoreactivity, but peritumor and normal liver were negative. Thepositive p53, c-erbB-2, H-rasp21 protein expression was 39.5 % ( 15 / 38), 60.5 % (23 / 38) and 39.5 % ( 15 /38) in tumors of Han patients; 66.7% (8/12), 100% (12/12) and 75.0% (9/12) in minority patientsrespectively. A statistical difference between Han and minority cancer samples was observed (P< 0.05).CONCLUSION Overexpression of p53, c-erbB-2 and H-rasp21 in human primary liver carcinoma is animportant biomarker of genetic alteration. The different frequency of these oncogenetic changes may reflectsome environmental factors or/and ethnic hereditary affecting the liver carcinogenesis. The special life styleof Han, Uygur, Kazak and Mongolia nationalities in Xinjiang may also involve the etiopathogenesis of thisdisease.

AIM To select a test method for specifical, sensitive and rapid identification of LT+ E. coli.METHODS Stool samples inoculated into LB solution were cultured for 4 hours at 35℃. 10 μ boiled culturesolution was taken to template. Two oligonucleotide primers were used in a polymerase chain reaction (PCR)procedure to amplify a highly conserved DNA sequence of the A subunit of the heat-labile enterotoxin.Detection of the 110 bp amplified product can be done by agarose gel electrophoresis. Thirty strains ofknown bacteria (LT+ E. coli (EC-129), ST+ E. coli (EC-130)and LT+ ST+ E. coli (EC-142), Salmonellatyphimurium , Salmonella typhi , Salmonella paratyphi A, Salmonella group C, Shigella sonnei , Enterobacteraerogenes, Alcaligenes sp, Providencia rettgeri, Proteus mirabilis, Morganella morganii, Pseudomouasaeruginosa, Aeromonas hydrophila, Klebsiella pneumoniae, Citrobacter diversus, Enterobacter cloacae, 12strains of E. coli isolated from bile samples ) and 108 diarrhea samples were detected. A total of 108 diarrheasamples were compared with LT probe hybridization, modified Eleck (M-Eleck) and ELISA simultaneously.RESULTS By PCR, of the 30 strains of bacteria, only LT+ E. coli and LT+ ST+ E. coli were positive; in40 of the 108 diarrhea samples, 20 were positive and in the other 68 samples from infants, only five werefound to be positive. Of the 25 positive samples by PCR, 23 were also found to be positive in the other 3tests; 1 was found to be positive by M-Eleck and ELISA. Of the 83 negative samples by PCR, the samenegative results were found by M-EIeck and ELISA, but 2 were found to be positive by LT probehybridization. The overall coincidence rate was about 95%. Analysis of correlation showed a significantdifference between PCR and other three tests (P<0.01) and analysis of difference showed no significantdifference (P>0.05) between them. In the detection of LT+ E. coli by means of PCR, the minimumnumber of target bacteria required was 50 CFU. The whole test was finished in 7 hours.CONCLUSION Detection of LT+ E. coli by PCR showed that the method is specific, sensitive and rapid.

AIM The hepatic content of collagens (type I, Ⅲ and Ⅶ) and laminin (LN) in rat model of experimentalliver fibrosis was observed to find out their roles in the pathogenesis of liver fibrosis.METHODS The experimental rat model was established by immunological injury induced by injectinghuman albumin. Histopathological and immunohistochemical methods were used to measure the hepaticcontent of collagens and laminin in the fibrotic rat livers.RESULTS The hepatic contents of collagens (type I, Ⅲ, Ⅶ) and LN in the fibrotic rat livers weresignificantly increased as compared with those in the control group, and they were found to be mainlylocalized in the portal space, central veins and fibrous septa. Electron microscopic study showed that pro-collagens were present around the “activated” hepatic stellate cells (HSC) and the hepatocytes atrophied.CONCLUSION Pathological deposition of collagens (type Ⅰ, Ⅲ and Ⅶ ) and laminin was the fundamentallesion of liver fibrosis. HSC may be the major cellular source of collagens (type Ⅰ, Ⅲ and Ⅶ) and laminin inthe liver tissue.

AIM We introduce a new highly selective vagotomy (HSV) procedure which can completely destroy anyexisting variant vagal fibers innervating the proximal stomach.METHODS Twenty-eight dogs were divided into three groups: group A had retrograde liberated highlyselective vagotomy (RLHSV), group B had traditional HSV and group C as control group. Gastric acidsecretion function was tested and gastric parasympathetic and sympathetic enervation were studied byretrograde tracing the horseradish peroxidase (HRP) or by histochemical staining. After being convincedthat the modified procedure was an easier and more effective HSV on animal model, we applied thetechnique to the treatment of duodenal ulcers in 100 patients.RESULTS Significant decrease of acid secretion was found in operated dogs in both group A and B. After injection of HRP subserously into the fundus and body, no HRP positive cells were found in the vagal dorsalnucleus in group A and B but were in group C. When HRP was injected into the antrum, HRP stained cellswere found in dorsal nucleus in all three groups. The negative histochemical staining of AchE and the positivefluorescence in the fundus and body in group A and B indicate that parasympathetic nerve fibers weredestroyed completely while norepinephrinergic nerve fibers were intact. When the operation was applied topatients, no severe complications or operative mortality occurred. Patients were followed up for 6- 84months. They all had complete gastric emptying function. Ninety-four patients were graded as Visick I orⅡ. Six as Visick Ⅲ and Ⅳ. Eighty patients had been followed up with gastroscopy for two years afteroperation. Four patients had recurrent ulcers. Among them two patients were asymptomatic and the othertwo had symptoms and were treated with partial gastrectomy.CONCLUSION Compared to the classic HSV, our modified procedure is more effective clinically andconvenient technically.

AIM To examine hepatitis C in hepatocellular carcinoma in most endemic area, Guangxi, China.METHODS Immunochemistry was performed on formalin fixed, paraffin embedded tissue sections. A total202 specimens were analysed from the high, intermediate and low HCC prevalent regions of Guangxi.RESULTS The distribution of positive hepatitis C cases from high, intermediate and low regions wasrespectively 24/63 (38%), 23/62 (37%) and 30/77 (39%), with a total of 77/202 (38.12%).CONCLUSION Hepatitis C virus is an important risk factor in the development of hepatocellularcarcinoma, but the regional difference in prevalence of this cancer is more likely influenced by hepatitis Bviral infection and aflatoxin B1 exposure. In Guangxi, infection of hepatitis B and C virus in thedevelopment of hepatocellular carcinoma may be greatly enhanced by exposure to aflatoxin.

AIM To explore gallbladder circadian rhythm (GCR) and the cholagogic action of Yin Chen Hao Ta(YCHT).METHODS Ultrasonography of rabbit gallbladder at 17:00 to 19:00, 23:00 to 01:00, 05:00 to 07:00 m11:00 to 13:00 showed its maximum area (MA), dilatation rate (GDR) and systole rate. Its movemecircadian rhythm (MCR) and the effect of YCHT on gallbladder and the relationship with time weobserved and evaluated.RESULTS The results showed that gallbladder area changed with time, which varied from 11:00 to 13:1>23:00 to 01:00 and 05:00 to 07:00> 17:00 to 19:00 (P<0.01, F=9.13 vs. control by analysisvariance). The cholagogic action at 23:00 to 01:00 and 17:00 to 19:00 was better than that at 11:00 to 13:and 05:00 to 07:00.CONCLUSION The gallbladder movement action (GMA) showed markedly circadian rhythm. Tcholagogic action of YCHT at 23:00 to 01:00 and 17:00 to 19:00 is better.

AIM To study the clinical and pathological features of hypoplasia of exocrine pancreas with myocardialnecrosis.METHODS One ease of hypoplasia of exocrine pancreas with myocardial necrosis was autopsied. Theclinical signs and pathological changes were analyzed.RESULTS A 15-month-old boy with hypoplasia of exocrine pancreas was reported. The main clinicalfeatures were steatorrhea and marked underdevelopment. He died of acute heart failure afterhospitalization. Autopsy showed that there were aplasia of exocrine portion and fatty metaplasia ofpancreas, the myocardium revealed focal necrosis and sear formation.CONCLUSION Atrophy of exocrine pancreas and myocardial necrosis exist at the same time, suggestingthat there may be some relationship between them. It was likely that the damaged pancreatic tissue releasedsome active materials that may harm the myocardium or decrease pancreatic juice that results in lack ofnutrient and myocardial necrosis.

AIM To establish a relevant animal model of human gastrointestinal cancer, which can be used forrepetitive investigations and may improve our understanding of carcinogenesis and cancer metastasis.METHODS Intact tissue of human colorectal and pancreatic cancers was transplanted in nude mice. Thebiological characteristics of the original and corresponding transplanted tumors were investigated by HEstaining, PAS staining and immunostaining. The metastases in livers and lungs of the nude mice wereinvestigated by immunostaining with biotinylated mab KL-1 and by RT-PCR using CK20 specific primers.RESULTS Nine of 16 surgical specimens grew in the nude mice subcutaneously and/or orthotopically (4 of6 colorectal and 5 of 10 pancreatic cancer). Tumor cell content of the specimens and freezing of tissuespecimens are important factors influencing the growth of transplanted tumor. In the group of fresh tumortissues with greater than 50% tumor cell content, transplantation rate was 100% (3 cases of pancreatic cancerand 3 cases of colorectal cancer). The orthotopically transplanted tumors resembled the original tumormorphologically and biologically, including TAA expression such as CEA by immunohistochemistry, andCEA level in the serum of mice. Ki-67 labeling index and the expression of TAA especially K-ras, 17-1A and RA-96, were associated with the potential of tumor growth in nude mice. Micrometastases in the lungs andlivers of tumor bearing mice could be detected by immunostaining with biotinylated mab KL-1 and CK20-sepcific RT-PCR.CONCLUSION An orthotopic transplantation model for human colon and pancreatic cancer in nude micehas been established. The sensitive detection methods with CK-immunohistochemistry and CK20-RT-PCRwere also established to study xenotransplanted human cancer and its metastatic cancer cells in the liver andlung of nude mice. This study may be helpful in understanding the mechanism of cancer metastasis and indeveloping new diagnostic methods and therapeutic strategies for metastases.Acknowledgement The authors thank Dr. J. Luettges, Department of Pathology; Kiel University, for investigating thepathological characterics of the specimens; Dr. N. Zawazawa, Institute of Immunology, Kiel University, for the quantitativemeasurement of serum of CEA.

Acute diarrhoea may manifest as acute watery diarrhoea or dysentery. The key to the management of acutewatery diarrhoea is correction of dehydration, proper feeding and appropriate use of antibiotic in selectedcases. Correction of dehydration may be done by oral route by using oral rehydration salts solution (ORS)recornmended by WHO/UNICEF or by intravenous administration of fluid and electrolytes, the preferredsolution being Ringer＇s lactate. Antibiotic is required for severe cholera and shigellosis. Antiparasitic drugsare required for amoebiasis or giardiasis. Use of various antidiarrhoeals is strongly discouraged. Feedingduring diarrhoea is very important. It does not worsen diarrhoea rather hastens recovery and preventsmalnutrition. Supplementation of zinc as an adjunct to rehydration therapy has also been suggested.

AIM To observe the regulating effect of decoction shugan bushen (SGBS) on testosterone (Te) andadrenocortiotropin (ACTH).METHODS Fifty wistar male rats divided into four groups randomly, that is, normal group, hepaticfibrosis group, and two Chinese herb medicine treatment groups. The model of toxic hepatic fibrosis wasinduced by 0.5% dimethylnitrosamine (DMN). The decoction SGBS is composed of such herbs as bupleurumRoot. Dodder Seed, curcuma rood indianmulberry etc. According to the different doses of the drugs, ratsare divided into two groups in the treatment groups. The Chinese herb medicine treatment begins in a weekafter the second celiac injection of DMN, lastiong 8 weeks. The rats of normal group and hepatic fibrosisgroup are fed with distilled water once a day. After 11 weeks of Chinese herb medicine treatment, the Teand ACTH were tested insera of rats, and the livers were dissected for the pathology examination.RESULTS The results of pathology examination in rat livers of each group show that the hepatocytes of thenormal group have normal array, no degeneration and fibrosis. Those in the pathology group have obviousdegenerative necrosis and hepatic fibrosis, and in some cases show the evidence of cirrosis. The results intreatment groups are essentially similar to those of normal group. Variance analysis of least significantdifference (LSD) method is employed to compare the hormone level between groups. The serum levels of Teand ACTH in the normal group are 75.30±45.25 ng/dl and 141.02±68.70 ng/L. The levels in hepaticfibrosis group are obviously lower than those of normal group, as 19.77±16.92 ng/dl and 92.85±27.24ng/L, respectivite and with statistically different (P < 0.01 ). But that levels in the two treatment groups arerespectively 63.29±26.09 ng/dl 135.48±36.89 ng/L and 59.77±4.64 ng/dl, 130.8±17.35 ng/L, whichare obviously higher than those of pathology group and approximale to those of normal group (P>0.05).Two different doses make no obvious difference between the treatment groups (P>0.05).CONCLUSION SGBS can correct the hormone disturbance and shows the effect of anti-hepatic fibrosis.

AIM To investigate the effects of collagen solution on the prevention of acute gastric mucosal injury inrestricted rats inflicted by cooling in low temperature (4℃),METHODS Thirty healthy Wistar rats were randomly divided into normal (N, n = 10),injury (I, n = 10)and prevention (P, n = 10) groups. The rats were fasted for 48 h but free access to water without restrictionand cooling in normal group, fasted for 48 h but free access to water with restriction of rats onto the fixationframe for cooling in 4℃ for 4 h, so to cause stress injury of gastric mucosal membrane in I group and fed with3 mL of collagen solution 30min before injury in P group in addition to the procedures in I grobp. Gastricmucosal potential difference, blood flow volume, content of nitrite (NO2-) and hydrogen ion concentration(H+ ) in gastric juice were determined under aneasthesia at 48 h after fast in N group and at 4 h after injuryin I and P groups to evaluate the degree of injury (injury index).RESULTS Gastric mucosal potential difference was 22.10±5.27 in N group and 11.46±5.25 in I groupwith obvious difference (P<0.01), but 16.98±4.84 in P group which was remarkably improved whencompared to that in I group. Gastric mucosal blood flow volume was 23.65±10.65 in I group and 57.20±11.75 in N group with evident difference (P<0.01), but 37.49±5.87 in P group with sound effects incontrast to that in I group (P<0.01). Gastric injury index was 18.40±8.35 in I group and 7.9±2.13 in Pgroup with significant difference (P<0.01). Hydrogenion concentration in gastric juice was 118.0±41.2mmol/L in N group, 186.9±74.7 mmol/L in I group and 96.4±57.2 mmol/L in P group with prominentdifference (P< 0.01 ) between those in I and P group. Gastric mucosal nitrite concentration was 1.15±0.46in N group, 0.69±0.15 in I group and 1.04±0.44 in P group with obvious differences between N and Igroups (P<0.01) and between I and P group (P<0.01).CONCLUSION Ischemic and hypoxic injury of gastric mucosal due to low blood perfusion during restrictionand cooling injury at 4℃ was supposed to be an important factor in inducing gastric mucosal stress injury. Butcollagen solution could maintain the integrity of gastric mucosal barrier, buffer gastric acid, promotethrombocytic agglutination and ameliorate direct injury to gastric mucosa caused by various factors.

AIM To assess the relationship between HBV X-gene, X-gene product and Fas/ FasL which mediatehepatocellular apoptosis in patients with hepatocellular carcinoma.METHODS Tissue from 34 patients with hepatocellular carcinoma was tested for the expression of HBxAg.Quantitative ELISA assay was used to detect sFas; and sFasL and PCR were used to detect the HBV X-genein sera from 30 patients with hepatocellular carcinoma, 32 patients with liver cirrhosis and 20 normalcontrols.RESULTS The positive expression of HBxAg, Fas and FasL in carcinoma tissue was 97.06%, 85.29% and100%, respectively. The positive signal was mainly presented in the plasma, and all of these three positivestaining may appear in the same area. Redit analysis showed that there was no significant difference amongthese three positive staining (P >0.05). The mean levels of sFas in sera from hepatocellular carcinoma, livercirrhosis and normal controls were 722.97±321.12, 801.90±419.94 and 224.07±148.23, respectively,showing that sFas levels in patients with hepatocellular carcinoma and liver cirrhosis were significantlyelevated than that in normal controls (P < 0.0l). The mean levels of sFasL in sera from hepatocellularcarcinoma, liver cirrhosis and normal controls were 152.27±7.99, 162.97±12.40 and 154.99 ± 6.96,showing that sFasL level in patients with liver cirrhosis was significantly higher than that in patients withhepatocellular carcinoma and normal controls (P< 0.01). HBV X-gene was found to be positive in sera of30% patients with hepatocellular carcinoma; HBV X-gene was found to be positive in sera of 43.75% ofpatients with liver cirrhosis. There was no significant difference in sFas/sFasL level between HBV X-genepositive patients and HBV X-gene negative patients (P >0.05).CONCLUSION The expression of HBxAg and Fas/FasL in the tissue of hepatocellular carcinoma seemed tobe almost the same, but relation between cause and effect is unclear. The detection of sFas and sFasL inpatient sera may reflect the state of apoptosis mediated by Fas/FasL system. Our data showed that HBV X-gene expression in sera seemed to have no relation to sFas/sFasL level; however, these data also suggestedthat some patients with negative HBsAg in sera might have integrated HBV X-gene in liver tissues, andtherefore X-gene is detectable in those patient sera.

AIM To analyze the psychological characteristics of enterostomized patients, identify the effective methodsin order to improve the psychological rehabilitation of these patients and promote their quality of life.METHODS Questionnaires were filled up by 293 enterostomized patients pre- and post-operatively toidentify their psychological characteristics. One group (n = 45) of post-enterostomized patients were taughtto take care of stoma by irrigation, the others (n = 248) to merely look after the colostomy bag.RESULTS The psychological characteristics were identified as disbelief, fear, desperation or anxiety pre-operatively; as unstable mood, irritable, afraid, sense of lost body image or depression post-operatively; aslow self-esteem, self isolation, or despondent in rehabilitative period respectively. Results revealed that thepatients need psychological support both pre-operatively and post-operatively. Meanwhile, proper stoma careis of the same importance. After irrigation 1 -3 months regularly, most of the 45 regular irrigating patientswere free from skin irritation problems; 40(89%) patients had daily or bidaily motions; and most of themshowed an absence of fecal leakage or gases, and they hardly suffer from bad odors. Some of them even onlypartially use the colostomy bag. These patients were more confident to reinstate to their previous daily life.Only 5 (11%) patients had irregular bowel movements. Enterostomized patient club and out-patientconsultation clinic are beneficial to improve their psychological rehabilitation.CONCLUSION Careful pre-operative psychological support can help patient's post-operative adoption. Thepsychological rehabilitation of the patients can speed their physical recovery. Proper stoma care and earlyreinstatement into previous social life are also important to improve the patients' rehabilitation.

AIM To study the safety and the traumatic degree of D4 approach by retrospective analysis of the para-operative data from the para-aortic lymph nodes excision in comparison with those from standard radicalresection in advanced gastric cancer (AGC).METHODS Several para-operative data including the resectability, the mortality, the complicatedmorbidity, the amount of transfused blood, and the hospitalized days relating to the operation were analyzedstatistically between D4(n = 30) and D2 lymph nodes excision (n = 34) groups. The data expressed as means±SD was analyzed statistically by Student t test. Percentage of the data was analyzed by x2 test statistically.It was taken as significant difference if P value was less than 0.05.RESULTS The percentage of palliated resection in D4 group was significantly lower than that in D2 group(16.67% vs 47.06%, P<0.05). This D4 radical resection would indeed prolong the drainage time (7.35±0.98 days vs 14.78±2.16 days, P < 0.01). The amount of transfused blood during operation (774.32±112.09mL) and the operative consuming time in D4 group (7.14±0.39h) increased significantly toocompared with those in D2 group (538.67±59.87mL, P < 0.05; 4.12±0.18h, P < 0.05), suggesting that thedraumatic degree of D4 operation was severer than that of D2 operation. But the mortality, the morbidity ofcomplication and the hospitalized time after D4 operation did not increase significantly, indicating that D4lymph nodes excision as a choice of the surgical treatment of AGC was safe and feasible.CONCLUSION D4 lymph nodes excision for AGC is safe, reasonable and feasible.

AIM To prepare 5-fluorouracil solid lipid nanoparticles (5-FuE-SLN) with liver targeting.METHODS 5-Fu was employed as model drug to acylate with stearyl chloride and obtain 5-Fu precurser N1-stearyl-5-Fu (5-FuE). The precurser was determined by nuclear magnetic resonance and infraredspectrometry and used to prepare 5-FuE-SLN by the method of physical agglomeration. TransmissionElectron Microscopy (TEM) was employed to study the shape, mean size and particle distribution of 5-FuE-SLN. The drug loading, and releasing characteristics in vitro, the drug distribution and pharmacokinetics invivo were also investigated by HPLC method.RESULTS The average diameter was 240.19nm, and the drug loading was 20.53%. The releasingcharacteristics in vitro was fitted to first-order pharmacokinetic model. The distribution of 5-FuE-SLN inmice showed that 5-FuE-SLN had significant liver targeting being compared with 5-Fu injection. Theconcentration of 5-FuE-SLN group in mice liver was double over that of control group. The mainpharmacokinetics parameters in rabbits were as follows: Vc = 0.04336 L·kg-1, T1/2β- 1.2834 h, CL =0.1632 L·h-1CONCLUSION 5-FuE-SLN has the characteristic of liver targeting. Using 5-Fu precurser to enhance itsliposoluble properties and the method of preparation presented in this paper seems to have significantadvantages and important reference value.

AIM To study the physico-chemical properties of biliary calculus and the relationship between the calculusformation and the phase change of liquid crystal, providing the best evidence for the biliary calculusprevention and treatment.METHODS The cholesterol contents in thirty one cases of biliary calculus in Kunming were determined bydouble-wave-length TLC scanning with high efficiency silica gel films.RESULTS Under magnifiers, the granular biliary calculus from 31 patients were classified according totheir section structures and colours, as cholesterol cholelith, 25 cases; bilirubin cholelith, 4 cases andcompound cholelith, 2 cases. By TLC scanning, it was found that the content of cholesterol in human biliarycalculus was 71%- 100%, about 80% cholesterol bilestones whose cholesterol content was more than 90%being pure cholesterol bilestones.CONCLUSION Cholesterol bilestone is the main human biliary calculus in Kunming, which was inaccordance with X-ray analysis. Compared with the related reports, it is proved that the proportion ofcholesterol bilestones to biliary calculus is increasing because of the improved life standard and the decreaseof bilirubin bilestones resulted from bile duct ascariasis or bacteria infection in China since 90s, and that theincrease of cholesterol in-take leads to the increase of cholesterol metabolism disorder

AIM To investigate the protective effects and mechanism of Diltiazem (Dil) on liver, pancreas and smallintestine in hemorrhagic-shock canine.METHODS The canines were bled to a mean arterial pressure (MAP) of 5.33kPa-6.67kPa for 30min toestablish the shock model. During the shock state, the dogs received either water-soluble calcium blocker Dilor saline solution. The MAP was kept at this level for 90min, then the total blood which was bled previouslywas reperfused. The total observation time of the experiment was 240min.RESULTS Dil could significantly increase MAP from 150min to 240min (P<0.01) and the activity ofsuperoxide dismutase (SOD) of pancreas tissue (P<0.01), and it could also decrease the content ofmalondialdehyde (MDA) in liver, pancreas and small intestine tissues (P< 0.01) and the activity of SOD ofthe liver and small intestinal tissues (P<0.01) in the canines. Electron microscopic data indicated that theultrastructures of liver, pancreas and small intestine tissues were normal in Dil group.CONCLUSION Dil can protect the structure and function of the liver, pancreas and small intestinal inhemorrhagic-shock canine.

AIM To observe the effect of repair of intrathoracic esophageal perforation with gastric seromuscularpatch.METHODS Twelve patients with intrathoracic esophageal perforation, none of whom were associated withcarcinoma, underwent primary repair with a gastric seromuscular patch and omental pedicle flap between1996 and 1999. Four perforations were iatrogenic and 8 were spontaneous. The interval from perforation tooperation was less than 12 hours in 4 patients, 12 to 24 hours in 3, and more than 24 hours in 5. The principleof repair included: ① To expose health mucosa and submucosa for the primary repair. The leading edge ofthe mucosa is grasped and the adjacent esophageal muscle is mobilized away from the submucosa until there isa 3 to 7 mm circumferential rim of normal submucosa. ② The gastric seromucular patch and omental pedicleflap require continuity of the right gastric piple, omental vessels and the rami. ③ To assure the blood flow ofthe esophagus when the necrotic mediastinal and esophageal tissue are debrided, the normal esophageal tissueoften extends well beyond the 3/4 diameter of the esophagus. ④ The mediastinal pleural is not closed inorder to drain. The catchers nasogastric tube decompression of the stomach is continued until thepostoperative ileus resolves.RESULTS Eleven of the 12 patients underwent primary repair, one patient had leak at the site of repairand died.CONCLUSION Meticulous repair of an intrathoracic esophageal perforation using a gastric seromuscularpatch is the preferred approach regardless of the duration of the injury.

AIM To study the liver-protecting and fibrosis-resisting effect of Ganxianning (GXN) and its mechanism.METHODS Model of carbon tetrachloride hepatic injury fibrosis rats was reproduced. In the experimentthere were six groups, the treatment groups with GXN's large, moderate and small dose (GXNb, GXNm andGXNs), the treatment group with colchicine, the blank model group and normal control group. The course of treatment was 30 days, then the rats were killed with their blood and liver tested.RESULTS In treatment groups, alanine aminotransferase (ALT) was lower than that in the model group(P<0.01), and albumin (Alb) higher than that in the model (P<0.01). Hydroxylproline (Hyp) and redcell membrane C3B receptor garland in GXNb's and GXNm's groups were lower and circulation complex(CIC) was slightly higher. Fibrinogen (Fb) in both colchicine and model groups was higher than that innormal group and the difference was significant (P<0.05, P<0.01). Compared with model group, acid-α-naphthyl acetate esterase (ANAE) increased in GXNb's and GXNm's groups (P<0.05, P<0.01). Underlight and electron microscopes, level of hepatic fibrosis of GXN groups was much lower than that of themodel group, P<0.01, and their difference was very significant. In GXNms group, liver cell was normal onthe whole and its chromatin was more than the model group and its nucleolus was evident.CONCLUSION GXN has rather good functions of protecting liver and resisting fibrosis, and thesefunctions are related to the increase of ANAE and C3b, decrease of CIC and Fb. and improvement of bodyimmunity function.

AIM To investigate DNA methylation status in gastric cancer and its relationship with folate metabolism.METHODS Serum before operation, the gastric mucosa from the lesion, and the surrounding area inpatients with gastric cancer and the remote normal-appearing mucosa of the resected stomach were collectedrespectively. The serum folate, mucosal tissue folate, S-adenosylmethionine ( SAM ), S-adenosylhomocysteine (SAH), and the DNA methylation levels were determined.RESULTS The tissue folate was significantly lower than that in ulcers, especially in the surrounding andnormal mucosa (0.38±0.13, 0.50±0.17 vs 0.53±0.50, 0.79±0.82ng/mg protein, P < 0.01), and itdecreased gradually in the lesion areas. The DNA methylation status showed similar decreasing trend incancers compared with the methylation increasing trend in ulcers. The SAM level ascended in the lesion areaswith a higher. concentration in cancer mueosa (63.5±43.0 vs 25.9±11.9nmol/g tissue, P < 0.01 ). Theaccumulation of SAH in the surrounding and normal mucosa of cancers was observed (17.3±24.6, 15.5±8.6vs 14.6±4.2, 10.0±1.9nmol/g tissue, P < 0.05 - 0.01). There were significantly negative correlationsbetween tissue folate and the SAM and SAH levels in the three areas.CONCLUSION Patients with gastric cancer have the regional folate deficiency in the stomach mucosa,although the serum folate level remains normal. This disturbs the local SAM and SAH metabolism withaccumulation of SAH and DNA hypomethylation which has been known as an important molecularmechanism for carcinogenesis. Folic acid can modulate DNA methylation status by its effect in one-carbongroup metabolism and thus affect the process of the carcinogenesis. Therefore, this may be an access for theprevention of gastric cancer.

AIM To understand the relationship between levels of endotoxin and cytokines in serum and to clarify thecause of cytokines change in liver diseases.METHODS Serum endotoxin level was determined by quantitative limulus amebocyte lysate chromogenicassay in 89 cases of acute and chronic liver diseases. Cytokines (TNF-a, IL-2, IL-6, IL-8, G-CSF) wereassayed by ELISA. Patients were divided into two groups based on oral administration of lactulose or not.Mean concentration of endotoxin and cytokines was compared before and 20 days after lactulose treatment.RESULTS The highest serum level of endotoxin was found in patients with cirrhosis (69.3±23.6pg/mL)and the lowest in patients with chronic hepatitis (28.4±7.9pg/mL), the moderate in patients with acutehepatitis (44.6±14.3pg/mL) (P<0.01). Serum levels of TNF-a, IL-2, IL-6, IL-8, G-CSF were higher inpatients with acute hepatitis than those with chronic hepatitis (P<0.05). No difference was noted betweenchronic hepatitis and cirrhosis (P >0.05). In all cases, serum levels of endotoxin were positively correlatedwith the concentration of TNF-a (r=0.555, P<0.05), IL-6 (r=0.531, P<0.01), IL-8 (r=0.440,P<0.05) and G-CSF (r =0.440, P<0.05), but not with IL-2 (r =0.10l, P<0.05). The decrease of serumlevels of endotoxin was greater in patients taking lactulose than controls (25.6±14.4pg/mL, n = 49 cases vs.10.9±9.Spg/mL, n = 40 cases, P < 0.01), the recovery from endotoxemia was higher in group withlactulose treatment than in controls (94.7%, n = 19 vs 36.4%, n = 22, P < 0.01 ). The decrease ofendotoxin resulted in decreases of TNF-a, IL-6, IL-8, G-CSF, ALT, AST and TB.CONCLUSION Endotoxemia is common in liver diseases, which could induce production and release ofcytokine from monocytes and macrophages and has harmful effects on hepatocytes. Treatment with lactulosecould decrease serum levels of endotoxin and cytokines, suggesting that lactulose could protect liver cells frominjury by reducing the absorption of endotoxin in intestine.

AIM To evaluate the expression of CD44v3 and v6 protein in colorectal carcinoma and its prognosticsignificance.METHODS One hundred and twenty-one cases of formalin-fixed paraffin-embedded colorectal carcinomaspecimens were retrospectively analyzed using EnvisionTM immunohistochemical method with the monoclonalantibody CD44v3 and v6. The median follow-up time was 67.77 months and the prognostic value of theCD44v3 and CD44v6 was assessed using univariate and multivariate survival analysis.RESULTS The positive rates of CD44v3 and v6 protein were 60.3% and 57.9%, respectively. There wassignificant correlation between CD44v3 immunoreactivity and tumor location, lymph node metastasis, distantmetastasis and Duke's stage (P< 0.05, Spearman correlation test). Significant correlation between CD44v6immunoreactivity and patients' gender, lymph node metastasis, distant metastasis, Duke's stage was alsonoticed (P < 0.05, Spearman correlation test). The 5-year survival rates were 81.25% and 60.27% inCD44v3 negative and positive cases, respectively. As CD44v6, the 5-year survival rates were 80.39% and60.00% in CD44v6 negative and positive cases, respectively; these differences between the two groups ofpatients were significant (P<0.05, Log-rank test). In multivariate analysis using the Cox regression model,CD44v3 expression emerges as an independent prognostic indicator.CONCLUSION CD44v3 and v6 might play some important roles in metastasis of colorectal carcinoma, andCD44v3 expression might be a new useful independent prognostic marker of colorectal carcinoma.

AIM To investigate the role of sphincter of Boyden in bile excretion and its regulating factors.METHODS Perfusion manometry, choledocho-cineradiography, reaction of the sphincter of Boyden toendogenous cholecystokinin (CCK) and immunohistochemical quantitative analysis were performed in 16dogs to study the motility and morphology of the sphincter of Boyden in experimental (postcholecystectomy)group ( n = 8) and the control group (n = 8).RESULTS The bile duct surrounded by SB was a low-pressure lumen (10.0 ± 2.0 mmHg), in which thepressure was significantly different (P<0.01, t = 6. 195) from the basal pressure of the high-pressure area ofsphincter of Oddi (SO), its basal pressure (SOBP) was 16.9±0.5 mmHg. The SB was an enlarged ampulladuring bile excretion interval, and showed active contraction during bile excretion. Intrinsic CCK could causediastole of SO, but does not affect the systole and diastole of SB. After cholecystectomy, spastic contractionpersisted in SB, which could not be relieved by intrinsic CCK. The sensitivity to CCK of SO was decreased,and the evacuation time of media prolonged (27.0±3.4 min vs precholecystectomy 17.l±0.9min P<0.01,t =7.961). In immunohistochemistry analysis, the contents of a-actin, myosin in the SB of experimentalgroup showed no increase. Under electronic microscope, the main changes were 3D structuraldisarrangement of the cell framework, distortion of the microfilaments, swelling and aggregation ofmitochondria at the nuclear side.CONCLUSION The excretion of bile can be divided into two types, physiological bile excretion with a drivemainly caused by the contraction of SB, and the other, functional bile excretion with a drive mainly causedby the contraction of gallbladder. It seems that the function of SB was controlled by vagus, whereas SO wasmore sensitive to the intrinsic CCK, The intact gallbladder is an elemental factor of functional coordinationof SB and SO.

AIM To establish a model system for studying gastric carcinogenesis of MNNG, a gastric cancer relatedcarcinogen.METHODS Cell culture transformation, PCR-restriction fragment length polymorphism (PCR-RFLP),DNA blotting and immunochemical techniques and analysis of LDH isozyme and chromosome wereperformed.RESULTS GES-1 cells surviving by MNNG treatment were named MC (2 × 105M for 24 hours) and MC-B(2 × 10-7M for 7 days). The two cell lines treated by MNNG showed more malignant than maternal cell GES-1 with the evidences of more chromosome aberrations, abnormal morphology and eytoskeleton and alsogained the ability of colony formation on soft agar. C-Ha-ras gene point mutation in the 12th codon and LDHisoenzyme abnormal express were found in MC-B cells. In addition, C-met gene rearrangement was revealedby Southern blot analysis in MC-B and MC.CONCLUSION This gastric epithelial cell system is an important model system for further study of stomachcancer, MNNG had a selective effect on the cytoskeleton mierofilament in human gastric epithelial cells andintimately associated with the activation of certain oncogenes and some protein.

AIM The control of diet regimen and nutrient intake, aiming to avoid the evaggerated levels of glucose andanabolic hormone is broadly accepted as basic treatment of diabetes mellitus. Maltose is an importanthydrolysate of starch, main source of nutrition. Acarbose is an alpha-D-glucosidase inhibitor but with a shortinhibitory duration. Gymnemic acid (GA), a group of triterpene glucuronides, inhibits glucose absorptionwith a longer effective duration but it needs a longer time to achieve its maximum effect. To determinewhether nutrient control in diabetic care can be improved by combination of them, we compared thecombinative and individual effect of acarbose and GA on maltose absorption and hydrolysis in smallintestine.METHODS The absorption and hydrolysis of maltose were studied by re-cyclic perfusion of intestinal loopsin situ and motility of the intestine was recorded with the intestinal loop in vitro, of Wistar rat.RESULTS The total inhibitory rate of maltose absorption was improved by the combination of GA (0.1 -1.0 mg/mL) and acarbose (0.1- 2.0 mmol/L) throughout their effective duration (P<0.05, U test ofMann-Whitney), although the improvement only could be seen in the low dosages during the first hour. Withthe combination, inhibitory duration of acarbose on maltose absorption was prolonged to 3 hours and theonset of GA inhibitory effect was fastened to 15 minutes. GAsuppressed the intestinal mobility with a goodcorrelation (r = 0.98) to the inhibitory effect of GA on maltose absorption and the inhibitory effect of2 mmol/L (higher dose) acarbose on maltose hydrolysis was dual modulated by 1 mg/mL GA in vivoindicating that the combined effects involved the functional alteration of intestinal barriers.CONCLUSION There are augmented effects of acarbose and GA, which involve pre-cellular andparacellular barriers. Furthermore, diabetic care can be improved by employing this combination.

AIM We have discovered that Limonene modulates interdigestive myoelectrical complexes (IMCs) ofgastrointestinal tract in rats. In this research we will elucidate weather limonene affects acetylcholine M-receptor in caudate nucleus.METHODS Changes of IMCs were studied after limonene and/or atropine were microinjected into caudatenucleus. IMCs were recorded by a RM-6200 four-channel recorder and then delivered to Maclab and PowerMacintosh.RESULTS The active phases of IMCs occupied about 40% of total cycle in average. After microinjection oflimonene into caudate nucleus, the active phases were significantly shortened, while the cycle time of IMCswere not changed significantly. The inhibitory effects of limonene were abolished by pretreatment withatropine, whilst the atropine has no effect on IMCs.CONCLUSION It is suggested that limonene inhabits the gastrointestinal IMCs by affecting M-receptor incaudate nucleus.

AIM To study the effect of a wide range of concentration of arsenic trioxide on human hepatoma cell lineBEL-7402 and its mechanism.METHODS The BEL-7402 cells were treated with arsenic trioxide (a final concentration of 0.5, 1 and2 μmol/L, respectively) in various durations or for 4 successive days. The cell growth and proliferation wereobserved by cell counting and cell-growth curve. Morphologic changes were studied under electronmicroscopy. Flow cytometry was used to assay cell-DNA distribution and the protein expression of Bcl-2 andBax was detected by immunocytochemical method.RESULTS The cell growth was significantly inhibited by the different concentrations of arsenic trioxide asrevealed by cell counting and cell-growth curve. Arsenic trioxide treatment at 0.5, 1 and 2 μmol/L, resultedin a sub-G1 cell peak. The decreased G0/G1 phase cell and the increased percentage of S phase cell were observed by flow cytometer, suggesting that the inhibiting effect of arsernic trioxide on BEL-7402 cell lay inG0/G1 phase cell. Apoptotis-related morphology, such as intact cell membrane, nucleic condensation,apoptotic body formation, can be seen under the electron microscopy. High protein expression level of Bcl-2and Bax was detected in 1 and 2 μmol/L arsenic trioxide-treated cells, but that of Bax was more significant.Arsenic trioxide treatment at 0.5 μmol/L resulted in higher expression level of Bcl-2 and lower expressionlevel of Bax compared with control (P1<0.01, P2<0.01).CONCLUSION Arsenic trioxide not only inhibited the proliferation but also induced apoptosis of humanhepatoma cell line BEL-7402. The induced-apoptosis effect of 1 and 2 μmol/L arsenic trioxide was relative tothe expression level of Bcl-2 and Bax.

AIM To observe the therapeutic effect of weile jiaonang (WLJN) for peptic ulcer (PU) and its toxicity toanimals, and to find out the nontoxic Chinese medicines in replacing those chemical medicines with sideeffect.METHODS Five hundred and forty patients with PU were divided into three groups, therapeutic group byWLJN, control group taking famotidine and combined group with WLJN and famotidine. One hundred andeighty patients in each group were studied. The diagnosis of 540 patients with PU is in accordance with thebasis provided by the National Scientific Congress of Digestive System Disease convened in Hangzhou, 1978.The study followed the criterion provided by this Congress.RESULTS Total effective rate in therapeutic group was 93.3%, and 93.3% in control group. Combinedgroup achieved a total effective rate of 100%. For all three groups, there was no significant differencestatistically, but the control group appeared obvious side effects. The result of acute toxic experiments onwhite mice showed that there no death and toxic side effect even the highest dosage was given, which wasequivalant to 120 times to the dosage of patients. The result of chronic toxic experiment showed there was noobvious pathologic change in three dosed groups. The tails of mice in dosed groups were more smooth delicateand cleaner than those in control group.CONCLUSION Through observation in clinic and exprimental animal, it is proved that weilejiaonang isparticularly effective and safe Chinese patent drug against PU.

AIM To observe the therapeutic effect of colloidal bismuth tartrate in an animal colitis model.METHODS Immune-complex colitis was induced in groups of rabbits by formalin, and two hours later0.85 mL heat-aggregated rabbit IgG was given intravenously through the ear cannula. Animals wereintracolonically treated with colloidal bismuth tartrate (BITNAL), and its effect was compared withsulfasalazine (SASP), indomethacin (IND) and bifidobiogen (BIFG). Animals were killed, the mucosalappearance was scored (0-4), and tissue saved for histological studies, the number of neutrophils present ininflamed colonic tissue was quantitated by the myeloperoxidase (MPO) activity assay, the production oflipoxygenase and cyclo-oxygenase products was monitored and eicosanoid production were assayed byincubation colonic specimens and the media for prostaglandin E2(PGE2), leukotriene (LTB4), thromboxaneB2(TXPe) were examined by radiommunoassay.RESULTS Immune-complex colitis was induced by formalin and IgG, colonic damage persisted for at least1 wk by macrography. Histologically, the inflammatory response included mucosal and submucosalinfiltration by polymorphonuclear leukocytes, macrophages, lymphocytes and fibroblasts, the macroscopic,persent 2 wk after IgG, was correlated with greatly increased PGE2, LTB4 and TXB2 compared with levels incontrols. Treatment with BITNAL (500 mg/kg) resulted in a lowered inflammation index, lowered MPOactivity and inhibited the increased formation of PGF-2, LTB4 and TXB2 by the inflamed colon, and IND(500 mg/kg) markedly inhibited prostanoid formation in both inflamed and control colon but did not reducetissue damage, SASP (500 mg/kg) also inhibited the formation of PGE2, LTB4 and TXB2 but the effectswere less marked. BIFG (400 mg/kg) did not significantly reduce the colonic injury and the media sythesizedby the rabbit colon.CONCLUSION BITAL provides better therapeutic effects in experimental colitis than anti-inflammatorydrug IND or SASP.

AIM To provide evidence that UBT is the most cost-effective tool for evaluation of H. pylori eradication.METHODS Data on twenty-six consecutive patients at Atlanta VA Hospital who underwent UBT wereretrospectively reviewed. All patients had endoscopic diagnosis of peptic ulcers and biopsy proven H. pyloriinfection. Eight to ten weeks after completion of triple therapy (amoxicillin, biaxin and prilosec), allpatients had C14 UBT (PY test kit, Charlottesville, Virginia). Ten patients had repeated endoscopicexaminations and gastric biopsies. Twelve patients had serology tests for H. pylori.RESULTS UBT was negative in all patients (two patients had indeterminate result on the first time, butshown to be negative on the second UBT). Biopsies from all ten patients who were re-endoscoped werenegative for H. pylori. Serology tests on all the twelve patients were positive. Cure of H. Pylori could notbe determined on the titer change. All patients spent about 30 minutes in nuclear medicine laboratory, theendoscopic patients spent 2 hours to 4 hours in endoscopic laboratory; the cost for a UBT was about 50, thecost for an endoscopy with biopsy was above 200.CONCLUSION The 04 UBT is a rapid, economic and accurate test to monitor H. pylori eradication. Thetest should be considered a gold standard test for evaluating the effectiveness of treatment of H. pyloriinfection, unless patients need repeated endoscopy to rule out gastric cancer.

AIM To explore the method to prolong the survival of patients with postoperative rectal cancer and toprevent its recurrence.METHODS To analyze the reasons of recurrence after curative resections for rectal cancer of 399 patients.RESULTS Ninety out of 399 patients who received curative excision died of relapse of the tumor. Pelvicrecurrence was found in most of the patients followed by liver and pulmonany metastasis. The survival timein Dukes A was the longest and in Dukes C the shortest. The survival period was 12 months longer, in thepatients receiving pre-operative radiotherapy than that did not. Inadequate excision of the primary tumor orthe draining lymph nodes was the main cause for local recurrence.CONCLUSION Adequate surgery and adjuvant therapy are the most effective methods to prolong thesurvival of patients with postoperative rectal cancer and to prevent its recurrence.

In the western world a sharp rise in the incidence of inflammatory bowel disease (IBD) has been observedsince the early 1950s. The increase in the incidence of ulcerative colitis preceded the increase in the incidenceof Crohn's disease by about 10 - 15 years. In high incidence areas, a female preponderance at a young age isobserved in Crohn's disease, whereas in ulcerative colitis male incidence is still high at older ages. IBD ismore common in the western world than in eastern areas and, in both the United States and Europe, a north-south gradient has been reported, with IBD more common in the north than in the south. There are alsoindications that in typically low-incidence areas, more cases are being seen lately. Rates for Japan suggestthat this Asian population is now affected with approximately equal frequency as western populations withregard to ulcerative colitis; Crohn's disease in contrast is still less common. The prevalence of Crohn'sdisease in the Chinese populations in Hong Kong and Singapore appears to be increasing, and more cases havealso been observed lately in central China. This could be due to a greater awareness and better availability ofhealth care and/or improved study methods. However, it may also be a real increase, reflecting changingenvironmental factors. Both genetic factors and environment are thought tO be important in developing IBD,the observed increase during the past decennia is probably due to environmental factors since genetic make-upcannot change that quickly. Smoking is the only consistent risk factor in case-control studies, but does notseem to explain the observed changes in incidence and age and gender distribution in the two diseases,nutrition and life-style factors changed to a great extent during the period in which the rising incidence ofIBD has been reported. Following the temporal trends in these areas and using case-control settings in apopulation based manner during the coming years should prove to be of great interest, as this might shedsome light on the role of environmental factors in the etiology of IBD.

AIM To investigate the therapeutic effect of TNF gene transfected LAK cells on ascitic liver carcinoma-bearing mice.METHODS TNF gene was transfected into murine LAK cells by retrovirus. Low dose TNF gene-transfectcdLAK cells and IL-2 were i.p. injected into murine model. Cytotoxicity of gene transfected LAK cells wasstudied in vitro growth and the survival time of murine model was observed.RESULTS TNF gene-transfected LAK cells secreted higher level of TNF than that of normal LAK cells orcontrol gene-transfected LAK ceils. The in vitro growth ability and cytotoxicity of TNF gene-transfectedLAK cells were markedly inhibited by anti-TNF monoclonal antibodies. Significant therapeutic effect onascitic liver carcinoma-bearing mice was achieved.CONCLUSION TNF gene-transfected LAK cells have therapeutic effect on ascitic liver carcinoma-bearingmice.

AIM To study the antitumor effect of Zhenhuang Injection (ZHI) on the mice bearing transplanted tumor.METHODS The solid type of H22 transplantation hepotocarcinoma, ascitic type of S-180 sarcoma and ascitictype of LⅡ malignant lymphoma of mice were treated at three doses (crude drug 1.25g/kg, 2.5g/kg,5.0 g/kg of body weight) of ZH1. The solid tumor group and ascitic tumor group were injected intravenously.and intraperitoneally. The experiment was repeated three times.RESULTS The tumor-inhibition rate of H22 hepatocarcinoma in moderate and large doses was 30.23% -35.67% (P<0.01) and 46.36%-54.07% (P<0.01) respectively; the survival rate of ascitic type of S-180sarcoma and ascitic type of LⅡ malignant lymphoma in large dose group was 77.23% - 86.91% (P<0.01)and 75.42%-79.04% (P<0.01), respectively.CONCLUSION ZHI has a certain tumor-inhibiting effect. Under the tolerant dose, the effect improveswith the increase of dose.

AIM The incision in rectal cancer operation is adopted commonly in the left mid-lower abdomen. But thereare some defects for the incision, which is close to the artificial colotomy, readily be contaminated by feces,difficult to treat the lesions in hepatic and cholecystic area at the same time and in the weakened area ofabdominal wall. So, we employed the abdominal right lower paramedian incision to solve these problems.METHODS The abdominal right lower paramedian incision is from publc tubercle upward to 3 cm- 4 cmabove navel. The incision should be extended upward if individual need of performing hepatic and cholecysticoperation, or placing catheter or pump in hepatic artery or portal vein for chemotherapy at the same time.RESULTS One hundred and eighty three cases with rectal cancer were adopted this incision in differentoperation procedure, and out of them 41 patients were taken different operation on hepatic and cholecysticlesions and place a catheter or pump to hepatic artery or portal vein. Operators feel that the incision dose nothinder exploring and operating in all of the patients.CONCLUSION The right lower paramedian incision of abdomen is far away from the artificial colotomy,and it can reduce the feces contamination, lower down the rate of incision hernia and paramedian hernia orfistula. Furthermore, it is easy to treat the complicated hepatic and cholecystic lesion. So, authors suggestthat this incision is useful for the operation of rectal cancer, and it is worth to populize in clinical practice.

AIM To incorporate p12 in a plasmid under the control of the CMV promotor and test for the ability of theconstruct to produce specific immune responses in DNA-immunized mice.METHODS A His-tag fusion of the protein p12, was expressed in the prokaryotic expression vector (pQE)and the recombinant protein purified using nickel-chelate chromatography. His-tagged p12 was sub-clonedinto the pBK-CMV vector for expression in eukaryotic systems. Groups of six female balb/c mice werevaccinated with either 50μg im of the DNA pBK-CMV-p12 or pBK-CMV vector alone at week 0, andboosted at 2 and 4 weeks. ELISPOT assays (detection of p12 T-cell dependant IF-γ release) on mouse spleniccells were used to measure cell mediated immune responses and anti-mouse IgG ELISAs to detect antibodyresponse.RESULTS Significant CMI and humoral immune responses to recombinant p12 were detected in micevaccinated with pBK-CMV-p12 vector compared to mice vaccinated with pBK-CMV vector alone. The miceremained well throughout the development of immunity to p12.CONCLUSION A DNA vaccine coding for a specific MAP protein will stimulate humoral and cell mediatedimmune responses in mice.

AIM To investigate the epidemiological features of HCV prevalence, a seroepidemiological survey on HCVinfection has been carried out in Fujian since 1992.METHODS Using stratified multistage random cluster sampling, 3809 serum samples collected from 1237families in the diseases surveillance points were tested by UBI HCV EIA kit.RESULTS The results showed that the prevalence rate was 3.99%. The rate in male and female was3.63% and 4.25%, and in urban and rural 3.12% and 4.6% respectively (P>0.05). There was lower ratein children aged under 10 years. The highest rate was in 20 - 24 years old. The rates in different areas wereranged from 1.39% to 6.08% (P<0.05). The intrafamilial transmission was not important, indicating nointrafamilial aggregation. The superinfection of HCV with HAV, HBV and HEV were existed. The HCVinfection was slightly correlated with the history of hepatitis and transfusion.CONCLUSION It suggests that the HCV transmission among the population in Fujian is mainly sporadicinfection.

AIM To study the expression of telomerase activity in malignant esophageal neoplasms and normal humanesophageal epithelia.METHODS Telomerase activity was assayed by the telomere repeat amplification protocol (TRAP)method. All the neoplasms and epithelia of esophagus were confirmed by routine pathological diagnosis.RESULTS Telomerase activity was assayed in 18 normal esophageal epithelial tissues and in 35 malignantneoplasms of esophagus, including 27 cases of esophageal carcinoma and 8 cases of cardiac carcinoma.Telomerase activity was detected in most of malignant neoplasms of esophagus (91.4%, 32/35) and in allthe normal esophageal epithelial tissues except one (18/19).CONCLUSION The results suggest that in addition to contributing to proliferation of immortal blast cellsand neoplastic cells, telomerase activity may also play a similar role in regeneration of normal epithelia ofhuman esophagus. The potential use of telomerase activity as a diagnostic marker in human esophagealneoplasm might not be suitable.

AIM To study the development of D (somatostatin-secreting) and P (bombesin-secreting) cells ofproventriculus from Shao ducks at different ages.METHODS Ninety Shao ducks were divided into nine groups, 10 ducks per group. The ducks were slayedgroupby group at the nine time points of week 0 (after hatching), 1, 2, 4, 6, 10, 14, 18 and 22.Proventriculus samples from each duck were collected, fixed by Bouin solution and embedded with paraffin.gections were made and stained with an avidin-biotin-peroxidase complex kit (Dako Co., Ltd. ) to visualizeD and P cells of each proventriculus. Thirty glandular lobes per duck were observed for enumeration of Dand P cells.RESULTS ① Both D and P cells were mostly oval or polygonal shape with dumpy cytoplasmic processesand located in the inner and central area of the glandular lobe. ② The D and P cells peaked at wk 18 and 6respectively. ③ There was no apparent correlation between D cells and the body weight until wk 4. Negativecorrelation was observed from wk 6 and reached a marked level at 18wk (r = -0.829, P<0.05).Individuals with maximum body weight had less D cells than those with minimum body weight from wk 10-wk 18.CONCLUSION The morphology and distribution of D and P cells in the proventriculus of Shao ducks weresimilar to Peking ducks, gooses and chickens. Both D and P cells had continuing development during thepostnatal period, though the rates of their development were different. If appeared that beyond a definitenumber of D cells, they were negatively correlated with the body weight.

AIM To study the effects of ATRA on experimental liver metastasis of gastric cancer cells.METHODS MGc80-3 and SGC-7901 cells were injectied into spleen subcapsule of nude mice, who weresubsequently administrated with ATRA every other day. Food-intake and body weight of mice were measuredweekly. After six weeks, the nude mice were executed, tumors in spleen and liver were examinedpathologically, microtumor vessel density (MVD) was accounted by immunohistochemical method and serumCEA was measured by radioimmunoassay.RESULTS Nude mice administrated with ATRA, the growth of spleen tumor and its metastatic ability toliver were inhibited, the metastatic rate was decreased by 33.3% (MGc80-3) and 50.0% (SGC-7901). SpleenMVD and liver MVD were reduced by 28.6% and 22.9% (MGc80-3), 23.7% and 37.6% (SGC-7901),respectively. The serum CEA was lowered by 43.4% (MGc80-3).CONCLUSION ATRA can effectively inhibit the experimental liver metastasis of gastric cancer cells,which is relavant with the decrease of MVD and CEA.

AIM Autoimmunity has been emphasized in the pathogenesis of ulcerative colitis (UC). We reported thattropomyosin (TM) or TM related protein is a putative autoantigen in UC. In human fibroblast, at least 8isoforms of TM have been identified with molecular weight range from 30kD to 40kD, depending upon theisoforms, and human TM isoforms (hTM5) has been found the main isoform in human intestinal epithelialcells. In this study, hTM5 was used as a putative auto-antigen for the humoral and T cell immune responses inpatients with UC, Crohn＇s disease (CD) and healthy subjects (HS) as controls.METHODS Anti-bTM antibody was examined by enzyme-linked immunosorbent assay using human sera(UC 59, CD 28, HS 26) against hTM isoforms. The IFN-γ production by peripheral blood T cells followingstimulation by recombinant hTM5 was analyzed by ELISPOT assay.RESULTS Anti-hTM5 antibody (IgG1) was detected in 15/59 (25.4％) patients with UC, 3/28 (10.γ％)with CD, and 3/26 (11.5％) of HS. The OD value in UC was significantly higher than in CD and HS groups(P ＜ 0.05; P ＜ 0.01 respectively). Western blot analysis demonstrated immunoreactivity against hTM5 inseveral UC sera. ELISPOT assay demonstrated that IFN-γ production is significantly higher in UC (7/18),39.0％), compared with CD (0/8, 0％) and HS (0/7, 0％), (P＜0.05).CONCLUSION A significantly higher immune response to hTM5 was present in UC compared to CD andHS. Further studies of the hTM5/peptides may provide immuno-biochemical mechanism of autoimmuneprocess in UC.

AIM To substantiate the therapeutic effects of carbonate buffer mixture on naturally occurringgastrointestinal atony in cattle.METHODS Therapeutic effects of carbonate buffer mixture (Na2CO350 g, NaHCO3420 g, KCI 20 g, NaC1100 g, water 10 L) were observed in 120 cases of gastrointestinal atony including forestomach atony, rumenimpaction, rumen acidosis, omasum impaction and intestinal constipation. Judgement of curative effects ascure: after treated, the cases become clinically normal in general conditions, appetite, rumination, ruminalperistalsis and defecation; uncure: after giving two doses, the gasto-intestinal atony has not been eliminated.RESULTS Average cure rate of carbonate buffer mixture on above-mentioned diseases were 95%, andaverage dose was 1.4±0.5.CONCLUSION Being a new approach for treatment of gastrointestinal atony in ruminants, the carbonatebuffer mixture can eliminate the gastrointestinal atony originated from the over acidity in gastrointestinalcanal.

AIM To study the effect of acupuncture on the IL2-IFN-NKC immunoregulatory system and tumorinhibition of HAC grafting hepatocarcinoma mice models, and to provide the latest theoretical evidence ofcuring diseases immunologically with acupuncture.METHODS The 28 HAC-vaccinated BALB/C mice were randomly divided into a tumor-bearing controlledgroup and tumor-bearing group to be needed. For the latter group, the selected acupoints are Dazhui (DU,14) and Zusanli (St, 36) which are localized according to the corresponding positions indicated in thecomparative anatomy of animals. The mice in the group were needled once a day for 12 days with thesupplementing and reducing methods, the frequency being 60 times/minute and the needles being retained for2 minutes. The former group was treated in the same way as the latter except needling. Twenty-four hoursafter the last needling, the mice were killed and the spleen taken out to prepare a cell suspension at requiredconcentration, The IL-2 (MTT method) and NKC (colorimetric method) were determined respectively; theIFN (CPE micr-oplate staining) was determined by using the serum separated from the mice's orbit blood; thetumor mass was taken and weighed with an analytical balance (1/1000) to calculate the tumor inhibitationrate according to the formula.RESULTS In the tumor-bearing group after having been needled. the activity of IL-2 (OD value), the titerof IFN (U/mL), the soluble rate of NKC (%) and the tumor weight were respectively 1. 3542±0. 226, 50±0.12, 33.19±4.01 and 70.88±22.8, while those corresponding items in the controlled group were 1.1049±0.028, 3.1±0.22, 21.58±2.77 and 112.45±21.1, When all the concerned items were compared with, thedifference was obvious (P<0.01), showing the IL-2, NKC and IFN of the tumor-bearing group after beingneedled were greatly increased, and the tumor weight is much decresed (inhibitation rate 43.06%). Thedifference between groups was studied by Student's t test.CONCLUSION Acupuncture can strengthen the positive immunoregulatory function of the IL2-IFN-NKCsystem of the HAC bearing mice with hypoimmunity.

The current established drugs used to treat inflammatory bowel disease include glucocorticoids includingnewer agent budesonide, sulfasalazine and 5-ASA compounds such as Asacol, Pentasa, Dipentum andBalsalazide and immunomodulatory agents such as azathioprine, and 6-mercaptopurine. Additional drugswhich have been found to be useful, particularly in refractory cases of Crohn's disease including fistulizingtype of Crohn's disease, include cyclosporine A, methotrexate, humanized antibody against TNFa(cA2),FK506, IL-10, IL-11 and Probiotics. Various agents, whether used alone or in combination, have to betailored for each patient and none is ideal. Exciting new developments directed against proinflammatorypathways, cytokines, free oxygen radicals and cell surface related immune targets are areas of intense recentinvestigations and many novel therapeutic agents are expected to be available in the near future for medicaltreatment of inflammatory bowel disease.

AIM To evaluate the pharmacological effect of phosphorus-32 glass microspheres (32p-GMS) injected intothe implanted human liver cancer cell mass in nude mice.METHODS Fifty-two Balb/c tumor loaded nude mice were allocated into treatment group (n =38) andcontrol group (n = 14), in the former group different doses of 32p-GMS were injected into the tumor mass,while in the latter group 31 P-GMS or no treatment were given instead of 32 P-GMS. After dynamicallyobserving the growth of tumor for d 3 - d 28, the experimental animals were killed in batches, the tumor andits nearby tissues were examined by light and electronic microscopy.RESULTS In comparing with the control group, the treatment group showed the tumor inhibiting rates of59.7% -93.6% (Variance analysis of the mean weight of different doses and control group after square rootcorrection, F= 579.62, P<0.01). As the tumor mass attained the absorbed dose of 7320Gy, the tumor cellswere completely destroyed and at this maximal dose in one case, the epithelial tissue neighboring to this massshowed the signs of metaplasia. When the absorbed doses ranged from 1830Gy to 3660Gy, most of the tumorcells showed the evidences of injury or necrosis, and some well differentiated tumor cells appeared. As theabsorbed dose being 366Gy or less, some tumor cells remained in active proliferative stage with a lot offibroblasts and lymphocytes presented in the neighboring interstitial tissues.CONCLUSION When the experimental model of implanted human liver cancer cells received 32p-GMS of1830Gy-3660Gy, it produces excellent anticancer action without any injury to the normal neighboringtissues and the prominent anticancer effect is found within d 3 after intratumor injection.

AIM To investigate the effects of sinusoidal endothelial cell (SEC) conditioned medium on the expression ofconnective tissue growth factor (CTGF) in rat hepatic stellate cells (HSC).METHODS By in situ collagenase perfusion and two-step Percoll gradient centrifugation, SECs wereisolated and cultured from normally and CCl4-treated Wistar rats, and the SEC conditioned media werecollected. HSCs were prepared from Wistar rats by in situ perfusion and single-step Nycodenz gradient, andwere cultured with SEC conditioned media. Expression of CTGF in HSC was assessed using reversetranscription-polymerase chain reaction (RT-PCR).RESULTS Expression of CTGF was not found in freshly isolated HSC and in primary culture of HSC onday 4 with SEC conditioned media from normal rats, but was present in primary culture of HSC on day 4 withSEC conditioned media from CCl4-induced liver fibrosis rats. Expression of CTGF was observed in culture-activated HSCs, and the effect of SEC conditioned media from CCl4-induced liver fibrosis rats on theexpression of CTGF gene in activated HSCs was not significant.CONCLUSION Expression of CTGF might be relative to the activation of HSC and the liver fibrogenesis,and damaged SECs play a very important role in the early stage of activation of HSC.

AIM To review the progress in pharmacological mechanisms of terandrine (Tet) and its therapeutic use indigestive diseases.METHODS We reviewed almost all the papers related to Tet from various magazines published in Englishand Chinese in recent years.RESULTS It has been demonstrated that Tet had multiple bioactivities: ① Tet could act as a Ca2+antagonist via blocking cellular plasma membrane voltage- or receptor-operating Ca2+ channels, inhibiting extracellular Ca2+ entry into the cell and intracellular Ca2+ mobilization to the cytosol, so as to preventhepatocytes, cardiomyocytes, pancreas cells and neurocytes from toxic or ischemia-reperfusion injuries.However, in HL-60 and leukemic T cells, Tet promoted Ca2+ releasing from mitochondria and microsomes,increased the concentration of intracellular Ca2 + , and induced cell death; ② Tet inhibited phobol 12-myristat13-acetate (PMA) plus ionomycin-induced T cell proliferation, interleukin-2 secretion and expression of theT cell activation antigen, CD71. It could also interrupt the integrity of macrophages, and reduced respiratoryburst of neutrophils and macrophages and proinflammatory cytokines secretion through minimizing nucleartranscriptional factor kappa B DNA binding activity; ③ Tet could induce tumor cell apoptosis, and down-regulate P-glucoprotein activity; and ④ Tet has the therapeutic effects on hepatic fibrogenesis, portalhypertension, immunomodulation, etc.CONCLUSION Tet can act as a Ca2 + channel blocker, inhibit proinflammatory factors releasing, modulateimmunoreaction, and induce tumor cell apoptosis. It can be used to prevent hepatocyte injury induced bytoxins and virus, inhibit hepatic fibrogenesis, reduce portal venous pressure, and can be used as an anti-tumor drug as well.

AIM To study the long-term efficiency of therapy with Interferon alpha (IFN-a) in patients with HCVRNA positive chronic hepatitis C.METHODS Ten patients were enrolled in the study, whose age 31 -62 years (mean 53 years), course 6- 72months (mean 24 months), of whom, 6 patients with mild CHC, 4 moderate CHC. All patients receivedIFN-a 3 MU three times weekly for six to twelve months, and then followed up for seven years after the endof treatment. The results of hepatic functions and HCV RNA at the end of treatment and follow-up period inall patients were observed.RESULTS ( At the end of treatment, clinical symptoms recovered obviously in all patients, virologicalresponse (defined as HCV RNA loss) occurred in 5 of 7 (71.4%) patients (<60 years old) and in 1 of 3(33.3%) patients ( >60 years old). At the end of follow-up, the rates of HCV RNA loss were 42.9% (3/7)and 33.3% (1/3), respectively, in these group. Virological sustained response (defined as HCV RNA loss atthe end of treatment and follow-up) occurred in 3 of 6 (50%) patients (6 - 12 month-course) and in 1 of 4(25%) patients (> 12 month-course). A sustained HCV RNA response was observed in 2 of 7 (28.6%)patients with IFN-a therapy for 6m and in 2 of 3 (66.7%) patients with IFN-a therapy for more than 6 m. Ofall patients, 4 patients with sustained HCV RNA response were mild CHC, 4 patients with sustained HCVRNA positive were mild CHC (2 patients), moderate CHC (2 patients), respectively; other 2 patients withHCV RNA loss at the end of treatment but recurred at the end of follow-up, were moderate CHC. ②Biochemically sustained response (defined as ALT normalization at the end of treatment and follow-up) wasobserved in 5 out of 10 (50%) patients, and these 5 patients were mild CHC, of whom, 4 patients with HCVRNA sustained negative, 1 patient with HCV RNA loss and then recurred again. Two patients with ALTnormalization at the end of follow-up were one mild CHC, one moderate CHC, respectively. Other 3patients with no response were moderate CHC, of whom, 2 patients with HCV RNA sustained positive, 1patient with HCV RNA loss then recurred, and in these 3 patients, the lower limits of ALT were more than121 U/L- 148 U/L. ③ Of 10 patients, 3 moderate CHC patients were far from satisfactory to IFN-αtherapy, of whom, 2 coinfected with HBV, t with post-hepatitis cirrhosis.CONCLUSION The CHC patients with younger age, shorted course, and lighter liver changes in biopsy(mild CHC) have better response to IFN-α therapy, and the efficiency of therapy with IFN-α for 12 m aremore satisfactory than those for 6 m. The patients with coinfected HCV and HBV have a response to IFN-αtherapy worse than the others.

AIM To search for a new surgical method which accords with physiologico-anatomical principles, reducethe incidence rate of some postoperative complications in conventional Billroth I (CB1) gastrectomy andraise the life quality of patients after surgery.METHODS Using the blood vessels and innervation of the remaining stomach and duodenum, we designeda new pyloric sphincter reconstruction (PSR) in Billroth I gastrectomy, in which the end of the duodenumremnant is surrounded by the seromuscular valve of 2 cm wide in the end of the greater curvature, thickenedthe muscle of the stoma and reconstructed a similar pylorus with the sphincteric function.RESULTS Eleven patients were treated, 8 males and 3 females, 6 malignant and 5 benign and 1accompanied by mould infection, aged from 33 to 73 years, with 1 to 29 years of gastric disease history(average 7.9 years). The function of gastric emptying was shown to be essentially normal by barium mealstudy with video record one month after the operation. The pyloric-like control effect was present in thereconstructive pylorus. PSR vs CB1 vs NES (P >0.01); PSR vs CB1 (P < 0.01); PSR vs NSE (P >0.05).CONCLUSION The new method of pyloric reconstruction is safer, simpler and more effective thanconventional procedures. This method can be applied to all patients for whom Billroth 1 anastomosis can beperformed regardless of benign or malignant lesion.

AIM To observe the effects of Innovar and Atropine on Visceral pull response.METHODS Patients were randomly divided into two groups. The experimental group was treated by DanNang Xue blockade with Innovar 4 mL and Atropine 0.5 mg (n = 40) and the control group was treated byabdominal vagus blockade with 10 mL of 10 g/L Lidocaine (n = 40). Dan Nang Xue was chosen for insertionof No 5 needle (5 cm in length) after local sterilization. The acupoint of Dan Nang Xue is located at theoutside of knee-jont and it is one-finger wider below Yanglingquan can be found. A sensitive point. Theneedle was inserted between tibia and fibulae, lifted, thrusted and twirled until the patient felt ache. Innovarand Atropine were injected on Dan Nang Xue and the acupoint was gently messaged.RESULTS Patients in the experimental group remained quiet during operation. Neither nausea or vomitingnor uncomfortable reaction was complained, 85% of the patients belonged to grade m. Acupunctureenhanced the peristalsis of gallbladder and biliary secretions. Atropine relieved muscular spasm andprevented vomiting. A low heart rate was noted in the control during abdominal survey and gallbladder pull(P<0.05).CONCLUSION Dan Nang Xue blockade with innovar and atropine can prevent visceral pull response.

AIM To explore the therapeutic potential of antisense oligodeoxynucleotides on hepatcellular cacinoma(HCC).METHODS Four antisense phosphorothioated oligodeoxynucleotides (asON), complementary to differentsites of HBV, were synthesized and assayed for their anti-HBV activity in HepG22. 2.15 cells with ELISA.The most effective asON was chosen for the following study: FACSCAN, TRAP and immuno-staining wereused respectively for checking apoptosis, telomerase activity and expression of oncogene p21ras and p62C-myc inHepG2.2.15 cells after treated by asON.RESULTS The oligomer directed against the initiator of pre-S2 was the most effective one with aninhibitory rate of 66% on HBsAg and 91% on HBeAg (P<0.02). Two inhibitory peaks (bimodal)appeared. Telomerase activity as well as the expression of p21fas and p62C-myc decreased drastically 3 days afterasON-HBpreS2 treatment. Meanwhile, apoptosis appeared in the experiments.CONCLUSION The inhibitory effects of as-preS2 on the HBV gene expression and the reversion of somemalignant behaviour in HepG2.2.15 cells were the significant, effective therapy against HBV infection andhepatocellular carcinoma.

AIM To evluate the curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy.METHODS Ten patients with pedicellated gastrointestinal polyps were treated with metal clips (OlympusMD-850) combining with microwave by endoscopy. Among them, gastric polyps were found in 6 cases (6polyps), colonic polyps in 4 cases(4 polyps), 9 polyps were 1.5 cm - 2 cm in size, the other one was morethan 2 cm, the diameter of pedicel was 1 cm to 1.5 cm. All patients were repeatedly examined withendoscopy to observe the curative effect at 5 to 10 days and one month after treatment.RESULTS All the 10 polyps were eradicated, 2- 4 metal clips were placed in one polyp, the succeedingcurative rate was 100%. No hemorrhage, perforation and other complications occurred.CONCLUSION The curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy is reliable and safe.

The polyamines [putrescine (PU), spermidine (SPD) and spermine (SPM)] are ubiquitous polycationiccompounds found in all prokaryotic and eukaryotic cells, are essentially involved in a variety of regulatorysteps during normal, adaptive, and malignant cell proliferation. Nearly four decades investigation about thepolyamines contributed to the synthesis and decomposition of polyamines and the active and passive enzymeswhich regulate them at different levels. This review focuses on the sources and homeostasis of intracellularpolyamines, the transport and role of the polyamines in the growth of the gastrointestinal mucosa and theirpossible mechanism. We tried to point out the gaps remaining in the story and give a working hypothesis forthe role of polyamines in gastrointestinal mucosal growth. We propose in the hypothesis that polyamine is a“key”to unlock the “door”of cell proliferation. How many “doors” between the “polyamine key” and the“real start” of proliferation? The polyamine might be the only key for cell proliferation. Another possibilityis that polyamine is the first key and its “unlocking-effect” resulting in getting another key for the next doorin the proliferation chain, for example, proto-oncogenes. To decide whether polyamine is an intermediatestep or just only one step of cell proliferation, the possible way is to keep polyamine to be a stimulus and finda way to deprive the function of proto-oncogene protein (or other possible gene expression product) to checkthe effect on the cell proliferation. Another important question is how polyamine can trigger the synthesis ofDNA in virtual. Arabinose operon model may give us some ideas to investigate about that. And furthermore,it is necessary to pay attention to the relationship between polyamine and other cell proliferation regulator,like growth factor, chalone, cAMP, cGMP, etc. Further studies are needed to investigate the mechanism ofpolyamine acted on the gastrointestinal mucosal growth.

AIM To investigate the short-term and long-term therapeutic effect of traditional medicine preparation andIFN-α1 b on hepatic fibrosis due to chronic hepatitis B.METHODS Fifty-two patients with hepatic fibrosis of hepatitis B were treated by IFN-alb and traditionalmedicine preparation, then observed the change of serum indexes of hepatic fibrosis, liver biopsy,ultrasonography and fibergastroscopy.RESULTS The serum indexes of hepatic fibrosis decreased significantly after 3-month treatment(P<0.05). The improvement of liver fibrosis was confirmed by liver biopsy, ultrasonography andfibergastroscopy. After 3-year continuous follow-up, the conditions of patients were got better. Symptomsand signs were disappeared. The pathohistologic change of liver, serum index of hepatic fibrosis and liverfunction were continuously improved.CONCLUSION The good short-term and long-term effects were obtained by using IFN-α1b to suppressduplication of hepatitis B virus and traditional medicine preparation to reverse hepatic fibrosis.

AIM To study the clinicopathological significance of CD15 antigen expression and its contents in humancarcinoma.METHODS CD15 expression and its contents in 45 cases of gallbladder carcinoma, 17 cases of gallbladderadenoma and 10 cases of chronic cholecystitis were evaluated by microwave-LSAB immunohistochemicaltechnique combined with image analysis.RESULTS Positive rate of CD15 and its integral absorbance (optic density) in the gallbladder carcinomawere 71% and 4.0±3.2 respectively, being significantly higher than 35% (6/17) and 0.9±0.3 in thegallbladder adenoma, 20% (2/10) and 0.4±0.1 in chronic cholecystitis (P<0.05, P<0.01). In grade Ⅱ-Ⅲ cancer, they were 90% (17/19) and 5.4±1.7, being significantly higher than 58% (15/26) and 2.2±3.1 in grade I cancer (P<0.05, P<0.01). In lymph node positive cases, they were 88% (21/24) and 6.5±3.5, which were significantly higher than 52% (11/21) and 3.3±2.1 in the negative ones (P<0.025,P<0.01).CONCLUSION CD15 expression and its contents could be involved in aggresiveness of gallbladdercarcinoma and might be a useful indicator to evaluate the malignancy and biological features, and could beconsidered as a good prognostic predictor for patients with gallbladder carcinoma.

AIM To determine the function and cellular localization of GS-encoded proteins and to assess their potentialas drug targets and vaccine components.METHODS Bioinformatics software was used to predict the function of GS-encoded proteins and theirlocation within MAP. Protein modelling software was used to build protein structures.RESULTS The gene gsa is a truncated glycosyl transferase and probably non-functional. gsbA and gsbBproduce GDP-fucose which is methylated by gsc and acetylated by mpa. gsd is a fucosyl transferase whichattaches fucose to subterminal rhamnose on cell surface glycopeptidolipid. gsa, gsbA and gsbB and gsc arelocated within the cytoplasm. mpa is embedded in the plasma membrane with 10 transmembrane regions anda conspicuous extracellular loop. gsd is lipid-linked and predicted to localize to the microbial cell surface.CONCLUSION GS encodes the biosynthetic machinery to give MAP a surface coat of methylated andacetylated fucose which may contribute to its protease-resistant nature and ability to minimize immunerecognition. The gsbA/gsbB operon and gsd are promising drug targets and gsd is a good candidatecomponent of a new class of anti-MAP vaccines.

AIM To investigate the diagnostic significance of cytology and telomerase activity in the exfoliated cells ofcardia obtained from endoscopic brushing in the cardiac cancer.METHODS The techniques of the qualitative TRAP-silver staining and quantitative TRAP-PCR-ELISAwere employed to detect telomerase activity in the exfoliated cells of cardia obtained from endoscopicbrushing in 72 cases with cardial lesions, cytological diagnosis was made at the same time.RESULTS Telomerase activity with cardiac cancer group (1.521 ± 0. 192) was significantly higher than thatwith cardialitis group (0.065± 0.014). Positive rate of telomerase activity detected in cardiac cancer group(88.89%) was significantly higher than that with cardialitis group (11.11%), the former was significantlyhiger than cytological examination (77.78%). The diagnostic rate of cardiac cancer reached 93.33% iftelomerase activity and cytology were examined at the same time.CONCLUSION Cytology and telomerase activity in the exfoliated cardiac cells may be an effective andsensitive methods in the diagnosis of cardiac cancer. This research can be a basis for the mass screening ofcardiac cancer.

AIM To explore molecular biology developing mechanism of non-and-hyporesponder.METHODS Thirty children (3-7 years old) were selected whose anti-HBs titres were lower than 10min/mLand HBsAg, anti-HBc were negative. 843 children were defined as non-and-hyporesponders. Control groupswere 30 normal responders to HB vaccine. Experiment groups and control groups Peripheral venous bloodwas drawn in preservative-free heparin (25 U/mL), and unfractionated mononuclear cells were obtained byFicoll gradient centrifugation. Cell suspensions were routinely incubated in complete culture medium at 37℃for 1 h before cultured to eliminate cytophilic antibodies. Mononuclear cell concentration of cell suspensionsmust be geared to 1×105 cells/mL with complete culture medium, taking these cell suspensions (1 mL) intoflatbottom 24-well culture plates, then ConA 10 mg/L was added to wells and the plates were incubated at37C in a humidified atmosphere of 95% air and 5% CO2 for 48 h. This cell culture supernatants wereremoved to test tubes and level centrifugation (2000rpm) for 10 minutes, upper liquid was samples of IL-2 orIL-6. IL-2 or IL-6 activity was measured by CTLL-2 cells or 7TD1 cells toxin transfer test methods respectly.The results were expressed as stimulation index (SI) which represent the ratio of the mean counts per minute in quadruplicate well containing IL-2 (or IL-6) samples or IL-2 (or IL-6) standard solution to the meancounts per minute in quadruplicate wells containing cells and medium only.RRSULTS Interleukin-2 (IL-2) mean activity (74.5±64.1 U/mL) of the non-and-hyporesponders tohepatitis B vaccine in the 20 subjects was much less than that of the normal responder groups (298.0±101.1)to hepatitis B vaccine (t = 5.23, P<0.01); The correlation coefficient (r) between the anti-HBs levels andIL-2 activity in the 20 normal response to HB vaccine was 0.68 (r = 0.68, P<0.05). There was a positivecorrelation between the anti-HBs levels and IL-2 activity. Difference in interleukin-6 mean activity was noted in serum from subjects who responded to HB vaccinecompared with those who failed to respond. The responder groups (58.98±16.4) had a significantly higherIL-6 activity than the non-and-hyporesponder groups (30.10±12.4) (t =5.68, P<0.05). The correlationcoefficent of the IL-6 activity and titers of serum anti-HBs in the responder groups was 0.79 (P<0.05).CONCLUSION Some cytokines as IL-2 and IL-6 play an important role in the response to HB vaccine.

AIM To investigate the effect of recombinant human tumor necrosis factor (rbTNF) on telomerase activityin hepatoma cell line HepG2 and HepG1-6.METHODS TRAP-ELISA method was used to determine the telomerase activity in HepG2 and HepG1-6cells which were treated by different concentrations of rhTNF. In addition, the TERTLuc (800) plasmid wastransiently transfected, which was inserted 800 bp of the human telomerase reverse transcriptase (hTERT)promoter, into HepG2 cells by Lipofect. Different concentrations of rhTNF were added into the culturemedia 2 hours later, and the activity of the hTERT promoter was detected 48 hours after transfection.RESULTS The telomerase activity of HepG2 was suppressed by rhTNF in a dose-dependent manner. Theresults also revealed that the activity of hTERT promoter was inhibited linearly with rhTNF at the dose of 10- 1000 IU/mL.CONCLUSION Inhibition of the hTERT promoter expression by rhTNF may contribute to its anti-tumoractivity.

AIM To observe the effects of Lanwei acupiont blockade with drug to prevent pull re,ponse duringappendectomy.METHODS Sixty patients with appendix (37 male and 23 female, ASA Ⅰ - Ⅱ) aged from 16 to 58 yearsold, were divided into two groups at random, and they underwent persistent epidural nerve ,lock and McBurney opening. Group A for experiment (nA = 30) received persistent epidural nerve blck plus druginjection of Lanwei acupoint. And the control group, group B (nB=30), received simple epidural nerveblock. No remarkable difference was found in the general data of both groups (P>0.05).RESULTS None of the experimental group had marked nausea and vomiting. Twenty-six cases belonged tograde 0 (account for 86.67%). Three cases were of grade Ⅰ. One case was of grade Ⅱ. None belonged tograde Ⅲ. There were fewer changes in HR, BP and SPO2 during the operation. Compared with the experimental group. The results in the control group showed obvious changes in HR,BP and SPO2, especially at the time of 5 minute post-pull appendix (P<0.01). Eleven cases belonged tograde Ⅲ (36.67%), seven cases to grade Ⅱ and Four cases to grade Ⅰ, only 2 cases to grade 0.CONCLUSION Adjusting the function of Zang and Fu, maintaining the coordination and the balanceamong Zang and Fu, drug injection of Lanwei acupoint may prevent vagus-vagus reflex. The method issimple, easy, inexpensive and effective. It is advantageous to anesthetic care during the operation.

AIM To investigate the local effect of phosphorus-32 glass microspheres (32 P-GMS) on hepatocellularcancer and its relation with chemoembolism.MVIETHODS (① Thirty-two BALB/c nu/nu nude mice were divided randomly into four groups, control groupand 3 treatment groups. Every mouse was implanted with human liver cancer cell line subset (H-CS). 32p-GMS amalgamated in iodine oil was injected directly into the tumor mass. After 2 wk, all animals but thosein the control group, were injected with 32p-GMS in the dosage of 880cGY, 1760cGY and 3520cGY formouce groups Ⅰ, Ⅱ and Ⅲ respectively. The histological reactions of tumor mass were observed; multidrugresistance (MDR) expressed p-glycoprotein was detected by flow cytometry. ②Forty-three patients withhepatocellular carcinoma based on the evidence from B sonography or CT and serum AFP >400 ng/mL orcytological and histological evidences in some cases with the negative AFP were divided randomly into twogroups, group Ⅰ treated with 32p-GMS (absorbed dose of 50Gy- 100Gy) alone, group Ⅱ treated with 32p-GMS and chemotherapeutics (half-dosage, doxorubicin 20mg/m2, cisplatin 30mg/m2). 32 P-GMS wasinjected through intra hepatic artery in these cases with single massive type and multi-nodular type. Everypatient was repeatedly treated with this method for 2 - 3 times. For evaluating the therapeutic results. Themodified WHO criteria for tumor therapy standard is the.RESULTS (①) Animal bearing tumors showed that the mass decreased markedly and the inhibitive ratesattained 66.53%, 83.06% and 91.53% in the absorbed doses ranged form 880GY, 1760Gy and 3520Gyrespectively (P<0.05, ANOVA). Flow cytometry detected MDR expressed p-glycoprotein decreased from68.2 ± 4.6 in control to 43.6 ± 3.4, 35.3 ± 4.3 and 33.2 ± 3.8 (P<0.05, compared with control, t-test) inthe cells from the tumors. (②) The foci in group Ⅰ revealed decreased in size dramatically with effective rate of71.43%, compared with 86.36% in the group Ⅱ (P<0.05, Chi-squaur test). The median survival period ofthe patients were 532 and 564 d in group Ⅰ and Ⅱ respectivcey (Kaplan-Meire method).CONCLUSION The enhanced effectiveness of the local treatment of 32 P-GMS conjugated withchemotherapeutics may be related to the local action on the MDR expressed p-glycoprotein.

AIM To investigate the effect of boschniakia rossica (BR) extract on expression of GST-P, p53 and p21fasproteins in early-stage chemical hepatocarcinogenesis in rats and its anti-inflammatory actions.METHODS The expression of tumor marker, placental form glutathione S-transferase (GST-P), p53 and p21ras proteins were investigated by immunohistochemical techniques and ABC method. Anti-inflammatoryactivities of BR were observed by xylene and croton oil-induced mouse ear edema, carrageenin, histamineand hot scald-induced rat pow edema, adjuvant-induced rat arthritis and cotton pellet-induced mousegranuloma formation methods.RESULTS The 500 mg/kg of BR-H2O extract fractionated from BR-Methanol extract had inhibitory effecton the formation of DEN-induced GST-P-positive foci in rat liver and the expression of mutant p53 and p21fasprotein was lower than that of hepatic preneoplastic lesions. Both CH2Cl2 and H2O extract from BR haveinhibitory effect in xylene and croton oil-induced mouse ear edema. BR-H2O extract exhibited inhibitoryeffect in carrageenin, histamine and hot scald-induced hind paw edema and adjuvant-induced arthritis in ratsand cotton pellet-induced granuloma formation in mice.CONCLUSION BR extract exhibited inhibitory effect on formation of preneoplastic hepatic foci in earlystage of rat chemical hepatocarcinogenesis. Both CH2Cl2 and H2O extract from BR exerted anti-inflammatory effect in rats and mice.

AIM To study the change of trace elements in the hair of patients with esophageal carcinoma and the role oftrace elements in its development and progress.METHODS The hair of 60 normal people and 126 patients was collected and was divided into groupsaccording to the patients' pathologic changes. The atomic absorption method and fluorescence method wereused to measure the trace elements of copper, zinc, iron, calcium and selenium.RESULTS Zinc in the hair of various patients: a remarkable difference was found between normal people(182mg· kg 1)and the patients (103- 81.6mg·kg 1) (t = 3.79, P<0.01 Duncan' new multiple rangemethod). There was a certain difference between simple hyperplasia and cancer (t = 3.21, P<0.01 ). As forcopper, a great difference existed between normal people (12.01mg· kg-l) and patients with dysphagia (15.16mg·kg-1) and cancer (17.02-17.15mg·kg-1) (t=2.43, P<0.05). No change of zinc and copperwas observed in cancer patients (t = 1.61, P >0.05). The ratio of zinc to copper increased with thedevelopment of pathologic change. The selenium levels in patients (0.46-0.67mg·kg-1) was below that ofnormal people (l.03mg·kg-1), while iron and calcium levels in the patients decreased with the developmentof pathologic process.CONCLUSION Both zinc and copper play an important role in the pathologic change of esophagealcarcinoma. Zinc and copper in the hair changed with development of the pathologic process. Zinc revealedpositive correlation ( r = -0. 889, P < 0.01 while copper showed negative correlation ( r = 0.921, P < 0.01 ).The ratio of copper to zinc in the hair is of great diagnostic value.

AIM To study the clonality of the esophageal carcinosarcoma by using molecular approaches.METHODS Two esophageal carcinosarcomas were included in the study. Tumor area from dysplasticlesion, squamout cell carcinoma, basaloid cell carcinoma and spindle cell elements were microdissectedseparately. Each element was analyzed with 14 microsatellite markers and direct sequenced for p53 gene andras gene mutation.RESULTS Both tumors displayed a typical histologic feature of carcinosarcoma. Both cases showed thedivergent differentiation by immunohistochemistry study. In case 1 the identical LOH at p53 and hMLH1 lociwas detected. The heterogenous LOH was detected only in carcinosarcoma at RB1 and BRCA1 loci, whilethe LOH at ACTC locus was seen only in sarcoma. The same mutation of the splice site of exon 6-intron 6displayed in the two tumor elements. In case 2, a coordinate LOH at RB locus was demonstrated in threetypes of tumor elements: sqamous carcinoma, basaloid carcinoma and spindle cell element. A heterogenousLOH was seen only in spindle cells at TAP1 locus. No mutation in exon 5-8 of p53 gene has been found incase 2. No mutation of K-ras gene was found.CONCLUSION Although the different differentiation, the two elements of esophageal carcinosarcoma mayhave a single clonality. The p53 gene mutation occurred before the two differentiation directions switched.The distinct molecular genotype can be determined through molecular biological analysis. The microsatelliteprofiling can serve as an approach to find out which genetic alteration occurs before or after thedifferentiation is determines.

AIM To increase the production of recombinant des (1 - 3) IGF- I by increasing the copy number of genecarried on an expression vector, and to partially purify the expressed des (1 - 3) IGF-Ⅰ , as well as compareits bio-activity with standard IGF-Ⅰ.METHODS Second copy of des (1 - 3) IGF-Ⅰ gene was inserted into pExSecl/IGF-Ⅰ expression vectorconstructed by our previous work and carryed already one des (1 -3) IGF-Ⅰ gene, to form PExSec1/2 (IGF-Ⅰ) expression plasmid, which carried two copies of tandem des (1 - 3) IGF-Ⅰ gene. This plasmid wastranformed into a protease-deficient E. coli strain BL21 (DE3). The engineered bacteria was cultured andinduced at low temperature. The expressed product was purified through ultra-filtration and gel-filtration.The bio-activity of partially purified protein was tested by MTT method and compared with standard IGF-Ⅰ.RESULTS The amount of des (1-3) IGF-Ⅰ expressed by pExSec 1/2 (IGF-Ⅰ) reached up to 19% -22%of the total soluble bacterial protein, which is about 7% higher than that of des (1 -3) IGF-Ⅰ expressed bypExSec1/IGF-Ⅰ. The purity of recombinant des (1 - 3) IGF-Ⅰ reached 49% and 82% respectively after thetreatments by ultra-filtration and gel-filtration. The result of MTT assay showed that the bio-activity of des(1- 3) 1GF-I after gel-filtration was about 77% of that of standard IGF-Ⅰ at the same concentration.CONCLUSION The yield of recombinant des (1 - 3) IGF-Ⅰ was increased about 7% by construction ofexpression plasmid with two copies of des (1 -3) IGF-Ⅰ gene, compared with only one copy of gene,preliminarily purified des (1 -3) IGF-Ⅰ showed relatively high biological activity, which was about 77% ofthat of standard IGF-Ⅰ.

AIM To search for a simple and safe method to avoid reoperation, reduce complications and mortality,shorten hospital stay and lower the medical cost.METHODS Based on the characteristic of pathology and anatomy of biliary fistula and pancreatic fistula,modified endoscopic nasobiliary drainage or endoscopic nasopancreas drainage with negative pressure wereused to drain the bile and pancreatic juice to the duodenum and in vitro to facilitate fistulous tract close.RESULTS In seven patients with biliary fistulas with conservative treatment who were not yet recoveredafter 6 - 110 days, the leakage was blocked after 6 - 17 days treatment, and in 6 patients with pancreaticfistulas with conservative treatment who were not recovered after 90 - 720 days, the leakage was blockedafter treatment for 12- 28 days.CONCLUSION The advantages of this modefied method are: retain the function of the Oddi sphincter; the anatomy of the pancreatic duct and bile duct and the position of fistulas can be seen clearly withcontrast examination; the drainage effect was defieate, safe and with less complications; the leakageblock can be promoted with the drainage of negative pressure; and hospital stay is shortened and medicalcost is reduced.

Advances in molecular biology made possible the discovery of the virus that causes hepatitis C. However,little is known about the fundamental aspects of hepatitis C virus (HCV) replication, primarily because arobust cell culture has not been established. As a result, the currently available drugs for the treatment ofhepatitis C are not specifically directed against HCV. Based on what is known about the molecular biology ofHCV, however, drugs can now be developed against specific viral and cellular targets. The next generationof drugs for the treatment of hepatitis C will likely be directed against non-structural HCV proteins withknown enzymatic activities, such as the proteases, RNA helicase and RNA polymerase. Others agentstargeted against the viral RNA, core protein that assembles into the virion capsid and putative cellular“receptors” that bind HCV envelope proteins are also being developed. These drugs should have fewer sideeffects than those currently available and be much more effective for the treatment of chronic hepatitis C.

AIM To investigate the effect of BCG vaccine and dipyridamole in treating hepatitis B due to their anti-virus effects.METHODS Among 602 patients with positive HBeAg, 512 were allocated to the treatment group and 90patients to the control group. There was no significant difference in disease and age between the two groups.All the patients in the treatment group with no abnormal findings by chest X-ray fluoroscopy, whose localskin scleromata diameters were less than 7 mm after the 1:2000 OT test, were given BCG vaccine 0.1 mlintracutaneously at the deltoid once a month, and simultaneously took dipyridamole 50 mg twice a day forfour to eight months. The hepatic function, B-mode ultrasound and the five markers of hepatitis B wereroutinely examined before each injection. The results at one month after the last injection in the treatmentgroup were compared with those of the control group.RESULTS The recovery rates of hepatic functions and the rates of improvement of the symptoms and signsin the treatment group were better than those in the control group. The negative transformation rates ofHBeAg and the positive transformation rates of HBeAb were 60.3% and 31.6% in the treatment group vs.13.3% and 13.0% in the control group (P<0.01, Test x2, x2=26.82, 6.81). The negative transformationrates of HBsAg and the positive transformation rates of HBsAb were 5.5% and 8.2% in the treatment groupvs. 5.6% and 9.9% in the control group (P>0.05. Test x2, x2=1.11, 0.22).CONCLUSION The application of BCG vaccine in combination with dipyridamole increased the negativetransformation rate of HBeAg and the positive transformation rate of HBeAb, improved the clinicalsymptoms, signs and hepatic function of the patients. These two drugs had significant anti-HBV effect andshowed good efficacy in the treatment of HBV infection.

AIM To study the effect of immune treatment on gastric cancer.METHODS Thirteen patients with advanced gastric cancer were given TIL adoptive immunotherapy in thisstudy. Histological findings showed that 13 patients had gastric adenocarcinoma. Patients received operationson their primary tumor, which could not be resected. Small tumor tissue and metastic lymph nodes were gotduring the operation for TIL preparation. Ten patients were treated as control group. During TILtreatment, the patients did not received any other treatment. Surgical speciments (metastatic lymph nodes )with pathological diagnosis were obtained from operating room. The lymph nodes were minced anddissociated in RPMI 1640 with 0.03% hyaluronidase type V (1500U/g), 0.05% collagenase type Ⅳ(200 U/g), and 0.008% deoxyribonuclease type I (100 U/g) (Sigma, USA) at 37℃ for 12 h. The cellmixture was then filtered through 4-layer gauge, washed twice in Hank's and separated on Ficoll-Hypague(Shanghai ist Chemical Reagent Factory) at 900×g for 20min. Finally, the cells were harvested andcounted. Cells suspension containing TIL and tumor cells were extensively washed and resuspended at a finalconcentration of 106 lymphocytes/mL in complete medium containing 15% human AB serum, 100 U/mLpenicillin and 100 μg/mL streptomycin in RPMI 1640 (Gibco). The final concentration of rIL-2 (Military Medical Institute, Nanjing ) was 500 U/mL. Cultured after 3 d-4 d, lymphoid cells were counted andculture was separated into more flasks when the concentration of lymmphoid cells reached or exceeded 2×106/mL until the total amount reached about 5×109/mL cells. Cytotoxic activities of TIL were tested by 6 h51Cr-release assay. Target cells (5×10s/mL) (human gastric adenocarcinoma) in 1 mL of culture mediumwere labelled with 100 μci of Na251CrO4(Beijing Atomic Energy Research Institute, Beijing), washed andadjusted to 105cells/mL. Labelled cells (E/T: 50: 1, 25: 1 and 12.5: 1) were seeded in round-bottom microtest plates (Corning, Japan) at 104cells/well. Isotope release was measured in a gamma counter (Packard,USA). The percentage of cytotoxicity was calculated according to the following formula: Cytotoxicity% = (Experimental- Spontaneous)/ (Maximum-Spontaneous)×100. Target cells without effective cells weremixed with 0.1 mL of culture media to obtain spontaneous release, and with 0.1 mL of 0.1 mol/L HCl toobtain maximum 51Cr release. TIL cells so induced were counted, washed twice, resupended in 100 mL 0.9%NaC1 solution and intravenouslly transferred. The number of total autologous TIL cells injected was morethan 5×109 cells for one patient and usually separated into 2 - 3 injection during the treatment, rIL-25000 U/d (Nanjing Military Medical institute, Nanjing) in 2 mL of 0.9% NaCl solution was intramuscularlyinjected starting from 5 days before TIL cells transfer to 5 days after transfer of TIL cells. All patients weregiven scheduled gastric roentgenograms. CT scanning, B type ultrasound, histological examination andimmune function were used to observe the changes before, during and after treatment. The curative effectswere judged by the standard of WHO. The methods of the assays of SIL-2R, NK cytotoxicity and CD4/CD8were carried out respectively according to the references.RESULTS The Nk cytotoxicity and CD4/CD8 were significantly increased (P<0.01) after 3- 6 monthstreatment. The soluble IL-2 receptor in sera of patients was significantly decreased (P<0.01) after 3- 6months treatment. There were no significantly differences in the test of CD4/CD8, the cytotoxicity of Nkcells and the soluble IL-2 receptor in serum between the group before treated by TIL and the control group(P >0.05). The NK cytotoxicity and CD4/CD8 in patients treated by TIL were significantly more than thosein the control group. On the contrary, the soluble IL-2 receptor in serum of patients treated by TIL wassignificantly less than those in serum of the control group. The patients of control group survived from 4.5months to 9 months (less than one year) after operation. However seven of the thirteen patients treated byTIL after operation survived over one year. Appetite was improved, sinew enhanced, weight increased andpain relieved in most of patients treated by TIL. On the contrary, the symptoms and signs of patients ofcontrol group were not improved. According to the standard of WHO, there were significantly differences ofPD(Disease Progress), MR (Minor remission), and PR(partial remission) between TIL group and controlgroup. The results indicated that tumor focus completely disapeared in 1(80%) of 13 patients, significantlydecreased in 4 (30%) of 13 patients and slightly decreased in 7 (53%) of 13 patients, suggesting that thetreatment of TIL in the patients with advanced cancer was effective. No side effects were found except fortransient fever in 2 patients.CONCLUSION TIL should be one of the fundamental therapies for the advanced gastric cancer, it canregulate the balance of immunity, relieve pain, improve symptoms and signs and prolong survival time.

AIM To study the change of T cell subsets and erythrocytes immune function in children with acuterotavicus enteritis (RE) and to explore its clinical significance.METHODS T cell subsets were detected by indirect immunofluorescence technique, RBC immune functionwas achieved by detecting RBC C3b receptor rosette (RBC-CR1R) and RBC immune complex rosette (RBC-ICR). The statistical significance of differences was evaluated by using analysis of variance (ANOVA).RESULTS The percentage rate of CD3 and CD4 cell and the ratio of CD4/CD8 in acute stage of RE weresignificantly lower than those of control ( P <0.01), while the percentage rate of CD8 cell remained almostunchangec Along with the improvement of clinical symptoms, the level of CD3, CD4 and CD4/CD8returned to normal in recovery stage. RBC-CR1R in acute stage of RE was significantly lower than that ofcontrol (F = 15.44, P<0.01) and returned to normal in recovery stage. RBC-ICR rose slightly in acute stageof RE, but there was no significant difference between acute stage of RE and the control (F=0.02518,P>0.05). Correlative analysis showed that RBC-CR1R was positively correlated to the percentage rate ofCD4 cell (r =0.528l, P<0.01) and the ratio of CD4/CD8 (r=0.4832, P<0.01), in acute stage of RE.CONCLUSION Cellular immune might take part in the development of RE, CD4/CD8 ratio might berelated to the prognosis of RE. The immune function of RBC reduced secondarily in acute stage of RE. It isnecessary to keep the immune function of RBC in treatment of RE in order to strengthen the patient's abilityof anti-infection.

AIM To study the relationship between nitric oxide (NO), nitric oxide synthase (NOS) and humanhepatocellular carcinoma (HCC).METHODS Plsama NO2-/NO3- was measured by Griess reaction in 122 patients with chronic hepatitis(CH) and compensated liver cirrhosis (LC), among which 62 patients were complicated with HCC(CH = 28, LC = 34), and the rest 60 patients were not (CH = 29, LC = 31). Thirty healthy persons served asnormal controls (NC). There were no prominent differences among the groups in sex, age and the ratio ofCH to LC. The expression of inducible nitric oxide synthase (iNOS) in HCC (n = 40), CH (n = 30) and LC(n = 30) samples obtained from liver biopsy or operation was compared with that in normal liver tissues byusing immunohistochemistry. Ten normal liver tissue samples obtained from liver operation served as normalcontrols. The samples were fixed in formalin and embeded in paraffin. Anti-iNOS antibody (Santacruzcompany) was served as antibody-Ⅰ in immunohistochemical assay of iNOS in tissue.RESULTS Plasma NO2-/NO3- level in normal was 11.5 μmol/L±4.2μmol/L. The plasma level ofNO2 /NO3- in CH (58.6±17.4 μmol/L) and LC (38.7±10.6μmol/L) accompanied with HCC wasnotably higher than in those patients without HCC (CH: 24.8±9.4 μmol/L; LC: 22.3±8.7μmol/L,t=2.901, 2.756, P<0.01). Plasma NO2-/NO3- level in HCC accompanied with CH was significantlyhigher than in those accompanied with LC ( t = 2.216, P<0.05). Positive rate of iNOS in HCC, CH and LCwas 95%, 93% and 57% respectively. iNOS was not expressed in normal liver tissues. The expression level ofiNOS in HCC (χ2=17.4, P<0.001) and CH (χ2=11.64, P<0.025) was much higher than in LC.CONCLUSION Plasma NO2 / NO3- level significantly increased in patients with HCC and theimmunohistochemical staining of iNOS was positive. This suggests that the liver secrets NO in the higherlevel may participate in the carcinogenesis and progression of HCC.

AIM To investigate the morphological and ultrastructural changes in the human gastric carcinoma cell lineBGC-823 after being treated with tachyplesin.METHODS Tachyplesin was isolated from acid extracts of Chinese horseshoe crab (Tachypleus tridentatus)hemocytes. BGC-823 cells and the cells treated with 2.0 μg/mL tachyplesin were examined respectively withlight microscope, scanning and transmission electron microscope.RESULTS BGC-823 cells had undergone restorative morphological and ultrastructural changes after beingtreated with 2.0 μg/mL tachyplesin. The cells tended to be flat and spread, and their volume enlarged,nucleo-cytoplasmic ratio decreased, the shape of nucleus became relatively regular, the number and volumeof nuleous decreased, heterchromatin decreased while euchromatin increased, the number of mitochondriaincreased with their structure relatively consistent, Golgi apparatus turned to be typical, rough endoplasmicreticulum increased, polyribosome decreased, microvilli and filopodia reduced while lamellipodia increased.CONCLUSION Tachyplesin could change the malignant morphological and ultrastructural characteristics ofhuman gastric carcinoma cells effectively and had certain effects on inducing differentiation of human gastriccarcinoma cells.

AIM To clarify the surgical strategy for patients with stage Ⅳa primary hepatic carcinoma (PHC).METHODS Twenty-seven patients with stage Ⅳ a PHC were retrospectively studied in 1989 - 1998,including resected group (19 cases) whose all tumor nodes were resected and cytoreductive group (8 cases)whose most tumor nodules were resected and remnant nodules treated by ethanol injection. B-ultrosoundshould be used intraoperation in order to prevent from missing any tumor nodule. All the tumor nodules inthe liver should be removed, and residual nodules should be treated by ethanol injection during operation ifall the tumor nodules can not be removed. Multidisciphinary therapies were undertaken perioperatively.RESULTS The 1-, 2- and 3-year survival rates were 71.4%, 55.6% and 7.7% respectively. The 1-, 2- and3-year survival rates of the resected and cytoreductive groups were 73.3%, 53.3%, 10.0% and 66.7%,50.0%, 0% (P>0.05) respectively. The rate of complications was 22.0%, without operative and in-hospital mortality.CONCLUSION The surgical treatment included resected or cytoreductive operation plus supplementarytherapy considered to be both useful and the first choise for stage Ⅳa PHC.

AIM To study the effect of sclerotic complex agents (SCA) on the gallbladder wall of hybrid rabbits, andits therapeutic effect in hepatic cysts.METHODS The SCA containing tetracycline and dexamethasone was injected into the gallbladder of rabbitsto compare its action with those of normal saline and absolute ethylalcohol on the gallbladder wall. Thetherapeutic effects of SCA and absolute ethylalcohol on hepatic cysts were observed.RESULTS Abnormal changes were not found in the tissue cells of gallbladder in normal saline group. Butin absolute ethylalcohol group, a large amount of oozing fluid and blood appeared, the absorption processwas slow, and the fibrous tissue proliferated scarcely. In SCA group, there was less oozing fluid, no blood inthe gallbladder, and the absorption was active and the fibrous tissues grow obviously. In clinical practice,SCA possesses much advantage in the treatment of hepatic cysts, by which the cysts closed promptly, theexudation reduced from early stimulation, and no relapse occurred. The cure rates at the third, sixth,twelfth and twenty-fourth month were 65.1%, 96.2%, 98.1%, and 99.1% respectively; while in thecontrol group were 10.8%, 36.0%, 67.6% and 88.3% respectively. The difference was significant(P<0.01, <0.01, <0.01, <0.05). After the observation for 24 months, no relapse occurred in the SCAgroup, but 7 (6.3%) cases relapsed in control group (P<0.05).CONCLUSION The sclerotic agents should be used in sequence, i. e., a high concentration wasadministered to reduce and destroy the epithelium of the cysts, and to promote fiber tissue adhesion and thenthe remaining drug was used to stimulate epithelium to absorb the exudation. This combined regimen wasproved to be an ideal and effective method for treating hepatic cysts clinically.

AIM To study the hepatitis B virus (HBV) status in peripheral blood mononuclear cells (PBMC) and itsrelationship with serum HBV infection in newborns of hepatitis B surface antigen (HBsAg) positive mothers.METHODS Blood specimens were collected by femoral puncture from newborns of HBsAg positive motherswithin 24 hours after birth between February, 1997 and May, 1998. All sera were examined for HBV DNAand HBsAg by nested polymerase chain reaction (nPCR) and enzyme-linked immunosorbent assay (ELISA).PBMC were separated from above blood specimen of newborns. Fifty-five FBMC smear of newborns wereobtained whose sera were HBV DNA positive and 38 PBMC smear were randomly selected from newbornswhose'sera were HBV DNA negative. These Ninety-three smear of newborns' PBMC at birth were detectedfor HBV DNA by in situ polymerase chain reaction (IS PCR) and in situ hybridization (ISH) using digoxin-labelled HBV DNA probe.RESULTS Twenty-seven (49.09%) out of 55 HBV DNA positive newborns sera had HBV DNA in PBMCand 4 (10.53%) out of 38 HBV DNA negative newborns sera were detected for HBV DNA in their PBMC byISH. Sixty-two HBV DNA negative newborns PBMC by ISH were examined for HBV DNA by IS PCR. Ten(35.71%) out of 28 HBV DNA positive newborns sera had HBV DNA in their PBMC. Two (5.88%) out of 34 HBV DNA negative newborns sera were found HBV DNA in their PBMC. Total positive rates of PBMCHBV DNA (by ISH and/or IS PCR) were 67.27% (37/55) in those newborns with HBV DNA positive seraand 15.79% (6/38) in those newborns with HBV DNA negative sera.CONCLUSION HBV DNA in PBMC were found in most of newborns who had HBV DNA positive sera.But HBV DNA in PBMC also were positive in some of newborns who were negative for HBV DNA in theirsera at birth. It suggests that intrauterine HBV infection may be demonstrated only by HBV infection intheir PBMC and should be served as diagnosis index for intrauterine HBV infection. HBV infection in PBMCmay play some role in HBV intrauterine infection and its persistence, but it needs to study furthermore.

AIM To investigate the diagnostic value of CagA IgG in serum.METHODS Seventy three patients with peptic ulcer infected with HP were eradicated by antibioticstherapy. At pretreatment, wk9 and wk20 after treatment, the detection of Hp in gastric muscosa bybacteriologic method were performed, and CagA and whole-cell antigen of HP igG in serum by ELISAmethod were also performed at the same time.RESULTS The IgG titres of Hp CagA and whole-cell antigen changes in accordance with the efficacy ofHp eradicated. The former with an earlier appearance and a greater number of cases decreased to normallevel in comparison with the latter.CONCLUSION CagA IgG is a better index for observing the effectiveness of the eradication of Hp.

AIM To observe the effect of herbs-partition moxibustion on IL-1β and TNF-c in UC rats.METHODS The animal models were created by immunological method. They were divided into 5 groups atrandom, after treated by different methods, IL-1β and TNF-α in colon tissue of UC rats were detected withimmunologic technique.RESULTS In control group, there was a little or no IL-1β positive cell in colon mucosa. Compared withthat in rats of control group, the number of IL-1 positive cell in model group was much larger, and IL-1βcells with brown granules were mainly expressed in cytoplasm of macrophage in lamina propria of colon.Compared with model group, IL-1β positive cells in mild moxibustion group markedly decreased (P < 0.05),and those in electro-acupuncture group and herbs-partition moxibustion group decreased even more markedly(P < 0.01). The difference between the last two groups is evident (P < 0.05). TNF-α positive cells are not or seldomly found in UC rats, but in model group, these cells increasedevidently, which were mainly the macrophages in lamina propria of colon. Compared with those in modelgroup, the positive cells decreased markedly in electro-acupuncture group (P<0.05), and decreased moremarkedly in mild moxibustion group and in herbs-partition moxibustion group (P<0.01). There werestatistically significant differences between herbs-partition moxibustion group and electro-acupuncture group(P<0.05).CONCLUSION The mechanism of acupuncture and moxibustion may be that inhibited macrophageactivation, reduced expression of IL-1β and TNF-a and thereby blocking their further activation and thencontrolled, the initiated inflammation and its immunity cascade reaction and resulted in restoring the normalimmunity function and benefited in healing of ulcer.

AIM To understand the pollution status of drinking water in Cixian area and to find out a way to solute it.METHODS Contents of nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were measured andcompared with controls and national standards.RESULTS Levels of nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were higher than the nationalpermissive levels by 20.60%, 50.50% and 33.30% respectively. Also the levels in Cixian are significantlyhigher than those of a controls areas of Chicheng - a county with very low incidence rate of esophagealcancer.CONCLUSION Three nitrogen levels in drinking water correlate both with the amount of N-containingfertilizer used in these areas and the mortality rates of esophageal cancer.

AIM To observe the features of acupuncture and meridians by measuring transcutaneous CO2 emission(TCE).METHODS A high sensitive CO2 analyzer was used to measure the TCE. TCE on 31 levels of meridianpoints and control points along stomach meridian on leg, large intestine meridian on arm (30) andpericardium meridian on whole course (22) were measured. During needling Jianshi (P5), the changes ofTCE on distal side, proximal side and outside of the pericardium meridian were measured in 20 healthypeople. TCE on 24 source points of twelve meridians in 30 healthy people and some related source points inpatients were measured. TCE on source points, connecting points and sea points in 20 healthy cases weremeasured. Acupoints and reference points (no opening time) were measured on the opening time and nonopening time according to day-prescription in midnight-noon Ebb-flow law in 15 healthy people. The relationbetween TCE and skin temperature and TCE change after muscular exercise were also studied.RESULTS The mean TCE on the meridians was significantly higher (P<0.05, same below) than controlpoints. About 40% levers showed significantly higher TCE on meridian points than on control points amongwhich two third were acupoints, mostly were Jing point and He point where Oi were rich. TCE increasedsignificantly in both the meridian and control points during the needling, while moderately increased on themeridian line, particularly the proximal direction. The correlative coefficient (CC) between the points alongpericardium meridian was 0.65 between acupoi, nts which was significantly higher than 0.56 between nonacupoints. For the 24 source points, CC between the points on same meridian, exterior meridian and internalmeridian, same named hand and foot meridian and normal meridian were 0.81, 0.65, 0.51 and 0.38respectively with significant difference. The mean CC between connecting points was 0.67, significantlyhigher than 0.61 between source points and 0.56 between sea points. The imbalance degree (ID) betweenleft and right meridian points, Yin and Yang meridian points and same named hand and foot meridian pointswere 13.6%, 17.6% and 19.6% respectively, while ID was 30.2% in patients, significantly higher than inhealthy people. For midnight-noon law, TCE relative to the reference points on the opening time was 1.25which was significantly higher than 1.08 before the opening time. The certain correlation (r = 0. 19,P < 0.01) between TCE and skin temperature and the increase after muscular exercise illustrate that TCE canindicate the energy metabolism level on meridians.CONCLUSION TCE is an ideal index to show the feature of acupuncture and meridians and may widely beused in the study and practice of traditional Chinese medicine.

AIM To study the effects of heat exposure and swimming on membranous structure of the small intestinalepithelium and the biochemical indexes.METHODS The distribution of the intra-membranous particles (IMPs) in enteric epithelium of SD rats andthe number of IMPs were analyzed with freeze-etching technique and TxB2, PGFIa, PRL, CORT and totalSA (TSA) were measured with the techniques of biochemistry and radio-immunity.RESULTS Heat exposure markedly affected the distributive pattern of IMPs in intestinal epithelium andmade the numbers of IMPs on the PF and EF faces of cell membrane and nuclear membrane decreased.Swimming exacerbated the above changes. And in the meantime heat exposure resulted in the massivereleasing of the body-hurting substance as TxB2 and reducing of the body-protecting substance as PGFIa.TSA increased obviously. These changes recovered partly after heat exposure, but the number of IMPs onboth PF and EF faces and certain biochemical indexes were still not restored to the levels as in the controlgroup.CONCLUSION Heat exposure and swimming can make the cellular catabolism accelerated and anabolismreduced, then bring about the numbers of IMPs of intestinal epithelium membrane and nuclear membranedecreased, and the distribution was abnormal. TxB2, PGFIa, PRL, CORT and TSA were changedabnormally during heat exposure. And above indexes showed no notable evidence of recovery after stoppingheat exposure 4 hours-24 hours; the delayed injury was obviously presented.

AIM To observe the clinical effect of self-made Jinhuang Pingan Decoction (JHPAD) in treating intestinaladhesion.METHODS Among 580 cases of intestinal adhesion, 492 cases were treated with oral JHPAD alone; 88cases with incomplete intestinal obstruction were treated by gastrointestinal decompression, then givingconcentrated JHPAD through the GI tube as well as fluid replacement and anti-inflammation therapy.RESULTS Among 580 cases, 302 cases were cured, 232 cases, improved and 46 cases had no change, thetotal effective rate was 92.1%. In 492 patients treated with JHPAD alone, 264 cases had obvious effect, 202cases were improved and 26 cases had no effect, the total effective rate was 94.7%, and the corresponingresults in 88 cases treated with JHPAD and gastrointestinal decompression were 39 cases, 29 cases, 20 casesand 77.3% respectively. In addition, there was close relationship between the therapeutic efficacy anddisease course, and had significant statistical difference in therapeutic efficacy with the disease course of lessthan 30 d or over 12 m (x2=87.32, P<0.0001).CONCLUSION JHPAD has the effect of clearing heat, detoxication, anti-inflammation, relieving edema,analgesia, hemostasis and anti-adhesion in the treatment of intestinal adhesion. It has a satisfactory efficacyand no toxic reaction, so it is worthy to popularize in clinical practice.

AIM To review the evolution of gastrointestinal (GI) imageology in China over the past 50 years.METHODS The evolution of GI imageological equipment and techniques, published original articles of GIimageology in the Chinese Journal of Radiology, books of GI imageology in China, academic researcheswhich won the academic award of scientific and technological progress at the ministrial and national levelwere reviewed.RESULTS Within 50 years of GI imageology evolution, equipment of GI imageology were developed from200mA X-rays apparatus in the 50s to digital X-rays in the 90s. Technique of GI imaging was developed fromgeneral radiography in the 50s to digital radiography (DR), CT and MR virtual endoscopy of GI in the 90s.About 211 original articles were published in the Chinese Journal of Radiology on the GI imageology.Radiography and single contrast examination of disease were mainly described in the 50s and CT and MR andDR and interventional radiology in the 90s. Twelve books about GI imageology were published within the 50years, ranging from atlas of X-ray examination and diagnosis of GI by Chen Zhen-Lin to atlas of imagingdiagnosis of alimentary tract disease by Xie Jin-Xia. Three academic prizes of scientific and technologicalprogress were awarded by the Ministry of Health and the nation. The study of double contrast barium sulfateof Hua-Shan 2000 by Chen Gen-Fang et al acquired class 3 award of national invention in the 70s, andexperimental study and applications of double contrast radiography by Shang Ke-Zhong et al won class 3award of the Ministry of Health.CONCLUSION In keeping abreast with the development of world GI imageology, great achievements havebeen made in the study and development in GI imageology in China with its own features.

AIM To explore the feasibility of early gastric cancer diagnosis with 2LC reagent, and to establish a grossexploration method for early gastric cancer with the reagent based on the feasibility.METHODS Add 30 mg or 0.3 mL 2LC reagent into 5 mL urinary sample, observe the change of urinary,and analyze the sample on DAO-JIN-UV-260 Ultraviolet-analyzer at 190nm - 700nm, then, record theabsorbance at 490nm. To determine best stage of sample, take some samples on 8:00 pm and 8:00 am,respectively. To select best dosage of 2LC, take the test with different concentrations. To test the effect ofoperation, conduct the experiment in different stages before and after the operation for the patients withgastric cancer. Two parallel samples were taken each time in the whole experiment.RESULTS Red compound produced by some reactions when the 2LC reagent was added into the urinary ofpatients with gastric cancer, and the urine had obvious absorptivity at about 490nm (positive). There was almost no reaction in the urine of other samples (negative). A total of 172 samples were tested, the positiverate of gastric cancer was above 90% in 48 samples before the operation, in which 8 advanced gastric cancerand 9 early stage gastric cancer samples behaved stronger positive reaction. The positive rate of 118 othersamples was less than 10%. The urine taken in the morning was batter than that in the evening. The bestdosage of 2LC was 6 mg/mL for crystal and 0.05 mL/mL for liquid. The test results of gastric cancerpatients with postoperative tumor recrudescence or transfer were positive, and the others were negative.CONCLUSION There is a high feasibility in manipulation simplification, specificity and receptivity of 2LCreagent for early gastric cancer detection, and the characteristics mentioned above will be improved based onthe advanced raw material used and the style of the 2LC reagent. It is an effective gross exploration methodfor early gastric cancer with the 2LC reagent, and can determine the effect of operation for the gastriccancer.

AIM To determine the role of Helicobacter pylori in altering gastric mucin synthesis and define how thprocess relates to H. pylori-related diseases.METHODS Analyses of human gastric tissues using immunohistochemistry and in situ hybridizatiodocument the role of H. pylori in altering the composition and distribution of gastric mucins.RESULTS These data indicate a decrease in the product of the MUC5 (MUC5AC) gene and aberraexpression of MUC6 in the surface epithelium of H. pylori-infected patients. A normal pattern was restorby H. pylori eradication. Inhibition of mucin synthesis including MUC5AC and MUCl mucins by H. pvlohas been established in vitro using biochemical and Western blot analyses. This effect is not due to inhibitiof glycosylation, but results from inhibition of synthesis of mucin core structures. In vitro experiments usiinhibitors of mucin synthesis indicate that cell surface mucins decrease adhesion of H. pylori to gastepithelial cells.CONCLUSION Inhibition of mucin synthesis by H. pylori in vivo can disrupt the protective mucous layand facilitate bacterial adhesion, which may lead to increased inflammation in thc gastric epithelium.

AIM To study the biopathologic characteristics of the transitional mucosa (TM) adjacent to rectalcarcinoma and the resecting length of bowel.METHODS Immunohistochemical and mucin histochemical methods were used in 81 cases to observe theexpression of PCNA and the changing regulations of TM adjacent to rectal carcinoma.RESULTS The PCNA expression rate was the highest in cancer and gradually decreased in atypicaldysplasia, TM and normal mucosa (P<0.01). The range of TM adjacent to the mucinous adenocarcinomawas more extensive than that to the papilla adenocarcinoma and the tubular adenocarcinoma (P< 0.01 ). Therange of TM adjacent to the rectal carcinoma in Dukes C stage was more extensive than that in stage A, B(P<0.01, P<0.05).CONCLUSION The TM of rectal carcinoma possesses certain potential of malignancy. The range of TMadjacent to rectal carcinoma is closely related to the pathological type and advancement of rectal carcinoma.

AIM To construct an expression vector for anti-HBsAg antibody Fab fragment and interferon-aA (IFN-aA)fusion protein in E. coli.METHODS With PCR and molecular clone techniques, we amplified the gene fragment of IFN-aA withcorresponding endonuclease sites and artificial linker at 5', 3' termini, and then formed pHS/IFN-aA byrecombining it within the vector in correct endonuclease sites, choosing the positive clone to transform intoE. coli and intoduced by IPTG to express the fusion protein.RESULTS Enzymic hydrolysis and DNA sequence measurement confirmed that human gene of IFN-aA wascorrectly cloned to the vector and could express fusion protein in E. coli.CONCLUSION The success in construction and expression of a fusion protein makes it possible to carry outfurther studies on its purification and targeted polypeptide therapy to HB virus.

AIM To determine NO, NO synthase (NOS) and NOSmRNA of the esophageal carcinoma cells (SHEEC1)in apoptotic process induced by As2O3 and to explore the relationship between NO and apoptosis.METHODS The apoptosis of the cell line (SHEEC1) was induced by arsenite (As2O3, 5 μmol/L and10 μmol/L). In the process, at 2 h, 4 h, 8 h, 16 h and 24 h after administration of As2O3, NO production incultural medium was detected quantitatively by spectrophotometry; NOS Ⅱ was detected byimmunohistochemistry and NOS mRNA by in situ hybridization (ISH). The cells at endpoint of theexperiment were examined under transmitted electron microscope (TEM) for apoptosis.RESULTS The amount of NO released from SHEEC1 were increased from the basal condition (0.68×10-2μmol/L) up to the high level (2.38×10-2μmol/L) at h 16. The increment of NOS Ⅱ was found afteradministration of As2O3; the intracytoplasmic ISH signals of NOSmRNA in small size was found firstly at4 h, and then became highly predominant. Apoptotic changes of SHEEC1 occurred at 24 h under TEM.CONCLUSION After administration of As2O3, NO released from cultured SHEEC1 cells was detected withincreasing amount up to 16 h. The expression of NOS H and transcription of NOSmRNA are upregulated.The present findings suggest a concept that the NO may be a mediated and effective factor in apoptosisinduced by As2O3,

AIM To investigate the effect of cold preservation on rat livers by modified storage method with self-madeHYD solution.METHODS The modified method was that the vascular bed of rat livers was expended with an additional20 mL, 30 mL and 40 mL self-made HYD solution / 100 g liver. After resection of the liver, the extra HYDsolution expressed as % liver weight was entrapped via portal infusion by tying off the supra- and infrahepatic inferior vena cava. According to the amount of extra HYD solution, 40 rats were randomly dividedinto four groups: control group with conventional storage method, 20% group, 30% group and 40% group.The preservation effect of modified storage method was compared with that of conventional storage methodusing isolated perfused rat liver model.RESULTS Bile production and all the indices of hepatic microcirculation including portal perfused pressure, endothelin in the effluent, Trypan blue distribution time and histology in modified method groupswere significantly superior to those in control group (P< 0.05). The liver enzymes in 30% group weremarkedly lower than those in control group (P<0.05). The preservative efficiency of rat liver in 30% groupwas the best among the modified method groups.CONCLUSION The cold preservative efficiency with modified storage method is obviously superior to thatwith conventional storage method. It is suggested that the modified cold storage method is effective and mayhave potential for liver preservation

AIM To study the role of lipid peroxides reaction on hepatic ischemia damage and the protective effects ofantioxidants (TMP, co-Q10).MgTHODS Twenty-four adult dogs were performed portacaval shunt and randomly put into 3 groups:group 1 (control group); 8 dogs with portacaval shunt (PCS group); group 2:8 dogs with portacaval shuntand only given antioxidants -TMP (ligustrazine) (PCS + TMP group); group 3:8 dogs with portacaval shuntand given antioxidants in combination with co-Q10, TMP and co-Q10 (PCS + TMP + co-Q10 group). Drugusage: TMP, 50 mg/ kg/ isolation day; coenzyme Q10, 1.5 mg/kg/isolation day; PCS + TMP, given up atthe end of 4 weeks after operation; and PCS + TMP + co-Q10, given up at the end of 8 weeks afteroperation. The experiment indices: super-peroxide dismutase (SOD), malondialdehyde (MDA), ALT,AST, AKP were all measured before operation, and 8 weeks after operation. The liver tissues were obtainedin the 4th week and 8th week respectively after operation and the changes of hepatic structures were observedunder light and electronic microscope.RESULTS There were obvious increase of MDA and decrease of SOD in PCS group, which was remarkablydifferent from pre-operation (P<0.01). In PCS + TMP group, there was no difference between pre-operation and within 4 weeks after operation (P>0.05). But it was remarkably different from PCS group(P<0.01). Beginning from the 5th week after operation, we stopped TMP (ligustrazine), as a result, theobvious increase of MDA, rapid decrease of SOD were found, but not different from PCS group (P >0.05).In PCS+ TMP+ co-QlO group, MDA increased slightlly, and SOD decreated, but it was superior to that inPCS and PCS + TMP groups. The data in PCS + TMP + co-Q10 group had statistical significance compared tothat in PCS+ TMP group (P<0.05) during 4 weeks after operation; but from the 5th to 8th week, there wasa remarkable difference (P<0.01). The results of ALT, AST and AKP showed remarkable differencebetween PCS + TMP + co-Q10, PCS group (P<0.01) and PCS + TMP compared to PCS + TMP + co-Q10(P<0.05). After stopping TMP, PCS + TMP were compared with PCS + TMP + co-Q10 (P<0.01). Thechanges in liver structures were fatty degeneration, atrophy and necrosis; decrease in rough surfacedendoplasmic reticulum (PER), mitochondrial swelling, partial mitochondria fusion, disappearance ofmitochondrial crista, diminution of Golgi body. The structures of liver cells in PCS + TMP and PCS + TMP +co-Q10 groups were superior to that in PCS group; but in the 8th week after operation, the liver structuralchanges bad no difference between PCS + TMP and PCS group. The results of light electronic microscopy inPCS + TMP + co-Q10 were better than that in PCS and PCS + TMP groups.CONCLUSION The over-activated lipid peroxides reaction may be one of the important factors of hepaticischemia damage after portacaval shunt; combined use of the antioxidants can enhance the protection fromthe hepatic ischemia damage.

mycobacterium avium; paratuberculosis; glycosyltransferases; bacillus subtilis;chromatography, affinity; antibodies, anti-idiotypic

AIM To explore the anti-tumor effect of indomethacin (IN) on human colon adenocarcinoma cells anddetermine the influence of indomethacin on cancer cell proliferation and apoptosis and elucidate the anti-tumor mechanism of Indomethacin.METHODS Human colon adenocarcinoma HCT116 cell line were cultured separately in vitro. Indomethacin(final concentration 100 μm - 800 gm) was administered alone or altogether with 5-Fu (50 μm). Agarose gelelectrophoresis, MTT, and Flow cytometry were used to study cell proliferation and apoptosis in humancolon carcinoma cell RT-PCR, western blot were used to detect the expression level of Bcl-2, bax gene andcdk4 protein expression in HCT116 cell lines after treated with IN for 24 hours.RESULTS Indomethacin can inhibit significantly the proliferation of HCT116 cell, change the morphology,and cause the cells to accumulate in the G0/Gl phase of the cell cycle, and induce apoptosis. The apoptosis oftumor cells was confirmed by DNA ladder formation on gel electrophoresis and sub-Gl peak on flowcytometry. These responses were time-and concentration-dependent. A synergic effect of inhibiting cancercell proliferation was observed when combined with Indomethacin and 5-Fu. RT-PCR results showed that INdown-regulated Bcl-2 mRNA expression, and did not change Bax mRNA expression. Western blot resultsconfirmed that IN inhibited Bcl-2 protein expression. No influence was found in the translation of Baxprotein. In inhibited cdk4 protein expression.CONCLUSION Our study results indicate that IN induce apoptosis of HCT116 cell by down-regulating Bcl-2expression and inhibiting cdk4 protein expression partially. This explains the mechanisms of antitumoractivity of the Indomethacin.

AIM To compare the point mutation deviations of HGV among E2, NS3 and NSSA.METHODS Seven patients with hepatic diseases from Japan and China were selected for this study. RNAwas extracted and amplified by semi-nested RT-PCR; and the PCR products were sequenced directly.RESULTS The point mutation deviations of HGV ia E2, NS3 and NS5A were 10% - 17%, 11% -23%,and 0% - 5%, in nuclcotide sequences and 4% - 12%, 0%, and 0% - 6% in amino acid sequencesrespectively.CONCLUSION The frequency of variation at the nucleotide level was in the order NS3>E2>NS5A, whileat the amino acid level the order was E2 >NS5A>NS3. The detected sequences from the N-terminus of E2may be the poorly conserved region of HGV.

AIM To study the combined expression of gastrointestinal hormone substance P and anti-apoptosis gene Bcl-2 in gastric carcinoma and its significance.METHODS Substance P and Bcl-2 protein expression was examined by the S-P immunohistochemicalmethod in 33 cases of gastric carcinoma, 17 adjacent the carcinoma and 13 normal gastric mucoma.RESULTS Positive expression of SP in gastric carcinoma was higher than that of both adjacent and normalmucosa (P < 0.001). There was no statistical difference in the positive expression between adjacent andnormal mucosa (P > 0.05). The expression of bcl-2 both in gastric carcinoma and adjacent tissues werehigher than that of normal gastric mucosa (P< 0.05-0.01). But the positive expression of Bcl-2 had nostatistical significance between gastric carcinoma and adjacent tissues.CONCLUSION Both gastrointestinal hormone SP and Bcl-2 gene have synergistic expression in gastriccarcinoma, indicating that they all take part in the occurrence of gastric carcinoma. Abnormal expression ofBcl-2 gene occurred in benign gastric pathological changes, once they become carcinoma, the positiveexpression of cell is no more increased, possibly because that there is no more increase of the intensity of Bcl-2 inhibition of cell apoptosis.

AIM To determine the effect of glutathione (GSH) on stress gastric mucosal lesion.METHODS The stress gastric mucosal lesion as produced by restraint water-immersion in rats and gastricmucosal lesion, gastric mucosal GSH content, gastric acid secretion and gastric barrier mucus secretion wereexamined. We also observed the effect of GSH on gastric mucosal lesion and the effect of N-ethylmaleimine(NEM) and indomethacin on GSH protection. Comparisons between two groups were made using the Students t test.RESULTS GSH (100 and 200 mg/kg) intraperitoneally protected against stress gastric mucosal lesion(P<0.001 and P<0.001). Restraint water-immersion stress significantly reduced gastric mucosal GSHcontent (P < 0.001), but pretreatment with GSH (100 mg/kg) had no effect on gastric mucosal GSH content(P>0.05). The preinjection of NEM (10 mg/kg, sc.), a sulfhydryl-blocking reagent, or indomethacin(5 mg/kg, im.), a cyclooxygenase inhibitor, had no effect on protection of GSH (P>0.05). GSH(100mg/kg) significantly increased secretion of gastric barrier mucus (P<0.05), but had no effect onsecretion of gastric acid in restraint water-immersed rats (P >0.05).CONCLUSION GSH can inhibit the formation of gastric mucosal lesions induced by restraint water-immersion. The protective effect of GSH was due, in part, to promoting the secretion of gastric barriermucus, but not to suppress the gastric acid secretion. The protection effect of GSH has no relation withgastric mucosal GSH and PGs.

AIM To evaluate the significance of alhafetoprotein (AFP). gamma-glutamyltransferase (GGT).Carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) in diagnosis of primary hepaticcancer.METHODS Thirty-six patients with liver carcinoma (male 26, female 10, aged 29- 72 years), 6 withhepatic metastasis of gastrointestinal cancer (all male, aged 37- 69 years), 62 with benign liver diseases(male 53, female 9, aged 32- 71 years) and 222 without liver diseases (male 152, female 70, aged 22- 76years) were studied. Blood samples were taken by venipuncture. Serum was separated and frozen at -20℃until the analysis was made. AFP, CEA and CA125 were measured by RIA.RESULTS Serum AFP in liver cancer (476.3 - 181.4 ug/L) was significantly higher than that in hepaticmetastasis of gastrointestinal cancer, benign liver diseases and monhepatic diseases (P<0.01). Serum GGTin liver cancer was 621.1±289.9 w/L, significantly higher than that in the other groups (P<0.05). CA125level in liver cancer (236.3±127.2 u/L) was markedly higher than that in benign liver diseases andmonhepatic diseases (P<0.01), but no significantly difference was found in hepatic metastasis ofgastroentestinal cancer (219.4±143.7 U/L). Serum CEA in liver cancer (8.8±2.1 ug/L) was markedlylower than that in hepatic metastasis of gastroentestinal cancer (32.7±7.2 ug/L) (P<0.01). Thesensitivity of AFP, GGT, CA125 and CEA in the diagnosis of liver cancer was 72.2%, 88.9%, 63.9% and11.1% repectively; their specificity was 93.1%, 71.1%, 78.2% and 65.8% respectively. The diagnosticsensitivity and specificity of simultaneous detection of AFP, GGT and CA125 in liver cancer were 91.7% and88.4% respectively.CONCLUSION AFP is superior to GGT, CA125 and CEA in the diagnosis of liver cancer; simultaneousdetection of AFP, GGT and CA125 might increase the diagnositic sensitivity and specificity of liver cancer.

AIM To characterize genomic DNA flanking IS900 insertions and develop a rapid Multiplex PCR IS900Locus (MPIL) typing method for MAP reporting the presence or absence of the element at each locus,METHODS Genomic DNA flanking 14 of the 18 IS900 loci was sequenced and compared with databasehomologues. An MPIL typing method was developed using a common IS900 primer and individual locus-specific primers designed to produce amplification products differing by about 50bp which could be easilyresolved on a single gel. MPIL was applied to a panel of 81 MAP isolates and compared with RFLP profiles.RESULTS Genes flanking IS900 loci included homologues of transcription regulators, a sigma factor, anitrate reductase, a polyketide synthase and an O6-methylguanine-methyl transferase. MPIL rapidly andconsistently identified 10 individual types of MAP from the panel of 81 isolates, and distinguished betweenbovine and ovine strains. Nine MPIL types corresponded directly to single RFLP types previously identified.CONCLUSION Isg00 insertions in MAP may affect the expression of genes critically associated with thepathogenic phenotype. MPIL typing can identify bovine and ovine strains independent of the need for cultureand may contribute to studies of the molecular epidemiology of these difficult organisms.

AIM To investigate the expression of endothelial NO synthase (eNOS), inducible NO synthase (iNOS)protein and eNOS mRNA gene in the splanchnic organs of liver cirrhosis and portal hypertensive rats.METHODS In control and CCl4-induced liver cirrhotic rats, the expression of eNOS and iNOS proteins wasdetected by immunohistochemical method, and eNOS mRNA was detected by in situ hybridization.RESULTS The expression of eNOS protein and eNOS mRNA increased in most organs of the cirrhotic rats,including bronchial and alveolar epithelial cells, renal tubular epithelial cells and mesenchyma, endothelialand adventitial cells of aorta and superior mesenteric artery, whereas no significant increase of iNOS proteinwas found. In the hepatic tissue, NOS protein and eNOS mRNA were present in mesenchymal cells and vesseladventitial cells, no difference was observed in the expression between control and cirrhotic rats.CONCLUSION The expression of NOS varied in region. In splanchnic organs and vasculars there was anincreased expression of eNOS which induced aplanchnic vasodilation and increased the inflow of portal vein,while in the liver tissue and blood vessel showed no increased expression, which may be associated withincreased intrahepatic vascular resistance.

AIM To study the protective effects of Weitongling decoction (WTL) on gastric mucosa.METHODS Rats with gastric lesion induced by dehydrated alcohol were used to observe the gastric mucosalblood flow (GMBF), rats with spleen deficiency syndrome induced by reserpine were applied to investigatethe D-xylose absorption rate, the Alcian blue binding properties of gastric wall, the gastric acid secretion andthe activity of pepsin.RESULTS Remarkable increases in GMBF (19.5±3.5 mL/min, 20.4±3.3 mL/min respectively in largedose group and small dose group, P<0.01), in Alcian blue binding properties of gastric wall (2.497 mg±0.138 mg, 2.223 ug±0.186 mg respectively in large dose group and small dose group, P<0.05) and in D-xylose absorption rate (1.287±0.043, 1.294±0.019 respectively in large dose group and small dose group,P<0.05) were found after administrations of WTL, while no significant alteration in gastric secretion wasshown and in vitro WTL did not neutralize gastric acid.CONCLUSION WTL can improve the Spleen deficiency syndrome, strengthen the gastric mucosal barrier,and thus protect gastric mucosa against injury agents.

AIM To understand the rule and possible function of apoptosis and protein expression of bcl-2, p53 and C-myc in chronic gastritis, gastric ulcer, non-classic proliferation of gastric mucosa and gastric cancer.METHODS Apoptosis was detected by using in situ terminal labelling (TUNEL). The protein expression ofbcl-2, p53 and C-myc was detected by immunohistochemical method.RESULTS The indexes of apoptosis in chronic active gastritis, gastric ulcer, mild and severe non-classicproliferation of gastric mucosa, early and progressive gastric cancer were 16.8%±12.3%, 24.1%±20.0%,19.3%±16.4%, 15.7%±15.2%, 10.1%±9.1% and 6.3%±6.0%, respectively. The index of progressivegastric cancer was lower than that of early gastric cancer and non-classic proliferation of gastric mucosa(P<0.05). The positive rate of bcl-2 protein was 9.4%, 27.6%, 52.9%, 75.0%, 83.3% and 46.7%,respectively. The positive rate of bcl-2 of early gastric cancer was higher than that of progressive gastriccancer. The positive rates of p53 protein of severe non-classic proliferation, early and progressive gastriccancer were 25.0%, 33.3% and 63.3%, respectively. The positive rate of p53 of progressive gastric cancerwas higher than that of early gastric cancer and non-classic proliferation (P<0.05). In Lauren types, theindex of apoptosis, protein expression rates of bcl-2, p53 and C-myc of intestinal type were 8.3%±7.2%,38.9%, 77.7% and 56.6%, while that of diffuse type were 5.1%±4.9%, 58.3%, 50.0% and 8.3%,respectively. All markers had statistical difference between two types (P<0.05).CONCLUSION Apoptosis was inhibited stepwise in the development of non-classic proliferation of gastricmucosa to early gastric cancer and then to progressive gastric cancer. The high expression of bcl-2, p53 andC-myc was related to the development of gastric cancer, bcl-2 might play an important role in early gastriccancer while p53 and C-myc act mostly in middle and late stage gastric cancer. The Lauren typing of gastriccancer is closely related to the index of apoptosis and expression of bcl-2, p53 and C-myc.

AIM To summarize the experience of surgical treatment of hilar cholangiocarcinoma and the results of aseries of experiments.METHODS AND RESULTS Personal perspectives of surgical treatment of hilar cholangiocarcinoma werebased on the experience of a series of patients with hilar bile duct cancer treated in the General Hospital ofPLA, Beijing from 1986 to 1999. A total of 157 cases were treated surgically, with 106 (67.5%) resections ofthe tumor , 37.6% of the resections was proved to be radical. The 1-, 2-, 3-, and 5-year survival rate of theradical resection group was 96.7%, 40.0%, 23.3% and 13.3%, respectively. No patient of the palliativeresection group lived beyond 3 years postoperatively. The recent trends of surgical management of hilar bileduct cancer were discussed. Experiments were carried out for cooperative clinicopathological study toevaluate the perineural space involvement, the neural cell adhesion molecule expression, p16 geneexpression, and the 3-dimensional reconstruction of the bile duct cancer specimens. The pathogeneticrelationship of HBV and HCV with extrahepatic cholangiocarcinoma was evaluated by histochemical and IS-PCR methods. And an inquiry into the possibility of gene therapy was made.CONCLUSION Hilar bile duct cancer rarely runs a “benign” course. It is a regional disease rather than alocal affection and may be related to HBV and HCV infection in China. It possesses the metastasing abilityalong the perineural space by a “jumping” fashion, therefore, in most cases, conventional surgical excision isbound to be unradical in the region of the porta hepatis for anatomical reasons.

AIM To treat esophageal stricture secondary to the ingestion of corrosive materials in children using theileocolon with ileocecal valve as a substitute for esophagus.METHODS Between 1992 and 1999, isoperistaltic retrosternal ileocolic esophageal replacements wereperformed in 12 patients; 50 cadavers were studied to observe the vascularity in the ileocolic region andmetabolic indexes were measured before and after surgery or between the operative group and the normalcontrols in 20 piglet models.RESULTS A follow-up of 3 years in the 12 cases found no death in intra- and post- operative periodclinically. Cervical ileoesophageal anastomotic leaks occurred in 2 cases. The distribution pattern of venousvessel in the ileocolic region was far more constant than that of the artery. The arrangements of artery in theileocolic segment were classified into 7 types, and there was no interruption of paracolic anastomosis betweenarteries. The resections of 50 cm terminal ileum, cecum and 50 cm ascending colon affected enterohepaticcirculation of bile acid (bile salt) and the fatty metabolism in early period after surgery in piglet models.Shortening of the time and reducing of the area for water absorption after ileocolic resection resulted indiarrhea in piglet models. The loss of “bacterial barrier” role of ileocecal valve led to bacteria immigrationfrom colon to ileum and small intestinal bacterial overgrowth.CONCLUSION The ileocolic esophageal replacement taking advantage of antireflux role of the ileocecalvalve has obtained satisfactory effect. To understand the characteristics of the patterns of arteries and veinsdistribution and physiological functions of the ileocolic segment is useful in guiding clinical practice andpostoperative management and preventing postoperative complications as well.

AIM To compare the effects of intravenous route and peritoneal route on liver targeted uptake andexpression of plasmid delivered by glyco-poly-L-lysine (G-PLL).METHODS The plasmid pTM/MMP-1 which could be expressed in eukaryotic cells was bound to thegalactose-terminal glyco-poly-L-lysine (G-PLL), and then was transferred into Wistar rats by intravenousand intraperitoneal injection respectively. Afterwards the expression and distribution of the plasmid wereobserved at different time points by in situ hybridization and immunohistochemistry.RESULTS The plasmid could be expressed obviously in 24 hours after being transferred in vivo by bothintravenous and intraperitoneal route. One week later the expression began to decrease, and still could beovserved three weeks later. Although both the intravenous and intraperitoneal route could deliver theplasmid to liver targetly, the effect of the former was better as compared with that of the latter.CONCLUSION Intravenous route was better for liver targeted uptake and expression of G-PLL-boundplasmid than peritoneal route.

AIM To observe the effect of acupuncture and moxibustion on the expression of IL-1β and iNOSmRNA inrats, with ulcerative colitis.METHODS Surgical samples of fresh human colonic mucosa was homogenized by adding appropriateamount of normal saline and centrifuged at 3000 r/min. Protein content of the supernatant was measuredand then mixed with Freund adjuvant, and injected into the plantae of the rats models, then into theplantae, dorsa, inguen and abdominal cavities (no Freund adjuvant for the last injection) on the 10th, 17th,24th and 31st day respectively. When serum titer of anti-colonic antibody has reached to a certain level,20 mL/L formalin and antigen fluid (no Freund adjuvant) were administered by enema to set up ulcerativecolitis rat mode. The animals were randomly divided into four groups: model control group (MC = 8),electroacupuncture group (EP=8), herbs partition moxibustion group (HPM= 8) and normal control group(NC=8). HPM: Mosa cones made of refined mugwort floss were placed on the medicinal pads (medicinalpad dispensing: Radix Aconiti Praeparata, cortex Cinnamomi, etc. ) for qihai (RN6) and tianshu (ST25,bilateral) and ignited. Two moxa cones were used for each acupuncture once a day and 14 times in all. EP:tisnshu (bilateral) and qihai were stimulated by the intermittent pulse with 2Hz frequency, 4mA intensity for20 minutes once a day and 14 times in all. After treatment, all rats were killed simultaneously. The spleenwas separated and distal colon was dissected. Total tissue RNA was isolated by the guanidinium thiocyanate-phenol-chloroform extraction method. RT-PCR technique was used to observe the expression of IL-1β andiNOSmRNA no Freund adjuvant.RESULTS IL-1β and iNOSmRNA were not detected in the spleen and colonic mucosa of NC rats, whilethey were significantly expressed in those of MC rats. IL-1β and iNOSmRNA were markedly lower in EF andHPM rats than those in MC rats. There were no significant difference in the levels of IL-1β and iNOSmRNAbetween EP and HPM rats. The amount of IL-1β and iNOSmRNA was nearly the same between the spleenand colon in different groups.CONCLUSION Acupuncture and moxibustion greatly inhibited the expression of IL-lβ and iNOSmRNA inthe ulcerative colitis rats.

AIM To explore the components and the distributions of the cytoskeleton network in neoplastic Hep G2 cellsextracted with triton X-100 and (NH4)2SO4.METHODS Using the mouse lung adenocarcinoma cell sublines (C6/C7) with low and high metastasis as acontrol, the human hepatocellular carcinoma cell line (Hep G2) as well as the cell sublines (C6/C7) wasextracted with triton X-100 and/or (NH4)2SO4, then stained with Coomasie blue R250 or labeled withimmunoenzymatic technique to identify the cytokeratin-type or vimentin-type intermediate filamentcomponents and study the distributions of cytoskeleton comparatively.RESULTS Extracted with triton X-100 and/or (NH4)2SO4, then stained with Coomasie blue R250, the cells'cytoskeleton network were showed clearly; still it was very difficult to identify the variations of thecytoskeleton network in morphology by light microscopy when the same cells was extracted with the differentextraction above; compared with the low metastasis cells (C7), most of the high metastasis cells (C6) werelikely showed that the distribution of the cytoskeleton network was more irregular and uneven as well asgathering on one side to the cell neucleus, and so did a few of Hep G2 cells (the percentage of regular andeven distribution of cytoskeleton, C6: 8.0±1.0; C7: 84.0±2.0; Hep G2: 96.0±2.0; n = 500; x2-test,P<0.01). Moreover, extracted with triton X-100 and (NH4)2SO4, then labeled by immunoenzymatictechnique, the mouse lung adenocarcinoma sublines (C6/C7) were positive for cytokeratin antibody only, butthe hepatocellular carcinoma cell (Hep G2) was positive for both cytokeratin and vimentin antibodies.Besides these, in the same cells, the distribution of the intermediate filament network showed by theimmunoenzymatic technique was nearly keeping with that of the cytoskeleton network showed by Coomasieblue R250 stain.CONCLUSION ① It is very difficult to identify the variations of the cytoskeleton network in morphologyby light microscopy when the same cell was extracted with triton X-100 and/or (NH4)2SO4 then stained withCoomasie blue R250 in comparsion. ② The characterizing distribution of the intermediate filament as well asthe ctoskeleton network that was irregular, uneven and gathering on one side to the nucleus in neoplastic cellmight provide a valuable information for studing tumor metastasis. ③ In analysing the components ofintermediate filament protein of malignant tumor cells, the heterogenous proteins (co-expression) must betaken into consideration.

AIM To study the clinical effect and mechanism of retention enema with quick-acting Kuijie powder(QAKJP) in treating chronic non-specific ulcerative colitis (CUC).METHODS A treatment group of 156 patients treated with QAKJP and a control group of 78 patientstreated with sulfasalazine orally were established randomly and their scores of main symptoms and signs weremeasured and compared before and after treatment. Animal experiments were conducted at the same time.RESULTS The total effective rate in the treatment and control group was 98.7% and 70.5% respectively,the clinical cure rate was 78.2% and 6.4% and the recurrence rate 5.3% and 20.0% respectively. Theeffectiveness of the treatment group was markedly superior to that of the control group, P<0.01.Experimental study showed QAKJB could rapidly alleviate the congestion and edema of intestinal mucosa,promote the healing of ulcer, inhibit spasm of colon and had significant antidiarrheal action and antagonisticeffect against allergic mediator histamine.CONCLUSION Retention enema with QAKJP has good effect on CUC, with low recurrence rate and notoxic or side effect.

AIM To study the changes of IL-6,IL-2, sIL-2R and TNF ir patients with hepatocellular carcinoma(HCC)and their clinical significance.METHODS IL-6, IL-2, sIL-2R and TNF were detected by avidin-biotin-system ELISA, double-sandwichELISA respectively in 60 patients with HCC and 36 patients with liver cirrhosis (LC) and 66 healthy persons.RESULTS The levels of IL-6, sIL-2R and TNF increased, but IL-2 level was lower in patients with HCCthan that in normal controls (NC) (t test, t=8.21, 4.71, 3.87, 2.13, P<0.01 or 0.05). IL-6 level in HCCwas 10 fold higher than NC, and also much higher than LC. IL-6 level was higher in later stage than that inearlier stage. There was a positive correlation between IL-6 and sIL-2R, TNF, while no positive correlationwas found between IL-2 and IL-6, sIL-2R in HCC.CONCLUSION The remarkably higher level of IL-6 is helpful for the early diagnosis of HCC.

AIM To observe the predictive value of gastric intramucosal pH (pHi) for critical patients.METHODS The gastric intramucosal pH (pHi) of 32 ICU patients was measured with a self-madegastrointestinal tonometer, and the APACHE l score was determined simultaneously.RESULTS pHi of the nonsurvivors was significantly lower than that of the survivors (P<0.05). The pHiwas remarkably higher in the nonsepsis group than in the sepsis group (P<0.01). Only in multiple organfailure groups, pHi was found statistically lower (P<0.05).CONCLUSION pHi may be the most simple, reliable, sensitive and accurate parameter to indicate theadequacy of tissue oxygenation, and it may be widely used in ICU monitoring in near future.

AIM To study the nosocomial infection in the patients with liver diseases and its risk factors.METHODS A prospective survey of nosocomial infection in 848 patients with various liver diseases wascarried out in our hospital for a 24-month period.RESULTS Incidence of nosocomial infection in patients with liver diseases was 9.20%, nosocomialinfection rate in severe hepatitis was significantly higherthan in mild and moderate liver diseases. Infectionof respiratory tract accounted for 44.33%. Infection rate in abdominal cavity, intestinal tract, gallbladderand bile ducts, oral region, and other regions was 15.46%, 12.37%, 8.25%, 7.22% and 12.37%,respectively.CONCLUSION The factors related to nosocomial infection were the severity of liver diseases, cellularimmunological condition, Co-infection of hepatitis virus, severe accompanying diseases, improper medicalmanipulations and use of broad-spectrum antibiotics. Nosocomial infection obviously affects the prognosis ofliver diseases.

AIM To understand the characteristics and investigate the diagnosis, treatment of intrahepatic biliarypapillomatosis.METHODS Two cases were confirmed operatively and pathologically, and the literature reviewed.RESULTS The causes of the disease are not clear, but the long-term irritations of stone and inflammationmay be considered. Despite being histologically benign, it has low-grade malignant potential, characterizedby multiple and diffusive manner, and has high rates of recurrence and malignant transformation. Jaundiceand cholangitis are the dominant manifestations. Imaging modalities are beneficial in it's diagnosis, and thescanning of choledochoscopy is of great value.CONCLUSION The management of the disease is difficult. Curative resection is the primary therapy.Curettage and drainage may lead to high recurrence. The chemotherapy and lasertherapy represent othermodalities in the treatment. Biliary papillomatosis may become a new indication for liver transplantation.

AIM To determine the serumal type of a species of salmonella which was isolated from imported frozenlarge yellow croaker.METHODS Aseptically weigh 25 g gill and viscera of the fish into sterile wide-mouth 500 mL jar. Add225 mL sterile buffered protein broth (BP) and incubate 18 h - 24 h at 36℃±1℃. Gently shake incubatedsample mixture, and transfer 1 mL to 10 mL selenite cystine broth (SC), add additional 1 mL to 10 mLtetrathionate broth (TTb). Incubate 18 h- 24 h at 36℃±1℃. Streak 1 loopful of incubated SC on selectivemedia plates of DHL. Repeat with 1 loopful of incubated TTb and incubate plates 24 h at 36℃±1℃. FromDHL, pick with needle 3 typical Salmonella colonies-colorless with black centers. Inoculate Ktiger's Ironagar (KIA) and Lysine-motilify agar (LMA) for screening. Finally they are suggested to be Salmonella.Then apply biochemical and serological identification tests to 3 presumptive positive samples reexaminated byChina National Institute for the Control of Pharmaceutical & Biological Products and certified by WHO Collaborating Center for Reference and Research on Salmonella.RESULTS According to the biochemical reaction, accordance with the characteristics of Salmonella andthe ability to utilize malonate, duicitol negative, ONPG positive, KCN negative etc. the specialities can beprimarily determined as subgroup Ⅲ. Basing on the results of serological examinations it can defined as O50group. Its H antigen revealed a phase HZ66, Z57, Z68, but the another phase still remained undiscovered. The reexamining result of China National Institute for the Control of Pharmaceutical & BiologicalProducts (checking No. SJKS 961037): Through Gram stain, culture, biochemical and serologicalexaminations this bacterium remained unverified and suggested to send the specimen to WHO SalmonellaCentral Laboratory for checking up. WHO Collaborating Center for Reference and Research on Salmonella appraised this species as a newserumal type of Salmonella. diarizonde with serumal type 50:K:Zs7:Z68NT (checking No. 8687).CONCLUSION The species of Salmonella was certified to be a newly discovered serovar of Salmonella.

AIM To probe into the effect of abnormal protection on coronary artery disease (CAD) in patients withliver cirrhosis (LC).METHODS Fifty-two cases of LC associated with diabetes mellitus (DM) and 63 cases of simple DM werecompared prospectively. Blood biochemistry, blood viscosity and ECG were examined carefully every threemonths, and the three-year morbidities CAD in both groups were monitored dynamically.RESULTS There were significant decreases in blood biochemistry and viscosity in LC group as comparedwith those in control (P<0.05 or 0.01), and there was a more significant decrease in ST-T abnormality ratein LC group than in the simple DM group (P<0.05). As a result, the three-year morbidity of CAD in LCgroup was 64% lower than in the control 1group.CONCLUSION There is truly an abnormal protection against CAD in patients with LC.

AIM To evaluate the clinical significance of early nutrition support in severe head-injured patients.METHODS One hundred and forty cases (GCS≤8) were randomly divided into 5 groups: each one had 28cases with similar data in age, sex, GCS or prognosis (P>0.05, x2= 0.43). Group A were given earlyparenteral nutrition (PN) and enteral nutrition (EN); group B were given early PN and EN after 1 week;group C were given PN only for more than 2 weeks; group D were given early PN only and group E weregiven traditional delayed EN. The clinical nutritional data, the rate of complication and the progrosis wereobserved and statistical comparison (t test and Chi-square test) was made.RESULTS The severe head-injured patients could get nourishment from different ways at early stage.Groups A and B had better outcomes and their clinical data such as blood glucose, blood total goblin, bloodalbumin, lymphocyte amount were superior to that of groups D and E (P<0.05, t = 2.12) and were thesame as that of group C (P>0.05, t = 0.98), the rate of complication and the prognosis of patients werebetter than that of the other groups. Group C had similar nutritional data in early stage, but had higher rateof complication and infection after 2 weeks than group A or B ( P<0.01, x2 = 7.38). Group A had lowerrate of gastric hemorrhage.CONCLUSION Early rational nutritional support had significant effect in the severe head-injured patients.The nutritional support of early PN and EN could afford nourishment, protect and improve the gastroentericfunction, reduce the rate of complication. So it is a rational nutritional support.

AIM To evaluate the role of intraoperative cholangiogram (IOC) in preventing biliary duct injury duringlaparoscopic cholecystectomy.METHODS Injury location, mechanism, time of detection, treatment outcome, and whether anintraoperative cholangiogram was performed were evaluated in 31 cases of bile duct injuries.RESULTS Cholangiograms were done in 22 cases, but they were misinterpreted in 3 of them. In 12 of 19misidentified cases, the cholangiogram was interpreted correctly, and the injury detected intraoperatively.Primary laparoscopic repair or open repair and T-tube drainage solved the problem. No long-termcomplications occurred. However, in 3 of the 19 cases the cholangiogram was misinterpreted and in 4 of the19 cases no cholangiogram was performed. Three of the seven patients required a cholangioentericanastomosis. In 2 cases the diagnosis was delayed and one of these required a two-stage procedure. Morbiditywas increased. Three cases of clim impingement of the common duct had delayed diagnoses, and two of themhad injuries. Thermal injury developed in 4 cases who had cholangiograms.CONCLUSION Routine IOC plays no role in inducing, preventing, detecting, or minimizing any of theinjuries due to clips, lacerations, or electrocautery, IOC does not prevent injuries due to ductmisidentification either. Careful interpretation of IOC would prevent injuries and avoid an open operation.

AIM To determine whether MAP can be detected in archival paraffin embedded full thickness samples ofintestinal tissue from patients in China with Crohn's disease (CD), ulcerative colitis (UC), and in controlsubjects (NIBD) having surgery for bowel cancer.METHODS Optimized procedures for the removal of paraffin, recovery of tissue and access to MAP DNA,followed by MAP-specific nested IS900 PCR. Confirmation of specific amplification by Southern blotting andDNA sequencing.RESULTS IS900 PCR positive tests identified MAP in 9 (69%) of 13 CD, 1 of 3 UC and 2 (14%) of 14NIBD in the presence of correctly reporting positive and negative sample and reagent control reactions. DNAsequence analysis of the 298bp IS900 PCR amplification product from MAP in 2 Chinese CD patientsdemonstrated 99% homology with the GenBank IS900 sequence accession number X16293.CONCLUSION Although larger numbers of Chinese samples need to be studied, these initial results areconsistent with an exposure of human populations in China to MAP, and an involvement of this pathogen inchronic inflammation of the intestine of the Crohn's disease type. The results are in agreement with similarpositive studies reported from China, from Western Europe and elsewhere.

AIM To explore a method to control splenic embolic volume precisely for partial splenic embolization(PSE) to improve the validity and safety of PSE, and study the portal hemodynamic changes after PSE.METHODS Gelfoam particles of identical standard (2×2×1.6mm) were used as embolic material tomeasure the splenic radiographic parameters SAI (spleen activity index) was measured scanning withradioisotope technetium-99mTc sulfur colloid and splenic embolic volume was calculated with the followingformula: splenic embolic volume = [SAI(pre-PSE)-SAI(post- PSE )]/SAI(pre-PSE)×100%. The regressionequation of gelfoam particles in splenic embolic volume and splenic radiographic parameters was calculatedusing SAS (statistical analysis system) software (version 6.02). Portal hemodynamic changes were examinedby color Doppler ultrasound.RESULTS The amount of gelfoam particles was correlated with splenic embolic volume and top-bottomlength of spleen, regression equation was achieved: Y = 5.77X1 + 15.19X3-164.75, (multi-regression wasused, significant level P = 0.15). Y: number of gelfoam particles used, Xl: splenic embolic volume (%),X3: top-bottom length of spleen (cm). The diameter and blood flow volume of spleen and portal vein and thepeak velocity of spleen vein all decreased after PSE. The decreased parameters were positively correlatedwith splenic embolic volume.CONCLUSION By calculating gelfoam particles for PSE, splenic embolic volume could be controlled withinthe effective and safe limit. PSE could decrease the high dynamic circulating state of portal systemeffectively.

AIM To study the prognostic significance of the p53 cDNA mutation and mutant p53 protein in colorectaladenocarcinomas.METHODS p53 cDNA mutaiton was detected with RT-PCR-SSCP, and mutant p53 protein overexpressionwas detected by PAb 240 monoclonal antibody in 100 cases of colorectal adenocarcinomas. The follow-upsurvey of all patients were done within the five years after operation, and comparing with p53 cDNAmutation and mutant p53 protein overexpression for the prognostic significance of colorectaladenocarcinomas. The data is treated with SPSS computer program, Kaplan-Meier Survival Plots werecalculated and analyzed by Log-rank analysis.RESULTS Fifty-one cases of p53 eDNA mutations (51%) were found with RT-PCR-SSCP and 76 cases ofmutant p53 protein overexpression (76%) found with PAb 240 monoclonal antibody immunohistochemistrystaining in 100 cases of colorectal adenocarcinomas. There are no relationship with Dukes stage in thestatistics in p53 eDNA mutation (mutation: Dukes A 9%, B 10%, C 20%, D 12%; No mutation: A 13%, B12%, C 12%, D 12%) and mutant p53 protein overexpression (positive: Dukes A 17%, B 6%, C 27%, D16%; negative: A 5%, B 6%, C 5%, D 8%) (P<0.05). Moreover, the data show p53 cDNA mutation isassociated with mutant p53 protein overexpression (both positive 49%, single positive 29%, both negative22%) (P<0.01), p53 eDNA mutation can provide prognostic information (p53 eDNA mutation positive:alive 35, dead 16; negative: alive 42, dead 7) (P<0.05), and mutant p53 protein overexpression isambiguous and does not assess prognosis (p53 protein overexpression positive: alive 58, dead 18; negative:alive 19, dead 5) (P = 0.72) with Kaplan-Meier Survival Plots and Log-rank analysis.CONCLUSION p53 eDNA mutation is associated with mutant p53 protein overexpression (p53 eDNAmutation and mutant p53 protein overexpression both positive 49%, single positive 29%, both negative 22%)(P<0.01) and p53 eDNA mutation can provide poor prognostic information, and is the biomarker of poorsurvival of colon cancer . However, mutant p53 protein overexpression could not predict prognosis and maybe effected by other multi-factors in colon cancer.

AIM To describe a liver cancer = specific gene expression profile and to identify genes that showed alteredexpression between liver cancer tissues and their adjacent nearly normal tissues.METHODS The cDNA probes which were labeled with a-32P dATP were synthesized from total RNA ofliver cancer and adjacent normal tissues and hybridized separately to two identical Atlas human cancer eDNAexpression array membranes containing 588 known genes.RESULTS Autoradiographic results were analyzed by specific Atlas ImageTM (version 1. 0) software.Among the 588 genes analyzed, 18 genes were found up-regulated in cancer, including TFDP2, Aktl, E2F-3etc, and 25 genes were down-regulated in cancer, including TDGF1, BAK, LAR, etc. Expression levels ofgenes that associated with the regulation of cell proliferation, apoptosis, differentiation, cell-cellinteraction, invasion regulators and eytokines altered mostly.CONCLUSION The result obtained from Atlas microarray provides a comprehensive liver cancer-specificexpression profile. The results can lead to the identification of liver cancer-specific biomarkers and may behelpful in early diagnosis and dentifiction of target genes for designing rational therapeutic strategies.

AIM To study the detection of micrometastasis in peripheral blood of patients with gastric carcinomas andits clinical significance.METHODS A cytokeratin 19 (CK19)-specific nested reverse transcriptase-polimerase chain reaction (RT-PCR) assay was developed to detect CK19 expressing cancer cells, the sensitivity was determined by serialdilution method using CK19 expressing gastric cancer cells, the specificity was assessed by examining 12negative controls and 12 positive controls. Then pre-operative peripheral blood from 42 patients with gastriccancer was detected and the relationship between positive results and biological behavior was studied.RESULTS CK19mRNA was expressed in all the 12 gastric cancer tissues but not in peripheral blood from12 healthy individuals；sensitivity of nested RT-PCR amplification for CK19mRNA was confirmed to be 1/106 by serial dilution method using human gastric cancer line SGC-7901; micrometastases in pre-operativeperipheral blood were detected in 13 (30,9%) patients with gastric carcinomas, the frequency ofmicrometastasis in peripheral blood was significantly correlated with tumor size,depth of invasion and TNMstage (x2 test, P<0.05).CONCLUSION Nested RT-PCR amplification for CK19mRNA is a sensitive and specific method for thedetection of micrometastases in peripheral blood in gastric cancer patients; pre-operative detection ofmicrometastasis in peripheral blood may be helpful in the prediction of tumor progression.

AIM Endoscopic ultrasonography (EUS) guided pancreatic pseudocysts drainage is an ideal therapeuticprocedure. We perform it in just one step by using the self-made drainage stent.ETHODS We made an aperture at the tip of the needle outer sheath, and tied the outer sheath with theself-made stent by suture. EUS-guided pancreatic pseudocysts drainage was performed in five patients. Nopatient had visible endosmotic bulge on the gastrointestinal wall. Mean pseudocyst diameter was 4.5 cm(pancreatic head 1, body 2, tail 4). We determined the optimal site for puncture and advanced the needlyand stent into cyst. Taking out the needle made the stent separated from the sheath.RESULTS No hemorrhage happened among these patients. One patient suffering from fever up to 40℃recovered within two days after operation. All the cysts diminished insige after 7 days and resolvedcompletely after 6.8 weeks in average. Cyst resolution was accompanied by symptomatic improvement in allpatients. During a follow-up of 6 months no cyst recurred.CONCLUSION EUS-guided drainage of pseudocysts is a safe and effective procedure, which performs thejust in one process and diminishes the patients' distness.

AIM To study the clinical significance of alterations of serum hyaluronic acid in rats with carbontetrachioride-induced liver fibrosis.METHODS Rat liver fibrosis model was induced by carbon tetrachloride (CC14). The rats were divided intofive groups; group 1 (control): 0 week with no CCl4-inducing; group 2, 3, 4 and 5: 3, 6, 9 and 12 weeksafter CCl4-induction respectively. Serum HA level was analysed among various liver fibrosis groups andcontrol, and then compared the HA findings with the hepatic histopathology.RESULTS During rat liver fibrosis, serum HA levels of the liver fibrosis groups (group 2: 7.98ng/mL;group 3: 20.10 ng/mL; group 4:229.73 ng/mL; group 5:324,74 ng/mL) were significantly higher thanthat of control group (group 1:0.21 ng/mL) (P<0.01), in which group 4 and group 5 are much higher1094 times (229.73ng/mL/0.21 ng/mL) and 1546 times (324.74 ng/mL/0.21 ng/mL) than group 1respectively. When compared with each other, the serum HA levels are 38 times (7.98ng/mL/0.21 ng/mL; P<0.01, group 2 vs group 1); 2.5 times (20.10ng/mL/7.98 ng/mL; P<0.01, group 3 vsgroup 2); 11.4 times (229.73 ng/mL/20.10 ng/mL; P<0.01, group 4 vs group 3); 1.4 times (324.74 ng/mL/229.73 ng/mL; P<0.01, group 5 vs group 4) respectively.CONCLUSION The results demonstrated that the dynamic alterations of serum HA play an important rolein the early clinical diagnosis and staging of liver cirrhosis.

Acute severe pancreatitis (ASP) was habitually called acute hemorrhagic necrotizing pancreatitis. Butaccording to the pathological finditgs of our 139 surgical cases, 59.7% belonged to necrotizing type, whilehemorrhagic necrotizing type only accounted for 23.0%. Involvement of pancreas is not necessarily diffuse,3.7% only affected pancreatic tail. The incidence of the disease is highest in 41 - 60 year age group. Earlyrecognition of severe type of the disease is always an emphasis in clinical studies. CT scanning is the maindiagnostic tool used. Clinical diagnostic criteria offer some help in clinical practice. Banks' criteria is morecommonly used in western countries instead of Ranson criteria in the past. For clinical evaluation of theprogress of the disease, APACHEII scoring method is commonly used. Classification of CT findings ishelpful in judging the severity of the disease. Once the diagnosis was definitely established, should it betreated surgically or managed by medical way? The pendulum had swung for many years. Our currentconsensus is “combined treatment system”. That is: patients with uninfected pancreatic necrosis shouldreceive non-surgical treatment. The success rate is over 85%. Cases of infected necrosis went downhill,vigorous treatment should be given immediately. Otherwise, late stage operation should by all means be considered and wait for localization of theinfection with the hope of complete cure after single drainage operation. “Obstructive biliary pancreatitis”and “Ruptured pancreatic abscess causing peritoritis” are indicated for immediate operation. Cure rate bynon-surgical treatment is significantly increased, with a success rate of operative treatment of 80%. Medicaltreatment is administered by the combined traditional Chirtese and Western medicine. Besides all thenecessary supportive and symptomatic treatment, three major aspects of treatment should be speciallyemphasized: ① pancreatic infection. According to the bacterial spectrum, concentration of antibiotics in thepancreas and drug sensitivity test, we advocate the use of quinolone class antidacterial agents such asimipenem, Ofloxacin,ciprofloxacin, etc as drug of first choice. ② Inhibition of pancreatic secretion usingGabexate mesilate or synthetic analogue of somatostatin. The two analogues that are widely used in China areOctreotide (Sandostatin) introduced to China earlier; and the 14-pepitide somatostatin (Stilamin) introducedlater but also has been used for some years. There were reports about the benefits and drawbacks of the twoand sometimes quite controversial. According to our experience in using these two analogues, we have notmet with serious side effects of Octreotide as reported in the western literatures. The action of Stilamin onsphincter of Oddi is causation of relaxation, but the action of Octreotide on it was quite controversial. Somereported about its spasmodic action on the sphincter. We have studied in dog experimentation and provedthat Sandostatin can significantly lower the basal pressure of sphincter of Oddi. Our consensus of their use inASP is that either can be used as available, except in most severe cases, we prefer Stilamin. However,Saadostatiu has some merits in the following conditions: It can be given hypodermically orintramuscatarly. It is more suitable for outpatients with milder disease. (?) Chronic pancreatitis with acuteflare up. ③ Treatment with traditional Chinese medicine: according to the Chinese theory of thepathogenesis -“wetness and heat stagnated at middle focus”, the principle of treatment is “relieving liver,adjutsting gas, clearing heat, drying wetness, getting through and driving down”. We have made aprescription consisting of several important ingredients, in the form of decoction. Since the 1980s, we havestudied a few Chinese herbal medicines separately. They were all proved to have promising effect. Inconclusion, in ASP, we advocate combination of Western and traditional Chinese medical treatment.

AIM To obserwe tb e effect of pentagastrin (G-5) on IL-1β induced inhibition of insulin secretion in newbornrat islet of Langerhans.METHODS Islets of Langerhans of 3- to 5-day-old rats were isolated by collagenase digestion. The isletswere maintained free-floating in culture medium RPMI-1640, containing 10% (V/V) calf serum, anddistributed randomly in 96-well plastic plates (6 wells in each group). There are 15 islets per well in 0.2 mLculture medium. The islets were kept at 37℃ in mixed gases of 5% CO2 and 95% humidified air for the timerequired by the experimental design. Three experiments were performed in this study. (①) IL-13 inducedinhibition of insulin secretion in isolated islets of Langerhans. (②) Effect of G-5 on IL-lβ induced inhibition ofinsulin secretion. ③ Effect of G-5 on the functional repair of islet B-cells inhibited by IL-1β. Accumulatedand glucose stimulated insulin secretion was measured by radioimmunoassay in all studies. Data are presentedas ~ ± s. Differences between groups were analyzed using the Student's t test. P <0.05 was consideredsignificant.RESULTS The function of islet B-cells, which has been received 1L-1β treated for 24 hours, was dose-dependently inhibited. The accumulated and glucose stimulated insulin secretion was significantly lower thanthat of the control group (P<0. 05). The inhibitory effect of IL-1β on islet B-cells can be partially reversedby G-5. Accumulated and stimulated insulin secretion of G-5 0.6 ng/mL and 0.8 ng/mL groups wassignificantly higher than that of IL-1β treated alone group (P<0.05). The function of islet B-cells, whichreceived IL-iβ treatment for 24 hours, could partially recover after G-5 treatment for another 24 hours. Butaccumulated and glucose-stimulated insulin secretion in groups with G-5 treatment for 10 hours groups had nosignificant difference as compared with IL-1β treated alone group (P>0.05).CONCLUSION The present results indicate that G-5 may have a protective effect against the toxicity of IL-1β on islet B-cells.

AIM To study the relationship between the lipid peroxide (LPO) and superoxide dismutase (SOD) and thepathogenesis of gastrointestinal cancers.METHODS We investigated the SOD activity and LPO levels in blood and mucosa of patients withesophageal (EC), gastric (GC) and colorectal cancer (CC), gastric ulcer (GU) and compared with normalesophagus (NE), stomach (NS) and colon (NC). respectively, 287 patients who underwent endoscopy werestudied. SOD activity of the tissue and blood was determined using SUN's adrenaline auto oxidation method.LPO levels were determined according to YU's method.RESULTS The SOD activity and LPO level in blood and mucosa are shown in the Table 1 (x±Sx).Table 1 SOD and LPO in blood and tissues of patients with gastrointestinal cancers SOD(U／mg protein) LPO(U／mg)Groups n Tissue blood Tissue BloodNormal stomachGastric ulcerGastric cancerNormal esophagusEsophageal cancerNormal colonColon cancer 60 42 43 32 52 28 30 1.90±0.18 0.64±0.40a 0.37±0.24a 1.17±0.70 0.39±0.30a 0.81±0.36 0.31±0.17b 33.70±1.73 25.50±0.67b 27.86±1.02b 30.80±3.78 28.23±10.63 20.97±4.77 19.35±7.32 0.01±0.004 0.05±0.010b 0.06±0.021b 0.014±0.005 0.061±0.033b 0.012±0.003 0.069±0.015b 0.83±0.01 0.11±0.02 0.12±0.03 0.08±0.02 0.11±0.02 0.08±0.03 0.11±0.02aP<0.001, bp<0.01 vs corresponding normal controls, respectively.CONCLUSION SOD activity of the tissue is significantly decreased in EC. GC and CC. LPO levels weresignificantly higher than those of corresponding normal tissue. These results suggest that mucosal SOD andLPO levels are closely related to the pathogenesis of the gastrointestinal cancers.

AIM To report a new method designed to collect gastric juice from chicken, and determine the basal levelof gastric acid and serum gastrin, and the effect of pentagastrin on gastric acid output.METHODS White Leghorn chickens, weighing 1.3 kg- 1.7 kg, deprived of food 24 h prior to experiment,were anaesthetized with pentobarbital sodium (60μg/kg, im). A reverse double lumen perfusion cannulawas introduced into the distal portion of the proventriculus through the crop incision. The perfusate drainedout from the cannular outlet was collected to determine the gastric acid. Gastric acid volume was determinedby titration with 0.01N NaOH. Serum gastrin levels were measured by radioimmunoassay using gastrin assaykit.RESULTS Acid output in the basal state was 0.041±0.006 mmol/L/10min, or 0.246±0.031mmol/L/h. The serum gastrin concentration was 78.27±19.19 pg/mL (n = 22). Three groups wereinjected pentagastrin at three dose level, 20μg/kg, 60μg/kg, 120μg/kg, respectively. The maximumoutput in three groups was 275%, 181% and 167% of their control acid output. Isoproterenol at a dose of0.3 mg/kg produced obvious inhibition of pentagastrin-stimulated gastric secretion. The effect ofisoproterenol on gastric secretion was completely abolished by propranolol, a β-receptor antagonist, but wasnot done by practolol, another 31-receptor antagonist.CONCLUSION The basal gastric acid output of chicken was high. Pentagastrin remarkably stimulatedgastric acid secretion, which could be inhibited by isoproterenol.

AIM To isolate, done and sequence gcys-18 overexpressed in gastric carcinoma.METHODS gcys-18 was isolated from differential display gel between GC7901 and GES-1 by mRNAdifferential display PCR, and was cloned into T vector. As a probe gcys-18 was hybridized to total RNAs ofGC7901 and GES-l, and was sequenced. Its sequence was screened against GeneBank. According to theobtained sequence, a pair of primers were designed and used to examine 26 specimens of gastric cancers andcorresponding paracancerous tissues by quantitative reverse transcriptase PCR.RESULTS gcys-18 was isolated and cloned, and confirmed to be expressed higher in GC7901 than in GES-1 by RNA dot blot; gcys-18 was 416bp, and partly similar to HEK5, and its accepted number in GeneBankwas AF071057; 18 out of 26 specimens of gastric cancers and 2 out of corresponding paracancerous tissueswere examined by RT-PCR.CONCLUSION gcys-18 may be an important expressed sequence tag in gastric cancer, and takes part inprogression of gastric carcinoma.

AIM To evaluate a system for bile acid formation in human hepatocytes in comparison with HepG2 cells.METHODS Hepatocytes were isolated from normal human liver tissue and were cultured in serum-freeWilliam's E medium. The medium was collected and renewed every 24 h. Bile acids and their precursors inmedia were finally analysed by gas chromatography-mass spectrometry.RESULTS Cholic acid (CA) and chenodeoxycholic acid (CDCA) conjugated with glycine or taurineaccounted for 70% and 25% of total steroids. One third of CDCA was also conjugated with sulphuric acid.Dexamethasone and thyroid hormone alone or in combination did not significantly affect bile acid formation.The addition of cyclosporin A (10 tm) inhibited the synthesis of CA and CDCA by about 13% and 30%,respectively.CONCLUSION Isolated human hepatocytes in primary culture behave as in the intact liver by convertingalmost quantitatively cholesterol to conjugated CA and CDCA. This is in contrast to cultured HepG2 cells,which release large amounts of bile acid precursors and unconjugated bile acids into the medium.

AIM To investigate the effects of low dosage of nitric oxide synthesis (NOS) inhibitor NG-nitro-L-argininemethyl ester (L-NAME) in long-term treatment on hyperdynamic circulatory state in rats with cirrhosis.METHODS Cirrhosis model was induced in male SD rats by injection of 60% CC14 oily solutionsubcutaneously. Cirrhotic rats were treated with L-NAME (0.5 mg·kg-1·d-1) by gavage for two weeks. Meanarterial pressure (MAP), cardiac output (CO), cardiac index (CI), splanchnic vascular resistance (SVR),splanchnic blood flow (SBF) and serum NO levels were determinded in L-NAME-treated, L-NAME-untreated cirrhotic rats and controls by using 57Co-Labled microsphere technique and a fluorometric assay,respectively.RESULTS Untreated cirrhotic rats had significantly lower MAP, SVR and higher PP, CO, CI, SBF andNO concentration than controls ( 14.42±0,47 kPa vs 17.05±0.34 kPa, 2.974±0.186 kPa·mL-1·min-1 vs4.234±0.118 kPa·mL-1·min-1, 1.665±0.067 kPa vs 1.123±0.096 kPa, 189.99±9.26 mL/min vs 135.5±3.55 mL/min, 55.89±1.82 mL-1·min-1·100g-1 BW vs 39.68±1.64 mL-1·min-1·100g-1 BW, 4.60±1.25μmol/L vs 0.53±0.26 μmol/L, P<0.01, respectively). In treated cirrhotic rats, L-NAME significantlyattenuated the increase of CO, CI, SBF, NO concentration and the decrease of MAP and SVR. In treatedcirrhotic rats, L-NAME induced a marked decrement of NO concentration than untreated cirrhotic rats(1.471 ±0.907 μmol/L vs 4.204±1.253 μmol/L, P<0.01).CONCLUSION The endogenous NO may play an important role in the changes of hemodynamics pattern incirrhosis,and hyperdynamic circulatory state in rats with cirrhosis can be ameliorated by long-term low doseL-NAME treatment.

AIM Pylorus and pyloric vagus preserving gastrectomy (PPVPG) is an efficient operation mode for treatinggastric and duodenal ulcers. For its better application and popularization, we have designed andmanufactured a special multifunctional stomach clamp.METHODS The clamp has been designed carefully in view of the different sizes of the patients' stomachsand the different starting points of Latarjer nerves so as to facilitate the execution of the present operationmode, which requires the preservation of the vagus innervated pyloric region so as to make the remnantstomach maintain its normal physiological function and the vagus branches clinging antral seromuscular flapkept in proper size so that avoiding too much remaining antral mucosa is removed to cause greater difficultyin operation. With this in view, we observed and measured the distance between the Latarjer nerves distribution and the pyloric rings of 42 patients' stomachs in the course of operations. We bent an aluminumstring 3 mm thick for each stomach according to the size of antral seromuecular flap and chose an optimalcurvature from the 42 sizes for manufacturing the clamp. The clamp is made of 3 Cr13 stainless steel,consisting of three parts, the curved head, the fastening ring and the handle. The curved head is shapedalmost exactly like the remained antral seromuscular flap. The ring at its tip when in place fastens the twosides of the clamp so that the tissue of the stomach between will be clutched by an even force. On one sideare three cuts for moving the ring upwards, each cut representing 1 mm for fastening and adjustments can bemade in view of the thickness or thinness of the tissue. The handles bend backward for fighting shy of thecuts so as to facilitate the operation.RESULTS With the stomach disassociated in the light of PPVPG procedures, the clamp may easily beapplied from the upper part of the Latarjer nerves. The following merits can be noted. ① The curving line ofthe flap can be precisely cut. ②Before the antrum mucosa is stripped, the submucosal injection of hemostaticsalt solution can be confined without being expanded and the solution will separate muscular layer frommucous layer and helpful in stripping. ③The bleeding of the cuts on the antral seromuscular layer beingclamped and stopped. ④The antral seromuscular flap shaped by the clamp and facilitated to strip the antrummucosa beneath. ⑤The gastric juice can be prevented from flowing to the stripped region. All theseevidently facilitates the operation and shorten the time consumed. By the adjustment of its position in theoperation the clamp can be applied to stomachs in different size or with different starting points of Latarjernerves and even to those of experimental animal. Apart from applying to PPVPG, the clamp can be used forthe following operations: the Bancroft operation, with the curved part directing upwards; the resection ofgastric ulcer at the high portion of the stomach; the Billroth Ⅱ anastomosis. The clamp has proved in goodperformance for 122 cases of clinical treatment, worthy to be recommended to our colleagues.CONCLUSION The clamp can be used not only for this operation mode, but also for Bancroft operation,for the resection of gastric ulcer at the proximal end of the stomach and the Billroth Ⅱ anastomosis hencenamed the multifunctional stomach clamp.

AIM To evaluate the effect of chitosan on rat body weight, concetration of plasma leptin and serumtestosterone.METHODS Five groups of rats were respectively given access to basic diet, high fat diet and high fat dietwith different doses of chitosan (1.5%,3.0% and 6.0% of chitosan in high fat diet respectively) for 7 wk.All rats were weighed once a week. By the end of wk 7, the animals were sacrificed and their blood sampleswere taken, the concentration of plasma leptin and serum testosterone were determined by RIA Kit method.RESULTS At the end of wk7, the average body weight of rats treated with high-fat diet was 67.3 gheavier than that with the basic diet, however, the average body weight of rats treated with high doses of chitosan in high-fat diet was 56.3 g lighter than that with high-fat diet (P < 0.01). In addition, plasma leptinconcentration in rats treated with high fat diet was significantly different from those with basic diet(P<0.01); plasma leptin concentration in rats treated with high dose of chitosan in high-fat diet wassignificantly lower than those with high-fat diet (P<0.01), but was significantly higher than those withbasic diet (P<0.05). Serum testosterone level in rats treated with high-fat diet was significantly lower thanthose with basic diet (P<0.01). Serum testosterone levels in rats administrated high dose of chitosan inhigh-fat diet were sighificantly lower than those with high-fat diet (P<0.01).CONCLUSION Chitosan prevents the increase of rat body weight induced by high-fat diet, and lowersplasma leptin and serum testosterone in rats.

AIM To observe the therapeutic effect of Welcome on gastric mucosal dysplasia in rats.METHODS Rats with gastric mucosal dysplasia induced by MMNG and heat-damage were treated withWelcome, a kind of traditional Chinese medicine compound which has the functions of replenishing qi toinvigorate the spleen, and of nourishing the liver and kidney and clearing away heat and toxic materials, thecontrol rats were treated with saline and tretinoin.RESULTS AND CONCLUSION The results showed Welcome could obviously block the mutagenic action ofMNNG and prevent the occurrence of gastric mucosal dysplasia of rats.

AIM To investigate the effect and regulation of electrical stimulation on the paraventricular nucleus (PVN)of hypothalamus using rat gastric ischemia-reperfusion injury (I-RI)induced ulcer model.METHODS Adult male Sprague-Dawley rats weighing 150 g-250 g were used. The surgically prepared ratswere kept fasting for 24 h, but allowed free access to water. They were then anesthetized with urathane(1 g/kg), the celiac artery was clamped with a small clip (holding force 145 g) for 30min, reperfusion wasestablished by removal of the clamp, 60min after reperfusion, the rats were killed and their stomachs wereremoved and perfused intragastrically with 100 mL/L formalin for 30min, and the ulcer index was scoredaccording to Guth et al. The PVN was obtained according to atlas of Paxinos and Watson. The electrodesand cannula were inserted into the PVN for the electrical stimulation, electrical injury and PVN injection，RESULTS In control group (30min ischemia and 60ain reperfusion only), ulcer index was 184.70±60.80(n = 8); in electrical stimulations of PVN (0.2mA, 0.4mA and 0.6mA) + I-RI group, ulcer indexes were102.40±20.39, 85.37±39.76 and 45.00±19.04 (n =8) respectively. Compared with the control groupthere was significant difference ( P < 0.01) in a dose-dependent manner. In electrical lesion of bilateral PVN+ I-RI group, ulcer index was greatly increased (230.00±47.30, n = 8). Microinjection of 3% L-glutamate0.5μL into PVN could produce similar effect to that of PVN stimulation (ulcer index 75.14±37.18, n = 8).A further study indicated that the MDA, pepsin activity and gastric acidity were reduced by PVN stimulationbut no obvious changes of gastric juice volume, total acid output and gastric mucus barrier were observed.CONCLUSION The PVN is one of the specific CNS areas capable of protecting the gastric ischemic-reperfusion injury in rats, and related to decreased MPA, pepsin activity, gastric acidity, while gastric juicevolume, total acid output and gastric mucus do not likely play any important role in it.

AIM To evaluate the clinical value of creatine kinase macroisoenzyme type 2 (CK-M2) and oligosaccharideprotein (OP) in serum from patients with gastric carcinoma (GC).METHODS Serum level of CK-M2 was detected by agar gel electrophoresis. OP concentration was measuredby an enzyme immunoassay.RESULTS Serum levels of CK-M2 and OP in 57 cases of GC were significantly higher than those in 51 caseswith gastric precancerous lesion and 28 controls. The diagnostic sensitivity and specificity for GC with CK-M2 was 56.10% and 98.63% respectively. CK-M2 and OP were not associated with histologic type and degreeof differentiation.CONCLUSION These results suggest that CK-M2 may serve as a marker to diagnose GC, and the specificityis higher, whereas OP is not more significant for GC diagnosis, but it could be a useful indicator forevaluation the status of body immune.

AIM To study the effect and alteration of hepatic blood flow as well as ultrastructure of hepatic tissue inchronic cholestatic hepatitis after hypebaric oxygenation (HBO).METHODS Using the hepatic rheometer and Doppler B-mode ultrasound equipment, the contractive waveof hepatic blood flow and blood flow of portal vein were tested; the biochemistry, immunohistochemistryand ultrastructure of hepatic tissue were determined and served as the evaluating indexes.RESULTS After the HBO treatment, the contractive wave of hepatic blood-flow in 76% patients and bloodof right portal vein in 70% patients were increased, the improvement of serum ALT and BILI was 88.9%and 93.3% respectively. In addition, the swelling mitochondria, cholestasis of hepatic cells and capillariesreduced obviously; Kupffer's cells decreased. There was significant difference (t=2.85, P<0.05) beforeand after HBO treatment.CONCLUSION It is suggested that the HBO could increase the blood flow of portal vein and arteries,improve the hepatic function, cholestatsis and inflammation.

AIM In order to provide the TCM therapeutic basis for MODS in clinical critical patients, the role of shockdecoction in anti-bacterial translocation from the gut was tested in rats.METHODS Based on the pathophysiology of MODS following bacterial translocation from the gut causedby severe injuries such as burn, shock, hemorrhagic shock model that induced obvious bacterial translocationwas established and used to determine whether shock decoction, that is composed of modified WenpiDecoction, reduces bacterial translocation. Bacterial culture for mesenteric lymph nodes, liver and spleen ofrats in shock, treatment and control groups was used to calculate the incidence of bacterial translocation.RESULTS The incidence of intestinal bacteria translocating to mesenteric lymph nodes, liver and spleenwas lower in the shocked rats infused via gastrogavage with shock decoction (3/ 15) than that in thenoninfused shocked rats (11 / 13), (P = 0.0009, < 0.01 ). The incidence of intestinal bacteria translocationof rats in shock and control groups were distinctly different (P = 0.0017, <0.01). The amounts and speciesof intestinal flora between infused and noninfused shocked rats were not different statistically (P=0.101,P>0.05). Histological examination showed that intestinal mucosa edema was severer in the shocked ratsthan in the shocked rats with gastrogavage.CONCLUSION Shock beverage could inhibit the shock-induced enterogenous bacterial translocation in ratsprobably by its protective role in intestinal mucosa structure; and has no effect on the growth of intestinalbacteria.

Management of inflammatory bowel disease includes not only drug, endoscopic and surgical therapy but alsopsychosocial support, dietary and specific nutritional measures: a multidisciplinary medical, surgical, nursingand dietetic approach is essential for all patients, particularly those with complex or refractory disease. Inthis paper, current treatment of acute severe ulcerative colitis and steroid-refractory or -dependent Crohn'sdisease is reviewed. Adjunctive intravenous cyclosporin is an alternative to urgent colectomy in steroid-refractory patients with acute severe ulcerative colitis, while the place of intravenous heparin for thisindication awaits clarification. Azathioprine or 6-mercaptopurine are useful options in chronically active,steroid-refractory or -dependent Crohn's disease, but may take up to 4 months to work. Methotrexate is amore recent immunomodulatory alternative. Of new therapies selectively aimed at specific pathophysiologicaltargets, the first to reach clinical application is anti-TNF-alpha antibody (infliximab) for refractory Crohn'sdisease: its benefits are promising, but experience with it is limited to date, its cost is high and there areuncertainties about long-term safety. In view of the increasing variety and complexity of management optionsin inflammatory bowel disease, whether apparently responsive or difficult to treat, patients must participatein decisions about which therapies they are to be given.

AIM To investigate the infection of hepatitis G virus (HGV) in 105 cases of drug abusers.MATERIALS AND METHODS One hundred and five heroin addicts including 85 males and 20 females,aged from 17a to 45a old, mean age 26.3a±5.8a were observed. Duration of the drug abusing was rangedfrom 5 mo to 168 mo with mean 37.5 mo±23.6 mo. Seventy-five cases accepted the drug by intravenousinjection only, 30 others by both intravenous and scalded inhaling ways. All cases had no history of bloodtransfusion. ① Detection of HGV-RNA: total RNA was extracted from serum by the acid quanidinum thiocyanate-phenol-ethanol method, the 5'terminal non-coded region of HGV-RNA was amplified by nested reversetranscription-PCR, ② anti-HAV-IgM, HBsAg, anti-HCV, HDAg, anti-HD, anti-HD-IgM and anti-HEVwere detected by ELISA. Reagents were provided by Shenzhen Moon Bay Biologic Company. ③ Hepaticfunctions were determined by Hitachi 7510 automatic analyzer.RESULTS (① Incidence of HGV infection: 25(23.8%) of 105 drug abusers, 21 men and 4 women,wereinfected with HGV. The mean drug taking time of HGV infected cases were 38.6 mo±19.9 mo, it is similarwith the mean duration of drug abusing, 37.7 mo±24.6 mo (P>0.05), of those cases without HGVinfection. ② Superinfection of HGV with hepatitis B virus (HBV) or hepatitis C virus (HCV): 26 (24.7%)of 105 addicts were infected with HBV and 68 (64.8%) with HCV. Among 25 cases infected with HGV, 8(32%) of them were infected with HGV alone, 6(24.0%) were superinfected with HCV, 2(8.0%) withHBVand 9(36.0%) with HCV and HBV. Thus, 17(68.0%) of 25 cases infected with HGV weresuperinfected with HCV and/or HBV. ③ Hepatic function tests: The total serum bilirubin levels of all 105cases were less than 20 umol/L. The ALT levels of 30(28.6%) cases were more than 40 U/L and amongthem, 1 case was infected with HGV only, 1 was superinfected with HGV and HBV, 3 with HGV and HCV,7 with HGV, HBV and HCV respectively. Meanwhile also among the cases with abnormal increased ALTlevel, 1 case infected with HBV, 15 with HCV, 2 superinfected with HBV and HCV.CONCLUSION The results of this investigation neveal that in drug abusers the incrdence of viral hepatitis isin the order of HCV, HBV and HGV.

AIM To investigate a mixture of traditional Chinese medicine (TCM) in the prevention of chronic colitis inrats.METHODS Sixty rats were divided into 3 groups. Colitis was induced by trinitrobenzene-sulfonic acid(TNB). On day 10, all the survived rats were killed, the mortality and intestinal obstruction rate werecalculated, the colonic lesion score was assessed and collagenase activity and collagen concentration weremeasured.RESULTS The survival rate was much lower and intestinal obstruction rate much higher in TNB than thosein TCM, they were 53% and 81% vs. 80% and 24% (P<0.05 and P<0.01, respectively). There were alsosignificant differences in colonic stricture score and colonic weight between TNB and TCM groups (1.75±1.2 vs 0.22±0.67 and 0.57±0.36 vs 0.31±0.10, P<0.01 and P<0.05, respectively). No hydroxyprolineand collagenase activity differences were found between the two groups.CONCLUSION This mixture of TCM prevents the formation of intestinal stricture, increases the survivalrate and decreases intestinal obstruction rate in a rat model of chronic colitis.

AIM To evaluate the effects of expandable metallic stent biliary endoprostheses (EMSBE) viaultrasonographic guided percutaneous transhepatic approach on the treatment of benign and malignantobstructive jaundice.METHODS Thirty-eight patients with obstructive jaundice (29 males and 9 females) aged 27 to 69 years(mean 54.7 years) were studied. Of them, 4 were benign and 34 malignant obstructions. Percutaneoustranshepatic cholangiography (PTC) was performed under ultrasonic guidance. A catheter was introducedinto the dilated bile duct via the introducer. A guide wire was inserted through the occlusive part of biliary duct after dilating with a double-lumen balloon catheter. A self-expandable metallic stent was inserted intcthe occlusive bile duct under fluoroscopic control.RESULTS The success rate of sonographic guided PTC was 100% (38/38) and the success rate of stentimplantation was 86.8% (33/ 38). Biliary obstruction was eliminated immediately, jaundice subsidedgradually and symptoms relieved after the procedure. During the 3 to 28 months fellow-up, re-occlusionoccurred in 4 malignant cases which were corrected by balloon catheter dilation and/or by stent, one patienthad secondary cholangitis and fifteen died without jaundice 6 - 28 months after the procedure. The otherswere alive with no jaundice. No severe complications or side effects were observed.CONCLUSION EMSBE via sonographic guided percutaneous transhepatic approach is a reliable and safepalliative therapy for malignant jaundice and an ideal nonoperative method for benign biliary obstruction. Ithas a definite positive impact on the quality of patient life.

AIM To establish an ideal model of gastric precancerous lesions for rats.METHODS Fifty rats were fed with carcinogen MNNG for 35 wk and heat-plaste at 60C for 20 wk, thepathological changes were observed. Data in the groups were analyzed by Ridit test.RESULTS The occurrence rate of dysplasia in rats due to MNNG and heat-damage was 65%, which wasobviously higher than that due to MNNG only. The differences between the two groups were significant.CONCLUSION The animal model made by MNNG and heat-damage was an ideal one which could be usedto investigate the pathologic mechanism of gastric precancerous lesions.