key: cord-0010133-sop7pedo
authors: nan
title: Published Only
date: 2004-09-15
journal: J Gastroenterol Hepatol
DOI: 10.1111/j.1440-1746.2004.03622.x
sha: 0779265783edd52a3bd9cd4fa8de76417e836e79
doc_id: 10133
cord_uid: sop7pedo

nan

tion, the proportion of G 0 /G 1 phase cell increased while that of S and G 2 /M phases decreased. The difference between groups was great significant, and P value was less than 0.001. The cell growth inhibition of Aspirin and Nimesulide was correlated with the downgrade of COX-2 gene and PGE 2 production inhibition. 48 hours after Aspirin and Nimesulide effected on EC9706 cells, cell apoptosis was not obvious except 10.2% apoptosis rate attributing by 8 mmol/l Aspirin while apoptosis rate did not add with the extension of drug action period. 48 hours after Aspirin and Nimesulide effected on EC109 cells, cell apoptosis demonstrated obvious increase (the apoptosis rate attributing by 8 mmol/l Aspirin and 100 mmol/l Nimesulide were 20.35% and 45.27% respectively). The apoptosis gained further increase with the extension of drug action period. Within certain concentration limit, cell apoptosis presented dose-dependent manner and accumulated in G 1 phrase, which accounted for more than 90% of total apoptosis. Compared with total apoptosis, P value was less than 0.01, and enjoyed great statistical significance. Apoptosis were further confirmed by agarose gel electrophoresis analysis of DNA fragmentation, fluorescence staining and Giemsa staining. The apoptosis induction effect of Aspirin and Nimesulide was related with downgrade expression of Bcl-2 gene, and didn't relate with Bax gene expression. Conclusion COX-2 expression or expression upgrade may be one of etiologic factors of esophageal squamous cell carcinoma. The cell growth of esophageal squamous cell carcinoma cells (EC9706 and EC109) could be inhibited by Aspirin and Nimesulide in a dose and time dependent manner, and is closely related with expression downgrade of COX-2 gene and PGE 2 production inhibition. The cell growth inhibition of EC9706 and EC109 by Aspirin and Nimesulide is through influencing the transition of cell cycle from G 1 to S phase. There is a dose-dependent manner of EC109 cell lines in certain concentration limit of Aspirin and Nimesulide. The apoptosis accumulates in G 0 /G 1 phrase with cell cycle specific manner. The apoptosis induction effect is relatively weakly related with expression of COX-2 gene and PGE 2 production, doesn't relate with Bax gene, but correlates well with the downgrade expression of Bcl-2 gene. COX-2 specific inhibitors may be one of the effective preventive and treating methods for human esophageal squamous cell carcinoma.

average absorbency of b-galactoside-binding protein-3 in well, moderate and Poorly differentiated adenocarcinoma tissues was 0.2441 ± 0.04119, 0.1690 ± 0.03613 and 0.1346 ± 0.02195 respectively. Conclusions With decreasing of differentiation of gastric carcinoma, the ratio of positive Smad4 expression in gastric cancerous tissue decline. It was suggested that loss of Smas4 destroyed the signal pathway of the transforming growth factor b, which weakened the function of cell growth in gastric carcinoma. Therefore, the reduced Smad4 expression facilitated the development and metastasis of gastric carcinoma.

Methods There are 38 gastric ulcer patients in the experiment. Western-blot methods and immunohistochemistry (DAB) were used to determine the expression of leptin in human surrounding mucosa of gastric ulcer. The model of gastric ulcer was made by pouring stomach with HCl and sulfosalicylate in rat. FCM, Western-blot and immunohistochemistry (DAB) was used to determine the expression of leptin in rat gastric ulcer surrounding mucosa in different time point. Result Leptin protein is mensurated in human peptic ulcer surrounding mucosa by Western-blot methods and immunohistochemistry. To rat gastric ulcer, leptin expression level showed a cure trend according to different time, the top point is around 24 hour. Conclusions Leptin expression level is higher in gastric ulcer surrounding mucosa compare to normal mucosa, which show leptin might be relate to the occurrenc and development of gastric ulcer.

The investigation of chronic functional constipation and analysis of the associated factors YUSHAN HAN

Objectives To explore the epidemic state of functional constipation of the older in Tian Jin.

To surrey the older more than 60year old draw from Tian Jin using stratified cluster sampling by questionnaire. Result The total prevalence rate is 23.0 percent about constipation of the older.With age increasing, prevalence rate increases.The prevalence rate is 24.8%, 34.4%, 37.3% among age groups of 60-, 65-, 70-, 75-, 80-respectively. There exists difference in prevalence rate of various occupation, when hobo > cadre > peasurd > armyman. The rate is in no relation to habitation, nation. CFC is relatively high relation to hemorrhoids, reflux esophagitis, hypertension, chronic gastritis and functional dyspepsia. CFC is in close relation to family constipation, especially parents, children, brothers and sisters, so is mate. CFC is also closely relative to mentation, sleeping, character, exercise and diet. Multiple factor logistic regression analysis indicates that prevalence rate of constipation is closely relative to sex, age, town and region. Conclusion With age increasing, the prevalence rate of the older in Tian Jin increases moreover is higher than other cities. In addition, constipation in the older may be relative to the factors including exercise mental, psychologic, diet, family and some diseases which affect neuroendocrine and gastroenteric dynamics.

Objectives To investigate the prevalence of Giardia lamblia in functional dyspepsia and evaluate the coinfection of Giardia lamblia and Helicobacter pylori in the symptomatic patients with functional dyspepsia. Materials and Methods 248 (137 males, 111 females; meanage 32.6 years) out-patients with chronic dyspepsia (mean symptom duration 8 weeks) were studied from Jun 2001 to April 2003. Organic upper GI disorder were ruled out by endoscopy and gastric antral biopsies were obtained for H&E and rapid urease test for Helicobacter pylori, Gimesa staining for Giardia lamblia, duodenal aspiration as well as three consecutive stool samples were carried on every patients for Giardia antigen immunoassay. The paired Giardiasis patients were treated by cross-over design. One of the pair was randomly treated by a single dose of Tinidazole 2 g po and followed by a single dose of placebo a week later; The other one was treated by a single dose of placebo first and followed by a single dose of Tinidazole 2 g po a week later. Follow up investigation were performed 2 weeks after the treatment. Dyspepsia symptom scores were evaluated before and 2 weeks after the treatment. Results There were about 9.7% patients with chronic dyspepsia were infected by Giardia lamblia. A single dose of Tinidazole can cure about 87.5% Giardiasis with well tolerance. The dyspepsia mean scores were significantly reduced with Tnidazole treatment (before = 5.35 after = 1.8; 0.01). Conclusions One has to be aware of gastric giardiasis as a possible cause of upper GI symptoms. The investigation and treatment of Giardiasis are very important to control the dyspeptic complains in some chronic dyspepsia. It is necessary to know the coincidence of Hp and Giardia lamblia in dyspepsia patients. Clinical improvement after Hp eradication in dyspepsia patients maybe because of eradication of giardiasis, but not from Hp eradication. A single dose of Tinidazole is an effective way to cure over 85 percent of individuals who had giardiasis.

Objective To investigate the reactions to pacing parameters of retrograde gastric electrical stimulation (RGES) in healthy humans and to derive the effective and compliant parameter for treatment of patients with obesity. Materials and Methods RGES with a number of effective parameters were performed via a pair of mucosa/admucosa electrodes implanted along the great curvature 5 cm above pylorus of stomach in twelve healthy human subjects. Symptoms associated with dyspepsia and other discomfort were observed and graded during RGES at different settings, including long pulse and pulse train. The gastric myoelectrical activity at baseline and during different settings of stimulation was recorded with a multi-channel electrogastrography. Result The gastric slow wave was entrained in all the subjects at the pacing parameter of 9 cycles per minute in frequency, 500 msec in pulse width, and 5 mA in amplitude. Mild symptoms as initial sensation appeared at the amplitude of 10 mA with both long pulse and pulsed train in partial subjects. Intolerable symptoms occurred in 11/12 subjects at 15 mA of pulsed train (2s-on, 3s-off, 20 Hz, and 20 msec). Bloating, satiety, discomfort, sting, and nausea were frequently appeared as the stimuli became stronger, and upper abdominal pain was the dominant symptom at the maximum tolerable pacing parameter. Conclusion Acute RGES with stronger parameter results in remarkable symptoms associated with dyspepsia, which would be accepted to deal with obesity. The pacing parameter of 9 cpm, 500 ms and 5 mA would be applicable for RGES.

Objective Abnormal anorectal function was one of pathogenesis in patients with functional constipation. We investigated the effect and the changes of anorectal function in patients with different categories of functional constipation following titanoreine suppositories therapy and studied the possible mechanism. Methods patients with functional constipation were selected on the basis of Rome II criteria. The patients were categorized according to colonic transit time and transit index. Multichannel and singleballoon anorectal function detector of Pc Ploygraf HR was applied in patients with slow transit constipation and outlet obstructive constipation to measure such parameters as rectal resting pressure, anal resting pressure, maximal sphincteric squeezing pressure, anorectal pressure when defecation was stimulated, minimum relaxation volume to elicit the anorectal inhibitory reflex and rectal sensation volume. The patients were separately given titanoreine suppositories treatment and kangfu anti-inflammatory suppositories as control.The symptom scores and anorectal manometry were evaluated before and after therapy. Results patients with outlet obstructive constipation showed significantly higher anal resting pressure, higher anal pressure when defecation was stimulated, larger minimum relaxation volume and higher rectal first sensation volume than patients with slow transit constipation.There was no significant difference in the values of defecating sensation volume and maximal tolerable volume.The symptom scores were significantly decreased and the effective rate was higher in patients with outlet obstructive constipation following titanoreine suppositories treatment than following kangfu anti-inflammatory suppositories treatment. After giving titanoreine suppositories therapy, the anal resting pressure, anal pressure when defecation was stimulated, and rectal sensation volume were descended in patients with outlet obstructive constipation. The values of rectal first sensation volume and defecating sensation volume were also decreased in patients with slow transit constipation, however, there was no significant change in symptom scores. Conclusion Low sensitivity and high tolerance of rectum were the same in response to volume stimulation in two types of patients with functional constipation. Patients with outlet obstructive constipation had discoordination of annorectum during defecation and anal sphincter dysfunction in relaxtion. A Titanoreine suppository was effective to patients with functional constipation, in particular, patients with outlet obstructive constipation by protecting anorectal mucous membrana, improving rectal visceral perception and correcting abnormal anorectal motility. tegaserod groups compared with the controls, there are obvious differences in them after treatment due to N1, P1, N2, P2 latencies noticeable prolonging of SEP (P < 0.05). Pronounced differences also lie in before and after treatment with tegaserod P < 0.05), but the difference in two tegaserod groups can be neglected at the same treatment stage. ª Two tegaserod groups compared with the controls, there are obvious differences in them after treatment due to N1, P1, N2, P2 latencies noticeable prolonging of CEP (P < 0.05). Noticeable differences also lie in before and after treatment with tegaserod (P < 0.05), but the difference in two tegaserod groups can be neglected at the same treatment stage. oe Two tegaserod groups compared with the controls, there are significant differences in them after treatment due to N1/P1, P1/N2, N2/P2 peak-to-peak amplitudes noticeable decreasing of SEP (P < 0.05). Pronounced differences also lie in before and after treatment with tegaserod (P < 0.05), but the difference in two tegaserod groups can be neglected at the same treatment stage. There is decreasing trend of N1/P1, P1/N2, N2/P2 peak-to-peak amplitudes of CEP in two tegaserod groups after treatment, but no statistics significance. There is no distinct difference of peak-to-peak amplitudes before and after treatment in two tegaserod groups. Conclusions Tegasrrod (2-4 mg/kg) can efficiently decrease sensitivity to rectal distention in visceral hypersensitivity rats. SEP and CEP can record the changes objectively, which is manifested by long lantencies and small amplitude of SEP and CEP. was given to 42 patients in omeprazole group and cimetidine 400 mg two times daily for 2 weeks to 40 patients in cimetidine group. The 24 h intragastric pH monitoring was done at first day and eighth day during treatment in ten patients randomly from omeprazole group and ten patients randomly from cimetidine group. Results The score of upper abdominal pain, abdominal discomfort, acid reflux, heart burn, belching, abdominal bloating and total dyspepsia symptoms in both groups decreased after two weeks treatment (P < 0.01). The score of upper abdominal pain, abdominal discomfort, acid reflux, heart burn and total dyspepsia symptoms in omeprazole group after two weeks treatment were lower than those in cimetidine group respectively (P < 0.05). The total efficacy rate of total dyspepsia symptoms in omeprazole group was significantly higher than those in cimetidine group (73.8% vs 45.0%, P < 0.01). At first day and eighth day during treatment, the intragastric media pH and the total time percentage of pH > 3, pH > 4 in omeprazole group was significantly higher than those in cimetidine group respectively (P < 0.05). The declined value of total dyspepsia symptoms score was relative positive to the intragastric media pH (r = 0.868, P < 0.01) and the total time percentage of pH > 3 (r = 0.928, P < 0.01) at eighth day during treatment respectively. Conclusions 10 mg daily omeprazole had a better clinical efficacy on u-FD and a greater inhibitory effect on gastric acid secretion when comparing with 800 mg daily cimetidine.

Lesions of gastric mucosa caused by aspirin in patients with acute cerebral infarction LIU CHUNAN, LI DEYANG, CHAI TONGHAI, ET AL.

Objective To investigate the lesion of gastric mucosa caused by different doses of aspirin in patients with acute cerebral infarction. Methods 137 patients with acute cerebral infarction were randomly divided into the following aspirin treating groups (loading dose/maintaining dose, mg): 150/50, 300/100, 450/150 and the control group. The clinical symptoms were observed; stools occult blood test, gastroscopy and gastric mucosal histologic examination were carried out; the levels of prostaglandin E 2 (PGE 2 ) in gastric juice and throbomxane B 2 (TXB 2 ) in plasma were measured with radioimmunoassay before and 48 hrs, 14 days after treatment. Results The positive rates of stools occult blood test, the degree of gastric mucosal lesion endoscopically and the histopathologic index were significantly higher in the group with 450/150 mg of aspirin than those in groups with 300/100 mg, 150/50 mg of aspirin and control group (p < 0.01, all). While the PGE 2 level in gastric juice was markedly lower in group with 450/150 mg of aspirin than that in other three groups (p < 0.001, all). There was no difference of the indices mentioned above in other three groups. Conclusion these results suggested that 300 mg of aspirin as loading dose and 100 mg of aspirin daily as maintaining dose to patients with acute cerebral infarction can markedly reduce plasma TXB2 level but does not cause marked damage to gastric mucosa in the near future.

Study on change of a-actin in diabetic rats' antrum QINGLIN LONG, DIANCHUN FANG, HONGTAO SHI, YUANHUI LUO Gastroenterology Research Center of PLA, Southwest Hospital, The Third Military Medical University, Chongqing, China. Objectives To investigate reason of gastric motility abnormity in diabetic rats by measuring the change of a-actin in rat's antrum.

Health Wistar's rats (n = 50) were randomly divided into control group (n = 20) and diabetic group (n = 30). The model of diabetic rats was established by peritoneally injection of streptozotocin. After diabetic model was established for 3 months, gastric emptying was measured. Then a-actin in smooth muscle of diabetic rats' antrum was measured with Western blotting method. Results In the study, time of gastric emptying was measured with blue methylene, speed of gastric emptying was judged according to remnant rate of blue methylene in stomach. The remnant rate of blue methylene in diabetic rats was 134.38 ± 21.25%, and the remnant rate of blue methylene in normal rats was 100.00 ± 16.46% and was significantly lower than that in diabetic rats (P < 0.01), this suggested delayed gastric emptying occurred in diabetic rats.The optical density of a-actin in muscular layer in normal rats' antrum was 737.05 ± 69.08, only 488.29 ± 135.51 in diabeitic rats and was significantly decreased compared with that in normal rats. Conclusions a-Actin is a important protein of smooth muscle and is crucial for contracrion of smooth muscle. In diabetic rats, decrease of a-actin in antrum impair contraction of smooth muscle, then led to delayed gastric emptying.

Intrafamilial clustering of Helicobacter pylori infection in tianzhu area QIMING LU, PING CAO, RUI JIANG, LIPING ZHANG, SHULAN LI, XIULAN ZHANG People's Hospital of Gansu, Gansu, China Objectives To investigate the intrafamilial clustering of H. pylori infection and the potential modes of transmission.

Methods 1 Serologic examination for HP-IgG in all tested subjects 2 14 C-urea breath test in adults. H. pylori infection was diagnosed by at least one criterion. Results The overall H. pylori infections rate was 72.6% among 990 tested subjects. The family members with the head of household infected had a significantly higher prevalence of H. pylori infection (73%) than those with the head of household uninfected (53.5%). The Hp infections rate of children from families with both parents positive (52.8%) or only one parent infected (43.2%) than that of children from families with both parents uninfected (13.3%). Conclusions These findings demonstrate the Hp infection clustering within families. This suggests either a person to person transmission or a common source of exposure for Hp infection.

Expression of a novel apoptosis inhibitor-survivin in gastric carcinomas XIAOYUN LU, NANZHI LIU

Objectives To investigate the role of survivin expression in the pathogenesis of gastric carcinoma. Materials and Methods Thirty-two histologically verified gastric carcinomous and their neighboring noncancerous tissues were obtained. Semi-quantitative RT-PCR was used to measure survivin mRNA levels. Immunohistochemical assay was to detect the protein expression of survivin. Flow cytometry (FCM) was employed to examine the apoptosis index of gastric cancerous tissues. Results Survivin protein and mRNA expression were detected in 20 of 32 (62.5%) gastric cancerous tissues. In contrast, no expression of survivin was detected in corresponding noncancerous tissues (P < 0.05). The expression of survivin was irrelated to the size of tumor, differentiation, stage and lymph node metastasis (P < 0.05). Survivin expression was found significantly associated with reduced apoptosis index (3%± 0.5% vs 10%± 0.9%) of no expression by using FCM (P < 0.05). Conclusions The expression of survivin in gastric cancerous tissues is up-regulated, but is undetected in normal tissues. Survivin could be a new diagnostic/therapeutic target in gastric tissues. Its expression is irrelated with the develop, growth and transfer of gastric cancers which indicated that survivin is only a biological index reflecting the develop of gastric carcinomas. Survivin is associated with reduced apoptosis index, which indicates that the gene act an important role during the onset and progression of gastric cancer.

Objectives To investigate the effect of Helicobacter pylori (H. pylori) eradication on the melocular biological behavior of gastric mucosa lesions.

From 2001 to 2002, we followed up 60 patients who had been received H. pylori eradication therapy or symptomatic treatment during 1997 to 2000. Human telomerase RNA (hTR) and apoptosis was determined by in situ RNA hybridization and terminal deoxynucleotidyl transferase-medicated nick end labeling (TUNEL) technique whereas proliferating cell nuclear antigen (PCNA), human telomerase catalytic subuint (hTERT), bcl-2 and c-myc protein were detected by immunohistochemical staining. Results (1) Before treatment, the expression of hTR and hTERT, cell proliferation and apoptosis, c-myc protein were significantly higher in the H. pylori-positive group than that in the H. pylorinegative group (P < 0.05). (2) After H. pylori eradication, the positive rate of hTR and hTERT, cell proliferation and apoptosis, bcl-2 and c-myc protein decreased significantly campared with itself before H. pylori eradication (P < 0.05); in the persisting H. pylori infected and H. pylori-negative patients, all the six parameters were not statistically decreased (P > 0.05). (3) There were significant correlations between hTERT and hTR (r s 0.45, P < 0.01), hTERT and c-myc protein (r s 0.474, P < 0.01), hTERT and bcl-2 (r s 0.269, P < 0.05); The positive cell density of PCNA was significantly higher in the hTR positive group than that in the hTR negative group (P < 0.05). Conclusions (1) H. pylori infection induces hTR, hTERT, oncogenes overexpression and prompts apoptosis and stimulates cell proliferation, which may be the mechanisms of H. pylori to pathogenesis.

(2) H. pylori infection increase the expression of hTERT by inducing the overexpression of bcl-2 and c-myc protein. (3) The expression of hTR, hTERT and oncogenes may decrease or disappear and the abmormal cell proliferation and apoptosis may correct after H. pylori is eradicated, which can decrease the risk of gastric carcinogenesis.

The clinic value of immune cells infiltrated in gastric carcinoma BO NING, XIAOLING WU Departments of Gastroenterology, the No. 

Objectives To investigate the clinic value of and the effect of FasL and PCNA expression on immune cells infiltrated in gastric carcinoma.

The 39 cases of gastric carcinoma were studied by monoclone antibody CD3 and CD20 and CD68 to analyse the infiltration of anti-tumor infiltrating-lymphcytes (TIL) and tumor-associated macrophage (TAM). The expression rates of FasL and PCNA were studied by immunohistochemistry. Results 1) The amount of CD3 + lymphocytes infiltrated was 11.05 (7.71-14.39) every visual field (¥400), and 45.46 (36.21-54.71 ) of CD68 + macrophage. The amount of CD68 + macrophage was significantly larger than CD3 + lymphocytes. 2) The amount of CD20 + lymphocytes was 60 (11.5-144.5) every visual field (¥200), significantly smaller than the other two cells.

3) The cases with lower expression of FasL have remarkably more CD3 + and CD20 + lymphocytes infiltration, however, significantly less infiltration of CD3 + lymphocytes in cases with lower expression of PCNA. 4) Except for CD20 + lymphocytes, the amount of which correlated with depth of tumor invasion, there were no significant differences of TIL and TAM infiltration rate between groups of gastric carcinomas' type, tumor infiltration and lymph nodes metastasis, either there were no significant differences between gastric carcinomas' groups of age, sex, tumor size and location. Conclusions 1) There were TIL and TAM infiltrated into gastric carcinoma, but these immune cells tend to have no effect on tumor growth. Some factor expressed by gastric carcinoma influence the infiltration of immune cells. The expression of FasL depress the infiltration of TIL and the expression of PCNA concurred with more TIL infiltration.

2) The number of TIL and TAM in sute may not be suitable to value the malignity of gastric carcinoma.

Objective To analysis clinical, endoscopic, pathologic characteristic of gastric cancer complicated with duodenal ulcer and to discuss its etiopathology Methods A retrospective analysis has been made on 37 cases in the general hospital of Wuhan University from 1991, 1 to 2002, 12. Results The majority of patients are median-old male with 24·3% have previous history of duodenal ulcer. 86·4% lack alarm symptoms and signs while 87·1% have alleviation in abdominal pain with acid inhibitor. The gastic cancer is most prevalent in stomach antrum and body (33/37). Most cancer are in Bormann II stage (29/37) and of median differentiated adenocarcinoma phenotype (27/37). 83.7% are positive in RUT (31/37). Conclusion gastric cancer complicated with duodenal ulcer is worth of note. Repeat endoscopyic examination and careful observation should be done. Hp infection may be it's etiology and eradication may reduce its incidence.

Significance of changes of gastric cytochrome oxidases gene expression in diabetic rats HONGTAO SHI, DIANCHUN FANG & QINGLIN LONG Gastroenterology Research Center of PLA, Southwest Hospital of Third Military Medical University, Chongqing, China Objectives To study the significance of gastric mitochondrial DNA cytochrome c oxidases (COX) subunits II gene expression in diabetic gastric motility dysfunction.

Seventy Wister rats were randomly divided into 2 groups: diabetic group (STZ 60 mg/Kg intraperitoneal injection) and control group. The expression of COX II protein was examined by Western-blot. Mitochondrial DNA COX II mRNA was assayed by reverse-transcriptional polymerase chain reaction (RT-PCR). Cytochrome c oxidase activity was determined by ultraviolet spectrophotometer. Results Gastric-electric dysrhythm increased in diabetic rats, and the COX activity in diabetic rats was 0.41 ± 0.21/min and significantly decreased than the normal which was 0.78 ± 0.37/min. The expression of gastrointestinal COX II protein and COX II gene in diabetic gastroparesis rats were markedly decreased than the normal. Conclusions Cytochrome c oxidases activity greatly reduced in diabetic rats. Diabetic gastroparesis was associated with downregulation expression of gastrointestinal mtDNA encoding COX II gene and protein, which may play a key role in pathogenesis of diabetic gastroparesis.

Objectives To investigate the relationship between mitochondrial membrane potential changes and apoptosis of smooth muscle cells in diabetic rats. Materials and Methods Seventy Wistar rats were randomly divided into two groups: diabetic group (STZ60 mg/kg intraperitoneal injection) and control group. Time of gastric emptying and intestinal transit was measured. Mitochondrial membrane potential in small intestinal smooth muscle cells was determined with the changes of intensity of labeling rhodamine 123 by laser scanning confocal microscopy, apoptosis index was detected with the terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL) test and flow cytometry. The expression of cytochrome c was examined by Western blot. Results The mitochondrial membrane potential in diabetic gastroparesis rats significantly decreased compared with the normal. Apoptosis index of small intestinal smooth muscle cells in diabetic group was significantly higher than normal group. Apoptosis rate inof diabetic rats was 15% and significantly higher than that of normal (P < 0.01). Cytochrome c expression of small intestinal smooth muscle cells in diabetic gastroparesis rats markedly increased compared with normal. Conclusions Diabetic gastroparesis was associated with mitochondrial dysfunction and apoptosis.

The relationship between methylenetetrahydrofolate reductase gene polymorphisms and H. pylori infection in gastric cancer

Objectives To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) gene C677T and A1298C polymorphisms and H. pylori infection in gastric adenocarcinoma. Materials and Methods MTHFR gene C677T and A1298C polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and H. pylori was examined by PCR and Warthin-Starry silver stain methods. Results MTHFR gene C677T and A1298C polymorphisms was analysyzed for 122 gastric adenocarcinomas and 110 normal controls. The genotype frequency of MTHFR 677CC, 677CT and 677TT was 47.5%, 39.3% and 13.1% in gastric adenocarcinoma, and 48.5%, 42.6% and 8.9% in the controls respectively. There was not significant difference of genotype frequency between gastric adenocarcinoma and controls (P > 0.05).The individuals with 677CT genotype, 677TT genotype and 677CT + TT genotype group had a 0.38-fold [95% confidence interval (CI), 0.15-0.98], 0.26-fold (95%CI, 0.03-2.18) and 0.36-fold (95%CI, 0.07-0.98) reduced risk of developing gastric cardia adenocarcinoma compared with those had 677CC genotype. The individuals with 677TT genotype had a 3.03fold (95%CI, 1.07-8.65) increased risk of developing gastric corpus adenocarcinoma. The genotype frequency of MTHFR 1298AA, 1298AC and 1298CC was 59.8%, 36.1% and 4.1% in gastric adenocarcinoma, and 57.4%, 7.6%, 5.0% in the controls respectively. The distribution of MTHFR A1298C genotype was not significantly different between gastric adenocarcinoma and controls (P > 0.05). The individuals with 1298CC genotype had a 0.41-fold (95%CI, 0.05-3.72) reduced risk of developing gastric antrum adenocarcinoma compared with those had 1298AA genotype. MTHFR gene C677T and A1298C polymorphism were not correlated with H. pylori infection in gastric adenocarcinoma (P > 0.05). Conclusions The polymorphism of MTHFR C677T is associated with increased risk for gastric corpus adenocarcinoma, and is associated with reduced risk for gastric cardia adenocarcinoma. The polymorphism of MTHFR A1298C is associated with reduced risk for gastric antrum adenocarcinoma. There is not significant correlation between MTHFR gene polymorphisms and H. pylori infection.

Analysis of relevant factors of biliary regurgitation to stomach DANLI SUN YUSHU ZHANG XIAN XU Department of Gastroenterology, Nanjing Medical University Affiliated Nanjing First Hospital, Nanjing, China Objectives To analyze the related factors of biliary regurgitation to stomach. To provide useful clinical basis for diagnosis of bile reflux gastritis Materials and Methods 784 patients with no history of stomach operation were found yellow mucus and bile spot attached to gastric mucosa under endoscopy during the past two years. Clinical manifestation, endoscopic diagnosis, histology and rapid urease test were recorded and analysed. Results 67% patients with yellow mucus and bile spot attached to gastric mucosa were found suffered from chronic gastritis in age of 30-60 years old, chronic superficial gastitis 46%, chronic atrophic gastritis 21%. Others, 27.3% suffered from peptic ulcer, 51% rapid urease tests was positive. Few patients were found with significant histologic change as gastric foveola hyperplasia. There was no special clinical manifestation, most appears as stomachache or bulge after meal. Conclusions Biliary regurgitation is one of the common manifestations in endoscopic foundings in patients with chronic gastritis and peptic ulcer. HP infection and biliary regurgitation are two independent pathogenenic factors in chronic gastritis and peptic ulcer. Gastric foveola hyperplasia is not the specificity histologic change for biliary regurgitation type of gastritis.

The influence of hbv on the curative effect of peptic ulcer with ranitidine bismuth citrate JUN SUN Department of Gastroenterology, People's Hospital,Wuhan University, Hubei, China Objective to study the influence of HBV on the curative effect of peptic ulcer with ranitidine bismuth citrate. Methods 227 cases of patients with peptic ulcer in our hospital from 2003-8~2004-2 (partly), the diagnosis was confirmed by endoscopy. The diameter of the ulcer was between 0.5 cm and 2 cm. The H. pylori was examined at the same time. After the course, 21 cases of patients were withdrawn from the study (9%). There were 121 cases with HBsAg (-) and normal liver function, 72 cases of H. pylori positive, 42 cases of gastric ulcer and 79 cases of duodenal ulcer among them. And there were 85 cases with HBsAg (-), 30 cases of normal lever function, 52 cases of H. pylori positive, 37 cases of gastric ulcer and 48 cases of duodenal ulcer among them. All the patients were received ranitidine bismuth citrate (RBC) 350 mg, twice a day (for gastric peptic, 6 weeks, and duodenal peptic, 4 weeks). After the course we repeated the endoscopy. For the H. pylori positive patients we examined it again. Analysis the curative effect by the rate of disappearance of pain, the healing of ulcer and the eradication of H. pylori. Results In the HbsAg (-) group, the disappearance of pain was 95% (107/113), and it was 77% (59/77) in the HbsAg (+) group, there was significant difference between them (P < 0.05). In the HbsAg (-) group, the healing of ulcer was 85% (103/121), and 60% (51/85) in the HbsAg (+) group, there was significant difference between them (P < 0.05) too. In the HbsAg (-) group, the eradication of H. pylori was 26% (19/72), and 23% (12/52) in the HbsAg (+) group, there was no significant difference between them (P > 0.05). Conclusion It was confirmed that the ranitidine bismuth citrate had good effect on the healing of peptic ulcer especially the duodenal ulcer. But something else would change the effect of drugs on the peptic ulcer. The patients with HBV infection had different secretion of gastric, mental state, etc. In our research, with the comparison of curative effect between the two groups, it could be said that the infection of HBV would change the curative effect of ranitidine bismuth citrate on the peptic ulcer.

Effects of sympathetic nerve and myenteric nerve plexus on gastric slow wave after electrical stimulation SHENGBIN SUN, JING WANG, WEI QIAN, XIAOHUA HOU

Objectives The aim of this study was to investigate the nervous mechanism of gastric electrical stimulation regulating the gastric slow wave and demonstrate the roles of sympathetic nerve and myenteric nerve plexus in the entrainment Materials and Methods Ten male Wistar rats were randomly divided into two sessions. All rats were implanted with two pairs of electrodes on gastric serosa. In one session long-pulse electrical stimulation was applied until completed entrainment was achieved, and in the other session, no stimulation was applied. Immunohistochemistry was used to detect fos expression in myenteric plexus of gastric antrum whole layer preparations and posterior horn of T6-T10 spinal cord, and the differences of fos-positive neurons number between the two sessions were identified. Results Completed entrainment was achieved in all of the five rats, the necessary energy was 200 ms to 300 ms, 2 mA. There was no fos-immunoreactive neuron in intermedionedial nucleus and intermediolateral nucleus of two sessions. Some dispersing fos expression in superficial lamina of posterior horn was detected, but no difference between two sessions (P > 0.05). There were 6.40 ± 2.79 (n = 5) fosimmunoreactive neurons in myenteric plexus of stimulated rats and there is not one in that of non-stimulating rats. Conclusions Electrical stimulation with proper parameters can entrain completely gastric slow wave of rats. Myenteric plexus may play a role in this entrainment, but sympathetic nerve seems not. endoscopy and test of Hp were repeated. Every patient was followed up half a year. Results In these two groups, there wasn't sigruficant differenle in curd rates of DU (P < 0.05), but there was significant differenle in the eradication rates in HP (P < 0.01). Followed up half a year, the rate of recurrenle in treatment group was 3.8%, but the controled group that was 58%, there was significant difference in these two groups. Conclusions The treatment group has a higher efficacy in eradication of helicobacter pylori (HP) antt treatment of duodenal ulcer. It has not obrious adverse realtions and resistance. It is a better method in treatment of DU and the eradication of HP.

Experimental study of relationship between high-salt hot diet and chronic atrophic gastritis MEI TAO, LI ZHANG, LINGXIA ZHANG, MEI JIANG, GUANGZHOU CAO Department of Gastroenterology of Xi'an Central Hospital, Xi'an, China Objectives The CAG rat model was constructed by feeding high salt hot water intragastrically, and the ultrostructure of gastric mucosa was observed. The dynamic diversification of COX-2 was tested to discuss the relationship between high salt hot diet and CAG. Materials and Methods 1. CAG rat models were made firstly by feeding 15%55°C salty water for 12 weeks intragastrically. 2. Ultrostructure change in gastric antrum mucosa in the process of CAG formation wa observed by transmission electron microscope. 3 . The expression of COX-2 in rat gastric mucosa was tested by immunohistochemical. 4 The PEG2 in rat gastric mucosa was tested by competition ELISA. Results 1. All the model group rats formed CAG at the end of 12 weeks with the following Pathological changes of CAG and with the time prolonging, the atrophy of gastric mucosa became more seriously. 2. After feeding 8 wks, gastric mucosa cell mitochondrion swelled, endoplasmic reticulum enlarged, microvillus shorted and lose. With the feeding time prolonging, mitochondrion swelled more seriously and became vacuoles in some part, and some mitochondrion dissolve and necrosis and microvillus lose largely. 3. There was no or little expression of COX-2 in normal control rats' gastric mucosa. On the contrary, in CAG model rats' gastric mucosa, large amount of expression in 12 wk while CAG was formed. With the feeding time prolonging, expression of COX-2 kept on increasing, PEG2 level increased in 12 wk and has significant difference compare with normal group. In 32 wk PEG2 level remain increased. Conclusions 1. The ultrostructure injury of gastric mucosa appeared earlier during the process of CAG formation carused by high salt hot water feeding. And with time prolonging, every organelle injury aggravated. 2. COX-2 appeared over expression in CAG rat gastric mucosa, and company with increased of PEG2. With the aggravation of atrophy, expression of COX-2 increased durative and PEG2 level increased correspondently.The study suggested that CAG caused by high salt hot water has large potential canceration probability. 3 . The results indicated that long period high salt hot diet play an important role in the formation of CAG.

Objectives Localization of first pass metabolism of alcohol was confirmed in order to find a new method of treatment of alcoholic diseases. Materials and Methods Forty rats were divided into two groups, ie model one (24/40) and control one, at random. Then alcoholic models of rats were established. The activity varieties of hepatic and gastric alcohol dehydrogenases (ADH) were observed by optical microscopy after hepatic and gastric tissues had been stained by enzyme histo-cytochemistry assay. The activity varieties were determined by LUZEX-F analysis instrument as a semi-quantitative method.

Results It was shown that the activities of hepatic ADH gradually increased, and ones of gastric ADH gradually decreased after long alcohol administration. There were significantly differences between model group and control one (p < 0.05), respectively. Conclusions It is determined that location of the first pass metabolism of alcohol is stomach by combining this test with literatures. Poisonous roles of alcohol will be decreased by induced activity of gastric ADH.

The effect of rabeprazole and omeprazole on intragastric acidity and its relation to CYP2C19 genetic polymorphisms HONG WANG, YUQIANG NIE, SHOUJUN DAI, QINGZHU SHE, YUYUAN LI

Objective To study the effect of Rabeprazole (Rab) and Omeprazole (Ome) on intragastric acidity and it relationship to CYP2C19 genetic polymorphism. Materials and Methods Thirty duodenal ulcer patients were randomly divided into two groups. They were treated by one of the following strategies: [1] rabeprazole 10 mg [2] omeprazole 20 mg twice daily orally for two days. Intragastric pH over 24 hours was recorded from morning of the second day. Blood CYP2C19 genotyping of each patient was detected by PCR-restriction enzyme analysis. Results 1. In Rab group, the mean intragastric pH values of the PM, hetEM and homEM were 6.3 ± 0.1, 6.1 ± 0.2, 6.0 ± 0.1, no significant difference was observed among the three different genotype groups. In Ome group, they were 6.3 ± 0.1, 5.9 ± 0.2, 5.6 ± 0.3. The differences were significant (P < 0.05). 2. After treated with Rab for 24 hours, the mean and median 24-h intragastric pH values were significant higher than that of Ome (6.1 ± 0.2, 6.1 ± 0.3 vs. 5.8 ± 0.4, 5.7 ± 0.4, P < 0.05). The reason was that big difference existed in homEM type between Rab (6.0 ± 0.1) than Ome (5.6 ± 0.3) group. 3. Nocturnal acid break through (NAB) occurred in 3 patients of each group. The sustaining time of NAB in Rab group was shorter than that of Ome group (2.6 ± 0.2 vs. 3.4 ± 0.6 h) (p < 0.05). Conclusions 1.The effect of Rab on control of intragastric pH was less affected by an individual's CYP2C19 status. 2. Both Rab and Ome could not overcome NAB, but Rab could shorten the sustaining time of NAB.

Tegaserod action on colonic motility in passive cigarette smoking rats HUAHONG WANG, YUE ZHENG, CH CHO* Department of Gastroenterology, Peking University First Hospital *Department of Pharmacology, University of Hong Kong, Hong Kong, China Objectives Tegaserod, a potent and selective agonist at 5HT4 receptors in the gastrointestinal tract, has been developed to relieve symptoms of abdominal pain/discomfort, bloating and constipation in patients with irritable bowel syndrome. In animal models, tegaserod has been shown to stimulate peristalsis in intestinal tissues at very low concentrations. But there is no data to show tegaserod action on colonic motility in smoking. Our aim is to study tegaserod action on colonic motility in passive cigarette smoking rats and its active mechanism. Materials and Methods Rats were exposed to cigarette smoke for 1 hour and tegaserod (1 mg/kg) was treated. Motility of the distal colon and rectum was measured using a polyethylene (with a balloon at top) catheter. High-amplitude propagated contraction and and motility index (MI) were recorded and analyzed both by observation of the manometry tracings on the monitor and with the aid of a software analysis program (Synectics Medical System, Sweden) . Conclusions Tegaserod significantly stimulates the colonic motility in passive cigarette smoking rats, both Motility Index and Highamplitude propagated contractions are significantly increased. The colonic motility of rats is stronger near rectum. after using tegaserod.

The comparative study of the effects of Helicobacter pylori strains from different diseases on expression of matrix metalloproteinases in ags cell line JIHENG WANG, WENZHONG LIU Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Second Medical University, Shanghai, China Objectives To observe the effects of H. pylori from different diseases on the expression of matrix metalloproteinases (MMPs) in human gastric cancer cells in vitro, and to determine whether the different effect on matrix metalloproteinases exists among H. pylori strains from different diseases. Materials and Method AGS cells were co-cultured with H. pylori strains from gastric cancer and gastritis respectively. Expressions of MMP-2, MMP-7 and MMP-9 genes in both mRNA and protein levels were determined by RT-PCR and Western blot. As a bacterial control, AGS cells also were co-cultured with enteropathogenic Escherichia coli. Results E. coli and H. pylori strains from gastritis have no effects on the expression of MMP-2, MMP-7 and MMP-9 both in protein and mRNA levels on the whole. In contrast, all the H. pylori strains from gastric cancer decrease the expression of MMP-2, MMP-7 and MMP-9 in both protein and mRNA levels. Conclusions There were different effects of H. pylori between strains from gastric cancer and gastritis on expression of MMP-2, MMP-7 and MMP-9 in AGS cell line. These results suggest that difference in ability of promoting the cell malignant transformation existed between H. pylori strains from gastric caner and those from gastritis.

The comparative study of the effects of Helicobacter pylori strains from different diseases on DNA mismatch repair system in ags cell line JIHENG WANG, WENZHONG LIU Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Second Medical University, Shanghai, China Objectives To observe the effects of H. pylori strains from different diseases on the expression of DNA mismatch repair system (MMR) genes in human gastric cancer cells in vitro, and to determine whether the different effect of H. pylori on expression of DNA MMR exists between strains from different diseases. 

The incidence of gastric cancer in the young was 3.89% of gastric cancers; Most cancers located at the antrum of stomach in male patients, and female's in the body (p < 0.05); Pathologically, the low-differentiated cell structures in female patients were higher than that in male patients (p < 0.05). Conclusions Gastric cancer in the young, especially female patients has malignancy and rapid progress; Gastroscopy for patients with epigastrec sym ptoms can detect more gastric cancer in the young.

Influence of Helicobacter pylori on healing and recurrence of peptic ulcer being correlated with nonsteroial antiinflammatory drug: teport of 69 cases ZHAO WANG, HENGQING LIU

Objectives To study influence of eradicating Helicobacter pylori (Hp) on healing and recurrence of peptic ulcer cases with long-term nonsteroial antiinflammatory drug (NSAID) use. Materials and Methods 69 peptic ulcer cases taking long-term NSAID were divided into ranitiding group of Hp positive reaction (n = 25, ranitidine 0.15 g, two times a day), ranitidine plus amoxicillin group of Hp positive reaction (n = 23, r anitidine 0.15 g, two times a day; amoxicillin 0.5 g, three times a day) and ranitidine group of Hp negative reaction (n = 21, Ranitidine 0.15 g, two times a day). Results Ulcer healing rates in there groups were 64%, 74%, 71% in turn (P > 0.05). 43 healed cases were diveded into the eradicated Hp group (n = 13), Hp lasting positive reaction group (n = 16) and Hp lasting negative reaction group (n = 14). Peptic ulcer drug use weren't stopped. NSAID was taken continuously. 43 cases were checked in 6 months. Ulcer recurrence rates in three healed groups were 31%, 44%, and 29% respectively (p > 0.05). Conclusions Eradicating Hp cannot improve the ulcer healing rates and cannot reduce the recurrence rates either. But the ulcer recurrence rates of Hp lasting position reaction reaction show a tendency to increase. Objective To study the mechanism of chitosan anti-H. pylori in vitro. Materials and Methods H. pylori was suspended in the Chitosan solutions, after 48 h and 24 h, the aspartate transaminase (AST) activity and the glucose content in the supernatants were determinated, and alterations of morphology and ultrastructure of H. pylori were observed by scanning electron microscope and transmission electron microscope.

Results 1 The AST activity and glucose content in chitosan solutions were significant higher than those in control (P < 0.01 or P < 0.05). 2 Transmission electron microscope: the morpha of H. pylori were multiplicity, spheroid, V-morpha, U-morpha and anomalous morpha; The cell wall of H. pylori attenuate, and was no-integrity, abscission; The silhouette and structure of bacterium were illegibility; bacterium appeared depression deformation, perforation and crush; The cytoplasm was rarenfied, asymmetric, and lacuna augment; The component in bacterium disappear and distribute abnormally; The lectro-density of cytoplasm were decreased or increased. 3 Scanning electron microscope: The morpha of H. pylori were multiplicity, spheroid, U-morpha and anomalous morpha; Bacterial surface was changed widely, and binded refractable substance; The bacterial appearance showed flocky. Conclusion Chitosans might exert anti-H. pylori action by two mechanisms below: one was chitosan interacted with outer membrane of H. pylori, which caused the damage of structure, function and permeability of H. pylori outer membrane, and the leakage of intracellular components and the ultimate lysis of cell; the other was chitosan passed through the damaged membrane into H. pylori and interacted with cytoplasm to interfere with its metabolism.

The study of anti- The intensity of gastric mucosal inflammation were significantly lower in these groups with chitosan than these groups without chitosan (P < 0.05 ~0.001). 3 The labeling index for sIgApositive lumen of glands were significantly higher in these groups with chitosan (18.50%, 20.08%, 21.25%, 19.67%) than these groups without chitosan (9.58%, 8.83%, 9.42%, 9.17%) (P < 0.05 ~0.01). 4 There was not difference in the content of IL-2 in gastric mucosa among these eight groups (P > 0.05); The content of IL-4 and IL-10 in gastric mucosa were significantly higher in these groups with chitosan (IL-4 Objectives To determine the serum vascular endothelial growth factor (VEGF) and nitric oxide (NO) levels in patients with gastric cancer and to elucidate their significance of pre-operative VEGF and NO levels.

Fifty-seven patients with gastric cancer entered this trial. Serum VEGF level was measured by enzyme linked immunosorbent assay (ELISA) and serum NO level detected by spectrophotometry in these patients before operation. In addition, 40 chronic gastritis patients and 30 healthy individuals served as controls. Serum VEGF and NO levels were analyzed with their relation to differenation degree, depth of invasion, lymph node metastasis and TNM stage of gastric cancer.

The serum levels of VEGF and NO in chronic gastritis patients were 158.4 ± 53.2 pg/ml and 37.8 ± 10.6 mmol/L which were no significant difference from those in healthy subjects (132.7 ± 41.8 pg/ml and 40.3 ± 9.2 mmol/L, P > 0.05). The pre-operative serum VEGF and NO levels in gastric cancers patients were 394.6 ± 121.5 pg/ml and 85.2 ± 21.7 mmol/L and were significantly higher than those in patients with chronic gastritis and those of normal persons respectively (P < 0.01). Serum VEGF and NO levels positively correlated with tumor invasion depth, lymph node metastasis and TNM stage (P < 0.01 or 0.05). There was also a positive correlation between serum VEGF level and serum NO level (r = 0.8236, P < 0.01). Objective To evaluate the efficacy and safety of dimethicone and calcium carbonate on the treatment of intestinal distension in patients with functional dyspepsia. Methods By using a randomized and controlled clinical trial, the functional dyspepsia patients were divided into drug group (n = 27) and placebo group (n = 27). The changes of symptom score, the amount of intestinal gas and gas excretion in two groups were observed before and after the treatment. Outcome measurement was assessed at baseline and 1 week after treatment. Results After 1 week, treatment with dimethicone and calcium carbonate significantly improved symptoms (abdominal distention, early satiety, abdominal pain and belching) compared with that of baseline. Compared with placebo, dimethicone and calcium carbonate could significantly decrease the symptom scores, the amount of intestinal gas and increase the gas excretion (0.65 ± 0.61 vs 1.83 ± 0.49, 45 ± 21 vs 117 ± 40, 13 ± 4 vs 8 ± 3, P < 0.01). Total efficacy rate of dimethicone and calcium carbonate and placebo were 85% and 35%), respectively, with a statistically significant difference between the two groups (P < 0.01). Side-effect of dimethicone and calcium carbonate was mainly constipation (5%), but most of the patients could endure. Conclusion Dimethicone and calcium carbonate can reduce the amount of intestinal gas and improve the symptoms caused by overful gas. Objective Clinic operation and experiment have proved that Berberine can increase the density of blood medicine of Ciclosporin a, but the specific mechanism has not been known till now. The experiment observed the change of density of blood medicine and parameters related to electrogastrointestinalgram after the health volunteers took Ciclosporin a, and jointly took Ciclosporin A and Berberine, and discussed the effect of Berberine and Ciclosporin a on the density of blood medicine of Ciclosporin a from the perspective of electrogastrointestinalgram physiology. Method Choose 6 health volunteers, and respectively make a record of electrogastrointestinalgram after they have took Ciclosporin a, and jointly took Ciclosporin a and Berberine before taking medicine. At the same time, test the blood medicine density of Ciclosporin a., and discuss the relativity of blood medicine of Ciclosporin A and relevant parameters of electrogastrointestinalgram by the means of medical statistics. Conclusion The effect on electrogastrogram after taking Ciclosporin A is the apparent decrease of main frequency, with the same after the joint taking Berberine and Ciclosporin a, which indicates that taking Ciclosporin a has apparent effect on electrogastrogram and Berberine can strengthen this effect. In terms of the electrical movement, the main effect after taking Ciclosporin a is the apparent decrease of peak range, and taking additional Berberine strengthens the change, which shows the slowing down of electrical movement ahead and the increase of re-absorption of medicine in intestines. Therefore, Ciclosporin a itself has some effect on electrogastrogram movement, while Berberine can strengthen the effect, which may increase the blood medicine density of Ciclosporina. Materials and Methods 56 patients with histologically confirmed gastric adenocarcinoma (GC case group) and 56 healthy persons (control group), matched by age, sex, smoking, dietary habits and family history of cancer were studied. Genomic DNA samples were assayed for restriction fragment length polymorphisms in the CYP2E1 by PCR amplification followed by digestion with endonuclease PstI, and GSTT1 genes was detected by multiplex PCR. Results The frequency of CYP2E1 C 1 /C 1 genotype was 69.6% in GC group and 46.4% in control group, with a statistically significant difference (c 2 = 6.27; p < 0.05, OR = 1.915, 95% CI = 1.051-3.489). The frequency of GSTT1 null genotype was higher among GC group (60.7%) than among control group (46.4%), but the difference was not statistically significant (c 2 = 2.30; 0.1 < p < 0.25, OR = 1.783, 95% CI = 0.842-3.777). Furthermore, a joint effect of the CYP2E1 genotype and the GSTT1 genotype on the cancer risk was observed, showing GSTT1 non-null genotype/C 1 /C 2 or C 2 /C 2 genotype is lower than the other among GC group (c 2 = 6.23; 0.01 < p < 0.025, OR = 0.302, 95% CI = 0.114-0.796). The GSTT1 null genotype/C 1 /C 1 genotype among GC group was significantly higher than the other (c 2 = 3.98; p < 0.05, OR = 2.250, 95% CI = 1.007-5.026). Conclusions CYP2E1 C 1 /C 1 genotype is associated with gastric cancer and individuals who carried the C 1 allele have higher risk of developing GC than those with the C 1 /C 2 or C 2 /C 2 genotype. GSTT 1 null genotype doesn't increase the risk of GC. Combined analysis of polymorphisms showed that GSTT1 non-null genotype/C 1 /C 2 or C 2 /C 2 genotype was protective factor of GC and GSTT1 null genotype/C 1 /C 1 genotype was risk factor of GC. That is, individuals with both GSTT1 null genotype and CYP2E1 C 1 /C 1 genotype elevate the risk of GC.

Objectives To study esophageal dysmotility in GERD patients, and to determine whether there are any difference of esophageal dysmotility between RE and NERD. DNA-binding activity in moderate and poor differentiated stomach adenocarcinoma cell lines (SGC7901, MKN45 and AGS) was higher than that of other cell lines (MKN28 and NCI-SNU-1). The intensity of phospho-Stat3 protein expression was significantly increased in gastric cancer tissues as compared with adjacent normal gastric mucosa, especially in moderate and poor differentiated stomach adenocarcinoma (P < 0.05). And it was closely correlated with the differentiation of gastric cancer, but not correlated with age, sex and TNM classification of these patients. The result of survival analysis showed that patients whose activity shown elevated phospho-Stat3 activity had better overall survival than those patients who had negative results on their specimens. Conclusions The activation of Stat3 signaling makes a critical role in gastric cancer formation and progression.

A clinical pathological study of the telomerase activity and gastric cancer LIQUN YU, YAN GAO, CHUNHUA FANG, ET AL.

Objective To investigate the relationship between telomerase and gastric cancer and its pathological characterization. Methods Gastric cancer tissues of 64 cases and its adjacent tissues were detected by PCR-TRAP method.

The positive rate of telomerase activity of gastric cancer tissues were significant higher than those of adjacent tissues (c 2 = 81.78, P < 0.005). The rate of telomerase activity of low and non-differentiation group was higher than that of high and middle differentiation group significantly (c 2 = 7.96, P < 0.005).

The increase of telomerase activity may be an important contributing factor of gastric cancer. The detection of telomerase activity could be used as an auxiliary maker for diagnosis and prognosis of gastric cancer.

The role of vascular endothelial growth factor ( Objectives To examine the relationship between the expression of cytokeratins 20 (CK20) in peripheral blood with the concentration of vascular endothelial growth factor (VEGF) in plasma and the expression of VEGF in tissue in patients with gastric cancer, and further to explore the mechanism and clinical significance of micrometastasis in peripheral blood in patients with gastric cancer.

The peripheral blood specimens were obtained from 32 patients with gastric cancer, 8 patients with peptic ulcer and 8 healthy volunteers. The expression of CK20 was detected by reverse transcriptase nested polymerase chain reaction (Nested RT-PCR). Engyme-linked immunosorbent Assay (Elisa) and immunohistochemical were used to detect the concentration of VEGF in plasma and the expression of VEGF in tissue, respectively.

The proportion of positive expression of CK20 gene in peripheral blood is 40.63% in patients with gastric cancer, while there is no positive finding detected among those with peptic ulcer and contrast. The plasma VEGF level is significantly higher in gastric cancer patients than in contrast. In this study, positive expression of tissue VEGF is found in 56.25% of patients with gastric cancer, which is detected mainly in gastric cancer cytoplasm or membrane instead of in normal vascular endothelial cells. There is a significantly positive correlation between the plasma and tissue VEGF level. The abovementioned three indices have certain correlation with the clinic and pathologic materials of gastric cancer. When the expression of CK20 in peripheral blood act as dependent variable, the expression of VEGF in tissue is the only risk factor to finally enter Logistic regression equation with statistical significance. In the cases with positive expression of peripheral blood CK20, when distance metastasis is used as dependent variable, plasma VEGF level is the only covariate that can enter regression equation with obvious risk tendency, but no statistical significance. Conclusion It is likely that higher tissue and plasma VEGF level can promote early occurrence of gastric cancer peripheral blood micrometastasis and to form the distance metastasis by micrometastasis cells. It is likely to be the important and independent risk factors that can predict gastric cancer patients' prognosis.

Effect of eradication of H. pylori and using Lizhu gastric triple on treatment of chronic gastris and peptic ulcer PEIYING YUAN Department of Gastroenterology, Second clinical Medical College, Shanxi Medical University, Taiyuan, China Objectives To study the efficiency of triple and quadruple therapies in eradicating Helicobacter pylori (Hp) and curling chronic gastris and peptic ulcer Materials and Methods Nine hundreds and fifty-four patients with H. pylori infection were randomized into two groups. They were proven chronic gastris, peptic ulcer and partial functional dyspepsia by examing endoscopy. Group one received Lizhu Gastric Triple therapy (citral bismuth 220 mg bid, and tinidazole 500 mg bid and claritheomycin 250 mg bid, while group two increased omeprazol 10 mg qd based on group one. Both therapies were administered for one week. 14 C-urea breath test ( 14 C-UBT) was carried before treatment.

Results Four weeks later, six hundreds and eighty-six patients were repeated 14 C-UBT. Five hundreds and eighty-six patients were H. pylori negative. Eradication rates of H. pylori were 82.8% (288/348), and 87.5% (298/340) in group one and group two. There was no significant difference between two groups (P > 0.05).

Conclusions Triple and quadruple therapies of citral bismuth combination were both high eradication rates of H. pilori and highly effective in the treatment of peptic ulcer. Eradication of H. pylori could alleviate of the severity of gastris and prevent the reoccurene of peptic ulcer.

The Object To explore the relating mechanisms why the gastric cancer cell line shows the chemo-resistance to the cytotoxicity drug: cisplatin (abbreviated as CDDP), so to present the theoretical support for settling the chemo-resistance of gastric cancer cell.

We used the methods of MTT to detect the inhibition rate of CDDP to the cell proliferation, the fluorescence staining to detect the apoptosis of cell and RT-PCR to detect the mRNA expression of survivin, p53, bcl-2 genes before and after the application of CDDP.

The high concentration of CDDP (10 mg/L) shows relatively strong time-effect dependence, while the low concentration of CDDP (1 mg/L) has no effect to the cell apoptosis after 24 hours, due to the chemo-resistance mechanisms. The results of RT-PCR to the MGC803 cell indicate that the expression of p53 genes has strengthened after 12 hours of the application of the low concentration of CDDP (1 mg/L) and it came to the peak after the 24 hours, while the mRNA expression of bcl-2 gradually declined after 6 hours and mRNA of survivin gradually strengthened after 12 hours of the interference of CDDP. Conclusion The mRNA expression of survivin, p53 genes after the application of CDDP was involved in the chemo-resistance of gastric cancer cell to the chemical treatment.

Gastric distention enhances fos and CGRP expression in spinal cord and brain Objectives The purpose of the present study is to determine the pathway and mode of input of visceral afferent by immunohistochemical localization of Fos protein and CGRP.

Twenty-four male SD rats were divided randomly into three groups: experiment group (n = 12), surgery controls (n = 6) and innocent controls (n = 6). Balloons were implanted into the stomach of experiment group and surgery controls. 48 hours later, the experiment group was received gastric distention (80 mmHg) lasting 2 hours. All rats were sacrificed, and the antrum, the thoracal spinal cord and brain were dissected. Objectives To observe the ultrastructure diversification of gastric mucosa in atrophic gastritis model caused by high-salt-hot water. To investigate the pathogenesis of atrophic gastritis and the relationship between CAG and high-salt-hot diet.

The atrophic gastritis rat model was made by high-salt-hot water (55°C, 150 g/mL, 2.5 mL/d ¥ 32 wk) perfusion and the ultrastructure of gastric mucosa were observed by scanning electromicroscope.

The scanning electromicroscope observation: in control group, the gastric mucosa was compared into many micro grastric area, vertically and horizontally, and like gastric pits. Round and elliptic epithelium cells lined on the wall of gastric pits were in the same size and have short and spares microvillus. the surface of the gastric mucosa was smooth. The epithelium was lined regularly and was covered by laminar mucus. In high-salt-hot water perfusion group that the high-salt-hot water was given for 24 weeks, the gastric mucosa cells became atrophy, the adeno-vessle was broaden and bleeding could be seen. When the high-salt-hot water was given for 32 weeks, except for the mucosa atrophy and adeno-vessle broadens it also could be seen the fall of epithelium, the breakage of the cells and the erosion of mucosa.

Conclusions Long time hot diet may ingury gastric mucosa and lead to cell ultro-structure damge in gastric mucosa and lead to atrophy of grastric mucosa in the end. Objectives Diabetic gastroparesis is a common and troublesome complication of diabetes mellitus. Autonomic neuropathy seems to be one of the most important mechanisms underlying this entity, together with the other probable pathologies. This study aimed to investigate the gastric emptying of solids in diabetic patients and the correlation between gastrointestinal symptoms, autonomic neuropathy and gastric emptying in patients with diabetes mellitus.

The forty-six patients with diabetes mellitus and fifteen controls were enrolled. The frequency of upper gastrointestinal symptoms was determined using a questionnaire. And cardiovascular autonomic function tests (CAFT) were assessed. The gastric emptying were observed by acetaminophen test in 46 diabetic patients and 16 healthy subjects. The parameter of gastric emptying is the value of gastric emptying (serum acetaminophen concentrationtime cure) and the emptying index (peak time/peak serum concentration ratio).

Results Compared with control subjects, the value of gastric emptying was significantly lower in diabetic patients (P < 0.05), and the emptying index was significantly higher in diabetic patients (P < 0.05). Delayed gastric emptying was found in 14 diabetic patients. Objective Using flow cytometry to study DNA content and cell proliferation in gastric mucosa cell of chronic gastritis.

Gastric biopsy was obtained in 90 patients who were chronic gastritis diagnosed by endoscopy. Single cell suspension was prepared to stain with propdiun iodide (PI); and was detected cell DNA content and proliferation by flow cytometer.

We oberserved DNA ploidy, S-phase and cell proliferation in gastric mucosa cell in 4 groups that chronic superficial gastritis, chronic atrophic gastritis, chronic atrophic gastritis with intestinal metaplastic (mild-moderate), and chronic atrophic gastritis with intestinal metaplastic (severe). The aneuploidy DNA were not found in chronic gastritis and chronic atrophic gastritis with intestinal metaplastic; but cell proliferation in chronic atrophic gastritis was increased significantly comparing with chronic superficial gastritis (P < 0.05). Cell proliferation was also increased significantly (P < 0.05) in chronic atrophic gastritis, chronic atrophic gastritis with intestinal metaplastic (mild-moderate), and chronic atrophic gastritis with intestinal metaplastic (severe), which are H. Pylori positive comparing with H. Pylori negative. Conclusions Our research found: (1) cell proliferation activity was significant increased in chronic atrophic gastritis and in chronic atrophic gastritis with metaplastic (mild-severe); (2) cell proliferation is significant increased in chronic atrophic gastritis with H. pylori positve. Chronic gastritis is common disease and is recognized precancerous condition. Many methods including histochemistry, immuno-histochemistry, sper-microstructure and etc. In clinic, we will follow up and surveil these patients. Flow cytometry is a precise and routine examination to detect mucosa cell aneupoidy and cell proliferation in chronic gastritis or precanerous lesion.

To observe the ultrastructure diversification of gastric mucosa in atrophic gastritis model caused by high-salt-hot water. To investigate the pathogenesis of atrophic gastritis and the relationship between CAG and high-salt-hot diet.

The atrophic gastritis rat model was made by high-salt-hot water (55°C, 150 g/mL, 2.5 mL/d ¥ 32 wk) perfusion and the ultrastructure of gastric mucosa were observed by scanning electromicroscope.

(1) The Optic-microscope observation: in control group, the surface of the gastric mucosa was smooth and no erosion could be seen there. Inflammatory infiltration was absent in lamina propria. There was no edema in submucous layer and inflammatory infiltration in muscular layer. In high-salt-hot water perfusion group (highsalt-hot water was given for 12 weeks), the gastric gland was shrunk obviously.The muscle in muscular layer was hyperplasia and cramped into the lamina propria. The adeno-epithelium in the up 1 / 3~2 / 3 edge of the gland was atrophy, the vessel became broaden and the villous became narrow.

(2) The scanning electromicroscope observation: in control group, the gastric mucosa was compared into much micro grastric area, vertically and horizontally, and like gastric pits. Round and elliptic epithelium cells lined on the wall of gastric pits were in the same size and have short and spares microvillus. The surface of the gastric mucosa was smooth. The epithelium was lined regularly and was covered by laminar mucus. In high-salt-hot water perfusion group that the high-salt-hot water was given for 12 weeks, the surface of the gastric mucosa became rough and erosion could be seen.When the high-salt-hot water was given for 32 weeks, the gastric mucosa cells appeared shrunk, and the adeno-vessle was broaden and there was breakage in the cell surface. Fibrotic diffusion could be seen there.

Conclusions High-salt-hot water perfusion may cause the ultrastructural damage in gastric mucosa. The long-term high-salt and hot stimulation can induce the injury and atrophy of gastric mucosa. 

The relationship between the functional measurement of proximal stomach motor and symptoms of dyspepsia RUIXING ZHANG, SHUKUN YAO, YANLI ZHANG, JUNBAO LIU

Objective To evaluate motor and sensory functions of the proximal stomach in the functional dyspeptics (FD) and the relationship between these functions and the causes to induce the symptoms of dyspepsia.

Methods The indexes of proximal stomach motor function, such as compliance, initial volume and pressure, maximal tolerance volume and pressure, were measured by SVS/barostat in 22 functional dyspeptics and 8 healthy volunteers.

In comparison with control group (66.7 ± 7.7, 768.75 ± 47.04 ml), the compliance and maximal tolerance volumes in FD group (49.9 ± 13.8, 646.60 ± 145.10 ml) were lower (p < 0.05).

According to the degree of dyspepsia and bloating, all patients were divided into 3 groups, mild, moderate and severe. The compliance in moderate and severe group (40.8 ± 17.6, 34.9 ± 12.4,) were lower than mild group of dyspepsia (50.4 ± 25.4), respectively (p < 0.05). As far as the bloating was concerned, the initial volumes in moderate (343.3 ± 108.4 ml) and severe (326.1 ± 114 ml) were smaller than mild (463.5 ± 150.9 ml) (p < 0.05). In addition, there was correlation between bloating and the indexes as initial volume (r = 0.41922, p = 0.0211); so were between the dyspeptic value and compliance (r = 0.35611, p = 0.033). Conclusion The compliance in FD group was lower than the controls', which indicates the viscoelastic change in the proximal stomach wall was a cause of FD. Furthermore, there was correlation between visceral perceptive threshold in proximal stomach and symptoms, which illustrated the changes of visceral perceptive threshold was involved in the appearance of symptoms of dyspepsia, especially of bloating. years (50 ± 20), onset during the 5th to 35th day of illness (22 ± 9), hematemesis/melena in 5 cases, positive occult blood test in 15.Treatment with famotidine, omeprazole, reptilase and thrombin stopped bleeding in 16 cases within 7 to 10 days. Four cases died of respiratory failure. Rate of hemorrhage was lower in patients receiving prophylactic therapy with H2 receptor blocker famotidine than those not receiving prophylactic therapy (p < 0.01). Anoxia, prominent mental symptoms, and low CD 3 + T lymphocytes indicated a higher hemorrhagic rate with respect to controls, while dosage of glucocorticosteroid used, sex, age, number of pulmonary lobes affected, liver function abnormality, thrombocytopenia, low CD 4 + /CD 8 + T lymphocyte level were not indicators. Conclusions Anoxia, mental distress, low immune function constitute factors precipitating GI hemorrhage in SARS; H 2 receptor blocker famotidine is useful for its prevention. In critically ill patients with marked anoxia the use of stronger agents suppressing acid secretion like omeprazole is recommended.

The application of tissue microarray in studying the multiple genetic expressions of gastric carcinoma and precancerous lesion WEI ZHANG, MENGWEI WANG Department of Nanlou Gastroenterology, PLA General Hospital of Beijing, China Objectives To explore the application of tissue microarray technology in studying the multiple genetic spectrums of carcinoma and precancerous lesions of stomach and to provide genetic evidence for understanding the mechanism of oncogenesis of gastric carcinoma.

A tissue microarray including 17 cases of normal gastric tissue, 33 cases of gastric hyperplasia, 19 cases of intestinal metaplasia and 48 cases of gastric carcinoma was constructed. Immunohistochemistry was used to detected the expression of oncogenes (P27, DPC4, FHIT), suppress genes, apoptosis associ-ated genes, cell cycle proteins and adhesion molecules (MDM2, CyclinD1, Survivin, COX-2, E-cadherin, b-catenin, ICAM-1). Results Histological appearance was well preserved in the most dots of the tissue microarray section. The difference of expression positive rates between gastric carcinoma and precancerous lesion was statistically significant (P < 0.05). Conclusions It is feasible to utilize tissue microarray for highthoughput, economic and accurate screening of clinical tissue specimens on a large scale. Tissue microarray may play an important role in the oncogenesis and progression of gastric carcinoma. The multiple genetic alteration was associated with the biological behavior of gastric carcinoma.

Influence of Helicobacter pylori and smoking on serum pepsinogen levels in gastric adenocarinoma YOUCAI ZHANG, CHANGSHENG DENG, JINXIA CHENG Department of Gastroenterology, Zhongnan Hospital,Wuhan University,Wuhan, China Objective In this study, we analyzed the influence of Helicobacter pylori (H. pylori) and smoking on serum pepsinogen (PG) levels in gastric adenocarcinoma (GAC). Methods Serum PGI and PGII levels were measured using radioimmunosarry method. H. pylori infection was determined by IgG antibodies H. pylori in stored serum samples using enzymelinked immunosobant assay and 14 C urea breath test.

The serum PGI mean levels in H. pylori negative and current smoking GACs were significant increased compared with the H. pylori negative with no smoking or even-smoking GACs (the former: t = 2.709, v = 20, P < 0.02, and the latter: t = 2.157, v = 19, P < 0.05), but the serum PGI mean levels in H. pylori positive with no smoking or even smoking GACs was significant decreased compared with H. pylori positive and current smoking GACs (the former: t = 2.537, v = 56, P < 0.02, and the latter: t = 2.185,v = 52, P < 0.05). The serum PGII mean levels in H. pylori negative with no smoking or even-smoking was significant decreased compared with the GACs who were in H. pylori positive with no smoking or even-smoking (the former, t = 2.944, v = 29, P < 0.01, and the latter, t = 2.427, v = 24, P < 0.05). Conclusion Smoking can increase the serum PGI levels in GAC, and the serum PGI levels decrease when stopping smoking, H. pylori infection can increased the serum PGII levels in GAC with no smoking or even-smoking. Objectives To study the mechanism of cisapride treating electrogastric dysrhythmia.

Cisarpride was poured into the stomach of the model rats after the model had been established. The cholinergic and nitregic nerves in antral myenteric plexus were observed with histochemical staining methods. The levels of cAMP and cGMP in the antral smooth muscle were measured by radioimmunoassary.

The electrogastric dysrhythmia in the model group was decreased after the treatment with cisarpride (P < 0.01). The content of cholinergic nerves was significantly enhanced while the content of nitregic nerves was reduced after the treatment with cisarpride (P < 0.01). The levels of cAMP and cGMP were much lower in cisarpride group than the model rats (P < 0.05). Conclusions Cisarpride decreases electrogastric dysrythmia by increasing the content of cholinergic nerves, decreasing the content of nitregic nerves, and reducing cAMP and cGMP.

Risk factor of hyperplastic polyps FASHOU ZHENG, XIAOMING FAN, HONGYAN LIU, YUANHUA MA, RUIJUAN WANG Department of Gastroenterology, Jinshan Hospital, Fudan University, Shanghai 200540, China Objective To detect relation between hyperplastic polyps and helicobacter pylori infection, antrum histology. Methods 88 patients with hyperplastic polyps and 496 controls were enrolled. Helicobacter pylori were detected by rapid urease test and histological examination of gastrical mucosal biopsies, Helicobercter pylori status was considered positive if one or more these tests were positive. Biospies were taken in polyps and antrum for pathology examination. Results Females with hyperplastic polyps were more frequently than control (65.91% vs 51.61%). over 50 years old patients with hyperplastic polyps were more common than control. Positive rate of Helicobacter pylori in patients with hyperplastic polyps was significantly higher then that in control (59.09% vs 47.96%, P < 0.05). Intestinal metaplasia and/or gastric atrophy were more common in patients with hyperplastic polyps than in control (21.59% vs 7.46%, P < 0.01). Conclusions Female, >50 years old, Helicobacter pylori infection and intestinal metaplasia and/or gastric atrophy are risk factors of gastric hyperplastic polyps.

Efficacy of quadruple therapies as second-line regimens for eradication of Helicobacter pylori SONGBAI ZHENG, PING XIANG, FUXING XU Huadong Hospital, Shanghai, China Objective To determine efficacy of two quadruple therapies as second-line regiments for eradication of Helicobacter pylori (Hp).

One hundred and eight patients, who had failed eradication after proton pump inhibitor (PPI)-based triple or had relapsed after eradication, were divided into two groups. Group A (n = 54, M44, F10; age 61a ± s 13a) was treated for 1 wk with omeprazole 20 mg, colloidal bismuth subcitrate 240 mg, amxoicillin 1000 mg, metronidazole 400 mg, po, bid. One month after anti-Hp therapy, tests of Hp were repeated. Result One patient was lost to follow up in group A and group B, respectively. Two patients in group A and one patient in group B stopped treatment because of adverse reactions. One the perprotocol analysis, eradication rates of Hp was 82% in group A and 81% in group B. On the Intention-to-treat analysis, eradication rates of Hp were 78% in group A and in group B, respectively. Adverse reaction rates were 23% in group A and 11% in group B. The results between group A and group B showed no significant difference. Conclusion The two quadruple therapies as second-line regimens for eradication of Hp are highly effective and without severe adverse reactions.

The study on metronidazole resistance and rdxa gene of Helicobacter pylori from three people in yunnan ZENGFEN Objectives To compare rdxA gene identity of H. pylori strains among three people in Yunnan with that in west countries and research metronidazole resistance gene mechanism of H. pylori strains in Yunnan. Methods According to susceptibility results by the Epsilometer test (E-test) and agar dilution test and genotypes and subtypes of 109 H. pylori strains isolated from three People diagnosed chronic gastritis and peptic ulcers with endoscopy and histology examination in Yunnan, 12 strains of non-multiple, sensitive H. pylori (5 Han People strains, 3 Bai People strains, 4 Naxi People strains) were selected.The inoculum approximating 10 9 CFU/ml after a 72-h growth of each H. pylori strain was transferred onto agar containing one-half the MIC of metronidazole. Surface growth after 72 h of incubation was transferred onto the medium containing twice the prior concentration of metronidazole. These plates were then incubated for 72 h. This process was repeated serially until no growth occurred or a predefined maximum antibacterial concentration of metronidazole (8 mg/ml) was reached. Isolates were also transferred at least three times on metronidazole-free medium, followed by a redetermination of the MIC with the agar dilution test to asses the stability of the selected resistance. Extracted DNA of metronidazole sensitive and resistant pairs of H. pylori strains before and after induced, amplified rdxA gene by PCR and sequenced rdxA gene. The sequences were analyzed with DS Gene 1.1 Trial (Accelrys Inc. USA, 2002) software. Results 4 of 12 H. pylori strains were induced successfully with metronidazole whose MICs increased by 16 ~64 times, from 1 4 mg/ml to 32 ~128 mg/ml. Strains were transferred three times on metronidazole-free medium and the MICs redetermined were the same as those after induced. In three pairs of metronidazole sensitive and resistant H. pylori strains (1-170S, 1-170R, 3-108S, 3-108R, 4-123S, 4-123R), two fragments overlapped 105 bp were amplified by PCR and sequenced 491 bp and 405 bp respectively that constituted a total of 789 bp that contained the entire rdxA gene of 630 bp. Compared with that of standard H. pylori strain 26695, DNA sequences of rdxA gene of H. pylori strains from Yunnan had 95.2% ~94.8% identity. Identity was 97.6% ~97.3% compared rdxA gene sequences of H. pylori strains from three People. H. pylori strains from three People contained mutations within their rdxA genes. The type and position of mutation in rdxA gene were diverse. Base substitution, deletion, insertion, missense, frameshift, nonsense mutation at different position could be detected in different H. pylori strains and some H. pylori strain contained multiple mutations. Induced with metronidazole of 1 ~8 mg/ml concentration, H. pylori strain 3-108R from Bai People generated transition mutation at one position, while base mutation at 4 positions in H. pylori strain 1-170R from Han People were all transversion mutation. Conclusions Metronidazole resistant H. pylori strains from Yunnan was mainly due to mutational inactivation of rdxA gene. RdxA gene mutation in metronidazole resistant H. pylori strain from Han People in Yunnan was distinct.

The study of mixed infection and pathogenicity of Helicobacter pylori strains with multiple vacA m-region subtype and/or iceA mixed genotype of Bai, Naxi Objectives To study the distribution feature of the genotype of helicobacter pylori. To make clear the association between the differences of the virulence factors of helicobacter pylori and helicobacter pylori related diseases, so as to contribute to the proper clinical therapy for the different conditions. This subject observed the mixed infections of helicobacter pylori strains in Bai, Naxi, and Han Group which contain multiple vacA m-region subtype and/or iceA mixed genotype, to research their roles in pathogenicity. Methods Chose patients who had upper gastrointestinal symptoms and accept the gastroscopy examination in Yunnan Province from August of 2000 to August of 2001. All the patients were diagnosed through gastroscopy, urease test and pathology. Gastric mucosa specimen of 444 cases was collected, including 165 of Han, 117 of Bai, 162 of Naxi.When patients were diagnosed as peptic ulcers or chronic gastritis during the course of gastroscopy examination, 1 gastric biopsy specimen was taken for the rapid urease test (RUT). If the RUT was positive, another 2 specimens were taken from the same position for the use of culture of helicobacter pylori and histopathology diagnosis. Helicobacter pylori were isolated and cultured; the gastric biopsy specimens were used for the evaluation of inflammation degree and inflammation activity grades after HE stain, and for the evaluation of the density degree of helicobacter pylri embedment in the gastric mucosa after Wathing-Starry stain. The inflammation degree of gastric mucosa and the density degree of helicobacter pylori in the gastric mucosa were classified as negative, mild, median and severe according to the standard of chromic gastritis histology put forward on Gastroenterology Conference of Chinese Medical Association, May, 2000. The histopathological diagnosis was made by two senior doctor of pathology department who were not informed the surrounding of the helicobacter pylori strains previously. All the collected data were dealed via SPSS Ver 10.0. P < 0.05 was regarded as having statistical significance. Results Mixed infections were defined as containing multiple vacA m-region subtype and/or iceA mixed genotype. Thirty-four (31.2%) of 109 cases had mixed infections. The occurrence rate of iceA mixed genotye was significantly higher than the rate of multiple vacA mregion subtype (P < 0.05). The mixed infection rate of the Bai Group (67.7%, 21/31) was significantly higher than Naxi Group (20.0%, 9/45) (c 2 = 17.511, P < 0.001) and Han Group (12.1%, 4/33) (c 2 = 20.774, P < 0.001), but there was no significant difference between Naxi Group and Bai Group (c 2 = 0.851, P > 0.05). For the rate of the mixed infection of iceA1 + iceA2, Bai Group (61.3%, 19/31) was significantly higher than Naxi Group (17.8%, 8/45) (c 2 = 15.172, P < 0.001) and Han Group (9.1%, 3/33) (c 2 = 19.073, P < 0.001), but there was no statistic significance between Naxi and Han Group. Among the 34 cases of mixed infection, 16 were with peptic ulcer and 18 were with chronic gastritis. There were 8 cases (23.5%) containing both the multiple vacA m-rigion subtype and the iceA mixed genotype, and the occurrence rate in the cases with peptic ulcer (43.8%, 7/16) was higher than with chronic gastritis (5.6%, 1/18) (c 2 = 6.868, P = 0.014 < 0.05). There were 4 cases (11.8%) only containing the multiple vacA m-region subtype, and there was no significant difference (c 2 = 0.016, P > 0.05) between the occurrence rate of chronic gastritis group (11.1%, 2/18) and peptic ulcer group (12.5%, 2/16). There were 22 cases (64.7%) only containing iceA mixed genotype; the occurrence rate of chronic gastritis group (83.3%, 15/18) was higer than the one of peptic ulcer group (43.8%, 7/16) (c 2 = 5.812, P = 0.016 < 0.05). Conclusions In this study, helicobacter pylori strains were isolated by smearing the homogenized gastric mucosa specimens onto the plate culture median, and when the subculture was performed afer 5 to 7 days, clones of the bacterium were swept and collected from the plate instead of selecting the single clone. Therefore, mixed infections could be regarded existing in one gastric mucosa specimen when multiple vacA m-region subtype and/or iceA mixed genotype were detected by PCR. Mixed infection rate are various in different countries and districts. Mixed infection of multiple vacA m-region subtype and/or iceA mixed genotype detected in helicobacter pylori strains has a polymorphism in Bai, Naxi and Han Group in Yunnan Province. Multiple vacA mregion subtype is sensitive for the determination of the mixed infection in Han Group, while the iceA mixed genotype is sensitive for the determination of mixed infection in Bai and Naxi Group. The pathogenicity of helicobacter pylori is associated with multiple vacA mregion subtype and iceA mixed genotype in Yunnan strains and with multiple vacA m-region subtype in Bai Group strains. In Yunnan helicobacter pylori strains, iceA mixed genotype is sensitive for the determination of mixed infection.

The experiment study of culturing of H. pylori mouse-passaged strains ZENGFEN ZHOU, JINGYI ZHANG, HONG WANG, YUQIONG ZHANG

Objectives Observing the H. pylori plant condition of BALB/c mice's stomache which were inoculated with different toxic genes, culturing of H. pylori mouse-passaged strains, to establish the base of developing a animal model. Amplify the vacA gene and cagA gene of 29 Yunnan H. pylori strains using the PCR; and then culture the H. pylori mouse-passaged strains using the H. pylori carrying vacA gene and cagA gene. Methods (1) 29 H. pylori strains were refreshed. Prepare the genomic DNA, and detect the vacA gene and cagA gene using PCR.

(2) Each mouse was inoculated with drugs which were combined by three drugs, and only once to clear the others stomache bacterias. (3) Thirty mice were randomly separated into three groups: the infected group I were inoculated H. pylori 11639 with 0.4 ml of 10 9 colones formation unit per milliliter (CFU/ml); the infected group II were inoculated mixed H. pylori which include 1-1, 1-4, 4-3 and 3-8 strains with 0.4 ml of 10 9 CFU/ml H. pylori; the normal control group, the brain heart infusion was inoculated to the mice instead of H. pylori. The same treatment were repeated for five days. Mice of three groups were fasted for 12 hours before the inoculation and fasted 2 hours after inocultion. (4) After 4 weeks of infection, all the mice were killed, and before being killed they were fasted for 24 hours. (5) Observing the specimen morphology of the gastric mucosa after the mice were killed. Three pieces of the gastric mucosa were obtained from pyloric potion, one was used for rapid urease testing, one for histopathological detections, and the rest one was used for culture of H. pylori. (6) The plant density of H. pylori is based on the criterion which is instituted by Zhonghua medical research institute Digestive Branch. Let a high prof. of pathology who doesn't know the background of the strains read the preparaed smears. (7) It can be confirmed that the strain is the same before inoculated and after using PCR method that amplifying vacA gene and cagA gene of H. pylori mouse-passaged strains. (8) Transferred and reserved the cultured Yunnan H. pylori mouse-passaged strains carrying cagA genes and vacA gene. Results (1) CagA is detected in 86.2% (25/29) in the 29 Yunnan isolates, vacA is 89.66% (26/29); (2) The infected rate of the infected group II was 33.3% (3/9); It is unsuccessful with the infected group I (there was a mouse dead of disease) and the normal control group. There was significant difference between the infected rate of H. pylori with Yunnan strains and NCTC11639 strains (P < 0.05), the normal control group (P < 0.05). Amplified the vacA gene subtypes and cagA genes of the H. pylori mouse-passaged strains using polymerase chain reaction (PCR), it is confirmed that the stain is the same before inoculated and after. (3) The H. pylori were often found to be planted in the top of gastric faveoli and the gastric adenoid cavity, and the number is vary. Conclusions The animal model, BABL/c mice of infection is established by Yunnan H. pylori mouse-passaged strains carrying cagA genes and vacA gene. It supplys a convenient and useful way to develop a mouse model in common environment.

The study of extract of garlic oil and its stability in ampoule dosage form ZENGFEN 

Objectives garlic is a kind of bload-spectrum botan-antibiotic drug. but its value in drug is confined, many questions about garlic, such as pungent taste and odour, the unstabbility of chemical property, the period of preservation in nature and so on, never have been answered. The strong volatility and unstalility of property in fresh garlic, the easy volatilization of many ingredients in extracts from garlic in natural condition, these influence on the therapeutic effect and in-service use of garlic; garlic oil has obvious unstability to hot, especially, temperature above 80°C. The stability of garlic dosage has been studied, but never been solved. The present study is to extract garlic oil from purple clove of singular garlic in Kunming and analyze oil rate and survey Stability In Ampoule Dosage Form. Methods to obtain 5 kg garlic from peeled purple clove of singular garlic, and turn it into garlic mud by meat chopper, and obtain crude extracts of garlic oil by streaming acetone and aether with spin-distillator, and extract garlic oil by organic solvent, and evalue antibacterial compound Diallyl disulfide and Diallyl trisulfide by GC/MS.To make garlic oil extracted into Ampoule Dosage Form, and be reserved in 4°C frig through sterilizing in radiation form; to regularily (one per month, continuous three month) check relative amount of main antibacterial compound with GC, and survey stability repeatedly, and obtain stable garlic oil in Ampoule Dosage Form. Results 6.6 g garlic oil was extracted from 5 kg garlic;The extracted oil rate of garlic was 0.132%. the main compound of garlic oil evalued by GC/MS is more 20 kind. the main antibacterial compound of garlic oil quantitatively analyzed by GC is: Diallyl disulfide, Diallyl trisulfide extracted from garlic oil were 13.5%,14.8% respectively; the main antibacterial compound of garlic oil stablly surveyed by GC In three months is: Diallyl disulfide were 13.4743%, 13.3603%, 13.8852%, Diallyl trisulfide were 14.8408%, 14.9045%, 14.2677%, per month respectively. Conclusions the garlic oil extracted from purple clove of singular garlic in Kunming has more quantitative Diallyl disulfide and Diallyl trisulfide, which can be apply to study the effect of inhibition on Helicobacter pylori. under condition of lower temperature, the stability of antibacterial compound in garlic oil in Ampoule Dosage Form is very good and reserved for longer time, and is good way of developing garlic oil the value in drug and futher use to clinic. additionally, the technology of garlic oil in Ampoule Dosage Form is easy and practicable, and is good for its generalization and application.

The study of in vitro and vivo inhibition effects of garlic oil on Helicobacter pylori ZENGFEN ZHOU, JINGYI ZHANG, HONG WANG, YUQIONG ZHANG Digestive Department of the First Affiliated Hospital of Kunming Medical College, China Objectives To study the inhibition effect of garlic oil on helicobacter pylori in Vitro and Vivo; To probe a well new anti-H. pylori drug from Allium sativum L. Methods 1) In Vitro experiment, the multiple proportion dilution of garlic oil were select to observe the minimum inhibitiory concentration (MIC) against NCTC11639 and Yunnan H. pylori; 2) Seventy mice were inoculated the H. pylori mouse-passaged strains; the normal control group (30 mice) were inoculated the brain heart infusion instead of H. pylori, and to develope a mouse model with infection of H. pylori; 3) Eighty mice were randomly separated into: the normal control group: 20 mice; the pathological control group (60 mice) which were randomly separated into three groups: (1) the control infection mice treated with cooking oil (20 mice): every time they are inoculated 0.2 ml cooking oil, twice one day, and repeated seven days, then a week later it is finished. Ten mice separately were killed at 1 day and 4 week after drug inoculation, and before being killed they were fasted for 24 hours. (2) garlic oil treated group (20 mice): every time they are inoculated 0.2 ml garlic oil, twice one day, and repeated seven days, then a week later it is finished.Ten mice separately were killed at 1 day and 4 week after drug inoculation and before being killed they were fasted for 24 hours. (3) untreated infection control group: they had no treatment. Ten mice separately were killed at the same time mentioned above, and before being killed they were fasted for 24 hours. Then observe the result of treatment. Results 1) 100% H. pylori strains inhibited when the concentration is 165 mg/ml, 83.3% H. pylori strains inhibited when the concentration is 82.5 mg/ml, 26.7% H. pylori strains inhibited when the concentration is 41.25 mg/ml. Complete lack of resistrance of bacteria to garlic oil has been found. 2) After inoculated with the H. pylori mousepassaged strains, at 4 weeks, H. pylori infection was assessed by bacterial culture, urease assay and histological method, the infection rate of infection group was 100% (10/10). No H. pylori were found in normal control group. It showed that a mouse model with infection of H. pylori is successfully developed. 3) After the pathological control group were separated into three groups, 1 day and 4 weeks after the cessation of treatment, the clearance rates of H. pylori in garlic oil treated group respectively were 60% (6/10) and 70% (7/10), the combined eradication rate of H. pylori is 65% (13/20 Objectives the deeping study of pathogenicity of helicobacter pylori, the therapeutic effect of drug eradicating helicobacter pylori, the screening of antigent in helicobacter pylori vaccine and cural immunity and so on, all these need establish animal model of the helicobacter pylori-infection. Present, there is sizable difficult in establishment of animal model. The present study attempt to establish animal model by H. pylori mouse-passaged strains infected. Methods 20 BALB/C mice are divided into two groups, the sex divided equally, after clearing hetero-bacter in gaster by trigeminy therapy. the normal control group (10): to pour brain heart infusion, 0.4 mlX5, to finish during 1 week. Fasting diet and water is 12 hour before pouring gaster and 2 hour after pouring gaster. after Fasting diet and water for 24 hour, all mice are to be sacrificed after the last pouring gaster in 4 weeks; the patho-model group (10): H. pylori mouse-passaged strains, 0.4 ml (1 ¥ 10 9 FU/ML) ¥ 5, to finish during 1 week. Fasting diet and water is 12 hour before pouring gaster and 2 hour after pouring gaster. after Fasting diet and water for 24 hour, all mice are to be sacrificed after the last pouring gaster in 4 weeks. After being sacrificed, the gastric mucous morphology is observed, and is applied to helicobacter pylori culture, RUT-test, warthin-starry stain.The helicobacter pylori density is evalued according to the standard formulated by the gastroenterology assiciation of C.M.A in May, 2000. Film readed by advanced professional doctor in pathology who do not know the blackgroud of strain. Results (1) in the patho-model group, gastric mucous of all mice (10) are positive by RUT; in the normal control group, gastric mucous of all mice (10) are negative by RUT. (2) in the patho-model group, the growth of pink helicobacter pylori colony are finded in gastric mucous of all mice (10), which are evalued by form of colony, smear and stain, three-enzyme test (urase, catalase, oxidase); in the normal control group, the growth of helicobacter pylori colony are not finded in gastric mucous of all mice (10) which grow a few of mixed bacter. (3) in the patho-model group, the distribution of helicobacter pylori mainly exist epithelium mucosae cell and the up-half part of gastric pit and glandular cavity. Compared the patho-model group to the normal control group, c 2 = 20.000, P = 0.000. Before animal model established, the mixed bacter, including Flectobacillus, is cleared in gaster by trigeminy therapy. Subsequently, the mixed liquid, consisted of many kinds of high concentration H. pylori mouse-passaged strains (from yunnan), pour continuously mice gaster for infecting BALA/C mice gaster. the establishment of animalmodel use H. pylori mouse-passaged strains who have been cultured before, those strains have gone through a course of hostadaptation, which make infection rate achieve 100% (those strains infect BALA/C mice gaster). Conclusions first time, in internal and abroad, under normal raising condition, the H. pylori mouse-passaged strains (from yunnang)-BALA/C mice model is established. the its forte is: 1, the H. pylori mouse-passaged strains (from yunnang), which are consisted of many kinds of high concentration strains (CagA and VacA genes are positive), easily plant BALA/C mice gaster. 2, under normal raising condition, the establishment of helicobacter pylori-BALA/C mice model is good for study related to helicobacter pylori, and can save research funds and reduce experiment cost and easily general-ize. 3, the culture of H. pylori mouse-passaged strains utilize strains in Yunnan which can evaluate the rate of planting in environment concerned therapy. The helicobacter pylori-BALA/C mice model can better apply to the study of pathogenicity, the therapeutic effect of drug, vaccine and so on. Objectives Yunnan province lies in southwest frontier to YunNan-KweiChow Plateau in our country. and the climates, geograhpy and environments are complex, it's a place owning many minorities (26 minorities), so the living tradition and habits are different. In our past institiute we found that Helicobacter pylori infection rate of natural crowds is 51.1% in Yunnan distinct, which belong to the region of high genesis. It is essential to investigate and study the distribution of Helicobacter pylori genotype in different groups. Our study is aim to discuss the distribution of Helicobacter pylori vacA, cagA, iceA1, iceA2 and babA2 strains of Han, Bai and Naxi Group in Yunnan and the difference between the three groups. Methods Selected patients' related syndrom of upper digestive tract confirmed by gastroendoscopy, urease test and pathohistology between 2000.8-2000.8 in Yunnan. Collected gastric mucosa specimens, which is 444 cases in all included 165 from Han group, 117 from Bai group, 162 from Naxi group. One specimen was obtained for rapid urease test from 2-3 cm to greater curvature of gastric antrum by aseptic biopsy forceps once the patient was confirmed as chronic gastritis and peptic ulcer by gastroendoscopy. Another 2 specimens were processed for culture histopathology and conservation if urease test is positive. Prepare the DNA templatel of HP stains. VacA gene subtypes and CagA, CagE, iceA and babA gene were detected by PCR. Using spss for windows ver 10.0 statistics software package to analyze data. Results were considered significant at p < 0.05. Results (1) The vacA genes were all detected in the 109 Helicobacter pylori strains. The vacA s-regions of all the strains isolated from Yunnan are s1, s2 subtype. They were detected in 98.2%, 1.8%, respectively; m2, m1a, m1b and mixed m-region were detected in 45.9% (50/109), 0.9% (1/109), 23.9% (26/109), 11% (12/109), respectively; 18.3% (20/109) strains were not detected using the same primer; cagA, cage, iceA1, iceA2 and babA2 were detected in 92.7% (101/109), 92.7% (101/109), 67.0% (73/109), 41.3% (45/109), 67.0% (73/109) of the strains, respectively. There is no significant difference in the incidences of five genes in the three groups. (2) VacAs1/m2 gene subtypes (44.0%) is predominant in Yunnan Helicobacter pylori. VacAs2/m1 gene subtypes not detected. VacAs1/m2 gene subtypes (45.2%) is predominant in Bai group.VacAs2 gene subtypes not detected in Bai group; VacAs1/m1b gene subtypes (37.8%) is predominant in Naxi group. VacA s2/m1 gene subtypes not detected in Naxi group; The vacA s-regions of all the strains isolated from Han group are s1. VacAs1/m1b is more prevalent in Naxi group patients (37.8%) than Han (15.2%) (P < 0.05) and Bai (12.9%) (P < 0.05); VacAs1/m2 is more prevalent in Han group patients (63.6%) than Naxi (28.9%) (P < 0.05).

Conclusions It shows multiple genes character and the difference of prefecture and nationality in Yunnan Helicobacter pylori. Our study is the first time to carry out a complete and large sample size investigation to the distribution of Helicobacter pylori genotype in different groups. so that it can provide theory base on prevention and treatment of HP infection in Yunnan three groups, and meanwhile to fill in the blank of systematic study to the difference of HP infection in different groups.

The concentration of serum bFGF of patients with gastric cancer and its clinical significance JINQUAN ZHU, JING CHEN, DEQIANG HUANG, KUNHE ZHANG, YONG XIE The Institute Of Digestive Disease Of Jiangxi Medical College, Nanchang, China Objectives To observe the clinical signification of the alternation of serum basic Growth Factor (bFGF) concentration of the patients with gastrc cancer.

The serum bFGF concentration of the patients with blood-supplier, non-inflammatory disease, inflammatory disease and gastric cancer gastric cancer was detected by method of Sandwich-ELISA.

The concentration of bFGF in group of blood-supplier, non-inflammatory disease, inflammatory disease and gastric cancer were 91.8 ± 15.4, 95.0 ± 21.2, 122.9 ± 21.4, 146.8 ± 29.7 pg/ml, respectively. The average concentration of bFGF in group of gastric cancer was remarkably higher than that in group of inflammatory disease, non-inflammatory disease and blood-sypplier (p < 0.05 0 .01). The average concentration of bFGF in group of blood-supplier was significanty lower than that in group of inflammatory disease (p < 0.05), but no significantly differential than that in group of non-inflammatory disease; the concentration of bFGF in group of inflammatory was remarkably higher than one in group of noninflammatory (p < 0.05); the concentration of bFGF in patients with gastric cancer was significantly differential between before and after operation. there are no significantly related to concentration of with age, sex and the degree of differentiention of gastric cancer cell. Conclusion The average concentration of bFGF in group of gastric cancer was remarkably higher than that in group of inflammatory disease, non-inflammatory disease and blood-sypplier, and it is value to diagnosis or to expect of gastric cancer.

Objectives To investigate the number of enterochromaffin (EC) cell in proximal gastric mucosa in gastric hypersensitivity patients, and find out the change of enterochromaffin cell degranulation after stimulation in order to evaluate the role of enterochromaffin cell in gastric hypersensitivity. Methods Gastric sensation threshold were applied by gastric barostat. According perception threshold, 26 patients were devided into two groups: hypersensitivity group (FD-H) and normal sensation group (FD-N). Enterochromaffin cells were stained by immunohistochemistry method, got enterochromaffin cell number by microscope and the average optial density valves (OD) of enterochromaffin cell under mitrospectrophotomefer (MSP).

Enterochromaffin cell number in proximal gastric mucosa in FD-H was significant increased than FD-N and controls (ANOVA P < 0.05).The reduce percent of Enterochromaffin cell OD after stimulation was significant increased in FD-H than FD-N and controls (ANOVA P < 0.05). Conclusions Enterochromaffin cell number in proximal gastric mucosa didn't change in normal sensation patients. Enterochromaffin cell number in proximal gastric mucosa was increased in gastric hypersensitivity patients, and the degranulation of enterochromaffin cell was increased after mechanism stimulation. Gastric hypersensitivity may be correlated with increasing number and degranulation of enterochromaffin cell.

G-aminobutyric acid and glutamate contents in human gastric cancer RENMIN ZHU, SUDI QIN, XIAOPING HE, FANGYU WANG, ZHENKAI WANG, LIN WANG Department of Gastroenterology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China Objectives To explore whether g-aminobutyric acid (GABA)-Glutamate (Glu) system plays any role in the pathogenesis of gastric cancer, we investigated the contents of GABA and Glu in human gastric cancer.

Thirty patients with primary gastric cancers who were diagnosed and treated at Jinling Hospital between 2002.11 and 2003.3 were entered into the current study (mean age 58 years, range 38-72 years). A high performance liquid chromatographic (HPLC) method was used for the separation and quantification of GABA and Glu in human gastric cancer tissue and adjacent normal tissue obtained from these patients operated for gastric cancer.

The research reported here has revealed that GABA and Glu contents in human gastric cancer tissue increased apparently compared with the adjacent normal tissue (p < 0.05) No significant correlation was found between the content of GABA and clinicalpathological character of the cancer (p > 0.05). Similar results were obtained for Glu (p > 0.05).

The existence of such a close metabolic relation of GABA and Glu, and the results of the present experiment prompt one to speculate that abnormalities of the GABA-Glu system might contribute to the pathogenesis of gastric cancer, Moreover, interfere in this system might be useful in the prevention or treatment of human gastric cancer.

Objectives To identify the role of PTEN, Tumor Suppressor Gene in human gastric cancer, we detected the expression level of PTEN and evaluated its relationship with clinicopathological parameters and expression of MMP-9 protein.

Expression level of PTEN and MMP-9 protein was examined in 57 gastric cancer and correspondent adjacent normal tissues by immunohistochemistry. Results 1. The positive rate of PTEN was significantly lower in gastric cancer (61.4%) than in normal tissues (100%, P < 0.01). No correlation was found between expression level of PTEN and patients' sex and age (P > 0.05). Expression level of PTEN protein decreased in III, II stage of gastric cancer compared to II, I stage of gastric cancer (P < 0.01). The positive rate of PTEN oncoprotein was lower in poor differentiation tissues than in well differentiation tissues (P < 0.01) and was lower in gastric cancer with lymphnode metastasis than in thoes without lymphnode metastasis (P < 0.05).The deeper extent of invasiveness, the lower PTEN positive rate was. 2. The positive rate of MMP-9 was significantly higher in gastric cancer (73.7%) than in normal tissues (19.3%, P < 0.01), and with the development of tissue invasiveness, lymphnode metastasis and TNM stage, expression level of MMP-9 becomes higher. 3. A significant negative relationship was observed between the expression of PTEN and MMP-9 protein in gastric cancer (r s = -0.462, P < 0.01). Conclusions The data suggest that the expression level of PTEN protein was closely related to biological behavior of gastric cancer. Decrease or deletion of PTEN protein expression may not be able to effectively inhibit the over-activation of MMP-9, this will result in invasiveness and metastasis.

The relationships of prolapse of gastric mucosa and chronic gastritis YUANMIN ZHU, YULAN LIU

Aims To study the relationships of prolapse of gastric mucosa (GMP) and chronic gastritis. Methods Two groups of patients accepted endoscopy were studied one group included 103 patients with chronic gastritis all accorded with the standard of sedney 1996 included man 57 and woman 46, aged 22~74, mean age: 48.9. Control groups included 103 patients with normal of stomach and duodenum on endoscopy, man 60 and woman 43, aged 20~76, mean age 47.3. Results Total 104 patients (50.5%) with GMP were founded on endoscopy. The rate (65/103, 63.1%) of GMP in chronic gastritis patients was significantly higher than the rate (39/103, 37.9%) in control (p < 0.001). (OR:2.81, 95% confidence interval: 1.62~4.87). There were no relationships between GMP and age, gender (P < 0.05). The rate (8/84, 9.5%) of Hp infection in GMP patients was significantly lower than the rate (20/75, 26.7%) in patients without GMP (p < 0.01). Strip of erythma in gastric antrum were founded in 20 cases (30.8%) and esophagitis were founded in 10 cases (15.4%) in chronic gastritis patients with GMP, the rates were higher than the rates in chronic gastritis patients without GMP (10.5%, p < 0.025; 2.6%, p < 0.1). Conclusions GMP is a common cause of chronic gastritis; strip of erythma in gastric antrum is the characteric represent of GMP on endoscopy. There are no relationships in GMP and age, gender. The rate of Hp infection in patients with GMP is lower.

Objective To explore the role of psychological factors (anxiety and depression) in functional gastrointestinal disorders and chronic digestive diseases (such as peptic ulcer and liver cirrhosis).

From January to December in 2002, 45 patients with confirmed functional dyspepsia (FD), 30 with irritable bowel syndrome (IBS), 30 with peptic ulcer and 32 with liver cirrhosis were interviewed. Zung self-rating depression scales (SAS) and anxiety scales (SAS) were given to each subject. 28 healthy people were also studied.

Among each study group, the prevalence of anxiety, depression and anxiety mixed with depression was, FD 15.6%, 46.7%, 11.1%; IBS 74.4%, 41.8%, 34.9%; peptic ulcer 33.3%, 20.0%, 16.7%; liver cirrhosis 1.9%, 46.9%, 21.9%. Compared with health control group (7.1%, 3.4%, 0.0%), the prevalence of anxiety in IBS and peptic ulcer differed significantly from it (P < 0.05), the rate of depression in FD, IBS and liver cirrhosis was higher (P < 0.05), the incidence of anxiety mixed with depression was significantly higher (P < 0.05). Conclusions 1. Anxiety/depression are common in functional gastrointestinal disorders, and there is a link between them; 2. mental health problems, in varying degrees, exist in many patients with peptic ulcer or liver cirrhosis, generally speaking, anxiety is more common in the former, and depression occurs in the latter more frequently.

A systematic literature review: the basic research on inflammatory bowel disease in China AIPING BAI, QIN OUYANG, RENWEI HU

Objectives The basic investigative papers of inflammatory bowel disease (IBD) in Chinese medical journals from 1989 to 2003 were searched to find out the status of progress on IBD basic research.

The basic investigative papers about IBD in Chinese medical journals from 1989 to 2003 in Chinese periodical contents (VIP and CMCC) were reviewed and analyzed, the key words used as following: inflammatory bowel disease, ulcerative colitis, Crohn's disease. Results 1. There are 3384 articles about IBD published in Chinese medical journals since 1989 to 2003, and 508 basic investigative papers (15.01%). The numbers of the basic research papers from 1989 to 1993, from 1994 to 1998, and from 1999 to 2003 are 26,120 and 362 respectively. 2. There are 463 papers investigating the pathogenesis of IBD, which have 287 papers discussing immunological mechanism and 176 papers about other mechanism. 3. There are 142 papers investigating the mechanisms of Chinese medicine on IBD from 1989 to 2003, which include 117 papers related to animal experiment, 25 papers to clinical experiment. The studies in this area were intensified in the last 5 years as the number of the articles is increased rapidly. 4. There are 226 articles about clinical experiment of ulcerative colitis, and 17 of Crohn's disease in the period. Conclusion 1. There are a few of the basic investigative papers of IBD published in Chinese journals. The study about IBD basic research should be intensified in China. 2. The researches on the immunological mechanism are the focus among the studies about IBD pathogenesis. 3. The basic studies about the effect of Chinese medicine on IBD are a quite portion of total researches, which shows the advantage of investigating and treating IBD. 4. There have more papers about ulcerative colitis basic research than Crohn's disease, which accords with the epidemiological feature of IBD in China. 

Of 379 patients, 317 had ulcerative colitis (UC) (83.6%, 168 men, 149 women, male/female ratio 1.13 : 1, age at diagnosis range 14-79, mean age 44 years) and 62 had Crohn's disease (CD) (16.4%, 39 men and 23 women, male/female ratio 1.70 : 1, age at diagnosis range 13-70, mean age 33 years). In UC, 11.4% of patients had proctitis, 25.2% had proctosigmoiditis, 18.6% were diseased to the splenic flexure and 44.8% had extensive colitis. 9 patients with UC had arthritis (2.8%), 3 patients (0.9%) had iritis or conjunctivitis. Of the 62 CD patients, 16 (25.8%) had disease restricted to the terminal ileum; 15 (24.2%) had colonic disease; 20 (32.3%) ileocolonic disease and 11 (17.7%) disease involving the upper gastrointestinal tract. Conclusions IBD in Chinese is similar to that in the west but there are some differences with respect to severity and extra-intestinal manifestations. The ethnic and geographic difference may give important clues as to the etiology of the disease. 

Aims Ulcerative colitis is a disease that causes inflammation and ulcers that can interest the large intestine, more frequently it occurs in the rectum and lower part of the colon. We present a case report of a young woman. Case and Methods A 23-years old woman was admitted to hospital with a 10 days history of generalized urticaria, abdominal painful spasms (tenesmus) but without changes of the alvus.These symptoms began after a dinner with fried fish. She was treated with corticosteroids and anti-histaminic therapy with partial benefit. On admission physical findings revealed the presence of generalized pruritic urticarial papules and hepato-splenomegaly. We did the blood exams and researched also the signs of inflammation, autoantibodies and hepatotrophic viruses' antibodies. Physical, chemical, bacteriological and cultural analysis of stool was done. We performed abdominal echography, barium enema X-rays of colon and colonscopy with biopsy. Results Erythrocytes sedimentation rate and reactive C protein were higher, with mild white blood cells elevation and pernicious anemia. Diagnostic for images confirmed mild hepato-splenomegaly without focal lesions. X-rays of the colon showed irregularity in filling up with barium. Colonscopy uncovered hyperaemic regions and presence of haemorrhagic soffusions. Endoscopy biopsy specimens were obtained from patient, during the exam, for histology. Histological examination confirmed the diagnosis of ulcerative colitis. Conclusions Even if bloody and profuse diarrhea is a frequent symptom of ulcerative colitis, at the beginning can be absent and the patient may present mild or atypical symptoms. In particular skin rashes, as a first manifestation, may occur when the immune system triggers inflammation in other parts of body and it could support the hypothesis that the cause of ulcerative colitis may be an overactive immune response.

Expression and significance of survivin in colorectal carcinoma WEICHANG CHEN, QIANG LIU Department of Gastroenterology, the First Affiliated Hospital of Soochow University, Suzhou, China

Objective To study the expression and significance of survivin in colorectal carcinoma.

Expressions of survivin mRNA and VEGF mRNA were evaluated by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) in 52 colorectal carcinoma samples and 48 adjacent normal colorectal tissue samples. Expressions of survivin and VEGF proteins, proliferating cell nuclear antigen labelling index (LI), microvessel density (MVD) and apoptotic index (AI) were detected immunohistochemically in 52 human colorectal carcinomas.

Results Expressions of survivin mRNA and VEGF mRNA were detected in a significantly greater proportion of colorectal carcinoma samples (67.3%, 76.9%) than adjacent normal colorectal tissues (25%, 52.1%). (P < 0.01). There was no relationship between survivin mRNA expression and sex, tumor size, histological types, lymphnode metastasis, distant metastasis and Dukes' stage. The expression of VEGF mRNA in CRC correlated with distant metastasis and Dukes' stage (P < 0.01). Survivin expression was observed in 27 of 52 cases of colorectal carcinoma (51.9%) and VEGF expression was 55.8%. The AI was significently lower in survivin positive group than in survivin negative group (0.67% ± 0.18% vs 1.14% ± 0.42%; P < 0.001) while the PCNA was greater in survivin positive group than in survivin negative group (51% ± 22% vs. 27% ± 18%, P < 0.001). The expression of survivin was positively correlated with VEGF and MVD. Conclusion Survivin may play an important role during human colorectal tumorigenesis through inhibiting apoptosis and accelerating proliferative activity of colorectal tumor cells. The expression of survivin was associated with angiogenesis in the development of colorectal cancer. A potential correlation between survivin and VEGF was likely in colorectal carcinogenesis.

The effect of different proton pump inhibitors (PPI) strategies on the treatment of peptic ulcer bleeding WENJI CHEN, WEIHONG SHA, YUQIANG NIE, YUYUAN LI

Objectives To investigate the effect different PPI strategies on the control of peptic ulcer bleeding.

Eighty-three patients with peptic ulcer bleeding diagnosed clinically and endoscopically were randomly divided into 4 groups: patients in group A (19 cases) received intravenously injection (iv) of omeprazole 40 mg bid for 5 days; those in group B (22 cases) omeprazole 40 mg iv bid in addition to famotidine 20 mg iv qn for five days; those in group C (22 cases) pantoprazole 40 mg iv bid for 5 days; those in group D (20 cases) pantoprazole 40 mg iv bid in addition to famotidine 20 mg iv for 5 days. Data of the time of hemastasis, the rate of recurrent bleeding, operation and mortality, the amount of blood transfusion were collected and analyzed.

The rate of recurrent bleeding in group A was 5.3% vs 0% in other 3 groups; The average times needed for hemastasis were 1.3 ± 1.0, 1.2 ± 0.8, 1.3 ± 0.8, 1.4 ± 0.8 days for 4 groups; The rates of operation and mortality in all 4 groups were 0%; The amount of blood transfusion were 1.7 ± 2.8, 1.5 ± 2.5, 1.6 ± 2.4, 1.6 ± 2.5 U.

The average times of hospitalization were 10.6 ± 7.4, 11.7 ± 6.9, 12.9 ± 5.9, 11.6 ± 7.5 days. All parameters mentioned above in 4 groups were not significantly different (p < 0.05). Conclusion The effect of omeprazole and pantoprazole on the treatment of peptic ulcer bleeding is identical. There is no need to add H2RA to PPI strategies.

A logistic regression analysis of risk factory in ulcerative colitis 

Effects of depression on free radical and cyclooxygenase-2 in colon of rat HAIYAN DONG, WEIGUO DONG, BAOPING YU, HESHENG LUO, JIEPING YU

Objectives To investigate the effects of depression on the content of free radical and the expression of cyclooxygenase-2 (COX-2) in colon of rat.

Thirty healthy male Wistar rats, weighing 250 ± 30 g, were employed in the present study, and the chonic stress-induced model of depression of rat was producted. Colonic activities of nitric oxide (NO) and superoxide dismutase (SOD), the levels of malondialdehyde (MDA) and inducible nitric oxide synthase (iNOS) were detected by corresponding biochemistry kits and assayed with ultraviolet spectrophotometry. The expression of cyclooxygenase-2 (COX-2) in colonic tissue was detected with immunohistochemistry.

Results Enhanced colon inflammatory response and oxidative stress were observed in the chonic stress-induced depression model of rats, which manifested as the significant increase of MDA, iNOS and NO levels, as well as the expressions of COX-2 in the colon tissue, although the colonic SOD activity was significantly decreased compared with the normal control (MDA: 10.34 ± 2.77 vs 2.55 ± 0.70; iNOS: 1.11 ± 0.44 vs 0.25 ± 0.16; NO: 11.28 ± 5.66 vs 4.76 ± 1.55; SOD: 53.39 ± 11.15 vs 84.45 ± 22.31; absorbance of COX-2: 53.26% ± 8.16% vs 4.87% ± 1.65%; P < 0.01).

The injuries on colon of depression model rat were induced by increasing the levels of free radical and the expression of COX-2 in colon.

Effects of depression on substance P and vasoactive intestinal peptide in colon and brain in rat WEIGUO DONG, HAIYAN DONG, BAOPING YU, HESHENG LUO, JIEPING YU

Objectives To explore the injuries on colon and brain in depression model of rat by studying the levels of brain-gut peptides P substance (SP) and vasoactive intestinal peptide (VIP).

Thirty healthy male Wistar rats, weighing 250 ± 30 g, were employed in the present study, and the chonic stress-induced model of depression of rat was producted. Blood samples of 5 ml from the heart were collected in tubes and was immediately separated by centrifugation, then was frozen and stored at -20°C until analysis. Colonic tissue (8 cm proximal to the anus) and prefrontal brain tissue were removed, rinsed and weighed, then were put into tubes with boiling water 1 ml. The tubes were plunged into vigorous boiling water for 3 min, then they were cooled down and homogenized for 10 min. After centrifugation at 3000 r/min for 10 min, the supernatant was collected and stored at -20°C until analysis. The contents of SP and VIP in blood, colon and brain were measured by radioimmunoassays (RIA). Results SP levels in plasma, colon and brain of depression model rats were signficantly higher than that of the control groups (P < 0.05), While the VIP levels of depression model rats were significantly lower than that of the controls (P < 0.05).

Conclusions Changes of SP and VIP levels in plasma, colon and brain of depression model rats maybe closely related to the gastrointestinal motility disorders and colonic, cerebral injuries presented in depression model rats. SP and VIP may play important roles in the interaction between brain and gut.

Loss of fragile histidine triad protein expression in inflammatory bowel disease CHUNMEI XU, WEIGUO DONG, BAOPING YU, HESHENG LUO, JIEPING YU

Objectives To investigate the expression of fragile histidine triad protein (Fhit) and the possible relationship between Fhit expression and clinicopathological data in inflammatory bowel disease.

Using the rabbit-anti-Fhit antibody detecting FHIT protein expression in 60 cases of formalin-fixed, paraffin-embedded inflammatory bowel disease tissues by citratemicrowave-Streptavidin-HRP (SP) immunohistochemical method and analyzing its relationship to age and sex.

The pattern of immunostaining of Fhit protein expression was confined to the epithelial cells, being specifically cytoplasmic.The positive rate of FHIT expression in ulcerative colitis tissues was 31.88% ± 20.33%, which was significantly lower than the tissues of the normal colon mucosa (57.05% ± 8.86%) (P < 0.01); the positive rate of FHIT expession in Crohn's disease tissues was 29.99% ± 19.82%, which was significantly lower than the tissues of the normal colon mucosa (57.05% ± 8.86%) (P < 0.01); the expression level of FHIT gene between ulcerative colitis and Crohn's disease had no difference (P > 0.05); the expression level of FHIT gene in IBD was not closely related to age and sex (P > 0.05).

Conclusions Reduction or absense of FHIT gene expression might be associated with the oncogenesis and progression of IBD, which might be an early event from inflammatory conditions to the carcinoma in IBD. A 58-year-old man visited our hospital because of an abrupt onset of right lower quadrant pain and vomiting, but without any watery diarrhea or bloody diarrhea. He suffered hypertention and two surgical operations of appendectomy and ileus. Reversible ischemia of partial small intestine was observed during the open operation of ileus, and mesenteric vascular ischemia on the resected material was indicated.

In serum tests in our hospital, laboratory data were normal. Barium enemas showed rigidity of the colonic wall, irregularity and narrow-ness of the colonic lumen, thumb-printing sign and disappeared colonic haustra in the transverse colon. Ulceration in the ascending colon was also detected. Colonoscopy was performed two times in the past one year, showing disappeared colonic haustra with no visible vascularity, and that the colonic mucosa was rough, brown in the transverse colon, and longitudinal ulceration in the ascending colon. Erosions and hemorrhage were seen in the mucosa of distal ileum. Ulcerative colitis was suspected based on macroscopic findings.While small round cell infiltration in the mucosa were observed on biopsy materials obtained from colonoscopies. Erosions, necrosis, epithelial omission, hemorrhage, congestion, marked dilation of vessels and edema were seen in the colonic mucosa. However, crypt abscess, which often appears in ulcerative colitis, was not observed. Anisodamine and Agacore were given after ischemic colitis was diagnosed. Symptoms were improved. He is under follow-up out-patient.

Eventhough it is always difficult to diagnose ischemic colitis in the earlier stage, it is helpful to combine barium enemas, angiography with colonoscopy and biopsy to make a diagnosis. The characteristic findings of barium enemas and colonoscopy of the patient resulted from relapse of colonic ischemia. We suggested that the etiology of intestinal ischemia of the case might be phlebosclerosis. Objective To evaluate the value of endoscopic ultrasonography (EUS) in the diagnosis of ulcerative colitis (UC).

Methods EUS was carried out in 31 patients with active ulcerative colitis.Wall features and percolorectal lymph nodes were documented systematically. The correlation between Baron' endoscopic grades in ulcerative colitis and colorectal wall structure were evaluated ulteriorly.

The total wall thickness was increased, with (6.62 ± 0.58) mm on average. The thickening of the mucosal (M), submucal (SM), muscularis propria (MP) and serosa (S) or adventitia (A) layers of the colonic wall were observed in patients with ulcerative colitis for: M77.4% (24/31), SM93.5% (29/31), MP64.5% (20/31), S71.0% (22/31), respectively. Among them, 81.8% MP layer was thickening in Baron' grades 4, significantly higher than Baron' grades 2 (0%) and 3 (33.3%) cases (p < 0.05). In patients with acute UC the mucosa appeared abnormal in 77.4% (24/31) of cases, 7 cases (31.4%) of a three-layer structure and 17 cases (54.8%) of a four-layer structure.

The former was seen all in the Baron' grades 4 cases, the latter was observed in 16 patients (72.7%) of Baron' grades 4, significantly higher than Baron' grades 2 (0%) and 3 (16.7%) cases (p < 0.05). Submucosa and muscularis propria layer were also always preserved. Thickening and increased echogenicity of the fifth layer was seen in 22 (71.0%) patients. Two cases (6.5%) of enlarged vessels and 17 cases (54.8%) of polypi were observed. The existence of percolorectal pathological lymph nodes was found in 18 patients (58.1%), no significantly different between the patient subgroups of Baron' grades.

Conclusions EUS can show the depth of inflammation in UC, and the EUS images was correlation with the severity of colonoscopic changes. EUS is a reliable and useful diagnostic tool to assess the severity and anticipate the prognosis of active ulcerative colitis, and beneficial to choose the therapic project.

Objective To analysis the clinical representation and therapy of patients with atypical pneumonia and diarrhea. Methods 229 patients with atypical pneumoni were studied retrospectively. patients were allocated with group A (with diarrhea within two weeks of atypical pneumonia, 29 patients), group B (with diarrhea after two weeks of atypical pneumonia, 16 patients) and group C (no diarrhea, 184 patients).

Results Comparing cases of decreased CD 4 at the time of diarrhea, group A was higher than group B. Group B was higher than group A and C in proportion of using cephalosporin. And comparing proportion of using antiviral, group C was higher than group B. Conclusions The level of Immunity of patients with diarrhea within two weeks of atypical pneumonia was low. And Immunity and the use of medicine had nothing to do with diarrhea. The level of Immunity of patients with diarrhea after two weeks of atypical pneumonia was higher than that within two weeks. And immunity had nothing to do with diarrhea. But diarrhea after two weeks of atypical pneumonia concerned with the use of cephalosporin. Antiviral was useful in treating atypical pneumonia.

Functional constipation and psychosocial factors JIANPING HUA, GUIFENG MA, JUNMEI LI, QIU ZHANG, YINDIAO LI

Objective To investigate the relationship between FC (Functional Constipation) and psychosocial factors and to study the role that psychosocial factors plays in FC. Methods There are 58 patients whose ages ranged from 18 to 70 (23 males and 35 females) in the investigation. They have had constipation for more than three months, and they all accord with the qualifications in what follows.1. Less than 3 stools per week.2. Straining and/or lumpy or hard stools and/or sensation of an rectal obstruction. (No. 2 must happen at least 25% of one year.) 3. Excluding the organic disease through examinations. Healthy 32 men that selected according to age, sex, vocation, etc, are regarded as contrast. Psychological evaluation is taken by using of SCL-90, HAMD, HAMA, and the vocation, smoking, insomnia, dietary and negative events in FC group are recorded. Result The total mark and various factors marks in HAMD of 58 patients in FC group are higher than that of the contrast group obviously (P < 0.01), especially for the factors such as anxiety, depression and somatization. The HAMD mark in FC group is 15.1 ± 4.27, and that of the contrast group is 6.67 ± 3.03. The HAMA mark in FC group is 9.82 ± 4.2, whereas that of the contrast group is 2.46 ± 2.96. The difference between the two groups is obvious (p < 0.05). It is shown in the study that there are 24.14% of the patients associated with obvious depression and 18.97% associated with anxiety in FC group, and 8 patients (13.79%) are both suffered from depression and anxiety. Furthermore, the investigation indicates that 48.9% of the cases including females, insomniacs, brainworkers and others who meet with negative events are accompanied with depression and anxiety. It is irrespective of smoking and dietary (P > 0.01). Conclusions FC is a common disorder that causes a lot of trouble to patients and has a pronounced effect on the quality of life. With the development of the society, the competition is more and more fierce and the dietary ingredient is changing.These lead to a high incidence of constipation. The investigations of constipation are focused on colonic transmit time, dysfunction of anorectal sphincter and anal allergy at the present time. People also pay attention to the emotional stress system and the gastrointestinal ataxic movement. This investigation shows that there is a visible psychosocial abnormality in patients of FC, especially for depression, anxiety and somatization. The incidence of FC is increasing obviously in the patients accompanied with negative events such as insomnia, psychological trauma and stimulation and brainworkers. Depression may aggravate constipation, while severe FC could lead to the appearance and aggravation of depression and anxiety. Clinical research and practice prove that people's relation between psychology and physiology is inseparable. The emotional stressors affect brain-gut interaction and gestrointestinal movement through autonomic nervous system and neuroendocrine system. So routine arrangement and psychotherapy should be taken. Normal defecation reflex will be set up with the essential antidepressant and antianxiety therapy, and the quality of life will be improved.

Analysis of 389 patients with ulcerative colitis in Wuhan LI JIANG, WENJUAN YAN, CHANGSHENG DENG, BING XIA

Objective To investigate clinical and pathologic characteristics of patients with ulcerative colitis (UC) in recent 14 years in Wuhan.

The cases of ulcerative colitis from 1990 to 2003 diagnosed colonoscopically were retrospectively studied in five main hospitals in Wuhan and all data from clinical manifestation, endoscopy and partial biopsy were analyzed.

The ratio of male to female was 1.53/1. The mean age was 43.1 years old. The mean duration of the disease was 2.68 years. The common clinical manifestations were diarrhea (80.21%), mucopurulent stool (62.47%) and bloody stool (75.06%).The common colonoscopic findings were mucosal edema, erythema (78.41%), erosion and ulcer (82.26%). The mild and moderate severity and left-sided colitis were the most common, accounted for (86.38%) and (66.07%). The common biopsy findings were chronic inflammatory cell infiltration (68.78%), mucosal erosion and ulcer (34.84%), cryptitis or crypt abscess (17.19%), goblet cell depletion (17.19%). The misdiagnostic rate was (22.37%). Conclusion The prevalence of UC increased in recent years in our area, especially in the middle age group. Mild and moderate severity and left dided colitis were common. The diagnosis of ulcerative colitis must be made by combination of clinical manifestation, colonoscopic finding and biopsy histology.

Effects of cyclooxygenase-2 specific inhibitor on treatment and prevention of multiple adenoma of colon: a randomized, controlled tried of celecoxib vs. aspirin DADAO JING, YIHE ZHOU, GUOQING ZHU, YUDE ZHOU, XINGPENG WANG

Objectives To investigate and evaluate the preventive and treating effects of cyclooxygenase-2 (Cox-2) specific inhibitor, Celecoxib on multiple adenoma of colon and compare with its nonselective inhibitor, Aspirin. Materials and Methods 68 patients with colorectal multiple adenoma were divided randomizedly into A, B and C groups. The adenomas in all patients were removed with high-frequency electrocoagulation and electroexcision under endoscopy, then group A were administered Celecoxbib 200 mg qd, group B were administered to aspirin 50 mg bid, group C as a control. Endoscopy was given every 3-6 months in the first year, then once a year to observe and evaluate the reoccurrence and the side effects after the treatment. Results There were 22 patients in group A and 18 patients in group B completed the treatment. 3 patients in group A dropped out because of abnormal liver functions, epigastric discomfort and ascending blood pressure; while 5 patients in group B dropped out for the bleeding of peptic ulcer and epigastric discomfort. The reoccurrence rates of colorectal adenomas were 9.09% in group A and 16.67% in group B, respectively after one year of the treatment. Specifically, The reoccurrence rate of colorectal adenomas in group A was significantly lowered than that of group C (9.09% vs. 40.0%, x 2 = 5.517, P < 0.05).

Conclusions After resection of the colorectal multiple adenomas, administration of the Cox-2 specific inhibitor, Celecoxib, may reduce its reoccurrence rate with good tolerance and lower side-effects. However, its further effects need to be investigated. Objective To investigate the portal hemodynamics and its correlation with esophageal variceal bleeding (EVB) in cirrhotics and search for the best parameter predicting esophageal variceal hemorrage.

Methods 76 cirrhosis patients with esophageal varices, including 39 with previous esophageal varices bleeding history (EVB group), 36 without previous esophageal varices bleeding history (NEVB group) and 29 healthy control subjects were enrolled. Doppler sonographic machines (HP-sonos-4500 and HID-5000SonoCT) were used.The diameter and the timed-average velocity of the three vessels, portal vein (PV), splenic vein (SV) and left gastric vein (LGV) were calculated. Minwhile the flow direction was observed. Flow volume and congestive index of portal vein (CI) were calculated. Results 1. Compared with control group, the diameter, flow volume and CI of the portal vein; the diameter, flow volume of the splenic vein, the ratio of SV to PT flow volume and the diameter of the left gastric vein were significantly increased in cirrhotics with portal hypertension group (P < 0.05). 2. The diameter, flow volume and CI of the portal vein haqd no difference between EVB group and NEVB group. The diameter, flow volume of the splenic vein and the ratio of SV to PT flow volume were significantly higher in EVB group than in NEVB group (P < 0.05). 3. In all healthy controls, the blood flow direction in the LGV was hepatopetal; by contrast, in 36 of 39 (92.31%) patients with EVB, the flow direction was hepatofugal, but the prevalence of hepatofugal in EVB group was significantly higher in NEVB group (P < 0.05). In patients with EVB, the flow hepatofugal velocity of LGV was significantly higher than in NEVB group, but there was no difference in flow volume among both groups. 4. The hepatofugal of LGV as a parameter was associated with 92.31% sensitivity, 75.68% specificity, and 84.21% accuracy in distinguishing patients with EVB from all cirrhotics. When hepatofugal flow velocity of LGV was more than 16 cm/s, it was associated with 71.79% sensitivity, 91.89% specificity, and 81.58% accuracy in distinguishing patients with EVB from all cirrhotics. And the two parameters were better than others. Conclusions Color Doppler flow imaging provided useful prognostic information regarding the risk of current hemorrhage in cirrhotics with portal hypertehsion. Hepatofugal blood flow in the left gastric vein and increased hepatofugal flow velocity (>=16 cm/s) may be the most valuable parameters.

The effects of sulindac on the pathology of colorectal remnant polyposis of FAP patients JUN LI, YUMIN LU, ZHU JIN, ET AL

Objectives To evaluate the long-term effectiveness of sulindac in attempting to maintain the regression of colorectal adenomas of familial adenomatous polyposis (FAP) patients. Materials and Methods FAP patients were treated with sulindac 400 mg per day. The change of colorectal polyps was assessed every 3 months in the first year. After the significant regression of colorectal polyps was achieved, sulindac was used to maintain the effects. The patients received colonoscopy examination regularly. Biopsies of remnant polyps and other lesions were obtained.

Before the study, 90.8% of adenoma biopsies were tubular, while 9.2% was tubulovillous adenoma. The dysplasia of I grade, II grade and III grade were 42.1%, 45.6% and 12.3%, respectively. After sulindac treatment, 99.8% of adenoma biopsies were tubular, while 0.2% was tubulovillous adenoma. There was significant difference compared with baseline (P < 0.01). The dysplasia of I grade, II grade and III grade were 55.8%, 41.8% and 2.4% respectively, which had significant difference with baseline (P < 0.01). Minor flat elevation and erythema were found during the treatment, in which approximately 65% was adenoma. Conclusions Long-term use of sulindac seems to be effective in reducing dysplasia grade of retained adenoma of colorectal adenoma of FAP patients. Minor flat elevation and erythema may be the lesions appeared during the regression of adenoma.

Effects of ionizing irradiation on pkc in multidrug resistant cell of colorectal Results Compared to sham-irradiation group, the positive percentage of PKC increased significantly (P < 0.05) after HCT-8 cell were treated with 2 Gy, the positive percentage of PKC increased insignificantly after HCT-8 cell were treated with low dose (50 mGy,100 mGy) before high dose, the increaaing of positive percentage of PKC in the group of 200 mGy + 2 Gy is significant (P < 0.05) compared to the group of only high dose (2 Gy), the positive percentage of PKC in the group of pretreating the cells with 100 mGy decrease significantly (P < 0.05). Conclusions High dose ionizing irradiation increaed the expression of PKC of colorectal carcinoma significantly, reversely when HCT-8 cell were pretreated with low dose before high dose there was no additional increase of PKC this experiment hinted that the expression of PKC of colorectal carcinoma may be one of the mechanisms that high dose induced the muitidrug resistance of tumor.

Clinical Aims To determine the psychosocial characteristics and the influence with the efficacy and long-tem outcome of biofeedback in functional constipation. Methods Forty-four patients (16 men, 28 women) who had completed more than 4 courses of biofeedback were identified. Pretreatment details of bowel function and symptoms, anorectal manometry and anal sphincter electromyography had been collected at first. All patients were treated as outpatients and subjected to biofeedback one to two times per week for more than 4 sessions. After treatment, patients were also asked to make a global assessment of the treatment effect by stating whether their bowel problems were worse, unaltered, or better than before treatment. At follow-up one year later, patients completed another one-week bowel habit questionnaire and made another global assessment of treatment effect.

The mean age of the 86 patients was 51.3 years with a mean duration of symptoms of 13.8 years. After biofeedback, the success rate was about 80%. On long-term follow up, 47.7% felt that their constipation was relived, but 52.3% of the patients were not satisfied with the treatment. The factors concern with their constipation were considered to be the eating disorder, lack of activity, the low motility of the gastrointestinal caused by old age and psychological disorders. About 93.2% of the patients complained that constipation had to be a disturbance with a strong impact on their quality of life.

Only 43.2% of the patients have confidence in the treatment of constipation.

Conclusions The Functional constipation patients reported more psychological distress than healthy subjects, and the psychosocial characteristics had an influence in the success of the biofeedback retraining. The single and only important factors in the predictor of success were the patient's willingness and confidence to complete the therapeutic course.

resented corresponding chronic pathologic changes of CD at various stages. In addition, a new radiologic sign, i.e., multiple-feet insect sign was observed, which corresponded to chronic pathologic changes with active disease and wide encroachment. Arch dilatation of the bowel, as the lead pipe, small bowel pseudodiverticulum, cobblestone mucosal pattern, multiple-feet insect sign, and bound sign and elongated ulcer were important for diagnosis and differential diagnosis.

Only one case showed CD in the duodenum, the jejunum and the ileum at the same time, while 2 patients had disease in the jejunum, 3 in the jejunum and the ileum, and 6 in the ileum or the terminal ileum.

Conclusion Double-contrast examination of the small bowel shows various radiologic findings of CD, which correspond to different stages of pathologic changes and are useful for diagnosis and differential diagnosis of CD.

The long-term effects of sulindac on familial adenomatous poliposis JUN LI, YUMIN LU, FANG GU, ET AL.

Objectives To evaluate the long-term effects and safety of sulindac in attempting to maintain the regression of colorectal adenomas of familial adenomatous polyposis (FAP) patients. Materials and Methods FAP patients were treated with sulindac 400 mg per day. The change of colorectal polyps was assessed every 3 months in the first year. After the significant regression of colorectal polyps was achieved, sulindac was used to maintain the effects. The dosage was reduced from 300 mg, 200 mg to 150 mg. If there was recurrence of colorectal polyps on subsequent endoscopic examinations, the dosage of sulindac was increased to the prior dosage.

Results 18 patients of FAP who received sulindac got significant effectiveness in the first 12 months. The average period of treatment was 35.5 ± 17.7 months. Compared with baseline, the average number and size of polyps reduced significantly at last follow-up (P < 0.01). The minimal effective dosage of sulindac had individual difference (range, 150 mg/day-300 mg/day). Minor flat elevation and erythema were found during the treatment, in which approximately 65% was adenoma. Colorectal polyps of 5 patients recurred after withdrawal. Two of them got regression once more when they took sulindac again. The most common side effect identified was colorectal mucosal erosions. No severe adverse events were found during the treatment with sulindac. Conclusions Long-term use of sulindac seems to be effective in maintaining the regression of colorectal adenoma of FAP patients. The minimal effective dosage of sulindac has individual difference (range, 150 mg/day-300 mg/day). It is safe for long-term treatment.

Colorectal polyps tend to recur after withdrawal, but can be regressed by sulindac once more.

2.86)%. The cell ratios of G 0 /G 1 increased, whereas the cell ratio of S and G 2 /M phase decreased after treatment and was in a dosedependent manner. The HT-29 cell line exhibited some morphologie feature of apoptosis, including cell shrinkage, nuclear condensation, DNA fragmentation, and formation of apoptosis bodies, and the ratio of apoptosis was in a dose and time-dependent manner under Acridine orange and Ethidium bromide staining. Celecoxib down-regulated the expression of CDK 2 , CDK 4 and up-regulated the expression of P 21

Conclusions Celecoxib inhibited proliferation and induced apoptosis of human colorectal cancer cell the HT-29, down-regulated the expression of CDK 2 , CDK 4 protein, and up-regulated the expression of P 21 WAF1/CIP1 . The effect of celecoxib on phase of cell cycle may be partially explained as the cytotoxic effects of celecoxib.

The status of hypermethylation of CpG island in promoter regions and protein expression of O6-methylguanine-DNA methyltransferase gene in colorectal tumor JIAN QI, YOUQING ZHU, HUANG MEIFANG, DONG YANG

Objectives To investigate the functions of promoter hypermethylation of O 6 -methylguanine-DNA methyltransferase (MGMT) gene in colorectal tumorigenesis and progression.

The promoter hypermethylation of O 6 -methylguanine-DNA methyltransferase gene was detected in 27 sporadic colorectal adenomas, 62 sporadic colorectal carcinomas and 20 normal colorectal mucosa tissues by Methylation-specific PCR. At the same time, the expression of MGMT protein was carried out in the same samples using immunohistochemistry. Results None of the normal colorectal mucosa tissues showed methylated bands. Promoter hypermethylation was detected in 40.7% (11/27) of adenomas and 43.5% (27/62) of carcinomas, respectively. Loss of expression was found in 22.2% (6/27) of adenomas and 45.2% (28/62) of carcinomas, respectively (P = 0.041). There were 5 and 24 cases presented methylation in the 6 adenomas and 28 carcinomas losing MGMT expression, respectively. Conclusions Promoter hypermethylation and loss of expression of MGMT gene were common events in colorectal tumorigenesis, and loss of expression of MGMT occurs more frequently in carcinoma than in adenoma in sporadic patients. Loss of MGMT expression was associated with hypermethylation of the CpG island of MGMT gene in colorectal tumor. It suggests that epigenetic inactivation of MGMT plays an important role in colorectal neoplasia.

Fhit protein expression and its relation to colorectal carcinoma and premalignant lesions JIANLIN REN, HUAXIU SHI, LIN WANG, ET AL.

Objective To investigate the expression of Fhit protein in 45 patients with colorectal carcinoma and 36 patients with colorectal adenoma, as well as in 23 normal, and its eventual relationship with clinicopathological data. Methods We performed immunohistochemistry in archival material of formalin-fixed, paraffin-embedded tissues using the anti-Fhit antibody and the streptavidin-biotin peroxidase method, and analyzing its relationship to Dukes' stage.

In 28/45 cases of colorectal carcinoma, Fhit protein (pFhit) was absent or reduced. In the remaining 17 cases, 12 cases were expressed normally. In 7/36 cases of colorectal adenoma, pFhit was absent or reduced. Carcinomas with reduced expression of FHIT correlated with Dukes' stage (P < 0.05). The correlation between decreased expression of FHIT and Dukes' staging was 6/11 in stage A, 5/12 in stage B, and 17/22 in stage C. The difference between stages A, B with no lymph nodes metastases and the stage C with lymph nodes metastases was significant (P < 0.05). Statistically significant differences of pFhit expression were also observed between (1) colorectal carcinoma and normal colon mucosa, (2) colorectal carcinoma and colorectal adenoma. There is no significant difference in pFhit expression between colorectal adenoma and normal colon mucosa. Conclusions Our results show that immunohistochemical expression of pFhit is completely absent or much reduced in colorectal carcinoma. The reduced expression of FHIT may be associated metastasis. It is suggested that decreased FHIT expression plays an important role in the development and progression of colorectal carcinoma.

were counted during 0 to 3 hour and 3 to 24 hour. The data in corresponding period were also recorded for the following seven days continuously. With the method of rectal balloon distention, the perception thresholds and the number of abdominal withdrawal reflexes (AWR) of different balloon volume were observed on the fourteenth day. The expression of c-fos in CNS was detected by immunohistochemistry and was analyzed semi-quantitively by computerized image analysis system. Results There was no difference of granules and moisture contents of feces during 0 to 3 hour after gavage between two groups, while the above items of group A were found significantly higher compared with group B during 3 to 24 hour (p < 0.05). The perception threshold of group A was slightly lower than that of Group B, but there is no significant difference statistically (p > 0.05). At the same time, the number of AWR to the lower balloon content (1.0 ml) was much higher in Group A than in Group B (p < 0.05), though no difference was found with the higher balloon content (1.5 ml and 2.0 ml). Besides, the area and OD value of c-fos positive neurons in Group A were significantly lower than those of group B (p < 0.05). Conclusions Tegaserod increases the bowel sensitivity as well as improves the constipation in the model of C-IBS induced by gavage of cool water. Lower expression of C-FOS in CNS is probably involved in the process.

Objectives To determine the clinical features of IBS in the inpatients and to evaluate the diagnostic criteria of IBS.

By the retrospective study, the data of 55 IBS inpatients in our hospital from January 1993 to August 2002 was analyzed. Results IBS inpatients took 0.99% of all the ones in our hospital at the same time. The ratio of male and female was 1 : 1.39, the average age was 48.4 ± 2.0 years old, 41.8% of those were over 50. There were respectively 63.6%, 54.5%, 38.2%, 27.3% and 18.2% of the IBS inpatients fit the criteria of Manning, Rome, RomeII, Kruis score system and our national criteria. And there was correlation between the criteria of Manning and Rome, RomeII; Rome and RomeII; Kruis score system and our national criteria (P < 0.01). The "r" value was 0.524, 0.516; 0. 567, 0.452, respectively.The coefficient of the coincidence was 76.4%; 70.9%; 76.4%; 80.0% respectively. 20% cases had positive history of operation on abdominal region; appendectomy and cholecystectomy took on 7.2% and 3.6% respectively. There was no significant difference between the group of positive history of operation on abdominal region and negative one. 14.5% cases had hemorrhoids, and one patient's symptom was relieved after hemorrhoids ectomy. When using Rome and Rome II diagnostic criteria, there were notable difference between the group of positive history of hemorrhoids and negative one (P < 0.05), and no difference among other groups. Conclusions We still need to sum up, analysis and evaluate the specific symptoms of IBS; under this condition, it is very important to choose suitable diagnostic criteria according to different require and different object. We also need to select and appraise the screening work-up to eliminate organic disease. Abnormal biliary motility and infection of intestines aren't contradictive with IBS; hemorrhoids (at least serious ones) patients may be diagnosed IBS only if no improvement gained after therapy; Patients who had positive history of operation on abdominal region should be more cautious to be made IBS diagnosis. So it is suggested that Manning criteria and Rome criteria are most common to diagnose IBS at presen. It is necessary to make new criteria of IBS according to our national characteristic or use international criteria.

Selective angiography diagnosis in unknown cause gastrointestinal bleeding YUANJIE SUN, TAO XV, YUJIE TAN Department of Gastroenterology, The Fourth Hospital of Jilin University, Changchun, China Objectives To investigate the clinical significance selective angiography In unknown cause gastrointestinal bleedenteric. Materials and Methods By using Seldinger's method the duct is put into mesenteric artery through right femoral artery and take agiography. Results Positive results were in 16 cases amang 18 cases. three cases were a vescular malformation, one case is cancer, six cases were a small intestinal leiomyma, tow were small-intestinal lymphosarcoma, tow were small-intestinal crohn. One is duodenal ulcer one is a thick wall of intestinal. Conclusion Selective angiography is a safe and sensitive method for unknown cause gastro-intestinal bleeding, it also used treatment.

Background Recent research suggests that the immunosuppressive drugs, such as cyclosporine, may have benefit in treating patients with severe colitis who are steroid resistant. Intravenous cyclosporine will induce remission within 14 days in 50%~80% of patients who fail intravenous corticosteroids [1] . Patients in severe ulcerative colitis (UC) with the short-term applying cyclophosphamide can avoid the colectomy. Between 2001 and 2004, we used Cyclosporine rescues to cure 4 cases of severe UC, which showed obviously the curative effect, patients avoided emergency colectomy during their hospital admission. Report now as follows. Methods Four Patients (man: n = 2; female: n = 2) with a severe attack of UC were described. 4 cases' age were 17-24 years old. They had attacked repeatedly bloody pus diarrhea stools, abdominal pain, synchronously fever, nause and vomiting, anorexia. UC was diagnosed through colonoscopy and correlation checks. The symptom hadn't any relieve and aggravated after treatment with large dosage of steroid (i.v) and 5-ASA during hospitalizing 13-20 days.There was marker of colectomy.Those patients refused to accept colectomy, then cyclosporine A was used instead. they received treatment with IV cyclosporine A 250 mg/d (3.2 mg-4.8 mg/kg.d). The blood concentration of cyclosporine A was about 372 ng/ml. After 7-10 days, the patients received the same medication orally (3.8 mg-6.7 mg/kg.d).

The blood concentration of cyclosporine A was about 153 ng/ml. Steroid decreased gradually. Results All 4 cases presented favorable response in 3-5 days with intravenous of cyclosporine A and rapid remission of their symptoms after 7 to 10 days. One patient developed hirsutism. One patient complained of paresthesia, tremor and hypertension. But other two didn't show any significant side effect. Hepatic, renal function and electrolures were in normal range during whole treatment period. One patient had relapsed to receive colectomy after one month. Conclusions The patients with steroid refractory ulcerative colitis can get a good initial response, with rapid resolution of their symptoms. The patients given cyclosporine intravenously showed rapid improvement within 5 days.This means that short-term efficacy using cyclosporine A for UC patients was striking. This treatment can avert surgery in some patients or improve the clinical condition before operation. Its side effects were quite mild. But blood pressure, hepatic function, renal function and electrolures during using cyclosporine to treat severe UC should be monited. Cyclosporine A therapy is an effective and safe alternative to glucocorticosteroids in patients with severe attacks of UC.

Expression and significance of apoptosis related gene BCL-2, caspase-3 in human large intesine adenocarcinoma MINGWU TANG, TAO DENG, ZHIXIANG SHEN

Objective To investigate the expression of apoptosis-related gene bcl-2, capsase-3, and their clinical significances in colorectal carcinoma. Methods Expressions of caspase-3 bcl-2 were detected in 30 cases of colorectal adenoma and 40 cases of colorectal carcinoma and 20 cases of normal tissues by the immunohistochemical method. Apoptotic cells are detected by TUNEL method. Results The caspase-3 expression was detectable in 96% of normal tissue and in 65% cancer specimens and in 70% adenoma. The bcl-2 expression was detectable in 15.00% and 62.5% and 86.67%.There was no significant correlation between the expression of caspase-3 and bcl-2. Apoptotic index correlated positively with expression of caspase-3 (r = -0.89, p < 0.001) and inversely with expression of Bcl-2 (r = 0.73, p < 0.001). Conclusion There is low expression of caspase-3 and high expression of bcl-2 in human colorectal carcinoma. The colorectal carcinoma is associated with an inhibition of apoptosis and the augmentation of proliferative activity. There results also suggest that caspase-3 in involved in the development of regulation of apoptotic cell death in normal and neoplastic mucosa of the human color.

Objectives To explore the efficacy and possible mechanisms of nonsteroidal anti-inflammatory drug indomethacin on tumor growth and tumor angiogenesis of human colon cancer xenografts in nude mice.

To assess the effect of indomethacin on cultured HT116 cells. Human colorectal cancer HCT116 cells were inoculated subcutaneously into BALB/c-nu/nu mice. After treated with indomethacin orally every day for 4 weeks (3 mg/kg/d), animals were sacrificed by cervical dislocation. Immunohistochemical staining was employed to determine microvessel density (MVD) and vascular endothelial growth factors (VEGF) expression in tumor tissues. Results Indomethacin, a non-selective COX inhibitor, significantly decreased the viability of HCT116 cells in a dose-dependent manner (P < 0.05), with 50% inhibition at approximate 318.2 ± 12.7 mM. Growth of HCT116 tumor was significantly suppressed by indomethacin. The tumor volume (mm 3 ) was 458.89 ± 32.07 in the treated group versus 828.21 ± 31.59 in the control group (P < 0.05). The MVD of the treated and control groups was 19.50 ± 5.32 and 37.40 ± 4.93 respectively (P < 0.001). The VEGF expression of the treated and control groups was 1.19 ± 0.17 and 1.90 ± 0.48, respectively (P < 0.01). MVD and VEGF expression in the treated tumor tissue noticeably declined compared to the controls. There was a positive correlation between decrease of VEGF and decrease of MVD (r s = 0.714, P < 0.05). No obvious toxicity was observed in nude mice. Conclusions Indomethacin can significantly decrease the viability of cultured HCT116 cells and retard human colorectal HCT116 tumor growth in association with a significant reduction in angiogenesis, which may be through inhibition of VEGF.

Effect of indomethacin on human colorectal cancer cells HCT116 and SW480 HONGMEI WANG, GUIYING ZHANG Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008, China Objective To explore the effect of indomethacin on COX nonexpressing colon cancer cells (HCT116 and SW480).

We used MTT assay to assess the effect of indomethacin on the growth of cultured cells. Transplanted tumor models were established with BALB/c nude mice and were treated with indomethacin at a dose of 3 mg/(kg·d) for 4 weeks. Tumor volume and mouse weight were recorded every other day. Histologic examination was performed. Results After 48-hour incubation with various concentrations of indomethacin, growth of the two cell lines was significantly suppressed in a dose-dependent manner, with IC 50 being (318.2 ± 12.7) mmol/L and (701.4 ± 29.5) mmol/L, respectively. Indomethacin also effectively retarded the tumor growth within xenografts by 44.6% according to the tumor volume. No obvious toxicity was observed in nude mice. Conclusion Indomethacin can inhibit the growth of COX-negative human colon cancer cells both in vitro and in vivo, which indirectly suggests that indomethacin exerts its anti-tumor effect at least partly independent of the cyclooxygenase inhibitory profile.

Objective To investigate retrospectively hospitalized ulcerative colitis (UC) for providing correct diagnosis and proper management of the disease. Methods The cases of hospitalized UC in Sichuan University West China Hospital from 1990 to 2003 were reviewed and diagnostic and therapeutic data were analyzed. Results 201 cases of UC were reviewed. The male to female ration was 1.96 : 1. Average age of patients was 44.2 ± 13.8 years old. The course of UC was from 12 h to 34 years, with 55.2% from 1-10 years. In all cases, 99% were active UC, mild 18.6%, moderate 39.2%, severe 42.2%, and 25.4% were first onset, 63.7% chronic relapsing, 7.9% chronic persistent, only 3% acute fulminant.The most common clinical features were diarrhea (93%), abdominal pain (20.9%) and bloody stool (83.1%), etc. The extraintestinal manifestations were arthralgia (11 cases), rash (2 cases), and oral ulcer (3 cases).The complications were including large bleeding (4 cases), intestinal perforation (2 cases), carcinoma of colon (1 case), etc.The correct diagnostic rate of colonscopy, biopsy, intestinal X-ray was 83.5%, 47.6%, 33.3%. SASP/5ASA (72.6%) and steroids (67.2%) is still the major medica-tion used for the treatment of UC. Only 1 cases accepted immunosuppressive agents. The remission rate by medicine was 91.5%. The operation rate is 2.5%. The mortality is 1.5%. Conclusion There seem to be a tendency to moderate and severe predominance in UC in our hospital, and chronic relapsing is the commonest disease type. The course of illness is nor short but with less extraintestinal manifestations and systemic complications. SASP/5ASA and steroids are still the mainstay agents used for the treatment of UC.

Objective The objective of the study is to understand, from clinical perspectives, the relationship between colorectal polyps and colorectal cancer and to find out if the intervention of endoscopic treatment helps reduce the chance of colorectal cancer. Methods The methodology used in the study was to make a comparative study of those 340 cases of colorectal polyps and 107 cases of colorectal cancer, out of 1387 cases that have undergone endoscopic inspection from Aug. 1993 till Mar. 2004.The study was made from the perspectives of symptoms by patients' complaints, area of the illness, pathological study and age distribution of those patients. Result Our study results in the following findings. From the perspective of symptoms by the patients' complaints, even though bloody stool is among the symptoms complained from both patients, the complaints from the patients of colorectal cancer is much higher. From the perspective of area of the illness, the highest occurrence appears in the section from rectum to colon for both cases.The pathological study shows there exists a cause and effect relationship. Therefore, the 2 illnesses are closely related. The age distribution study shows that it occurs mostly between 40 to 70 years' old, but colorectal polyps could be detected much earlier than colorectal cancer. It indicates that there is a time difference between the two illnesses. Conclusion Great importance should be attached to the symptoms of bloody stool by patients' complaints. The early endoscopic treatment can effectively reduce the chance and prevent the occurrence of cancerous growth in colorectal. In addition, regular visit and inspection of patients of both illnesses, especially after surgical operation, is highly recommended.

Association of HLA-DRB1 polymorphism with ulcerative colitis in Chinese population with Han nationality in Hubei province MIN LV, BING XIA

Aims To investigate association between HLA-DRB1 alleles and ulcerative colitis and look for susceptibility or resistance genes to ulcerative colitis in Chinese population with Han nationality.

Using PCR-SSP method we tested a distribution of frequency of HLA-DRB1 alleles in 72 unrelated patients with ulcerative colitis and 314 matched healthy volunteers in Chinese Han population in Hubei province. Results The frequency of DRB1*07x allele was increased in ulcerative colitis compared with normal controls (19.4% vs 9.2%, P = 0.0207, OR = 2.372), but the association was not significant when using Bonferroni correction. There was not difference in the frequencies of DRB1*01x, DRB1*15x, DRB1*04x and DRB1*09x between ulcerative colitis and controls (1.4% vs 7.6% for DRB1*01x, P = 0.0610; 19.4% vs 27.1% for DRB1*15x, P = 0.2310; 16.1% vs 20.4% for DRB1*04x, P = 0.5162 and 27.8% vs 31.2% for DRB1*09x, P = 0.6708). No associations were found between HLA-DRB1 alleles and subgroups of ulcerative colitis, such as gender, site of disease, extraintestinal manifestations, disease types and severity). Conclusions HLA-DRB1 gene alleles were not associated with susceptibility or resistance to ulcerative colitis in Chinese population with Han nationality in Hubei province.

No association between NOD2 gene 3020 insc frameshift mutation and Chinese Han patients with inflammatory bowel disease BING XIA, YAN ZHOU, PING WANG, QIUSHA GUO, YAN QU, JIN LI Department of Internal Medicine,Wuhan University Zhongnan Hospital,Wuhan, China Aim NOD2/CARD15 was a newly identified susceptibility gene for Crohn's disease in Western countries. The present study was aimed to genotype NOD2/CARD15 in Chinese patients with inflammatory bowel disease. Methods We genotyped an insertion polymorphism affecting the leucine-rich region of the protein product in 74 unralated Hubei Han nationality patients with ulcerative colitis, 15 patients with Crohn's disease and 172 healthy individuals by the allele specific PCR. Results We did not find significant differences in genotype and allele frequencies of the C-insertion mutation of NOD2 gene among Crohn's disease and ulcerative colitis and healthy controls. Conclusion Our findings suggested that the NOD2 gene 3020 insc frameshift mutation is not a major contributor to the susceptibility for both Crohn's disease and ulcerative colitis in Chinese Han patients.

Objective To study cytotoxic T lymphocyte associated antigen 4 (CTLA4) expression on surface of peripheral blood mononuclear cells in inflammatory bowel disease. Methods Peripheral blood mononuclear cells were isolated from 10 patients with ulcerative colitis (UC), 4 patients with Crohn's disease (CD) and 10 healthy controls. CTLA4, CD4+ and CD8+ expressions on cells were determined by flow cytometry. Results CTLA4 spontaneous expressions were significantly increased on CD4+ and CD8+ cells in patients with UC and CD compared to healthy controls (for CD4+ cells, 7.63%, 4.28% and 1.36% respectively, P UC = 0.022 and P CD = 0.010; for CD8+ cells, 12.69%, 8.73% and 0.82%, respectively, P UC = 0.007 and P CD < 0.001). After the cells were stimulated with mitogen phytohaemagglutinin, only CTLA4 on CD8+ cells in patients with CD were highly expressed significantly compared with healthy controls (35.04% vs 16.18%, P = 0.007). Conclusion CTLA4 expressions were upregulated in patients with UC and CD and may therefore play a role in pathogenesis of IBD.

Expression and significance of survivin and caspase-3 in colorectal carcinoma YONGXIN XIA, YUXIU YANG

Objectives To investigate the expression of survivin and caspase-3 in colorectal carcinoma, and evaluate their relationship with clinicopathological features.

The expression of survivin and caspase-3 protein was detected by the standard streptavidin-peroxidase technique in 12 normal colorectal mucosa, 28 adenomas and 46 carcinomas. Situ hybridization was used to detect the expression of survivin mRNA. Results The positive rates of survivin mRNA and protein expression in normal colorectal mucosa, adenomas and carcinoma were 0%, 21.4%, 67.4%; 0%, 14.3%, 65.2%, respectively. Expressions of survivin mRNA and protein were higher in colorectal carcinomas than in normal colorectal mucosa and adenomas (P < 0.01). The expression of survivin has no obvious relation with clinical pathologic parameter in colorectal carcinoma (P > 0.05). The positive rates of caspase-3 expression in normal colorectal mucosae, adenomas and carcinomas were 25%, 75%, 60.9%, respectively. The expression of caspase-3 in adenomas and carcinomas was significantly higher than in normal mucosa (P < 0.05). The positive rates of caspase-3 were higher in well differentiated than in poorly differentiated colorectal carcinomas (P < 0.01). There was a negative correlation between survivin and caspase-3 in colorectal carcinoma (P < 0.05). Conclusion The expression of survivin may be regulated at the transcriptional level. Survivin may play an important role in the early part of the developing course of colorectal cancer and it may become a potential early diagnostic marker. The compensatory caspase-3 over expression is an early event during colorectal carcinogenesis.

The effect of enteral nutrition on protecting cirrhotic patients from malnutrition post ligation of esophageal varices HUILING XIANG, JUN LI, CHUNXI WANG, LI YANG, FEI YUAN, HONGMIN LV

Objectives Decompensative cirrhotic patients often have dysfunction in glucose, protein and lipid synthesis. Their condition becomes worse after endoscopy ligation therapy for esophageal varices because of insufficient intake. Therefore, it is necessary to ensure enough feed to avoid dystrophia. And enteral nutrition may have some contribution. We try to investigate the effect of enteral nutrition on protecting cirrhotic patients from malnutrition post ligation of esophageal varices in this exploration. Patients and methods All 33 cases were the in-hospital patients from 2004. January to May who were undergone endoscopy ligation therapy for their esophageal varices because of bleeding. Pepti-2000 variant were administrated to 18 of these 33 patients by 126 gram per day for continuously 14 days. The other 15 patients received only normal fluid to half fluid meals served as control. All patients were detected total serum protein, albumin level, hemoglobin, reticulocyte, ALT, BUN and Cr before and the 14th day after endoscopy ligation to estimate general nutritional condition. Results The total protein level, albumin level maintained stable, the blood hemoglobin and reticulocyte ratio increased a little compared with baseline in those patients received normal meals with Pepti-200 variant; while both decreased in control groups receiving normal meals only. (P < 0.05) Conclusion Supplemented enteral nutrition therapy is useful and clinical necessary for decompensate cirrhotic patients received endoscopy therapy to protect them from malnutrition often suffered from operation or other treatments.

From March 1998 to December 2004, a total of 45SAP patients (mean age 47.1 years, range 27-80 years) were divided randomly into lipid group (22 cases) and non-fat group (23 cases) according to whether there were fat emulsion in parenteral nutrition. Heat: nitrogen with lipid group was 666.6~1100.4 KJ:1 g and patients with triglyceride >6.8 mmol/L were excluded. Results After parenteral nutrition treatment, the levels of serum albumin in lipid group were impoved signifantly (p < 0.05), creatinine and urea nitrogen were decreased obviously (p < 0.05) and the level of blood sugar was controlled more effictively (p < 0.01) when compared with those of non-fat group. Relief of abdominal ditension and return of bowel sound and rate of morbidity and mortality and time of blood amylase and WBC count returning to normal levels were not signifantly (p > 0.05) between lipid group and non-fat group. Conclusions It is safe and effective to use fat emulsion in the treatment of SAP although it cannot improve course of disease of SAP.

The incidence of ulcerative colitis identified by colonoscopy and localization characteristic in Chinese population XUESONG YANG, WENBIN LIU, YUMIN LU Department of Gastroenterology, 3rd Hospital of Peking University, Beijing, China Objectives To investigate the incidence and its change of ulcerative colitis (UC) over the past years, and to evaluate the demology and endoscopic characteristics of UC in Chinese population.

Retrospectively review all the colonoscopic data from 1978~2003 recorded in the department of gastroenterology, 3rd hospital of Peking University. Results There were 27312 patients received colonoscopy during this period, and of those, 749 cases were diagnosed as UC by colonoscopic and histologic findings. The incidence of UC identified by colonoscopy in our department was 2.74%. The annual new cases of UC were from 15 to 41 and there was no significant difference either in the number of new cases or the incidence identified by endoscopy comparing every year. The onset age of UC was from 11 to 82 years old and the average onset age was 37.4 years, with the ratio of male : female 1.46 : 1. The overall peak region of onset age was 20~50 years which accounted for 78.1% cases with slight difference between male (20-30 yrs) and female (30-40 yrs). The localization of lesions was ranked as followings: rectal-sigmoid 40.2%; rectum 28.5%; pancolitis 14.6%; left colon 9.6%; subtotal colitis 3.9%; terminal ileum involved 1.1% and segmental distribution 1.9%. Conclusions In this cohort, there is no significant increase of ulcerative colitis cases over the last 25 years.The rectum is the region where ulcerative colitis most commonly involeved.

Observation on treating irritable bowel syndrome with golden bifid DESHUN YU, JIPING FENG Department of Gastroenterology, Jincheng People's Hospital, Jincheng, Shanxi, China Objective To investigate the curative effect of golden bifid (live combined Bifiddobacterium Lactobacillus and Streptococcus thermophilus Tablets, Oral) on irritable bowel syndrome (IBS).

Ninety-three patient group (A) (n = 34), who received golden bifid tablets, the control group (B) (n = 30), who received Nifedipine Tablets, and the control group (c) (n = 29), who received placebo (oryzanol Tablets and vitamin B 1 Tablets). All the patients stopped using antibiotics and other related therapy, and then four weeks treatment in their own scheme and dose was required.

Symptoms and defecation were recorded one time a week during the course of the treatment.

The total effective rate of group A was 82.35%, group B was 80%, and group C was 48.28%. Results of c 2 analysis manifested that statistically significant difference between group A group C existed (c 2 = 8.18 P < 0.01), and the same result appeared between group B and group C (c 2 = 6.47 P < 0.05). But no significant difference was found between group A and group B (c 2 = 0.058 P > 0.05). Conclusion Golden bifid is effective in treating IBS, and no significant difference was observed by comparison with the therapeutic effect of nifedipine.

Effect of gastrin on invasiveness of human colon cancer cells HONGGANG YU, JIAN DIN, HESHENG LUO, JIEPING YU

Objectives The purpose of this study was to determine the effect of gastrin and its receptor-CCK 2 receptor on invasion of human colon cancer cells. The role of focal adhesion kinase (FAK) was also investigated. Material and methods Two colorectal cancer cell lines: Colo320 and Colo320WT, which was stably transfected with CCK 2 receptor plasmid, were recruited in this study. Antisense oligonucleotide of focal adhesion kinase (FAK) was used to block the expression of FAK. Invasiveness and FAK tyrosine phosphorylation of colorectal cancer cells were detected by Boyden chamber and immunoblotting, respectively. Results An increased invasiveness was induced by different concentrations of gastrin in Colo320. Stable transfection of CCK 2 receptor amplified this increase and incubation with 1 mM L-365, 260, a specific CCK 2 receptor antagonist, completely inhibited the effect of gastrin. Meanwhile, an elevated FAK tyrosine phosphorylation (Tyr-397) was observed after treated with different concentrations of gastrin. FAK antisense completely blocked the increase of invasiveness in Colo320 cells. Conclusions Gastrin can promote invasiveness of colorectal cancer through activation of FAK pathway.

Clinical features of UC patients in the elderly and pre-elderly XIAOFENG YU, WEI ZHANG, YIRONG CAO, JIANFENG YAO, JIE CHEN, TING GU Division of Gastroenterology, Huadong Hospital, Shanghai 200032, China Background Despite recent improvements in our knowledge concerning UC in the elderly and pre-elderly, many fundamental issues are remaining unresolved: the true frequency of disease onset in old age; the natural history and location of disease; the response of these patients to medical therapy. Nevertheless, reasonably successful treatment options are available to many elderly UC patients, given that an alert and careful diagnostician identifies the problem.We aim to study and analysis the occurrence and clinical features of UC patients in the elderly (over 60 years old) and the pre-elderly (between 45-59 years old). Methods All patients hospitalized with UC at Huadong Hospital during 1998 and 2003 were evaluated. Among all the 45 patients, 7 are the pre-elderly and 15 the elderly. Patients were retrospectively evaluated by general information such as gender concerning diagnosis, clinical manifestation, colonoscopy reports and medical therapy.

All colonic mucosal biopsies were reassessed using strict diagnostic criteria. All patients are degreed by Truelove criteria. All the above were comparable among the elderly, the pre-elderly and patients under 45. Results History from 45 patients was reassessed. Among all the patients, abdomen ache, abdominal distension, diarrhea and bloody stools are very familiar. Diarrhea, bloody stools and weight loss are most frequent in the pre-elderly, while the elderly is second. Fever is most common in the elderly. According to the Truelove Criteria, mild degree in the elderly, pre-elderly and under 45 are respectively 18.8%, 26.5% and 57.4%, while moderate to intensive degree are 81.2%, 73.5% and 42.6%. 75.0% in the elderly were occurred in rectum, sigmoid and left colon with only 25.0% in pan-or extensive colon. The prevalence of pan-or extensive UC in the pre-elderly and under 45 are 41.4%, 34.8% each. Discussion UC, as a nonspecific inflammation of intestine, has an increase incidence in Chinese mainland these decades. The process is chronic and recurrent with unknown pathogenesis. Our research shows the difference among the elderly, the pre-elderly and fewer than 45. 1. Gender difference: among the pre-elderly UC patients and under 45, male are more than female with the proportion is 17 : 13, in accordance with other reports. However in the elderly, female patients are much more than male with the proportion is 4 : 11, which is greatly different with west countries. 2. Clinical symptoms: in the elderly and pre-elderly patients, symptoms such as abdomen ache, diarrhea and bloody stools are much more common than the under 45. However the conditions in the elderly are the most serious, because of the long history, relapse of illness and the bad state of the elderly. 3. Colonoscopy characters: in the elderly, most have disease confined to the rectum and sigmoid colon, while in the pre-elderly and under 45, the number of extensive disease increases. 4. Therapies: many patients still use traditional medicine, such as SASP and steroids. Although the states in the elderly and the preelderly are worse, all cases remit with SASP or steroids, while 2 cases in the under 45 have to be treated with immunosuppressor. Such difference maybe due to the pathogenesis in different age group.

Study on the inhibitory effect of berberine on deoxycholic acid induced cell proliferation CHUNYING ZHAI, BANGMAO WANG Department of Gastroenterology, Tianjin General Hospital, Tianjin, China Objectives In the present work we assessed the effect of berberine on DCA induced cell proliferation in human HT-29 colon cancer cell line to discuss their underlying anti-cancer mechanisms. Materials and Methods Cultured HT-29 Colon cancer cells were divided into two groups (DCA, DCA and berberine). The effect of berberine on cell proliferation was studied using the method of MTT. RT-PCR was applied to measure COX-2 mRNA transcription level. Cellular immunochemical stain (CIS) was applied, using a mouse anti-human COX-2 monoclonal antibody to label COX-2 protein expression. Radio immunoassay (RIA) was applied to assess PGE2 level in the culture medium. Results 200 mM DCA induced cell proliferation and COX-2 mRNA transcription. The inhibitory rate of 1 mM berberine in DCA induced cell proliferation was 7.38%. Berberine at concentration higher than 1 mM inhibited DCA induced COX-2 mRNA transcription at 6 hours. Berberine at concentration higher than 1 mM inhibited DCA induced COX-2 expression and PGE2 synthesis at 12-48 hours. 20 mM berberine led to maximal induction of COX-2 protein expression and COX-2 mRNA transcription at 48 and 12 hours, respectively.

Conclusions Treatment with berberine suppressed DCAmediated induction of cell proliferation. Berberine also suppressed the induction of COX-2mRNA transcription and COX-2 protein expression.These data provide new insights into the anti-cancer properties of berberine.

Expression of survivin in colon carcinoma and its significance ZHAN JUN 1 , JIANG ZHIMIN 2 , XIE DERONG 2 , LI HAIGANG 3 Departments of Internal medicine 1 , Oncology 2 and Pathology, The 2 nd Affiliated Hospital of Sun Yet-sen University, Guangzhou, China Abstract Objectives To evaluate the expression of survivin in colon adenocarcinoma and the relationship between its expression and the clinical characteristics and prognosis of colon adenocarcinoma. Method Expression of survivin protein was investigated using immunohistochemical staining method in 12 cases normal colon tissues and 79 cases colon adenocarcinoma tissues without the history of radiotherapy or chemotherapy. Results Expression of survivin was detected in 78.5% (62/79) colon adenocarcinoma, higher than in the tissues adjacent to tumor nests, which was 32.9% (26/79). In contrast, normal colon tissues did not express survivin. There was no relationship between survivin protein expression and age, sex, blood group, serum CEA level, lymph-node metastasis, histological grade, infiltration degreed and Dukes stage (P > 0.05). When 25% was used as the cut-off point of high and low expression of survivin, the 3-year overall survival rate of low expression group was much higher than the high expression group (63.56% vs 39.96%, P = 0.0405). Cox proportional hazards model analysis showed that Dukes stage and high expression of survivin were the only two prognosis factors influenced the survival times (Wald values were 25.636 and 5.853 respectively, P values were 0.000 and 0.016 respectively). Conclusions There is a high expression level of survivin in colon adenocarcinoma, survivin may play an important role in the tumoregenesis and development of colon adenocarcinoma. Over expression of this protein was related with poor prognosis and it might become a potential prognostic index.

Gastrointestinal symptoms in the elderly patients with diabetes mellitus-a case control study DAZHENG ZHANG, ZHENGLIANG QUAN

Objectives There still has been some controversy as to whether upper GI tract symptoms are moved common in diabetic patients than in no diabetic controls. The aim of this study was to evaluate the frequency of GI tract symptoms in elderly diabetes patients in the county of China.

Case control study using a questionnaire (GSRS-a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndromes and peptic ulcer) disease to establish a detailed GI tract symptom for 76 elderly diabetic patients and 152 age and sex matched non-diabetic controls. Results No significant differences were found between diabetic patients and controls with regard to 12 common GI tract symptoms; however, diabetes patients reported significantly more symptoms than controls (median: 0.35 VS 0.24, P < 0.057) and diabetic patients had significantly higher score for the following symptoms: decreased

Induction of apoptosis by celecoxib through activation of cytochrome C-caspase 9/parp pathway in HT-29 cell GUIYING ZHANG, JIE PENG, ZHIQIANG XIAO Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008, China

Objective We aimed to study the effect of selective COX-2 inhibitor Celecoxib on cell apoptosis of human colorectal cancer cell line HT-29 and the probable mechanism involved by detecting the expressions of cytochrome C, caspase-9 and PARP at protein level. Methods Apoptosis was determined by Acridine orange and Ethidium bromide staining under fluorescence microscope and flow cytometry. The protein expression of cytochrome C, Capsase-9 and PARP were examined by western blotting. Results Celecoxib induced apoptosis of HT-29 human colorectal cancer cells in a concentration and time-dependent manner from 0 to 120 mmol/L. Sub-G 1 peak was detected by FCM, and the apoptotic rate was between (7.31 ± 2.37)%~(48.30 ± 2.86)%. Celecoxib induced cytochrome C release into the cytosol from mitochondria, then activated caspase-9 and consequently triggered PARP cleavage. Conclusions Celecoxib can induce apoptosis through a cytochrome C-dependent pathway in human colorectal cancer cell line HT-29.

A survey of hospitalized Crohn's disease in China, a retrospective nationwide study From 1990 To 2003 Objectives To investigate the diversity of clinical manifestination, diagnosis and treatment of Crohn's disease (CD) in china.

Five hundred and fifteen hospitalized CD from 16 2003 were studied for diagnostic and hospitals across China during 1990 therapeutic status. Results: The hospitalized incidence (18/105) of CD from 1997 to 2003 was significantly higher than that (10/105) from 1990 to 1996. Mean age at onset was 37.7 ± 20.5 years. Peak prevalence of CD occurred among the age groups 20-50 years, and the overall male : female ratio of CD was 1.67. Abdominal pain, diarrhea, bloody and mucus stool, intestinal obstruction and constipation are the commonest symptoms of CD. Cobble stone sign, segmental lesions, fistula and extraintestinal diseases were not common. During hospitalization a colonoscopy was performed in 348 cases (61.75%), Intestinal x-ray examination performed in 221 cases (42.91%). The behaviour of CD was stricturing in 92 cases (17.86%), penetrating in 32 cases (6.21%). The location of CD was only ileal in 146 cases (28.35%), ileocolonic in 162 cases (31.46%), colonic in 187 cases (36.31%), recto-anal in 20 cases (3.88%). The disease was mainly located in ileum and colon 95%) in the in CD. Sulphasalazine and corticosteroid were effective (80% treatment of CD. About 33.20% (171 of 515) of the CD patients underwent surgery. The evaluations of quality of life about 17.82% (54 of 303) patients were poor. Conclusions These results were similar to those observed in European studies. This retrospective, hospital-based study shows that, in China, the incidence rate of IBD has steadily increased over the period considered. Further studies specifically focused on risk factors are needed. Because of complexity of clinical patterns, more attention should be paid to CD. The diagnosis and therapeutic strategy should need improvement.

Combination of hyperbaric oxygen and sulfasalazine in treating ulcerative colitis PING ZHANG

Objective To investigate the effects of hyperbaric oxygen (HBO) therapy in combination with sulfasalazine (SASP) on ulcerative colitis.

The 82 patients of active ulcerative colitis were randomly divided into two groups (group A HBO + SASP. Group B SASP). The group A was treated with sulfasalazine 1 g three times daily for four weeks and hyperbaric oxygen one time daily for two weeks. The group B was treated only with sulfasalazine 1 g three times daily for four weeks. The clinical signs and IgA IgG IgE lymphocyte transformation rate were observed before and after the treatment.

The total effective rate. Clinical effective rate the reaccure rate was 95.6%. 76.5%, 30.6% in group A and 75.0%. 27.0% 85.0% in group B. IgA 172.5 ± 11.2 mg/100 ml vs 132.6 ± 8.3 mg/100 ml in group A (p < 0.01) and 168.5 ± 13.3 mg/100 ml vs 166.7 ± 7.4 mg/100 ml in group B (p > 0.05) before and after the treatment. IgG 1175.3 ± 33.3 mg/100 ml vs 912.5 ± 21.3 mg/100 ml in group A (p < 0.01) and 1155.3 ± 31.7 mg/100 ml vs 1031.3 ± 23.4 mg/100 ml in group B (p > 0.05) before and after the treatment. IgM there were no deference before and after the treatment lymphocyte transformation rate 51.5 ± 2.4 vs 62.5 ± 3.6 in group A (p < 0.01) and 53.5 ± 2.2 vs 55.6 ± 2.4 in group B (p < 0.05). Conclusions The combination of HBO therapy and SASP exhibits benefitial effects on the ulcerative colitis, which may be related with the action of immune adjusting.

Clinicopathologic and endoscopic analysis of 67 young patients with coiorectal cancer QIUSHENG ZHANG, XIABIAO PENG, HUIMIN CUI, HUABIN QUAN

Objective To investigate the characteristics of young patients with colorectal cancer in clinicopathology and endoscopy.

The clinical, endoscopic and pathologic features of 67 young patients aged 35 or younger (group A) with colorectal cancer were analysed retrospectively, and compared with those of contemporaneous 379 middl-old aged patients (group B). Results The rates of muco-bloody stools, undifferentiated carcinoma, Dukes stage B 1 and radical resection, were 61.2%, 6.0%, 22.4% and 88.1% in group A respectively higher than 34.6%, 1.1%, 12.4% and 77.3% in group B (P < 0.05).The rates of colonic obstruction, high differentiated adenocarcinoma and Dukes D, were 1.5%, 7.5%, 6.0% in group A respectively lower than 11.3%, 20.8%, 15.3% in group B (P < 0.05). The rates of left-half colon (rectum, sigmoid and descending colon) cancer, mucinous adenocarcinoma, Dukes stage B 2 , were 77.6%, 23.9% and 29.9% in group A respectively, and 68.6%, 15.6% and 31.7% in group B (P > 0.05). The other clinico-pathologic and endoscopic shows were no significantly difference between group A and B. The time from the earliest symptoms to confirmed diagnosis in Group A and B were 19.5 ± 17.7 and 22.6 ± 38.3 weeks (P > 0.05). Conclusion The differentiation of colorectal cancer is lower in young patients, but pathologic stages are better and the rate of radical resection is higher.Young age is not a poor prognostic marker in colorectal cancer.

Studying the activity of intestinal mucosal mast cells in dextran salfate sodium induced colitis of rats WENYUAN ZHANG, SHENGXI HAN, HONG YANG Department of Gastroenterology, Sichuan Provincial Academy of Medical and People's Hospital, Chendu 610072, China Objective To investigate the activity of intestinal mucosal mast cells (IMMC) in dextran salfate sodium (DSS) induced colitis of rats. Methods Acute colitis was induced by giving 3% DSS orally. 18 male rats were randomized into DSS control group (n = 10) and normal control group (n = 8). The rats in DSS control group drank 3% DSS solution from day 1 to day 7. The rats in normal control group was drank water normally from day 1 to day 7, Diarrhea and bloody stool as well as colonic histology were observed. The levels of colonic tissue histamine, trumor necrosis factor-a (TNF-a) and Prostaglandin E 2 (PGE 2 ) were determined by fluorimetry and ELISA, and the expression of IMMC in colonic tissue was detected by histochemical stain method. Results Compared with normal control group, the inflammatory symptoms and histological damages of colonic mucosa in DSS group were significantly showed. The level of histamine in colonic tissue was significantly reduced (p < 0.05), the tissul levels of TNF-a, PGE 2 and the expression of IMMC in colonic tissule were significantly elevated (P < 0.05 -P < 0.01). Conclusions The data suggest that intestinal mucosa mast cell have an inflammatory action on experimental colitis through the mechanism other than elevating the tissue levels of TNF-a, PGE 2 and activity of IMMC in colonic tissue. distal ileitis. (4) The change of pathology: lymph follicular hyperplasis is very evident, germinal center enlarge and inflammatory reaction. The difference with chronic distal ileitis isn't evident. Conclusions It's similar in clinical, endoscope and pathology between lymph follicular hyperplasic disease and chronic distal ileitis. The former may be one stage or one kind of the chronic distal ileitis, the cause of the former may have relation with infection and immunogenesis.

To evaluate the value of diagonistic criterias in irritable bowel syndrome HUIQING ZHOU, DINGGUO LI, XIAOXING XU, CHUNHUA ZHONG, GUANHUI SONG & QINGHUA LIU Department of Gastroenterology, Xinhua Hospital, Shanghai Second Medical University, Shanghai, China Objective To evaluate the validity and discriminatory value of the manning criteria, Chinese Cheng Du criteria and Rome II criteria.

We studied 499 patients. According to above criterias, we separately caculated the sensitivity and 95% CI, specifity and 95% CI, validity, positive and negative predictive value, positive and negative likelihood in discriminating irritable bowel syndrome from non-ulcer dyspepsia, ulcerative colitis and healthy controls. Results 1. When all irritable bowel syndrome patients were compared with non-ulcer dyspepsia patients with the Manning criteria three more scores, the sensitivity and 95% CI significantly decreased, the specifity and 95% CI significantly increased, the positive predictive value and positive and negative likelihood also significantly increased. 2. When compared with non-ulcer dyspedsia, ulcerative colitis patients and healthy subjects with the Rome II criteria, there were the same sensitivity and 95% CI, similar specifity and 95% CI, positive and negative predictive value and positive and negative likelihood. 3. When compared with non-ulcer dyspepsia, ulcerative colitis patients and healthy subjects with the Chinese Cheng Du criteria, the validity was low in discriminating from irritable bowel syndrome patients with non-ulcer dyspepsia patients, ulcerative colitis patients and healthy subjects. Conclusions 1. Irritable bowel syndrome can be positively diagnosed by taking an accurate history and asking the right questions. 2. The Manning criteria three more scores can discriminate irritable bowel syndrome from non-ulcer dyspepsia and ulcerative colitis patients and healthy subjects. 3. If we strictly practise the Rome II criteria in clinics, we will make come irritable bowel syndrome patients whose symptoms are not severe not be treated. 4. The Chinese Cheng Du criteria's validity is bad and need to be revised or to be made new. Objectives To find out the main points for differential diagnosis by comparing the differences between Crohn's disease (CD) and intestinal tuberculosis (TB).

Twelve cases of CD and six cases of TB confirmed postoperatively were investigated retrospectively during1984 ~2003 in PUMC hospital. Their clinical situations, radiological examinations and pathologic features were compared. Results In 12 patients with CD, mean age was 40 ± 12 yrs (21 6 5 yrs), 11 were male and one female. In six patients with TB, mean age was 49 ± 19 yrs (32 ~83 yrs), One was male and five female.There is a significant difference in sex (P < 0.05). The most common symptom was abdominal pain in both CD (11/12) and TB (6/6). Other common symptoms were change in bowel habits (10/12), fever (9/12), abdominal mass (5/12) in CD and change in bowel habits (2/6), abdominal mass (2/6), and fever (1/6) in TB. There is a significant difference in change bowel habits and fever (P < 0.05).The existence of pulmonary tuberculosis and complications were helpless for the differential diagnosis. The enlarged mesenteric lymph nodes were found in 10/12 cases of CD and in 5/6 cases of TB; which diameter ranged from 0.2 cm to 1.5 cm in CD and 1.5 cm to 2.5 cm in TB. Atypical micro-granulomas were found in only one case, and no typical granulomas were found in mesenteric lymph node of CD cases. Epithelioid granulomas were found in all cases of TB (6/6), which commonly distributed in submucosa and the margin of ulcer. The mesenteric lymph node granulomas were found in 5/5 cases of TB. There were transmural inflammations in Crohn's disease. Conclusions The enlargement of mesenteric lymph nodes is more obviously in TB. CT scan might be valuable in differential diagnosis. It is helpful for TB diagnosis if epithelioid granulomas are found. Deeply multi-biopsy from the margin of the ulcer under endoscopy are benefitial for diagnosis.

The change of TXA2 and PG12 in the pathophysiology of severe acute pncreatitis of rat JIANYING BAI, XIAOYAN ZHAO Digestive Department, Xinqiao Hospital, Third Military Medical College, Chongqing 400037, China Objective To elucidate the pathogenesis of severe acute pancreatitis (SPA). Methods LThirty-six Wistar rats were selected and divided randomly into two groups: normal control group (NC, n = 18) and SAP group (SAP, n = 18). Under surgery, SAP models were established by injecting 5% sodium taurocholate (NaTc) with dosage of 0.1 ml per 100 g weight under pancreatic capsule. And NC group were injected same dosage normal saline. Light microscopy on the pancreatic pathologic tissue and electron microscopy on the pathologic changes of ultrastructure of the pancreatic acinar cells were carried out continuously. The changes of fthromboxane A2 (TXA2) and prostaglandin 12 (PG12) were dynamically determined. Results In SAP group the level of TXA2 and PG12 were significantly higher than those of NC groups. And the changes of pathology in SAP group was more seriously than NC group. Conclusion The changes of TXA2 and PG12 might play critical roles in rat SAP.

Clinical significance and cheanges of serum CRP, IL-8 and T cell subgroup in acute pancreatitis MINGMING DENG, XUAN WANG, ZHONGQIONG WANG, XIAOYUN LI

Abstract Objective To study the clinical significance and changes of serum acute phase protein, cytokines and T cell subgroup in acute panereatitis (AP). Methods 66 patients with AP were divided into SAP (36 patients) and MAP (30 patients). Serum CRP was determined by immuae nephelometry, IL-8 was determined by ELISA, T cell subgroup was determined by flow cytometry in all patients and 20 healthy volunteers.

The values of CRP in SAP was significantly increased than in MAP and controls (P < 0.05) and CRP levels was inereased in association with complications in SAP than without complications (P < 0.05); IL-8 levels in SAP increased markedly than in MAP and controls (P < 0.01), there was no significant difference between MAP and normal controls (P > 0.05); the percentages of CD 4 + , the ratio of CD 4 + /CD 8 + SAP significantly tower than those in MAP and controls (P < 0.01), but there was no significant difference between MAP and controls (P < 0.05). Conclusions There was cellular immunity functional disorder in SAP, there were important values in determination of sevum IL-8, CRP, T cell subgroup to assess early diagnosis, disease severity and prognosis of SAP.

Characteristics of early severe acute pancreatitis: pumch experience RUIXUE DENG, JIAMING QIAN, XINGHUA LU

Objective To discuss the characteristics of early severe acute pancreatitis (ESAP).

Twenty-two patients with severe acute pancreatitis (SAP) admitted to Peking Union Medical College Hospital (PUMCH) within 72 hours after onset of symptoms between Jan 1995 and Jan 2004 was reviewed. ESAP was defined as presence of organ failure within the initial 72 hours of the disease. Results Fourteen patients had ESAP. Compared with 8 patients without organ failure (SAP group), patients with ESAP were older (mean age 57 vs. 45) and had more disease histories. As for etiology, alcohol was less common in ESAP group, while all 3 patients with hyperlipemia had ESAP. Patients with ESAP more frequently developed progressive organ failures. The incidence of infected pancreatic necrosis was higher in ESAP (43% vs. 25%). More ESAP patients had surgical interventions than SAP patients (36% vs. 13%). All 5 deaths were occurred in ESAP group. Three patients died of MOF, the other 2 patients died of local and/or systemic infections. Conclusions ESAP is more common in elder patients with other organ disease histories. ESAP is characterized by a complicated clinical course and high mortality. Aggressive intensive medical care in early phase is crucial. Infected pancreatic necrosis and progressive organ failure are indications for surgery.

A study on correlation between obesity and hyperlipaemia and acute pancreatitis XIAOLING DING, GUOXIONG ZHOU, LIANG CAO Department of Gastroenterology, Nantong Medical College Affiliated Hospital, Nangtong, China Objective To investigate the influence of obesity and hyperlipaemia on the development of acute pancreatitis (AP). Materials and Methods 98 patients with severe acute pancreatitis (SAP) and 107 patients with mild acute pancreatitis (MAP) were included in this study. Obesity was evaluated by measurement of body mass index (BMI). The levels of serum triglyceride and cholesterol were also measured. The impairment of pancreas, liver and kidney functions was assessed according to laboratory evaluations. Results There were 64 patients in group 1 (BMI > 28 kg/m 2 , obese); 66 in group 2 (BMI > 24 and <= 28 kg/m 2 , overweight); and 75 in group 3 (BMI <= 24 kg/m2, normal or low weight). The incidence of SAP in group 1 was significantly higher than that of the other two groups; BMI and serum triglyceride of SAP patients were also higher than MAP patients. It was also found that obese AP patients with hyperlipaemia had poorer prognosis of the disease. The same phenomenon was not found in hyperlipaemic patients of group 2 and group 3.

Conclusions The results of this study show that obesity was associated with increased incidence of SAP, and that the level of serum triglyceride in obese patients intensifies the severity of acute pancreatitis. The results suggest that obese patients should be given closer monitoring and intensive treatments.

Up-regulation of EGR-1 in the cearulein-induced acute pancreatitis in rats LANBO GONG, XUEQING CHEN, BO JIANG, YUGANG SONG, ET AL. Department of Gastroenterology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China Aim To observe the expression of early growth response 1 (Egr-1) and tissue factor (TF) in the cearulein-induced experimental pancreatitis in rats, and to explore their significance. Methods The rat experimental pancreatitis was induced by highdoes of Cearulein. The changes of Egr-1 mRNA and protein in pancreata were recorded by quantitative PCR and western blotting. The localization of Egr-1 protein in acinar cells was visualized by immunohistochemistry. The TF mRNA levels were also measured by quantitative PCR. High-dose of bombesin stimulated rats were as control. Results The Egr-1 mRNA was rapidly increased in the pancreas when stimulated by high-dose of cearulein, with the peak level at 30 min after stimulation. However, the Egr-1 protein band was visualized by western blotting at the peak level in 2 h after stimulation. The immunohistochemistry showed that almost every acinar cell in pancreas were Egr-1 positive, especially in the nucleus. In line with Egr-1 activation, TF mRNA level was shown in 1 h and went up steadily within 4 h after cearulein stimulation. Tiny Egr-1 mRNA expression was obsvered in bombesion stimulated rats. The Egr-1 protein and TF mRNA were not detected after stimulation of bombesion. Conclusion Egr-1 mRNA and protein were up-regulated in the early stage of pancreatitis. Egr-1, as a pro-inflammatory transcriptional factor, probably plays a very important role in the initiation of acute pancreatitis, to some extent, which may be mediated through up-regulation of TF exprssion. Objectives To study the effect on invasive and motor ability of MiaPaCa II pancreatic cancer cell transfected by recombinant plasmid pCMV-KAI1, alteration of KAI1 in the trasfecting cancer cells, and the metastatic mechanism in the malignancy.

MiaPaCa II pancreatic cancer cell was transfected with pCMV-KAI1 by liposome, the invasive and gelatinase ability of two pancreatic cancer cell lines were analyzed with transwell culture cell and PAGE (polyacrylamided gel electrophoresis) before and after KAI1 cDNA transfection. Results After KAI1 cDNA transfected into MiaPaCa II, the migrative ability of passing through the membrane filte decreased evidently (P < 0.05). The width of negative staining band narrowed the intensity level of tape weakened through PAGE. These results showed that reduced the ability of degrading basement membrane and extra-cell base and metastasis were influenced after MiaPaCa II pancreatic cancer cells were transfected. Conclusions The suppressed invasion and motor function of pancreatic cancer cells seems to influence their metastatic ability and thereby entrances the malignant potential of pancreatic cancer. Objectives To transfect recombinant plasmid pCMV-KAI1 to PANC I and MiaPaCa II pancreatic cancer cells for studying the expression of KAI1 gene. The transfected cells will be used as the target cell in the study of anti-metastatic role of KAI1 gene on human pancreatic cancer, and provide the experimental and theoretic foundation for genic therapy to human pancreatic cancer with KAI1 gene.

The expression of KAI1 protein was negative in PANC I and MiaPaCa II of seven kind of pancreatic cancer cells with Western blot, so PANC I and MiaPaCa II were transfected with pCMV-KAI1 by lipofectamine, then selected by G418, the expression of KAI1 in the obtained monoclone cells were detected by Western blot, immunofluorescence staining and immunocytochemistry.

The transfected stably cells were obtained; Western blot showed there was the protein of KAI1 in 29.100 D inside the transfected PANC I and MiaPaCa II pancreatic cancer cells; KAI1 protein was found by immunofluorescence staining and immunocytochemistry in transfected the pancreatic cancer cells. Conclusions KAI1 can be expressed effectively in PANC I and MiaPaCa II pancreatic cancer cells transfected by recombinant plasmid pCMV-KAI1. The metastatic mechanism of transfected pancreatic cancer cell can be explained to be concerned with that of patients with pancreatic cancer.

Evaluation of the urinary trypsinogen-2 dipstick test in acute pancreatitis GUANGMING HUANG, GUOZHONG JI, LIHUA YANG, LING MIAO, SHUHUA ZHANG, SHUMING ZHU Department of Gastroenterology, the Second Affiliated Hospital of Nanjin Medical University, Nanjin, China Aims To investigate the change of urinary trypsinogen-2 dipstick test (UTDT) in patients with acute pancreatitis (AP), and to evaluate the value of UTDT in diagnosis of AP. Materials and Methods One hundred and ten consecutive patients (mean age 47 years, range 20-82 years, male 61, female 49) with AP were retrospectively reviewed, and different time periods were divided by first attack of abdominal pain, such as the first 24 hours, the second 48 hours, and etc. The results of urinary trypsinogen-2 dipstick test were analyzed in different time periods. The severity of AP patients at admission was evaluated retrospectively according to Ranson's criteria. Eight patients were severe acute pancreatitis (SAP) and the others were mild acute pancreatitis (MAP). The serum and urinal amylase were also analyzed. Results The UTDT has a changing sensitivity in different time periods. The sensitivity of UTDT in first 24 hours is 26.8%, second 68%, and third 69.4%, 4 th 46.8%, 5 th 32.5%, 6 th 18.7%, 7 th 19.4%. The UTDT in 8 patients with SAP were all positive, and the UTDT may be positive prolong after the fiftieth day of admission. The sensitivity of serum amylase assay in first is 66.7%, second 85.2%, third 47.3%, 4 th 27.1%, 5 th 15.6%, 6 th 12.1%, 7 th 11.1%. The sensitivity of urinary amylase assay in first is 79.7%, second is 91.8%, third is 78.0%, forth is 46.3%, fifth is 53.4%, sixth is 34.3%, seventh is 16.9%. Conclusions UTDT is a useful and rapid diagnostic indicator in patients with AP. Its sensitivity is different in different time of AP attacks and is higher in patients with SAP than MAP. The UTDT may have a prolong time positive in patients with SAP.

Enhanced suppression of pancreatic carcinoma by combination of angiogenesis inhibitor TNP-470 and cytotoxic agents gemcitabine in mice LIN JIA, SHIZHEN YUAN Departments of Gastroenterology, First Municipal Hospital of Guangzhou, 510180, China Objectives To investigate the enhanced anti-tumor effects by combination of TNP-470 with Gemcitabine (angiocytotoxic therapy) using a model of pancreatic carcinoma by surgical orthotopic implantation (SOI) in nude mice.

The SOI model was developed by suturing small pieces of SW1990 pancreatic carcinoma into the tail of pancreas in nude mice. (1) Single-drug therapy: 24 male mice were randomly divided into control group, G100 group receiving 100 mg/kg Gemcitabine i.p on days 0, 3, 6 and 9 after transplantation, and T30 group receiving 30 mg/kg TNP-470 s.c on alternate days for 8 weeks.

(2) Combination therapy: 32 male mice were randomly divided into control group, T15 group, G50 group and combination group (TNP-470 30 mg/kg+ Gemcitabine 50 mg/kg). Animals were killed at the tenth week after transplantation. The weight of transplanted tumors, T/C rate, and the change of body weight of mice, metastases rate, and survival rate of nude mice after 9 weeks were investigated. Results G100 group showed a significant inhibitory effect on primary tumor growth of pancreatic carcinoma compared to T30 group, while the metastasis of tumor was significantly inhibited by T30 group compared to G100 group. Neither G100 group nor T30 group showed a significant improvement on its survival rate. T15 group and G50 group alone had no significant inhibitory effect on the tumor growth and its metastasis. On the other hands, a significant anti-tumor, anti-metastatic effect and a significant improvement on the survival rate were observed in combination group. The inhibitory effect of G50 group was enhanced 2 times by T30, and 25% of the animals of bearing tumors were cured by the combination therapy. Conclusions Angiocytotoxic therapy that showed significant antitumor and anti-metastatic effect and was helpful to reduce the dosage of cytotoxic drugs and its side effect is a safe and effective anti-tumor strategy.

Frequent loss of heterozygosity at MEN-1 gene and chromosome 22q in insulinoma and its significance WEIJUN JIANG 1 , YUANJIA CHEN 1 , TONGHUA LIU 2 , JIE CHEN 2 , JIE GAO 2 , SHAFEI WU 2

Objectives The molecular pathogenesis of insulinomas is unknown, we detected whether Loss of Heterozygosity (LOH) at the MEN-1 locus as well as 22q occurs in sporadic insulinomas and if LOH could be used as a genetic marker to differentiate malignant insulinomas from benigns. Materials and Methods MEN-1 gene and 22q allelotyping were performed by PCR with microsatallite markers in DNA from microdissected normal and tumor tissue from archived or frozen insulinomas (8 malignant, 32 benign, from 38 patients). Significance was calculated using t test and Cochran-Mantel-Haenszel Statistics, P < 0.05 was considered significant. Conclusions The data demonstrate that MEN-1 gene LOH may contribute to a proportion of insulinomas, and 22q LOH occur frequently in insulinomas. D22S 280 (22q12) LOH may independently contribute to the tumorogenesis of sporadic insulinoams, whereas detecting 22q13.3 LOH in insulinomas could be a potential genetic marker to distinguish malignancy from benigns.

High intensity focused ultrasound (HIFU) ablation on pig's pancreas and its application to patients with pancreas cancer BIAO XIE, YUYUAN LI, YUQIAN NIE, LING JIA, YONGJIAN ZHOU, PEZHI LIANG, HONG DU, JING ZHANG

Objectives To investigate the theoretical basis of applying HIFU to ablation of pig's pancreas, and to evaluate the efficacy and safety of HIFU in the clinical treatment of patients with pancreas cancer. Materials and Methods HIFU was performed at 8 mongrel pig's pancreas to see its feasibility in pancreatic diseases, and then 6 patients with advanced pancreas cancer to observe its efficacy and safety in clinical use. Results In animal study, precise coagulation necrosis regions were defined by autopsy and pathology at the targeted areas in all specimens. The levels of blood and urine amylase rose in the first three days after operation, then fell down to normal levels. All pigs survived with no severe complication. In clinical study, following indicators were used to evaluate the efficacy of HIFU. 1. Reduction of tumor sizes over 50% in image examinations (CT, MR, ultrasound), 2. Decrease of serum tumor makers (CA199, CEA), 3. Improvement of clinical symptoms. The rate of 1-month complete response (CR, indicators 1 + 2 + 3) was 1/6 (16.7%), partial response (PR, 1 + 2 or 1 + 3) 4/6 (66.7%). Totally 5/6 (83.3%) patients responded to HIFU. No severe complication was found. Conclusions This study suggested the feasibility of HIFU in the treatment of pancreatic diseases. The clinical application of HIFU to pancreas cancer was effective and safe.

Exprimental study of high intensity focused ultrasound (HIFU) ablation on pig's pancreas BIAO XIE, YUYUAN LI, YUQIAN NIE, LING JIA, YONGJIAN ZHOU, PE-ZHI LIANG, HONG DU, JING ZHANG

Objectives To evaluate the feasibility and safety of HIFU in ablation of pig's pancreas for providing theoretical basis on its clinical application. Materials and Methods 12 mongrel pigs were randomly divided into 3 groups (n = 4 in each group). After the dissection of the animals of group A, the pig's pancreases were ablated directly from the surface of the organ by a HIFU probe. Extracorporeal HIFU ablation on the pancreases was applied through the skin of group B and C. The pigs of group B were killed immediately after sonication. Blood and urine amylases of the pigs of group C were tested before and on the 1st, 2nd, 3rd, 5th and 7th day after sonication. The pigs of group C were killed on the 7th day. The pancreases extracted from all animals were sent for examination of histology and electronic microscope. Results Steadily vital signs of all animals during sonication and good recovery after sonication in group C were observed. Precisely defined coagulation necrosis regions were found in all specimens.The necrosis volumes and shakes of 3 groups were not significantly different (p > 0.05). Coagulation nucleus pyknosis, cytochylema vacuolation and nucleus membrane disruption were seen soon after sonication. The levels of blood and urine amylases rose in the first 3 days after sonication, and then fell down to normal levels. Conclusions This study suggested the feasibility of HIFU in the treatment of pancreatic diseases in pigs. Objectives Severe acute pancreatitis (SAP) is characterized by high mortality. The aim of this study was to analyze a consecutive series of patients with SAP and to identify clinical characteristics and prognostic factors for mortality.

Clinical data of SAP admitted to our hospital from Jan. 2003 to Jan. 2004 were retrospectively reviewed. Collected data included age, gender, etiology, scores of APACHE II at admission, local complications and organ / systemic complications. Results Out of a total of 268 acute pancreatitis, 94 developed SAP. The mean age of the SAP was 52; the commonest etiology was cholelithiasis; the mean score of APACHE II was 7.7; 54% developed necrosis; 25% developed abscess; 58% developed organ / systemic failure. A total of 23.4% (22/94) of the SAP died. Respiratory failure was the most common organ dysfunction (90.9%) in the deceased group, followed by cardiovascular failure (86.4%), renal failure (50.0%). In the deceased SAP, 90.9% (20/22) developed multiple organ / systemic failure, 18.1% (13/72) in the survivor. There were significant differences in age, score of APACHE II and the incidence of respiratory failure, renal failure, cardiovascular failure, hematological failure between deceased SAP group and SAP survivor. By multivariate Logistic regression analysis, independent prognostic factors for mortality were respiratory failure, cardiovascular failure and renal failure. Conclusions SAP is characterized by advanced age, high score of APACHE II, development of organ failure and mainly died due to multiple organ / systemic failure. In patients with SAP, failures of respiratory, cardiovascular and renal predict fatal outcome and thus should be paid more attention on clinical evaluation.

Effect of As2O3 on human pancreatic cancer cell line PANC-1 cultured in vitro TIEFU LIU, CHUNYAN DONG, LIPING SUN First Teaching Hospital, Harbin Medical University, Harbin, China Aim To study the effect of varying concentration of As2O3 (arsenic trioxide) on human pancreatic cancer cell line PANC-1 and protein expression of p-Erk cultured in vitro. Methods The PANC-1 cells were treated with As2O3 (at concentrations of 0.2, 1, 10 mmol/L, respectively) for successive 7 days. Morphologic changes were studied with phase-contrast microscopy. The cell growth and inhibit rate were observed by cell counting and cellgrowth curve. The protein expression of p-Erk detected by Western blot method. Results Morphologic changes such as out of shape, nuclei condensation, shedding were seen under phase-contrast microscopy after As2O3 treated 24 h. The cell counting and cell-growth curve dis-played that As2O3 inhibiting cells was dose-and time-dependent which reach peak at 7d. Western blot method show As2O3 inhibit protein expression of p-Erk which was dose-and time-dependent also. Conclusions As2O3 not only significantly inhibit proliferation of human pancreatic cancer PANC-1, but also inhibit protein expression of p-Erk.

Adenoviral mediated suicide gene transfer in the treatment of pancreatic cancer XUE PAN 1 , ZHAOSHEN LI 1 , GUOMING XV 1 , LONG CUI 2 Department of 1 Gastroenterology and Surgery 2 , Changhai Hospital, Second Military Medical University, Shanghai, China Objectives Suicide gene therapy is a new experimental form of cancer chemotherapy that is currently being evaluated in human trials. The aim of this study was to evaluate the killing effects of cytosine deaminase (CD) gene mediated by adenovirus vector on human pancreatic carcinoma in vitro and in vivo. Materials and Methods CD gene was cloned into pAdTrack-CMV-CD, pAdTrack-CMV-CD and pAdEasy-1 were recombinated in bacteria BJ5183.The newly recombinated Ad-CD containing green fluorescent protein (GFP) were propagated in 293 cells and purified by cesium chloride gradient centrifugation. Human pancreatic carcinoma cell line PaTu8988/SW1990 were infected with this virus, then 5-FC was added, XTT assay was used to estimate relative numbers of viable cells. In vivo model of pancreatic cancer was established by injecting 1.0 ¥ 10 7 PaTu8988/SW1990 cells subcutaneously in Balb/c nude mice. When tumors were palpable, Ad-CD was injected into each tumor and 5-FC was administered. Results The positive clones selected by using endonuclease to digest the combinatants and the concentration of viral liquids containing CD gene was 2 ¥ 10 11 pfu/ml. It was found that significant cytotoxic activities were possessed by 5-FC for CD gene transduced PaTu8988/SW1990, but little effects on the nontransduced pancreatic carcinoma cells. The antitumor effect was observed in PaTu8988/SW1990 xenografts nude mice with in situ CD gene transduction. Conclusions These results indicate that CD gene mediated by adenovirus has a high infectivity and is efficient for gene therapy of pancreatic carcinoma.

Expression of vascular endothelial growth factor and cell adhesion molecule in pancreatic cancer XUE PAN 1 , ZHAOSHEN LI 1 , GUOMING XV 1 , LONG CUI 2 Department of 1 Gastroenterology and Surgery 2 , Changhai Hospital, Second Military Medical University, Shanghai, China Objectives To study the significance of microvessel density (MVD) and the expression of CD 34 , vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1 (ICAM-1) in chronic pancreatitis and pancreatic adenocarcinoma. To hypothesize that angiogenesis might play a pivotal role in the etiology of both PCA and CP.

In pathological specimens of 24 patients with PCA, 24 with CP, and 7 controls, microvessel density (MVD) were assessed after immunostaining of endothelial cells for CD 34 . Furthermore the expression of cell adhesion molecules ICAM-1 and of VEGF (vascular endothelial growth factor) was investigated in all specimens.

Both PCA and CP exhibited areas of high vascular density (hot spots). The mean microvessel density (MVD) in these areas in PCA was 47.2 ± 9.4 and in CP, 40.8 ± 7.93. Versus controls 9.85 ± 2.86 (p < 0.01). Enhanced expression of ICAM-1 in CP and PCA was seen in ductal cells in CP and cancer cells. In controls, ICAM-1 was expressed only at low levels in endothelial cells. VEGF was strongly expressed in tumors and ductal formations, In CP, both inter and intralobular ducts expressed VEGF. Conclusions Angiogenesis, angiogenic growth factors and cell adhesion molecules had a high relationship with the biological activities of CP and PCA. And play an important role in the evolvement of PCA. We suggest that antiangiogenesis might be a novel target for prevetion or therapy in chronic pancreatitis and pancreatic cancer.

Electron microscopic observation of the CD gene transduced pancreatic carcinoma cells by the effect of 5-flurocytosine XUE PAN 1 , ZHAOSHEN LI 1 , GUOMING XV 1 , LONG CUI 2

Objectives To investigate the effect of 5-flurocytosine to the Cytosine Deaminase (CD) gene tranduced pancreatic carcinoma cells by the electron microscopic method.

Recombinated adenovirus containing CD gene were constructed, propagated and purified. Pancreatic carcinoma cells were cultured in vitro and An in vivo model of pancreatic cancer was established by injecting 1 ¥ 10 7 Patu 8988 cells subcutaneously into the flanks of Balb/c nude mice, adenovirus liquids containing CD gene were transduced to the pancreatic carcinoma cells, following administration of 5-FC to observe the antitumor effects under the electron microscope. Results The positive clones selected by using endonuclease to digest the combinatants and the concentration of viral liquids containing CD gene was 2 ¥ 10 11 pfu/ml. Under the electron microscope, the killing effect of CD/5-FC suicide system to the pancreatic carcinoma cells in vitro was kind of apoptosis, not necrosis. But apoptosis and necrosis were both seen in vivo as well as lymphocytes. Conclusions CD/5-FC suicide gene system mediated by adenovirus is efficient for the killing effects of pancreatic carcinoma. In vitro results show that the intake of apoptotic bodies and toxic metabolic substances may play important role in the killing of pancreatic carcinoma cells. In vivo, the apotosis and necrosis both exist, and immune response also participate in the inhibiting of tumor growth. 

The abnormal expression of b-catenin was 67.57% in pancreatic cancer, only 40% cases were detected abnormal staining in benignant disease; none of the staining in normal pancreas was abnormal. There were significant differences between them (P < 0.05). In pancreatic cancer, the abnormal expression of b-catenin was closely related to clinical stages and lymph node metastasis (P < 0.05). 26 cases of pancreatic cancer and 3 cases of benign disease were detected positive staining of cyclinD1, there was no positive expression in normal pancreas. There were significant difference between cancer and benign, normal tissues (P < 0.05). No significant were found between the expression of cyclinD1 and the differentiation, clinical stage and lymph node metastasis (P > 0.05). In pancreatic cancer the expression of Smad4 (51.38%) was lower than the normal pancreas (85.71%) (p < 0.05), but had no association with benign disease (P > 0.05). Smad4 expression had no relationship with the clinical parameters of pancreatic cancer. (P > 0.05). The expression of b-catenin and cyclinD1 had significant relationship (P < 0.05). Similar relationship also was found between b-catenin and Smad4 (P < 0.05). The relationship between Smad4 and cyclinD1 was no significant (P > 0.05). Conclusions b-catenin plays an important role in the early stage of pancreas carcinogenesis, it prompts the metastasis and invasion. bcatenin exhibites its effects mainly by the transactivation of cyclinD1. The mutation of Smad4 disrupt TGF-b signaling pathway, the consequent changes in cell behavior lead to tumorigenesis. The Wnt and TGF-b signaling pathways have crosstalk. b-catenin cooperate with Smad4 in the pancreatic tumorigenesis.

Establish and characterization of the human pancreatic carcinoma transplantation in nude mouse LINAN REN, JIANHUA XU, XIAOZHONG GUO, MINPEI LIU

Objectives To establish and characterize human pancreatic cancer xenograft in nude mouse.

The MiaPaca II cells were injected into the subcutaneous, after the tumor was established; the cells from the tumor were injected into the subcutaneous part of other BALB/cnv/nu again. Results Human transplantable pancreatic carcinoma was established in nude mouse. This xenograft as us counterpart exhibited striking lump overlying skin. Pathology detected showed the tumor was differentiation poor cancer. The average tumor volume of the mouse after injected with cells 4 weeks was 7.234 ± 0.035 cm 3 , the average tumor weight was 6.458 ± 0.169 g, and the metastasis ratio was 93.33% (28/30).The lung was the easy part of the internal organs to be transferred. Armpit and groin were the easy Lymphovasculor invasion parts. About 4 weeks was the metastasis time. Conclusions The BALB/c-nv/nu mouse was the ideal experiment animal. The human pancreatic carcinoma xenograft will provide an excellent animal model to allow us to further dissect out both the upstream regulatory machinery and downstream molecular responsible for the pancreatic cancer.

Objectives To improve the understanding of pancreas cancer and to avoid diagnostic errors and management. 

The clinical condition of illness of earlier period of pancreas cancer is unknown to show, and often cause the misdiagnosis, careful inquiry into the history and careful differentiation of imaging features would lead to correct preoperative diagnosis. We think in the diagnosis of cancer pancreas below what time deserve to pay attention to: 1. the cancer-causing thing of food, smoking and contact industry of old age male, high fat of high and dangerous crowd need to periodically make the image to learn the check with the hereditary pancreatitis. 2. the right emergence ascend the belly ache or not well, the jaundice, have a poor appetite, the proceeding is emaciated, lumbago that have relation with, not construable diabetes and indigestion the etc. condition of illness need the possibility that doubt the pancreas cancer, and combine to make into a check. 3. tumor marking thing CA-199, is beneficial to distinct, but cholangitis hour serum the CA-199 can also go up, need to note the differentiation. Endoscopic ultrasonography (EUS) pancreas cancer is discovereds to earlier period the help is big. 4. proceeds to suspicious patient first US inspection, if the feminine gender need a belly CT etc. inspection, display the pancreatic enzzymes capitis enlarge to CT but did not see the clear and definite lump, the MRI is beneficial to the clear and definite diagnosis. The EUS pancreas cancer is discovereds to earlier period the help is big. 5. for the altitude doubt pancreas cancer but can't make sure the diagnosis, should early open the belly cavity to fish for.

The role of p38MAPK signal transduction pathway in the pathogenesis of severe acute pancreatitis XINGANG SHI, YITAO JIA, ZHENXING TU, YANFANG GONG, YONGCHUN XU, XIAOHUA MAN, JING JIN, ZHAOSHEN LI

Objectives To study the dynamic changes of p38 mitogen-activated protein kinase (p38MAPK) activitions and assess the effects of blocking the p38MAPK in rats experimental severe acute pancreatitis (SAP).

The SAP model was induced by bilipancreatic duct infusion with 5% sterile sodium taurocholate solution. Eighty SD rats were randomly divided into SO group (n = 30), SAP-NS group (n = 25) and SAP-CNI1493 group (n = 25). In the SAP-CNI1493 group, SD rats were given 10 mg/kg inhibitor CNI1493 (i.v.) 30 minutes before induction of SAP. In SAP-NS group SD rats received some volume isotonic saline (i.v.) as CNI1493.Western blot analysis was performed to determine the activations of p38MAPK in the pancreas homogenates. Results In the SO group, basal active p38MAPK can be detected. In the SAP-NS group, the active p38MAPK in the pancreas homogenates reached the maximum at 15 minutes and remained at a similar level at 30, 60 and 180 minutes and declined to the level of SO group at 6 hours. In the SAP-NS group and SAP-CNI1493 group, the densities of the band detected by Western blot were 5200 ± 360, 3500 ± 250 at 15 minutes, and 4910 ± 320, 2500 ± 340 at 30 minutes (P < 0.01). In SAP-CNI1493 group, the serum levels of IL-1b and TNF-a were decreased significantly (P < 0.01, vs SAP-NS group). Conclusions p38MAPK play an important role in the pathogenesis of SAP. p38MAPK may mediate the production of proinflammatory cytokines in SAP rats. Blockade of p38MAPK phosphorylation may be as a potential target in the prevention and treatment of SAP.

Clinical observation on the therapeutic efficacy of lipo prostaglandine1 in treating acute pancreatitis WEIHAO SUN, FENG ZHU, XILONG OU, DAZHONG CAO, QIAN YU, TING YU, XILING FU, HAN SU, YUNLIANG SUN Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China Objectives Autodigestion and impairment of microcirculation of the pancreas play an important role in the pathogenesis of acute pancreatitis (AP). ProstaglandinE 1 (PGE 1 ) is an effective agent in treating peripheral vascular disorders such as Buerger's disease and diabetic peripheral neuropathy. However, little is known about the effects of PGE 1 on the treatment of AP. Therefore, the aim of this study was to evaluate the therapeutic effects of Lipo PGE 1 on the treatment of AP.

A total of 62 patients with AP were randomized divided into two groups. The treatment group including 22 cases of mild AP (MAP) and 12 cases of severe AP (SAP) were intravenously given Lipo PGE 1 20 mg once daily for 10 days. The control group including 18 cases of MAP and 10 cases of SAP were managed with routine treatment. Results In the patients with MAP, the relief rate of clinical symptoms and abdominal signs, and the recovery rate of serum amylase levels in the treatment group were significantly higher than those in the control group; the total effective rate was 100.0% in the treatment group, significantly higher than 66.7% in the control group (P < 0.05). In the patients with SAP, the total effective rate in the treatment group was superior to the control group, but there was no statistical difference between two groups (P > 0.05). Conclusions Lipo ProstaglandinE 1 has a better therapeutic effect on AP.

Enhanced expression of cap43 gene in pancreatic cancer LUOWEI WANG, ZHAOSHEN LI, GUOMING XU, ZHENXING TU, YANFANG GONG, XINGHUA HUANG

Objectives To investigate the expression of cap43 gene in human pancreatic cancer, and to evaluate the diagnostic value for early pancreatic cancer. Methods Thirty-three pancreatic cancer and normal tissues near tumor of 33 patients (22 male and 11 female) were obtained from Apr. 1999 to Aug. 2002 in changhai hospital. The age ranged from 30 to 73, with a mean of 58.1. The diagnosis of all patients was confirmed by pathology. And the neoplasm and normal tissues were matched pairs. Results Semi-quantitative RT-PCR analysis showed cap43 gene highly up-regulated expressed in pancreatic cancer. The density of Semi-quantitative RT-PCR products of cap43 were 4033 ± 1986 and 2244 ± 1145 (P < 0.001). Northern blotting analysis also showed cap43 gene highly expressed in tumor tissues. And it coincide with semi-quantitative RT-PCR (P > 0.1).

Cap43 gene is overexpressed in pancreatic cancer compared to low level of expression in normal pancreatic tissues. It makes cap43 gene a new, important tumor marker of pancreatic cancer.

Diagnostic value for the immunocytochemical detection of VEGF combined with cytological examination from pancreatic duct brushings in patients with pancreatic carcinoma LUOWEI WANG, ZHAOSHEN LI, GUOMING XU, ZHENXING SUN

Objectives To investigate the diagnostic value of immunocytochemical detection of VEGF combined with cytological examination from pancreatic duct brushing in patients with pancreatic carcinoma. Methods Pancreatic brushing samples were collected prospectively under ERCP in 52 patients with pancreatic cancer and 11 cases with chronic pancreatitis. Cytological morphology was examined by using HE staining and VEGF expression was analyzed by immunecytochemistry in cytological specimens. Results Sensitivity of HE staining to detect pancreatic carcinoma was 51.9% (27/52), while VEGF was 63.5% (33/52). There was no expression of VEGF in pancreatitis. The specificity for HE staining and VEGF was 100%. Combining HE staining with VEGF, the sensitivity increased to 75%. Conclusions These results suggest that combining HE staining with VEGF immunocytochemistry of pancreatic ductal brushing might be a useful manners for the differentiatial diagnosis of pancreatic carcinoma.

Aim This work was undertaken to analyze whether mast cells play a role in inflammation and fibrosis in the TNBS-induced rat chronic pancreatitis. Methods Rats were bilo-pancreatic ductly instilled 2, 4, 6,-trinitrobenzene sulfonic acid (TNBS) in ethanol, and then injected daily i.p. with nedocromil sodium, a mast cell stabilizer, compound 48/80, a mast cell activator, or saline. Rats were sacrificed 3 days, 7 days, 14 days, 21 days, 28 days post-TNBS. Pancreatic inflammation and fibrosis were assessed by gross and histopathological evaluation. Pancreatic mast cells distribution, numbers and their state of activation (toluidine blue) were evaluated. The activation of PSCs was assessed by the expression of a-SMA through immunohistochemistry and Western Blot. The expression of angiotensin II receptors, type I collagen mRNA and TGF-b1 mRNA, which were the factors of fibrosis, were also assessed. Results Nedocromil reduced inflammation and fibrosis possibly by decreasing mast cell numbers and activation and consequent collagen production and PSCs activation and the expression of angiotensin II receptors. Compound 48/80 enhanced the severity of the disease by activating mast cells and increased collagen production and the expression of angiotensin II receptors and accelerates PSCs activation. Conclusions Mast cells are involved in the pancreatic inflammation and fibrosis of the TNBS-induced chronic pancreatitis rats.

Objective To investigate the gene expression of cerulein-induced acute pancreatitis (AP) in mice with microarray. Methods Fifty C56BL/6J mice were randomly divided into AP group (n = 25) and normal group (n = 25). AP model was induced by seven times administration of cerulein (50 mg/kg · body weight) intraperitoneal injection and was identified by elevated serum level of amylase and pathological changes of pancreas. Gene expression profiles of AP mice and normal mice were studied with oligonucleotide microarrays of 12479 full length mouse genes respectively for three times. Genes of which ratio average (RA) > 1.5 or RA < -1.5 were identified as changed genes. The relationship between changed genes and AP was analyzed. Results There were 166 changed genes expressed in AP group, of which 135 genes were up-regulated as well as 31 genes were downregulated. The significantly up-regulated genes expessed in AP included 5 transcription factor genes, 14 signal transduction genes, 10 inflammatory response genes, 5 cell cycle-regulated genes, 3 cell adhesion genes, 1 anion channel gene, 1 electron transport gene, 3 proteinase genes, 2 acute response protein genes, 3 transport protein genes, 4 metabolism enzyme genes, 2 superoxide metabolism genes, 1 endocytosis gene and 1 cytolysis gene. The significantly down-regulated genes expessed in AP included 2 transport protein genes, 2 signal transduction genes, 5 metabolism enzyme genes, 1 cell adhesion genes and 1 cytoskeleton gene. Conclusion Gene expression profile of AP mice can describe the mechanism mode of changed genes in AP: inflammatory signals initially stimulated TPK signal pathway and G-protein-mediated signal transduction, further activated transcriptional factor of C/EBPd and C/EBPb, and then promoted the target genes expression.

Study on cerulein enhancing lipopolysaccharide tolerance in mice with acute pancreatitis and its mechanism LEI LI, XINGPENG WANG, KAI WU Department Of Gastroentorology, Shanghai First Hospital, Shanghai Jiaotong University, 200080, Shanghai, China Objective To investigate the effect of cerulein on lipopolysaccharide (LPS) tolerance in mice with acute pancreatitis (AP) and its possible mechanism. Methods 210 C56BL/6J mice were randomly divided into NS + LPS group (n = 105) and AP + LPS group (n = 105). NS + LPS group was subdivided into NS + LPS (5 mg/kg) group (n = 15), NS + LPS (10 mg/kg) group (n = 15), NS + LPS (15 mg/kg) group (n = 15), NS + LPS (20 mg/kg) group (n = 15), NS + LPS (25 mg/kg) group (n = 15), NS + LPS (30 mg/kg) group (n = 15) and NS + LPS (35 mg/kg) group (n = 15). AP + LPS group was subdivided into AP + LPS (5 mg/kg) group (n = 15), AP + LPS (10 mg/kg) group (n = 15), AP + LPS (15 mg/kg) group (n = 15), AP + LPS (20 mg/kg) group (n = 15), AP + LPS (25 mg/kg) group (n = 15), AP + LPS (30 mg/kg) group (n = 15) and AP + LPS (35 mg/kg) group (n = 15). AP model was induced by seven times administration of cerulein (50 mg/kg·body weight). LPS was given 6 hours after the first celulein injection. Cerulein was replaced by NS in NS + LPS group. 10 mice were randomly separated from every group to investigate mortality rate for 7 days. Another 5 mice were killed 12 hours after the first celulein injection. Liver, lung, kidney, pancreas and Blood serum were reserved to mesure pathological changes of each organ and serum levels of amylase (AMS) and lactate dehydrogenase (LDH). Gene expression profiles of leucocyte in NS + LPS (15 mg/kg) group and AP + LPS (15 mg/kg) group were studied with oligonucleotide microarrays of 12479 full length mouse genes respectively for three times to screen the different genes between two groups. Results Mortality rate in both NS + LPS group and AP + LPS group was increased with the elevation of LPS dose. Mortality rate in AP + LPS group was significantly less than that in NS + LPS group with equal LPS dose (P < 0.05). Serum level of LDH in AP + LPS group was significantly lower than that in NS + LPS group with equal LPS dose (P < 0.05), but serum level of AMS was significantly higher than that in NS + LPS group with equal LPS dose (P < 0.05). Histologically, the injury of lug, liver and kidney in AP + LPS group was relieved in comparison with that in NS + LPS group. The screening result of gene chip showed that inflammatory response genes, intracellular signal transduction genes and transcriptional regulation genes were down-regulated in AP + LPS (15 mg/kg) group vs NS + LPS (15 mg/kg) group. Conclusions Cerulein enhanced LPS tolerance in mice with AP. Its possible mechanism was that cerulein depressed the inflammatory signal pathway and thus down-regulated the expression of inflammatory medium.

Objectives To examine the expression of lipoxygenases on human pancreatic carcinoma and their effects on proliferation and apoptosis of human pancreatic carcinoma in vitro. Methods 1. To examine the effects of polyunsaturated fatty acids on pancreatic cancer cell line, the proliferation rate of SW1990 cells treated with AA, DHA and EPA was analyzed through a colorimetric assay using 3-(4,5-dimethylthiazol-2-yl) -2,5-diphenyl tetrazolium bromide (MTT) and a staining assay by incorporation of bromodeoxyuridine (BrdU). An annexinV/propidium iodide (PI) assay by flow cytometry and in situ terminal deoxynucleotidyl transferasemediated dUTP-digoxigenin end labeling (TUNEL) assay were used to identify potential induction of apoptosis by the unsaturated fatty acids. 2. Expression of 5-LOX and 12-LOX in the tissue of human pancreatic carcinoma and the pancreatic cancer cell line was detected by using immunohistochemical (immunocytochemical) staining and reverse transcription-polymerase chain reaction assay (RT-PCR). The correlation between AA treatment and the expression levels of LOXs was also investigated. 3. The effects of 5-LOX inhibitor (MK-886) and 12-LOX inhibitor (baicalein) on the proliferation of SW1990 cells were examined by MTT assay and BrdU staining. Flow cytometry and TUNEL assay were used to demonstrate induction of apoptosis by MK-886 and baicalein. Results 1. MTT assay and BrdU staining showed that AA had a stimulative effect on the growth of SW1990 cells while EPA and DHA had an inhibitory effect with a dose-dependent manner. Flow cytometry and TUNEL assay proved that apoptosis of SW1990 cells cocultured with DHA or EPA lasting for 24 hours was increased markedly. 2. Both 5-LOX and 12-LOX are overexpressed in the tissue of human pancreatic carcinoma and the pancreatic cancer cell line. Furthermore, the level of expression could be up-regulated by AA treatment. 3. It was corroborated through MTT assay and BrdU staining that both MK-886 and baicalein suppressed the growth of SW1990 cells in a dose-dependent way. Flow cytometry and TUNEL revealed a significant increase of apoptotic cells rate.

Conclusions 1. Polyunsaturated fatty acids have regulatory effects on the growth of pancreatic carcinoma in vitro. AA stimulates proliferation of pancreatic cancer cell line; DHA and EPA suppress proliferation, simultaneously inducing apoptosis of pancreatic cancer cell line. 2. Expression of lipoxygenase is up-regulated in human pancreatic cancer. AA presents a stimulative effect on the expression of lipoxygenase. 3. Blocking the functions of lipoxygenase with its inhibitor exerts a negative regulatory effect on the growth of pancreatic carcinoma in vitro. Lipoxygenase might be a novel therapeutic target for the pancreatic carcinoma.

Objectives To assess the effect of selective cyclooxygenase-2 (COX-2) inhibitor celecoxib in the treatment of pancreatic carcinoma combined with gemcitbine.

Effects of celecoxib and/or gemcitabine in pancreatic carcinoma cell SW1990 with different dose and time were investigated by MTT assay. Effects on apoptosis were studied by TUNEL or DNA electrophoresis. Effects on cell cycle were investigated by flow cytometry. Results Celecoxib and gemcitabine inhibited pancreatic carcinoma cell growth dose-and time-dependently, and the combination of celecoxib with gemcitabine inhibited cell growth to a greater degree than either compound alone. Apoptosis were induced in SW1990 by celecoxib alone or in combined with gemcitabine, and when combined with gemcitabine the number of apoptotic cells was more than that in treatment with celecoxib alone. Treatment with celecoxib only or combined with gemcitabine altered the cell cycle phase distribution in SW1990, cells were mainly arrested in G 0 /G 1 phase and S phase development were greatly inhibited. Conclusions Selective COX-2 inhibitor celecoxib can enhance the effect of gemcitabine in growth inhibition of pancreatic carcinoma cell. The enhancement is due to the arrest of cell cycle progression and induction of apoptotic cell death.

Objectives To explore the effect of selective cyclooxygenase-2 (COX-2) inhibitor celecoxib combined with gemcitabine in human pancreatic carcinoma in vivo.

Effects of gemcitabine combined with celecoxib on the proliferation in xenograft pancreatic carcinoma induced by SW1990 were investigated by immunohistochemistry of proliferating cell nuclear antigen (PCNA) and cyclin D 1 . Gemcitabine was administered intraperitoneally twice a week, and celecoxib was given via water daily. Results The mean volume of xenograft tumor was significantly reduced in gemcitabine group, celecoxib group and combination group (0.414 ± 0.113 mm 3 , 1.276 ± 0.645 mm 3 , 0.022 ± 0.017 mm 3 vs 2.309 ± 0.410 mm 3 ). The expression of PCNA and cyclin D 1 was significantly reduced in celecoxib group and gemcitabine group, and can hardly be detected in combination group. Conclusions Selective COX-2 inhibitor celecoxib can enhance the growth inhibition of gemcitabine in pancreatic carcinoma in vivo. Objectives To evaluate the effects and clinical significance of endothelin (ET), calcitonin-gene-related peptide (CGRP) and nitric oxide (NO) in the early phase of acute pancreatitis (AP).

The contents of ET, CGRP and NO were measured by analysis of radioimmunoassay and nitrate reductase in the blood samples from 17 patients with severe acute pancreatitis (SAP), 35 patients with mild acute pancreatitis (MAP) and 30 normal controls (NC). SAP: Imrie' score >3, APACHE II ≥ 8.

The score of Imrie and APACHE II in the patients of SAP was obviously higher than that in those of MAP (p < 0.05, p < 0.01). ET levels (59.20 ± 10.69) ng/L increased significantly in SAP, while those (34.20 ± 9.44) ng/L decreased obviously in MAP; NO levels decreased significantly in AP, there were significant differences (p < 0.001) between SAP and MAP. CGRP levels (67.68 ± 25.60) ng/L increased significantly (p < 0.001) in MAP. CGRP levels (42.27 ± 24.30) ng/L had no statistic different significance (p > 0.05) in SAP as compared with NC. The ratios of ET/CGRP (1.89 ± 1.02) and ET/NO (2.37 ± 1.18) in SAP were higher than that in MAP and NC (p < 0.01). The ratios of ET/CGRP (0.66 ± 0.57) and ET/NO (0.64 ± 0.33) in MAP were reduced or unchanged as compared with NC (p < 0.05, p > 0.05). Conclusions ET may have close relationship with the pathological haemorrhage and necrosis in pancreas tissue in SAP. CGRP and NO may have a beneficial influence on MAP by improves the microcirculation within the pancreatic gland. The ratios of ET/CGRP and ET/NO may serve as the sign to judge prognosis in the early phase of AP.

Clinical study of prevention acute pancreatitis induced by endoscopic retrograde cholangiopancreatography with famotidine JINQI WEI, WEIHU LU, HUAILI ZHOU

Objective The preventive effect of famotidine on acute pancreatitis and hyperamylasemia induced by diagnositic and/or treatment endoscopic retrograde cholangiopancreatography (ERCP) was investigated. Materials and Methods 86 patients were divided into famotidine and placebo groups. The famotidine group received perioperative intravenous famotidine 20 mg bid injection for two days, and the placebo group received physiological saline intravenous injection. Blood was drawn in each group the day before, 4 hours and 24 hours following ERCP for amylase mensuration, the clinical manifestations of acute pancreatitis were also observed. Results Acute pancreatitis was clinically established in 7% cases of famotidine group with significance (P < 0.01) when compared with the placebo group (13%); Hyperamylasemia of 4 hours post-ERCP occurred in 30% in famotidine group, while 48% in placebo group, P < 0.05; There were no significance differences in amylase 24 hours following ERCP between the two groups. Conclusion Famotidine can prevent the acute pancreatitis and hyperamylasemia from diagnositic and or treatment ERCP.

Objectives To explore the relationship between chronic pancreatitis (CP) and the chronic small intestinal diarrhea (SID) Methods 87 SID cases (48 females, 39 males) are examined per CP diagnostic laboratory examinations. Subsequently each diagnosed CP patients will be given a tailored treatment based on the etiology that deduced from his past history, and duly to set up the clinical cure evaluation criteria. Results 43 patients out of 87 SID cases are diagnosed as CP (18 males, 25 females) with mean age 47.9 (19 to 71 years old). The etiological distribution is as follows, the biliary diseases 18 cases (41.9%), chronic alcohol intake 8 cases (18.6%), history of acute pancreatitis 7 cases (16.3%), adipohepatic history 4 cases (9.3%), coronary heart disease 1 case (2.3%), history of acute enteritis 1 case (2.3%) and unkown origin 4 cases (9.3%). According to the clinical cure evaluation criteria, all the 43 CP patients have shown significant improvement after the treatment. Conclusion Actually quite a few chronic diarrhea patients belong to chronic SID. Furthermore, there is a relative high percentage of CP within SID patients which should raise great clinical attention.

Objectives To observe the therapeutic efficacy of somatostatin for treatment of severe acute pancreatitis and to make economic analysis on it. Materials and Methods 48 patients with severe acute pancreatitis were analyzed in this study. They were divided into 2 groups: the somatostatin group (21 patients) and the control group (27 patients). Laboratory parameters, therapeutic effect indexes including recovery of symptoms, occurrence of organic dysfunction, local complication, mortality and economical costs between the two groups were compared.

The recovery of amylase levels in serum and urine in somatostatin group were quicker than those in the control group (P < 0.05). The symptoms such as: abdominal pain, distention and tenderness were released in a shorter time in somatostatin group than in the control group (P < 0.05). The occurrence of organic dysfunction and local complication in somatostatin group were lower than those in the control group (P < 0.05). Comparison of the mortality in these two groups showed no significant difference (P > 0.05). The cost of the somatostatin group was much higher than that of the control group (P < 0.05). Conclusions Somatostatin had a significant therapeutic efficacy on severe acute pancreatitis with a relatively higher cost. 

Aims Acetylcholinesterase (AChE) was suggested to be neurotoxic in vivo and in vitro, nowadays studies showed that it was also potentially a marker and regulator of apoptosis. Retinoids can inhibit carcinogenesis in various cell types and our study previous showed the apoptosis induction effect of ATRA in pancreatic cancer cells in vitro. The current study was designed to explore the effect of ATRA on the apoptosis of human AChE transferred pancreatic cancer cells.

Human AChE Gene was cloned into pcDNA3 plasmid with GFP as a report gene. The recombinant plasmid was then transfected into pancreatic adenocarcinoma cell line Patu-8988 cells via Lipofectamine (TM). The expression of GFP in cells was examined using fluorescence microscope every day after transfection. Cells before and after transfection was treated with ATRA (Sigma, 1 mM) for 24 hr and 48 hr respectively. FCM and Karnovsky & Roots cytochemical staining were used to examine the expression level of the apoptosis and transfected gene expression.

The positive GFP expression in Patu 8988 cells reached 45.50 ± 3.84% in 24 h after transfection. The results of cytochemical staining demonstrated the higher expression levels of AChE gene expression in transfected cells than in control. After the treatment of ATRA, the apoptotic cells were detected by flow cytometry at the rate of 42.84 ± 7.21% (24 h) and 56.29 ± 2.54% (48 h) respectively, higher than untreated group (24 h: 14.26 ± 1.16%, p < 0.01; 48 h: 18.08 ± 0.75%, p < 0.01). Conclusions These data show that overexpression of AChE gene could increase the ATRA-induced apoptosis in pancreatic cancer cells, but it is unclear how AChE contributes to the apoptotic process. We believe that further study for the role of AChE in apoptotic cells and the relationship between this apoptotic regulator and retinoids will provide important information for understanding the mechanisms of apoptosis. 

Background & Aims Histone acetylation is emerging as a major regulatory mechanism thought to modulate gene expression by altering the accessibility of transcription factors to DNA. All-trans retinoic acid (ATRA) can induce cell cycle arrest and upregulation of p21 WAF1 in pancreatic cancer cells as we previously studied. In this study we observed the effects of ATRA on HDAC activity and chromatin acetylation in certain gene.

The synchronized cells were treated by ATRA (Sigma, 1 mM) for 0, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h, 14 h and 16 h respectively, and the activity of histone deacetylase (HDAC), the acetylated histone H3 were assessed at each time point. Chromatin immunoprecipitation (ChIP) was used to measure the acetylation status of p21 WAF1 promoter to explore the link between chromatin modification and gene expression. Results ATRA causes an accumulation of acetylated histone H3 in total cellular chromatin combined with the inhition of HDAC activity. ChIP experiments indicate that acetylated histone H3 are increased in both the proximal and distal promoter regions of the p21 WAF1 . Such changes in chromatin structure could play an important role of p21 WAF1 expression by ATRA. Conclusions This study demonstrates that ATRA can inhibit HDAC directly and furthermore increase the acetylation of H3-associated chromatin and alters p21 waf1 gene expression. The phenomena further indicate that ATRA can regulate the transcription level of certain genes through remodeling of chromatin structure.

The duodenal stimulation of sodium chloride induced hanges in nucleus of solitary tract in rat QING XIA, XIAOHUA MAN, ZHENDONG JIN, ZHAOSHEN LI, ZHENXING TU

Objectives To investigate the activity of visceral sensory neurons in nucleus of solitary tract and to eluciate the increase of protein content in pancreatic juice in rat when being given the duodenal stimulation of sodium chloride and 5-HT.

For the first round forty rats were randomly divided into NaCl (0.86 mol/L) group (n = 8), NaCl (0.15 mol/L) group (n = 8), deionized water group (n = 8), 5-HT (10 -4 mol/L) group (n = 8) and the group of sham operation (n = 8). Immunhistochemical staining and quantitative analysis of FOS were achieved in all kinds of groups. For the second round, rats were randomly given the duodenal stimulation of NaCl (0.86 mol/L) (n = 8) and 5-HT (10 -4 mol/L) (n = 8) and were collected bile-pancreatic juice every 15 min. Double-label immunohistochemistry was performed for NK1-R and for FOS in all kinds of groups. Otherwise BCA Protein Assay was applied to measure protein content of the pancreatic juice. Results NaCl (0.86 mol/L) and 5-HT (10 -4 mol/L) groups induced strong FOS like Immunoreactivity in NTS (P < 0.01), compared with the others. And NK1-R expressed the regions where FOS expression was enhanced by the duodenal stimulation in NaCl (0.86 mol/L) and 5-HT (10 -4 mol/L) groups. But in the group of sham operation, there is no overlap between NK1-R and FOS expression. As for pancreatic juice, Infusion of NaCl (0.86 mol/L) and 5-HT (10 -4 mol/L) increased pancreatic protein secretion over basal (P < 0.05). Conclusions The duodenal stimulation of NaCl (0.86 mol/L) and 5-HT (10 -4 mol/L) probably activated NK1-R like neurons and then induced increase of pancreatic protein secretion, but NaCl (0.15 mol/L) and deionized water groups did not activate the neurons in NTS.

Analysis of predictive factors of prognosis in patients with acute serious pancreatitis ZHONGSHENG XIA, JUN ZHAN, SHINENG ZHANG, YINGQIANG ZHONG, ZHAOHUA ZHU, WEIXIAN CHEN

Objectives To explore the predictive factors of prognosis in patients with acute serious pancreatitis. Methods 50 cases with acute serious pancreatitis were divided into two groups, the death group (14 cases) and the non-death group (36 cases), according to prognosis. The death group was compared with the non-death group in sex, age, duration between attacking and seeking medical advice, blood amylase activity, urine amylase activity, white blood cell counts in peripheral blood, serum albumin, fasting blood glucose, blood urea nitrogen, serum calcium, medication of amicine and intervention of surgical operation, occurrence of Grey-Turner sign or Cullen sign, shock, respiratory failure, renal failure, heart failure, pancreatic encephalopathy, gastrointestinal bleeding, DIC (disseminated intravascular coagulation), pancreatic pseudocyst, and pancreatic abscess. Multi-factors Logistic regression analysis was applied. Results There were significant differences between two groups in duration between attacking and seeking medical advice, fasting blood glucose, blood urea nitrogen, shock, respiratory failure, renal failure, heart failure, pancreatic encephalopathy, medication of amicine and intervention of surgical operation (P < 0.05). The regression coefficient of blood urea nitrogen, shock, respiratory failure and pancreatic encephalopathy were -0.0177 (P = 0.002), -0.245 (P = 0.018), -0.333 (P = 0.000) and -0.288 (P = 0.027) respectively. Conclusions Blood urea nitrogen, occurrence of shock, respiratory failure and pancreatic encephalopathy may be independent predictive factors of prognosis in patients with acute serious pancreatitis. The patient with high blood urea nitrogen, occurrence of shock, respiratory failure and pancreatic encephalopathy may be apt to die.

The role of cyclooxygenase-2 in the severity of acute pancreatitis HUA XIE, SHUMING WU

Aims The initiating pathogenesis of acute pancreatitis is the intracellular activation of digestive enzymes; however, the factors that determine the severity and prognosis have remained unclear. The inflammation actived by enzymes plays an important role in severity of acute pancreatitis. Cyclooxygenase-2 has been implicated in a variety of inflammatory processes. We investigate the effect of cyclooxygenase-2 in severe acute pancreatitis.

Severe acute pancreatitis was induced by retrograde cholangio-pancreatic duct infusion of 5% sodium taurocholate in rat. A COX-2 inhibitor (NS-398) was administered intraperitoneally before the time of induction 2 hours. Rats were sacrificed at 6, 9, 12, 18 or 24 hours after induction. The COX-2 expression in pancreatic tissue was evaluated by immunohistochemical straining. The pancreas sample was removed for microscopic histological examination to score lesions.The activity of serum amylase and iNOS were determined by biochemical methods. Results Expression of COX-2 was undetectable in intact pancreas but could be observed from 6 hours to 24 hours after induction of Pancreatitis, the Maximum was at 12 hours afterwards. COX-2 expression decreased significantly in NS-398 treated group as compared with non-treated group at any times of induction. Furthermore, intervetion with NS-398 significantly attenuated the histopathologic scores of pancreatic tissue. The serum amylase level was no significant between treated group and non-treated group, but the iNOS activity reduced significantly in NS-398 treated group. Conclusions The COX-2 expression can be induced in severe acute pancreatitis. Inhibition of COX-2 could ameliorate the severity of acute pancreatitis by reducing inflammation and iNOS expression. These results indicated that COX-2 play an important role in pathophysiological progression of acute pancreatitis.

Objectives To evaluate the effect on proliferous ability of PANC I and MiaPaCa II pancreatic cancer cells transfected by recombinant plasmid pCMV-KAI1, and discuss the suppress metastatic mechanism of KAI1 gene in the malignancy. Materials and Methods pCMV-KAI1 was transfected into the human pancreatic cancer cells PANC I and MiaPaCa II by liposome. The proliferative ability of two pancreatic cancer cell lines was analyzed with MTT, colony-forming test; the cycle pattern was assayed by flow cytometry method. Results After KAI1 cDNA transfected into PANC I and MiaPaCa II, the cell growth rate were respectively inhibited 1.7 times and 2.9 times compared with that of control cells (p < 0.05). Colony formation in the transfected cells greatly decreased compared with untransfected cells from 49.56% to 14.00% (p < 0.01). Flow cytometry analysis revealed that the number of cells in G 0 /G 1 phase increased markedly in KAI1-transfected PANC I cells from 40.97 ± 1.34% to 65.36 ± 1.23% and in KAI1-transfected MiaPaCa II cells from 24.10 ± 1.00% to 43.18 ± 1.06%. However the number of cells in M/G 2 phase decreased in transfected cells, from 21.46 ± 0.96% to 13.35 ± 0.22% in PANC I cells and from 24.89 ± 1.14% to 19.06 ± 0.57% in MiaPaCa II cells (p < 0.05). Conclusions These results showed that the change of cycle pattern and the reduced proliferous ability after pancreatic cancer cells transfected with KAI1 may be a key step of KAI1 gene suppressing the metastasis of pancreatic cancer cell.

Peritoneal lavage for the treatment of severe acute pancreatitis PING XU, NONGHUA LU, XUAN ZHU, YOUXIANG CHEN, BAOLIAN LI, CHONGWEN WANG

Objectives To evaluate the effectiveness of early lavage of the peritoneal cavity on the condition of patients with severe acute pancreatitis and organ dysfunctions. Materials and Methods 36 patients (mean age 42 years, range 22-71 years) accompanied by the exudates in abdominal cavity, The diagnosis was based on Chinese clinical diagnosis standard of acute pancreatitis in 1996. All patients had dark brown fluid at peritoneal puncture. And early computed tomographic (CT) scans showed peripancreatic fluid collections. All of them were treated with peritoneal lavage. At the same time, they were also given regular therapy, such as fasting, relieving spasm, preventing infection, keeping the balance of Water-Electrolyte and treating with Chinese traditional medicine. Results After 24 ~28 hours treatment, 36 patients were improved evidently and their lengths of stay were from 7 to 21 days (average 15.7 days). All patients had fully recovered from the illness except one patient who refused treatment and discharged. Among them, 8 patients had pancreatic pseudocysts but none died or had secondary infection or required a surgical operation. Conclusions Peritoneal lavage is an effective measure to drain the exudates in abdominal cavity and can be easily and safely performed. It can decrease early mortality and shorten the course of SAP, so the patients of SAP with the exudates in abdominal cavity should be treated with peritoneal lavage in time.

Objective To study the diagnostic value of CT and ultrasound B in aute pancreatitis (AP) in elderly patients. Methods The inpatients of elderly AP with CT or ultrasound B examination from January 1993 to October 1999 in our hospital were studied retrospectively. Results There were 83 cases with 107 times diagnosed AP which included mild AP 80 times and severe AP 27 times 86 times and 62 times had type B ultrasonic and CT examination respectively. 60.5% and 72.6% patients were diagnosed respectively by. In mild patients 52.5% (32/61) and 64.3% (27/42). In severe patients 80% (20/25) and 90% (18/20). In 72 hours 66.7% (48/72) and 79.6% (39/49). After 72 hours 26.8% (4/14) and 53.8% (6/13). CT severity index was consistent with clinical severity. Conclusions In elderly AP patients type B ultrasonic and CT examination were important means in diagnosis.

Initial exploration of single markers on the evaluation for severity of acute pancreatitis WEI WANG, DAMING YANG, HONG ZHANG, ZHONGWEI HUANG, QUN WEI, MINGBING XIAO, FENG LI, FENG JIANG, XIANYONG MENG Department of Gastroenterology, Affiliated Hospital of Nantong Medical Collage, Nantong, China Objectives To investigate the serum level of C-response protein (CRP), interleukin (IL)-6, IL-8, tumor necrosis factor-alpha (TNFa) on evaluating the severity of AP at early stage. Materials and Methods 31 patients with AP were divided into sever AP (SAP) group (n = 14) and mild AP (MAP) group (n = 17). Nine healthy individuals were used as the control group. The serum level of CRP was detected by super-sensitive method, while the one of IL-6, IL-8 and TNF-a by ELISA. Results In the three groups, the serum level of CRP, IL-6 and TNF-a decreases in order (P < 0.05). IL-8 in the SAP group was higher than that in the MAP group and in the control group (P < 0.05), but there was no significant difference between the MAP group and control group. The serum level of those markers is related to the severity of AP. The sensitivity (calculated on patients with SAP), specificity (calculated on patients with MAP) and area under the receiver operator characteristic curve (AUC ROC ) for establishing the severity of AP on admission were 85.71%, 64.71% and 0.7521 for CRP, 78.57%, 76.47% and 0.7752 for IL-6, 92.86%, 52.94% and 0.7290 for IL-8 and TNF-a. Combined in serial tests, the sensitivity, specificity and AUC ROC were 85.71%, 88.24% and 0.8697 for IL-8 + TNF-a, 78.57%, 88.24% and 0.8340 for CRP + IL-8. But when combined in parallel tests, only IL-6 + TNF-a and IL-6 + IL-8 can be used to evaluate the severity of AP. Conclusions The serum level of CRP, IL-6, IL-8 and TNF-a can be used as valuable indexes to predict the severity of AP at the early stage. When both of them are combined in serial tests, or IL-6 and TNF-a or IL-8 in parallel tests, the sensitivity or the specificity increased significantly.

Objectives To detect aberrant methylation status of the 5¢CpG island locating in the promoter area of ARHI/NOEY2 in pancreatic cancer, the relationship between the aberrant methylation of ARHI/NOEY2 and clinical manifestation was analyzed. Materials and Methods Target DNA was modified by bisulfit, and ARHI/NOEY2 fragment was amplified with primers specific for methylated and unmethylated DNA. Results Aberrant metnylation of 5¢CpG island location in the promoter area of ARHI/NOEY2 was detected in 7/36 cases of pancreatic cancer, and aberrant methylation was relateing with no expression of ARHI/NOEY2. Conclusions Methylation of ARHI/NOEY2 gene promoter 5¢CpG island can induce inactivation of ARHI/NOEY2 gene and the methylation can be detected in pancreatic cancer. Detection of aberrant ARHI/NOEY2 methylaion may be helpful to the diagnosis of pancreatic cancer.

Chromosome 1q loss of heterozygosity frequently occurs in insulinomas and is correlated with malignancy YINGMAI YANG 1 , YUANJIA CHEN 1 , JIAMING QIAN 1 , WEIJUN JIANG 1 , TONGHUA LIU 2 , JIE CHEN 2

Objectives The molecular pathogenesis of sporadic insulinomas is unknown. It is impossible to distinguish malignant from benign insulinomas by pathologic morphology. Loss of Heterozygosity (LOH) in chromosome 1q was frequently found in some pancreatic endocrine tumors. However, whether 1q LOH contributes to the pathogenesis of insulinomas is unclear. In this study we detected if 1q LOH occurred in sporadic insulinomas and if it could be used as a genetic marker to differentiate malignant insulinomas from benign tumors. Materials and Methods DNA from microdissected normal and tumor tissue (8 malignant, 32 benign, from 38 patients) was extracted through digestion with proteinase K, and 1q allelotyping was performed by PCR with 15 microsatallite markers. Statistics was analyzed by using Fisher exact test. P £ 0.05 was considered significant. Results LOH in 1q was found in 34 of 40 tumors (85%). Fourteen of 34 (41%) tumors with 1q LOH had LOH over a 7.5 cM region (1q21.3-23.2), while 22 of 34 tumors (65%) had LOH at 1q31.1-1q32.1 over a 20.6 cM area. Six of 14 tumors (43%) with 1q21.3-23.2 LOH are malignant, whereas only 2 of 26 tumors without 1q21.3-23.2 LOH (8.0%) are malignant (P = 0.014). Conclusions The data indicates that 1q LOH occurred frequently in insulinomas. LOH at 1q31.1-1q32.1 might contribute to the tumorogenesis of sporadic insulinoams. LOH at 1q21.3-23.2 was associated with tumor malignancy, and its presence could be a potential genetic marker to distinguish malignancy from benigns.

The effect of histone H3 acetylation on the cell cycle arrest induced by all-trans retinoic acid in pancreatic cancer cells YAOZONG YUAN 1 , LU XIA 1 , MINMIN QIAO 1 , YONGPING ZHANG 1 , XUEJUN ZHANG 2 1 Department of Gastroenterology, Ruijin Hospital, Shanghai, China 2 Institute of Biochemistry and Cell Biology, Chinese Academy of Science, China Aims The present study observed the effect of ATRA on cell cycle in vitro and the pathway in cell cycle arrest of pancreatic cancer cells.

The synchronized cells were treated by ATRA (Sigma, 1 mM) for 0, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h, 14 h and 16 h respectively, cell cycle was detected by FCM staining with propidium iodide. To identify changes in the gene expression patterns of pancreatic cancer cells during cell cycle arrest, we compared the gene expression profiles with or without ATRA treatment using a cDNA microarray GEArray TM Q. At the same time, the protein level of p21 waf1 , p27 kip1 and the acetylated histone H3 were assessed wth Western blotting at each time point to observe the link between chromatin modification and gene expression. Results ATRA induced a rapid arrest of synchronized cells in the G0/G1 phase, accompanied by a increasing Cyclin D1, Cyclin E1, Cdk2, Cdk4, P21/Waf1, p27Kip1, p16INK4 and p19-INK4D gene expression. The higher expression level of p21 waf1 , p27 kip1 protein induced by ATRA and an accumulation of acetylated histone H3 (lys 18) in total cellular chromatin were detected during the time course. Conclusions The therapeutic and preventive effects of retinoids in cancer are due to their ability to modulate the growth, differentiation, and survival or apoptosis of cancer cells. Our data support the phenomena of cell cycle arrest induced by ATRA in pancreatic cancer cells.The hyperacetylation caused by ATRA in pancreatic cancer cells further indicate that ATRA may regulate the transcription level of certain genes through remodeling of chromatin structure.

Prognostic value of the initial hamatocrit in prediciting severe and complications in patients with acute pancreatitis JINHUA ZHANG, ANQIN JIN, LIANSHENG MIAO

Objective To determine whether the hematocrit (Hct) value on admission is predictive of severe course, complications and death in patients with acute pancreatitis (AP). Methods We included 142 patients with acute pancreatitis admitted to our hospital from 1998 to April 2003. A retrospective cohort study was conducted. Difference of the mean Hct value was compared in patients between with sever acute pancreatitis (SAP) and no SAP; with systemic complications and no systemic complications; with local complications and no local complications. We used multiple logistic regression analysis to evaluate the relation between Hct and SAP, systemic and local complications. We also determined the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Hct as a risk factor to develop SAP, complications and death. Results The mean Hct in patients with SAP was 43.43 ± 6.83, with no SAP was 39.14 ± 4.71 (P = 0.000); the mean Hct in patients with systemic complications was 43.42 ± 6.86, with no systemic complications was 39.39 ± 4.96 (P = 0.002); with local complications was 42.19 ± 7.11, with no local complications was 39.40 ± 4.74 (P = 0.015). In the logistic regression analysis the Hct was a risk factor for SAP (P = 0.0007, OR = 1.1832, CI = 95% 1.07-1.30); systemic complications (P = 0.0029, OR = 1.1770, CI = 95% 1.057-1.310) and local complications (P = 0.0176, OR = 1.1055, CI = 95% 0.018-0.201). As Hct level ≥45%, sensitivity and specificity of Hct to detect SAP were 55.56% and 89.69%; systemic complications were 47.62% and 85.44%; local complications were 43.33% and 87.23% respectively. Conclusions In our study, initial Hct on admission is an early clinical predictor of SAP, systemic and local complications. However, considering its high NPV, a normal Hct value on admission may imply a low risk of developing SAP, systemic and local complications.

The effect of mat1 gene on cell cycle G 1 AE S transition of human pancreatic cancer cells SHINENG ZHANG, ZHAOHUA ZHU, LIANYUAN WANG, JUN ZHAN, YINGQIANG ZHONG, YING LIN, SHIZHEN YUAN

Objective To investigate the regulatory effect of the human MAT1 (ménage à trois 1) gene on the cell cycle G 1 AE S transition of human pancreatic cancer BxPC-3 cells.

To construct the replication deficient recombinant adenovirus of antisense MAT1 gene using homologous recombination by AdEasy system. Cell growth assay was carried out by counting alive cells after trypan blue exclusion.The protein expressions of MAT1, cyclin D1, cyclin E, and pRb were detected by western blotting. The cell cycle status was determined by flow cytometry. Results The recombinant adenovirus encoding antisense MAT1 fragment Ad-MAT1AS was obtained with the titer of expression was 5 ¥ 10 10 pfu/ml. The expression of MAT1 of BxPC-3 was significantly reduced after Ad-MAT1AS infection. In this case BxPC-3 cell cycle was arrested in G 1 phase. The estimated proportion of G 0 /G 1 phase cells in the control for blank and vector cultures ranged from 40% to 44%. In contrast, 79% of the Ad-MAT1AS cells were in G 0 /G 1 phase. Cyclin E and pRb gene expression changes were observed in the infected cells. Conclusion The results suggest that MAT1 gene may play an important role in the regulation of cell cycle G 1 AE S transition of BxPC-3 cells.

Objectives To better understand the molecular mechanism of carcinogenesis and metastasis of gastric cancer at the protein level.

We established a well-described gastric cancer animal model by using N-methyl-N'-Nitro-N-Nitrosoguanidine (MNNG) to induce gastric cancer in rat. The protein expression pattern of normal gastric tissue, primary gastric tumor tissue and corresponding metastatic tumor tissue was analysed using a proteomics approach. Proteins in the region of molecular masses of 15-75 kDa and isoelectric point of 3-7 were separated by two-dimensional electrophoresis (2-DE) and identified by peptide fingerprinting with matrix assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS). The overexpression of HSP27 in gastric cancer was further confirmed by immunohistochemical analysis of human gastric cancer samples. Results Twenty-seven spots corresponding to 25 proteins were identified to serve as landmarks for comparison between tissues. The identified proteins included cytoskeletal elements, stress associated proteins, proteins involved in signal transduction, cell proliferation and differentiation and metabolism. Eleven proteins were up-regulated and 2 proteins were down-regulated in tumor tissue when compared with normal tissue. Twelve proteins were up-regulated while 8 proteins were down-regulated in metastasis tumor by further comparison between primary and metastatic gastric tumor tissues. The overexpression of HSP27 was confirmed in a series of human gastric cancers. Conclusions Combining well-defined animal models with proteome analysis will improve our understanding of the fundamental changes that contribute to the process of carcinogenesis and the formation of metastasis in gastric cancer. Conclusions Our findings indicate that cathepsin D, an intracellular aspartyl protease, is expressed in both primary and metastatic colon cancer. Despite the fact that Cathepsin D was expressed at the invasion front, inhibition of Cathepsin D in colon cancer cells does not modulate invasion of cancer cells, supporting the hypothesis that the primary biological function of cathepsin D is the destruction of the extracellular matrix mediated by stromal cells which in turn may allow cancer cells to invade the surrounding structures and give them a growth-advantage. and growth promoting effect of CA9, AGS gastric cancer cells were transfected with CA9 cDNA. Gastric cancer cell lines were also treated with 5¢-azadeoxycytidine to analyse methylation as a potential molecular mechanism underlying the loss of CA9 expression. Results In the non-cancerous tissues CA9 was strongly expressed with membranous localization. In contrast, CA9 expression was frequently lost in diffuse-and intestinal-type gastric cancers as well as cell lines (p < 0.001). However, gastric cancers that retained CA9 expression in the cancer cells, which was typically located at the invasion front of the cancers, exhibited a shorter post-operative survival (p = 0.028). In vitro analysis revealed that the loss or reduced CA9 expression in gastric cancer cell lines was restored after treatment with 5¢-azadeoxycytidine and was associated with increased invasion (p < 0.01). Moreover, AGS cells transfected with CA9 exhibited significantly enhanced invasive growth and increased cell proliferation (p < 0.05). Conclusions While the loss of CA9 expression is frequent in gastric cancers by promoter hypermethylation, a subgroup of gastric cancers retain CA9 expression in the cancer cells at the invasion front which is associated with increased invasion and poor prognosis.

Objectives To Tobserve the influence of intraduodenal infusion of 20% intralipid on the expression of c-Fos in intrapancreatic neurons. Materials and Methods 16 SD rats weighing 250 ~300 g were selected and divided into two groups (8 in experimental group and 8 in control group) at random. After anesthetized the rat was equipped with pancreatic duct cannula inserted into the sphincter of Oddi. After a 30-min stabilization period, the combined bile-pancreatic secretions were collected every 15 min for 4 times. Then intraduodenal perfusion of 20% intralipid was performed in the experimental group at a speed of 3 ml/h for 2 h, and the combined bile-pancreatic secretions were collected every 15 min and the pancreatic fluid flow and protein secretion were measured. The pancreas was studied by immunohistochemistry (IHC) of c-fos. The control group had no intestinal infusion. The control group had no intraduodenal infusion. Results After the intraduodenal infusion of 20% intralipid the volume of combined bile-pancreatic secretions was increased by 31.6% over basal, P value < 0.01; and the protein output (mg/15 min) was increased by 115.1% over basal, P value < 0.01. Significant increase of c-fos positive-neurons in positive intensity, postive area and in density of immunostaining was found compared to that of the controls, P value < 0.01. Conclusions This study suggested that the intraduodenal infusion of 20% intralipid has an excitatory effect on the activity of intrapancreatic neurons, which promotes the pancreatic exocrine secretion function. method for the synthesis of apoptin coding DNA sequence from a large number of oligodeoxyribonucleotides (oligos). Methods Based on apoptin gene coding sequence (GeneBank accession number AY171617), a number of oligos were designed to assembely apoptin gene in pfu mix reaction system, each oligos was 40 nucleotides (nt) in length, in which synonymous codon substitution was used to eliminate restriction enzyme sites of Bgl II (position 172, agatct AE agatcc) and Hind III (position 306, aagctt AE aatcct). The assembly mixture was further diluted and amplified with two end oligos. The targeted sequence was gel-purifed, amplified one more time, added T to 3¢ end in the presence of Taq polymerase and dATP, and at last cloned to pGEM T easy vector. The positive colonies were confirmed byrestriction enzyme excision and sequencing. Results The synthetic mixture in the first assembly reaction was in the form of smearing. Besides DNA ladder bands, a clear targeted band was yielded when diluted mixture was amplified with two end oligos. After the PCR targeted gene was cloned to pGEM T easy vector, 75% (3/4) of positive colonies were confirmed in one single experiment. The positive colonies were finally verified by sequencing which were totally in line with the designed coding sequence of apoptin gene. Conclusion Gene assembly is rapid and cost-effective approach of synthesis of genes or vectors. It is well suited for several in vitro mutagenesis strategies. The apoptin gene synthesized in this study is easy to subclone and will be good for therapy investigation in gastrointestinal tumor.

Objective To study the mechanism of TNF related apoptosis inducing ligand (TRAIL) induces the apoptosis of gastric cancer cells Materials and Methods RT-PCR was used to detect the receptors expression of the receptors of TRAIL (include its death receptor R1, R2, and decoy receptor R3, R4) in SGC-7901 gastric cancer cell. Immunohistochemistry was used to detect the change of Bcl-2 and caspase-3 after the gastric cancer cell was treated with TRAIL. The concentration of TRAIL was 50 ng/ml, 500 ng/ml. Result SGC-7901 gastric cancer cell only expresses the R1, R2, not express R3, R4. Bcl-2 is positive in the SGC-7901 gastric cancer cell, TRAIL has no effect to it. But TRAIL can enhance the expression of caspase-3 in the SGC-7901 gastric cancer cell. Conclusions TRAIL can induce the apoptosis of gastric cancer cells is that gastric cancer cells only expresses its R1, R2, not express R3, R4. TRAIL induces the apoptosis of gastric cancer cells through enhancing the expression of caspase-3, and this effect is not affected by Bcl-2.

The study on relationship between gastrointestinal hormone and duodenogastric reflux and interdigestive antroduodenal migrating moter complex FEI DAI, JUN GONG, JINYAN LUO, LEI DONG, YOULING ZHU AND XUEQIN WANG

Objective To study the relationship between gastrointestinal hormones and duodenogastric reflux (DGR) and interdigestive antroduodenal migrating moter complex (MMC).

Antroduodenal manometry, simultaneous 24-hour intragastric pH and Bilitec monitoring were carried out in 20 healthy volunteers overnight for a long time. Blood samples were drawn at episodes of alkaline reflux and/or bile reflux, and after reflux, as well as at interdigestive migrating motor complex phase I, II, III respectively and were detected for motilin (MTL), substance P (SP), somatostatin (SS) and nitric oxide (NO). Results The serum concentration of NO was significantly increased during alkaline reflux compared to no episodes of alkaline reflux (98.23 ± 12.14 mmol.l -1 vs 71.24 ± 10.21 mmol.l -1 , P < 0.01) and during bile reflux compared to no episodes of bile reflux (87.32 ± 11.46 mmol.l -1 vs 69.45 ± 10.56 mmol.l -1 , P < 0.05). The concentrations of MTL, SP and SS were no difference between alkaline or bile reflux and no episodes of alkaline or bile reflux. The plasma concentration of MTL was higher in phase III than in phase I (P < 0.05) and phase II (P < 0.05). The concentrations of SP, SS and NO were no difference among each phase of the MMC. Conclusions DGR may be related to increased concentration of NO and MMC phase III related to the concentration of MTL.

Objective To investigate whether the expression of COX-2 in gastric cancer cells can influence the angiogenic ability of endothelial cells (EC) in vitro.

In SGC7901 and its derived two other gastric cancer cells, the COX-2 expression levels were detected by semi-quantitative RT-PCR and Western blot, Prostaglandin E 2 (PGE 2 ) in supernatant were detected by radioimmunoassay; Animal models were set up to study tumorigenesis of those cells in vivo and microvessel density (MVD) was analyzed by immunohistochemistry for VIII-Factor staining. Conditioned culture media from cells SGC7901, 7901-P and 7901-AS (COX-2 antisense transfected cells) were used to stimulate EC, and the proliferation, migration and tubeformation ability of EC in vitro was assessed upon stimulation of the conditioned medium. The expression of endothelium-specific angiogenic factors were measured by semi-quantitative RT-PCR. Results Antisense treatment for COX-2 gene significantly reduced the expression level of COX-2 protein and mRNA and decreased the PGE 2 level in the supernatant (P < 0.01). The tumor graft of 7901-AS cells 30 days after implantation in nude mice had less volume and vessel formation than those of SGC7901 and 7901-P (P < 0.05). When incubated with the conditioned medium from 7901-AS, the proliferation, migration and tube-formation ability of EC was inhibited (P < 0.01) compared to those from parental and empty-vector transfected cells. Expression of angiopoietin-1 (Ang-1) and vascular endothelial growth factor (VEGF) were reduced in gastric cancer cells after transfection with COX-2 antisense. Conclusion Suppression of COX-2 in cancer cells reduces the angiogenesis by EC. The overexpression of COX-2 may influence the angiogenesis of EC by altering the level of angiogenic factors in gastric cancer cells, and promote tumorgenesis, progression and metastasis of the tumor.

To investigate the protein level of dopamine D 4 receptor in gastro-duodenum mucosa of patients with gastric ulcer (GU), duodenal ulcer (DU) and gastritis.

Endoscopic biopsy samples of gastric antrum and duodenal bulb from 32 patients with gastric ulcer (10 cases), duodenal ulcer (12 cases) and gastritis (10 cases) were assessed. Membrane protein of D 4 was extracted and purified, after electrophoresis and western blotting. The results of western blotting were analyzed by the pathological image analysis system. Results The protein level of D 4 in peptic ulcer patients (gastric and duodenum ulcer) was higher than that in gastritis patients both in gastric antrum and duodenal bulb (table). Further analysis showed that the D 4 protein level was not related to gender and age of the patients, as well as the Helicobacter pylori infection state. Conclusion Dopamine D4 receptor exist in human stomach and duodenum. The protein level of D4 receptor in gastro-duodenum mucosa in peptic ulcer patients is up regulated. We can speculate that dopamine level is a relative independent factor in the occurring of peptic ulcer. Objective To explore the effect of DNA methyltransferase, demethylase and methyl-CpG binding protein MeCP2 on the expressions and methylation of hMSH2 and proto-oncogene in human gastric cancer. Materials and Methods Paired samples of primary gastric cancer and corresponding para-cancerous, non-cancerous gastric mucosae were obtained from surgically resection specimens of 28 patients. The transcription levels of Dnmt1, mbd2, MeCP2, p16 INK4A , hMSH2 and c-myc were detected by using real-time RT-PCR or RT-PCR. The promoters' methylation of p16 INK4A , c-myc and hMSH2 genes were assayed by methylation-specific PCR (MSP) and sequencing (mapping). Their relationships were analyzed by Fisher exact test using the software SPSS. Results Average mRNA levels of Dnmt1 and mbd2 genes from cancerous tissue were higher and lower than that from non-cancerous tissue, respectively. mbd2 was lower in cancerous tissue than noncancerous tissue in 13 (42.9%) of patient but higher in 3 cases (10.7%) of non-cancerous gastric tissue (P < 0.001). c-myc expression was up-regulated in cancer tissues (P < 0.05), and all cases with hypomethylated c-myc have been found the up-regulation of mbd2. The transcriptional levels of p16 INK4A and MeCP2 genes did not display any difference between gastric cancerous and matched noncancerous tissues. The correlation of mbd2 expression with unmethylation of c-myc promoter suggests that these sites may be targets for demethylation by the enzyme. There was down-regulation and hypermethylation of hMSH2 in cancer tissues, and the hypermethylation of hMSH2 in the cases who down-regulated transcription. However, the transcription level of the above gene may be not associated with biological behave. Conclusions The up-regulation of proto-oncogene may be the consequence of epigenetic control of gene expression by the demethylase, and mbd2 is involved in the regulation of hMSH2 expression in human gastric cancer.

Objectives To investigate the expression of a novel inhibitor apoptosis gene of Livin and its relationship with the biological behavior, the apoptosis and proliferation in colorectal cancer. Materials and Methods Seventy-two cases of histologically verified colorectal cancer specimens and forty cases of the neighboring normal colorectal tissues were obtained. In situ reverse transcription polymerase chain reaction (ISRT-PCR) was used to detect Livin mRNA levels. Immunohistochemical method was employed to measure protein expression of Livin and proliferating cell nuclear antigen (PCNA). Apoptotic cells were examined by in situ end labeling. Results Livin mRNA and protein expression were detected in 84.7% (61/72) and 79.2% (57/72) colorectal cancerous tissues respectively. In contrast, no expression of Livin mRNA or protein in surrounding normal tissues was detected. The Livin mRNA expression increased as tumor differentiation decreased as well Dukes stage and metastasis increased (P < 0.05). Cells with Livin mRNA and protein expression were prone to be focal/diffuse in cancerous area. The positive signals of Livin mRNA and protein located in the cytoplasms of colorectal cancerous cells. Furthermore, Livin proteinpositive cancer had significantly lower values for apoptosis index (AI) than Livin protein-negative cancer (P < 0.05); whereas the PCNA index (PI) in Livin protein-positive cancer was higher than that in Livin protein-negative cancer (P < 0.05). Conclusion Livin expression may play a critical role in the onset and progression of colorectal cancer and is associated with the suppression of apoptosis and activation of proliferation. ISRT-PCR provides a novel method for further studying the relationship between Livin mRNA expression and colorectal cancer.

Objectives The gastric cancer cell death triggered by parvovirus H-1 infection, an autonomous parvovirus exhibited preferential cell toxicity and growth suppression to neoplastic transformed or tumor cells, may involve some intracellular cell death stimulating signaling pathways.The present study aimed at exploring the possible cell death signaling pathways exerted by H-1 virus inoculation.

The H-1 virus-sensitive gastric cancer cell line HGC27 and insensitive cell line BGC823 were employed in this study and the cellular DNA were extracted 48 h after H-1 virus infection. The cDNA genechip containing 8000 spots of human somatic gene sequences was used to analyze the changes of apoptosis related gene expression profiles in HGC27. Some of these genes, such as SARP1, BCL-10, CL-20, NCDRP and RAIDD were further verified by RT-PCR, and were compared to those in insensitive cell line BGC823. Results The cDNA microarray results indicated 15 out of 64 apoptosis related gene were down-regulated (inferior to 0.5 fold) and only one gene was up-regulated (superior to 2 fold). The results of RT-PCR amplification displayed that the expression of SARP1, BCL-10, CL-20 and NCDRP were markedly decreased 48 h after virus infection, whilst the expression of RAIDD had no apparently change in HGC27 cells. However, the expression of BCL-10 and NCDRP were increased at the same time point post virus infection in BGC823 cells, the expression of CL-20 and RAIDD had no apparently change, while the expression of SARP1 was failed to detect. Conclusions Comparing the gene expression profiles in HGC27 cells to those in insensitive BGC823 cells, the results indicate that cytotoxic effects of parvovirus H-1 might be achieved by upregulation and/or down-regulation the expression of some of the apoptosis related gene, in another words, it may influence the expression of apoptotic pathways related genes in gastric cancer cells.

The transfection of gastric cancer cell SGC7901 with tet-off regulating system and detection of tet-off regulating system's induction regulating

Objectives To determine the possibility of using Tet-off regulatory system to transfect human gastric cancer cell SGC7901, and control the expression of target gene.

The tet-off regulatory system were prepared and then transfected to gastric cancer cell SGC7901 by lipo-fect2000. With a series of concentration of doxycycline added the activity of the fluorescence caused by the expression of the target gene (the luciferase gene) which transfected to SGC7901 with tet-off regulatory system were analyzed. Results With the increasing concentration of Dox, the activity of the fluorescence caused by the expression of the target gene was inhibited gradually. The expression of the luciferase gene could been detected until the concentration of Dox reached 1 ug/ml. Uninfected gastric cancer cells were not inhibited by Dox. The activity of the fluorescence was high in the untransfected gastric cells. Conclusions With the help of Lipofect2000, the gactric cancer cell SGC7901 can be transfected by tet-off regulatory system successfully. The expression of target gene can be regulated by Dox. So it is feasible to control the gene expression by tet-off system in gastric cell.

Objectives To establish a reliable method for enrichment of cancer cells from peripheral blood in patients with gastric carcinoma. Materials and Methods MGC-803 gastric cancer cells were serially diluted in normal blood. Mononuclear cells (MNC) were collected by Ficoll density gradient medium. Then, MNC was divided into 3 parts and used 3 methods to enrich cancer cells: Method A, CD45 immunomagnetic beads were used to deplete the leucocytes; Method B, Ber-EP4 immunomagnetic beads were used to enrich cancer cells; Method C, first CD45 immunomagnetic beads were used then Ber-EP4 immunomagnetic beads were used. Finally, realtime quantitative RT-PCR was used to detect the expression of carcinoembryonic antigen (CEA) mRNA and housekeeping gene b2 mircoglobulin (b2MG) mRNA. Results The crossing point (Cp) value of amplifying CEA mRNA and b2MG mRNA obtained by Method C was the biggest among three methods. The melting curve analyses showed that the melting temperature of different samples was identical.The Cp value was proportional with the initial cancer cells. A high correlation between Cp value and cell number was found (Method A, P < 0.05; Method B and C, P < 0.01). However, if none of the immunomagetic beads was used, there was no correlation between the CEA mRNA and the cancer cells spiked into healthy blood. The CEA mRNA in PCR negative control had not been detected. The sensitivity of these methods was one cancer cell per ml blood. Conclusions Combinative use of negative and positive immunobeads can minimize the contamination from leukocytes in the enrichment of cancer cells.

Role of Akt in carcinogenesis and chemosensitivity of gastric cancer ZHEYI HAN, KAICHUN WU, HUIQIN SHEN, SHUANG HAN, CHANGJIANG LIU, DAIMING FAN Institute of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Shannxi Xi'an, 710032 Objectives To examine the expression of Akt in gastric cancer tissues and the regulation of Akt on chemosensitivity of gastric cancer cells. Methods Expression of total Akt(t-Akt) and phospho Akt(p-Akt) in gastric cancers was examined by immunohistochemistry and western blot. Constitutively activated and kinase dead mutant of Akt transfectants were established. Apoptosis of the transfectants was examined by Annexin V/PI staining when administrated with adriamycin. Regulation of Akt on MDR1 expression was studied by RT-PCR and western blot. Effect of Akt on P-gp activity was studied accumulation and retention of adriamycin and verapamil block assay. Luciferase assay was performed to indicate the regulation of Akt on MDR1 promoter transcription. Results p-Akt was overexpressed in human gastric cancers and its expression levels correlated with the carcinogenesis and the degree of tumor differentiation, but t-Akt not. Constitutively activated Akt confered anti-apoptotic ability and drug resistance of gastric cancer cells. While kinase dead Akt induced apoptosis and caused reversal of the drug resistance. Kinase dead Akt decreased the expressions of both MDR1 mRNA and protein. P-gp function analysed revealed that adriamycin accumulation and retention were decreased in constitutively activated Akt transfectants and could be blocked by Verapamil. Reporter gene assay suggested that AGS cells co-transfected with kinase dead Akt and pGL-MDR1 showed weaker fluorescence intensity than the empty vector co-transfected cells, which indicated that kinase dead Akt could suppress the promoter activity of MDR1. Conclusions Akt is constitutively activated in gastric cancers and p-Akt contributes to gastric carcinogenesis. Akt activity decreases cell chemosensitivity in vitro, causing inhibition of pro-apoptotic effect of anti-tumor drugs. Down-regulated Akt activity decreases the expressions of MDR1 mRNA and protein as well as MDR1 promoter activity.

includes 34 patients with advanced atrophic gastritis: 12 at antrum, 2 at corpus, and 20 both at antrum and corpus. 7 patients with superficial gastritis were as the controls. All patients' biopsies were undergone rapid urease test during endoscopy. The fasting levels of S-PGI and S-PGII were determined with ELISA methods. Results Hp infection was found in 9 of 12 (75%) patients with advanced antrum atrophic gastritis, 2 of 2 patients with advanced corpus atrophic gastritis, and 12 of 20 (60%) patients with advanced atrophic gastritis both at antrum and corpus, 4 of 7 (57%) were found Hp positive in controls. Totally, 27 of 41 (67%) patients were found Hp positive. The mean fasting level of S-PGI in 10 patients with severe corpus atrophic gastritis was 84 mg/L, 12 patients with moderate corpus atrophic gastritis was 159 mg/L, and 19 patients without advanced corpus atrophic gastritis was 141 mg/L. The mean levels of S-PGI and S-PGII were higher in Hp positive patients than those in Hp negative patients, but the ratio of S-PGI/II was lower. Conclusions Low fasting S-PGI level is a sign of severe corpus atrophic gastritis. When patients without advanced atrophic gastritis were infected by Hp, the fasting levels of S-PGI and S-PGII were higher compared to those without Hp infection, but the ratio of S-PGI/II was lower.

Aims ZNRD1, a transcription-associated gene, was recently found sharply downregulated in human gastric cancer tissues as compared to the matched normal adjacent tissues. In this study, we have investigated the role of ZNRD1 in cell growth regulation and the potential of ZNRD1 as a target for gastric cancer therapy.

The expression of ZNRD1 was examined by western blot and immunohistochemical analysis. Small interference RNA vector of ZNRD1 was constructed and transfected into normal gastric epithelial cells (GES-1). We also introduced the ZNRD1 gene into gastric cancer cells that do (SGC7901) and do not (AGS) express ZNRD1 endogenously. We further investigated the effect of ZNRD1 expression on cell proliferation in vitro and in vivo. Results The expression of ZNRD1 was found decreased progressively in the process of carcinogenesis of stomach cancer. ZNRD1 expression was also confirmed to be downregulated in gastric cancer cell lines compared to normal gastric epithelial cell line. GES-1 cells stably transfected with the ZNRD1-RNAi was found exhibit significantly quicker proliferation than control vector transfectants. SGC7901 cells and AGS cells stably transfected with the ZNRD1 cDNA exhibited increased growth rate as compared to control vector transfectants. Furthermore, ZNRD1 suppresses growth of AGS cells in soft agar and tumor formation in athymic nude mice. Conclusions This study clearly demonstrates that ZNRD1 may play an important role in the control of human gastric cancer development and that ZNRD1 suppresses gastric carcinogenesis by negatively regulating cell proliferation and modulating cell survival. These results provide new insights into the function of ZNRD1 and further validate ZNRD1 as a potential therapeutic target in gastric cancer.

Efficacy of self-expanding nitinol stent for malignant biliary obstruction XIAOJUN HUANG 1 , HONG FAN 1 , XIANG WANG 1 , YANHU FENG 1 , DEKUI ZHANG 1 The Second Hospital Affiliated to Lanzhou Medical University, Lanzhou, Gansu Province, China Objectives To evaluate the drainage effect of endoscopic metal biliary stent in treatment of malignant biliary obstruction. Materials and Methods Biliary stents insertion was performed in 22 patients with malignant biliary obstruction, who had been diagnosed after routine ERCP examinations. Restuls The successful rate of stent inserting technique was 100%, the total effective rate of biliary drainage was 95.4%, while was 90%, 65% and 30% at 3, 6, 12 months respectively. The median patency period of the stents and median survival period of the patients were 8, 9 months. Conclusions Endoscopic metal stent placement for patients with malignant biliary obstruction is a safe and effective way.

The positive hybridomas secreting antibody to lower-molecular outer membrane proteins of H. pylori were screened by means of ELISA with the lysated of E. coli containing the recombinant plasmid pET32a(+)/594 as coating antigen and the lysate of E. coli containing plasmid pET32a(+) as control for coating antigen. The reactivities of McAb secreted by the positive hybridoma to lower-molecular outer membrane proteins of H. pylori and the fusion expression in prokaryocyte of E. coli (DH5a) containing the recombinant plasmid pQE30/594 were confirmed by means of ELISA and Western blot methods.

The positive hybridomas secreting McAbs to lowermolecular outer membrane protein of H. pylori were screened successfully; the specific reactions of antigen-antibody were confirmed between the McAbs and lower-molecular outer membrane proteins of H. pylori expressed in prokaryocyte of E. coli (DH5a). The McAbs were stably secreted by the hybridoma for a number of moths. Conclusions The preparations of monoclonal antibodies to lowermolecular OMP of H. pylori make it possible to exploit the pathogenesis of H. pylori and study the relationship between H. pylori and extra-gastroenterologic diseases.

Objectives To investigate the effects of celebrex on the proliferation and apoptosis of human gastric carcinoma (GC) cell line as well as the growth of GC xenografts in nude mice.

Cell cycle was determined using Flow Cytometry (FCM) analysis, cytotoxicity assay was tested by MTT method. Nude mice bearing xenografts of the cell line were treated with celebrex daily until six weeks after tumor implantation. Results MTT showed that the growth of SGC-7901 was inhibited by celebrex, the inhibitory rates for growth of SGC-7901 were positively correlated with the concentration and duration of celebrex in the media.The FCM data showed that the cell cycle pattern on SGC-7901 cells was changed when treated with celebrex. After exposure of the cells to various concentration of celebrex for 24 h, the S and G 2 /M phase ratio was elevated significantly in a dose-dependent manner. The apoptosis rate was higher in treat group than that of control group [(19.2 ± 3.5)% vs. (7.6 ± 1.9)%, P < 0.05]. At necropsy, in mice given celebrex, the mean tumor weight were significantly lower than that of control group (0.43 ± 0.21 vs. 1.33 ± 0.45, P < 0.05). 

This is a state-wide telephone interview protocol, the first of its kind conducted in Malaysia. A telephone directory provided by a major telecommunication provider in Malaysia was used. Samples selection utilized a systematic cluster sampling based on alphabetical ascending order list. Statistical analy-sis was performed using SPSS® v.12 statistical software and Excel® Microsoft®. Test of significance using Pearson Chi-Square with a p-value set at a significant level of <0.05. Results Out of the 402 subjects interviewed, the prevalence of (IBS) was 29.4%. Of all the 402 subjects interviewed, 4.5% (18 subjects) had consulted doctors for their abdominal symptoms. Of these 17 (14.41%) had a diagnosis of IBS and only one was not diagnosed as IBS. The difference between IBS and non-IBS with regard to Consulters and Non-Consulters is significant. (Pearson Chi-Square, P = 0.000). IBS subjects consult doctors more frequently than non-IBS subjects. Apparently there are more diarrhea predominant subjects (12 or 70.59%) who seek medical help. However there is no difference in consultation pattern between constipation predominant (C-IBS) and diarrhea predominant (D-IBS) subjects (p = 0.918). Out of the 402 subjects interviewed, 8 or 2.0% of the subjects were told by their health care provider that they have IBS. 7 of them were diagnosed to have IBS by ROME II criteria. Only one subject did not fulfill the criteria.The only one alternator subject was never diagnosed by the health care provider as having IBS. The IBS group were aware of the diagnosis of IBS made by their health care provider (p = 0.001). Among the C-IBS and D-IBS groups there was no difference in terms of whether they were informed by their physician of the diagnosis of IBS (p = 0.626). 6 (7.32%) of the D-IBS said they were informed while only 1 (2.86%) of the C-IBS was informed. Of all the 402 subjects, 39 (9.7%) had actually taken some forms of medication for their abdominal symptoms. A small proportion (37 or 31.36%) of IBS subjects took some form of medication for relief of abdominal symptoms. This finding is significant (p = 0.000). There is no difference between C-IBS and D-IBS groups with regard to intake of medication for abdominal symptom relief (P = 0.070). Out of the 402 subjects, 17 (4.2%) had taken prescription medications from their doctors. The number of IBS patient who took prescription medication (16 or 13.56%) from their doctor is very significantly low (p = 0.000). There is no difference in prescription-seeking behaviour between C-IBS and D-IBS subjects. 31 subjects of C-IBS (88.57%) and 70 subjects of D-IBS (85.36%) did not seek prescriptions from doctors (p = 0.830). Of all subjects interviewed, 7 or 1.7% had taken over-the-counter (OTC) drugs for abdominal symptom relief. The difference between IBS and non-IBS subjects with regard to OTC usage is significant (p = 0.000). 111 or 94.07% IBS patient do not take OTC medications. Among the 402 subjects, 27 (5.5%) had taken herbal drugs or natural remedies. The number of IBS subjects who took alternative medicine (20 subjects or 16.95%) is significantly low (p = 0.000). There is no difference between C-IBS and D-IBS subjects with regard to alternative therapy. Only 3 subjects of C-IBS (8.57%) and 17 subjects of D-IBS (20.73%) who seek alternative therapy (p = 0.249). Conclusion IBS subjects in East Malaysia seek help from doctors more frequently than non-IBS subjects. There was however no different in consultation pattern between constipation predominant and diarrhea predominant subjects. All IBS subjects in this study were well informed about the diagnosis of IBS by their health care provider even before. There is no difference between C-IBS and D-IBS groups with regard to being informed of the diagnosis. Most IBS subject does not take prescription medication and there is no difference between C-IBS and D-IBS groups. The number of IBS patient who took OTC medications and/or alternative therapy is significantly low.

This is a state-wide telephone interview protocol, the first of its kind conducted in Malaysia. A telephone directory provided by a major telecommunication provider in Malaysia was used. Samples selection utilized a systematic cluster sampling based on alphabetical ascending order list. Statistical analysis was performed using SPSS® v.12 statistical software and Excel® Microsoft®. Test of significance using Pearson Chi-Square with a pvalue set at a significant level of <0.05. Results A total of 402 fixed-line telephone users were interviewed via telephone by a single, well trained research assistant. 178 (44.3%) of the subjects were male and 224 (55.7%) were female. The prevalence of IBS was 29.4% (118 subjects). On sub-group analysis, the prevalence of Constipation predominant IBS (C-IBS) is 8.7% (35 subjects). This reflects a 29.7% or 35 subjects within the IBS diagnosed group. The Diarrhea predominant IBS (D-IBS) group was identified in 82 subjects or 20.4% of the entire population under survey. Subgroup analysis shows that 82 subjects (69.5%) are diarrhea predominant within the IBS diagnosed group. Comparing IBS and non-IBS group, more female (75) are having IBS as compared with male (43). However this is non-significant (p = 0.079). There is only one alternator IBS subject who is a female. Most IBS subjects are in the age range of 35-44 followed by 45-54 and 55-64. However this is not significantly different from the non-IBS group (p = 0.654). The prevalence of IBS among the Kadazan-Dusun, Chinese, Malay, and Bajau are 29.0%, 28.5%, 27.65% and 24.2% respectively. There is no ethnic distribution variability between IBS and non-IBS subjects (Pearson Chi-Square, p = 0.926). There is no gender difference in the D-IBS (p = 0.364) nor in the C-IBS (p = 0.249) groups. D-IBS and indeterminate (mixed) group had not shown any significant pattern of different among the different races in east Malaysia (P = 0.550). C-IBS also shows no significance pattern of different among the different races (p = 0.278). Overall, there is no difference in the prevalence of IBS among males and females (p = 0.079) as well as the various ethnic groups (p = 0.926) in Sabah. Conclusion The prevalence of IBS in east Malaysia was noted to be 29.4%. The prevalence of C-IBS and D-IBS were also determined according to the ROME II criteria. There were no different in the IBS, C-IBS and D-IBS prevalence with regards to gender, age and race.

Objective It was proved that Sodium Butyrate can inhabit the growth of many cancer cell lines in vitro. HT-29 cell line is a cell line which is used in numerous researchs about colon cancer. Our study was investigate the effect of Sodium Butyrate on the growth of HT-29 colon carcinoma cells, the expression of iNOS and the excretion of NO from the cells to find out the mechanism of butyrate to colon cancer Methods HT-29 cell lines were cultured in the medium of 10% calf blood serum, 100 IU/ml penicillin, 100 mg/ml streptomycin and in the environment of 37°C, 5%CO 2 saturation degree of wetness for multiplicative growth, transfer of culture and reserve. Sodium Butyrate in various concentrations of 1.0 mmol/L, 2.0 mmol/L, 5.0 mmol/L, 10.0 mmol/L and 20.0 mmol/L was co-incubated with the cells, then adopted MTT test to detect the cells' proliferation inhibitory concentration of 50% cells (IC), and stained the iNOS protein of HT-29 cells with a immunochemical method (SP Staining). The absorbance value (A value) of iNOS was measured by the system of automatic image analysis. Griess's technique was used to detect the excretion of nitric oxide (NO).

The survival rates of HT-29 cells treated by Sodium Butyrate decreased in a time-dependant and dose-dependent manner. IC 50 value of Sodium Butyrate at different treatment periods are altered (15.4 mmol/L at 12 hours, 5.7 mmol/L at 24 hours, 2.5 mmol/L at 36 hours, 0.9 mmol/L at 48 hours). Simultaneously Sodium Butyrate decreased the expression of iNOS in the cells' cytoplasm and the excretion of NO in the similar manner. Conclusion Sodium Butyrate could inhibit the expression of iNOS, consequently reduce the excretion of NO. It maybe one of the mechanisms by which Sodium Butyrate inhibits the growth of HT-29 colon carcinoma cells.

Influence of NS398 on cyclooxygenase-2 expression and cell proliferation and apoptosis in human gastric cancer cell line SGC7901 JINPING ZHANG, JIANSHENG LI

Objectives To study the effects of NS-398 on cyclooxygenase-2 (COX-2) expression, cell proliferation and apoptosis in human gastric cancer cell line SGC7901. Materials and Methods SGC7901 cells were treated with NS-398 (10 mmol/L, 50 mmol/L, 100 mmol/L) for 48 h, the expression of COX-2 mRNA and protein were evaluated by RT-PCR and Western blot, respectively. The cell cycle and apoptosis rate were analyzed by flow cytometry. MTT reduction assay was used to evaluate the inhibitory rate of SGC7901 cells treated with NS-398 for 24 h, 48 h and 72 h. Results COX-2 mRNA and protein expression of SGC7901 cells were inhibited by NS-398 in a concentration dependent pattern (P < 0.01). NS-398 increased the proportion of cells in the G o /G 1 phase and decreased the proportion in the S phase of cell cycle, and induced apoptosis of SGC7901 cells in a concentration dependent pattern (P < 0.01). The inhibition rate of NS-398 on SGC7901 cell proliferation increased as incubation time and NS-398 concentration increasing. Conclusions The inhibitive effect of NS-398 on COX-2 expression may be an important cause of cell proliferation inhibition and apoptosis induction in human gastric cancer cell line SGC7901.

Expression of ornithine decarboxylase mRNA, endostatin mRNA and angiogenesis in esophageal squamous cell carcinoma XINPU MIAO, JIANSHENG LI

Objectives To investigate the expression of ornithine decarboxylase (ODC) mRNA, endostatin mRNA and microvessel density (MVD) in the esophageal squamous cell carcinoma and their correlation.

Reverse transcription-PCR method was used to examine the expression of ODC mRNA and endostatin mRNA in fresh surgical specimens of 41 pairs of primary esophageal squamous cell carcinomas and adjacent normal esophageal mucosa, their T : N ratios were calculated after a correction for the T : N ration of b-actin mRNA expression. Immunohistochemistry was used to examine the MVD by anti-CD34 monoclonal antibody in esophageal carcinoma tissue and correspondingly adjacent tissue. Results The expression of ODC mRNA, endostatin mRNA and MVD was greater in T than in N. The T : N ratio of ODC mRNA expression, endostatin mRNA expression and MVD has a significant correlation with tumor size, lymph node metastasis and adventitia invasion. ODC and endostatin also have a significant correlation with histology of the tumor.There was a correlation between the T : N ratio of ODC mRNA and the T : N ratio of MVD (g = 0.738, p < 0.05); There was a reverse correlation between the T : N ratio of ODC mRNA and the T : N ratio of endostatin mRNA (g = -0.458, p < 0.05), as well as the T : N ratio of MVD and the T : N ratio of endostatin mRNA (g = -0.536, p < 0.05). Conclusions ODC and endostatin expression is closely related to tumor angiogenesis, invasion and metastasis of esophageal squamous cell carcinoma. ODC over-expression may promote tumor angiogenesis by suppressing endostatin. It is possible that ODC may facilitate tumor invasion and metastasis through stimulating angiogenesis.

Components of bilirubin before and after PI and resin adsorption detected by high pressure liquid chromatography LI JUN

Objectives To investigate the influence of PI and resin adsorption on bilirubin components. Methods (1) Ascites of jaundice patients was put into brown bottles with 4 mL wet adsorbents. The adsorption rate of bilirubin, protein and electrolytes were measured at 15, 30, 60, 120 minutes. The adsorption rates at 37°C or at 25°C, when resin adsorbing alone or combining with photo-illumination (PI, i.e. blue light radiation), at shaking or perfusion were compared. The concentration-peak area standard curve of bilirubin was made, peak areas in bilirubin solution and jaundice ascites were measured before and at different time when PI or adsorption. Results The concentration of I-BIX a isomer deceased after PI whereas the concentration of the conversion products increased both in bilirubin standard solution and ascites. The conversion products could also be adsorbed by resin. These changes were not so obvious after 60 minutes. Conclusion The components of bilirubin changed after PI, I-BIX a isomer deceased, new products developed which could be adsorbed by resin too. High pressure liquid chromatography is a sensitive and exact method in testing the components of bilirubin.

Procalcitonin measurement in the primary liver cancer patients performed TACE JUN LI, HUILING XIANG, HONGMIN LV,

Objectives To evaluate the significance of procalcitonin (PCT) measurement in primary liver cancer patients who were performed transatery chemical therapy and embolization (TACE) and got pyretic. Materials and Methods 34 primary liver cancer patients performed TACE and got pyretic from October 2003~May 2004 was studied. Among them 29 was male, 5 was female, average age was 59 ± 17 years old. The regular therapy was given post the TACE. All patients were tested the PCT level at the third day after TACE. That PCT level at 0.5~2 ng/L, neutrophil ratio at 50%~75% is definited to normal or mild elevation, PCT > 10 ng/L, neutrophill ratio >90% is definited to marked elevation, and that between the two group is definited to moderate elevation. Results The PCT level was normal or mild elevation in 28 of the 34 cases (28/34, 82.35%), 4 of the 34 cases (11.77%) marked eleva-tion, 2 of 34 (5.88%) moderate elevation. The neutrophil ratio was normal/mild increased in 3/34 (8.82%), 24/34 (70.59%) moderatly increased, 7/34 (20.59%) marked increased. Discussion Fever is the common symptom after the TACE. Antibiotics is now regularly given. It is thought that fever is due to the absorbtion of necrotic tumor tissue, the immunity response, drug induced and so on, some are caused by bacteria infection only for which the antibiotics should be used. PCT is the precursor of calcitonin (CT), encoding by the CALC-1 gene. The concentration of plasma PCT usually significantly increase when serious bacteria infection or pyemia exist. In vitro PCT is induced by endotoxin. Our result showed PCT level was normal/mild elevated in 82.35% pyretic patients, so fever has no relationship with bacteria infection. We stopped the antibiotics in these patients and found no severe complications. Conclusion It is of significance that PCT measurement in analyzing the reason of fever post TACE and in advising the usage of antibiotics.

The expression of estrogen inducing gene PS2/TFF1 in gastric precancerous lesion JUNMEI LI, JIAN PING HUA, GUIFENG MA

Objective To determine the significance of expression of PS2/TFF1 protein in chronic superficial gastritis (CSG), gastric ulcer (GU), gastric mucosal intestinal metaplasia (IM), gastric mucosal dysplasia and gastric cancer (GC). Methods Pathologic specimens of 121 patients with gastric mucosal diseases and 20 healthy volunteers were immunostained for PS2/TFF1 protein. mRNA expression of PS2/TFF1 in 25 GC tissues and paired normal gastric mucosas were detected by RT-PCR. Results Positive PS2/TFF1 staining was seen throughout all epithelia with normal gastric mucosas, CSG, GU and in complete type of intestinal metaplasia (20/21). On the contrary, nine of 20 incomplete type of intestinal metaplasia had negative PS2 staining (P < 0.05). The expressions of PS2/TFF1 protein in CSG and GU were significantly higher than that in control group (P < 0.05), while the expressions of PS2/TFF1 protein in incomplete type of intestinal metaplasia, gastric mucosal dysplasia and GC were obviously lower than that in control group (P < 0.01). PS2/TFF1mRNA was expressed in 16% GC tissue and 100% paired normal gastric tissue, respectively. There was statistical significance in positive rate of PS2/TFF1mRNA between GC tissues and paired normal gastric tissues.

Our results indicate that PS2 maybe play an important role in gastric mucosal protective; and loss of PS2 expression may occur as an early event in the malignant transformation process of intestinal-type tumors. potent angiogenesis inhibitors. Adenovirus is a useful vector for gene therapy. A recombinant adenovirus carrying vasostatin gene was constructed and identified for further using. Materials and Methods AdEasy XL adenovirus vector system which is defective for replication due to the deletion of gene E1/E3 was used as vector for gene therapy. A cDNA clone encoding vasostatin was isolated from human muscle cDNA library with PCR cloning technique. The PCR fragment was cloned into a pshuttle vector, which contains a cytomegalovirus promoter. The resultant plasmid (pshuttle-CMV-vasostatin) linearized with Pme I was transformed into E. coli. BJ5183 pre-transformed with the pAdEasy-1 plasmid to undergo homologous recombination by electroporation means. The recombinant plasmid (pAd-CMV-vasostatin) linearized with Pac I was then transfected into 293 cells. The recombinant adenovirus was evidenced by the cytopathic effect of 293 cells, and confirmed by PCR. Results The PCR producet was 564 bp confirmed by agarose gel electrophoresis. The successful cloning of vasostatin into pshuttle-CMV was confirmed by restriction endonuclease analysis, and the gene of interest was identified as vasostatin by nucleotides sequencing technique. The recombinants were selected for kanamycin resistance and the recombination was confirmed by the presence of 4.5 kb fragment in the restriction endonuclease analysis. Both the cytopathic effect of 293 cells and the 564 bp PCR producet indicated the presence of the recombinant adenovirus containing vasostatin gene. Conclusions The recombinant adenovirus containing vasostatin gene was constructed successfully, which is helpful to further investigation of its potentiality in the gene therapy of gastroenterological cancer.

(120 nM)or heat-inactivated VacA (120 nM) and incubated with Fluoro labeled anti-VacA antibody (1 ul), analyzed by flow cytometry. Washed platelets (18 ul) were incubated with VacA (120 nM) and separated GEMs fraction and non-GEMs fraction, and analyzed by SDS-PAGE followed by Western blotting with antibodies to VacA. Results P-selection expression increased in a dose-dependent manner in platelets incubated with activated VacA,.VacA per se at the highest concentration tested (120 nM) did not induce platelet aggregation. However, there was an increase in the magnitude of platelet aggregation induced by the combination of von Willebrand factor and botrocetin or by convulxin. The mean fluorescence intensity of platelets previously incubated with VacA and fluoro labeled VacA antibody was significantly higher than that of a vehicle. It suggests that VacA binding occurs in the majority of platelets. We investigated the localization of VacA on membrane fractions suggested that the presence of VacA was almost totally confined to GEMs fraction. Conclusions VacA bind to platelet surface in GEMs and stimulate platelet activation.

Immunohistochemical distribution and fecal levels of the myeloic related protein-calprotectin in ulcerative colitis BINWEN LIU. YUMIN LV. ZHU JIN. XUELING YANG

Objectives To investigate the correlation between the disease activity of ulcerative colitis and Immunohistochemical distribution of the myeloic related protein calprotectin, as well as fecal levels of calprtectin.

Monoclonal antibody against calprotectin was used to investigate immunohistochemically the distribution of these proteins in large bowel tissues from 42 patients with ulcerative colitis and 20 healthy controls. Furthermore, we used ELISA assay to measure fecal concentrations of calprotectin. The disease activity of UC was simultaneously determined by endoscopic and histological criteria. Results Calprotectin was demonstrated in the majority of granulocytes and macrophages in tissues of patients with active UC while negative in unactive UC and healthy controls. A strong calprotectin immunoreactivity was present in ulcerative and erosion lesions in the bowel. Fecal concentrations were significantly (P < 0.0001) higher in patients with active UC [n = 23, median 223 ug/g, (16.5, 975)] than in unactive UC [n = 19, median 3.5 ug/g, (1.6, 8.9)] and healthy controls [n = 20, median 2.9 ug/g, (0.01, 8. 3) ]. There was no significant difference between unactive UC and healthy controls (P = 0.36). Both immunohistochemical distribution and fecal levels of calprotectin in Ulcerative colitis were significantly correlated with the histological grades respectively [(r = 0.89, p = 0.0001); (r = 0.849, p < 0.0001)], the two parameter themselves were correlated well (r = 0.99, p = 0.0007). Conclusions We suggest that fecal calprotecin mostly derived from the loss of calprotecin from the lage bowel mucosa in active ulcerative colitis. Fecal calprotecin accurately reflects the degree of disease activity in UC. The morphological results confirm the finding of enhanced fecal calprotectin levels in patients with active UC.

Enhanced inhibitive effects of combination of rofecoxib and octreotide on the growth of human gastric cancer CHUNLUN LIU 1 , CHENGWEI TANG 2 , XUCHUN ZHOU 1 , CHUNHUI WANG 2 1 Department of Gastroenterology, Frist Affiliated Hospital of Chongqing University of Mediccal Sciences, Chongqing, China 2 Department of Gastroenterology,West China Hospital, Sichuan University, Chengdu, China Objectives To know whether rofecoxib combined with octreotide would enhance the inhibitive effects of growth of gastric cancer.

Proliferation of gastric cancer cell line affected with rofecoxib or octreotide was determined by 3Hthymidine ribotide incorporation.To determine the synergic effects of anti-neoplasm, the interaction between rofecoxib and octreotide on SGC-7901 cell was evaluated according to the median effect plot.The expression of proliferating cell nuclear antigen (PCNA) of gastric adenocarcinoma cells was detected by immunocytochemistry. The TdTmediated dUTP nick end labeling assay was used to detect the apoptosis. Results After xenografts of human gastric cancer were implanted orthotopically in stomach, nude mice were administrated rofecoxib plus octreotide for 8 weeks. Combination of rofecoxib and octreotide presented synergistic effect (combination index <1) in majority of responses. The inhibitory rate for xenografts in nude mice was 89.7% in rofecoxib group. However, rofecoxib combined with octreotide was able to enhance inhibitory rate of tumor to 98.8%. Futhermore, the combination of rofecoxib and octreotide greatly increased the apoptosis index (78.20% ± 6.45) of the xenografts when compared with rofecoxib alone (46.60% ± 3.42%), p < 0.001. Moreover, the combination therapy greatly decreased the PCNA index of SGC7901 either in vitro or in vivo. Conclusions Combination of rofecoxib and octreotide significantly enhanced the anti-proliferation effect in gastric adenocarcinoma.

Expression of cyclind1 and vascular endothelial growth factor in gastric carcinoma tissue and its signification HONG LIU

Objective To investigate the expression of CyclinD 1 and VEGF in gastric carcinoma (GC) tissue and chronic atrophy gastritis (CAG) tissue, its relation with infiltration and metastasis of GC, and its relativity. Methods A case-control study was conducted. Expression of CyclinD 1 and VEGF were tested using the monoclonal antibody by S-P immunohistochemistry in 57 cases of GC and 20 cases of chronic atrophy gastritis (CAG) which were collected. Results 1 CyclinD 1 and VEGF were presented in gastric carcinoma (GC) lesions; 2 It was found that the positive rate of CyclinD 1 expression in GC (47.4%) was higher than in CAG (20.0%) (P = 0.032), in GC of undifferential-type (59.4%) was higher than in differential-type (32.0%, P = 0.040). The positive expression intensity of CyclinD 1 in diffuse-type of Lauren typing was higher than in intestinal-type (P = 0.048). But the positive rate and the positive expression intensity was no significant difference in lymph node metastasis, distant place metastasis and TNM staging. 3 The positive rate of VEGF expression in GC (77.2%) was much higher than in CAG (5.0%) (P = 0.001); VEGF expression rate were higher in GC of undifferential-type than in differential-type (87.5%, 64.0%, P = 0.036), in the group of N 2 (93.8%) and N 1 (91.7%) was higher than in N 0 (62.1%, P = 0.023, P = 0.041, respectively), in GC of distant place metastasis (100%) than in no distant place metastasis (74.5%, P = 0.033), IIIb, IV stage of TNM staging expression (95.0%) was higher than I,IIa stage (53.8%, P = 0.009). The positive expression intensity of VEGF in infiltrated type was higher than in bump type (P = 0.039), in tumor lenghth of more than 6 cm was higher than that of less than 4 cm (P = 0.039). 4 There was a relationship between CyclinD 1 and VEGF expression in GC (P = 0.041, r = 0.264). Conclusion 1 The excessive expression of CyclinD 1 take part in the occurrence of GC. It was a early molecular event of GC 2 VEGF promote tumor's growth, infiltration, and distant place metastasis.

3 The combination detection of CyclinD 1 and VEGF may evaluate the prognosis of GC. 4 The co-expression of CyclinD 1 and VEGF is closely related to TNM staging, indicating the reference to operation of GC. 5 Expanding new pathway to other therapy such as genetic therapy of GC. 

Background/Aims The current study was therefore designed to determine gene expression patterns of matrix metalloproteinases (MMPs) and their tissue inhibitor (TIMP-1) in endoscopic biopsies of patients with ulcerative colitis and the control. Patients/methods Total RNA was isolated from biopsies of patients with ulcerative colitis (n = 25) and the control (n = 20), The expressions of MMP-1, MMP-2, MMP-3 and TIMP-1 mRNA in colon mucosa were assessed by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Results In non-inflamed colonic mucosa (control group), the Expessions of MMP-1, MMP-2 and MMP-3 were 0.18 ± 0.15, 0.16 ± 0.13 and 0.09 ± 0.13 respectively. In inflamed colonic mucosa of ulcerative colitis, the Expessions of MMP-1, MMP-2 and MMP-3 mRNAs were 0.37 ± 0.19, 0.40 ± 0.16 and 0.24 ± 0.13 respectively, and significantly increased compared with the expression in noninflamed colonic mucosa (p < 0.01); TIMP-1 transcripts of ulcerative colitis and the control were 0.53 ± 0.18 and 0.54 ± 0.18 respectively, and there was no significant difference between ulcerative colitis and the control (p > 0.05). Conclusion Overexpression of matrix metalloproteinases (especially MMP-1 and MMP-3) mRNAs transcripts suggests an important role for these enzymes in the process of tissue remodeling and destruction in ulcerative colitis.

Immunohistochemical expression of glutathione stransferase-pi (GST-p) and topoisomerase ii alpha (TOPOII-a): correlation with prognostic histopathologic parameters in colorectal neoplasia XILONG OU, DAZHONG CAO, QIAN YU, TING YU, WEIHAO SUN Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, China Objectives To identify any relation between expression of glutathione S-transferase-pi (GST-p) and topoisomerase II alpha (TOPOII-a) and several histopathologic parameters including tumor size, pathologic stage, lymph node metastasis, tumor grade, and differentiation in human colorectal carcinoma.

Immunohistochemical staining for GSTp and TOPOII-aexpression was retrospectively investigated by the avidin-biotin-peroxide complex (ABC) method in a series of 60 colorectal carcinomas and adjacent uninvolved tissues. Results The expression rates of GST-p were 90.00% in tumors and 46.67% in the corresponding normal tissues. The expression rate of TOPOII-a was 86.67% in tumors while there was not any expression in normal tissues. The expression of GST-p and TOPOII-a in colorectal carcinoma was associated with cellular differentiation; Duke's stage and metastasis of lymph node (P < 0.001) but negative correlation to tumor size and type (P > 0.05). On the other hand, the expression of GST-p was significantly higher in poorly differentiated tumors than in the well-differentiated (P < 0.001) but inverse results existed in pericarcinoma tissue. The expression of TOPOII-a in welldifferentiated tumors was stronger than that in the poorly differentiated (P < 0.001). Conclusions The detection of GST-p and TOPOII-aexpression may be helpful to judge the malignant behavior, metastasis and prognosis of colorectal carcinomas.

Objectives To investigate the killing effects of EGCG on different digestive tract cancer cell lines, to find out the target sites of its antineoplastic effect. Materials and Methods MTT analysis was used to detect the discrepancies of eight digestive tract cancer cell lines'sensitivities to EGCG. The effect of EGCG on cell cycle distribution of sensitive cancer cell line was measured by flow cytometry. By polymerase chain reaction (PCR)-enzyme linked immunosorbent assay (ELISA) protocol, the influence of EGCG on telomerase activity of sensitive cancer cell line was also investigated. RT-PCR method was used to detect the influence of EGCG on the expressions of hTERT, c-myc, p53 and mad1 genes in sensitive cancer cell line. Results EGCG exhibited dose-dependent killing effects on all eight digestive tract cancer cell lines. There were no apparent changes in cell cycle distribution of sensitive cancer cell line MKN45 after 48 h incubating with three different concentrations of EGCG compared with the controls. It was found that EGCG could supress the telomerase activity of MKN45 cells. The expression of hTERT and c-myc genes in MKN45 cells were decreased, that of mad1 gene was increased, and the expression of p53 gene had no apparent changes. Conclusions EGCG has dose-dependent killing effects on different digestive tract cancer cell lines in vary degrees. Administration of EGCG has no obvious effect on cell cycle distribution of sensitive cancer cell line MKN45. The anti-neoplastic activity of EGCG might be due to inhibition of telomerase activity by means of its influence on hTERT and the up-stream regulation genes.

Objectives To study the significance of COX-2 (cyclooxygenase-2), MMP-2 (matrix metalloproteinase-2) protein expression and MVD (microvessel density) in human gastric carcinoma and their relationships. Materials and Methods COX-2 and MMP-2 expression and the change of MVD were examined by immunohistochemical s-p staining method in 45 cases of human gastric cancer and 20 cases of normal gastric tissue. Results Increased expression of COX-2 protein was present in the cytoplasm region of cancer cell in gastric carcinoma; 27 out of the 45 cases were COX-2 positive (60%), which was significantly higher than that in normal gastric mucosa (P < 0.01); Increased MMP-2 expression of protein was present in the cytoplasm region and cytomembrane of cancer cell in gastric carcinoma; 29 out of the 45 cases were MMP-2 positive (64.4%), which was significantly higher than that in normal gastric mucosa (P < 0.01);The expression of MMP-2 was significantly correlated with COX-2(r s = 0.569, P < 0.01); The mean MVD in group with both COX-2 and MMP-2 positive was significantly higher than that both COX-2 and MMP-2 negative group (38.5 ± 8.4 vs. 19.3 ± 5.1, P < 0.01). Conclusions The overexpression of COX-2 and MMP-2 Protein were found in gastric carcinoma, and the angiogenesis increased significantly. The expression of COX-2 was correlated with MMP-2 rankly, and that was also strongly related to the MVD. To stimulate MMP-2 overexpression and increase the angiogenesis directly or indirectly may be the pathways of COX-2 to contribute to the invasion and metastasis in human gastric carcinoma.

Roles of photodynamic therapy in the management of gastrointestinal cancer WEIHONG SHA, YUYUAN LI, YUQIANG NIE

Objectives To evaluate the efficacy of photodynamic therapy (PDT) on patients with advanced gastrointestinal carcinoma. Methods Seventeen patients underwent PDT combined with chemotherapy due to unrecectabe esophageal (8/17), colonic (5/17) and rectal (4/17) carcinoma. Endoscopic debulking of the cancers was carried out in 7 patients before PDT.Therapeutic response was determined by follow-up endoscopy on 1, 2, 3, 6, 9 and 12 months after PDT. Symptomatic improvement of the patients and side effects were recorded. Survival data were obtained in all the patients.

The follow-up period reached 0.5 to 18 months with a median time of 8.2 months. Symptomatic palliation was observed in 82.4% patients (14/17). The survival rates of 6 months and 1 year were 76.5% (13/17) and 47.1% (8/17) respectively. Complete response (CR) defined as complete disappearance of the lesion endoscopically with negative biopsies was observed in 29.4% (5/17) of the patients and a partial response (PR) defined as decrease of tumor sizes over 50% was observed in 52.9% (9/17). Cutaneous photosensitization was encountered in one patient corresponding to a side-effect rate of 5.9%. Major bleeding occurred in a patient with esophageal carcinoma corresponding to a complication rate of 5.9%. Conclusion PDT appears to be an effective and safe treatment for patients with advanced gastrointestinal cancer.

The mRNA level of mucin1 in ESCC and their adjacent tissues YING SHAO, ZHONG LINYU, SHU TIANZHANG Endoscopic Center, Beijing Friendship Hospital affiliated to the Capital University of Medical Sciences, Beijing 100050, China Esophageal squamous cell carcinoma (ESCC) is one of the most common and lethal cancers in the world. To study the mechanism of ESCC is one of the hotspots. There have not found any specific tumour markers of early ESCC. Aims To investigate the expression Mucin1 in ESCC and their adjacent tissues.To study the mechanism of ESCC and to explore the specific tumour marker of early ESCC. Materials and Methods Paired tumour and corresponding adjacent frozen tissue samples from 25 resected ESCC were analysed by revers transcription-polymerase chain reaction (RT-PCR) for Mucin 1. Results RT-PCR analysis revealed that the mRNA level expressed in the 25 adjacent tissues was markedly higher than that in their corresponding ESCC tissues (P = 0.018).

The expression of P53, P63 and MDM2 in ESCC and their adjacent tissues YING SHAO, PENG WANG, ZHONG LIN, YU SHU,

Aims To investigate the expression of P53, P63, and MDM 2 in ESCC and their adjacent tissues. To study the mechanism of ESCC and to explore the specific tumour marker of early ESCC. Materials and Methods Paired tumour and corresponding adjacent archival samples from 40 ESCC patients were analysed by immunohistochemical method with specific monoclone antibodies towards p53, p63 and MDM 2 . Results In 40 ESCC and their adjacent tissues, the positive expression rates of p53, MDM 2 and p63 were 40% (16/40) and 12.5% (5/40) (P < 0.01), 55% (22/40) and 7.5% (3/40) (P < 0.0001), 95% (38/40) and 100% (40/40) (P > 0.05), respectively. Among the 40 ESCC, there were 16 samples for p53 (-) / MDM 2 (+), 10 samples for P53 (+) / MDM 2 (-), 6 samples for both positive and 8 samples for both negative. There was an inversed correlation between the expression of p53 and MDM 2 protein, but it didn't reach statistic significance (P = 0.068). No association between P63 and p53 or MDM 2 was found. Conclusions The expression of p53 or MDM 2 is a common case in ESCC. There is an incersed correlative trend between the expression of p53 and MDM 2 .The expression of p63 in ESCC doesn't differ from their adjacent tissues, no association between p63 and p53 or between p63 and MDM 2 is found. The effect of p63 in ESCC should be further studied.

Up 

The expression of TSG101 was examined in gastric cancer cell line SGC7901 and it's vincristine (VCR)resistant subline SGC7901/VCR with semi-quantitative RT-PCR and Western blot. TSG101 expression vector was transfected into SGC7901 cells by lipofectamine TM 2000. The expression levels of TSG101 in SGC7901 and the transfectants were detected with Western blot and semi-quantitative RT-PCR. Fluorescence-activated cell sorting was applied to examine the capacity of cells to undergo apoptosis induced by VCR and the intracellular mean fluorescence intensity of adriamycin (ADR). Cell sensitivity towards chemotherapeutic drugs was analysed by MTT assay. The MDR-related molecule was examined with Western blot assay. Results It was found that TSG101 was highly expressed in VCR resistant gastric cancer cells. The ectopic overexpression of TSG101 could enhance the resistance of SGC7901 to multiple chemotherapeutic drugs such as VCR, ADR, cisplatin, mitomycin-C. The accumulation of ADR was reduced in the TSG101 transfectants and restored nearly to the levels of parental cells by coadministration of verapamil (a P-glycoprotein inhibitor). TSG101 significantly upregulated the expressions of the classical MDR-related molecule Pglycoprotein. The TSG101-mediated MDR could be partially reversed by verapamil. TSG101 could also suppress VCR-induced apoptosis and up-regulate the expression of Bcl-2, which might be another pathway contributing to TSG101-related MDR. The expression of Raf-1 protooncogene was also increased in TSG101 transfectants and Raf-1 inhibitor could decrease P-glycoprotein expression. Conclusions These observations implied that TSG101 might play a certain role in MDR of gastric cancer through Raf signal transduction cascade and/or cooperation with antiapoptotic protein Bcl-2. 

Objective To study the therapeutic effect of TCM formulation 'Chang Ji An' in patients of diarrhea predominant irritable bowel syndrome (IBS). Methods From Jan. 2003 to Dec. 2003, 24 diarrhea irritable bowel syndrome (IBS) patients were randomly divided into 2 groups: 'Chang Ji An' treatment group (n = 14) and placebo group (n = 10). 'Chang Ji An'formulation consisted of Chinese herbs including Atractylodes macrocaphala Koidc, Paeonia lactiflora Pall, Saposhnikovia divaricata, Prunus mume Sieb and Glycyrrhiza uralensis Fisch. Symptom evaluations, rectal sensation of rectal balloondistention, visual analogue scale (VAS), levels of serum vasoactive intestinal peptide (VIP), neuropeptide Y (NPY) and neurotensin (NT) were investigated before and after the administration. Results Symptom evaluations, including threshold of urgency and dyschizia were got much more improvement in treatment group than that in placebo group (P < 0.05). When the volume of rectal distention was over 60 ml, the difference of VAS between two groups was significantly demonstrated (P < 0.05). Besides, serum levels of VIP and NT were decreased and NPY was increased after administration of formulation (P < 0.05), while there were no significant changes of these peptides in placebo group. This clinical study was approved by Ruijin Hospital Ethical Committee and made the agreement of patients. Conclusions Our study suggested that 'Chang Ji An' formulation had therapeutic efficacy on patients of diarrhea predominant IBS by regulating the brain gut peptides.

Objective To investigate the serum levels and clinical significance of vasoactive intestinal peptide (VIP), neuropeptide Y (NPY) and neurotensin (NT) in patients of irritable bowel syndrome (IBS). Methods From Jan 2003 to Dec 2003, based on Rome II criteria, 36 cases of IBS (D-IBS 24 cases, 10 males and 14 females, average age 54.00; C-IBS 12 cases, 6 males and 6 females, average age 52.08) and 10 healthy subjects were enrolled into study. Serum VIP, NPY and NT were measured by radioimmuoassay (RIA). Results Both D-IBS and C-IBS patients had significantly lower serum NPY level than normals (P < 0.05), however, the NPY level was much lower in C-IBS patients than in D-IBS patients (P < 0.05). Serum VIP level was higher in D-IBS patients than in normals (P < 0.05) while there was no significant difference in C-IBS patients (P > 0.05). Both C-IBS and D-IBS patients had significantly higher serum NT level compared with normal group (P < 0.05) while there was no significant difference between two subtypes of IBS (P > 0.05). Conclusions Brain gut peptides may play an important role in the pathogenesis of IBS while different subtypes of IBS had different peptide levels. The present study indicated that both D-IBS and C-IBS patients had lower serum level of NPY and higher serum level of NT while only D-IBS had higher serum level of VIP.

Objective To illustrate the existance of bile reflux under stress condition, and explore the possible effects of the changes of gastrointestinal peptides' release on stress-induced bile reflux in rats. Methods (1)The changes in contents of plasma cholecystokinin (CCK) and somatostatin (SS) were simultaneously measured by using radio-immunon-assay (RIA) (2) Bile concentration of gastric juice was valued with RIA method and the gastric ulcer index (UI) and intragastric pH were calculated respectively (3) The positive effect of aluminum magnesium carbonate hydroxide(Talcid) by neutralizing refluxed bile under stress condition was observed. Results There was significantly different in bile reflux under stress condition compared with that of the normal control (p < 0.01), which reached the highest point at 2 h after the end of stress. Both the pH and the UI were apparently increased (p < 0.01). The plasma CCK contents was significantly different between the control group and stress group (p < 0.01), and the same with the SS (p < 0.05). Bile concentration and the UI of the Talcid medicine group were much lower than that of the physiological saline control group (p < 0.01). Conclusion Bile reflux does exist under stress condition, and bile acid play a critical role in SU. The changes of CCK and SS release during stress and the intragastric pH are closely related with the pathogensis of SU partly induced by bile acid.

Objectives To investigate the expression of cyclooxygenase-2 (COX-2) and matrix metalloproteinase-9 (MMP-9) in gastric adenocarcinoma and its correlation with angiogenesis and biologic behaviors of tumor. Materials and Methods Immunohistochemical stain was used for detecting the expression of COX-2 and MMP-9 in 90 resected specimens of gastric adenocarcinoma; the monoclonal antibody against CD34 was used for displaying vascular endothelial cells, and microvascular density (MVD) was detected by counting of CD34positive vascular endothelial cells. Paracancerous tissues were examined as control.

Results The positive expression rates of COX-2 and MMP-9 in gastric adenocarcinoma were 80.2% and 74% respectively, and MVD averaged 32.5 ± 8.3, which were significantly higher than hose in the control (P < 0.01). The expression of COX-2 and MMP-9 were associated with depth of tumor invasion and metastasis of lymph node (P < 0.05 or P < 0.01) but negative correlation to age, gender, tumor position, cellular differentiation and histologic type. COX-2 and MMP-9 expression were positively correlation to MVD (r = 0.311, P < 0.01; r = 0.349, P < 0.01 respectively). Expression of COX-2 was rightly correlated to MMP-9 expression (r = 0.244, P < 0.05). MVD in the specimens with COX-2 and MMP-9 co-expression was significantly higher than those without co-expression (P < 0.01). Conclusions Overexpression of COX-2 and MMP-9 in gastric adenocarcinoma is related to angiogenesis, tumor invasion and lymph node metastasis.

Evaluation of the new rapid urease test (pronto dry) for diagnosing helicobacter pylori in dyspeptic patients ARI F. SYAM 1 , M. ABDULLAH 1 , AA. RANI 1 , P. TARIGAN 2 , SITI NURDJANAH 3 , PANGESTU ADI 4 , A. DJUMHANA 5 1 Gastroenterology, Department of Internal Medicine, Medical Faculty University of Indonesia, Jakarta, Indonesia 2 North Sumatera University, Medan Indonesia 3 Gajah Mada University, Jogjakarta, Indonesia 4 Airlangga University, Surabaya, Indonesia 5 Padjajaran University, Bandung Indonesia Aims The rapid urease test is the most frequently used test for the diagnosis of Helicobacter pylori infection in routine gastrointestinal endoscopy practice. In this study we evaluate the accuracy of a new biopsy urease test, Pronto Dry and in the diagnosis of H. pylori infection.

Consecutive patients attending with dyspepsia to the endoscopy unit in 5 centers in Indonesia were recruited for the study. Patients who had received, proton pump inhibitors or antagonist H2 receptor in the preceding one week were excluded. H. pylori diagnosis was made based on histological examination of gastric biopsies.Three antral and three corpus biopsies were taken for histology and biopsy rapid urease test (Pronto Dry/ Medical Instruments Corporation, Solothurn, Switzerland). the urease test evaluated at 1 hour. Results A total of 428 patients were evaluated, consist of 275 (55, 9%) were males and 217 (44, 1%) females with a mean age of 44, 04 +/-14, 07 years old. Endoscopic findings found 10, 7% cases with peptic ulcer. Helicobacter pylori infection was diagnosed in 40 (9, 3%) patients by histology and 54 (12, 6%) patients by Pronto Dry. The Prontodry test showed a sensitivity and specificity in 1 hour of 77, 5% and 97,6% respectively. Conclusions The Pronto Dry test was highly specificity for the diagnosis of H. pylori infection and may be used as a rapid and cheap method to diagnose H pylori infection.This rapid urease test is a practical, fast, and cost effective method for the detection of Helicobacter Pylori infection.

Effects of bupivacaine on the gastric acid secretion in BALB/C and C57BL/6 mouse WANG CHANGCHENG, IRENEUSZ T PADOL 2 , RICHARD H. HUNT 2 Division of Gastroenterology, Huaian Second People's Hospital, Jiangsu Province (223002) Aims To investigate the effects of Bupivacaine on the gastric acid secretion in Balb/c and C57BL/6 mouse. Methods Measuring 3 h gastric acid volume (ml), acidity (mEq/l) and total acid output (mEq/3 h) in pylorus-ligated Balb/c and C57BL/6 mouse in basal state and after localized use of Bupivacaine. Results Gastric acid volume and total acid output were significantly higher in Balb/c (n = 9) than those in C57BL/6 (n = 10) (2.319 ± 0.181 vs 0.825 ± 0.062, p < 0.0001; 29.105 ± 4.90 vs 8.565 ± 1.203, p = 0.0005 respectively); Acidity was slightly higher in Balb/c than that in C57BL/6 (12.311 ± 1.737 vs 10.36 ± 1.313 respectively, p = 0.37). Gastric acid volume and total acid output after localized use of Bupivacaine (n = 6) were markedly lower than those in basal state (2.319 ± 0.181 vs 1.529 ± 0.142, p = 0.036; 29.105 ± 4.90 vs 11.956 ± 2.516, p = 0.04 respectively) in Balb/c mouse; Acidity after localized use of Bupivacaine was lower than that in basal state (12.311 ± 1.737 vs 6.433 ± 1.189, p = 0.07) in Balb/c mouse. There were no significant differences on gastric acid volume, acidity and total acid output before and after localized use of Bupivacaine (n = 6) (0.825 ± 0.062 vs 0.863 ± 0.105, p = 0.84; 8.565 ± 1.203 vs 8.725 ± 1.102, p = 0.95; 10.36 ± 1.313 vs 12.433 ± 1.27, p = 0.46 respectively). Conclusion There was a significant difference on gastric acid secretion between Balb/c and C57BL/6 mouse in basal state. Bupivacaine markedly decreased gastric acid volume and total acid output but had less effect on acidity in Balb/c mouse and had no inhibitory effect on gastric acid secretion in C57BL/6 mouse.

The research on expression of basic fibroblast growth factor mRNA in gastric adenocarcinoma and adjacent normal tissues JING WANG, GUOHUA LI, BING YANG, WEI QIAN, XIAOHUA HOU

Objectives To study the expression quantity of bFGF mRNA in gastric adenocarcinoma tissues, and to determine the role of bFGF in the pathogenesis of gastric adenocarcinoma.

Using RT-PCR method, we quantified the bFGF mRNA expression in 20 blocks of gastric adenocarcinoma tissues and adjacent normal gastric tissues. The ratio of integrated optical density of bFGF mRNA/GAPDH mRNA (B/G) was calculated. The relative amount of bFGF mRNA expression was represented by B/G. Results The B/G ratio of gastric adenocarcinoma tissues was more than that of adjacent normal gastric tissues (1.3173 ± 0.1578, 0.9427 ± 0.1402, p < 0.01). The expression amount of bFGF mRNA was closely related to the degree of gastric cancer differentiation. The B/G ratio of poorly differentiated gastric adenocarcinoma tissues was more than that of well-moderately differentiated gastric adenocarcinoma (1.4232 ± 0.1225, 1.2013 ± 0.1340, p < 0.05). In addition, the amount of bFGF expression in patients with metastasis of lymph node was more than that in patients without metastasis of lymph node. Conclusions The bFGF play an important role in the pathogenesis and metastasis of gastric adenocarcinoma by autocrine or paracrine.

The effect of human angiopoietin-1 on the tumorigenesis and angiogenesis of gastric cancer JUN WANG, KAICHUN WU, DEXIN ZHANG, LIPING YAO, DAIMING FAN Institute of Digestive Disease of PLA, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China Objective To investigate the role of human angiopoietin-1 (Ang1) in tumorigenesis and angiogenesis of human gastric cancer cell line SGC7901 in nude mice. Materials and Methods RT-PCR was used to amplify human Angiopoietin-1 gene from human plancental tissues.The recombinant sense or antisense eukaryotic expression vectors were constructed by directional cloning, and transfected by lipofectin into human gastric cancer line SGC7901. Stable transfectants were obtained respectively, namely 7Ang1+ for sense, 7Ang1-for antisense, and 7901P for empty vector transfected cells. Semiquatitive PCR and Western Blot were employed to testify the transfection efficiency. Cell growth curve and cell cycle were observed by MTT assays or flow cytometry. Animal model was set up to study in vivo tumorigenesis of those cells transplanted subcutaneously in the hind legs of nude mice BALBc. Microvessel density (MVD) was analyzed by immunohistochemistry for VIII-Factor staining. Results Stably transfected cell lines were established and a downregulated expression of Ang1 protein and mRNA in the antisense transfected cell was achieved.The proliferation and cell cycle of transfected cells wasn't altered significantly in all transfectants. The tumor graft of 7Ang1-cells 30 days after implantation in nude mice had less volume and weight than those of 7901P and 7Ang1+ (p < 0.01, 293.00 ± 95.54 mg vs. 624.00 ± 77.78 mg and 652.67 ± 132.07 mg). The tumor graft of 7Ang1-cell in nude mice had less (p < 0.01) vessel formation with MVD ( ± SD) 6.00 ± 1.73 compared to 7901P group 8.44 ± 1.33 and 7Ang1+ group 8.78 ± 1.92. Conclusion Ang1 may play an important role in tumorigenesis and angiogenesis of gastric cancer which could be partly offset by antisense technique. The Ang1 targeted strategy may have a potential of antiangiogenesis therapy for gastric cancer. patients (7.4%,7.4% and 14.8%, respectively). The value of CA19-9 and CA724 in TNM stage III and IV patients (136.9 + 290.1 u/ml, 18.0 + 35.9 u/ml) was higher than that in TNM stage IandII patients (16.3 + 27.3 u/ml, 4.5 + 8.5 u/ml). The positive rate and value of tumor markers were in no relation to tumor pathological type and differentiation. Conclusions CEA, CA19-9 and CA724 can be used for diagnosis of gastric carcinoma and judgement of patient's condition. CEA, CA19-9 and CA724 combination examination can increase diagnostic efficiency. But they have only limited diagnostic usefulness in early gastric carcinoma patients.

Protective role of melatonin in rats with stress ulcer and the effects of melatonin on mucosal nuclear factor-kb activation JIANSHENG WU, JINMING WU, DAN WANG, ET AL.

Objective To investigate the effects of melatonin on gastric lesions and mucosal nuclear factor-kB (NF-kB) activation in rats with stress ulcer fon elucidating the molecular mechanisms of melatonin intervention in vivo. Methods Stress ulcer was induced by water-immersion restraint (WIR) stress for 6 . Melatonin (5 and 20 mg/kg, ip) was administrated 30 min prior to WIR stress. After 6 h of WIR, rats were killed and the stomachs were removed. Ulcer index (UI) was evaluated macroscopically and gastric mucosal MDA contents and NF-kB activation were determined. Results WIR stress for 6 h induced severe gastric lesions associated with significantly increased MDA contents (P < 0.01) and NF-kB activation (P < 0.01) in gastric mucosa. Administration of melatonin (5 and 20 mg/kg, ip) 30 min prior to stress can significantly reduce gastric lesions (P < 0.01) and inhibit the increase in mucosal MDA contents (P < 0.01) and NF-kB activity (P < 0.01). There were significant differences in UI (P < 0.05) and mucosal MDA contents (P < 0.01), but not in mucosal NF-kB activity between MT intervention at doses of 5 mg/kg and 20 mg/kg. Conclusions These results suggest that melatonin can prevent the development of stress ulcer via a mechanism involving in reducing oxidative stress-induced NF-kB activation in gastric mucosa. Objectives To investigate the effects and their mechanisms on proliferation of gastric carcinoma cells by inhibiting ubiquitin-proteasome pathway (UPP).

The gastric carcinoma cell strain SGC-7901 was treated with MG-132 to inhibit its UPP specially.The effect of growth suppression on cells was evaluated with MTT assay. Cell cycle and apoptosis were detected by flow cytometry (FCM). DNA fragment analysis was used to confirm the presence of apoptosis. The activity of telomerase was examined by TRAP PCR-ELISA. Expression of p27kip1 was detected by immunocytochemical technique and Western blotting.

Results MG-132 had obvious inhibitory effect on the growth of SGC-7901 cells. The FCM analysis showed that the ratio of G 0 /G 1 phase of control group was (46.3 ± 4.1)%, the ratio of G 0 /G 1 phase of SGC-7901 cells treated with MG-132 increased which was (72.1 ± 5.0)% (P < 0.01) and a obviously apoptotic sub-G1 peak was found. Agarose electrophoresis showed marked ladder. TRAP PCR-ELISA showed that light absorption(value A) of SGC-7901 cells treated with MG-132 after 24 h, 48 h, 72 h and 96 h were 0.197 ± 0.007, 0.081 ± 0.005, 0.074 ± 0.004 and 0.063 ± 0.002 respectively, light absorption of control group were 1.801 ± 0.048, 1.887 ± 0.072, 2.047 ± 0.085 and 2.131 ± 0.076 respectively. The activity of telomerase was obviously inhibited (P < 0.01). Expression of p27kip1 was positive in plasma of SGC-7901 cells and it was positive in plasma and nuclei of cells treated with MG-132. Conclusions MG-132 can significantly inhibit the proliferation of SGC-7901 cells and induce its apoptosis. The mechanisms include enhancing expression of p27kip1, causing G 1 blocking and inhibiting activity of telomerase.

A study on mechanism of growth inhibitory effects of a cyclooxygenase-2 inhibitor-ns398 on cancer cells QINGMING WU, SHENGBAO LI, GUOJING XIE, XIAOHU WANG Department of Gastroenterology, Taihe Hospital,Yunyang Medical College, Shiyan Hubei, China Objective To study the mechanism of growth Inhibitory effect of a selective cyclooxygenase-2 (COX-2) inhibitor NS-398 on cancer cells.

The esophageal cancer cell lines (EC9706) which express COX-2 constitutively, and hepatocellular carcinoma cell lines (SMMC7721) which no expression of COX-2. Two kinds of cell lines were incubated with NS-398 at 0, 10, 20, 50, 100 mmol/L for 24 hr, 48 hr and 72 hr, Antiproliferation effect was measured by 3 H-TdR incorporation, The cell apoptosis were determined by flow cytometry (FCM), DNA fragmentation analysis. Survivin and ki67 were detected by immunocytochemical technique.

The growth inhibition could be induced by NS398 in a dose-and time-dependent manner in two kinds of cell lines. FCM analysis revealed a high sub-G 1 cell peak in EC9706 group, Agarose electrophroesis showed marked apoptosis ladder pattern, but no apoptosis by NS-398 in SMMC7721.The difference of apoptosis percentage in EC9706 and SMMC7721 was (45.23 ± 1.08)% and (3.05 ± 0.15)% (P < 0.001). And after 24 hr incubation with NS-398 at concentration of 20 mmol/L, the expression of survivin and ki67 were markedly reduced in EC9706, but only ki67 reduced in SMMC7721. Conclusions NS-398 could suppress cell growth in cancer cell lines by different mechanism. NS-398 could suppress cell growth and increase apoptosis in the cancer cells that express COX-2, but no apoptosis in the cancer cells that dose not express COX-2. GCRG213 protein. The titer and specificity of the antibody was determined by ELISA and Western-blot, respectively. Results The thioredoxin/GCRG213 fusion protein with relative molecular mass (Mr) of 29 400 was over expressed in E.coli. The purity of expressed product directly purified from a denaturing polyacrylamide gel was about 100%. The rabbit antibody against GCRG213 was obtained. The ELISA titer of antiserum against GCRG213 was about 1 : 256 000. Western blot analysis showed that the antiserum could bind to the expressed fusion protein specifically. Conclusions The polyclonal antibody against GCRG213 has been successfully prepared, which lays the foundation for further studying the biological function and the possible role of the GCRG213 in the development of gastric carcinoma.

Antitumor cellular immunity against colon cancer induced by dendritomas FENG XU, SHAN WANG*, YINGJIANG YE, ET AL

Objective To investigate the role of the dendritomas from fusion of dendritic cells and colon cancer SW480 cells in antitumor cellular immunity against colon cancer. Methods Dendritomas were generated by fused peripheral blood dendritic cells with colon cancer cells using 50% polyethylene glycol (PEG). The activated ratios of T lymphocytes were observed after T cell pulsed with dendritomas The specific T cell response and apoptosis were observed that stimulated by fusion cells (FCs) .

The fusion rates were about 10% to 16% in our experiments; The activated ratios of CD4 + Th1 and CD8 + Tc1 cells were about 54.45% and 77.86% after 24 hours since T cell mixed with fusions, which higher than those of controls; The proliferation of T cells were significantly higher than those of control after T cell pulsed with dendritomas (p < 0.01); The IFN-g secretion of T cell was significantly higher than that of control after 24 hour since T cell mixed with dendritomas (p < 0.01). Not only were the early apoptosis ratios of the colon cancer SW480 cells higher than that of controls, which affected by cytotoxic T lymphocytes(CTL) that activated by denritomas, but also the necrosis of the colon cancer cell increased as the time prolonged to 48 hours. Conclusion The CTL induced by dendritomas can lyse the colon cancer cells specially; meanwhile, it has a potent fuction in apoptosis of the colon cancer.

Characteristics of mRNA levels of hepatic cholesterol metabolism regulatory enzymes in genetically gallstone-susceptible and resistant mice XU GUOQIANG 1 , ZHAO LI 2 1 Department of Gastroenterology, First Hospital, Medical School of Zhejiang University, Hangzhou 310003, China 2 Department of Cardiology, First Hospital, Medical School of Zhejiang University, Hangzhou 310003, China Objective To investigate differences of mRNA levels of hepatic cholesterol metabolism regulatory enzymes between genetically gallstone-susceptible (C57L) and resistant (AKR) mice for exploring molecular mechanism of cholesterol gallstone formation. Methods The inbred C57L and AKR mice were fed a lithogenic diet containing 15% fat, 1.25% cholesterol and 0.5% cholic acid for four weeks, Their liver weight, hepatic cholesterol content and gallstone formation condition in gallbladder were examined before and after feeding the lithogenic diet; and mRNA levels of hepatic 3hydroxy-3-methylglutaryl-CoA reductase (Hmgcoar), cholesterol 7a-hydroxylase (C7h), acyl-CoA: cholesterol acyltransferase (Acat) and low density lipoprotein receptor (Ldlr) that are involved in the regulation of hepatic cholesterol homeostasis were measured and analysed by RT-PCR. Results Whether before or after feeding the lithogenic diet hepatic cholesterol content in AKR mice displayed markedly higher than that in C57L mice, Challenged with the lithogenic diet for four weeks, cholesterol gallstones were formed in C57L mice and was not occurred in AKR mice. Basal hepatic Hmgcoar mRNA levels were significantly higher in gallstone-resistant AKR mice compared with the C57L gallstone-susceptible strain; basal mRNA levels of Acat, Ldlr and C7h did not differ significantly among the mouse strains studied. In response to the lithogenic diet, expression levels of Hmgcoar and C7h mRNAs significantly decreased in AKR mice, whereas unchanged Hmgcoar and C7h mRNA levels occurred in C57L mice; The Ldlr mRNA increased slightly (14%) in AKR mice, and a significant elevation of 41% was present in C57L mice. Conclusions The lithogenic diet as an environment challenge unmasked phenotypes of mRNA expression of hepatic cholesterol metabolism regulatory enzymes of C57L and AKR mice, there were significant differences between both mouse strains on expression levels of Hmgcoar, C7h and Ldlr. After feeding the lithogenic diet, failure to sufficiently down-regulate Hmgcoar expression and significant increase of Ldlr level in C57L mice may play at least a part role in cholesterol gallstone formation.

Potassium antimonyl tartrate induces apoptosis of human colon cancer cells SHAOYONG XU 1 , GUANGYUN GUO 1 , JIANING WANG, YONGZHANG HUANG 2 1 Department of Gastroenterology and 2 Institution of Clinical Medicine, People's Hospital,Yunyang Medical College, Shiyan, China Objective To investigate the effect of potassium antimonyl tartrate on human colon cancer cells (SGC-7901) in vitro.

Human colon carcinoma line SW480 cells were used as experimental object in vitro. PAT of different concentrations was added into the media. Cell culture without addition of PAT was used as control. The growth inhibition of cells induced by various concentrations of PAT in different time course was analyzed by using MTT assay;The flow cytomery and terminal deoxynucleotidyl transferase-mediated duttp-biotin nick nedlabel (TNNEL) were applied to detect apoptotic cells. Results Potassium antimonyl tartrate inhibited SW480 cells growth significantly in does dependent and time dependent manner. Cell growth was suppressed by 8.8%, 16.27%, 31.76%, 64.28% after 72 h treatment with PAT at 5, 10, 20 and 40 mmol/L. DNA histograms showed the hypodiploid peak, the ration of hypodiploid cells was increased with the increase of dose and elongation of time. Bowncolor positive apoptotic cells were observed with TUNEL method. Conclusion Potassium antimonyl tartrat can inhibit the proliferation of SW480 cells and induce apoptosis.

Objective To study the effects of p27mt gene on the apoptosis in colorectal carcinoma cell lines SW480. Methods A recombinant adenovirus vector containing p27mt was constructed and human colorectal carcinoma cell lines SW480 were transfected in vitro. The cell apoptosis were determined by flow cytometry, TUNEL technique and DNA fragmentation analysis. Results Ad-p27mt was successfully constructed. The transfecttion efficiency was 100% when multiplicity of infection м50, FCM analysis revealed a sub-G1 cell peak in Ad-p27mt-transduced colorectal carcinoma cell lines. Agarose electrophoresis showed marked ladder. The difference of apoptosis index between the Ad-p27mt group and the control group was statistically significant (82.6 ± 3.2vs.5.0 ± 3.5, P < 0.01). Conclusions Human mutant p27 gene could induce the apoptosis in colorectal carcinoma cell lines SW480. 

The level of serum VIP of infantile rotavirus diarrhea is higher than that of normal controls.There were significant differences between mild, middle, severe diarrhea (p < 0.01), between diarrhea before treated and after recovery (p < 0.01). Conclusions To study the level of serum VIP may be helpful to understand the pathogenesis mechanism of rotavirus diarrhea; Serum VIP might be a better marker of diarrhea's states. Objectives To study the effects of a-Tocopheryl succinate (a-TOS) on apoptosis of gastric cancer cells induced by TRAIL.

The cell cycles and apoptosis rate were analyzed by flow cytometry analysis and the expressions of NF-kB, survivin, Bcl-2 and Caspase 3 in gastric cancer cells were measured by Western blot. Results After exposed to TRAIL 300 ng/ml for 24 hours, the apoptosis rate was 36.05% in MKN28, 20.27% in MKN45, 16 .50% in AGS and 11.80% in SGC-7901. After exposed to a-TOS 60 mmol/L for 24 hours, the apoptosis rate was 9.0% in MKN28 and 8.5% in SGC-7901. After treatment by both a-TOS 60 mmol/L and TRAIL 300 ng/ml for 24 hours, the apoptosis rate was 48.1% in SGC-7901 and 63.7% in MKN28 cell respectively. Western blot showed that TRAIL inhibited the expressions of NF-kB and survivin while it did not inhibit the expression of Bcl-2. a-TOS could decrease the level of Bcl-2 and survivin, and combined a-TOS and TRAIL treatment downregulated greatly the expression of NF-kB, Bcl-2 and survivin. Conclusions a-TOS can enhance TRAIL-induced apoptosis in gastric cancer cells, which may be associated with decreased expression of survivin, NF-kB and Bcl-2, and increased expression of Caspase3.

Screening differentially expressed genes of gastric adenocarcinoma by cDNA microarray SHAOBO YANG, MENGWEI WANG, YONG SHAO, BENYAN WU, WEIDI YOU, HONG LI Department of Gastroenterology, South Building, General Hospital of PLA, Beijing 100853, China Objective Despite the increase in our knowledge of oncogenes and tumor suppressor genes associated with gastric cancer over the past decades, the mechanism of the process of multistage carcinogenesis is still unknown for gastric cancer. The study was designed to investigate the changed gene expression patterns in the gastric carcinogenesis and screening the gastric cancer related genes would provide a credible key to improve the dignosis and therapy of gastric cancer. Materials and Method the PCR products of 8192 human genes were spotted onto a chemical-material-coated-glass plates in array. DNAs were fixed the glass plate after series of treatments. The total RNAs were isolated from the tissues, and were purified to mRNAs by Oligotex. Both mRNAs from the gastric adenocarcinoma and normal gastric mucosa were reversely transcribed to the cDNAs with the incorporation of fluorescent dUTP to prepare the hybidization probes. The mixed probes were hybridized to the cDNA microarray. After high-stringent washing, the cDNA microarray was scanned for fluorescent signals and showed differences between two tissuses. Results Among the 8192 target genes, the expression level of 327 genes differed between gastric adenocarcinoma and normal mucosa, 179 were down-regulated and 148 up-regulated. Conclusion cDNA microarray technique is effective in screening the differentially expressed genes between gastric adenocarcinoma and normal mucosa. Many genes take part in the carcinogenesis of gastric adenocarcinoma. The present study represents a global view of gene expression of gastric adenocarcinoma and provides important clues for further study of gastric adenocarcinoma related genes. centration was detected by ELISA. Tumoregenesis in nude mice was investigated for the siRNA transfected cells. Human umbilical vein endothelial cell (HUVEC) migration and tube formation assay were used to observe the effects of COX-2 downregulation on angiogenesis. Results COX-2 expression was inhibited in the transfected cells (SGC7901/siRNA). COX-2 catalytic product PGE 2 in the transfected cells was also significantly inhibited. Cell growth retardation was observed in COX-2 siRNA transfected cells both in vitro and in vivo. Cell cycle analysis suggested in the transfected cells a G 2 /M phase arrest. In HUVEC migration assay, cell numbers migrated was decreased from (140 ± 13) to (65 ± 10) (p < 0.01). Addtion of vascular endothelial growth factor (VEGF) partially reconstituded the cell migration (95 ± 13, p < 0.05). Tube formation assay suggested that the mean vessel length formed by HUVEC stimulated with culture medium from COX-2 siRNA transfected cells was significantly (p < 0.01) shorter than that from the control cells (10.11 ± 1.39 mm vs 18.45 ± 1.41 mm). Addition of VEGF partially reconstituded the tube formation (14.46 ± 1.14 mm, p < 0.05). Conclusions COX-2 siRNA can inhibit the proliferation of gastric cancer cell SGC7901 and angiogenesis by HUVEC which might be mediated by VEGF.

Expression of Akt/protein kinase B in gastric cancer and its possible implication HONGGANG YU, XIAODONG ZHOU, JIEPING YU, HESHENG LUO

Objectives Protooncogene Akt/protein kinase B (PKB) was found in 1991 and three Akt family members have been identified: Akt1/PKBa, Akt2/PKBb and Akt3/PKBg. Akt was phosphorylated and then activated by Phosphatidylinositol-3 kinases (PI3K)/Akt pathway. Alteration of Akt activity is associated with several human cancers by mediating survival signals and allowing cells to escape apoptosis. The present study was to investigate the expression of Akt and its phoshorylation level in gastric cancer and it possible implications. Methods Phosphorylated Akt (pAkt) and vascular endothelial growth factor C (VEGF-C) protein was detected in 55 gastric cancer tissue samples with pared normal tissues by immuhistochemical SP method. Reverse transcriptional PCR (RT-PCR) was used to detect the transcriptase of Akt1, Akt2 and Akt3 and western blotting was conducted to evaluate Akt and pAkt protein levels in 20 fresh cancer tissue samples of stomach with pared normal tissues. Results Akt1, Akt2 and Akt3 mRNA were constitutively expressed in gastric specimens and their levels in cancers were not significantly different with those in matched normal tissues (P > 0.05). Western blotting analysis demonstrated that the expression levels of Akt protein and pAkt protein in cancers were 1.7-fold (P < 0.001) and 2.1-fold (P < 0.01) higher than those in normal tissues respectively. Immunohistochemically, pAkt protein was found expressed in 67.3% (37/55) gastric cancers and 60.0% (33/55) pared normal tissues. Furthermore, statistical analysis revealed that abundance of pAkt was significantly associated with poorly differentiated phenotype (c 2 = 9.75, P < 0.01), late TNM stage (c 2 = 7.68, P < 0.05) and the presence of distant metastasis (c 2 = 6.56, P < 0.05). In addition, pAkt expression was significantly correlated with VEGF-C immunostaining (c 2 = 15.37, P < 0.0001). Conclusion Overexpression of Akt and pAkt protein is tumor specific and may be a result of alterations of the gene translation and (or) protein metabolism. Akt phosphorylation might contribute to malignant transformation and enhanced aggressiveness of gastric cancer through VEGF-C up-regulation.

To observe the alteration of distribution of immunoreactive 5-HT never/never fiber in visceral hypersensitivity model LIXING ZHAN*, GUOMING XU, ZHAOSHEN LI, DUOWU ZOU, BIN LV* Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China; *Department of Gastroenterology, Zhejiang hospital of TCM, Zhejiang college of Traditional Chinese medicine, Hangzhou, China Objectives To investigated the visceral hypersensitivity model which induced by intraperitoneal injection of chicken egg albumin, and the functional alteration of mast cell in this model. To investigate the distribution of serotoninergic neurons and fibers in the spinal cord and colon of visceral hypersensitivity rat, and the degranulation of mast cell react on the serotoninergic neurons. Materials and Methods SD rats were sensitized by intraperitoneal injection of chicken egg albumin, the colon mast cells were strained to study the alteration of morphology of mast cells. The responses of viscerosensitive neurons were recorded by the abdominal withdrawal reflex to investigate visceral nociceptive transmission on the repeated colon distention. Visceral hypersensitivity rats were divided into two groups (group A and group B), the rats of group B were intraperitoneally injected a stimulator of mast cell degranulation, compound 48/80. Immunohistochemical staining, quantitative analysis of 5-HT in the colon and spinal cord of visceral hypersensitivity rat and control group(group C), were achieved by IHN-Envision method and computerized image system colon hypersensitivity reaction. Results It was showed by the straining of toluidine blue that the number of mucosal and mesenteric mast cells increased significantly compared with the control group and that the granules in mesenteric mast cells were immaturity in control group and the experiment group after 3 days and mostly maturity after 2 weeks in mesenteric mast cells by staining of alcian blue-Safranine. The result of AWR score among 3 ml and 5 ml distention groups increased significantly compared with control group (P < 0.01). Compared with group C, the positive index (PI) of serotoninergic neurons / fibers increased in the submucosa layer in Group A (P < 0.01, 0.634 ± 0.275 vs 0.245 ± 0.131), and the PI in myenteric plexus and in the spinal cord increased significantly (P < 0.05, 0.009 ± 0.004 vs 0.007 ± 0.004, 1.036 ± 0.643 vs 0.949 ± 0.462). The PI of Group B in colon submucosa layer, myenteric plexus and spinal cord (0.958 ± 0.328, 0.012 ± 0.005, 1.732 ± 0.754) is much higher than Group A (P < 0.05). Conclusions The abnormal function of serotoninergic neurons / fibers in colon and spinal cord may be one of the mechanism of visceral hypersensitivity. Mast cell may act on the visceral sensory pathway partly by serotoninergic neurons.

Gastric cancer cell lines SGC7901, 9811, AGS, MKN45, KATO III and gastric epithelial cell line GES-1 were examinned by RT-PCR, western bloting and FACS for the exprsssion of CXCR3 receptor. CXCR3 expression was also anyalysed in human gastric cancer tissues and adjcent normal tissues by western blooting with b-actin as an internal control. Results Both CXCR3 protein and mRNA can be detedcted in all human gastric cancer cell lines with the highest level in KATO III cells. CXCR3 expression in these cells was higher than in normal gastric epithelial cell line GES-1. FACS analysis revealed that CXCR3 was present on SGC7901, 9811, AGS, MKN45 hunam gastric cancer cells with less than 5% cells posistive. However, KATO III human gastric cancer cells showed a significant 9.28% positive rate. In human gastric cancer samples, CXCR3 expression was higher in cancer tissues than in adjcent normal tissues as shown by western blotting. Conclusions Human CXC chemokine receptor CXCR3 is present in human gastric cancer cells, which has not been reported by literature. CXCR3 expression is higher in gastric cancer cells than in their normal counterparts. The presence of CXCR3 on human gastric cancer cells may be related to lymph node metastasis of gastric cancer cells.

Objectives To investigate effect of Helicobacter pylori on genes related to mitochondria-cytochrome c apoptotic pathway in gastric epithelial cells. Materials and Methods RT-PCR and Western Blot were used to measure Bid, Bax, Bcl-2, cytochrome c, caspase-9 and caspase-3 expression in gastric adenocarcinoma tissues and resection margins of 95 patients, and those genes expression in human gastric adenocarcinoma cell SGC-7901 after which had been co-cultured with a cytotoxic H. pylori strain, NCTC 11637. Results Expression of Bid and Bax mRNA in gastric adenocarcinoma tissues without H. pylori infection, with cagA -H. pylori infection and cagA + H. pylori infection increased significantly in turn (Bid, 0.304, 0.422 and 0.855 respectively, P < 0.05; Bax, 0.309, 0.650 and 0.979 respectively, P < 0.05). Bcl-2 mRNA levels in gastric adenocarcinoma tissues with cagA -H. pylori and cagA + H. pylori infection significantly increased, compared with those without H. pylori infection (0.696 and 0.849 vs. 0.411, P < 0.05). In resection margin tissues, expression of Bid, Bax and Bcl-2 mRNA without H. pylori infection, with cagA -H. pylori infection and cagA + H. pylori infection increased significantly in turn (Bid, 0.377, 0.686 and 0.939 respectively, P < 0.05; Bax, 0.353, 0.645 and 1.001 respectively, P < 0.05; Bcl-2, 0.371, 0.487 and 0.619 respectively, P < 0.05). H. pylori could upregulate protein levels of Bid, Bax and Bcl-2 in gastric adenocarcinoma tissues and resection margins, and promote activation of caspase-9 and caspase-3. After coculturing with SGC-7901 cells, NCTC 11637 could upregulate Bid, Bax, and Cytochrome c expression in a time-depend manner and promote activation of caspase-9 and caspase-3 in vitro. Conclusions Apoptosis induced by H. pylori in gastric epithelial cells may be mediated by altered expression of genes related to mitochondrion-cytochrome c apoptotic pathway.

Helicobacter pylori induced apoptosis in gastric epithelial cells through mitochondria-cytochrome C apoptotic pathway HAO ZHANG, DIANCHUN FANG Gastroenterology Research Center of PLA, Southwest Hospital of Third Military Medical University, Chongqing, China Objectives To identify that H. pylori may induce gastric epithelial cells apoptosis through mitochondria-cytochrome c pathway in vitro.

Apoptosis was evaluated in SGC-7901 cells by flow cytometry and effect of caspase inhibitors on apoptosis induced by NCTC 11637 was investigated. Results NCTC 11637 could induce SGC-7901 cells apoptosis in dose-and time-depend manner. When the bacteria : cancer cell ratio was 25 : 1, 50 : 1 and 100 : 1, apoptotic rate was 6.10%, 8.20% and 12.20% respectively at 24 h after coculturing. When the bacteria : cancer cell ratio was 50 : 1, apoptotic rate was 6.10%, 9.40% and 8.20% respectively at 6 h, 12 h and 24 h after coculturing. Apoptosis could be inhibited almost completely by prior incubation with the inhibitors of caspase-3 and -9 (Caspase-9 inhibitor: 1.90%, 2.56% and 3.05% respectively at 6 h, 12 h and 24 h; Caspase-3 inhibitor: 1.30%, 2.40% and 2.50% respectively at 6 h, 12 h and 24 h). Caspase-8 inhibitor could reduce nearly half of H. pylori-induced apoptosis (1.46%, 5.40% and 6.00% respectively at 6 h, 12 h and 24 h). Conclusions H. pylori may directly induce gastric epithelial cells apoptosis in dose-and time-depend manner mainly through mitochondrion-cytochrome c apoptotic pathway.

The 

The synergistic effects and its mechanisms of selective COX-2 inhibitor and 5-fluorouracil in inducing apoptosis in human gastric cancer cell lines LI ZHANG, WENZHONG LIU, HONG LU, ENLIN LI, SHUDONG XIAO Shanghai Second Medical University, Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai 200001, China Aim To investigate the possible synergistic effects and its mechanisms of selective COX-2 inhibitor nimesulide and 5-fluorouracil (5-FU) in inducing growth inhibition and apoptosis in human gastric cancer cell lines.

The human gastric cancer cell lines MKN45 and MKN28 were used in the study. Cytotoxicity was determined by MTT assay. Flow cytometry was used to examine the effect of drugs on the cell cycle. The expression of COX-2mRNA was detected by RT-PCR. The protein of Bax and Bcl-2 were detected by Western blotting. Results Different level of COX-2 mRNA expression was observed in MKN45 and MKN28 gastric cancer cell lines. Treating the two cell lines with nimesulide combined with 5-FU can significantly reduce the expression of COX-2 mRNA. Nimesulide could inhibit the growth of gastric cells in a dose-and time-dependent manner. Combination treatment of Nimesulide with 5-FU resulted in a synergistic cytotoxic effect. The synergistic cytotoxcity was noted irre-spective of treatment sequence but the highest percent cytotoxity was obtained when the cell lines were treated with two drugs simultaneously. The synergistic cytotoxcity achieved with two drugs was shown to be due to apoptosis. Treating with 5-FU enhances expression of the pro-apoptotic gene Bax, while nimesulide reduced expression of the anti-apoptotic gene Bcl-2, resulting in a significantly higher ratio of Bax-to-Bcl-2. Conclusions Combination treatment of gastric cancer cell lines with the selective COX-2 inhibitor nimesulide and 5-FU results in synergistic cytotoxcity and increased apoptosis due to the enhanced Bax-to-Bcl-2 ratio and suppression of COX-2mRNA express.

The experimental study of high cholesterol diet influence on gallbladder calculus formation and gallbladder motility LIN ZHANG, LEI DONG Department of Gastroenterology, Second Hospital, Xi'an Jiaotong University, Xi'an, China Objectives To investigate whether high cholesterol diet can cause gallbladder cholesterol calculus or not, as well as mechanism of influence on gallbladder motility function. Methods Use noumenon dissect and B-type ultrasonic apparatus to observe condition of gallbladder calculus formationin normal control and HCD group. At the same time, measure gallbladder motility function. Use radioimmunoassay to measure plasma CCK level in fast and 30 min after fatty meal.When experiment end, dissect animals, take gallbladder examples to check pathologic change. Results HCD group's gallbladder cholesterol calculus formation rate (80%) is remarked higher than normal control (0%) (P < 0.05). There is no obviously difference between HCD group and normal control in fast CCK level (P > 0.05). But HCD group's CCK level of post-fatty meal is obviously lower than normal control (P < 0.05). The main pathologic change of HCD group is chronic inflammation, there are 9 examples occurred inflammational changes such as gallbladder mucosa edema, exuviations, epithelial proliferation, lymphcell infitrate in tissue, In normal control only 1 example occurred mucosa edema, rest 9 examples have no inflammational pathologic change. Conclusions High cholesterol diet can cause rabbit gallbladder cholesterol calculus. Reasons probably have close relationship with gallbladder motility function obstacle, plasma CCK level decrease and gallbladder inflammation or synthetic action of three factors. There is possible to prevent cholecystolithiasis in diet.

Antitumor effect of trail is not associated with caspase-8 promoter methylation status in human gastric cancer cells RUGANG ZHANG, DIANCHUN FANG, LIUQIN YANG, YUANHUI LUO & ANGEN HU Gastroenterology Research Center of PLA, Southwest Hospital of Third Military Medical University, Chongqing, China Objectives To study the association between antitumor effect of TRAIL and caspase-8 promoter methylation status in gastric adenocarcinoma cells.

Caspase-8 promoter methylation status in 5 gastric adenocarcinoma cells was determined by methylationspecific PCR; Antitumor effect of TRAIL protein was measured by MTT aassay. Results No hypermethylation of caspase-8 promoter was found in all 5 gastric adenocarcinoma cells. Treatment with demethylation Objectives To investigate whether NSAIDs can induce apoptosis of gastric cancer cell lines, to observe the effect of different p53 genotype on NSAIDs induced apoptosis, to elucidate the regulation of NSAIDs on expression of apoptosis related genes.

The anti-proliferative effect of NSAIDs was measured by MTT assay. Apoptosis was determined by acridine orange (AO) staining, Annexin-V/PI double staining, laser scanning cytometry (LSC) and flow cytometry (FCM). Alteration of bcl-2 and bax genes was detected by reverse transcription polymerase chain reaction (RT-PCR). Protein expression was determined by Westernblotting. Results Indomethacin (Indo) and Aspirin (Asp) inhibited both AGS (wild-type p53) and MKN28 (mutant p53) gastric cancer cell lines growth in a time/dose dependent manner. AGS cell line was more sensitive to NSAIDs, which apoptosis percentage was significantly higher than MKN28 under the same condition. The percentages of apoptosis of MKN28 were somewhat higher among NSAIDs treated groups compared with the normal control group, but these slight differences were not statistically significant. The bax mRNA kept increasing since NSAIDs treatment accompanied by a decreasing of bcl-2 gene. The Bax protein increased after treatment while the Bcl-2 protein was undetectable, which tendency was more obvious during 6-24 hs. Conclusions Both Indo and Asp could induce apoptosis in gastric cancer cell lines, which supply a further theoretical foundation to the anti-cancer use of NSAIDs. NSAIDs could not induce notable apoptosis of MKN28, which indicated mutant p53 gene perhaps blocked NSAIDs induced apoptosis. One of the major pathways that mediated the anti-tumour response of NSAIDs in gastric cancer cells was through up-regulation of Bax and down-regulation of bcl-2 genes and/or proteins.

Objective To investigate the alteration and clinical significance of encephalic activated areas by using blood oxygenation dependent functional magnetic resonance imaging (BOLD-fMRI) in patients of irritable bowel syndrome (IBS). Methods From January 2002 to December 2003, based on Rome II criteria, 67 IBS patients including 44 cases of diarrhea predominant symptoms, 23 cases of constipation predominant symptoms and 10 healthy volunteers were enrolled into study. 30 ml, 60 ml, 90 ml, and 120 ml rectal balloon-distention stimuli were performed to all subjects. Rectal sensation and visual analogue scale (VAS) were recorded, activated area and activated intensity of focal encephalic functional area including anterior cingulate gyrus (ACC), prefrontal cortex (PFC), thalamus (THAL) and insular cortex (IC) were measured by using BOLD-fMRI. Results The thresholds of urgency and dyschizia in diarrhea predominant IBS (D-IBS) patients were significantly lower than those of constipation predominant IBS (C-IBS) patients and controls (P < 0.05 respectively). VAS of D-IBS instead of C-IBS patients was much higher than controls when administrated 90 ml and 120 ml rectal balloon-distention (P < 0.05); Activated encephalic areas of PFC and right THAL in C-IBS patients were significantly increased when rectal balloon-distention up to 120 ml (P < 0.05). Besides, activated area of IC, PFC and right THAL in D-IBS patients increased significantly when rectal balloon-distention up to 120 ml (P < 0.05); The alterative signal intensity of IC, PFC and THAL in all IBS patients was significantly higher than controls (P < 0.05) when rectal balloondistention up to 120 ml while it only had significance in intensity of IC when distention up to 90 ml (P < 0.05). Conclusions BOLD-fMRI has its clinic value in assessment of functional alterations of regional brain activation. The results of this study indicated that hypersusceptibility caused by rectal balloondistention could be demonstrated by BOLD-fMRI in IBS patients and both area and intensity of IC, PFC and THAL increased which may be the major encephalic functional areas involving visceral perception.

to check the activity of GAD protein Reverse thanscription polymerase chain reaction (RT-PCR) was performed to examine the expression of GADmRNA. Results Immunoreactive GAD was distributed in the cytoplasm of gastric cancer cells and matched normal cells. Immunohistochemistry analysis showed that GAD activity decreased in gastric cancer tissues relative to matched normal tissues (p < 0.05) RT-PCR analysis showed that the gastric mucosa was GAD65-negative and GAD67positive.

The results of the present experiment prompt one to speculate that abnormalities of GAD activity might contribute to the pathogenesis of human gastric cancer. Moreover, the biological significance of this difference of GAD in human gastric mucosa further supports the multiplicity of GAD in mammalian non-neural tissues.

Objectives To set up immortalized esophageal epithelial cell models imitating the malignant transformation process, and to explore the possible role of COX-2 expression in esophageal epithelial carcinogenesis through studying the alteration of COX-2 and Id-1 expression.

Human esophageal epithelial cell primary culture, NECA6, was isolated from surgically resected specimens that had been histologically diagnosed as normal. RT-PCR for mRNA analysis and Western Blot for protein analysis were undertaken in this study. Human papillomavirus type 16 (HPV16) E6 and E7 open reading frames, and hTERT-the catalytic subunit of telomerase-open reading frame were infected to NECA6. The expression of COX-2 and Id-1 were detected in NECA6 and transfected cells. Results Two immortalization cell models, NECA6-E6E7 and NECA6-E6E7-hTERT were established. The expression of hTERT mRNA was found in NECA6-E6E7-hTERT only, and the HPV-16-E6 was found in both of the two transfected cells but not in NECA6 cells. From NECA6 to NECA6-E6E7, and further to NECA6-E6E7-hTERT, the expression of COX-2 and Id-1 protein increased gradually (P < 0.05). The same tendency was found in mRNA expression of these two genes (P = 0.379, P = 0.064, respectively). Positive correlation was found between the protein but not mRNA expression of COX-2 and Id-1. Conclusions NECA6 could be immortalized by HPV-16-E6E7 via a telomerase independent pathway. The COX-2 expression in esophageal epithelial could be upregulated by HPV-16-E6E7 transfection, and be further stimulated by telomerase activation. A high coincidence between the changes of Id-1 and COX-2 expression in the progress of esophageal epithelial immortalization, which implied that COX-2 expression, may be another potential marker in regulating cell differentiation.

Time-course changes of gastric parietal cell function and ultrastructure in restraint-in-water rats and the effect of acid suppressor on it XIAOPING ZOU, ZHILIANG YU, ZHAOSHEN LI, GUOZHONG ZHOU Department of Gastroenterology, Changhai Hospital, Shanghai 200433, China Objective To assessed the time-course changes of gastric parietal cell function and ultrastructure under stress and the effect of acid suppressor on it. Methods Sprague-Dawley rats, randomly divided into three major groups, were exposed to various periods of stress by immersionrastraint. In Group A, four subgroups rats were killed after 0, 1, 2, or 4 hours of stress respectively. In Group B, rats were randomly divided by 5 subgroups including intact, stress, stress with pretreatment omeprazole (Om), cimetidine (Cm) and saline (NS) respectively. In Group C, rats were randomly divided by 5 subgroups incuding intact and 0, 24, 48 and 72 hours after the end of 4 hours of WRS respectively. Gastric juice pH, ulcer index (UI), the histopathological change of gastric mucosa in light microscope (LM) as well as the ultrastructural change of parietal cells in transmission electron microscope (TEM) were examined to all of the rats after sacrificed. Results The degree of gastric injury was positively correlated with the duration of exposure to WRS (r = 0.9876, p < 0.01). At 4 hours after WRS, gastric mucosa lesions progressed gradually to apparent erosions and haemorrhage. In the histological observations, ulcers involving damage to the musclaris mucosa were observed at 4 hours after WRS. Gastric acid secretion increased with the duration of exposure to WRS concomitant to progression of gastric mucosa damage. The parietal cells underwent a gradually changes from resting to secreting state with the duration of stress and from secreting to resting state after end of stress. Gastric damage of rats with pretreatment of omeprazole or cimetidine were significantly lightened and gastric pH value rised compare with that of without pretreatment them, but the parietal cells of rats with pretreatment of cimetidine presented nonsecreting state, while those of rats with pretreatment of omeprazole presented secreting state. Conclusion Increased gastric acid secretion induced by WRS was in accordance with the ultrastructural changes of parietal cells and was significantly correlated with the degree of gastric mucosa lesion, both omeprazole and cimetidine can mitigate the gastric damage induced by WRS. Gastric acid play an important role in the development of stress ulcer.

after DEN, the number and area of lesion foci or nodules in wild type mice were found much more than those in Bid deficient mice (p < 0.05 and p < 0.001, respectively), but there was no significant difference between wild type mice and Bid deficient mice at 8 months. Conclusion These data suggest that the lack of apoptosis on liver tissues in earlier stage after DEN exposure decrease some tumorigenesis potential of DEN.

Objectives To investigate the effectiveness of the treatment with Stronger-Neo-Minophagen C (SNMC) for Severe acute reapiratory syndrome (SARS); To assess the action of protecting liver and dropping enzyme with SNMC. Methods To select 102 patients, among them 27 patients were treated with SNMC and 20 patients with Glutathione, and 55 ones as contrasting. To observe changes of clinical symptoms, including coughing, chest suffocating, and air shortness and joint pain. It was measured ALT, AST and TBIL in Pre-and post-therapy. Results SNMC can ameliorate symptoms as coughing, chest suffocating, air shortness and joint pain. Hormone maximum dose and time, hormone decreasing time and hospitalization days were no significant difference in two groups. SNMC had actions of protecting liver and dropping transaminase. Blood routine and electrolure got no significant change after SNMC treatment. Conclusion SNMC had actions of protecting liver and dropping transaminase, it probably had a certain effect for SARS and no ill response.

Effects of interferon-alpha on experimental hepatic fibrosis and hepatic stellate cell in rats XINMING CHANG, YING CHANG Department of Gastroenterology, First Hospital, Xi'an Jiaotong University, Xi'an 710061, China Objective To investigate the effects of interferon-alpha on the expressions of transforming growth factor-b1 (TGF-b1), hepatic stellate cell (HSC) and a-smooth muscle actin (a-SMA) in hepatic tissue of rat experimental model induced by CCL4 and study the mechanism of interferon-alpha on prevent or reverse hepatic fibrosis. Methods 110 Sprague-Dawley rats were divided into five groups: 1. group A (normal controls) of 18 rats; 2. Group B (fibrotic model controls) of 22 rats; 3. Group C (IFNa prevention) of 22 rats were initiated treated with muscle injections of interferon-a in saline, administered daily in the doses of 1 ¥ 105 U for 6 W; 4. Group D (IFNa treatment) of 24 rats were treated with muscle injections of interferon-a in saline, administered daily in the doses of 1 ¥ 105 U for 6 W since the end of the sixth week; 5. Group E (0.9% sodium chloride treatment controls) of 24 rats, model of group B, C, D and E were all induced by carbon terrachloride (CCL4), high cholesterol and low protein At the end of the experiment, all rats of each group were killed, Samples of the liver obtained by biopsy were submitted to histological, immunohistochemical and electron microscope studies for the expressions of TGF-b1 and a-SMA.

The expressions of TGF-b1, the number of activated HSC and a-SMA in hepatic tissue in the group C was significantly less than that of the group B (P < 0.01). The degree of fibrosis score in group B was also significantly less than that of the group C under light microscope (P < 0.01). Conclusions IFNa could inhibit the production of TGF-b1, decrease HSC activated and stimulate its apoptosis, may be part of the mechanisms underlying the suppressive effect of IFNa on liver fibrosis.

Body mass index BMI) (OR: 4.392) was positive correlation to fatty liver in the patients with type 2 diabetes. In contrast, insulin sensitivity index (ISI) (OR: 0.000) and regular insulin treatment (OR: 0.058) were negative correlation to it. The abnormal frequencies of aspartate aminotransferase (AST, 6.0%), alanine aminotransferase (ALT, 25.2%), the ratio of AST/ALT less than 1 (52.8%) and gammaglutamyltransferase (GGT, 31.9%) of type 2 diabetes patients with fatty liver were significantly higher than those without fatty liver (3.2%, 6.4%, 36.5% and 11.1% respectively) . Conclusions Obesity and insulin resistance might increase the risk of fatty liver in the patients with type 2 diabetes. Patients of type 2 diabetes with fatty liver show higher serum lipid level and more obvious damages of liver function than without fatty liver.

Patient, man, 41-year-old was admission on 16th June 2003 because of both lower extremities inertia and walking lability. Chronic hepatitis B 10 years, posthepatitic cirrhosis 4 years, hepatic encephalopathy repeated half year, now recovery after treated. A month ago, the patient felt both lower extremities inertisa, but could walk normally. Subsequencely, both lower extremities inertisa and heavy became serious. He walked lability like walking on the cotton, body-oscill left and right, particularly closing his eyes, could not jumped on single foot. He felt both lower extremities no numbness and no bondage. No urinary and fecal incontinence. Physical examination: Phanero-mind, spastic gait, hepatic facies, liver palms, spider angioma, sclera yellow stained, corner Kayser-Fleischer cirle (-). Heart and lung normal. Abdomen full, liver untouched infraribs, spleen 2 cm infraribs, quality nature middling, shifting dullness (-). All limbs no myatrophy, both upper extremities muscle power and muscular tension normal, both lower extremities muscu-lar tension increased and muscle power 4 grade, both knee jerk active, both Babinski (+), deep and light sense normal. Laboratory examination: Wbc3.1 ¥ 10 9 /L, N0.69, L 0.24, Rbc2.85 ¥ 10 12 /L, Hb 98 g/L, Plt 40 ¥ 10 9 /L. Liver function: ALT44 IU/L, AST83 IU/L, ALP138 IU/L, g-GT69 IU/L, Tbil 57.1 umol/L, Ibil 16.3 umol/L, Dbil 40.8 umol/L, Bile acid 4.5 umol/L, TP 48.9 g/L, albumin 27.2 g/L, globulin 21.7 g/L, A/G 1.2, pre-albumin 0.06 g/L. blood ammonia 130~197 umol/L. AFP, CEA normal, HBsAg(+), anti-HBe(+), anti-HBc(+). B ultrasound: liver cirrhosis, portal vein broaden lightly and embolization, splenomegaly. Upper digestive tract barium meal: esophageal vein varicosis. Cranium CT: no occupied position lesion. EEG: borderline state change.Thoracid and lumber spine MRI: normal. Examination of cerebrospinal fluid did not be done because the patient refused to accept. Clinical diagnosis: Posthepatic B cirrhosis (failure compension), hepatic meylopathy. After therapy of protecting liver, decreasing blood ammonia, nutrating nerve cell for 2 months, and the patient was discharged. The symptom of both lower extremities inertia and walking liability was no significant remission and no significant deterioration either.

Pharmacological affection of cardiotonic pill in treating the nonalcoholic steatohepatitis GANG DING

Objective To test the pharmacological affection of Cardiotonic Pill, traditional Chinese medicine which has high ability in antioxydant and hepatic protection, in treating the Nonalcoholic steatohepatitis NASH) y observing the change of hepatic function (ALT, AST). Method 26 patients suffering NASH, 14 male and 12 female arranged randomly into 2 groups, 14 in treatment group and 12 in control. They all drunk less 40 g alcohol everyweek, AST 97.4 u/ml (mean), AST 78.3 u/ml mean), no virus hepatosis and other hepatic disease. Treatment group: Vc 0.2 g Tid, Tiopronin 0.2 g Bid, Cardiotonic Pill 10 pills Tid; Control: Vc 0.2 g Tid, Tiopronin 0.2 g Bid. Examined their plasma AST and ALT in the 4th and 8th week after treatment.

[Result]: In the 4th week, treatment group mean ALT reduce 23.3 u/ml, AST reduce 12.1 u/ml, control ALT mean reduce 16.1 u/ml, AST reduce 7.0 u/ml; 8th week control group mean ALT reduce 41.7 u/ml AST reduce 27.1 u/ml, control group mean ALT reduce 21.5 u/ml, AST reduce 13.7 u/ml. There are significant difference between the two groups in ALT and AST reduction in the 8th week after treatment. Conclusion Cardiotonic Pill can protect hepatocellular, ameliorate NASH, and promote the liver recovery. Purpose To investigate scoring model of severe liver diseases (MSLD) in order to predict scientifically and accurately the prognosis of patients with severe type viral hepatitis, and to estimate the surviving time of these patients in order to provide a scientific basis for judgment clinical treatment.

Using MSLD, which has been established in our previous study, we prospectively studied the prognosis of patients with severe type viral hepatitis. One hundred and three patients with severe type viral hepatitis were included by Cohort study. Of them, there are 85 chronic severe type hepatitis patients, 10 acute and 8 subacute severe type hepatitis patients. The follow-up endpoint was 6 months. The cutoff score of the MSLD was determined by ROC statistic analysis and the survival rate of severe type hepatitis patients in 2 weeks, 4 weeks, 3 months and 6 months were estimated by Kaplan-Meier statistic analysis. Results The cutoff MSLD score for predicting survival was 5. The survival curves of group A (total MSLD score £ 4) were significantly better than group B (total MSLD score ≥ 5), (P = 0.000), After treatment for two weeks, the survival in 2 weeks and 4 weeks are 37.9% and 3.5% if MSLD score had no change or increased. The survival rate in 2 weeks, 4 weeks and 3 months were 61.5%, 15.4%, 5.8% respectively if the MSLD score decreased 1. Then, the survival rate in 2 weeks, 4 weeks, 3 months and 6 months were 95%, 90%, 63.9% and 52.4%, respectively if MSLD score decreased 2 score or more. Conclusions It is suggested that MSLD may play an important role to predict 6-month survival of severe type viral hepatitis patients. It may be regarded as a index to determine the efficacy of internal medicine treatment, and to guide reasonable treatment decision.

Clinical research of combination rhGH and lactulose on prevention and treatment mod in patients with chronic severe hepatitis HUIGUO DING, JING SHAN, BIN ZHANG, HONGBO MA, LI ZHOU

Objective To evaluate the efficiency and safety of human growth hormone (rhGH) combination with lactulose as treatment and/or prevention of chronic severe hepatitis B with Multiple organ disfunction (MOD). The mechanism of drugs was also studied.

Forty-eight inpatients with chronic severe hepatitis B were studied and were randomizedly divided into rhGH group (n = 28) and control group (n = 20), respectively. In rhGH group, 4~4.5 IU of rhGH was intramuscle injected daily for 2-4 weeks and 100 ml of enemas contained 30 ml of Lactulose, 2 g of metronidazole and 0.9% saline was enemaed every two days for 2~4 weeks. The serum GH, IGF-1, IGFBP1 and IGFBP3 were respectively measured by ELISA. Results Clinical symptoms of 90% of these patients in rhGH group were obviously improved. The total efficiency in rhGH group was better than control group (75% vs 40%, p < 0.05). The serum Albumin (26.1 ± 4.1 before VS 30.2 ± 5.3, 31.9 ± 5.1 g/L after 2, 4 weeks respectively), prealbumin (79.6 ± 28.0 VS 106.6 ± 54.4, 108.4 ± 55.0 g/L after 2, 4 weeks respectively), cholesterol (76.3 ± 16.7 VS 85.6 ± 32.3, 96.1 ± 38.7 mg/dl after 2, 4 weeks), and IGFBP1 (56.8 ± 47.2 VS 89.7 ± 50.3 ng/ml after 2 weeks) significantly increased after rhGH treatment (p < 0.05). However, the serum GH was decreased. The tendency of increase of serum IGF 1 and IGFBP 3 after rhGH treatment was also observed. Conclusions rhGH combination with lactulose may be beneficial to prevention and treatment chronic severe hepatitis with multiple organ disfunction. These data provide preliminary evidence that rhGH combination with lactulose may be a novel approach for prevention and/or treatment of severe hepatitis concurrent with multiple organ disfunction.

Effects of tetrandrine on NFkB activation in hepatic stellate cells YICHAO Aims Activation of hepatic stellate cells (HSCs) is a key event in hepatic fibrogenesis. A hypothesis in therapeutic approaches to hepatic fibrogenesis is to inhibit HSCs activation via the NFkB pathway. In this study, we investigated the effects of tetrandrine, an alkaloid with anti-inflammatory activity, on the NFkB activation pathway in HSCs.

A cell line of rat hepatic stellate cells (HSC-T6) was stimulated with tumor necrosis factor a (TNF-a). We used a transient transfection (luciferase reporter gene) assay to determine the transcriptional activity of NFkB. Western blotting and immunofluorescent staining were carried out to investigate the NFkB activation pathway. Results After TNFa treatment, IkBa degradation and NFkB translocation were observed within 20 minutes in HSCs. Moreover, pro-inflammatory genes, including macrophage imflammatory protein (MIP-2), intercellular adhesion molecule 1 (ICAM-1) and inducible nitric oxide synthase (iNOS) were up-regulated at 2 hours. TNFa, lipopolysaccharide, phorbol 12-myristate 13-acetate and hydrogen peroxide (H 2 O 2 ) significantly induced NFkB transcriptional activity, and tetrandrine (0.5-5.0 mM) concentration-dependently inhibited NFkB transcriptional activity and NFkB (p65) translocation into nucleus. Tetrandrine also attenuated TNFa stimulated mRNA expressions of MIP-2 and ICAM-1, but not iNOS. Conclusions Tetrandrine exerted inhibitory effects on the the NFkB activation pathway in HSCs.

Natural history of minimal hepatic encephalopathy in cirrhosis and the reversal effects of lactulose LIN JIA, ZHENG ZENG, YUYUAN LI, YUQIANG NIE

Objectives Minimal hepatic encephalopathy (MHE) was often termed as SHE before. However, its natural history and the clinical efficacy of lactulose were unknown. The present study was conducted to study the natural history of MHE in cirrhosis and the reversal effects of lactulose.

Psychometric tests (number connection test, NCT and digital symbol test, DST) and/or somatosensory evoked potential (SEP) were administered for diagnoses of MHE and a quantitative evaluation of the efficacy of lactulose. Sixty MHE patients were randomly divided into 3 groups of 20 cases: short-term lactulose group, long-term lactulose group (administered orally with lactulose 15-90 ml/d for 8 weeks and 24 weeks respectively) and non-lactulose group (vitamin B complex only). NCT, DST and SEP were revaluated during 6 months follow-up period. The incidence of MHE and overt hepatic encephalopathy (HE) was recorded. Results In 20 MHE patients of non-lactulose group, there were 12 patients whose neuropsychological defects had remained nearly unchanged; clinical neurological exam continued to be negative, the other 8 patients (40%) that Child-Pugh grade A,B and C were 1,2,5 respectively had deteriorated and experienced HE during 6 months. Besides, significantly more patients with MHE in short-term group developed overt HE than patients in long-term group 6 months after (30% vs 5% respectively, P < 0.05). Compared with long-term group, psychometric test in short-term group was only improved temporarily, which were deteriorated after cessation of lactulose. Conclusions MHE has clinical significance as it proceeds overt HE and is associated with a poor prognosis. Long-term treatment with lactulose can significantly reverse the neurophysiological defects in MHE and cut down the occurrence rate of overt HE.

Objective To investegate the effects of acetaldehyde on the proliferation and the expression of NF-kB and IkB in rat hepatic stellate cells (HSC) and explore its mechanism. Methods HSC were isolated with method of density gradient centrifugation after digest in pronase E and collagenase IV, and then studyed the relationship between acetaldehyde and the proliferation, the expression of NF-kB and IkB in HSC, by means of MTT, Immunohistochemistry and EMSA. Results (1) The freshly isolated HSC proliferated significently after 24 hours stimulated by acetaldehyde with a concentration of 200 Um (2.21 ± 0.10 vs 0.52 ± 0.05, P < 0.01).

(2) The expression of IkB was inhibited when stimulated by acetaldehyde with a concentration of 200 uM (0.3227 ± 0.02054 vs 1.6043 ± 0.3182, P < 0.01). (3) 30 minutes after stimulated by acetaldehyde (200 uM), the expression of NF-kB in HSC increased, 120 after stimulated by acetaldehyde (200 uM), the NF-kB activity in HSC was provoked to the peak (3.9254 ± 0.8163 vs 0.8253 ± 0.0417, P < 0.01). Conclusions Acetaldehyde can inhibite the expression of IkB and activate the expression of NF-kB in quiescent HSCs then activated HSCs proliferate.

Relationship between focal adhesion kinase and hepatic stellate cell proliferation during rat hepatic fibrogenesis HUIQING JIANG, XIAOLAN ZHANG

Objectives To investigate dynamic expression of focal adhesion kinase (FAK) protein and FAK mRNA in fibrotic rat liver tissue and the relationship between FAK and hepatic stellate cell (HSC) proliferation.

The rat hepatic fibrosis was induced by bile duct ligation (BDL). Histopathological changes were evaluated by hematoxylin and eosin staining, and by Masson's trichrome method. FAK mRNA in the rat livers was determined by reverse transcription-polymerase chain reaction (RT-PCR), and the distributions of FAK were assessed immunohistochemistrically. Numbers of activated HSCs were quantified after alpha smooth muscle actin (a-SMA) staining. Results With the development of hepatic fibrosis, the positive staining cells of a-SMA increased obviously, which were mainly resided in the portal ducts, fiber septa and perisinuses accompanied by proliferating bile ducts. The positive staining areas of the rat livers in model groups at 1 to 4 week after ligation of common bileduct (12.88% ± 2.63%, 22.65% ± 2.16%, 27.45% ± 1.86%, 35.25% ± 2.34%, respectively) were significantly larger than that in the control group (5.88% ± 1.46%), P < 0.01. The positive staining for FAK significantly increased, which were mainly situated in portal ducts, fiber septa and around the bile ducts, vascular endothelial cells and perisinusoidal cells. The expression of FAK was positively correlated with a-SMA expression (r = 0.963, P < 0.05). Western blotting analysis results displayed that the expression of FAK protein was up-regulated with model course. FAK mRNA expression was obviously upregulated in the model groups compared to the control group. Conclusions These data suggest that expressions of FAK protein and mRNA are greatly increased in fibrotic rat liver, which may play an important role in HSC proliferation and hepatic fibrogenesis. Objectives To determine the inhibition of M1RNA ribozyme directed against the mutant-type p53 gene (mtp53) at codon 249 in exon 7 (AGGAEAGT) both cell-free system and MHCC97 cell lines. Materials and Methods M1RNA ribozyme directed against the mtp53 at codon 249 was designed by computer and cloned into the eukaryotic expression vector pBSKneoU6 (pU6M1RNA). In vitro, M1RNA ribozyme was driven by T7 RNA polymerase promoter. In cell lines, U6 promoter was driven by RNA Pol III. The mtp53 and wild type p53 (wtp53) gene fragments were cloned into the pGEM-T vector under T7 promoter control.The 32 p-labeled mtp53 transcript was the target RNA. Cold M1RNA ribozyme transcripts were incubated with 32 p-labeled target RNA in cell-free system and radioautographed after denaturing polyacrylamide gelelectrophoresis. The pU6M1RNA was introduced into MHCC97 cells by LipofectA-MINE AM 2000 and individual G418-resistant colonies were picked up and grown. The mtp53 expression was analyzed by RT-PCR, Northern Blot and Western Blot. Results M1RNA ribozyme showed a specific cleavage activity against mtp53 with cleavage efficiency of 58%, while the wild type p53 was not cleaved. After transfection into MHCC cell line, the mtp53 mRNA level and protein expression were inhibited by M1RNA ribozyme. Conclusion These findings suggest that the M1RNA ribozyme against the mtp53 is a new promosing gene theraputic agent against hepatocellular carcinoma. The M1RNA ribozyme technology is not limited to a specific case but may have broad general applicability in gene therapy. Our results also demonstrated that the U6 expression system is very efficient and suitable for the expression of small RNA, such as ribozyme and RNA interference.

The relationship between change of gastricreceptive relaxation function and gastroelectrograph in stressed rats CHANGPING LI, JUNFENG ZHANG, YIJUN ZOU, ZHEZHONG CUI, ZHIQIANG FENG Departments of Gastroenterology, The Affiliated Hospital, Luzhou Medical College, Sichuan Province, Luzhou, China.

Objectives To investigate the change of receptive relaxation function of and gastroelectrograph in stressed rat. Materials and Methods 20 rats were divided into control group (C) and experimental group (E) randomedly. E group was treated with electric stimulus through feet (I = 0.8 mA T = 1 h) and gastric volume under constant pressure infusion was measured and gastroelectrograph recorded. Results The gastric mean volume decreased remarkably when the pressure is 4 cmH 2 O (E: 25.20 ± 6.34 mlvs C: 36.78 ± 6.21 ml t = 3.14 p = 0.005 < 0.01) in E group, while when the pressure is 6 cmH 2 O and 8 cmH 2 O, the change showed no statistic difference. The mean amplitude of gastroelectrograph was 160.09-485.30 uv, mean frequency was 1.82-3.58 per minute. IC was 1.82-3.58 in stressed rats. Conclusion Gastric volume decreases remarkably under lowpressure infusion in Stressed rats. It may suggest that mean gastric receptive relaxation function decreases while amplitude of gastroelectrograph and mean frequency reduce.

Rapid amplification of cDNA ends (RACE) method was used to clone the complete cDNA of P65. Restriction sites of endonuclease were introduced into its open reading frame (ORF) by PCR. Digest the PCR products and expression vector pEGFP-C1 and ligate them together (named pEGFP-ORF). pEGFP-ORF and pEGFP-C1 were transfected into cell line HepG2 and L02, the cells stably expressing pEGFP-ORF and pEGFP-C1 were named HepG2/ORF, L02/ORF (test group) and HepG2/C1, L02/C1 (control group) respectively. The differences of biological character between the two groups were detected. Results A 1333 bp sequence was obtained (named IDD01), and submitted to GenBank (accession number-AY541587).The abilities of proliferation and clone forming on soft agar were enhanced in HepG2/ORF and L02/ORF (P < 0.05), and FCM showed increased cell division in the phase of G2+S/M, but L02/ORF could not form clones on soft agar. Conclusions 1. IDD01 is cloned for the first time. 2. The IDD01 eukaryotic expression vector pEGFP-ORF is constructed. 3. The expression of pEGFP-ORF can enhance malignant phenotype of HepG2. 4. The expression of pEGFP-ORF can promote the growth of L02, but can not make them malignant transformation.

Relationship between genetic polymorphism of cytochrome p450IIe1 and the development of fatty liver JINGTAO LI, HONGCHUANG ZHAO

Objective To investigate the relationship between the genetic polymorphism of Cytochrome P450IIE1 and the development of fatty liver.

Using PCR-RFLPs method, we analyzed the CYPIIE1 gene detracted from peripheral mononuclear cells of 73 fatty liver patients, 26 non-steatosis and 20 healthy control. The PCR production was a 410 bp fragment. After treated with RsaI and PstI, the genotype of CYPIIE1 was seperated into three types: type A, homozygote c1/c1; type B, heterozygote c1/c2; and type C, homozygote c2/c2. Result The distribution of CYPIIE1 had no relationship with age and sex. In 28 patients with alcoholic steatosis, the prevalence of type A was 28.6%, type B 50% and type C21.4% (c1 allelic frequency was 53.6%, c2 46.4%). All 8 heavy drinkers who did not have liver diseases were type A and c2 gene was not detected. The gene distribution in these two groups had no relation with daily alcohol consumption and duration.The prevalence of type A was 31.1%, type B 53.3% and type C 15.6% in 45 patients with non-alcoholic steatosis (c1 57.75%, c2 42.25%). In 18 patients with non-steatosis control, type A was 88.9% and type B was 11.1% (c1 94.45%, c2 5.55%). In 20 healthy subjects, type A was 85% and type B was 15% (c1 92.5%, c2 7.5%). Compared alcoholic steatosis group with heavy drinker without liver diseases group and healthy control, c1 decreased and c2 increased significantly. Between heavy drinker without liver diseases and healthy control, the gene frequence had no difference. Compared non-alcoholic steatosis group with non-steatosis control and healthy control, c1 decreased and c2 increased significantly. Between nonsteatosis control and healthy control, the gene frequence had no difference. The same condition between the non-alcoholic steatosis and alcohlic steatosis. Conclusion RsaI and PstI RFLPs played a role in the fatty liver susceptibility and c2 gene might be related to the development of diseases.

The diagnostic value of coagulation factors in assessing inflammatory grading in patients with chronic hepatitis B QIN LI, BAOEN WANG, YULONG CONG, JIDONG JIA, FUKUI ZHANG, XIAOJUAN OU, HONG MA Liver Research Center, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing, China Objectives Prothrombin time (PT) is an important index not only in clinical staging of liver disease, but also reflecting liver synthesis, reserve, disease severity and prognosis. The aim of the present study was to determine the role of PT and coagulation factors in assessing the inflammatory grading in patients with chronic hepatitis B.

Plasma of 108 patients with chronic hepatitis B proved by liver biopsy was collected. PT, APTT, HPT, FII : C, FV : C, FVII : C, FVIII : C, FIX : C and FX : C were determined by Diagnostica STA-R automatic clot detector made in France. Results The differences of PTA, HPTA, FII : C, FVII : C, FIX : C and FX : C between G1~2 group and G3~4 group were statistically significant (p < 0.01). The abnormal rates of FII : C, FIX : C and FX : C were 27%, 7.0% and 33.8%, respectively, in the former group; 72.7%, 42.1% and 54.5%, respectively, in the latter group (p < 0.05). ROC analysis showed that at cut-off values of 58.5% and 83.0%, the diagnostic sensitivity of FII : C and FIX : C for inflammatory degree were 67.9%, 64.3%, respectively; The specificity were 81.7% and 76.7%, respectively. Binary Logistic regression analysis showed that HPTA, FII : C, FIX : C, ALT and PIIIP were statistically significant (P < 0.000) in differenciating G1~2 and G3~4 groups. Regression result showed that FII : C, ALT and PIIIP could help predict inflammatory grading, with an accuracy of 81.8%. Conclusions FII : C may serve as a helpful marker in evaluating inflammatory status in patients with chronic hepatitis B. the screening in the place with high incidence of cancer of liver. It has a great significance in the detection of the cancer of liver early and theraphy timely. Objectives To study the therapeutic effect of arsenious acid on hepatoma and compare with Epirubicin and Mitomycin. Recombinant adenovirus Ad-IkBaM was used to enhances the effect of chemotherapies.To investigate the functions and mechanisms of arsenious acid in hepatoma treatment. And explore a new way that routine chemotherapy combine with gene therapy on treatment of hepatoma.

The hepatoma cell lines (BEL-7402 and SMMC-7721) were divided to different groups. Chemotherapy groups were treated with arsenious acid and routine chemotherapy agents (Epirubicin or Mitomycin) respectively; combination groups were transfected with Ad-IkBaM, then after 24 hours, arsenious acid or routine chemotherapy agents were added respectively; the cultured hepatoma cells were used as control groups. Proliferation inhibition and apoptosis were tested by MTT, TUNEL and DNA Ladder. The methods of EMSA and Western blot were used to detect the activity of NF-kB, which can be blocking by Ad-IkBaM.

The result of MTT indicates that the proliferation of all treated cells was greatly suppressed.The difference between arsenious acid and routine chemotherapy agents, Ad-IkBaM combined arsenious acid and Ad-IkBaM combined routine chemotherapy agents have no statistical significance; the difference between chemotherapy groups and combination groups was significantly (p < 0.05). The apoptosis of hepatoma cells is increased in chemotherapy groups and greatly increased in combination groups. The results of Western blot and EMSA showed that, NF-kB has certain activity in control cells, the activity of NF-kB was increased after treated with chemotherapy agents, and it decreased after transfection of Ad-IkBaM. Conclusions The arsenious acid has the likely effect with Epirubicin and Mitomycin.These results showed that Ad-IkBaM enhances apoptosis of hepatoma cells through inhibiting activity of NF-kB. Gene therapy can increase the curative effect of chemotherapy in tumor treatment. With the development of research, gene therapy combining with chemotherapy will become one of the best ways in tumor therapy.

The expression of pulmonary ET-1 and its receptors in rats of hepatopulmonary syndrome MEI LIU 1 , KUOHUAN Objectives To investigate the role of ET-1 and its receptors in the mechanism of hepatopulmonary syndrome in rats. Methods The level of lung ppET-1mRNA was determined by RT-PCR, and the distribution and expression of two kinds of subtype receptor of ET-1, ETRA and ETRB were evaluated by in situ hybridazation.

The level of lung ppET-1mRNA in HPS group was 2. 3 folds higher than that in Sham group (0.48 ± 0.06 vs 0.21 ± 0.04, P < 0.05). No distinct alteration of the distribution and the staining intensity of ETRA in pulmonary vascular was seen between HPS group and Sham group, but significant enhancement of ETRB staining in endothelium of distal small vascular were observed, especially in small veins.There was no difference of the ETRA staining area and average optical density between two groups (P > 0.05), while that of ETRB was higher than control (P < 0.001). Conclusions The gene expression of ET-1 increased in lung of HPS rats; the dilatation of the pulmonary vascular may be the final effect of ET-1 because of the increasing expression of ETRB.

A case of hepatic peliosis XIN LIU, JUN GONG, ZHENNI ZHANG

We reported a 67-year-old man with 1 month's history of abdominal distention and anorexia. The patient had taken some uncertain traditional Chinese medicine 2 months ago because of fracture of Lumbar Vertebra. Physical examination showed shifting dullness was positive and the enlargement of the liver was present. The tests of abdominal B-ultrasound, CT and MRI gave the same result. The needle biopsy of liver was done at last, which showed random bleeding in lobules of liver and hepatocyte swelling. Our review of the clinical and radiological findings, especially the needle biopsy of liver suggested that he was suffering from hepatic peliosis.

Follwing treatment of Chinese herbs for chronic hepatitis b infection XINMIN LIU, JIANPING WANG, YING XIONG, HAIJIAN GUO, RUODAN LIU, RUFENG HUANG Department of Gastroenterology, Second Hospital of Shenzhen, Shenzhen, China Objectives To describe and report two cases who suffer from a plumbism following treatment of Chinese herbs for chronic hepatitis B infection. Materials and Methods Two patients are described who suffer from a plumbism after taking Chinese herbs to treat chronic hepatitis B infection. One of the two patients, male, aged 27 years, was treated by Chinese herbs bought from Wuhan and the other one, female, aged 24 years, was receiving Chinese herbs bought from Guangzhou. Results After they received the treatment of Chinese herbs, the male patient had a stomach-ache off and on in the past 6 months and the female patient had an upper abdominal pain companied with vomiting for one month. Microelement test showed that lead level of blood and urine in the two patients was significantly increased. The lead level of blood and urine in the male patient was 4.93 mmol/L (normal < 1.45) and 0.52 mmol/L (normal < 0.39) respectively. The level of blood and urine in the female patient was 7.83 mmol/L and 1.21 mmol/L respectively. The lead content of Chinese herbs taken by the male patient was from 7.83 mg/g to 6455.20 mg/g and the lead content of Chinese herbs taken by the female patient was from 12.21 mg/g to 3569.70 mg/g. All of them were diagnosed as plumbism and were treated with Calcium Disodium Edetake. Conclusions The case report shows that abusing Chinese herbs may result in plumbism. Methods Six patients with thrombosis of the PV and SMV were treated by transjugular intrahepatic portosystemic shunt (TIPSS) Pathway. All 6 patients presented with abdominal pain, distention, and anorexia etc. No clinical signs of peritonitis were seen. The diagnosis was established by Doppler ultrasound scan and contrast enhanced CT. Control PV-SMV venography was performed after access to the PV branch. Then aspirate and fragment the thrombus in the PV and SMV. Contemporaneous local thrombolysis with urokinase (UK) was delivered through a catheter in the SMV. After the majority of the clot was cleared with flow restoration in the main trunk, a 4-French multiple side-hoes catheter was put in the SMV and UK was continuously infused for 3 to 13 days.

The majority of the thrombus in PV and SMV was cleared with flow restoration in all patients after the procedures. Clinical improvement was seen in 5 patients, characterized by progressive reduction of abdominal pain, distention, and diarrhea. Before removal of the infusion catheter at the SMV, venography revealed complete resolution of the thrombosis in 3 patients, and residual thrombus in the PV branches in 3 cases without clinical significance. Follow-up Doppler ultrasound scans performed during 4-36 months after the procedure confirmed patency of the PV and SMV. The symptoms did not recur. Conclusions With the TIPSS pathway catheter-directed thrombolysis, are safe and effective in the treatment of PV and SMV thrombosis.

Detection of plasma beta-carotene in patients with liver cirrhosis XINLIANG LU, QIN DU, JUNFU ZHOU

Objective To explore the change of beta-carotene in patients with liver cirrhosis and its significance.

The plasma levels of beta-carotene (P-b-CAR) and lipoperoxides (P-LPO), and the activities of erythrocyte superoxide dismutase (E-SOD) and lipoperoxides (E-LPO) in 63 patients with liver cirrhosis were measured, using sex-and agematched subjects from healthy people as the control group. Linear regression and Pearson correlation were performed among the factors in cirrhosis patients. Results Compared with the control group, the levels of P-b-CAR and E-SOD were significantly decreased in the liver cirrhosis group (all P < 0.01), and the levels of P-LPO, E-LPO and CRP significantly increased in liver cirrhosis group (all P < 0.01). The levels of P-b-CAR and E-SOD gradually decreased in the schistosomal hepatic fibrosis group, posthepatitic cirrhosis group and alcoholic cirrhosis group (all P < 0.01); While the levels of P-LPO, E-LPO and CRP progressively increased for the same groups (all P < 0.01). Correlation analysis showed that there were linear correlations between the P-b-CAR contents and the age, E-SOD, P-LPO, E-LPO and CRP levels (all P < 0.01). There was no relationship between the P-b-CAR contents and the Child-Pugh score (P > 0.05). The stepwise regres-sion showed that the P-b-CAR contents correlated most closely to E-SOD and CRP levels. Conclusions The levels of beta-carotene decreased significantly, and correlated with the etiologic factors of cirrhosis, oxidation and antioxidation in the patients with liver cirrhosis.

Expression Objectives To study the effects of telomerase antisense oligodeoxynucleotides on liver cancer cell, the investigation for ASODN -t as gene therapy supply clinic dependent appliance up basis.

The human liver cancer cell line SMMC-7721 was incubated, treated with ASODN -tt (5¢GTGAGTTGGGT-TAGAGA3¢) and control N-ODN group, the cell grown and change were observed by invert optical microscopy, extracted DNA and electroresish agarose gel to visualized under violet light, electrophoretic bands were photographed, the incubated cell with stained PI, and analysed with flow cytometry. Telomerase activity was detected with conventily assay read OD value at 450 nm, results were statisticsed. Results After the cancer cells were incubated with ASODN -t , cell proliferation was inhibited in a dose and time-dependant manner, the exhibited characteristics of apoptosis of including apoptositic bodies, detected activity OD value of melomerase was marked laid down (0.06), compared from control group (0.14 P < 0.001). DNA was extracted and electroporesished agrarose gel, the identify electrophtorate band were photographed. Flow cytometer assay, a reduced DNA content in apoptotic cell under PI stanning displays a "sub-G" subbiploid apoptotic peak in FCM prolile. That was described ASODN -t group, not in control group. Conclusions The telomerese antisense oligodeoxynucleotidess can effectively inhibite to activety of telomerase liver cancer cell, induce to apoptosis and represse to proliferation of cancer cell in dose and time-dependant manner, due to almost normal somatic cell with the absence of telomerase activity, this kind drug can enhance the specificity of treatment for hepatoma without side effect, it is anti-tumor agent provided a tremendous value and open up a bright prospects for effective elomerasese inhibitor in clinic appliance.

Clinical observation of liver cirrhosis ascites treated additionally by external application of mirabilite XIN MAO, YONGPING LI, GUANQIU JIN Dept. of Digestion, No. 411 Hospital of PLA, Shanghai, China Objectives It is important to use noninvasive method to differentiate the liver fibrosis and cirrhosis. A prospective study was conducted to evaluate the validity of ultrasonography (US) for the diagnosis of severity of liver fibrosis in patients with chronic virus hepatitis in comparison with pathologic diagnosis of liver biopsy specimens.

A total of 324 patients were evaluated for the fibrosis status of liver by both needle biopsy and US. The pathologic classification of liver fibrosis was divided into S0-S4 five stages. The US examination included qualitative description of liver surface and parenchyma, and the quantitative parameters were vascular diameters, blood flow velocity and spleen size. Results US qualitative description of liver surface and parenchyma was related to the severity of fibrosis. The analysis of US quantitative parameters showed, that the increase of spleen length began at stage 3 of liver fibrosis, while the diameter of portal vein increased later than the spleen length and diameter of spleen vein. A cut-off value of 12.1 cm for length of spleen had a sensitivity of 0.600, and a specificity of 0.753 for detection of early liver cirrhosis. For other quantitative parameters the cut-off values were 8 mm for diameter of spleen vein, and 12 mm for diameter of main portal vein.The diagnostic sensitivities for these parameters were 0.600, and 0.767; The diagnostic specificity were 0.781 and 0.446 respectively. Conclusions Severe liver fibrosis or cirrhosis could be predicted by US, the results were moderately well related with pathologic diagnosis of biopsy. Single US parameter had limited sensitivity and specificity in diagnosis of early cirrhosis, in clinical practice combination of 2-3 parameters could be used to detect or exclude severe liver fibrosis.

A experiment study of the pro-apoptotic function of introduction of maxizyme against mutated p53 on MHCC97 cells by adenovirus-enhanced transferrin receptor-mediated Objectives To evaluate the influence of introduction of maxizyme against mtp53 by adenovirus enhanced transferrin receptor-mediated gene delivery system on MHCC97 cells. Materials and Methods Hepatocellular carcinoma cell MHCC97 containing mutated p53 gene was served as model. The maxizyme aganist mtp53 was transfected to the cells by adenovirus enhanced transferrin receptor-mediated gene delivery system. The level of mtp53-mRNA was detected by means of semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). The apoptosis of hepatocellular carcinoma cell lines were measured by DNA ladder assay and FCM. Results After 48 hours of transfection by transferring receptor, RT-PCR showed the expression of mtp53-mRNA in the transfected cells was significantly lower than before. The level of apoptosis increased. The apoptosis index increased from 2.37% to 22.95% (P < 0.05). And DNA "Ladder"can be observed. Conclusions The recombinant ribozyme cDNA eukaryotic expression vector pEGFP-Maxizyme could be introduced into MHCC97 cell by transferrin receptor. The expression of maxizyme may inhibit the mtp53 gene expression and promote the apoptosis of MHCC97 cells.

Objectives To study the episodes and clinical features of druginduced liver disease by retrospective analysis.

Fifty-five cases with drug-induced liver disease (mean age 47.73 years, range 11~88 years), without viral hepatitis, alcohol liver disease, or bile duct disease, admitted to our hospital from 1994 to 2003 were reviewed. Results Most cases were only detected liver function abnormalities; almost no serious digestive symptoms excluded patients with jaundice. The etiological agents could be defined as follows: antituberculous drugs are the most common, and then anti-inflammatory agents, traditional Chinese medicine, anti-thyroid drugs and chemotherapy drugs. The dosages were within the normal range excepted 1 cases who took excessive 4-amino-PGA. Of the patients, the time of liver injury occurred: 24 within 4 weeks, 15 in 4-8 weeks, 5 in 8-12 weeks, 7 exceeding 12 weeks. Liver function tests: alanine aminotransferase (ALT) average 452.69 U/L, aspartate aminotransferase (AST) average 476.96 U/L, gamma glutamyl transferase (GGT) increased in 38 cases, average 213.76 U/L, alkaline phosphatase (AKP) increased in 36 cases, average 140.15 U/L. The prognosis of those patients was rather good and all recovered uneventfully after cessation of the hepatotoxic drugs and use proper treatment. Conclusions Drug-induced liver disease is not infrequence in clinic. Our retrospective analysis demonstrates that most druginduced liver disease is associated with anti-tuberculous drugs, antiinflammatory agents, traditional Chinese medicine, anti-thyroid drugs and chemotherapy drugs, and mainly occurs within 8 weeks. Re-examination liver function is effective method to find liver injury promptly. The prognosis of drug-induced liver disease is good after proper treatment.

Objective To investigate the clinical features of drug induced liver disease in the elderly (DILD).

The retrospectively study on the clinical date of 60 elderly patients of DILD was used. Results 1. The first symptoms of this group was asymptomatic enzymes elevated (70%). 2.The relative medicines:The medicine category is numerous, involve the treatment of each system illness to use the medicine, essentially some traditional Chinese medicines. 3. Clinical type: The type of hepatic cell harm was chief one (60%). 4. Prognosis: The case of hepatic failure was 18 (30%), the death case was 8 (13.33%). Conclusions Because the elderly take more prescription medication than any other age group, they are more likely to have adverse drug reactions. Therefore much effort has been directed toward understanding the changes in drug metabolism that occur with aging. Many factors may influence drug disposition in the elderly, including changes in body composition, a general decrease in serum albumin concentration, decreased renal function and environmental influence including dietary changes. Early diagnosis and prompt withdrawal of the offending drug is the key to successful management of most drug induced liver disease. When fulminant drug-induced liver failure occurs liver transplantation is the therapy of choice with a better prognosis than conventional therapy.

Therapeutic effect of lamivudine on subacute hepatic failure with hepatitis B virus infection BAOZHANG TANG, JING YOU, HONGYING CHENG, LU ZHANG, GAO CHENG

The six patients with subacute hepatic failure with HBV injection, whom with severe jaundice, ascites, the serum prothrombin time activation (PTA) at severest stage 12.4%-35.2%, the serum biochemical markers: albumin (A) 22.4-34.4 g/L, serum alanine transaminase (ALT) 45.0-767.0 u/L, aspartate transaminase (AST) 107.0-207.0 u/L, bilirubin (TB) 304.6-638.0 umol/L, the virological markers: all cases with positive serum tests for HBsAg and HBV DNA, 4 and 2 out of 5 cases with coincidentally positive HBeAg and IgM HBcAb respectively, were all treated actively with general anti-hepatic failure therapy after admission, but they all became continuously worse and worse. After receiving Lamivudine additionally (100 mg, oral, daily), out of 5 patients, four cases showed HBV DNA loss at the 20 th -62 th day, serum HBeAg and IgM HBcAb were negative in three and two at the 16 th -60 th day, respectively. The five patients had been in hospitalization for an average time of 86 days, and two and four of five cases were heal over and better at the end of hospitalization respectively. The six patients who administrated Lamivudine therapy continuously after hospital were followed up for 7.2 months (2-14 months), and were alive during the follow-up period. There were not any side effects.The study indicated that Lamivudine antiviral therapy on subacute hepatic failure caused by HBV infection might be effective and safe and with better tolerability.

Structural study on the humam insulin-like growth factor II (IGF-II) gene P3 promoter SHAOHUI TANG, DONGHUA YANG, WEI HUANG Department of Gastroenterology, First Affiliated Hospital, Jinan University, Guangzhou, China Objective To analyze the regulatory elements of IGF-III gene P3 promoter and their interaction with transcription factors to determine the mechanisms by which P3 is controlled and its relation to IGF-II overexpression in human hepatoma cells.

The five IGF-II P3 fragments-luciferase expression vectors were constructed. HepG2, SMMC-7721, L-02, and HeLa cells were transfected with the above vector DNAs. Luciferase activities of five constructs were measured using dual luciferase reporter assay system for determination of the elements involved in the regulation of P3. The interaction of the elements with transcription factors was analyzed by EMSA using -148/+152 and -1245/-820 fragments as probes to determine whether there are quantitative and qualitative differences in the nuclear factors binding to P3 in the above four cells. Results 1The luciferase activities of various P3 constructs in HepG2 and SMMC-7721 cells were 15~16 times those in HeLa cells and 2 times those in L-02 cells. The full-length P3 construct demonstrated maximal promoter activity. -1273/-839, -839/-551, -551/-310, and -310/-148 fragments each could contain stimulative elements. 2The six similar retarded complexes in the -148/+152 fragment were detected with the above four cell extracts, but the relative abundance of these complexes differed with weaker intensities in HeLa cells.There were different patterns and intensities of retarded complexes in the -1245/-820 fragment among the four cells with the stronger and more complexes in HepG2, SMMC-7721, and L-02. Conclusion 1Human IGF-II gene P3 promoter indicates complex structure, which may contain several stimulative elements. 2The activities of P3 differ in the above four cells. P3 demonstrates the strongest activities in HepG2 and SMMC-7721 cells, which is responsible mainly for IGF-II overexpression in HepG2 and SMMC-7721 cells. 3The high activity of P3 may be intimately associated with the expression up-regulation of corresponding transcription factor(s) and/or expression of additional factors in human hepatoma cells.

Of 32 patients LC with ascites who participate in this study consists of 23 males (71.88%) and 9 females (28.12%), age's range is 27-77 yrs old with the mayority of them were 51-60 yr age group (37.5%). SAAG mean was 1.79 ± 0.34 g/dl. Mean of portal vein diameter was 1.63 ± 0.33 cm. Mean of spleenic vein diameter was 1.85 ± 0.27 cm. There was found 96.88% of LC patients had SAAG ≥ 1.1 g/dl. Statistical test was found respectively the correlation between SAAG with portal vein diameter unsignificantly (r = 0.13 and p = 0.477), and SAAG with spleenic vein diameter significantly (r = 0.958 and p = 0.000). Conclusions There is a significant and strong correlation between SAAG with spleenic vein diameter; otherwise no significant correlation was found between SAAG with portal vein diameter. perfusion (HP) and a high volume therapeutic plasma exchange (PE) in addition to intensive medication during the first 8 days failed in improving her hepatic encephalopathy (HE) and liver function but developed her into deep coma, along with peak severe blood chemistry data and signs of threatened abortion. And then, the intermittent MARS (Molecular Adsorbents Recirculating System) treatments were been used. Results Treatments with 3 times intermittent MARS resulted in a immediate reversing of liver function and gradually improvement of severe clinical symptoms including HE and threatened abortion until her fully recovery, when the life threatening maternal illness was overcome gestation went on until premature birth in 36 th week of pregnancy, and infant subsequently undergone an undisturbed development.

Conclusions MARS method appeared to be an optimal therapy for patients with acute liver failure secondary to cytoxic mushroom poisoning during the pregnancy.

Successful clinical application of mars in maternal amanita poisoning during the second pregnancy trimester: a case report BANGFU Objectives To investigate the clinical effects of MARS method for rescue patients with acute liver failure secondary to cytoxic mushroom poisoning during the pregnancy. Methods A 27-year-old-woman who was hospitalized with food intoxication caused by Amanita phalloides in her 20th week of pregnancy. She suffered a severe liver failure. The previous extracorporeal purification treatments with 2 times of hemodialysis (HD) plus hemoperfusion (HP) and a high volume therapeutic plasma exchange (PE) in addition to intensive medication during the first 8 days failed in improving her hepatic encephalopathy (HE) and liver function but developed her into deep coma, along with peak severe blood chemistry data and signs of threatened abortion. And then, the intermittent MARS (Molecular Adsorbents Recirculating System) treatments were been used. Results Treatments with 3 times intermittent MARS resulted in a immediate reversing of liver function and gradually improvement of severe clinical symptoms including HE and threatened abortion until her fully recovery, when the life threatening maternal illness was overcome gestation went on until premature birth in 36 th week of pregnancy, and infant subsequently undergone an undisturbed development.

Conclusions MARS method appeared to be an optimal therapy for patients with acute liver failure secondary to cytoxic mushroom poisoning during the pregnancy.

Tetrandrine inhibits activation of rat hepatic stellate cell in culture via transforming growth factorb signalling JIANXIN WU, YUANWEN CHEN, DINGGUO LI, HANMING LU Department of Gastroenterology, Xinhua Hospital, Shanghai Second Medical University, Shanghai 200092, China Objective To investigate the effect of varied concentration of tetrandrine in culture media on activation of quiescent rat hepatic stellate cell (HSC) and transforming growth factorb (TGFb) signalling. Methods HSC was isolated from rat by in situ perfusion of liver and 8.2% Nycondenz gradient centrifugation, and primarily cultured on uncoated plastic for 24 h with DMEM containing 20% Fetal Bovine Serum (FBS/DMEM), before the culture medium was substituted with 2% FBS/DMEM for another 24 h. Then, the HSC was cultured in 2% FBS/DMEM with tetrandrine (0.25 mg/L, 0.5 mg/L, 1 mg/L, 2 mg/L, respectively). Cell phenotypes were observed under inverted microscope; a-smooth muscle actin (a-SMA) expression was checked by immunocytochemistry and image analysis system; laminin (LN) and procollagen type III peptide (P III P) in supernatant were detected with radioimmunoassay system; TGFb1 mRNA, Smad7 mRNA and Smad7 protein were analyzed with reverse transcription polymerase chain reaction (RT-PCR) and Western Blot, respectively. Result Tetrandrine in the concentration of 0.25 mg/L ~2 mg/L prevents morphological transformation of HSC from quiescent phonotype to the activated one while a-SMA, LN and P III P expression are inhibited. RT-PCR shows decreased expression of TGFb1 mRNA in significant negative correlation with increased Smad7 mRNA, and up-regulation of Smad7 protein by tetrandrine (1 mg/L) was confirmed by Western Blot as well. Conclusion Tetrandrine exerts direct inhibiting effect on the activation of rat hepatic stellate cells in culture. Meanwhile, it upregulates the expression of Smad7, which in turn blocks TGFb 1 expression and signalling.

The change of cytokines levels in cirrhotic patients with ascites JUN WU*, HONGCHUN HUANG, AIQIN HAO, JICHANG LI, CHANGQING GUO *Department of Gastroenterology, The Anyang 5 th People's Hospital, Anyang 455000, China Objective To evaluate plasma and ascetic fluid levels of pro-inflammatory cytokines (TNF-a, IL-6) in cirrhotic ascetic patients. Method The plasma and ascetic fluid levels of TNF-a, IL-6 were assayed by a double monoclonal sandwich enzyme linked immunosorbent assay (ELISA) and the levels of endotoxin were assayed by limulus amebocyte lysate test in 94 hepatitis cirrhosis patients with ascites. Result (1) The plasma and ascitic levels of TNF-a, IL-6 and endotoxin were significantly higher in hepatitis cirrhosis patients with Spontaneous Bacterial Peritonitis (SBP) than those without SBP in admitting hospital (P < 0.05). (2) The plasma levels of TNF-a, IL-6 and endotoxin were higher in cirrhosis without SBP than those in healthy control group (P < 0.05). (3) The plasma endotodxin level of endotoxin had significantly correlated with the level of TNF-a (P < 0.001) and IL-6 (P < 0.001). Conclusion (1) Plasma endotoxin, TNF-a and IL-6 levels ane increased in hepatitis cirrhosis patients with ascites. (2) Endotoxin in hepatitis cirrhosis Patients with ascites may stimulate some kinds of immune activated cells to produce pro-inflammatory cytokines,TNFa and IL-6, which may deteriorated the complications. alcohol dependent group is 70%, in ALD group is 90%. The difference of the frequency of the two alleli in these three groups has no statistic significance, and has no statistic significance between health control group and alcohol dependent group, health control group and ALD group (P > 0.05). The frequency of ADH3*1 allele in health control group is 45%, in alcohol dependent group is 45%, in ALD group is 50%; The frequency of ADH3*2 allele in health control group is 55%, in alcohol dependent group is 55%, in ALD group is 50%. The difference of the frequency of the two alleli in these three groups has no statistic significance, and has no statistic significance between health control group and alcohol dependent group, health control group and ALD group (P > 0.05). The frequency of ALDH2*1 allele in health control group is 60%, in alcohol dependent group is 85%, in ALD group is 90%; The frequency of ALDH2*2 allele in health control group is 40%, in alcohol dependent group is 15%, in ALD group is 10%. The difference of the frequency of the two alleli in these three groups has statistic significance (P < 0.05), and has no statistic significance between health control group and alcohol dependent group (P > 0.05). But has statistic significance between health control group and ALD group (P < 0.05). Conclusions In this study, we separate WBC out of the venous blood, and then genomic DNA is extracted from WBC as PCR amplification model. After PCR amplification, the PCR products is digested by respectively restriction endonuclease, and then by electrophoresis on 14% polyacrylamide gel, we can unambiguously determine the genotype of ADH2, ADH3 and ALDH2. The gene polymorphism of ADH2, ADH3 and ALDH2 do have relationships to ALD in some degree, but the difference of the frequency of ADH2 and ADH3 alleli in these three groups has no statistic significance, and has no statistic significance between health control group and alcohol dependent group, health control group and ALD group (P > 0.05). The difference of the frequency of ALDH2*1 and ALDH2*2 of the two alleli in these three groups has statistic significance (P < 0.05), and has no statistic significance between health control group and alcohol dependent group (P > 0.05). But has statistic significance between health control group and ALD group (P < 0.05). It suggests that gene polymorphism of the ALDH2 may play a more important role in the pathogenesis of ALD than that of ADH2 and ADH3.

Detection and significance of serum soluble e-selectin, T lymphocyte subsets and NK cell in peripheral blood in patients with chronic hepatitis B MINGXIAN YAN 1 , QIAN LIU 1 , WENQI WANG 1 , HAITING MAO 2 , GUANGYUN LI 3 & YUN WANG 2 1 Department of Gastroenterology, 3 Objectives To investigate the changes of serum soluble E-selectin, T lymphocyte subsets and NK cell in patients with chronic hepatitis B (CH-B) and analyze their clinical significance. Materials and Methods sE-selectin was measured by an enzymelinked immunosorbent assay in the sera of 54 patients with CH-B and 14 healthy controls. T lymphocyte subsets and NK cell were detected by flow cytometry (FCM). The liver function and the quantitation of HBV DNA were also detected in the same time.

The serum level of sE-selectin in patients with CH-B was higher significantly than that of controls (P < 0.001). The sE-selectin concentration had a correlation with sALT, sAST and TBIL levels respectively (P = 0.0000; P = 0.0000; P = 0.0069). The CD 4 + T cells, NK cells and the ratio of CD 4 + /CD 8 + were decreased significantly. The change of sE-selectin concentration correlated with the changes of T lymphocyte subsets and NK cell (p < 0.05, respectively). But the serum level of sE-selectin had no relation with HBV DNA quantitation (p = 0.6133).

Conclusions sE-selectin concentration was a valuable detection index to reflect the immunal disorder and inflammation degree in patients with CH-B but can not reflect HBVDNA level.

Effects of ursodeoxycholic acid (UDCA) on immunodamaged hepatic fibrosis in rats DAMING YANG, LIANG PAN, GONGSHENG SHI, HONG ZHANG, QUN WEI, MINGBING XIAO & XIANYONG MENG Department of Gastroenterology, Affiliated Hospital of Nantong Medical collage, Nantong, China Objectives To assess the effects of ursodeoxycholic acid (UDCA) in preventing immunodamaged hepatic fibrosis induced by pig serum in rats.

Thirty-six Sprague Dawley rats were randomly divided into three equal groups. Hepatic fibrotic models were established by injection of pig serum into the peritoneal cavity twice/week for 8 weeks in two groups. One of them was treated with UDCA 15 mg/(kg·d) for 8 weeks (UDCA group), the other was regarded as model group. The remaining group was alive without any treatment (control group). Liver fibrosis was assessed directly by hepaticmorphometric analysis, the levels of hyaluronic acid (HA), hydroxyproline (Hyp), alanine aminotransferase (ALT) were evaluated, the expression of a-smooth muscle actin (a-SMA), transforming growth factor-beta 1 (TGF-b1), nuclear factor-NFkB (NFkB p65) in liver tissue were detected by immunohistochemical techniques.

The area of collagen of liver tissue in model group was much higher than those in control group (11.1 ± 2 .09 vs. 0.73 ± 0.15, P < 0.05=, and so were the serum level of HA, Hyp, ALT and the expression of a-SMA, TGF-b1, NFkB p65 (P < 0.05=. Compared with model group, the area of collagen in UDCA group was not markedly decreased (9.49 ± 1.31 vs. 11.1 ± 2.09, P > 0.05). The same results were obtained from other indexes (P > 0.05). Conclusions UDCA with ordinary dosage may not significantly delay the progression of pig serum-induced liver fibrosis in rats.

Serum soluble tumour necrosis factor receptor and leptin levels in patients with cirrhosis SHAOQI YANG, XINNING GUO

Objective To assess the role of tumor necrosis factor-alpha (TNFalpha) system and leptin in patients with liver cirrhosis. Material and Methods 55 patients with liver cirrhosis and 36 healthy people were recruited. Serum leptin, sTNF-RI and sTNF-RII were tested by ELISA and TNF-alpha was tested by RIA. Results In cirrhotic patients, serum TNF-alpha, sTNF-RI and sTNF-RII were significantly elevated in cirrhotic patients compared to healthy controls [10.45 ± 3.66 vs 6.37 ± 2.17 pg/ml; 1.46 ± 0.61 ng/ml vs. 0.82 ± 0.34 ng/ml; 3.44 ± 1.37 ng/ml vs. 1.96 ± 0.83 ng/ml; respectively; P < 0.01] and correlated with disease severity (graded by Pugh-Child's scores). There were no difference of serum leptin levels between cirrhotic patients and healthy people (8.14 ± 1.67 vs 8.46 ± 2.12 ng/ml, p > 0.05). Conclusion Our study demonstrated that serum levels of TNFalpha, sTNF-RI, sTNF-RII were all elevated in cirrhotic patients. But leptin were not elevated. Severity of liver cirrhosis was an important factor for the activation of TNF-alpha system.

To investigate the effects of spironolactone on expression of metalloproteinase (MMP)-2, MMP-9, MMP-13 and tissue inhibitor of matrix metalloproteinase (TIMP)-1 in Hepatic Stellate Cells (HSCs). And to study the mechanism how spironolactone affects the collagen metabolism in HSCs.

The activated HSCs were treated with different concentrations of spironolactone (1 ¥ 10 -4 mol/L ~1 ¥ 10 -7 mol/L) for 48 hours. The expressions of MMP-2, MMP-9, MMP-13 and TIMP-1 mRNA were evaluated by RT-PCR (MMPs or TIMP-1/b-actin). At protein level, MMP-13 were analyzed by immunohistochemistry and TIMP-1 examined by Western blot respectively. Results The expression of MMP-13mRNA in spironolactone groups was up-regulated. This gene expression in 1 ¥ 10 -4 mol/L ~1 ¥ 10 -6 mol/L spironolactone treated groups (0.91 ± 0.13, 0.80 ± 0.01 and 0.67 ± 0.15 respectively) was significantly higher than that in the control (0.53 ± 0.10), P < 0.01. With the increasing of the spironolactone concentrations, the MMP-13 expression at protein level increased too. The positive cell ratio in groups 1 ¥ 10 -4 mol/L, 1 ¥ 10 -5 mol/L, 1 ¥ 10 -6 mol/L spironolactone was 0.50 ± 0.04, 0.41 ± 0.02, 0.32 ± 0.04, individually, while the control was 0.30 ± 0.03. Treatment with spironolactone for 48 h, the expression of TIMP-1mRNA decreased dose-dependently, and among 1 ¥ 10 -4 mol/L and 1 ¥ 10 -6 mol/L groups, the decrease was the most obvious (0.15 ± 0.05, 0.28 ± 0.15 and 0.37 ± 0.03 respectively vs control group 0.47 ± 0.04, P < 0.01 or P < 0.05). This result also was proved at protein level through Western blot. In groups 1 ¥ 10 -4 mol/L, 1 ¥ 10 -5 mol/L and 1 ¥ 10 -6 mol/L, the expression decreased as 68.58%, 38.12% and 18.86%, respectively. Spironolactone might reduce the TIMP-1content. MMP-2mRNA and MMP-9mRNA expression in HSCs stayed unchanged after incubation with different concentrations of spironolactone for 48 h. Conclusions Spironolactone may inhibit the expression of TIMP-1 and increases MMP-13 mRNA and its protein. Spironolactone may promote the collagen degradation by regulating MMPs and TIMP-1 expression.

Serapharmacological study of liver-clearing and stasis-removing on proliferation and expression of MEK in SMMC-7721 cells with transforming growth factor a FEI YIN, SHUKUN YAO, HONGSHENG GAO Department of Gastroenterology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China Objectives To investigate the serapharmacological effects of Liverclearing and Stasis-removing on proliferation and expression of MEK in SMMC-7721 cells with transforming growth factor a (TGFa).

The effects of Liver-clearing and Stasisremoving were investigated in vitro using serum pharmacological approach compared with pathologic serum. The inhibiting effect of drug serum on SMMC-7721 cells with TGFa was observed by MTT assay. Expression of MEK was detected by Western blotting and MEK1mRNA by RT-PCR.

The drug serum could significantly inhibit the proliferation of SMMC-7721 cells with TGFa time-dependently. It also could significantly reduce the expression of MEK and MEK1mRNA. Conclusions The serum containing Liver-clearing and Stasisremoving could inhibit the proliferation of SMMC-7721 cells with TGFa and reduce the expression of MEK1mRNA and MEK so that it could inhibit the signal transduction of TGFa in SMMC-7721 cells.

At the end of treatment, complete response (defined as ALT normalization and HBV DNA and HBeAg loss) occurred in 9 of 29 (31.0%) in the T-a1 group and in 15 of 33 (45.5%) in the IFNa group (x 2 = 1.36, p > 0.05). After a follow-up period of 6 months, a complete response was observed in 14 of 29 (48.3%) in the T-a1 group and in 9 of 33 (27.3%) in the IFN-a group (x 2 = 2.93, p > 0.05). And compared with the results observed in group of 30 patients never treated with IFN-a and followed for 12 months, the rate of complete response was significantly higher in IFN-a group at the end of therapy (1 of 30 vs. 15 of 33, respectively; x 2 = 14.72, p < 0.01) and in the T-a1 group at the end of follow-up (1 of 30 vs. 14 of 29, respectively; x 2 = 15.70 p < 0.01). Unlike IFN-a, T-a1 was well tolerated by all patients, and no any side effects appeared in T-a1 group. Conclusions The results suggest that a 6-months course of T-a1 therapy is effective and safe in patients with chronic hepatitis B. And T-a1 is able to reduce HBV replication in patients with chronic hepatitis B. Furthermore, compared with IFN-a,T-a1 is better tolerated and seems to induce a gradual and more sustained ALT normalization and HBV DNA and HBeAg loss. However, a response rate of 48.3% is still less than ideal. A more effective therapeutic approach, such as combination therapy using the immunomodulating effect of T-a1 and antiviral effect of interferon or nucleoside analogues (such as lamivudine, famciclovir, ets.), warrants further study.

Diagnosis and treatment of 10 cases with primary biliary cirrhosis XIAOFENG YU, JIANFENG YAO, WEI ZHANG, YIQIAN WANG, TONGJIN GU Huadong Hospital, Shanghai, 200040, China Aim To study the clinical features, the ways of diagnosis and the therapeutic outcome in old patients with PBC. Method Diagnostic criteria: abnormal increasement of both serum ALP and r-GT; serum AMA(+); excluding all types of hepatitis and bile duct disease. 1. Treatment way: 8 cases took UDCA only; 2 cases took UDCA and prednisone. Results Patientes age: 72-82 yrs, mean 76 yrs, 8 males, 2 feamales. Course: 7 days-15 years. 1. Clinical features: 1 case with abdominal distension and fever, 2 cases with skin ichy, jaundice and ascites. 7 cases without any symptoms. ALP and r-GT of the 10 cases were all increased unreasonably, as high as 2-5 times of normal value. All the 10 cases had AMA(+). 2. Outcome of treatment: After taking UDCA for 4 wks, ALP and r-GT in 8 cases decreased obviously. 4 of them regained to the normal values. The case with fever had normal body temperature after taking UDCA for 3 wks. No response in liver enlargement after taking UDCA.Two cases with jaundice and ascites did not improved neither in the symptoms and signs nor ALP and r-GT after taking UDCA together with prednisone, one of them died after taking the drugs one year. Conclusions AMA is very important in the diagnosis of PBC. Patients always show high ALP and r-GT earlier than jaundice, ascites or liver enlargement. According to the marks of AMA, ALP and r-GT, PBC can be diagnosed in early stage. We should pay more attention to unreasonable ascending of ALP and r-GT. UDCA is only useful to the patients with PBC in early stage, but no response to the cases in advanced stage.

The combination of vitamin C and vitamin K3 induced apoptosis on human hepatoblastoma cells and its mechanism YI YU 1 , LI MA 1 , XIAOJUN HUANG 1 , HONG FAN 1 , XIANG WANG 1 , YANHU FENG 1 , DEKUI ZHANG 1 & YINZHI ZHANG 1 The Second Hospital Affiliated to Lanzhou Medical University, Lanzhou 730030, Gansu, China Objectives To investigate apoptosis effects of vitamin C with vitamin K3 on hepatocarcinoma Cell Hep G2 and explore the mechanism. Materials and Methods By cells culturing in vitro, Anti-proliferation effects of Vitamin C and Vitamin K3 were assessed with methyl thiazolyl tetrazolium (MTT) colorimetric assay. The morphology of cells was observed under light microscope, transmission electron microscope and laser scanning confocal microscope respectively. The flow cytometry was used to detect apoptotic rate and cell cycle distribution. The activity of superoxide dismutase (SOD), the content of alondialdehyde (MDA), hydrogen peroxide (H 2 0 2 ) and protein in the cell were determined with biochemical method. And intracellular calcium concentration was observed by confocal microscopy. Results Vitamin c and Vitamin K3 separately did not induce any change of cell proliferation on HepG2, but showed a remarkable Antiproliferation as both combined. Morphological changes charasteristic of apoptosis were observed though light microscope, electron microscope: cellshrinkage, nuclear condensation, DNA fragmentation, vacuolation and formation bodies. A typical subdiploid peak before G0/G1 phase was observed by flow cytometry. The effect of CK3 on Hep G2 showed a remarkable cell cycle specificty, blocking at G0/G1 phase. The content of malondialdehyde (MDA) and hydrogen peroxide in the cell were increased, but depleting the activity of superoxide dismutase (SOD), significantly. The level of intracellular calcium concentration was step up, too. Conclusions CK3 inhibite significantly proliferation of hepatocarcinoma Cell Hep G2 and induce apoptosis and arresting cell cycle at G0/G1, the mechanism of which was related to Oxidative stress. CK3 may have a promising prospect in the treatment of hepatocarcinoma cancer though apoptosis.

Clinical study of integrated Chinese traditional and western medicine in treating alcohol liver cirrhosis YAOMING ZENG

Objective To evaluate the efficiency of integrated Chinese traditional and western medicine in treating alcohol liver cirrhosis. Methods 65 cases were randomly divided into 2 group, 38 cases in the treated group, and 25 cases in the control group. The control group was treated with conventional western medicine, while the treated group was treated by both conventional western medicine and Chinese traditional concoctions. The changes of symptoms, signs, liver functions were observed. Results The total effective rate was 86.8% in the treated group while 76% in the control group. the improvement of symptoms, signs, liver functions was better in the treated group. Conclusions The integrated Chinese traditional and western medicine has better effective in treating alcohol liver cirrhosis. Keywords: alcohol liver cirrhosis integrated Chinese traditional and western medicine.

An epidemiological survey of fatty liver in Guangzhou ZHENG ZENG, RONGMING SU, YUYUAN LI Department of Gastroenterology, First municipal people's hospital of Guangzhou, Guangzhou, China Objectives To investigate the prevalence and correlative factors of fatty liver in Guangzhou. Materials and Methods 1185 people were made body check.

The prevalence of fatty liver is 17.8%. It has no statistical significance between the fatty liver group and the non-fatty liver group on age (66.9 ± 8.4 : 66.7 ± 10.3) (p > 0.05). But highly statistical significance were found between the fatty liver group and the non-fatty liver group on prevalence of diabetes mellitus (DM) (16.1% : 11.2%), hypertension (54.0% : 40.6%), coronary heart disease (CHD) (16.6% : 9.5%) and proportion of excessive drinking (7.1% : 3.0%), obesity (18.0% : 10.8%) and female (27.0% : 16.4%). And the serum cholesterol (TC) (6.0 ± 1.3 : 5.7 ± 1.0), serum triglyceride (TG) (2.2 ± 1.9 : 1.6 ± 3.6), alanine aminotransferase (ALT) (37.9 ± 27.1 : 24.4 ± 16.4), concentration of uricema (UA) (391.8 ± 120.1 : 350.3 ± 104.3) were significantly elevated in the fatty liver group compared with those of the non-fatty liver group (p < 0.05 ~0.001). Conclusions The present study shows that the prevalence of fatty liver in Guangzhou is 17.8%, which is more often found in women. There were a close relationship between fatty liver and DM, hypertension, CHD, excessive drinking, obesity, and the concentration of TC, TG, ALT and UA.

Treatment of gastroesophageal varices bleeding by percutaneous transhepatic fixed TH glue embolization CHUNQING ZHANG 1 , HONGWEI XU 1 , TONGHAI CAI 2 , KAI FENG 1 , CHUNAN LIU 2 , LIN XU 1 , LINA FU 1 1 Deptartment of Gastroenterology, Shandong Provincial Hospital, Jinan, China 2 Deptartment of Gastroenterology, Tengzhou central Hospital, Tengzhou, China Objectives The value of percutaneous transhepatic gastroesophageal variceal embolization (PTVE) using stainless steel coils, absolute alcohol, Gelfoam, or 50% glucose proved to be limited. In this study a new embolization method was introduced, by which the TH glue (a-cyanoacrylate) was injected into the main stem of the feeder vein of varices and it's gastro-fundal branches, and the gastroesophageal varices was permanently embolized.

Thirty-six patients were performed the procedures. TH glue was injected into the main stem of the feeder vein of varices and it's gastro-fundal branches followed placing steel coils at the ostium of the feeder vein and injecting absolute alcohol in the varices. While 27 patients underwent varices embolization by the TH glue injection and partial splenic embolization, nine patients who underwent surgery before were performed the TH glue embolization alone. Results 1 The fixed TH glue embolization were performed on 33 patients, with a successful rate of 92%. 2 Post venogram showed absence of gastroesophageal varices in all patients immediately; the gastroscopy and barium showed disappearance of varices in 59.3%, reduction in caliter in 33.3%; alleviation of ypersplenism in 96% patients; 3 One patients died due to cerebral bleeding; no other sever complication occurred; 1 23 patients were followed-up with a mean period of 7.5 months (1-13 months); varices were controlled in 95.7% continuously, recurrence of varices in 2 patients, variceal rebleeding in 1 patient.

Our results suggest percutaneous transhepatic fixed TH glue embolization is safe, reasonable and effective in treatment of hemorrhage from gastroesophageal varices.

The clinical value of combining TSGF, AFP, CEA and CA-50 examination in diagnose of primary hepatocellullar carcinomar (PHC) DEKUI ZHANG

Objectives To evaluate the clinical value of combining TSGF, AFP, CEA and CA-50 examination in diagnose of primary hepatocellullar carcinomar (PHC). Methods In 42 patients with PHC and 30 normal people (as control group), the serum TSGF were examined by colorimetery and serum AFP, CEA, CA-50 were examined by radioimmuney assay. Results The mean serum TSGF, AFP, CEA and CA-50 in PHC group was significantly higher than that in control group, the sensitivity of TSGF, AFP, CEA and CA-50 in diagnose of PHC was 61.6%, 69.0%, 33.3%, 23.8% respectively while the specificity was 86.5%, 83.3%, 89.6%, 90.4% respectively.The sensitivity could rise to 91.5% markedly when these four tumor markers were examined together. Conclusions In diagnosing of PHC TSGF is a sensitive carcinoma marker and the detection of combining TSGF, AFP, CEA and CA-50 should effectively improve the accurate rate.

Clinic effect of combining TACE with RF on PEI in treatment of primary hepatocellular carcinoma FANGXIN ZHANG, HANPING WU, ET AL.

Objective To investigate the clinical effect of transcatheter artery chemoembolizatiom (TACE) in combination with ultrasound-guided radiofrequency (RF) or percutaneous ethanol injection (PEI) on primary hepatocellular carcinoma (PHC). Methods 326 patients with PHC were divided into TACE group (120 patients), RF/PEI group (94 patients) and TACE+RF / PEI group (112 patients). Results Three months after the treatment, the combined group was superior to TACE or RF/PEI group in the total response rates (P < 0.05), and decline of AFP (P < 0.01). Meanwhile, the bone marrow inhibition and liver function impairment were significantly lighter in the combined group than in TACE or RF/PEI group (P < 0.01, P < 0.01). Conclusions TACE in combination with RF or PEI is an effective therapy for PHC.

Methods 99 patients of liver cirrhosis with portal hypertension were investigated. Data were gathered on their portal and splenic vein widths, conditions of varicose vein in esophagus and gastric fundus, and portal pressures which were measured through radionucide method. Comparative research was done on these data. 49 healthy persons were also studied as controls. The positive percentage of different methods on portal hypertension diagnosis and their relationship were analysed. Results Although many in different areas and in different degrees, most of the patients with portal hypertension had extension of portal and splenic vein. There were no significant differences on the degree of portal and splenic vein extension regarding mild, moderate or severe esophageal varicose vein.Width of portal and splenic vein were not related with portal pressure. Radionucide method was most sensitive in diagnosing portal hypertension. Conclusion Portal hypertension can be diagnosed according to the situations of vessels and spleen. The sensitivities of different methods on diagnosing portal hypertension are different, among which radionucide method gains the highest. Width of portal and splenic vein has no close relation with portal pressure and the degree of esophageal varicose vein.

The clinical study on nonalcoholic fatty liver disease in 112 patients GUOYAN Objective To study the clinical features of nonalcoholic fatty liver disease (NAFL) and the relationship between NAFL and insulin resistance. Methods Liver function, body mass index (BMI) and insulin sensitivity were investigated in 121 patients (male 69, female 52) diagnosed by B ultrasonic echograph and 49 normal controls. Results The BMI, waist circumference, hip circumference and waist-to-hip ratio (WHR) of NAFL patients were all higher than those of normal group. The average age of male patients was lower than female and most of male patients were abdominal obese. The insulin sensitivity of patients were significantly lower than that of normal controls. ALT and TG were higher than those of normal controls. ALT and GGT show difference in NAFL patients at different injury degree. Conclusion There are significant associations between the occurrence of NAFL and BMI, abdominal obesity and insulin resistance. The degree of liver injury is relevant to the severity of NAFL and sex.

Minimal wounded treatment of gastric varices in 118 cases HUIZHEN ZHANG, HUILING XIANG, ET AL Department of Gastroenterology, NO 3 Centeral Hospital, TianJin 300170, China Objective To observe the effect of minimal wonded treatment on Gastric Varices (GV). Method 118 inpatienfs with GV received minimal wonded treatment. They were divided 3 groups according to variceal type and treatment method. Gastric Oesophageal Varices (GOV) type 1 (GOV1) 46 cases, type 2 (GOV2) 38 cases, Isolated Gastric Varices type 1 (IGV1) and GOV2 34 cases. GOV1 and GOV2 groups received Endoscopic Variceal Ligation (EVL) and/or Endoscopic Variceal Sclerotherapy (EVS), and IGV1, GOV2 group received primarily Percu-tancous Transhepatic Obliteration (PTO) of GV, thereafter plus EVL and/or EVS. Results The average integral of Esophageal Varices (EV) and GV before and after treatment were respectively 3.83 ± 0.44, 1.23 ± 0.24, 2.98 ± 0.27, 0.28 ± 0.13, P < 0.05 in GOV1 group, and 3.68 ± 0.24, 1.64 ± 0.32; 3.73 ± 0.27, 1.18 ± 0.14, P < 0.05 in GOV2 group; 2.89 ± 0.37, 1.53 ± 0.44, 3.87 ± 0.33, 1.33 ± 0.32, P < 0.05 in IGV, GOV2 group. Conclusion Minimal wonded treatment is an effective and relatively simple method in most patients for F3 GV, it must be treated by PTO primarily, preventing from severe rebleeding.

Effects of interleukin-10 on activation of hepatic stellate cells in fibrotic rat liver LIJUAN ZHANG, WEIDA ZHENG, MEINA SHI, XIAOZHONG WANG

Objectives To study the effects of interleukin-10 on the expression of nuclear factor-kB and a-smooth muscle actin in hepatic stellate cells in experimental rat hepatic fibrosis Materials and Methods Experimental rat hepatic fibrosis model induced by CCl 4 was established and treated with IL-10. Hepatic stellate cells were isolated from the control group, the model group and the IL-10 treated group by means of sequential perfusion with collagenase and pronase E at the seventh and eleventh weeks during the course of liver fibrosis, respectively. The expression of nuclear factor-kB and a-smooth muscle actin in different group and different phase in the development of hepatic fibrosis was measured by S-P immunohistochemistry.

The CCl 4 -induced experimental rat hepatic fibrosis model was established successfully. The purity of extracted hepatic stellate cells was about 95%, and the yield of hepatic stellate cells was 2 ¥ 10 7 averagely. The positive expression of nuclear factor-kB and asmooth muscle actin was increased obviously with the development of hepatic fibrosis, and the positive expression of nuclear factor-kB was mainly in the nucleus of hepatic stellate cells, while the expression of a-smooth muscle actin was mainly in the plasma. Ridit analysis indicated that there was significant difference between the positive expression of nuclear factor-kB and a-smooth muscle in control group and that in model group (P < 0.05), the positive expression in IL-10 treated group was decreased when compared with control group (P < 0.05), and the positive expression decreasing gradually with the increasing IL-10 treatment time. Conclusions The positive expression of nuclear factor-kB and asmooth muscle actin in hepatic stellate cells was increased with the development of hepatic fibrosis, and ectogenic IL-10 restrained the expression of them in liver fibrosis induced by CCl 4 . The IL-10 could inhibit the activation of hepatic stellate cells by these ways.

Effect of Cox-2 selective inhibitor on proliferation and apoptosis of human hepatocellular carcinoma LINGYI ZHANG, YOUCHENG ZHANG, XIANG WANG, LI MA

Objectives To study the effects of selective COX-2 inhibitor NS-398 on proliferation and apoptosis of HepG2 cell line, to evaluate the modulating activity of Bcl-2 and cycling D1 on the procession of HepG2 cell apoptosis and cell cycle. are in 30% full, joined the growth keeping liquid after cultured 1 hour in 37°C. Reverse microscope, HE dye, AO-EB fluorescence dye, transmission electron microscope and agarose gel electrophoresis were used to determine the cell death manner in morphologic and biochemisty After 24 and 48 hours. Results MTT showed that NDV could kill human HCC, and the kill effect of velogenic strain was stronger than lentogenic strain. In the cells with virus obvious cell pathological changes was seen after 24 hours: in reverse microscope and HE dye can see cells fusion and coenocytic, orange fluorescence congregating in the edge of karyotheca in AO-EB dye, typical morphologic changes of apoptosis were seen in transmission electron microscope, smear was seen in agarose gel electrophoresis. Above phenomenon was more evidence after 48 hours. Conclusions NDV could induce cell death by apoptosis, and the kill effect of velogenic strain F48E9 was stronger than lentogenic strain La Sota.

Study on relationship between insulin resistance and fatty liver in different causes RUIHONG ZHANG, RENHUA ZHANG

Objectives It is well know that insulin resistance associated with non-alcoholic fatty liver. The aim of this study was to investigate whether or not insulin resistance exists in patients with fatty liver induced by different cause. Methods Total of 78 with fatty liver was enrolled in this study. Aged from 20 to72 y. 32 patients with nonalcoholic fatty liver, 28 patients with alcoholic fatty liver, 20 patients with hepatitis virus fatty liver. 18 were in control. All cases were measure there fasting blood glucose and serum fasting insulin level. Insulin resistance was determined by the homeostasis model assessment. Insulin resistance (IR) were compared with normal subjects and three group fatty liver. Results Compared with controls (3.5 ± 0.3), The IR values in nonalcoholic fatty liver group (4.83 ± 0.42), alcoholic fatty liver group (4.38 ± 0.41) and hepatitis virus fatty liver group (3.98 ± 0.31) were significantly higher (p < 0.01). Compared with healthy subjects, three groups fatty liver patients all had lower insulin sensitivity. Conclusion Hyperinsulinemia and insulin resistance occur frequently in patients with nonalcoholic fatty liver; our data suggest that may play a role in the pathogenesis of alcoholic fatty liver and hepatitis virus fatty liver. female patients were 14.42% (135/936) and 10.35% (56/541) (P > 0.05). The rate (37.21%) of HCV infection in the patients with liver cirrhosis was significantly higher than that in the patients with hepatitis (12.32%) and in the patients with hepatocelluler carcinoma (6.67%, P < 0.01). The positive rates of HCV infection in various hepatitis were in order of severe hepatitis (33.33%) > chronic hepatitis (17.58%; of which, CPH 13.99% and CAH 29.41%) > acute hepatitis (9.83%) > HBV carrier (6.12%). Sex, age, profession, seasonal distribution and other epidemiological characteristics were discussed for the purpose of scientific preventive measures and preventive strategy development. Conclusions HCV infection might have played a certain role in the occurrence of these liver diseases. As indicated in our data, no sex difference was observed with HCV infection among liver diseases patients, but HCV infection rate increased with age, the highest seroprevalence of HCV was particularly in Group above-50-year-old. Therefore, it is important to study and prevent hepatitis C in Yunnan Province.

Atrophic gastritis and alternation in mucosal color JIA CAI, HESHENG LUO, YIJUAN DING, ET AL.

Objective To study the relationship between atrophic gastritis and alternation in mucosal color. Method All 30 patients were examined by the same endoscopy and two samples of gastric mucosa were examined by the same pathologist. The endoscopic pictures of 30 patients with different gastric diseases were studied using high pathologic image analysis system (HPIAS-2000) and under the same gastric pressure (15 mmHg), biopsies were taken from the position taken photos. The results of HPIAS of gastric mucosa were compared with the results of pathological study. Results There were 15 cases of chronic superficial gastritis (CSG), 15 cases of chronic atrophic gastritis (CAG) in all 30 patients. For CSG, comparing with pathology, endoscopic results had 33.3% of sensitivity and 45.5% of positive predictive value. In contrast their specific rate and negative predictive value were 60.0% • 47.4% respectively. Comparing with pathological results, the diagnostic standard of white area more than 50% by HPIAS had 26.7% of sensitivity and 33.3% of positive predictive value. In contrast their specific rate and negative predictive value were 46.7% and 38.9% respectively. There were no significant difference whose percentage of white area more than 50% in CSG and CAG patients (P > 0.05) as well as the maximum dispersion of luminosity between red and white area in mucosa color (P > 0.5). Conclusion The mucosal color was nonspecific for pathologic diagnosis.We cannot consider the mucosal color which is white in red background as a diagnostic standard of atrophic gastritis.

The diagnostic value of transendoscopic miniature ultrasonic probe in esophageal eminence lesions LIMING CHEN, LIMING ZHU, DONGLAQNG WONG, KONGSONG CHI Department of Internal Medicine, The Second Hospital of Wenzhou,Wenzhou, Zhenjian, China Objectives To evaluate the value of transendosopic miniature ultrasonic probe (TEMP) in esophageal eminence lesions. Materials and Method TEMP was conducted in 67 patients (mean age 50 years, range 28-81 years) with suspected esophageal eminence lesions.

Eight myogenic tumors (1 malignant myogenic tumors, 6 benign tumors), 10 carcinomas (5 early stage, 5 advanced stage), 24 cyst, 9 protuberance from pancreases in esophagus, 2 inflammations, 1 polypus. Conclusion TEMP possesses its unique value for superficial esophageal eminence lesions.

Endoscopic microwave coagulation intra-tumor injection of tumor necrosis factor (TNF) and chemotherapy for advanced gastric carcinoma MINGKUI CHEN, LIPING ZHANG, WANYI BAI Jiyuan Chinese Traditional Medicine Hospial, Jiyuan, Henan 454650, China Objective The techniques and early effect of advanced gastric cancer were treated with endoscopic microwave tissus coaguition (EMC) and intratumor injections of TNF and chemotherapy. Methods 68 patients (46 males. 22 females, ages rangde 37-85 years old) were followed us for a period of 2 ~3 months. EMC and TNF 5 ~10 ¥ 10 5 u FU 250 ~500 mg, MMC 4 mg, DDP 20 mg were injected into lesions weekly for 4 ~6 weeks with olympus endoscope NM-9L kneedles and MMTI-II multifunctional microwave therapeutic apparatus. The changes of lesions size were measurde with endoscope video tape recorder and X-ray after and before treatment. The efficacy judments were according to the standards of WHO and Karhofsky. Results 1. The mean index of quatity of life (Q.O.L) in 68 patients increased markedly from 48 ± 12 to 75 ± 12 (p < 0.05). 2. The effects of treatment for tumor were CR 10 cases (14.7%), PR 48 cases (70.6%), MR5 cases (7.4%), SD, 5 cases (7.4%). CR+PR 85.3%. Conclusion 1. This administration of EMC and intratumor injetions of TNF and chemotherapy can relief symptoms and improve Q.O.L of patients with gastric cancer. 2. It is a useful conservative therapy for advanced gastric cancer. Objective To evaluate the effect of endoscopic ultrasonography (EUS) in diagnosing pancreatic carcinoma. Methods 36 patients who were considered to be pancreas cancer by EUS (have the surgical operation pathology result) were compared with transabdominal ultrasonsgraphy (US) and computed tomography (CT). Among them male 20 examples, woman 16 examples, age 25-72 years old, and the average was 49.5 years old. EUS was performed with the Pentax instrument EG3630U, It is an electronic line array echoendoscopes with Doppler colors function. It has 5 MHz and 7.5 MHz frequency, and provide 2.4 mm work channal. The US and CT are normal regulational instrument. EUS was introduced into the descending duodenum. The balloon at the instrument's tip was filled with water to improve visualization. The other method is the diect water infusion method. When retracting the instrument to the duodenal bulb, the pancreatic head and body was scanned. From the gastric antrum, body, and fundus, the pancreatic body and tail were examined. The EUS features of pancreatic carcinoma were variable. Most tumors were hypoechoic, but showed different degrees of echofree and echodense areas within the tumor. The tumor margin was irregular. The diameter of the earlier pancreas cancer is smaller

O 2 )-stimulated hepatic stellate cells (HSCs)

mg·mL -1 , 20mg·mL -1 , 30mg·mL -1 , 40 mg·mL -1 ) and without IH764-3. Direct cell count, 3 H-thymidine incorporation, Annexin-V/Propidium Iodide double-labeled flow cytometry (FCM), TUNEL and transmission electron microscopy were employed to estimate the influence of IH764-3 on proliferation and apoptosis of HSCs. And the expression of ERK 1 mRNA and ERK

IH764-3 at concentrations of 10 mg/L, 20 mg/L, 30 mg/L and 40 mg/L inhibited the proliferation of HSCs. The inhibition rates were 7.13%, 28.36%, 53.80% and 73.10%, respectively, P < 0.01. And the inhibition rates of IH764-3 at concentrations of 30 mg/L at 12 h, 24 h and 48 h were 22.24%, 40.51% and 61.65%, respectively. Furthermore, IH764-3 could also induce the HSC apoptosis in dose-dependent and time-dependent manners (P < 0.01). In addition, after exposure of HSCs to IH764-3 for 24 h, ERK production decreased

Conclusions These results suggest that IH764-3 may inhibite the proliferation and induce apoptosis of HSCs in both dose-dependent and time-dependent manners in vitro, which may be related to downregulation of ERK expression

than 2.0 cm and have no the lymphoid metastases and the blood vessel invasion

Accuracy is 94.4%; The CT examine patients to match with surgical operation is 21 examples. Accuracy is 58.3%; The US examine patients to match with surgical operation 17 examples. Accuracy is 47.2%. The EUS compared with US and CT have siginificant difference (p < 0.05)

Conclusion EUS has a great value in the diagnosis of pancreatic cancer, particularly earlier pancreatic cancer. common lesion is beyond the body of stomach as well as small curve

5%, the erosion was 30.2%, the shallow ulcer was 18.5%, the bleeding scab was 16.9% and the bleeding was 6.5%, the no lesion was found in 4.8% under endoscopy. (4) The effect of drugs spraied under endoscopy was worse than that of the other treatment of intervention under endoscopy (c 2 = 8.71, P = 0.003). (5) No significant difference in prognosis was seen between non-surgery and surgery

Conclusions It is necessary to examine the gastrointestinal haemorrhage cosidered as Dieulafoy's disease by endoscopy, especially in emergency endoscopy. The intervention treatment under endoscopy might be for the first method in the treatment of this lesion. The surgery might be as added therapeutic option to the treatment regimen for this lesion

The clinical significance of intestinal permeability changing in cirrhotic patients with spontaneous ascitic fluid infection CHANGQING GUO, HONGCHUN HUANG, JICHANG LI, ET AL.

Aims To evaluate the change and clinical significance of intestinal permeability in hepatitis cirrhosis patients with Spontaneous Ascitic Fluid Infection (SAI). Materials and Methods 45 hepatitis cirrhosis patients with ascites were sorted into two groups: SAI group including 34 cases and SA control group including 11 cases. To evaluate intestinal permeability, the concentration of lactulose and mannitol in urine was measured using high-pressure liquid chromatograph with refractive index detector (HPLC-RID), and the levels of urinary excretion of LAC/MAN ratios were calculated. The plasma and ascitic fluid levels of endotoxin were measured with limulus amebocyte lysate test. Correlation between plasma endotoxin level and intestinal permeability was assessed by the method of Pearson correlation coefficients. Results The levels of urinary excretion of LAC/MAN ratios were significantly higher in cirrhotic patients with SAI than those in SA group in admitting hospital (P < 0.05). And they were higher in cirrhosis with SA than those in healthy control group (P < 0.05); The plasma and ascitic levels of endotoxin were significantly higher in cirrhosis patients with SAI than those in SA group in admitting hospital (P < 0.05). And they were higher in cirrhosis with SA than those in healthy control group (P < 0.05); By Pearson correlation, in SAI patients, the levels of urinary excretion of LAC/MAN ratios had significantly correlated with the level of endotoxin (r = 0.187, P < 0.001); After being treated for one week, the levels of urinary excretion of LAC/MAN ratios, the plasma and ascitic levels of endotoxin of cirrhotic patients with SAI were significantly decreased but only to the levels of those patients without SAI (P < 0.05). Conclusions The intestinal permeability in hepatitis cirrhosis patients is increased;The intestinal permeability participates in pathophysiological mechanisms of cirrhosis with SAI. To detect the change of intestinal permeability may be used as indexes for judging treatment efficacy and predicting prognosis.

The study on the treatment of NAFLD by compound traditional Chinese medicine -the role of PPAR-a and ligands FENGXIA LI, ZONGSHUN LV

Objects To study the effect of compound traditional Chinese medicine in nonalcoholic fatty liver disease. Material and Methods 46 Wistar rats, control group (n = 8), normal diet; model group (n = 14); traditional Chinese medicine high dose group (n = 8); traditional Chinese medicine low dose group (n = 8); gemfibrozil group (n = 8). All rats were sacrificed after 8 weeks. Examined body weight, liver weight, ALT, AST, TC, TG, FFA in serum and hepatic tissue and the expression of acyl-CoA oxidase (AOX) by RT-PCR. Results 1. lipids: The mean of TC, TG, FFA were significantly lower in three treatment groups than that in model group (P < 0.05). 2. ALT, AST: the mean is higher in gem group than that in traditional Chinese medicine high dose group (P < 0.05). 3. AOXmRNA: the expression of AOXmRNA was higher in three treatment groups than that in model group (P < 0.05). 4. Histology: The level of steatosis and steatohepatitis were significantly lower in traditional Chinese medicine high dose group and gem group than that in model group (P < 0.05). Conclusions 1. The effect of compound traditional Chinese medicine is remarkable in NAFLD. 2. Ligands of PPAR-a is prospective in the NAFLD.Objectives To establish the normal value of psychometric test and to investigate the prevalence of SHE in Chinese patients with stabilized hepatic cirrhosis. Materials and Methods 409 consecutive cirrhotic patients were screened for SHE by using number connection test part A (NCT) and symbol digit test (SDT). The age-corrected normal values were defined as the mean ±2 standard deviation, and developed in 356 healthy persons as normal controls. 416 patients with chronic viral hepatitis were tested as negative controls to assess the diagnostic validity of this test battery. Results There was no significant difference in NCT scores and SDT quotients between healthy controls and chronic hepatitis group (p > 0.05). In all age subgroups, the NCT and SDT measurements of cirrhotic patients differed significantly from those of the controls (p < 0.05).When mean ± 2SD of SDT and NCT measurements from healthy control group was set as normal range, 119 cirrhotic patients (29.1%) were found to have abnormal NCT and SDT tests, 53 (13.0%) being abnormal only in SDT and 36 (8.8%) only in NCT. Taken together, SHE was diagnosed in 208 (50.9%) cirrhotic patients by this test battery.The prevalence of SHE increased from 39.9% and 55.2% in Child-Pugh grade A and B to 71.8% in grade C (p < 0.05).

The experimental study of DC in the formation of rat liver fibrosis XIAOHONG LIAO 1 , DONGBIN ZHOU 1 , BO WANG 2 , TIANCAI WANG 2 , ZHIYONG ZHANG 3 Objective To study the role of intergrina 4 b 1 /VCAM-1 and FN in mediating MC recruitment during rat liver fibrosis and the probable mechanics of DC in preventing and treating rat liver fibrosis. Methods 80 male SD rats used for CCl4-induced liver fibrosis models. To study the relations between DC and connective tissues with photoscopy and electroscopy. Results (1) The numbers of MCs in the liver tissues increased markedly with fibrosis development. And most of MCs distributed along collagenous fibrils. (2) 76.4% MC S expressed integrina 4 b 1 positively. (3) Vascular endothelium in liver tissues and hepatic sinusoid endothelium expressed VCAM-1 positively. (4) And there were a number of FN between hepatic lobuli and in the periportal spaces. (5) The expresses of collage I and collage III have significant distinction between DC groups and model groups, P < 0.05.Conclusions Ingtegria 4 b 1 and its two ligands (VCAM-1 and FN) was a very important pathway mediating MCs recruitment in rat liver fibrosis. MCs were closely correlated to liver fibrosis. DC has some effect in preventing and treating rat liver fibrosis.

Invention of KangXian FuFang I on expression of extracellular matrix and matrix metalloproteinases in cultural hepatic stellate cells stimulated by acetaldehyde HONG LIN, YIXIA ZHANG, YILING LI, WEI CUI, BINGYUAN WANG, BAOYU FU Department of Gastroenterology, Number One Hospital of China Medical University, Shenyang 110001, China Objective To investigate the effects of acetaldehyde on extracellular matrix and matrix metalloproteinases in cultural hepatic stellate cells (HSC) and invention of KangXian FuFang I (KXI) on them. Methods The hepatic stellate cells were primarily cultured and subcultured in vitro in rats. The drug serum containing KXI was collected from the normal rats. HSCs were treated with acetaldehyde and drug serum. The content of laminin (LN) in conditional media, expression of type I (and IV) collagen (a1) mRNA and MMP-1, 2 mRNA in stimulated HSC were measured with radioimmunoassay and reverse transcription polymerase chain reaction (RT-PCR), respectively. Results After acetaldehyde (100 mM) stimulated HSCs for 24 hr, secretion of LN in conditioned media, expression of a1(I)collagen mRNA and MMP-2 mRNA in HSCs increased. The drug serum (10%) could obviously inhibit this stimulating action. While expression of a1(IV)collagen mRNA and MMP-1 mRNA decreased in the same condition. The drug serum (10%) could increase their expression. Conclusion The results indicated that KXI could inhibit secretion of LN, expression of a1(I)collagen mRNA and MMP-2 mRNA and increase expression of a1(IV)collagen mRNA and MMP-1 mRNA in HSCs stimulated by acetaldehyde.

The clinical application in the diagnosis of the cancer of liver with infrared photography XIANG LIN, YAN CAO, HANSHENG WU, ET AL.

Objective To investigate the value of infrared photography in the diagnosis of cancer of liver. Methods By applying THV570 Infrared Photography Diagnosis System, we test and take infrared photographies of the liver regions of 70 people in good health, 25 people with cyst o fliver and 30 people with cancer of liver in covertional operation, then contrast and analyse the consequences of the three groups. Result There are 4 people in the 70 people in good health with the liver region temperature (the warmest region temperature of the liver) ≥36°C with the proportion of 5.7%, there are 3 in the 25 people with cyst of liber with the proportion of 83.3%. There are 8 people in the 70 people in good health with the temperature difference between the warmest region of liver and the relevant region with the peoportion of 11.4%, there are 4 in the 25 people with cyst of liver with the proportion of 16%, while there are 22 in the 30 people with cancer of liver with the proportion of 73.3%. Conclusions It has been proved by laboratory observing and clinical examination that abnormal liver infrared photography is closely related to the cancer of liver and the liver Infrared Photography Test is convenient, ewnomical, no injury, no damage by ray. It can be used as a new test method in general survey in the common people and in Aims The experiment is applied to observe the therapeutic effect of the external application of mirabilite in the assistant treatment of liver cirrhosis ascites and investigate the functional mechanism of the therapy. Materials and Methods 41 cases of liver cirrhosis ascites were hospitalized to receive treatment of routine liver protection, low albumen correction, diuresis, and etc. They were randomly divided into the treatment group of the mirabilite and control group of the routine treatment, among them, 20 cases of mirabilite, and 21 cases of the routine treatments. For cases in the mirabilite group, the external application of mirabilite is used in the assistant treatment of liver cirrhosis ascites for comparison of the therapeutic effects. Seven days is calculated as a period of treatment. B-ultra appliances are used to recheck the volume of ascites in the patients before and after the treatment, leather ruler to reexamine the circulating length of their abdomen to see the effect.

The results were favorable and evident. For both groups the patients lost some serous fluid. The recheck showed that the decrease of the fluid of the treatment group was (38.3 ± 18.55) mm, t = 4.75, P < 0.01; and in comparison, the control group is (21.4 ± 14.24) mm, t = 2.25, P < 0.05. This revealed a remarkable difference of t = 3.23, P < 0.01. For the treatment group, the decrease of circulating length of their abdomen before and after the therapy is (4.7 ± 2.92) cm, and t = 7.23, P < 0.01, the comparison group is (2.7 ± 2.657) cm, and before and after the therapy t is 4.50, P < 0.01; Which also showed a great difference: t = 2.265, P < 0.05. Besides, the patients in the treatment group defecated more in frequency and quantity and without electrolyte foul-up and spontaneous peritoneum inflammation.Conclusions The treatment showed that the external application of mirabilite could help the dilatation of some blood vessels, expedite the blood flow, and improve the micro-circulation. The absorption of the ascites was better in the treatment group than that in the control group, which showed that the external application of mirabilite can absorb large quantity of serous fluid, facilitate vermiculation of stomach and intestines, assist the restoration of the function in digestion, accordingly it can release the abdomen bulge of the patients and improve their life quality. To sum up, the external application of mirabilite is convenient, efficient, and relatively cheap. It is recommended for wider adoption in daily therapy.

Biophysics interventions where biology fails: a breakthrough biophysical methodology counteracting cirrhosis progression G. MARINEO, F. MAROTTA, G. SISTI Delta Research & Development, Research Centre for Medical Bioengineering-"Tor Vergata" University, Rome, Italy Introduction Besides transplantation (OLTx), liver cirrhosis has no valid therapeutic options and a relentless progression with overcoming complication is still a dismal prospective while OLTx waiting lists hugely enlarge. Aims & Methods A pilot study was designed with a novel biophysical methodology as a new treatment modality. Such non-invasive technique has as a main principle the "decrease of entropy", which can be artificially obtained through an electromagnetic-driven delivery of "energy clusters". This has been modulated so as to be used by the body and integrated as "self" to support and charge the energy-dependent functional stores thus modifying reparative into regenerative mechanisms of liver parenchyma. We studied 5 HCV+ (Child A-B) cirrhotics with overt symptomatology and portal hypertension who stopped any medication and underwent daily 40 min sessions of Delta-S DVD, an entropy-variation system, for six months and followed up monthly. Results After six months patients showed either a complete (80%) or a partial (20%) regression of fatigue (Fisk score), a complete reversion of depression (Hamilton score), peripheral edema and pruritus. As assessed by independent observers, despite having stopped betablockers, F1 varices disappeared (60%) while F2 ones were reduced to F1. Doppler-US aspect of partial (40%) or total (20%) atrophy were either reduced (60%) or reverted to normal (20%) while overt scarring nodules disappeared in 40%. Portal vein respiratory dynamics improved (80%) or normalized (20%). A significant increase of active Blymphocytes and NK cells (mean increase: +71, 2% p < 0.002) also occurred. Conclusion Although limited, such preliminary data suggest that this novel biophysical technique can positively affect "biologicallyirreversible" parameters, thus representing a promising new modality to effectively treat liver cirrhosis.

Effect of losartan on the expression of Timp-1 and PAI-1 in the liver of rat with hepatic fibrosis YANNI MENG, GUIYING ZHANG Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008, China Objectives To study the effect of losartan on the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) and plasminogen activator inhibition-1 (PAI-1) in the liver of rat with hepatic fibrosis. Materials Methods Forty-eight SD rats were separated into four groups (model, prevent, treatment, control) . Excepting rats in control group, all rats were given subcutaneous injection of carbon tetrachloride. Rats in prevent and treatment groups were also given losartan via gastrogavage. At the end of 12 weeks, rats were sacrificed. HE, VG staining were used to evaluate the degree of fibrosis, Immunochemistry was used to detect the expression of TIMP-1 and PAI-1 in the liver tissue, respectively. Results Compared with model group, Losartan greatly attenuated the degree of liver fibrosis and significantly inhibit the expression of TIMP-1, PAI-1 in the liver of prevent and treatment group (P < 0.05). However, there was no obvious significantly difference between prevent and treatment group (P > 0.05). Conclusion Losartan can markly attenuate the degree of hepatic fibrosis.

Immunological effect of the therapeutic vaccination in patients with chronic hepatitis B FENYU REN, XIXU PIAO, SHUZI REN, HAICHENG PEI Department of Gastroenterology and Hepatology Yanbian University School of Medicine,Yanji, China Objectives Recent available therapeutic approaches to control chronic hepatitis B are unsatisfactory. Several pilot studies of vaccine therapy in human with chronic hepatitis B showed encouraging results. In the present study, to investigate the antiviral mechanism of vaccine therapy in chronic hepatitis B patients. Materials and Methods Vaccinated 13 patients were analyzed for T cell proliferative responses specific for enverope antigen and cytokine production by antigen-specific T cells. Results Serum HBV DNA levels decreased significantly at 6 months after completion of therapy and thereafter as compared to the baseline ones. Vacccination induced antigen-specific CD4 + T cell proliferative responses in 5 Patients (38.5%). The production of high levels of interferon-and tumor necrosis factor-a by antigen-specific T cells was found in 5 Patients who shouwed significantly lower HBV DNA levels in serum at 6 and 18 months after completion of therapy than those without high levels of cytokine production. Conclusions These results suggest that envelope-specific CD4 + T cells directly control HBV replication by producing antiviral cytokines in the therapeutic vaccination against chronic HBV infection.

Construction and application of the phage display single strain antibody (SCFV) library against hepatocellullar carcinoma (HCC) JIANCHANG SHU 1 , DONGHUA YANG 2 , JINGRUN ZHAO 1 , XIA LV 1 , SHAOHUI TANG 2 Objective To construct a specific phage ScFv library against HCC with large content, good diversity, and identify its biologic features and functions. Methods Spleen mRNA of immunized Balb/c mice was purified. The cDNA was synthesized from mRNA. The antibody heavy (V H ) and light (V L ) chain DNA and ScFv gene were generated.With phage display and gene clone technology, the primary phage library against HCC was constructed and identified. The recombinant phage library was panned with HCC cells and normal hepatic cells to construct the secondary library specific to HCC. E. coli HB2151 was infected by the specific recombinant phage. The ScFv antibody expression was induced by IPTG. ScFv antibodies were analyzed with SDSpolyacrylamide gel electrophoresis. The inhibitory influence of the ScFv on HCC cell was detected with microscope and MTT colorimetric method. By ABC immunohistochemical technique, the specificity of the ScFv antibody against HCC cell was identified. Results The phage library against HCC was constructed with library content of 5.3 ¥ 10 7 . The concentration of expressed ScFv antibody was 0.8 mg/ml. The molecular weight of the ScFv antibody was 31KD. The nucleotides sequencing showed 750 bp fragment including V H of 344 bp and V L of 306 bp. ScFv antibody inhibited HCC cell growth.The highest inhibitory rate was 31.0%. ScFv library showed positive ABC staining with two HCC cells. Conclusions A phage library against HCC with large content, high affinity and strong specificity had been constructed. The ScFv antibody showed high specificity to HCC cells, and inhibited HCC cells growth remarkably.

Effects Objective To investigate the effects of Chinese traditional compound of JinSanE and the changes of transforming growth factor-beta1 (TGF-b)/Smad signaling pathway system liver fibrosis in rat.

Wistar rats were divided into four groups, including normal group, model group, JinSanE group I and JinSanE Group II. Except for normal, all groups injentived CCl 4 for 8 weeks. At the beginning of the first and fourth week, rats in JinSanE group I and II were ofally treated with JinSanE Therapeutic effects of JinSanE was evaluated by the expression of TGF-b1 and TGF-b1 type II receptor (TR II) mRNA in the liver by reverse transcription polymerase chain reaction, the expressions of TGF-b1, Smad3 and Smad7 in liver by immunohistochemistry, the liver histopathology was examined by HE staining. The activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), the levels of serum hyaluronic acid (HA) were assayed. Results Experimental hepatic fibrosis was significantly inhibited by JinSanE. The degrees of necrosis and fibrosis scores were significantly lower in the JinSanE groups than in the model group (P < 0.05). The expression of TGF-b1, TR II and Smad3 were significantly higher in the model group than those in the JinSanE groups (P < 0.01). The amounts of positive staining Smad7 cells were significantly less in the model group than in the JinSanE groups and normal group (P < 0.01). The contents of ALT, ASTand HA were significantly lower in the JinSanE groups than those in the model group (P < 0.01). Conclusions JinSanE prevented the progression of hepatic damage and fibrosis through the inhibition of TGF-b1, TR II and Smad3 signal protein, and increased expression of Smad7 signal protein in vivo.

Dioctahedral smectite combined with Da Ji was used in curing cirrhosis of liver with diarrhea 60 cases MINXIAN SUN Department of Digestion, The 2 nd People's Hospital of Dalian City, Liaoning 116000, ChinaObjective To compare effect of using DS combined with DJ with DS or DJ being used alone in curing cirrhosis of liver with diarrhea. Method 60 cases were selected according to diagnostic criteria for cirrhosis of liver and eliminating infective and drug effective factor. Divided these cases into three groups, DS were given to control group A, 3 g three times daily, DJ was given to control group B, 2 pills three times daily, DS combined with DJ were given to treated group C with the amount of dosage is the same as above. The course of treatment is 10 days. Result There were 20 cases in each group. 4 cases of notable result, 6 cases of effective result and 10 cases of inefficient result were found in group A. 3 cases of notable result, 5 cases of effective result and 12 cases of inefficient result were found in group B. 16 cases of notable result, 3 cases of effective result and 11 cases of inefficient result were found in group C. the total effective rate in group A. B. and C. was 50%, 40% and 90% respectively. There was significant difference between treated group and two control groups, p < 0.05. Conclusion The curative effect of using DS combined with DJ in curing cirrhosis of liver with diarrhea is better than that of using DS or DJ alone.

The expression of hypoxia-inducible factor-1a in rat liver of cold/warm ischemia/ Objective To find effective way to reduce ischemia/reperfusion injury, we investigate the expressions of hypoxia-inducible factor-1a (HIF-1a) in rat liver following cold/warm ischemia/reperfusion. Material and method SD rats were divided into 11 groups randomly. Models of warm ischemia/reperfusion, cold ischemia/reperfusion and orthotopic liver transplantation were made. The expressions HIF-1a were examined with method of immunohistochemistry. The quantity analyses of the expression of HIF-1a were made by image analysis instrument. The changes of HIF-1a expression at 1 hour of ischemia and 0, 1, 12 and 72 h of reperfusion were examined. Results In groups of warm ischemia, the expression of HIF-1a increased 1 hour after ischemia, and laid in summit 12 of reperfusion. Then, it decreased at 72 hours of reperfusion, while still higher than that of control. In this group, the expressions of HIF-1a were strengthened in region I of liver acinus while weak in region II and III. In Group of cold ischemia, the expressions of HIF-1a were lower, but up-regulated at 72 hour of reperfusion. Conclusion HIF-1a can be induced immediately after warm ischemia, and expressed in regions of low oxygen supply. It may be related to the generation of vessel.

The hepatic injury in elderly patients with severe acute respiratory syndrome: retrospective analysis GENG TIAN, TAI-CHANG ZHANG, HUIQING YANG

Objectives To study the liver injury in elderly patients with severe acute respiratory syndrome retrospectively.

We study the symptoms/physical signs and liver function (ALT, AST,TBIL, DBIL,TBA), complications and prognosis patients with SARS retrospectively. Results The symptoms and physical signs of the digestive system in elderly patients with severe acute respiratory syndrome were diarrhea (19.5%), abdominal pain (7.3%). The tests of liver functions showed the levels of ALT (45.83 ± 43.82) u/L, AST (33.83 ± 28.04) u/L, TBIL (7.31 ± 14.84) umol/L, DBIL (6.89 ± 6.88) umol/L and TBA (3.92 ± 3.15 ) umol/L in elderly patients and the levels ALT (57.55 ± 48.80) u/L, AST (35.00 ± 35.25) u/L, TBIL (12.60 ± 7.18) umol/L, DBIL (4.78 ± 4.63) umol/L and TBA (4.85 ± 6.09) umol/Lin adult patients. There is no significant difference between elderly patients and adult patients. But the mean levels of ALT in two groups' patients were higher than normal levels (0-40) u/L. Conclusions The elderly patients with SARS had the liver injury. The reasons of high fatality rate in elderly patients may have some relationships with effects of SARS virus, original diseases and complications.

Serum ascites albumin gradient as a non-invasive parameter for portal hypertension on liver cirrotic patients with ascites at Manado general hospital BJ. WALELENG, NT. WENAS, JV. LUCIDA, C. WIBOWO Gastroenterohepatology, Sam Ratulangi University-Manado General Hospital, Indonesia Aims To assess the correlation of SAAG with portal vein and spleenic vein diameter on LC patients who had PH with ascites.

This is an analytic observasional study with cross sectional design. Subjects are LC patients with ascites who administered in Irina C and/or as out patients in Gastroenterohepatology Clinic at Manado General Hospital from May 2002 to April 2003. Patients who fulfilled the inclutions and exclutions were measured SAAG, and portal vein also spleenic vein diameter by using conventional USG. It was used z test and Pearson's correlation coefficient test for analyzing statistically.Objective To investigate the effects of recombinant human augmentor of liver regeneration (hALR) on c-jun gene expression in hepatic stellate cell. Methods Hepatic stellate cell (HSC-T6) was cultured in medium containing different concentrations of hALR (200 mg/L, 20 mg/L, 2 mg/L respectively) and cells were collected at different incubation period (8, 24, 48, 72 h) . Total RNA of HSC was isolated and c-jun gene expressions level was measured by reverse transcription polymerase chain reaction. Results c-jun gene expression levels of HSC in high (200 mg/L), middle (20 mg/L) and low (2 mg/L) concentrations of three hALR groups were much lower than those of control group after exposure to hALR at 8, 24, 48 and 72 h. Low dose group was 60-64% of control group, middle dose group was 41-43% of control group and high dose group were 29-35% of control group. Conclusions hALR could inhibit gene expression of c-jun in hepatic stellate cell.

The study on the changes of blood hormone of live cirrhosis patients FANG WANG, YULAN LIU, WENBIN XIAO Gastroenterology Department Of People's Hospital, Peking University, Beijing 100044, China Objective To study the changes of blood hormone of live cirrhosis patients. Methods A total of 30 live cirrhosis patients (study group) and 10 chronic hepatitis patients (control group) were examined by abdominal ultrosonography, and testet liver function test and H/L. Blood E (epinephrine), NE (norepinephrine), R (rennin), A (angiotensin), Aldo (aldosterone), ANP (atrial natruretic polypeptide), G (glucagon), ET (endothelin) and CGRP (calcitonin gene related protein) were measured. Results There was a significant difference between the epinephrine, norepinephrine of live cirrhosis patients and chronic hepatitis patients (P < 0.05). There were no significant differences among the A (angiotensin), Aldo (aldosterone), ANP (atrial natruretic polypeptide), G (glucagon), ET (endothelin), CGRP (calcitonin gene related protein) of two groups (P > 0.05). There were significant differences among the epinephrine, norepinephrine of Child A, Child B, Child C live cirrhosis patients (P < 0.05).Conclusion Epinephrine and norepinephrine of live cirrhosis patients obviously increase; there was a positive relation with liver function. Objectives To examine the functional characteristics of CD8+ and CD4+ T lymphocytes in liver and in blood of patients with chronic HCV infection. Materials and methods Intrahepatic lymphocytes (IHL) and peripheral blood lymphocytes (PBL) were isolated from paired liver biopsy and blood samples of 14 patients with chronic HCV infection. To examine the cytokine production capability the cells from 8 patients were stimulated with SEB for 5 hours, followed by intracellular staining for IFN. And the expression of Fas, Fas ligand and perforin were assessed by cell surface and intracellular staining, respectively. To examine the proliferation capability of the cells from other 6 patients were stained with CFSE and stimulated with IL-2 and anti-CD3, followed by 6-color flow cytometry. Results 1) Frequencies of IFNg-producing CD8+ and CD4+ T lymphocytes were lower in the liver than those in the blood (2.4 ± 2.5% vs. 6.8 ± 6.9 for CD8+ T cells and, 3.6 ± 1.3% vs. 5.1 ± 4.4% for CD4+ T cells, respectively, p < 0.05). 2) The frequency of per-forin+ CD8+ T lymphocytes was lower in liver than in blood (8.0 ± 5.5% vs. 20.3 ± 11.2%, p < 0.05).

3) The frequencies of FasL+ T lymphocytes were higher in the liver than than in the blood (2.9 ± 2.5% vs 0.5 ± 0.4 for CD8+ T cells and 8.3 ± 5.0% vs. 1.0 ± 0.8% for CD4+ T cells, both p < 0.05), while the frequencies of Fas+ T lymphocytes were higher in the liver than in blood (91.2 ± 4.6% vs. 75.7 ± 15.8% for CD8+ T cells and 89.0 ± 7.3% vs. 72.7 ± 15.1% for CD4+ T cells, both p < 0.05). 4) Intrahepatic CD4+ and CD8+ T cells did not proliferate when stimulated in vitro with the same condition used for amplifying peripheral T cells. Conclusions intrahepatic CD8+/CD4+ T lymphocytes from chronic hepatitis C patients are functionally different from their counterparts in the peripheral blood, which may contribute to the immunopathogenesis of HCV infection.

It has been suggested that siRNA have the potential to inhibit HBV gene expression and to block the HBV lifecycle by degradation of the pregenomic RNA.The aims of this study were to develop an RNAi approach that specifically targets the precore and core regions and S regions of hepatitis B virus (HBV) by synthesizing short interfering RNA (siRNA) in vivo, and to explore the inhibitory effect of siRNAs on HBV replication and expression.

Four PCR producing siRNA expression cassettes (SECs) which targeted HBV genome different sites of S and preC/C gene and a scramble SECs control directed unrelated sequence were designed and synthesized and their interfering efficacy to viral genome was quantified in HepG2. 2.15 cells by ELISA and dot hybridization method.

The endogenously expressed siRNAs directed at three sites in HBV gene showed a dose-dependent and sequence-specific inhibitory effect on HBV gene expression between PCR products concentrations of 0.5-2.0 ng/ul. HBV-specific siRNA producing system targeted the region 458 to 478 bases in HBV S gene produced the greatest decrease level of HBsAg and HBeAg, with inhibitory rates peaking at 100% and 64.78%. The interfering action was related to time and lasted 12 to 14 days. No inhibitory effect on the replication and expression of HBV were observed in culture cells treated by the scramble control system. The cells remained viable throughout the experiments and no morphological abnormalities and cytotoxicity were examined with SECs at PCR products concentrations below 4 ng/ul. Conclusions Our synthesized HBV-specific siRNAs producing system exhibited high efficient activity to suppress HBV gene replication and expression in HepG2. 2.15 cells, suggesting RNAi-based anti-HBV strategy may open a path toward using siRNAs to improve HBV therapy.

Effect of salvia miltiorrhiza monomer IH764-3 on collagen degredation in rat hepatic fibrosis ZHANKUI WANG 1 , HUIQING JIANG 2 Objective To probe roles of salvia miltiorrhiza monomer IH764-3 in anti-fibrogenesis and the mechanism.Methods Forty male SD rats were divided into three groups at random, control group 10 rats, model group 15 rats and IH764-3 group 15 rats. The hepatic fibrosis was induced by common bile duct ligation. The rats of IH764-3 group received 40 mg kg -1 of IH764-3 introperitoneally, while other rats were injected introperitoneally by equivalent saline. At the fourteenth day, animals were sacrificed. Tissue sections were stained immunohistochemstrically to detect TIMP-1 and TGFb1 positive areas.

The contents of hydroxyproline in model group were higher than those in control group [(0.586 ± 0.070)mg/mg vs (0.178 ± 0.034)mg/mg dry weight (P < 0.01==. Treated by IH764-3, they (0.349 ± 0.058 mg/mg) were lower than those in model group (P < 0.01=. Immunohistochemistrically, the positive areas of TIMP-1 increased more evidently than those in control group (12.36% ± 1.52% vs 4.31% ± 1.02%, P < 0.01=. In IH764-3 group, they were more diminutive than those of model group, which decreased to 7.88% ± 1.24% (P < 0.01=. The positive area of TGFb1 in model group increased from 4.05% ± 0.55% in control group to 10.52% ± 0.74% (P < 0.01=, meanwhile, they decreased to 7.10% ± 1.24% after exposed to IH764-3. TGFb1 was correlated positively with TIMP-1 in all groups (P < 0.05). Conclusions Silvia mitiorrhiza monomer IH764-3 may relieve hepatic fibrosis induced by BDL. It may downregulate the expression of TIMP-1 and TGFb1.

Study on therapeutic effect with a-interferon (IFN) injection/or combine with lamivudin for long term on chronic hepatitis B ZHAOQUAN WANG, XIAOGUANG DOU, ET AL.

Objective To study the therapeutic effect with a-IFN for long term on chronic hepatitis B. Methods The patients of three groups received a-IFN 3 MU, qod, im combines with Lamivudin over one year. The effect was depended on changes of clinical signs, aminotransferase, virology indexes (HBV-Ms). Results Three patients of first group were clinic complete cure. Other tree patients of second group were complete respond. Besides, tree patients were complete respond during therapy combine a-IFN with Lamivudin, but did not fall out of use with a-IFN and Lamivudin, because they were into relapse or break through easily. Conclusion The more patients with chronic hepatitis B could be to best prognosis, when to use a-IFN / or it combine with Lamivudin for long term. But the therapeutic effects were differently in several patients.

Successful clinical application of MARS in maternal amanita poisoning during the second pregnancy trimester: a case report BANGFU WU 1 , MINMIN WANG 2 Objectives To investigate the clinical effects of MARS method for rescue patients with acute liver failure secondary to cytoxic mushroom poisoning during the pregnancy. Methods A 27-year-old-woman who was hospitalized with food intoxication caused by Amanita phalloides in her 20th week of pregnancy. She suffered a severe liver failure. The previous extracorporeal purification treatments with 2 times of hemodialysis (HD) plus hemo-

Objectives Through investigating serum leptin levels relations with osteocalcin (BGP) and bonal mineral density (BMD), understand the pathophysiology of osteodystrophy in patients with cirrhosis of liver. Materials and Methods Thirty males and ten females patients with post-hepatitis cirrhosis. (mean age 50 years, rage 24-70 years), and age-and-gender-matched controls was include. BMD was measured by using dual energy X-ray absorptiometry, Serum leptin and BGP were measured by using a radioimmunoassay. Body mass index (BMI) was calculated by dividing weight (kg) by squared height (m 2 ). Results 1. No correlation was found between serum leptin levels and BMD or its Z-Score at lumbar spine either in patient group or in control group (P > 0.05, respetively). Subgrouping patients into Child-pugh grade, the result didn't change in male patients either Child-pugh A grade or Child-pugh C grade (P > 0.05, respectively). However, the inverse relationship was observed between serum leptin with BMD and its Z-Score at lumbar spine both in female cirrhosis group (Child-pughA + B) (P < 0.05) and in male cirrhosis of liver group (Child-pughB) (P < 0.05). Serum leptin adjusted for BMI positively correlated with BMD and Z-Score at lumbar spine in female patients with cirrhosis of liver (r = 0.698, 0.399, P < 0.05, respectively) and negatively correlated with BMD at lumbar spine in male patients with cirrhosis of liver (r = -0.576, P < 0.01). 2. There was significantly negatively correlations between serum leptin levels and BGP levels in cirrhotic patients (r = -0.576, P < 0.01). Conclusion Leptin may be a factor in the hepatic bone disease.Objective To investigate the effects of melatonin on nuclear factor kappa B expression of liver fibrosis in rats.

A rats liver fibrosis model was established by treating with carbon tetrachloride (CCl 4 ). The animals were randomized into 3 groups: normal group, model group, melatonin group (5.0 mg/kg), treated ip with saline, saline, melatonin respectively (once a day, from d 1 to d 90 during the model was prepared). After the end of the experiment, the score of the index of hepatic injury (HI) and the index of fibrosis (FI) were evaluated, the content of nitric oxide (NO) in rats liver homogenate were measured. Meanwhile, the expression of a-smooth muscle actin (SMA), the subunit of nuclear factor kappa B (p65 and p50), and that of iNOS in liver tissue were detected by immunohistochemistry methods. Results After treated with CCl 4 , the HI and FI were increased and the NO content was elevated, the expression of a-SMA, p65, p50 and iNOS protein were intensified in rats liver. Liver fibrosis was significantly improved by melatonin, which were supported by the reduction of the HI and FI.The expression of iNOS protein and the content of NO were downregulated by melatonin through inhibiting the expression of p65 and p50 protein.Conclusion Melatonin could reduce liver fibrosis through inhibiting the nuclear factor kappa B signal transduction to downregulating the expression of iNOS protein and the synthesis of NO.

Effects of estradial ON I, III-type collagens and TGFb 1 in liver of fibrosis rats JUNWANG XU, GONG JUN, XINMING CHANG, JINYAN LUO, LEI DONG, AI JIA, GUIPING XU Department of Gastroenterology, First Hospital of Xi'an Jiaotong University, Xi'an, China Objectives To study the effects of estradiol on the production of collagen I, III and TGFb 1 in experimental fibrosis rats induced by CCL 4 , and then to investigate the suppressive effects of estrogen on liver fibrosis. Methods Rats were randomly allocated into a normal control group, a model control group, a therapy control group and a estradiol group. Liver fibrosis was induced by CCL 4 administration. The estradiol group, apart from the CCL 4 used, was treated subcutaneausly with estradiol (benzoic estradiol) 1 mg/kg twice weekly. At the end of 8 weeks, all the rats were sacrificed. The liver inflammation and collagen deposition were observed with HE and Masson's collagen stains, analyzed with scoring and staging systems. The I, IIItype collagens and TGFb 1 were observed with immunohistochemical method. Results CCL 4 group had the typical liver fibrosis compared with normal control group. The fibrous septa were formed in CCL 4 group rats, and collagens were accumulated and deposited in the sinusoids and liver lobules. The expression of type I, III collagens (0.58 ± 0.26 vs 6.34 ± 2.24, 1.07 ± 0.49 vs 5.28 ± 1.28, P < 0.001) and TGFb 1 was significantly increased. Estradiol significantly attenuated collagen accumulation (P < 0.05) in the fibrotic livers, and decreased type I, III collagens (2.47 ± 0.76 vs 6.34 ± 2.24, 3.02 ± 1.20 vs 5.28 ± 1.28, P < 0.05) and TGFb 1 expression in the liver. Conclusion Estradiol treatment lowers the synthesis of hepatic type I, III collagens and TGFb 1 in the fibrotic rats induced by CCL 4 administration, and then reduces hepatic fibrosis.

Research on the relationship between ADH and ALDH gene polymorphism and alcoholic liver disease MING YAN, KONGXI ZHU, FANLI MENG, HONGJUAN WANG, MEILING WU Departments of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China Objectives By detecting the genotypes of the key enzymes of alcohol metabolizing in human body, to study the differences of the allele frequencies of ADH and ALDH gene at ADH2, ADH3 and ALDH2 loci in the following 3 groups: healthy control group, alcoholic dependence group (without liver damage), alcoholic liver disease (ALD) group.We hope to investigate the pathogenesis of ALD in view of genetic point, and may give the clinical physicians useful suggestions to prevent alcoholism and ALD. Materials and Methods 5 ml venous blood is taken from each patient of the healthy control group, alcohol dependent group (without liver damage), alcoholic liver disease (ALD) group, each group contains 20 patients. After add EDTA to prevent the blood from coagulating, separate WBC out of the blood within 2 hours. Then to freeze the WBC in liquid nitrogen for later use. DNA is extracted from WBC by saturated phenol method. Then polymerase chain reaction (PCR) is performed after the DNA is purified, sedimented and dissolved. One PCR mixture is for ADH2 and ADH3 gene amplification, another PCR mixture is for ALDH2 gene amplification. Adjust the reaction condition, exam whether there has been some amplification products by electrophoresis in polyacrylamide gel. After the amplification product is precipitated by ethanol, add Mae III to digest ADH2 gene amplification product to detect ADH2*1 and ADH2*2. Add Ssp I to digest ADH3 gene amplification product to detect ADH3*1 and ADH3*2. Add EcorR I to digest ALDH2 gene amplification product to detect ALDH2*1 and ALDH*2. The digested products are run on 14% polyacrylamide gel and stained with ethidium bromide, photographed and analysed by ID Image Analysis Software to determine the genotypes of each gene. Results The frequency of ADH2*1 allele in health control group is 10%, in alcohol dependent group is 30%, in ALD group is 10%; The frequency of ADH2*2 allele in health control group is 90%, in

Shift of Th1/Th2 cells in patient with primary carcinoma of liver SHENG YANG 1 , YINGPING CAO 2 , YANG WEIZHU 1 ET AL. 

Objective The study is to comprehend in immunological mechanism of the primary carcinoma of Liver and to develop a basic theory for the immunoloregulation of the disease by analyzing the shift of Th1 and Th2 cell. Methods Serum levels of IL-2, IFN-, IL-4, IL-10 were examined in 24 patients and 24 healthy subjects by using ELISA, the mRNA expression of type 1 cytokines (IL-2, IFN-) and type 2 cytokines (IL-4, IL-10) were also measured by PCR. Results It can be seen that serum levels and mRNA expression of Th1 cell from primary carcinoma of Liver patients was obyiously lower than that from the healthy control (p < 0.05), but serum levels and mRNA expression of Th2 cell from primary carcinoma of Liver patients was obyiously higher than that from healthy control (p < 0.05). Conclusions There exists two sabsets in the primary carcinoma of liver. The Th1 cell trends to the Th2 cell. This may account for the fact that makes tumor cells escape the immune surveillance of the host.Therefore it is very important to maintain the balance of Th cells in patients.

The role of heme oxygenase and carbon monoxide in hyperdynamic circulation of cirrhotic rats SHUPING YANG 1 , JIYAO WANG 2 , JINSHENG GUO 2 Objectives This paper was to explore the role of heme oxygenase and carbon monoxide in the hyperdynamic circulation of cirrhotic rats. Methods Liver cirrhosis was induced by percutaneous administration of carbon tetrachloride (CCl 4 ). A single dose of Zinc protoporphyrin IX (ZnPP), a specific HO inhibitor, was s.c. injected into the posterior neck of rats. Mean arterial pressure (MAP, kPa), heart rate (HR, b/min) and portal pressure (PP, cmH 2 O) were measured by indwelling catheters. Plasma carbon monoxide was measured by Chalmer's method. Heme oxygenase (HO) activity in splanchnic organs from cirrhotic rats and controls was also determined. Results Histologically typical features of cirrhosis were observed in the animals treated with CCl 4 . The cirrhotic group presented a significant increase in PP (P < 0.01) and a significant decrease in MAP (P < 0.01). No differences were observed regarding HR. Percutaneous injection of ZnPP significantly increased MAP (P < 0.05) and significantly decreased PP (P < 0.01) in cirrhotic rats. In a single regression analysis, significant correlation was detected between plasma carbon monoxide and MAP (r = -0.67, P < 0.05). In comparison with controls, HO activity was significantly increased in spleens (80% increase), intestines (100% increase), and mesenteries (30% increase). Conclusions Our finding sugest that heme oxygenase and carbon monoxide may play an important role in hyperdynamic circulation in cirrhosis. Objectives To investigate the anti-cancer mechanism of cisplatin (CDDP) and matrine (MT) that often used in liver cancer treatment by studying their effects on telomerase.

Microculture tetrazolium assay (MTT), flow cytometer (FCM) and PCR-ELISA were employed to determine and observe the killing effect of CDDP and MT, and their effects on adhering ability and telomerase activity of QGY cells. Results CDDP and MT had anti-QGY activity in distinct doseand time-dependent manners in vitro. CDDP had more strong antiadhering activity than MT. Two drugs could obviously inhibit telomerase activity. Conclusions The inhibition of telomerase activity may be one of the mechanism of anti-tumor effect of chemotherapeutic drugs CDDP and MT in liver cancer treatment.

Objective To investigate the mechanism of RSM in treating portal hypertension (PHT). Methods Preparation of RSM cream, with the immunocyte chemistry and LSCM, the study examined effects of RSM on expression of iNOS and eNOS and changes of HSCs [Ca 2+ ]i. Results 1 In activated HSCs, RSM increased the expression of iNOS, the absorbency increased from 0.034 ± 0.001 to 0.053 ± 0.002, P < 0.05, while there showed no significant changes in expression of eNOS; 2 Preincubation with RSM in buffer A, the ET-1-induced duration of calcium wave decreased compared with ET-1 alone (165.19 ± 10.11 vs 69.11 ± 12.46s, P < 0.01); 3 Preincubation with RSM in buffer B, the calcium peak value and duration of calcium wave had no significant changes (P > 0.05); 4 Preincubation with RSM, KCl-induced elevation of [Ca 2+ ]i decreased, the calcium peak value (78.02 ± 6.11 to 26.25 ± 1.19, P < 0.01) and duration of calcium wave (70.83 ± 10.36s vs 15.91 ± 5.14s, P < 0.01) both decreased significantly. Conclusions RSM increased the expression of iNOS in activated HSCs. RSM inhibited ET-1-induced depletion of intracellular calcium, had no relations with influx of extracellular. RSM can also inhibit KCl-induced calcium influx.Which showed that RSM had the character of blocking VOCC. Objective To study the change of serum levels of endotoxin, IL-4 and IL-18 in patients of various courses of chronic hepatitis B, research for their roles in the pathogenesis of chronic hepatitis B.

The serum level of endotoxin (LPS) was determined by limulus amebocyte lysate test, the serum levels of IL-4 and IL-18 were tested by double antibody sandwith ELISA, and meanwhile routine serum biochemical tests (serum alanine transaminase (ALT), aspartate transaminase (AST), r-glutamine transpeptidase (r-GT), alkaline phosphatase (AKP), albumin, globulin, bilirubin, ets) and hematological tests (including complete cell count) were performed with routine automated techniques in 35 cases of chronic hepatitis B (CHB) and 30 cases of healthy volunteers whom were set up as the control group respectively. Results The serum levels of LPS, IL-4, IL-18 and ALT were significantly higher in the active course of CHB group (46.97 ± 13.00, 58.71 ± 9.37, 149.22 ± 66.93, 222.61 ± 220.12) than those in the inactive course of CHB group (23.73 ± 5.88, 33.83 ± 6.46, 53.54 ± 20.85, 72.10 ± 40.18) respectively (t = 2.646, p < 0.01). And there were obvious differences between chronic hepatitis B group and control group respectively (t = 2.652, p < 0.01). As the serum ALT decreased and the disease released the serum levels of four markers decreased in the inactive course in CHB group. The results of correlativity analysis indicated that in the CHB group, there were positively correlativity between the serum level of LPS and those of IL-4 and IL-18 in the active of CHB respectively (r = 0.718, 0.883, p < 0.01). So did the same between IL-14 and IL-18 (r = 0.854, p < 0.01). Conclusions The change of the levels of endotoxin, IL-4, IL-18 and interaction and interregulation on each other plays an important role in the pathogenesis and development of chronic hepatitis B.

Efficacy of thymosin alpha-1 and interferon alpha in the treatment of chronic viral hepatitis B: a randomizer controlled study JING YOU, LIN ZHUANG, YANWEI QIAO, GAO Objective To observe the efficiency and safety of Thymosin-a1 treatment in patients with hepatitis B e Antigen (HBeAg) and HBV DNA positive chronic hepatitis.

Sixty-two patients were randomly divided into group A and B, and both groups were comparable (p > 0.05) at baseline (age, sex, alanine transaminase (ALT) levels, etc.). The patients in group A received Thymosin-a1 1.6 mg subcutaneous injection two times a week (T-a1 group), and the patients in group B received Interferon alpha 3-5 MU each day for fifteen days, then three times weekly (IFN-a group) for six months. Compared results between two groups treated patients, and compared with the results observed in a group of thirty patients never treated with IFN-a and followed for 12 months (historical control (HC) group), and three groups were comparable between each other (p > 0.05).

HepG2 cells were cultured in RPMI1640 media and treated by NS-398 for 24 to 48 hours. MTT cell proliferation assay was used to observe the inhibition of HepG2 after treating by NS-398. The apoptosis of HepG2 cells was displayed by fluorescent microscopy, transmission electron microscopy and flow cytometric analysis. The expression of Bcl-2 and cycling D1 in HepG2 cells during the cell cycle and apoptosis was measured by immunocellularchemical staining. Results NS-398 could significantly inhibit HepG2 cells proliferation in a dose-and time-dependent manner. NS-398 can inhibit the growth and proliferation of HepG2 cells (P < 0.01). The treatment of NS-398 can obviously induce some morphologic features of HepG2 cell apoptosis. Cellular nucleus shrinking, nucleus fragments, luniform chromatin agglutinating and chromatin fragmentation were visualized under transmission electron microscopy. The reduction of nucleus sizes and dense nucleus were viewed under fluorescent microscopy except for NS-398 treatment group. Flow cytometric analysis showed a typical sub-G1 peak in NS-398 group and the sub-G1 peak higher in NS-398 group than in that of controls along with the increased number of apoptotic cells whereas no sub-G1 peak was shown in the NS-398 group. Compared with control, the groups of NS-398 exhibited remarkable decreases in Bcl-2 expression, while the cyclin D1 expression was downregulated in both NS-398 group. Flow cytometric analysis found a notable arrest of G1-stage-cells in NS-398 group. Conclusions COX-2 selective inhibitor NS-398 could significantly inhibite the proliferation of hepatic cancer cells, and the apoptosis and G1-cell arrest induced by NS-398 was deeply implicated in these processes. Both Bcl-2 and cycling D1 play an important role in modulating apoptosis and cell cycle arrest induced by NS-398. Conclusively, NS-398 can be a candidate agent used for HCC prevention and treatment.

Dose-effect of thioacetamide on animal model of hepatic encephalopathy in rats MEIHUA ZHANG 1 , JIA LIN 1 , DU HONG 2 , CHANGQING SHU 3 , LI ZHE 3

Objectives To investigate the correlation between dose and effect of thioacetamide (TAA) on animal model of hepatic encephalopathy in rats.

Animal model of hepatic encephalopathy were induced by three different dose of TAA which receiving two intraperitoneal injections of TAA 200 mg/kg, 250 mg/kg, 350 mg/kg of body weight respectively at 48 h time intervals (n = 12). Brainstem auditory evoked potentials (BAEP) and plasma endotoxin from portal vein of rats, serum ammonia, serum liver function and pathology of liver were examined. Results There are significant differences among three different dose of TAA groups in rats on incidences of HE/MHE, grades of HE, plasma endotoxin, serum ammonia, serum liver function and changes of liver pathology (P < 0.05). Conclusion There are significantly differences on animal model of hepatic encephalopathy induced by different dose of TAA in rats, which has showed significant correlation between dose and effect.Two intraperitoneal injections of TAA (200 mg/kg body weight) at 48 hour intervals is ideal method of MHE model.

Objective To investigate effects of pioglitazone on rat hepatic fibrosis and to reveal its mechanism. Methods Rat hepatic fibrosis was induced by carbon tetrachlode (CCl 4 ). Forty Sprague-Dawley rats were divided randomly into four groups: control, model, and two treatment (PI, PII) groups. Excepting rats in control group, all rats were given subcutaneous injection of 40% CCl 4 , twice a week for 8 weeks. Rats in PI, PII groups were also treated with pioglitazone of 3 mg/kg, daily via gastrogavage at the beginning of or the end of second week of administration of CCl 4 respectively. At the end ofthe experiment, all rats were sacrificed, and blood and liver tissue specimens were obtained. Liver function (ALT, AST), serum fibrotic markers (HA, LN, PCIII) and hepatic hydroxypro1ine (HP) concentration were determined respectively. Histochemical staining of formalin-dixed 1iver sections with HE Masson-Trichrome, and immunohistochemical staining for a-smooth muscle actin (a-SMA) were performed. Modifled Knodell and Chevallier semi-quantitative scoring system (SSS) was used to evaluate necroinflammatory activity and fbrosis degree. Results Compared with model group, pioglitazone significantly reduced the serum level of ALT, AST and HA, LN, PCIII (P < 0.05 or <0.01. The HP concentrations in PII (210.90 ± 24.07 mg/g), PII (257.36 ± 30.55 mg/g) groups were also lower hean those in model group (317.80 ± 36.44 mg/g) (P < 0.01). Histologic examination show thet PI, PII groups had milder hepatocellular degeneration, nicrosis and infiltration of inflammatory cells, and thinner or less fibrotic septa than did model group. The scores for nicroinflammation in PI (2.80 ± 1.03), PII (3.00 ± 1.05) groups were significantly reduced as compared with model group (4.88 ± 2.30) (P < 0.05 or <0.01; the fibrosis scores in PI (3.40 ± 1.65), PII (4.60 ± 1.35) groups were also markedly lower than those in model group (7.00 ± 3.21) (P < 0.05 or <0.01). Immunohistochemical staining showed that expression of a-SMA in PI, PII groups was smeliorated dramatically compared with model group. Conclusion PPARg agonist pioglitazone greatly retards the progression of rat hepatic fibrosis induced by CCI 4 through inhibiting activation of hepatic stellate cells (HSCs) and attenuating necroinflsmmation. Objectives To study the activity of Newcastle disease virus (strain F48E9 and La Sota) kill the human hepatocellular carcinoma cells (HCC), and analyse the manner of cell death induced by NDV.

The velogenic strain of NDV F48E9 and lentogenic strain La Sota was provided by Haerbin Veterinary Gradulate School, and in our study NDV was diluted into 10, 20 and 40. The human HCC line HEPG2 was brought from Tumor Hospital of Heilongjiang Province. The cells, which are in logarithmic propagation, were used. First, MTT was adopted to determine the activity of NDV kill HCC. Then, added the diluted virus into the cells whichObjectives Malnutrition was one of the commonest manifestations in cirrhotic patients. Introvenous supplement of branched-chain amino acids (BCAA) in cirrhotic patients was effective to correct the imbalanced Fisher ratio and improve the hypoalbuminemia. Therefore, we performed a randomized study to evaluate the effect and safety of oral branched-chain amino acids in cirrhotic patients with hypoalbuminemia. Materials and Methods One hundred and fifty cirrhotic patients with hypoalbuminia were randomly assigned to receive oral branchedchain amino acids (4.74 g of granules, BCAA group, n = 100) or with compound amino acid capsules (3.5 g of capsules, CAA goup, n = 50) for 9 weeks. Liver function test and renal function test as well as karnofsky performance was evaluated before and after the treatment. Results After the treatment, the symptoms such as fatigue and edema of the lower extremities were improved more often in BCAA group than that in CAA group (p < 0.01). Improvement rates of appetite was not statistically different (p > 0.05). Quality of life evaluated with Karnofsky performance status was also improved in both groups (p > 0.05). Serum albumin level inceeased from 32.3 ± 3.1 g/L to 37.6 ± 5.1 g/L in BCAA group and 32.1 ± 2.0 to 36.6 ± 4.7 g/L in CAA group (p < 0.05). There was no statistical difference in the increase of total serum protein between the two groups (p > 0.05). There was no obvious adverse effect in either group. Conclusions Oral branched-chain amino acids were effective and safe to increase the serum albumin level and improve symptoms and the quality of life in cirrhotic patients.

Dynamical influence of cordyceps sinensis on the activity of hepatic insulinase of experimental liver cirrhosis XIA ZHANG, YUKAN LIU, WEI SHEN, DINGMING SHEN

Objective To investigate the dynamical effects and mechanisms of Cordyceps sinensis (CS) on the activity of the hepatic insulinase in CCl4 induced liver cirrhosis in rats. Methods Rats were randomly allocated into a normal group, a model group and a CS group. Rats in normal group were sacrificed at the beginning of experiment. While other two groups were sacrificed randomly at the end of the third, the sixth and the ninth week. Blood and tissue specimen were taken. Biochemical assay were used to determine the level change of ALT, ALB content in serum. And radioimmunological assay were used to determine the level change of HA, INS content in serum and the activity of the hepatic insulinase. Results (1) The serum level of ALT, HA in the CS group was lower than that in the model group at the ninth week (P < 0.05), but the serum level of ALB in the CS group was higher than that in the model group at the ninth week (P < 0.05). (2) The serum level of insulin in the CS group and model group at the sixth and the ninth week were higher than that in the normal group (P < 0.05). But the according activity of the hepatic insulinase were lower than that in the normal group (P < 0.05, or P < 0.01). (3) There were no significant differences of the serum level of the insulin and the activity of the hepatic insulinase between the CS group and the model group at the third, the sixth and the ninth week (P > 0.05). Conclusion (1) Cordyceps sinensis may decrease the destroy of the hepatocyte by CCl4, and inhibit the hepatic fibrogenesis; (2) Cordyceps sinensis can't inhibit the decreasing of the activity of the hepatic insulinase.

The Objectives To investigate the inhibitory effects of Arg-Gly-Asp-Ser (RGDS) tetrapeptide on focal adhesion kinase and extracellular signal-regulated kinase in rat hepatic stellate cells stimulated by fibronectin (FN). Materials and Methods 3 H-thymidine incorporation was employed to estimate the influence of RGDS on proliferation of hepatic stellate cells (HSCs). And the adhesion rates were observed by toluidine blue colorimetric assay. The expression of focal adhesion kinase (FAK) and extracellular signal-regulated kinase (ERK) both protein and mRNA in HSCs were detected by RT-PCR and Western blotting analysis respectively. Results Compared with control and FN groups, RGDS tetrapeptide at concentrations of 25 mg/ml, 50 mg/ml and 100 mg/ml inhibited the proliferation of HSCs, P < 0.01 and the inhibition rates of 100 mg/ml at 12 h, 24 h and 48 h were 62.73%, 74.23%, 80.22%, respectively. So RGDS tetrapeptide could inhibit the HSC proliferation in dose-dependent and time-dependent manners (P < 0.05, P < 0.01). After adding RGDS tetrapeptide to HSCs for 2 h, the inhibition rates of adhesion were 8.82%, 29.41% and 45.59%, respectively, but that of Arg-Gly-Glu-Ser (RGES) group was only 4.41%, F value is 20.58, P < 0.01. After exposure of HSCs to RGDS tetrapeptide for 24 h, the production of FAK protein decreased. Corresponding with the protein, FAK mRNA decreased by 62.32%, 67.68%, 76.37% about 2 h after exposure to RGDS tetrapeptide. ERK protein and ERK 1 mRNA were down-regulated by RGDS tetrapeptide by 49.70%, 86.31% and 86.30%. Conclusions These results suggest that RGDS tetrapeptide may inhibit proliferation of HSCs in both dose-dependent and timedependent manners in vitro, which may be related to the disruption of cell matrix adhesion and the down-regulation of FAK and ERK expression.

Clinical study on the severe hepatitis with nosocomial fungal infections and risk factors ZHANG XUEHAI, ZHANG GUANGHAI ET AL

Objective To study the nosocomial fungal infections in the patient with severe hepatitis and approach of risk factor. Methods All 115 severe hepatitis with fungal infections inpatients was diagnosed were studied prospectively. Results We identified 115 cases with fungal infections, the mean age of patients was 37.21 ± 21.5 years; men: 49 cases. Infection of abdominal cavity accounted for 40.9%, infection rate in respiratory tract, intestinal tract were 26.9%, 21.7%, respectively. Infection of Candida albicans accounted for 67.6%. Risk factors for fungal infection and predictors of mortality were investigated. Use of broad-spectrum antibiotic and corticosteroids, neutropenia, disease severity, improper medical manipulations as significant risk factors for fungal infection. The available antifungal chemotherapy is often unable to eradicate the infection in these patients (effective rate only 14.8%). Motality rate of study group and control group was 85.2%, 43.5%, respectively, X 2 = 43.66, p < 0.001. In multivariate analysis, being neutropenic, disseminated disease and severity were independent prognostic factors. Conclusion Identification of risk factors and predictors of a poor outcome in patients with severe hepatitis with fungal infections have important implications in prophylaxis of fungal infection, early diagnosis and appropriate therapy of these patients.

Effects observation of plasma exchange in treatment of chronic severe hepatitis YONG ZHANG, WEIZHENG ZHENG, MINGDE JIANG, XIAOBIN CHEN, ZHAO WANG, HUI XU

Objectives To investigate the therapeutic effect of artificial liver support system (plasma exchange) in chronic severe hepatitis. Materials and Methods 32 patients with chronic severe hepatitis (mean age 40.4 ± 10.2 years, range 28 ~62 years) were treated with 59 case-times of plasma exchange. The symptoms and the result of liver function, renal function, electrolyte, prothrombintime activity (PTa), blood ammonia (NH3), blood routine before and after the treatment were analyzed. Results After plasma exchange, symptoms of patients with chronic severe hepatitis were improved, such as fatigue, appetite, and abdominal distention. Alanine tranasaminase (ALT, 179.6 ± 98.1 IU/L VS 109.7 ± 56.3 IU/L, P < 0.01) and aspartase tranasaminase (AST, 179.6 ± 98.1 VS 109.7 ± 56.3 IU/L, P < 0.01), total bilirubin (TB, 412.5 ± 154.2 mmol/L VS 226.6 ± 121.2 mmol/L, P < 0.01), direct bilirubin (DB, 202.4 ± 109.5 VS 121.3 ± 78.8, P < 0.01), NH3 (113.8 ± 72.9 mol/LVS 83.2 ± 37.7 mol/L, P < 0.05) obviously reduced, PTa obviously increased (29.4 ± 9.7% VS 38.3 ± 10.5%, P < 0.05) compared with those before the therapy. There was no significant difference in renal function, electrolyte, blood routine compared with those before the therapy (P > 0.05). The side effects were mild. The survival rate in eayly, medium-term, late chronic severe hepatitis were respectively 100% (7/7), 66.7% (10/15), 30% (3/10). Conclusions Plasma exchange is comparatively effective in the treatment of eayly, medium-term chronic severe hepatitis.Aims Using duplicated models of hepatic fibrosis in Wistar rats, we explore the mechanisms of drogs on protecting liver and treating liver fibrosis. Methods The model of hepatic fibrosis was established in 66 Wistar rats that were randomly divided into seven groups: that were the treatment groups and the normal control. The hepatic levels of MDA, HYP and the serum ALT were measured according to the biochemical methods.The pathological and ultramicropthology changes of the liver were observed by light microscope and electronmicroscope. The distribution of collagens such as type, III, IV, V as well as cytokines including IGF-TGFb1 were investigated by the immunohistochemical echnique, and the quantitative analysis by the imaging analysis system.

The elevated MDA, HYP in the tissues and ALT in the serum were observed in the CCL4-induced rats rather than in the normal and the loger the experimental time of CCL4-induced rats lasted, the more the levels of these test results increased (P < 0.1). The hepatic ultramicro-pathological changes appeared as the damaged changes of the hepatic cells and infiltration of inflammatory cells in various degrees.These changes gradually increased along with the lapse of time in CCL4-induced liver fibrosis. The fibrotic proliferation was seen under the light microscope, and that the amounts of type, IV V collagens significantly increased by immunohitochemical technique in the meantime of the hepatic cells being damaged. The ALT, MDA and YHP were significantly decreased in the treatment groups compared with the untreated groups (P < 0.01) TGFb1 expression began to increase at W3 and reached to its most at w6, which began to reduce at W9. The expression of IGF-II, which was not seen at early stage of hepatic fibrosis and in control group, increased at the late stage especially when accompanied by atypical proliferation. Conclusions (1) The collagens accumulation in the liver is associated with lipoperoxidation in the course of liver fibrosis induced by CCL4 and low dose alcohol. The accumulation of type, IV, V collagens plays a important role in the liver fibrosis; (2) It is truth that improvement of hepatic lesions and decreased serum ALT and tissue MDA in the models in the drugs-treated groups which suggests that drugs might have the effects of antyhepatic damage; (3) Durgs could reduce liver HYP and decrease the accumulation of type and collagens in the liver of the models suggests that it could have the effects of anti-hepatic fibrosi; (4) TGFb1 can promote the syntheisis of extracellular interstitial substance and inhibit the degradation of collagen, it may be a major cytokine in the development of the hepatic fibrosis; (5) IGF-II can promote cell proliferation and differentiation, it may participate in the proliferation and fibrosis of hepatic cells.

Objectives To measure ghrelin, leptin levels in patients with hepatic cirrhosis and explore its relationships with nutritional status and complications.

The study comprised 45 patients with liver cirrhosis (32 males/13 females) and 18 control subjects (11 males/7 females). Fasting blood samples were obtained. Plasma ghrelin concentration was determined by enzyme immunoassay (EIA) and serum leptin, insulin, glucose levels were determined by radioimmunoassay (RIA). BMI (body mass index), body fat rate, ISI (insulin sensitivity index) were calculated. Child-pugh classification was also carried through. Results Ghrelin levels were significantly elevated in liver cirrhosis patients compared with healthy controls (3.4 ± 3.3 ng/ml vs 2.1 ± 1.4 ng/ml, P < 0.05). Correlation analysis showed that ghrelin negatively correlated with ISI (r = -0.326, P < 0.05) and body fat rate (r = -0.327, P < 0.05).There was no significant correlation between ghrelin and leptin (P > 0.05). Multiple linear regression analysis pinpointed body fat rate as the most important predictor discriminating ghrelin levels in patients with liver cirrhosis. Leptin was significantly elevated in hepatic cirrhosis patients compared with healthy controls (6.3 ± 8.0 ng/ml vs 1.2 ± 1.6 ng/ml, P < 0.001). Leptin levels became higher according to Child-pugh classification, and in Child-pugh B or C, leptin was significantly elevated compared with controls (P < 0.05). Fasting insulin levels in patients was strikingly increased compared with controls (19.6 ± 19.5 uIU/ml vs 11.1 ± 11.6 uIU/ml, P < 0.05); Glucose in patients was much higher than that in controls (7.0 ± 1.4 mmol/L vs 4.3 ± 1.0 mmol, P < 0.01). ISI in patients was significantly decreased compared with controls (-7.3 ± 1.0 vs -6.2 ± 1.2, P < 0.01). Conclusions Levels of ghrelin and leptin were elevated in patients with liver cirrhosis, they may have relations with nutritional status and complications.

Nuclear factor-kb in proliferation and apoptosis in rat hepatic stellate cells YILIN ZHENG, HUIQING JIANG, XIAOLAN ZHANG

Objectives To explore the dynamic expression of nuclear factor-kB (NF-kB) in hepatic fibrogenesis;To investigate the effects of pyrrolidine dithiocarbamate (PDTC) on apoptosis and NF-kB binding activity in TNFa-stimulated hepatic stellate cells (HSCs) in vitro.

Expression of NF-kB protein was examined using Western blotting analysis. The distributions of NF-kB in the livers were assessed immunohistochemistrically. The direct cell count was employed to estimate proliferation of HSCs and the apoptosis was determined by Annexin-V/Propidium Iodide doublelabelled flow cytometry (FCM), while the morphological change was observed by Hoechst 33258 fluorescent stain method. NF-kB binding activity was examined by electrophoretic mobility shift assay (EMSA). Results 1 NF-kB protein expressed in normal rat livers, which were up-regulated with model course. 2 Positive cells of NF-kB increased a lot in hepatic fibrogenesis. 3 TNFa at concentration of 0.5 ng·mL -1 had the mightiest effect on HSCs proliferation. 4 Block or article-liked fluorescent light appeared in nuclei or cytoplasm of some cells treated by PDTC at different concentrations for 24 h. 5 After exposure of HSCs to PDTC for 24 h, the apoptosis rates from group 5 mmol·L -1 to group 40 mmol·L -1 were 3.61%, 8.69%, 10.14% and 16.11%, respectively, P < 0.05, while the rates of TNFa groups and control groups were 2.79% and 3.27%. 6 NF-kB binding activity was comparatively high in control groups and increased in TNFa groups, while decreased in PDTC groups. Conclusions In hepatic fibrogenesis, the expressions of NF-kB protein increased a lot, which played an important role in hepatic fibrogenesis; TNFa could stimulate the proliferation of HSCs, increase binding activity of NF-kB; PDTC might inhibit the proliferation of TNFa-stimulated HSCs and induce HSC apoptosis in dose-dependent manners; PDTC could inhibit binding activity of NF-kB.

Effects of JNK signal transduction on proliferation stimulated by acetaldehyde in hepatic stellate cells in rats XIANFEI ZHONG, MINGDE JIANG, HONGDE MA, ET AL.

Objective To explore the mechanism of how JNK Signal transduction way regulates the proliferation of hepatic satellite cells stimulated by acetaldehyde. Methods Rat hepatic satellite cells stimulated by acetaldehyde were incubated with different concentration of SP600125 in vitro, the cell proliferation was evaluated by MTT colorimetric assay; variability of JNK was examined by Western blot. Results SP600125 at different concentration (20 ng ml-1; 60 ng ml-1; 100 ng ml-1) can not only suppress the activity of JNK (MVI 36.0 ± 3.4 24.2 ± 1.8 3.2 ± 0.9 VS 47.6 ± 8.6 P < 0.05), but also inhibit proliferation of HSC (OD value A: 0.130 ± 0.011, 0.125 ± 0.009, 0.115 ± 0.013 VS 0.161 ± 0.018 P < 0.05), stimulated by acetaldehyde, in does-dependent manner. Conclusions The proliferation inhibition is correlated with the decreased activeity of JNK on the aspect of HSC signal transduction, so JNK had an important effect on proliferation of HSC. 

Ligating lower choledochus to establish obstructive jaundice model. All rats were randomly divided into three groups: the sham-operative group (group A, n = 20), choledochus ligation group (group B, n = 20), and choledochus ligation treated with Chinese medicine group (group C, n = 20). The changes of the level of plasma endotoxin, TNF-a, IL-6, total bilirubin 21d postoperation, were examineal and compared, the extreme intestinal lumen mucosa was examined pathologically and Bacterial culture of mesenteric lymphnodes. Panereas and lung were measured with aseptic manipulation. Results At the 21th day postoperation, the plasma total bilirubin, glutamicpyruvic transaminase (GPT) between C group and B group were no difference, with 95.5 ± 11.9 umol/L vs. 92.3 ± 12.6 umol/L (p > 0.05) and 117 ± 21 u/L vs. 118 ± 20 u/L (p > 0.05). The levels of plasma endotoxin,TNF-a, IL-6 in group C were significantly lower than those in group B, with 409 ± 38 EU/L vs. 767 ± 64 EU/L (P < 0.05), 113 ± 18 pg/ml vs. 307 ± 25 pg/ml (p < 0.05), 65 ± 8 pg/ml vs. 130 ± 12 pg/ml (p < 0.05) respectively. The trauma of intestinal mucosa in group C was lower than that in group B; The positive rate of bacteria cuture with mesenteric lympha node and pancreas, lung in group C was significantly lower than those in group B, with 5/18 vs. 16/16 (p < 0.05), 3/18 vs. 15/16 (p < 0.05), 2/18 vs. 13/16 (p < 0.05), respectively. Conclusions The Chinese medicine DaHuang et al is able to protect the barrier of intestinal mucosa, reduce the bacteria translocation from intestinal lumen and the level of plasma cytokines.

The development and application of a quality of life instrument for patients with minimal hepatic encephalopathy YINGQUN ZHOU, SHIYAO CHEN, TIANSHU LIU, JIYAO WANG Department of Gastroenterology, Shanghai Zhongshan Hospital, Shanghai, China Aim Our study is to develop a health-related quality of life (HRQOL) instrument for measuring the sense of well-being in individuals with minimal hepatic encephalopathy (mHE) and to apply the instrument for evaluating the change of QOL on the patients being treated by 4 weeks Lactulose or HepaMerz. Materials and Methods All patients were diagnosed as mHE coming from 6 hospitals which located in Beijing, Shanghai and Shandong province respectively from April 2003 to March 2004. Based on the structured group the theory and methodology were employed to establish the instrument. The drug (Lactulose or HepaMerz.) was used to treat the patients with mHE. Results The instrument included five domains (30 items) is showed as follows: physical functioning (8 items), psychological wellbeing (7 items), symptoms/side effects (7 items), social functioning (4 items) and general-health (4 items). Forty-two patients diagnosed mHE attended the clinical trial being treated by Lactulose or HepaMerz. The mean scores of the four neuropsychological indexes (NCT-A, NCT-B, DST, LTT) were lower than that after treatment in patients. Especially the mean scores of NCT-A and DST were significantly lower than the before treatment. Both the five domains and the total QOL were more improved than before treatment. In the physical domain the three most bothersome items that were drowsy, reactivity and tired showed more improved after treatment. In the symptom/side effects domain which the three symptoms were fatigue, itch and energy proved better improvement after treatment. Patients with more advanced disease (worse Child-Pugh class) seemed to have more impairment of their well-being. Conclusions We have developed the first disease specific HRQOL instrument for patients with mHE using a comprehensive methodological framework. Lactulose or HepaMerz is showed to contribute to improvements in psychomotor performance and in the quality of life of cirrhotic patients with mHE. Objectives To investigate the effectiveness and reliability of endoscopic treatment of benign esophageal lesions by using retrievable expanding stents.

There were 46 cases of benign esophageal lesions were treated with retrievable expanding stents since 1997 to 2004. Traumatic and spontaneous esophageal rupture were 8 cases, chemical burn were 9 cases. Fistula of esophageo-gastric anastomosis was 7 cases. Stenosis of esophageal-gastric anastomosis was 22 cases. The diameter of esophageal rupture and fistula of were 0.3 cm ~3 cm. Final diagnosis of all patients were X-ray and endoscope. Esophageal stenosis was expanded at least one time.When dysphagia recurs in a short time, retrievable expanding stent were placed. After 4 to 12 weeks, stent was taken out by endoscope.

Of the 46 cases, 45 (97.8%) were successfully taken out of the stent. All esophageal rupture was cured. 7 cases of esophageogastric anastomosis fistula were cured, 2 cases were ineffective. 22 cases of stenosis of esophageal-gastric anastomosis were cured. 8 of 9 cases of chemical burn were effective, and one case is failure. Complications were chest pain, pharyngeal malaise, nausea, vomiting and the symptoms of GERD. Many symptoms disappeared in one week. Anodyne was needed in 7 patients. Conclusions There are controversies in the stent therapy of benign esophageal lesions. Our results show that retrievable expanding stents therapy of esophageal benign lesions is safe and effective. 

Objective To study the characteristic pathogenisis of the upper gastrointestinal disorders in the Tibet autonomous region. Methods Analyzing 44158cases under fibergastroscopic examination. Results Among all the subjects, there were 30197 cases related to inflammatory disease, 8366 cases of peptic ulcer, 1908 cases of carcinoma of upper gastrointestinal, 237 cases of upper gastrointestinal benign tumor, 474 cases of gastroduodenal polyp, 1035 cases of esophageal varicosity, and 1941 cases of others .There were 29038 male cases and 15120 female cases. The detectable rate differences between men and women was significant (p < 0.01). There were 30088 Tibetans, and 12480 Hans. The detectable rate differences between Tibetans and Hans was also significant (p < 0.01). There were 1590 cases of other minorities. Conclusion The result of this study was inflammation > ulcer > carcinoma. The incidence of male was higher than that of female. The incidence of Tibetans was higher than that of Hans. The detectable rate of inflammatory disease, ulcer and carcinorma are high in Tibet autonomous region. Among Tibetan patients with peptic ulcer, the incidence of gastric ulcer was higher than that of duodenal ulcer. These factscorrelated to the geographical environment, their daily life style, family economic status and home hygiene.

Applincation of endoscopic injection therapy on dieulafoy's disease bleeding HUIZHEN FAN, PING XIE, YUWENG WU, ET AL.

Objectives To determine the hemostatic effect of local endoscopic injection control of bleeding in 23 cases Dieulafoy disease.

To put injection needle through the biopsy channel opening of endoscopic to the bleeding parts, then inject on 3-5 points 1-2 mm surrounding the bleeding parts. Each injection contains 0.5-1 ml 5% SM or 1% AS in 23 cases. Results The hemostasis successful rate reaches 95.65% (22/23). Successful hemostasis after the second treatment occurred in 3 Cases (0.13%). 1 Cases failed to hemostasis after treatment. Conclusions These results suggest that local endoscopic injection is a first selection on control of bleeding in Dieulafoy disease. It can be wide-spread and used widely.

Gastroscopic diagnosis for gastric lymphoma XIAOJUN, GUAN JIWEI LIU, XIA XU, PEIYUN SUN, SHAOHUA ZHANG, JUN MA

Purpose To summarize the gastroscopic manifestations of 15 cases of primary gastric lymphoma. Materials and Methods Samples' source: the gastric biopsy samples and some operative pathological samples were taken from 15 hospitalized patients with gastric lymphoma diagnosed by pathology. Clinical data: there were 15 cases (9 males and 6 females), and their age ranged from 29-65 years old (median 48 years old). All cases were mainly presented with abdominal pain, weight loss and anemia. Results 15 cases of gastric lymphoma were diagnosed by pathology with gastroscopic biopsy samples. According to Ann Aobor classification, they were divided into Phase I (7 cases), Phase II (4 cases), Phase III (3 cases), and Phase IV (1 case). For gastroscopic manifestations, there were 4 types: protruded, ulcerative, phlegmonous and macrofold. Phlegmonous was the commonest among them. Because this disease extended mainly along lymphoid tissues, the lesion could expand over the pylorus into the duodenum. Discussion Gastric lymphoma occupied 3-5% of gastric malignant tumors, and 2-4% of systemic non-Hodgin's lymphomas. It was also main invasive location of extranodal non-Hodgkin's lymphomas. Because most lesions lay submucosa, diagnosis rate for routine biopsy was only 60%. Therefore, large samples should be taken for biopsy or the samples should be taken from the edge of medial ulcer. This can raise the positive diagnosis rate.

Objective To analyze and discuss the value of gastroscopy in diagnosis of upper gastrointestinal disease in children.

Retrospective analysis of the data about 171 cases of gastroscopy in children was performed from 1986 to 2002. Results Out of the 171 cases of gastroscopy, 151 cases of upper gastrointestinal disease into twelve types were found. Among them, 89 cases (52.4%) were chronic superficial gastritis, 31 cases (18.2%) were duodenal ulcer, 9 cases (5.26%) were gastric ulcer, 1 cases was complex ulcer; 6 cases were duodenitis; 9 cases were esophagi. Besides, diseases such as the esophageal hiatus hemia, Mallory-Weiss syndrome, stomach cancer, stomach stone and stomach ascayiasis, each had one case. No abnormalities were found in 20 cases. Detection of helicobacter pylori (HP) infection was performed with rapid urease test in 48 children; the positive rate of HP infection was 47.9 (23/48). The locations of duodenal ulcers were mainly on anterior wall of bulb and greater curvature. The diameters of the ulcers were less than 0.5 cm mostly. Conclusions The high incidencr of chronic superficial gastritis and duodenal ulcer in always seen in children. Gastroscopy is safe and reliable method to identify the upper gastro intestinal disease in children rapidly and accurately.

Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS) on Borrmann type 4 gastric carcinoma. Methods 36 patients with Borrmann type 4 gastric carcinomas underwent EUS, endoscopy and biopsy before operation. The results were compared with those of the surgical pathological diagnosis. Results 38.9% gastric cancer with Borrmann type 4 couldn't be diagnosed by the first endoscopic biopsy, and 33.3% of those couldn't be identified by the second one yet. EUS image of Borrmann type 4 gastric cancer was special with diffuse thickness of gastric wall, but the structure and layers could still be identified.When lymph node involved, the round low echo mass with clear margin could be found. All the cases with Borrmann type 4 were correctly diagnosed preoperation by EUS. The correct rate of diagnosis by EUS for this kind of tumor was 100%.Conclusion EUS is a better and effective way for the diagnosis of the Borrmann types 4 gastric cancers.

Objective To summarize the experience of diagnosing and removing foreign bodies in upper gastrointestinal tract. Materials and Methods 216 cases were examined endoscopically for their ingest foreign bodies from 1999 to 2004. Endoscopy and the instruments for grasping the foreign bodies were used. Results 216 patients had 272 pieces of foreign bodies, of which 97 pieces were impacted in the esophagus, 162 in the stomach and 11 in the duodenum. 267 pieces of bodies were successfully removed from 211 patients without any complications. But 5 pieces of bodies were failed to be taken out because the foreign bodies impacted in the gastrointestinal tract. The successful rate was 98.2% in respect to the number of patients. Among all the foreign bodies taken out, the longest one was 17.2 cm, the widest one was 3.7 cm. Conclusion Endoscopy can used safely and effectively in the patients with ingested foreign bodies.

Objective To compare the advantages and disadvantages of singleman method (which is performed by just one operator) with those of double-men method (which is performed by one operator and one assistant) of colonoscopy, and to appeal to our fellow endoscopic physicians for single-man method on the basis of being proficient double-men method of colonoscopy.

With grouping the candidates in two groups at random, group A (examined with single-man method) and group B (examined with double-men method), two different methods of colonoscopy were employed. We compared the two methods with each other by the final location of colonoscopy in colon, the rate and the time of colonoscopy being sent to the cecum, and also observed the status of the patient's feelings and colon convulsions. Results 1. The scores of the final location of colonoscopy in colon were 4.8 ± 1.1 and 5.0 ± 1.2 (P > 0.05), the mean rates of colonoscopy being sent to the cecum were 77.3% and 86.3% (P > 0.05), in group A and group B respectively.The mean time of colonoscopy being sent to the cecum in group A was 17.8 ± 8.9 minutes, while it was 11.7 ± 5.1 minutes in the other group (P < 0.001). 2. The mean scores of the feelings of patients were 0.95 ± 0.97 and 1.02 ± 1.01 (P > 0.05), and those of the colon convulsions were 0.50 ± 0.71 and 0.43 ± 0.70 (P > 0.05) in group A and group B respectively. Conclusions It is almost the same in such indexes as the final location of colonoscopy in colon, the mean rate of colonoscopy being sent to the cecum and the score of the patient's feelings. It can be assumed that the combination of two methods will benefit us more in colonoscopy.

The relationship between expression of vascular endothelial growth factor (VEGF) and tumor infultration and metastasis in human gastric cancer, as well as patient outcome, were investigated. Methods Sixty-one primary tumor specimens were investigated by immunohistochemical studies with anti-VEGF antibody and by by monitoring patients for at least 3 years after surgery. Results The more poorly differentiated tumor was, the weaker staining intensity was. Tumor with strong VEGF staining, assessed as HP (the product of staining intensity and positive staining ration of tumor cell) ≥0.5, had a significantly more ratio of larger size tumor (diameter ≥ 4 cm) and serous membrane involvement. The Cox proportional hazards model identified tumor histology, serous membrane involvement and metastasis as the significant and independent prognostic factor among various clinicopathologic factors. Conclusion The expression of VEGF may play a role in tumor infiltration and metastasis in gastric cancer.

The clinical observation of microgalvanopuncture analgesia gastroscopy XIAOJING JIN, WANLI LIU, QIN YANG Digestion Department, Nanjing Traditional Chinese Medicine Hospital, Nanjing, China Aims To observe the clinical effect of microgalvanopuncture agalgesia to gastroscopy.

The subjects was devided 2 groups randomly, single-blindness comparison, 120 cases of the acupuncture group received microgalvanopuncture on Neikuan, whose stimulating intensity was to deqi; 60 cases of the control group received microgalvanopuncture on Neikuan, but no stimulating intensity. Before and after the gastroscopy, the psychological activity, the malaise was evaluated by questionnaire and measuring meter, and the blood pressure, heart rate, breath frequency was monitored and recorded. Results Most of the subjects express fear, anxity, or dysphoria before the gastroscopy. After the examination, the malaise integral of the acupuncture group is significantly lower than the control group (P < 0.01). Conclusions The microgalvanopuncture on Neikuan can obviously reduce malaise, which is initiated by gastroscopy.Objective To investigate the safety of Propofol and Midazolam with endoscopic procedures in a cohort of elderly patients. Methods During 12 months 108 cases of endoscopy patients >65 years were eligible for propofol and midazolam study. The accumulation dosage of propofol and midazolam, sedative effect, variation of blood pressure and SaO 2 and behave in endoscopic procedures were observed in all elderly patients. Results Compared with elderly control group, there were no significant representations (nausea, cough, throat discomfort and so on) in elderly sedation group, and there were higher satisfaction with endoscopic procedures in elderly sedation group. The cumulative dosage of propofol and midazolam in elderly sedation group (>65 year) was lower than that in the elderly control group (<35 year). Arterial hypotension and a short oxygen desaturation occurred transitorily in elderly sedation group, and these changes reconvert momently after the end of endoscopic procedures. Compared with elderly control group, there were no significant uninfluenced behaves, the gastroesophageal reflux, stomach peristalsis, and pylori opening in elderly sedation group.

This present study suggests that combination propofol and midazolam with gastrointestinal endoscopic procedures in elderly patients are safe and well tolerated within careful monitoring.

The comparison research of the treatment by gianturco-rosch silicon covered esophageal expandable metallic Z-stent (GRZS) and esophageal expanding tube for advanced esophageal carcinoma JIAN LI, HONGJUN YE, FUE LI

Objective Use two kinds of methods to treat advanced esophageal carcinoma patients, and compare the improvement of survival quality and curative effect of esophagostenosis. Methods One: use GRZS which is retained by endascope to treat advanced esophageal carcinoma patients 22 cases, six of them have complicated esophago-pneogaster fistula two: retain the guide lineconductor by endoscope and guide silicagel tube MD-46100, use this kind of methods to treat advanced esophageal carcinoma patients 26 cases. Results After GRZS treatment, 22 patients esophageal empraxis degree abates from grade 3.5 ± 0.5 down to grade 0.85 ± 0.35 four weeks later, the body weight adds on 7.5 ± 0.5 kg, survival time achives to 10.3 ± 2.1 months, six of them have complicated esophagopneogaster fistula once only cure. After MD expanding treatment 26 patients esophageal empraxis degree abates from grade 3.15 ± 0.38 down to grade 2.15 ± 0.69 four weeks later, the body weight adds on 2.2 ± 0.7 kg, survival time achives to 3.7 ± 1.6 months. The GRZS treatment has obvious advantage over the MD expanding treatment in improving survival quality abating esophagostenosis degree and protracting survival time. Conclusions Retaining the Gianturo-Rosch silicon covered esophageal expandable metallic Z-stents (GRZS) by endoscope to treat advanced esophageal carcinoma that is a kind of popular palliative widely used in the world today, especially for complicated esophago-pneogaster fistulas.

Endoscopic removal of a duodenal Brunner's gland adenoma-a case report WEI LI, BILI HE, HONGDI WANG

Objectives Brunner's gland adenoma (BGA) is a rare benign tumour of the duodenum. Since first reported by Curveilhier in 1835 and Salvioli in 1876, less than 200 cases of BGA have been reported. BGA is asymptomatic in most patients and incidentally finded during endoscopy or other duodenal imaging procedures. However, bleeding and/or obstructive complications may occur, endoscopic or surgical resection is needed in a minority of cases.

A 42-year-old woman presented with a month history of melena. Physical examination was unremarkable except for pale conjunctiva and skin pallor. Hemoglobin was 55 g/L. Upper endoscopy showed a large polyp which had a stalk was found situated within the duodenal bulb and several small ulcers on its surface. The stalk was then easily snared and transected using coagulation current with no bleeding. Results The polyp was 2 ¥ 2 ¥ 3 cm big, the stalk was 2 cm long. Histologically, the surface epithelium consisted of normal duodenal mucosa with areas of focal ulceration. The main body of the polyp contained several lobules of mature Brunner's glands with areas of cystic dilation.Conclusions Endoscopic electrosurgical snare resection is widely used for removal of pedunculated polyps. BGA can be successfully treated by endoscopic polypectomy without complications.

The application value of bedside emergency nasobiliary drainage in sever bile duct and pancreatic disease the first people's hospital of Nantong YUMING LI, JUNBO QIAN, YAMING WANG Department of Gastroenterology, Nantong First Hospital, China Objective To explore the therapy value and study the indication, operation skill, announcements and cost of endoscopic nasobiliary drainage (ENBD) in dangerous bile duct and pancreatic disease without x-ray monitor. Methods All 112 cases with severe bile duct and pancreatic disease accepted emergency ENBD on bedside or in duodenoscope room without x-ray monitor. The nasobiliary tube still remained in the common bile duct, then taking stone by EST, ERBD or surgery was performed on cases according to cholangiopancreatography on alternative period. Result Of all 112 cases was successfully performing ENBD in one time after final diagnosis (acute suppurative cholangitis, n = 32; Calculus of common duct, n = 24; malignant common bile duct obstruction, n = 16; acute chole-pancteatitis, n = 16; acute severe pancreatitis, n = 12). ENBD on bedside was accepted by the old and the weak whose vital sign is no good. It made an opportunity of the subsequent therapy with easy and smooth draining, shorten the course of disease and reduced the cost after applying ENBD. Conclusion The bedside emergency ENBD without x-ray monitor is an effective and safe procedure in dangerous bile duct and pancreatic diseases. It has the advantage of minimal trauma and rare complication and could be widely applied on basic hospital.

Capsule endoscopy in the evaluation of obscure gastrointestinal bleeding YUNHONG LI, ZHAOMIN XU, LONGDIAN CHEN, SHUTANG HAN, CHENGGONG YU, ZHIHONG ZHANG Department of Gastroenterology, Medical College of Nanjing University Affiliated Gulou Hospital, Nanjing, China, 210008 Objectives To evaluate the role of Capsule endoscopy (CE) in the diagnosis of Obscure gastrointestinal bleeding (OGB).

All of these patients had experienced CE after extensive traditional investigations, which could not delineate a source of OGB. Every patient received an intestinal preparation before CE examination. Results Of these 37 patients, 29 (78.4%) had abnormal findings, which could delineate the OGB. Among them, 12 patients received surgical therapy which finally verified the diagnosis as 2 intestinal angioma, 2 intestinal stromal sarcoma, 2 intestinal adenocarcinoma, 1 asending colon cancer, 1 jejunum Dieulafoy's ulcer, 1 intestinal non-Hodgkin lymphoma, 2 intestinal AVM, and 1 Meckel's diverticular. Just one diagnosis of CE was not in accord with the surgery, and in this case Meckel's diverticular was misdiagnosed as ileum ulcer. The other 17 patients who had not received surgery included 10 intestinal AVM, 3 intestinal Crohn's disease, 1 duodenum ulcer, 1 jejunum hookworm disease, 1 stoma ulcer, 1 cardiac active bleeding (second gastroscopy proved to be cardiac deulafoy's ulcer). Except 10 diffused intestinal AVM who could just be follwed up, the others had ameliorated after receiving corresponding medical therapy. Conclusions CE has high detectable rate in the diagnosis of OGB and more than 50% OGB patients may take direct advantage from CE.

Clinical study on somatostatin in prevention of hyperamylasemia and pancreatitis after ERCP ZHAOSHEN LI, GUOMING XU, ZHENXING SUN, XIAOPING ZOU, ZHENDONG JIN Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China Objectives To study the preventive effect of somatostatin in the hyperamylasemia and pancreatitis after endoscopic retrograte cholangiopancreatography (ERCP). Methods 128 patients randomly chosen received either somatostatin (intravenously, 250 mg, at pre-ERCP and during 4 hours post-ERCP) or isotonic saline as placebo. The mean concentration of serum amylase at 4 hours and 24 hours after ERCP was measured in all patients, and the abdomenal pain and panereatitis after ERCP was also observed in all patients.

The mean concentration of serum amylase at 4 hours and 24 hours was 298 ± 33 U/L and 140 ± 156 U/L in preventive group, 380 ± 33 U/L and 240 ± 210 U/L in control group, 3 cases have occurred acute pancreatitis in control group, and only 1 case in preventive group after ERCP. The mean concentration of serum amylase and case number of happen pancreatitis after ERCP were significantly lower in preventive group than that of in control group (P < 0.01). Conclusion It is concluded that somatostatin used pre and post-ERCP can prevent effectively hyperamylasemia and acute pancreatitis after ERCP.

Observations on curative effects of joint application of esophagus varix logation and sclerosis under endoscope DUNJU LIU, DEXIANG WANG Department of Digestion, Nanchang Municipal No.3 Hospital, Nanchang, China Objectives To observe the curative effects of joint application of esophagus varix ligation and sclerosis under endoscope. Materials and Methods Forty-one patients suffering from esophagus varix breaking haemorrhage have been operated on for Esophagus Varix Multiring Ligation (EVML) by means of high-speed repeating under endoscope. Ten cases of them were applied the joint therapy of EVML and esophagus varix sclerosis (EVS) to. Each case is ligatured three times on an average,and each time about five spots on an average. In the sclerosis therapy each case is injected 1.75 times on an average, and each time about four dots on an average. Result The cases of tangible results account for 80.5%, the effective cases-12.2%, and the total effective rate is 92.7%. Short-term or immediate curative effects of applying single EVML are tangible or remarkable, and long-time or forward curative effects of applying it are not too contented, the rate of reproducing haemorrhage within one year accounts for 27.6%, while joint applying EVML and EVS, the rate of reproducing haemorrhage in a year is zero. Conclusion The joint application of EVML and EVS is considered as the first selective therapy of curing esophagus varix breaking haemorrhage, which can effectively prevent it from reproducing haemorrhage, reduce the probability of the relapse of varicosity, and raise long-term or forward curative effects. 

Study on emergency endoscopic variceal ligation (EEVL) in treatment of cirrhosis esophageal varices bleeding YUJIE LIU, ZHIJIAN ZHANG, YOUMING, HUANG ET AL.

Objective To investigate the efficacy and safety of emergency endoscopic variceal ligation (EEVL) in the treatment of cirrhosis esophageal varices bleeding. Methods 89 patients with cirrhosis esophageal varices bleeding accepted EEVL and heart rate, blood pressure, respiratory rate were observed before, during and after EEVL, respectively. Results Emergency hemostasis rates were 100%. EEVL had no significant effect on vital signs (P > 0.05). There were no adverse events duing EEVL. During a follow-up of 3 to 30 months in 76 patients with cirrhosis, the mortality was 14.5% and the rebleeding rate in the near future was 2.3%. Conclusion It is concluded that EEVL is safe, effective, reliable and short in the treatment of esophageal varices bleeding.

Objective To compare the Hp infective rate in verrulous gastritis and enythema-exudative gastritis, and to explore the association between pathological character and intestinal metaplasia in verrulous gastritis.Method 141 Verrulous gastritis (VG group) and 138 enythemaexudative (EEG group) were diagnosed by endoscopy. Hp was tested by rapid urease test. Intestinal metaplasia was examined by AB/? staining, blue colour means complete intestinal metaplasia, and blue mixed with red means incomplete intestinal metaplasia. Results 1. Hp infective rate was 70.21% in verrulous gastritis and 38.40% in enythema-exudative gastriris, and there was a signiticant difference between them (P < 0.005). 2. In VG group, 99 (70.21%) cases were found chronic atrophic gastritis by pathological examination, of which 73 (51.77%) were with Hp positive and 80 (56.74%). In EEG group 81 cases were found CAG by pathologic examination, of which 81 (56.69%) accompanied with acute inflammation. Hp positive rate was in CAG and accompanied with acute inflammation between two groups. (X 2 = 16.56, P < 0.005). 3.26 intestinal metaplasia were found in VG group, and out of them, 18 (12.76%) complete intestinal metaplasia and 10 (4.26%) incomplete intestinal metaplasia; 31 (22.46%) intestinal metaplasia were found in EEG group, 18 (13.04%) complete intestinal metaplasia and 13 (9.52%) incomplete intestinal metaplasia, no significant difference was found by statistical method. Conclusion 1. Hp infection is one of the main precipitating factors of verrulous gastritis. 2. There is a close relationship between acute inflammation and Hp infection in two groups. 3. No significant difference was found in intestinal metaplasia between two groups. 

Tumors in mucosa or its muscular layer, with peduncle were resected by snare polypectomy; without peduncle were removed by pieces polypectomy with local submucosal injectin saline-epinephrine 2-4 ml. Results Thirty two of neoplasms, including early cancers 5 (esophageal 1, gastric 1, colonic 3), severe gastric epithelial dysplasia 1, leiomyoma 6 and adenoma 20 were treated by endoscopic snare polypectomy, and three cases were resected 2-3 times. The diameters of neoplasms were 1-2 cm, 2.1-3 cm, 3.1-4 cm and over 4 cm is 19, 8, 3 and 2 cases respectively. Four cases have bleeding after polypectomy, bleeding was controlled by local injection of saline-epinephrine. No severe complication as perforation was found. Conclusion Endoscopic polypectomy of gastrointestinal tract tumor with local submucosal injection of saline-epinephrine solution is an effective and safe method.

The short and long-term efficacy of endoscopic variceal ligation (EVL) plus somatostatin/octreotide post-EVL for bleeding esophageal varices JIAQI RAO, QIYI WANG, WANWEI LIU, WEIMING LIANG

Objectives To evaluate the short and long-term efficacy of endoscopic variceal ligation (EVL) plus somatostatin/Octreotide post-EVL for bleeding esophageal varices.

Sixty-four cirrhosis patients with portal hypertension (male 51 cases, mean age 49 years, female 13 cases, mean age 13 years) underwent EVL within 24-48 hrs after hemorrhage. All patients accomplished EVL 78 times in total including 19 cases repeated one to four times. According to the patients' financial condition and heart situation, 78 times were divied to two groups, one only EVL, another plus somatostatin/Octreotide post-EVL. The second group received Somatostatin (250 ug per hr after a bolus of 250 ug) or Octreotide (2.5 ug per hr after a bolus of 0.1 mg) after EVL lasting 48-72 hr. There were no siginificant differences between the two groups in relation to Child-Pugh classification, characteristics of bleeding episodes. Results 64 cases were followed up, the longest period was 34 months and 15 cases were died. Only one of them died of rebleeding within 24 hr without combined using somatostatin or Octreotide. Hemostatic validity reached 93% in two groups. The rate of rebleeding and the interval of rebleeding was 59.6% and about 10 months average in EVL group and 41.9% and about 12 months average in combined group respectively. There was obvious difference between two groups (P < 0.05). Conclusion There is no obvious benifit if combined with somatostatin/Octreotide or not after EVL in the near future. But somatostatin/Octreotide seem can reduce the rate of rebleeding and prolong the interval of rebleeding in the long future.

The clinical study of detection of dysplasia and early ESCC before and after using 2.5% lugol chromoendoscopy YING SHAO, MING JI, YONGDONG WU, LI YU, YONGZHENG YU, LIANGXIAO MEI, YINGLIN NIU, ZHONGLIN YU, SHUTIAN ZHANG Endoscopic Center, Beijing Friendship Hospital affiliated to the Capital University of Medical Sciences, Beijing, 100050, China Esophageal squamous cell carcinoma (ESCC) is one of the most common fatal cancers of alimentary tract. The 5-year survival rate for ESCC is less than 10%, while the 5-year survival rate for early ESCC may be up to 86%~100%. Therefore, early detection, early diagnosis and early treatment are the cruxes in reducing the mortality of ESCC. Chromoendoscopy has been used in diagnosis of early carcinomas of alimentary tract for a long time. Lulol's stain, which is paid more attention to in Japan, is the most common method to detect early ESCC. However, it has not been used widely in China. Aim To investigate the difference of detection rate of dysplasia and early ESCC before and after using Lugol chromoendoscopy. Meterials and Methods Three hundred and eighty eight patients who received routine gastroscope examination and had high risk of ESCC were examined by the iodine dyeing on their esophageal mucosa with 2.5% Lugol's solution. From every >0.5 cm in diameter unstained or light-stained area, multiple biopsies were taken for pathology. Three hundred and forty six patients who were not stained by Lugol's were received as controls. Results With the lugol's staining method, the detection rate of light, moderate and high grade dysplasia/early ESCC was 7.5% (29/388), 2.6% (10/388) and 3.4% (13/388) respectively.While in the non-stained cases, the detection rate was 3.5% (12/346), 2.3% (8/346) and 0.6 (2/346) respectively. There was significant difference between two groups. Lugol chromoendoscopy showed a sensitivity of 84.6%, a specificity of 95.7%, a positive predictive value of 37.9% and a negative predictive value of 99.4% to diagnose early ESCC/ dysplasia. Conclusion Lugol chromoendoscopy may elevate the detection rate of early ESCC/dysplasia. It is a safe, convenient and available method in early detection of ESCC/dysplasia.

Study on endoscopic ligation with three therapeutic methods for variceal hemorrhage JIANPING SHI, XIADE QIU, YUEKUNG BI, GUOMEI GU

Objective The aim of this study is to investigate the safety, efficacy, complications and recurrence of varices with three therapeutic methods endoscopic variceal ligation (EVL).

Sixty-nine consecutively treated cirrhotic patients were allocated in three groups, 23 in EVL with pulling line group, 21 in EVL with pneumatic group and 25 in EVLwith nylon loop group. The stiegmann-Goff device pneumatic injection and nylon loop were used for variceal ligation at the same intervals. Results The rate of variceal eradication was similar for three groups. [78% (18/23), 80.9% (17/21) and 76% (19/25)] respectively, there was no significant difference (p > 0.05). The rate of recurrent bleeding were lower in three groups treat [76% (6/23) 23.8% (5/21) and 28% (7/25)] respectively, three therapeutic groups were no significant difference (p > 0.05). No serious complication occurred in Among Groups. The mean procedure time from endoscopic insertion to removal was 21, 10, 14 min. We observed no significant systemic complication or local adverse. EVL with pneumatic was the fastest procedure. Conclusions We considered that endoscopic ligation with three therapeutic methods for variceal hemorrhage is safe and effective. EVL with pneumatic is easier to perform than other two therapeutic methods and should be the first choice.

Objectives To assess the safety, feasibility, and acceptability of sedation with propofol for endoscopic procedures.

Two hundred and twenty-six patients aged from 18 to 80 who underwent enoscopies including 148 gastroscopies and 78 colonoscopies were prospectively and nonrandomly recruited from January 2001 to April 2004. Propofol was administered intravenously by means of a patient-controlled syringe pump at the inducing dose of 2.0 mg/kg and the boosting dose of 0.5 mg/kg while the patients were continuously given oxygen by a double trunk nasal catheter at the dose of 5.0 L/min. The patient's responses, and their heart rates, blood pressure and saturation of blood oxygen during the procedure were monitored. Their anterograde amnesia rate, satisfaction rate, recovery time, delayed side-effects after the procedure were measuered. Results The onset time of propofol is 20 to 30 seconds, and its duration was 8 to 10 minutes. The patient's heart rates and blood pressure were reduced by the average of 10%, and 20%~30%, respectively, but only 12 (5.3%) patients developed hypotension during the procedure. The median recovery time was 0 (0-5) minutes. Four (1.8%) patients developed delayed side effects such as dizziness. The anterograde amnesia rate was 100% and the satisfaction rate was 100%.

The use of sedation with propofol for endoscopic procedures is safe, feasible, and acceptable to almost all patients.

A case of ischemic disease of large intestine in a polyp state XIAOYU WANG 1 , LIRONG SUI 2 , YINGZHI LV 2 & LIBIN SUN 2 Departments of 1 Endoscopy and 2 Pathology, Six Hospital of Peking, Beijing, China Objectives A case of massive haemorrhage of transient ischemic disease of large Intestine was reported with special morphological changes in endoscopy.

Examinetion by instancy colon endoscopy: There was a polyp of 0.6 cm ¥ 1.0 cm apart from anus 10 cm. It was state of cruored scab after bursted and blooding. It was resected by electricity in base of polyp of recta after affusion after 6 day. Results Pathological diagnosis of the specimen: (rectum) Colonic mucosa tissne shaved chronic inflummation with edema in stromal. There was thrombosis of blood vessels in the submucosa. Conclusions Blood is supplied by both of inferior mesenteric arteries and rectum arteries in rectum. The patient's damage site is rare.

Study of magnetic resonance cholangiopancreatography comparing with endoscopic retrograde cholangiopancreatography in the diagnosis of bile duct and pancreatic duct diseases YULIN WU

Objectives To evaluate magnetic cholangiopancreatography (MRCP) in the diagnosis of bile duct and pancreatic tract diseases, comparing with endoscopic retrograde cholangiopancreatography (ERCP). Materials and Methods 57 patients (mean age 58 years) refered for elective MRCP comparing with ERCP. After performed MRCP every patient was performed ERCP within a week. Result 57 patients were performed both MRCP and ERCP successfully. The result is the same in 35 cases. There are 23 cases in difference. MRCP: Vater's ampulla tumor 9 cases, ERCP: CBS 4 cases, normal 5 cases. MRCP: CBS 5 cases, ERCP: normal 4 cases, Vater1s ampulla tumor 1 cases. MRCP: cyst of the common bile duct 3 cases, ERCP; Vater's ampulla tumor 2 cases, CBS 1 case. Conclusion MRCP has a noninvasive diagnostic modality capable of producing high quality images of the bile duct and pancreatic duct. It is still too early to predict weather MRCP will routinely substitute ERCP for diagnosis. Further clinical trails comparing MRCP with ERCP in a larger number of cases may be necessary.

Diagnostic and therapeutic ERCP in the patients with hepatobiliary stones ZIGANG WU, HONGJUN YE

Objectives To compare the diagnostic value of ERCP with abdominal B-ultrasound and CT in patients with hepatobilary diseases, to evaluate curative effect of EST, and to study the effect of octreotide and Somatostatin on the rise of pancreatic amylase in the serum and urine after ERCP and EST. Materials and Methods Forty-two patients with hepatobiliary diseases were examined with ERCP, abdominal B-ultrasound and CT simultaneously. A total of seventy-five cannulations were performed on 64 patients with hepatobilary diseases. Serum and urine amylase were checked in patients of 62 cannulations who had received octreotide and/or. Somatostatin.

The diagnostic rate of abdominal B ultrasound was 26.2%, The diagnostic rate of CT was 66.7%, and The diagnostic rate of ERCP was 97.6%. EST was performed on 36 patients with hepato-biliary diseases. Stones were removed from fourteen Patients with single common bile duct stones and nineteen patients with multple common bile duct calculi. Endoscopic drainage in eight patients is achieved by performing biliary sphincterotomy and placement of nasobiliary drain to effect irrigation. Haemorrhage, Acute cholangitis, and acute pancreatitis developed respectively in two, one and two patients after ERCP and EST. Following ERCP and EST, serum and Urine amylase values were increased in 64.71% and 70.58% of patients in the control group. Serum and Urine amylase values were increased in 17.24% and 34.48% of patients in the octreotide group. Serum and Urine amylase values were increased in 18.75% and 25.00% of patients in the Somatostatin group. Conclusions The diagnostic value of ERCP is very high. EST is a relatively safe and effective procedure in treatment of common bile duct stone. The results obtained in our study seem to indicate that octreotide and Somatostatin could prevent the increase in serum and Urine amylase values, compared to control group, but no significant difference was observed in octreotide group and the Somatostatin group.

Value of miniprobe sonography in the evaluation of remission of ulcerative colitis LU XIA, QI ZHU, JIHONG TAN

Aims Miniprobe sonography (MPS) has been shown to be useful for differentiation of acute inflammatory bowel diseases (IBD) and predict the remission of UC, but it still remains controversial. The present study tried to determine the clinic value of MPS in the assessment of severity and stage of ulcerative colitis (UC). Methods 25 patients with acute UC confirmed by endoscopy and histologic examination underwent a eight-week course of oral Balsalazide sodium (6.75 g/day). Clinical, MPS (Fujinon SP701, 15 MHz) and histologic data were collected at the beginning and the end of the study. As well as five imaging parameters of the MPS features (total wall thickness, mucosal appearance, submucosal thickness, number of enlarged vessels in the submucosa and number of enlarged lymph nodes around the colon) were measured between acute flare-ups and quiescent forms of UC in the same patients. Results 20 patients completed the study. After treatment, all imaging parameters had significantly improved in patients compared with pretreatment findings. Patients after treatment chieved remission assessed as 'complete' (70%) and 'symptomatic' (85%).The MPS features were also significantly improved after treatment. There was no significant difference in the thickness of the total wall around the lesion before and after the treatment (3.84 ± 0.64 mm/3.62 ± 0.61 mm, p = 0.15). But in active cases, submucosal thickness were greater than quiescent stage (2.96 ± 0.73 mm/2.12 ± 0.35 mm, p < 0.01), the mucosa-submucosa and submucosa-muscularis propria layer borders were blurred and the pathological lymph nodes were detected in some patients (20%) even if in quiescent stage, no enlarged vessel in the submucosa was found in both stage. Conclusions This study suggests that MPS could be helpful for the transmural assessment of the colorectal wall and may contribute to the diagnosis and prediction of remission in UC.

Objective Make an analysis of the data of 1014 cases of colonopathy for the aged so as to recognize the characters of enteroscope and clinical. Method Chose 1014 cases of colonopathy for the aged above 60 and made a review and analysis. Results Findings showed 975 cases of positive diseases (96.2%), among the former, large enteritis 35.1%, polyp 31.2%, malignant tumor 12.6%, angiectasis 6.5%, melanosis 7.3%, diverticulum 7.1%, ulcer large enteritis 1.8%, ischemic large enteritis 0.9%. The finding rate of large intestine polyp is 31.2%, among which unique incidence 41.1%, multiple incidence 59%. The likely occurring organs for polyps are sigmoid, colon ascendens, colon decendens, rectum, transverse colon, ileocecal valve. The finding rate of malignant tumor on large intestine is 12.6%. The likely occurring organs successively are sigmoid, colon decendens, rectum, ileocecal valve, colon ascendens, transverse colon. The clinical symptom is mainly diarrhoea (60.7%), others successively are constipation, diarrhoea, blood stool, abdominal distension, anaemia, thin, belly phyma. Conclusion 1. The positive finding rate among the group is high with 96.2%, and colonopathy is one of commonly-used examination methods. The three large intestines diseases with high incidence successively are large intestines inflammation, polyp and cancer. It has been known that polyp and cancer have relativity with each other, so special attention shall be paid. 2. Large intestines polyp has multiple incidences when examining, it is required to find carefully. 3. The likely occurring organs for large intestines cancer successively are sigmoid, colon ascendens, colon decendens, rectum, transverse colon, ileocecal valve and it is more important to look into ileocecal valve. 4. Abdominal pain, constipation, diarrhoea, blood stool are common symptoms. It is of key importance to inquire the medical history and make diagnosis.

Effect of colorectal obstruction with temporary metal internal stent dilation on operation methods HUIMIN XU, CHEN NI WEI, CHENG YING SHENG, ET AL.

Objective To explore the methods and clinical value of temporary internal metal stent by endoscopy under X ray control for treating patients with colorectal obstruction. Methods 27 patients with colorectal obstruction placed temporary metal intenal stent by endoscopy under the X ray control. Results 27 patients with colorectal obstruction symptom were disappeared within 48 hours after therapy, Elective radical resection were performed after bowel preparation. Conclution Colorectal obstruction symptom disappeared by plased metal internl stent, the therapy had higher success rate by endoscopy under X control, patients with malignant colorectal obstruction can performed Elective radical resection.

The diagnostic value of endoscopic ultrasonography in the lesion upper digestive tract PING XU, NONGHUA LU, XUANG ZHU, CHUNYAN PONG, HUAICHUN HE Department of Gastroenterology, The First Affiliated Hospital of Jiangxi Medical College, Nanchang, China Objective To investigate the diagnostic value of the lesion of upper digestive tract by endoscopic ultrasonography. Materials and Methods Endoscopic ultrasonography was applied to 73 patients with the lesion of upper digestive tract. Electronic ultra-sonic endoscopic diagnostic apparatus were brought from Olympus company, its type is Olympus GF-UM2000. The frequencies was 5 MHz, 7.5 MHz, 12 MHz, 20 MHz, respectively. All patients were applied at least two kind of frequencies. Prior to EUS, every patient was checked by gastroscopy and found the protrusion lesion of upper digestive tract, and part of patients underwent X-ray barium meal and computer tomography (CT), but were not diagnosed definitely. Results Of 73 patients in the lesion of upper digestive tract group, esophageal leiomyoma 10 (13.7%), esophageal venoneoplasia 1 (1.4%), esophageal cyst 1 (1.4%), esophageal carcinoma 1 (1.4%), compression from esophageal exterior organ 1 (1.4%), stomach leiomyoma 7 (9.6%), stomach leiomyosarcoma 1 (1.4%), stomach lymphoma 1 (1.4%), gastric ployp 8 (10.9%), gastric ulcer 3 (4.1%), gastric cancer 6 (8.2%), varicosis of gastric fundus 1 (1.4%), compression from gastric exterior organ 3 (4.1%), duodenal ployp 1 (1.4%), ectopic pancreas 1 (1.4%), pancreatic caner 6 (8.2%), pancreatic cyst 1 (1.4%), chronic pancreatitis 2 (2.7%), 18 (24.7%) patients didn't find evident abnormalities. the diagnostic accuracy of EUS was up to 95.1% and surpassed obviously 56.0% of CT and 43.1% of X-ray barium meal. Conclusions EUS has superior value to gastroscopy and X-ray barium meal and CT.

Anaiysis of 53 cases of the young's gastric cancer YUNZHEN YANG, FUPU LIU, SUZHEN LIU, LIHONG PAN Yuncheng Central Hospital, Yuncheng, Shanxi, 044000, China Objectives To study endoscopic appearances and pathologic characteristis in the young's gastric cancer. Methods A series of 53 cases the young's gastric carcinomas, proved bygastroscopy and operative specimens in past 15 years, were reviewed to have a further understanding of the young's gastric cancer.

The 53 caese were counted for 2.2% of 2446 gastric cancer cases in the same period, and of which 41 cases endoscop is biopsy appeared to be positive, 12 cases negative (9 cases Borrmann IV, 3 cases Borrmann II); 21 cases male, 32 cases female, at 1 : 1.5; average age 31.8 of the ages 19-35. Clinical manifestation: abdominal pain (35/53), abdominal distension and anorexia (20/53), haematemesis or hemafecia (14/53), heartburn (10/53), anemia (10/53), abdominal mass (5/53), weight loss (5/53), dysphagia (5/53), and low fever (1/53). The course lasted from 10-730 days, the average time being 2.8 months. All the cases were advanced gastric cancer. The location: cardia 4, gastric fundus 5, gastric body 20, gastric angle 7, gastric antrum 8, gastric body and antrum 9. Endoscopic revealed: Borrmann I type 6, II type 8, III type 18, IV type 21. The Histological change: poorly differentiated adenocarcinoma 27, undifferentiated cancer 5, signet-ring carcinoma 10, mucinous adencarcinoma 10, adenosquamous carcinoma 1. The resectability rate was 47.1% (25/53). Conclusions The result showed that young people's gastric cancers are characterized as the following: (1) They occur frequently among female, the proportion between male and female being 1 : 1.5, higher than 1 : 1-1 : 1.26 reported in document. Most scholors believe that the higher occurrence has something to do with estrogen. (2) No clinical speciality is easily misdiagnosed as benign gastrosia. (3) Shorter coure of the disease, faster development and lower rate of resection.(4) The pathological character shows poor differention and high malignancy. We should pay more attention to the early diagnosis of the young's gastric cancer, and multilocation biopsy and deep-biopsy to suspected Borrmann IV sufferer.

Research on the safety of applying EPT in aged patients with common bile duct stones LIPING YE, MINHUA LIN, SAIQIN HE, HONGFANG, CAI JIYA, CHEN JINSHUN ZHANG Department of Digestive Diseases, Taizhou Hospital, Zhejiang, 317000 Objective To evaluate the safety of applying Endoscopic Papillotomy (EPT) in aged patients with common bile duct stones. Methods Analyze retrospectively the patients who had been treated for the common bile duct stones by EPT between Oct. 2000 -Nov. 2003 in our hospital, of whom 142 over (and of ) 65 years old as the elder group, and 224 patients less than 65 years old during the same time as the placebo group. Then compare the clinical data and the complications after EPT between the two groups. Results The rate of hypertension, coronary heart disease, diabetes mellitus, pulmonary heart disease and cerebral infarction in the elder group was higher than the other group (P < 0.05). The complications of the two groups were not very different (P > 0.05), if grasping indication strictly, using anesthetic reasonably and monitoring vital signs. Conclusion EPT is a safe and effective method to treat the aged patients for the common bile duct stones.

A safe and effective strategy for endoscopic removal of gastrointestinal lipomas HONGGANG YU, LIANGLIANG YU, JIE-PING YU, HESHENG LUO

Objective Gastrointestinal (GI) lipomas are benign, slowly growing submucosal tumors, which may cause gastrointestinal bleeding, anemia, intussusception, and bowel obstruction.The aim of this study is to explore the safe and effective strategy for endoscopic removal of GI lipomas. Methods During last decade, nineteen small sessile lipomas with base size smaller than 2 cm in diameter were resected by "pushing" technique in our hospital; the only one flat lipoma was drained by "window-opening" technique; two giant lipomas with small stalk (<2 m in diameter) were resected by polypectomy; seven giant lipomas with base size greater than 2 cm in diameter were removed using a "subtotal resection". EUS was performed in three cases from 2000~2002 to confirm that those lesions were lipomas superficial to the muscularis propria. Results All 29 lesions were successfully removed and histopathologically confirmed to be lipomas. No severe complications such as perforation and hemorrhage were developed after endoscopic removal. No recurrence was observed after 1-8 years follow-up endoscopic examination. Conclusion Various GI lipomas can be removed safely by electrosurgical snare resection under endoscopy following the guidance of the present theraputic strategy.

Endoscopic management of gastrointestinal smooth muscule tumor HONGGANG YU, XIAODONG ZHOU, JIEPING YU, HESHENG LUO Department of Gastroenterology, Renmin Hospital of Wuhan University,Wuhan 430060, China Objectives Gastrointestinal smooth muscle tumors (SMTs, including leiomyoma and leiomyosarcoma) represent relatively common lesions that are thought to originate from muscular layer of gastrointestinal tract. In this study, we evaluated the efficacy and safety for endoscopic resection of submucosal leiomyoma. Our preliminary experiences on endoscopic diagnosis of gastrointestinal SMTs were also reviewed. Methods From January 1993 to May 2002, a total of 69 patients with gastrointestinal SMT (17-78 years old) underwent routine endoscopy. Endoscopic ultrasonography (EUS) was also performed in 9 cases of gastrointestinal SMT after February 2001. The sessile submucosal gastrointestinal SMTs with the base smaller than 2 cm in diameter were resected by "pushing" technique or "grasping and pushing" technique while the pedunculated SMTs were resected by polypectomy. All resected tumors were collected for histological examination. For those gastrointestinal SMTs originated from muscularis propria or with the base size ≥2 cm, ordinary biopsy technique was performed in tumors with ulcer while the "Digging" technique was performed in those without ulcer. Results In this study, 54 cases of leiomyoma and 15 cases of leiomyosarcoma were identified. In them, 19 cases of submucosal leiomyoma were resected by "pushing" technique and 10 cases were removed by "grasping and pushing" technique. Three cases pedunculated submucosal leiomyoma were resected by polypectomy. No complications such as perforation and severe bleeding developed during or after the procedure. No recurrence was observed after 1~2 years follow-up. Comparing to the final pathologic results after surgical removal, the diagnostic accuracy of ordinary and the "Digging" biopsy technique was 90.0% and 94.1%, respectively. Conclusion Endoscopic resection is a safe and effective treatment for leiomyomas with the base size £2 cm. The "digging" biopsy technique would be a good option for histologic diagnosis of SMTs.

Endoscopic and pathologic feature of fundic cancer and relationship with helicobacter pylori XIANEN YU, DAILIN WEI, PEININ HUANG, JIAZHONG LIAO, WEI LU Department of Gastroenterology, People's Hospital of Baise City, Baise, Guangxi 533000, China Objective To study the endoscopic and pathologic feature of fundic cancer and the relationship with Helicbacter pylori (Hp). Methods The endoscopic and pathologic feature and the relationship with Hp were studied in 26 patients with fundic cancer with retrospective analysis. Results 1. There were 57.7% eminence-ulcer type, 19.3% ulcer type, 11.5% eminence type and 11.5% severe erosive type in endoscopic features. 2. The pathologic positive rate was 92.3% in the first biopsies and there were 69.2% poorly differentiated adenocarcinona, 11.5% tubular adenocarcinoma, 7.7% papillary adenocarcinoma, 7.7% signer-ring cell caneer and 3.8% mucinous adenocarcinoma in total pathological sections. 3. The postive rate of Hp infection was 30.8% and the negative rate was 69.2%. Conclusion 1. The eminence-ulcer type in endoscopy and poorly differentiated adenocarcinoma in pathology were the main features of fundic cancer. 2. The Hp infection rate seems low in patients with fundic cancer.

The diagnosis valuation of ERCP to pancreaticobiliary diseases GUANGPING YUE The Central Hospital of Chengdu Railway Bureau, Chengdu 610081, China

Journal of Gastroenterology and Hepatology (2004) 19 (Suppl.) Objective To study the diagnosis valuation of Endoscopic Retrograde Cholangiopancreatography (ERCP) in pancreaticobiliary diseases. Materials and Methods ERCP was made for 262 cases of patients. After that, they were classified into several groups, such as gallstone, tumorous, benign stricture and some rare diseases. Then Analyzed their own characteristics according to the foundings from ERCP, comparing to the results made by ultrasonography and computed tomography. Results 22 cases of pancreaticobiliary opacification showed normal while other 231 cases did abnormal. Of the later group, there were 109 cases of gallstone, 84 cases of tumorous, 24 cases of inflammatory and 14 cases of other diseases. 253 cases were successfully made while 9 cases failed. The rate of success was 96.3%. Conclusions ERCP has an advantage over ultrasonography and computed tomography. It can provide clear biliary duct opacification for caput pancreatic cancer, carcinoma of ampulla, cholangiocarcinoma. ERCP has been the first option of diagnosis to the rare diseases.

Analysis of the relationship between gastroscopy changes and acute pancreatitis JIMEI ZHANG, GUOLIANG CAO, ZHIMIN WANG, XUELANG LIANG

Objectives To observe the relationship between acute pancreatitis and the accompaning damaging extent of stomach and duodenum and to guide clinic treatment. Materials and Methods 136 cases (76 of male, 60 of female, average 48 years old) of acute pancreatitis admitting in our department were analysed, Among them, 114 cases are light and 22 cases are severe; 64 caused by gall system disorder and 36 by alcohol. Gastroscopies were performed whithin one week after onset; Samples were taken from mucous membrane of gastric sinus in all cases without peptic ulcer history and examed by urea enzyme test and biopsy. 16 cases of them were companied by digestive tract bleeding (14 severe, 2 light). Incomplete closing of pylorus was observed in all cases, More reflux of gall and duodenum fluid was seen in 82 cases. Findings under gastroscopy: The mucosa of gastric body and sinus in light superficial gastritis appears piebald alternated with red and white (the majority is red). The mucosa in active gastritis and duodenitis looks like engorgement, edema, dot or patch bleeding and erosion in gastric base, body, sinus and duodenum. Dilapidation, hollow and adhering fog at bottom surrounding with engorgement and edema were found in the mucosa of gastric and duodenum ulcer. Positive diagnostic standard of HP infection: Both positives by rapid urea enzyme test and urea exhaling test is defined as positive of HP, Both negatives or one of two positive is belong to negative of HP. Results The occurring rate of acute pancreatitis companied by mucosa damages of upper digestive tract (including light superficial gastritis, active gastritis and duodenitis and gastric and duodenum ulcer) is 79.41% (108/136), among them the occurring rate in light pancreatitis is 73.68% (84/114), that in severe one is 100%. The mucosa damages give priority to active gastritis on gastric body and sinus, the more severe state of illness, the more damages in gastric and intestinal mucosa. There is statistic difference among them, P < 0.05. There are 38 cases in light and 8 in severe infected by HP. Conclusions 1,The occurring rate of acute pancreatitis companied by mucosa damages of upper digestive tract is high. 2, The more severe state of illness, the more damages in gastric and intestinal mucosa. 3, The mucosa damages in stomach are severer than that in duodenum. 4, The pathologic changes of mucosa give priority to acute damages. 5, These damages may be independent of HP infec-tion. 6, The abdominal pain can be released after treated by antiacid and gastric mucosa protecting drug.

Clinical feature and endoscopic findings in henoch-schonlein purpura LI ZHANG, LIPING DUAN, YAN XUE Department of Gastroenterology, The Third Hospital of Peking University, China Background Henoch-Schonlein purpura (HSP) is a small-vessel vasculitic disease. Abdominal pain and bleeding in gastrointestinal tract were often the first and predominant symptoms in these patients, so the diagnosis was difficult. Methods we reviewed the clinical dates of 81 patients diagnosed as HSP, and analyzed the endoscopic findings of 19 cases who received gastroduodenoscopy or colonoscopy. The histopathology of specimens form 15 cases was evaluated. Result 51 patients had a history of upper respiratory tract infection, taking medicine or variant protein before the onset of the disease. 71 patients experienced abdominal pain, which often occurred in periumbilical and epigastric regions; 34 patients had hematochezia, 18 had melena and 16 had bright blood stool. 43 patients had abdominal tenderness. Abdominal symptoms presented firstly in 21 patients, which can occur 1-40 days before the skin rashes appearing. 16 patients appeared rashes within 7 days.The main endoscopic finding include infusive edema and congestive of mucosa, multiple hemorrhagic spots, erythema, erosion and ulceration. The ulcers in stomach or duodenum were more superficial, but that in ileum seems deeper and larger. Erosion and ulcer were annulus along the folds. The findings in duodenum, especially second portion, and ileum were more severe than that in stomach or colon. The results of the microscopic examination of the specimens were: neutrophilic infiltration in mucosa and submucosa, small vessels necrosis, focal bleeding, erosion and ulceration. There are only various degrees of chronic inflammations in 7 cases. Hp was positive only in 2 cases, although the gastric biopsies were treated with W-S strain in 10 cases. Conclusion the characteristic chlinical feature and endoscopic findings may help in the diagnosis and treatment of Henoch-Schonlein purpura (HSP), especially in those typical skin rashes not occurring.Objective To study the epidemic characteristic of cancer on upper digestive. Method The3-step examination including OBB (occult blood bead test), gastroscope and pathology have been carried out for people aged than 30. Result The screening rate by OBB is 15.07% and the positive rate is 18.33%; the examination rate by gastroscope and pathology are 20.03% and 22.89% respectively, two hundred and thirteen people have been diagnosed as cancer, including 92 cases of esophagus cancer, 21 case of cardial cancer and 100 cases of gastric cancer. 1093 people were found in precancerous period and 158 people with cancer in early stage. The distribution of cancer show a remarkable difference in sexuality, age and district that the prevalence rate of man is greater than woman, age of 40-50 greater than other age, and people in rural or upland district greater than that of city or level ground. Conclusion The general examination for tumor of upper digestive tract is the solid basis for the study and prevention of cancer in the region.

Contact endoscopic argon coagulation in the treatment of erosive gastritis protuberans YEXING ZHANG*, XIAOFANG YU, KAI PAN, ET AL *Department of Endoscopy, Shen Zhen People's Hospital, Second Teaching Hospital of Jinan University, Shenzhen 518020, China Objective To study the effectiveness, efficiency and safety of the contact APC applied in patients with erosive gastritis protuberans. Method 63 patients, suffered with erosive gastritis protuberans, were divided to two groups, group A: Treated with non-contact APC and drugs; group B: treated with contact APC and drugs comparing the effectiveness, efficiency and safety. Results There is no significant difference between group A and Group B in the effectiveness (group A: cure rate : 96.8%, group B: cure rate : 96.9%, P > 0.05) and safety (only 3 cases patients had burbulece or/and abdominal pain started within 1-3 d after operation and disappeared within 3-7 d in each group, no any serious complications occurred in all 63 patients). But the number of the ineffective operation (group A: 284 times, group B: 96 times, P < 0.01), the duration of the operation (group A: 11 min 38 sec, Group B: 7 min 22 sec, P < 0.01) and the umber of accidental injury (group A: 137 times, group B: 58 times, P < 0.01) are significantly different between group A and group B. Conclusion treating erosive gastritis protuberans, contact endoscopic APC not only has excellent effectiveness and safety, but also more simple and convenient, less accidental injury and more efficient than non-contact endoscopic APC.

Treatment of erosive gastritis protuberans by means of endoscopic argon plasma coagulation (APC) ZHANG YEXIANG, YU XIAOFANG, PAN KAI, ET AL Department of Endoscopy, Shenzhen people's Hospital, the Second Teaching Hospital of Jinan University, Shenzhen 518020, China Objective To study the effectiveness and safety of the APC applied in patients with erosive gastritis protuberans. Methods 66 patients, suffered from erosive gastritis protuberans, were divided to two groups: group A: treated only with drugs firstly then by APC; group B: treated by APC and drugs simultaneously. Comparing the efficacy and safety. Results HP positive rate was 77.3% (51/66), intestinal metaplasia was found in 36.4% (24/66) patients with erosive gastritis protuberans. In group A: treated only with drugs, only 15.6% (5/32) patients were verified that the protruding lesions disappeared, but, treated with APC, all of the protruding lesions, the same as group B: were vanished, cure rate was 100%, significant higher than the patients only treated with drugs (P < 0.001) we had only one case with subcutaneous emphasema, disappeared without any treatment after 2 weeks. 7 cases patients had burbulece or and abdominal pain started within 1-3 d after operation and disappeared within 3-7 d. 69 times of APC were done and 352 Protruding lesions were treated by APC in 61 patients, the average operation time was 11 min.Conclusion HP infection play a role in the pathogency of erosive gastritis protuberans, intestinal metaplasia was found frequently in protruding lesion treating erosive gastritis protuberans with only drugs has no significant effect, APC has excellent effectiveness and safety in the treatment of erosive gastritis protuberans.

Endoscopic management of down common bile duct postcholecystectomy ZHENGKUN ZHANG Departments of Gastroenterology, Jiuquan Hospital of Gansu, Gansu, China Objectives To study the clinic value of endoscopic sphincterotomy (EST) in patients with stricture of down common bile duct postcholecystectomy. Materials and Methods 73 patients with stricture of down common bile duct were found in 174 patients with postcholecystectomy syndromes through endoscopic retrograde chalongiopancreatography (ERCP), who were treated through endoscopic sphincterotomy (EST). 7 patients with pancreatitis and 9 patients with acute cholangitis were treated through endoscopic nosobiliary drainage (ENBD) after EST. Results Relief rate of abdominal pain is respectively 83.33%, 73.81%, 80.95% in patients with simple stricture of down common bile duct and patients with stricture of down common bile duct and acute pancreatitis and patients with stricture of down common bile duct and stones. The rate of normal common bile duct, which was recovered, is respectively 100%, 88.89%, 100% in patients with simple stricture of down common bile duct and patients with stricture of down common bile duct and acute pancreatitis and patients with stricture of down common bile duct and stones. Serium ALT and AST and ALP and r-GT are normal in all patients after EST. Conclusions EST is effective in treatment of patients with stricture of down common bile duct and is first means.

Ercp for diagnosis and treatment of 173 cases of biliary and pancreatic disease ZHENZHONG ZHANG, YUANYUAN SUN, PING CHEN, ET AL Department of Gastroenterology, The 3rd People's Hospital of Nantong, China Objective To evaluate ERCP and endoscopic therapy in diagnosing and treating biliary and pancreatie diseases. Methods The clinical effect of applying duodenoendoscopy to diagnose and treat biliary and pancreatic disease on 173 patients was retrospectively analyzed. Results ERCP was successfully undergone in 93.6% of the total cases. Out of 69 cases common bile duct stones were removed in 66 cases with one session 20 cases were diagnosed as biliary or pancreatic cancer, of which 5 were treated with stent drainage. Post-ERCP pancreatitis was diagnosed in 2 patients, bleeding occurred in 2 patients. All complications were cured by non-operation methods. Conclusion ERCP is reliable on diagnosing biliary diseases and endoscopic therapy is available instead of operation.

Analysis of 69 cases by using endoscope to treat choledocholithasis ZHENZHONG ZHANG, YUANYUAN SUN, PING CHEN, ET AL Department of Gastroenterology, The 3rd People's Hospital of Nantong, China Objectives To find out the clinical value of therapeutic endoscopy to the treatment of common bile duct stone of 69 cases. Methods To use endoscape to finish ERCP and EST under the Xray monitor. The choledocholith were extracted with Dormia net basket.The bigger stones first carried out mechanical lithotripsy using BML, and then removed stones. Results To use endoscope to treat 69 cases of choledocholitasis diagnosed by ERCP. 68 cases were successfully treated by EST. All of the stones were extracted one time within 66 cases, 6 cases of all patients firstly underwent BEL mechanical lithotripay, and the removed chololith successfully.While the other 2 cases underwent the second expraction stones. Conclusions ERCP is one of the most important methods to diagnose choledocholithasis. Endoscope can also treat extrahepatic bile duct stones and residual stones after cholecystectomy and choledochotomy. ERCP and EST is an effective safe and micro-traumtic treatment for the Choledocholithasis.

Objectives To discuss the endoscopic application for diagnosis and therapy in patients with upper gastrointestinal (GI) bleeding caused by non-malignant diseases. Methods Reviewing endoscopic examination and treatment of 280 cases suffered from upper GI bleeding from September 2000 to February 2004. Results 1. The first pathogeny of upper GI bleeding is peptic ulcer (48.22%) in all cases, but it is variceal bleeding mostly among the cases with liver cirrhosis (47.37%). 2. Early endoscopy examination maybe point bleeding focus. 3.The key to hemostasia is correct choice of endoscopic hemostatic technique. 4. Roughage could result in bleeding after variceal band ligation (EVL). Conclusions 1. Knowing details of the cases may assist in choosing plan in therapeutic endoscopy. 2. We should perform endoscopic examination as soon as possible after bleeding in order to point and treat persistent bleeding. 3. Endoscopist must know well about surgery conditions and do something timely since hemostasis failure or rebleeding after therapy, including surgery. 4. Patients' diets must be paid attentions during band removing spontaneously to avoid bleeding caused by food.

Five patients (mean age 55.8 years, range 47-68 years) were diagnosed with fungal infection in biliary tract by smear or/and culture of bile obtained by ERCP and nasal-biliary tube. The clinical data of them were collected and analyzed retrospectively. All patients accepted local application through nasal-biliary tube and intravenous fluconazole for anti-fungal infections. Each drug was started immediately after positive result of smear/culture of bile and continued for at least 3 weeks. Patients were evaluated for fungal colonization, duration and efficacy of antifungal infection treatment, and drug-related side effects. Results Fungal colonizations of proven invasive fungal infections were candida glabrata (four patients), candida albicans (one patients). The mean duration of intravenous fluconazole was 30 days (24-40 days), local application of fluconazole through nasal-biliary tube was 19 days (8-24 days). The fluconazole were well tolerated excepted of nephrotoxicity of one patient. According to 3 months to 2 years follow up, all patients were proven cured. Conclusions Combining with typical clinical features of biliary tract infection, fungus detection of smear/culture of bile obtained in ERCP was the key-point for diagnosis of invasive fungal infection. Up to now, pharmacokinetics of anti-fungal medicine in biliary tract still is unknown. Local application through nasal-biliary tube and intravenous fluconazole would be an efficacy and safety treatment of fungal infection, and keeping nasal-biliary tube be unobstructed must be well emphasized.

A case report of the diagnosis and treatment of esophageal cavernous hemangioma XIAOYAN ZHAO, SIPING DA, PENGBIN ZHANG, LEI WANG Dept. Gastroenterology, Xinqiao Hospital, Third Military Medical University 400037, China Hamangioma of the esophagus is uncommon in patients with benign esophageal tumors. To our knowledge, there were less than 100 clinical case reports reported in the medical literature,We add a new case of esophageal hemangioma with treatment by access thoracic surgery, and evaluate the appropriate diagnostical access and review the treatment strategies for the disease. A 40-year-old woman with a history of repeated cholecystalgia underwent cholecystectomy 10 years ago. The patient complained to have been disturbed by lightly dysphagia and retrostemal pain for 1 year. The results of physical and laboratory examinations were unremarkable. However, endoscopic examination showed a protruding mass in the middle third of the esophagus, which located on the left esophageal wall 20 cm from incisors, and was covered with smooth mucosa with bluish coloration. Barium swallon examination found 2.0 cm filling defect on the middle third of the esophagus. EUS showed a hypoechoic submucosal mass compatible with a vascular stucture, projecting into the lumen. The routine B-ultrasonography also showed the same result by a specialist. In the case, we could not get a remarkable result by the either examination of CT and MRI. The tumor was completely resected by routine thoracic surgery.

Comparison analysis of clinical and endoscope manifestation of large intestinal tuberculosis and Crohn disease GUORONG ZHENG, DAOFEN LI, WEITIAN XU

Objective To analysis the clinical and endoscopic manifestation of large intestinal tuberculosis and Crohn disease so as to give a hand to diagnosis. Methods The cases of large intestinal tuberculosis and Crohn disease were collected from 1982 to 2003. The data were analyzed for clinical and endoscopic manifestation. Results 21 cases of large intestinal tuberculosis, 14 for men, 7 for women, 19 cases showing abdominal pain, 10 cases abdominal distension, 12 cases diarrhea 3 cases alternation of diarrhea and constipation, 4 cases lower temperature 10 cases speeding up of ESR.There are 15 cases of pathological change affecting caecum, 4 cases affecting end of ileum, 1 case affecting transverse colon. Under endoscope, there are 4 cases showing mocosa congestion, grain-like change and flaky erosion. The other 17 cases, there are 9 cases of ulcer, 1 case of hyperplasia, 7 cases of mixture. The ulcers mainly take round-like or irregular shape with different sizes and depths. 6 of them are confirmed by biopsy pathological diagnosis. There are 6 cases of Crohn disease, 5 for men, 1 for women, among whom, 6 cases show abdominal pain. 4 cases show diarrhoea. There 1 case affecting ileum end, 3 cases affecting caecum, 2 cases affecting both of them, 1 case affecting rectum. Under the endoscope, ulcers take irregular or elliptical shape, among which, 2 cases show crack shape, 2 cases show paving stone-like change. Conclusion The clinical and endoscopic manifestation of large intestines tuberculosis and Crohn disease do not have special characters, its diagnosis mainly is based on pathological examination. To distinguish them, besides referring to clinical and endoscopes, it is required to combine the trial anti-tuberculosis treatment and comprehensive analysis of biopsy results for many times and in many parts under endoscope.

Comparison studay between endoscopy and pathology on 55 cases CAG JING ZHOU, ZHIXIANG SHEN, LEI SHEN

Objective To explore the diagnostic value about various expressions under gastroscopic direct vision in chronic atrophic gastritis. Methods To contrastively analyse various expressions of CAG under gastroscopic direct vision and pathologic diagnosis in 55 cases, and to calculate respectively the sensitivity and specificity of CAG, intestinal metaplasia (IM), atypical hyperplasia (ATP) through various gastroscopic expressions. Results The coincidence of the diagnosis about CAG under gastroscopy as controlled with pathology was 85.45%. The gastroscopic sensitivity of pathologic CAG was about 12.77%~51.06%. The specificity of gastroscopic piebald change and thin-flat bulge about CAG were 87.50% and 75.00%. The specificity of some co-existed expressions was higher than that of single expression. Asper and granulelike change had higher diagnostic value about IM, its sensitivity and specificity was 66.67% and 71.74%. White-phas dominantly and blood vessel penetrately had higher sensitivity about ATP, it was 71.74%. Projecting erosion had higher specificity about ATP, it was 68.89%. Conclusion Piebald change, asper and granule-like change, whitephas dominantly and blood vessel penetrately under gastroscopic direct vision respectively possessed good value about pathologic CAG, IM, ATP. Only combined gastroscopic examination with pathologic diagnosis can correctly diagnose CAG, IM, ATP.

Aims To study the representations of prolapse of gastric mucosa (GMP) on endoscopy. Methods summarizing the representations on endoscopy of 79 patients with GMP diagnosed during 2001~2004. Results (1) Patients diagnosed as GMP aged from 10 to 80 years.(2) The number of the prolapsed mucosa in 50 cases (63%) was one strip mucosa, two strips in 22 cases (27%) and three strips in 7 cases (8%) respectively. (3) The prolapsed mucosa in 70 cases (88.6%) was located at small flex side of stomach. (4) The prolapsed mucosa was not changed when six patients were rechecked during two weeks to one year. (5) Inflammation was founded on the surface of the prolapsed mucosa in 30 cases (38.0%). Chronic gastritis was founded in 45 cases (56.9%), included 18 cases with Striped erythma in gastric antrum. The color of fluid in gastric fundus was kelly in 7 cases.Esophagitis were founded in 4 cases (5.1%). (6) The rate of Hp infection in 79 patients with GMP patients was 11% (9 cases). Conclusions GMP can be diagnosed in every age, the number of prolapsed mucosa is commonly one strip and most of the prolapsed mucosa is located at small flex side in stomach.The prolapsed mucosa can be sustained. Chronic inflammation is common in stomach and on the surface of prolapsed mucosa. Hp infection in patients with GMP is lower.

Early rebleeding after endoscopic multiple rubber-band ligation for varices CHUANXIN ZOU, MING XIE, SHAOJUN DAI

Objective The efficacy of endoscopic multiple rubber-band ligations for esophageal varices (EV) were summarized and the causes of rebleeding investigated. Methods Selective endoscopic ligation was exercised in 43 patients with portal hypertensive EV at bleeding intervals. Each case received 1~4 sessions (2 on average) of ligation and 4~12 bands per session, totalling 5~20 bands (9.2 averagely) using Wilson-Cook's or Microvasive Co's multiple rubber-band ligator. Results The EV were eradicated or basically eradicated in 60.5% (26) of cases. Bleeding complicated in 6instances (14%), which occurred intraoperatively, 15~36 hours or 3-10 days following the procedure with 3 cases died of hemorrhagic shock and 1 from hepatic failure. Conclusions Multiple band ligations are however a method of choice for EV, bleeding from the procedure needs much attention. Its possible cases and preventive measures being discussed.

Effects of interluekin 6 and retinoid acid on induced apoptosis of gastric cancer cells HONGJUN YE, ZIGANG WU, JIAZHI FANG, ET AL Shenzhen Hospital, Beijing University, Shenzhen 518036, China Objective To determine whether interleukin 6 (IL-6) and retinoid acid (RA) would induce apoptosis of gastric cancer cells in vivo.

Morphologic analysis, apoptosis rate and DNA fragmentation of SGC 7901 gastric cancer cells induced by IL-6 (Lake Placid, New Yerk) and RA (Sigma) were studied with transmission electron microscopy and agarose gel electrophoresis assays. Results Treatment SGC 7901 gastric cancer with different IL-6 and RA suppressed the growth of SGC 7901 gastric cancer in doseand time-dependent manner. There was marked difference in degree of the cytotoxicity. Electron microscopy analysis showed After 16 hours of exposure to IL-6, gastric cancer cells presented some morphologic features of apoptotic alteration, such as many cells nucleus shrinkage and chromosome condensation on edge of nucleus. After 24 hours of exposure to IL-6, cells presented chromatin condensation and nucear fragmentation. Then after 24 hours of exposure to RA, few gastric cancer cells presented cells nucleus shrinkage and chromosome condensation on edge of nucleus. Agarose gel electrophoresis of the soluble DNA exhibited the presesnce of oligonuosomal-sized fragmentation of apoptosis of 7901 gastric cancer cells induced by IL-6 is markerly than that by RA respictively. Conclusion It is suggested that IL-6 and RA induced apoptosis of gastric cancer cells.Then it is necessary to study the therapeutic value of IL-6 on gastric cancer further.

Management of unresectable carcinomas of the cardia and esophagus with covered mental stenting under the endoscopic approach DERONG WANG, SHUHONG ZHANG, SHUHONG YAN, XIULAN FENG Departments of Gastroenterology, Jinan Central Hospital, Shandong, China Objectives To evaluate the safety, clinical feasibility and long-term effectiveness of endoscopic mental stenting in patients with unresectable carcinomas of the cardia and esophagus. Materials and Methods 12 patients with unresectable carcinomas of the cardia and esophagus. (Mean age 63 years, range 48-85 years) were treated with covered mental stent implantation (CZES covered esophageal stent) under the endoscopic approach and were followed up until death. Evaluation of CZES mental stent on clinical symptom alleviation and complication rates and survival rates. Results Stents were inserted successfully under the endoscopic approach in all cases. A second stenting was needed in a patient. All of the patients experienced rapid improvement in dysphasia and other clinical symptoms. The median hospital stay for every treatment was 3.5 days (range 1-10 days). A complete follow-up until death was documented for all patients. The mean duration of follow-up of the patients was 127 days (range 45-289 days). During the entire followup, stent migrations in 1 cases and tumor overgrowth in 1cases were observed. One patient was died from cerebral embolism 2 days later. Conclusions Expandable covered mental stenting with endoscopic approach was a feasible and practical management in patients with unresectable carcinomas of the cardia and esophagus. This new approach thus represents a promising option for the treatment of unresectable carcinomas of the cardia and esophagus.

Helicobacter pylori stool antigen test: clinical application for detection of helicobacter pylori infection in the children YANLING ZHANG, LIYING JIA, MIN LIU Department of Gastroenterology, Capital Institute of Pediatrics, Beijing, China Objective To evaluate the accuracy of the Helicobacter pyloristool antigen (HpSA) test for detection of Helicobacter pylori (Hp) infection before and after treatment in children.Methods stool specimens were collected from 62 consecutive patients (4-17 years) who received 13 C-Urea Breath Test and/or gastroscopy for gastrointestinal symptoms and 31 patients after radical cure of Hp who received 13 C-Urea Breath Test within 2 day. The evaluation of Helicobacter pylori status was defined as positive when 13 C-Urea Breath Test were positive and gastroscopic biopsy were positive. Results the sensitivity of HpSA test for the diagnosis of Helicobacter pylori using a cutoff value of 0.121 was 92.30% and its specificity was 91.30%. The positive predictive and negative predictive value was 93.30% and 87.50%, respectively, and accuracy 91.94%. Sensitivity was 83.33% and its specificity was 88.00%. The positive predictive and negative predictive value were 62.50% and 95.65%, respectively, and accuracy 87.10% after radical cure of Hp. Conclusion HpSA test is higher to diagnose Helicobacter pylori infection the precision ration before the radical cure in children sensitivity and specificity after the radical cure are lower than before. Objective To investigate the influence of emodin on proliferation and cell cycle of hepatic stellate cell line-T6 and explore its mechanisms of antifibrotic. Methods The rat hepatic stellate cell line, HSC-T6 was generationally cultured in DMEM medium. Emodin of various concentrations was added to the medium in 48 hours. The changes of cell morphplogy, cell cycle, and expression of PCNAwere observed. The effects of emodin on proliferation of T6 cells were observed. Results (1) Emodin markedly inhibited the proliferation of HSC-T6 after 24 hours culture with concentration of 5~15 mg/L. The expression of PCNA proteins indicated the positive rate decreased along with the increase of concentration.

(2) The test data from flow cytometer showed emodin can block the cell cycle and along with the increase of concentration, the percentage of the cells in S phase and G 2 /M phase were gradually decreased and that in G 0 /G 1 increased. Conclusion Emodin can significantly prevent HSC-T6 cell proliferation significantly in vitro. The effect may be associated with changing the normal cell cycle of T6 cells and is time and concentration dependent on.