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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期