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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

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

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

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