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

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

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

作者： 刊期： 2000年第03期

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

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

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