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

作者： 刊期： 2000年第03期

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

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

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

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

作者： 刊期： 2000年第03期

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

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期