AIM To determine NO, NO synthase (NOS) and NOSmRNA of the esophageal carcinoma cells (SHEEC1)in apoptotic process induced by As2O3 and to explore the relationship between NO and apoptosis.METHODS The apoptosis of the cell line (SHEEC1) was induced by arsenite (As2O3, 5 μmol/L and10 μmol/L). In the process, at 2 h, 4 h, 8 h, 16 h and 24 h after administration of As2O3, NO production incultural medium was detected quantitatively by spectrophotometry; NOS Ⅱ was detected byimmunohistochemistry and NOS mRNA by in situ hybridization (ISH). The cells at endpoint of theexperiment were examined under transmitted electron microscope (TEM) for apoptosis.RESULTS The amount of NO released from SHEEC1 were increased from the basal condition (0.68×10-2μmol/L) up to the high level (2.38×10-2μmol/L) at h 16. The increment of NOS Ⅱ was found afteradministration of As2O3; the intracytoplasmic ISH signals of NOSmRNA in small size was found firstly at4 h, and then became highly predominant. Apoptotic changes of SHEEC1 occurred at 24 h under TEM.CONCLUSION After administration of As2O3, NO released from cultured SHEEC1 cells was detected withincreasing amount up to 16 h. The expression of NOS H and transcription of NOSmRNA are upregulated.The present findings suggest a concept that the NO may be a mediated and effective factor in apoptosisinduced by As2O3,

作者： 刊期： 2000年第03期

AIM To incorporate p12 in a plasmid under the control of the CMV promotor and test for the ability of theconstruct to produce specific immune responses in DNA-immunized mice.METHODS A His-tag fusion of the protein p12, was expressed in the prokaryotic expression vector (pQE)and the recombinant protein purified using nickel-chelate chromatography. His-tagged p12 was sub-clonedinto the pBK-CMV vector for expression in eukaryotic systems. Groups of six female balb/c mice werevaccinated with either 50μg im of the DNA pBK-CMV-p12 or pBK-CMV vector alone at week 0, andboosted at 2 and 4 weeks. ELISPOT assays (detection of p12 T-cell dependant IF-γ release) on mouse spleniccells were used to measure cell mediated immune responses and anti-mouse IgG ELISAs to detect antibodyresponse.RESULTS Significant CMI and humoral immune responses to recombinant p12 were detected in micevaccinated with pBK-CMV-p12 vector compared to mice vaccinated with pBK-CMV vector alone. The miceremained well throughout the development of immunity to p12.CONCLUSION A DNA vaccine coding for a specific MAP protein will stimulate humoral and cell mediatedimmune responses in mice.

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 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 provide evidence that UBT is the most cost-effective tool for evaluation of H. pylori eradication.METHODS Data on twenty-six consecutive patients at Atlanta VA Hospital who underwent UBT wereretrospectively reviewed. All patients had endoscopic diagnosis of peptic ulcers and biopsy proven H. pyloriinfection. Eight to ten weeks after completion of triple therapy (amoxicillin, biaxin and prilosec), allpatients had C14 UBT (PY test kit, Charlottesville, Virginia). Ten patients had repeated endoscopicexaminations and gastric biopsies. Twelve patients had serology tests for H. pylori.RESULTS UBT was negative in all patients (two patients had indeterminate result on the first time, butshown to be negative on the second UBT). Biopsies from all ten patients who were re-endoscoped werenegative for H. pylori. Serology tests on all the twelve patients were positive. Cure of H. Pylori could notbe determined on the titer change. All patients spent about 30 minutes in nuclear medicine laboratory, theendoscopic patients spent 2 hours to 4 hours in endoscopic laboratory; the cost for a UBT was about 50, thecost for an endoscopy with biopsy was above 200.CONCLUSION The 04 UBT is a rapid, economic and accurate test to monitor H. pylori eradication. Thetest should be considered a gold standard test for evaluating the effectiveness of treatment of H. pyloriinfection, unless patients need repeated endoscopy to rule out gastric cancer.

作者： 刊期： 2000年第03期

AIM To evaluate the significance of alhafetoprotein (AFP). gamma-glutamyltransferase (GGT).Carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) in diagnosis of primary hepaticcancer.METHODS Thirty-six patients with liver carcinoma (male 26, female 10, aged 29- 72 years), 6 withhepatic metastasis of gastrointestinal cancer (all male, aged 37- 69 years), 62 with benign liver diseases(male 53, female 9, aged 32- 71 years) and 222 without liver diseases (male 152, female 70, aged 22- 76years) were studied. Blood samples were taken by venipuncture. Serum was separated and frozen at -20℃until the analysis was made. AFP, CEA and CA125 were measured by RIA.RESULTS Serum AFP in liver cancer (476.3 - 181.4 ug/L) was significantly higher than that in hepaticmetastasis of gastrointestinal cancer, benign liver diseases and monhepatic diseases (P<0.01). Serum GGTin liver cancer was 621.1±289.9 w/L, significantly higher than that in the other groups (P<0.05). CA125level in liver cancer (236.3±127.2 u/L) was markedly higher than that in benign liver diseases andmonhepatic diseases (P<0.01), but no significantly difference was found in hepatic metastasis ofgastroentestinal cancer (219.4±143.7 U/L). Serum CEA in liver cancer (8.8±2.1 ug/L) was markedlylower than that in hepatic metastasis of gastroentestinal cancer (32.7±7.2 ug/L) (P<0.01). Thesensitivity of AFP, GGT, CA125 and CEA in the diagnosis of liver cancer was 72.2%, 88.9%, 63.9% and11.1% repectively; their specificity was 93.1%, 71.1%, 78.2% and 65.8% respectively. The diagnosticsensitivity and specificity of simultaneous detection of AFP, GGT and CA125 in liver cancer were 91.7% and88.4% respectively.CONCLUSION AFP is superior to GGT, CA125 and CEA in the diagnosis of liver cancer; simultaneousdetection of AFP, GGT and CA125 might increase the diagnositic sensitivity and specificity of liver cancer.

作者： 刊期： 2000年第03期

作者： 刊期： 2000年第03期

AIM To evaluate the effects of expandable metallic stent biliary endoprostheses (EMSBE) viaultrasonographic guided percutaneous transhepatic approach on the treatment of benign and malignantobstructive jaundice.METHODS Thirty-eight patients with obstructive jaundice (29 males and 9 females) aged 27 to 69 years(mean 54.7 years) were studied. Of them, 4 were benign and 34 malignant obstructions. Percutaneoustranshepatic cholangiography (PTC) was performed under ultrasonic guidance. A catheter was introducedinto the dilated bile duct via the introducer. A guide wire was inserted through the occlusive part of biliary duct after dilating with a double-lumen balloon catheter. A self-expandable metallic stent was inserted intcthe occlusive bile duct under fluoroscopic control.RESULTS The success rate of sonographic guided PTC was 100% (38/38) and the success rate of stentimplantation was 86.8% (33/ 38). Biliary obstruction was eliminated immediately, jaundice subsidedgradually and symptoms relieved after the procedure. During the 3 to 28 months fellow-up, re-occlusionoccurred in 4 malignant cases which were corrected by balloon catheter dilation and/or by stent, one patienthad secondary cholangitis and fifteen died without jaundice 6 - 28 months after the procedure. The otherswere alive with no jaundice. No severe complications or side effects were observed.CONCLUSION EMSBE via sonographic guided percutaneous transhepatic approach is a reliable and safepalliative therapy for malignant jaundice and an ideal nonoperative method for benign biliary obstruction. Ithas a definite positive impact on the quality of patient life.

作者： 刊期： 2000年第03期

AIM To observe the effect of herbs-partition moxibustion on IL-1β and TNF-c in UC rats.METHODS The animal models were created by immunological method. They were divided into 5 groups atrandom, after treated by different methods, IL-1β and TNF-α in colon tissue of UC rats were detected withimmunologic technique.RESULTS In control group, there was a little or no IL-1β positive cell in colon mucosa. Compared withthat in rats of control group, the number of IL-1 positive cell in model group was much larger, and IL-1βcells with brown granules were mainly expressed in cytoplasm of macrophage in lamina propria of colon.Compared with model group, IL-1β positive cells in mild moxibustion group markedly decreased (P < 0.05),and those in electro-acupuncture group and herbs-partition moxibustion group decreased even more markedly(P < 0.01). The difference between the last two groups is evident (P < 0.05). TNF-α positive cells are not or seldomly found in UC rats, but in model group, these cells increasedevidently, which were mainly the macrophages in lamina propria of colon. Compared with those in modelgroup, the positive cells decreased markedly in electro-acupuncture group (P<0.05), and decreased moremarkedly in mild moxibustion group and in herbs-partition moxibustion group (P<0.01). There werestatistically significant differences between herbs-partition moxibustion group and electro-acupuncture group(P<0.05).CONCLUSION The mechanism of acupuncture and moxibustion may be that inhibited macrophageactivation, reduced expression of IL-1β and TNF-a and thereby blocking their further activation and thencontrolled, the initiated inflammation and its immunity cascade reaction and resulted in restoring the normalimmunity function and benefited in healing of ulcer.

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 evaluate the clinical value of creatine kinase macroisoenzyme type 2 (CK-M2) and oligosaccharideprotein (OP) in serum from patients with gastric carcinoma (GC).METHODS Serum level of CK-M2 was detected by agar gel electrophoresis. OP concentration was measuredby an enzyme immunoassay.RESULTS Serum levels of CK-M2 and OP in 57 cases of GC were significantly higher than those in 51 caseswith gastric precancerous lesion and 28 controls. The diagnostic sensitivity and specificity for GC with CK-M2 was 56.10% and 98.63% respectively. CK-M2 and OP were not associated with histologic type and degreeof differentiation.CONCLUSION These results suggest that CK-M2 may serve as a marker to diagnose GC, and the specificityis higher, whereas OP is not more significant for GC diagnosis, but it could be a useful indicator forevaluation the status of body immune.

作者： 刊期： 2000年第03期

AIM To analyze the psychological characteristics of enterostomized patients, identify the effective methodsin order to improve the psychological rehabilitation of these patients and promote their quality of life.METHODS Questionnaires were filled up by 293 enterostomized patients pre- and post-operatively toidentify their psychological characteristics. One group (n = 45) of post-enterostomized patients were taughtto take care of stoma by irrigation, the others (n = 248) to merely look after the colostomy bag.RESULTS The psychological characteristics were identified as disbelief, fear, desperation or anxiety pre-operatively; as unstable mood, irritable, afraid, sense of lost body image or depression post-operatively; aslow self-esteem, self isolation, or despondent in rehabilitative period respectively. Results revealed that thepatients need psychological support both pre-operatively and post-operatively. Meanwhile, proper stoma careis of the same importance. After irrigation 1 -3 months regularly, most of the 45 regular irrigating patientswere free from skin irritation problems; 40(89%) patients had daily or bidaily motions; and most of themshowed an absence of fecal leakage or gases, and they hardly suffer from bad odors. Some of them even onlypartially use the colostomy bag. These patients were more confident to reinstate to their previous daily life.Only 5 (11%) patients had irregular bowel movements. Enterostomized patient club and out-patientconsultation clinic are beneficial to improve their psychological rehabilitation.CONCLUSION Careful pre-operative psychological support can help patient's post-operative adoption. Thepsychological rehabilitation of the patients can speed their physical recovery. Proper stoma care and earlyreinstatement into previous social life are also important to improve the patients' rehabilitation.

作者： 刊期： 2000年第03期

AIM We introduce a new highly selective vagotomy (HSV) procedure which can completely destroy anyexisting variant vagal fibers innervating the proximal stomach.METHODS Twenty-eight dogs were divided into three groups: group A had retrograde liberated highlyselective vagotomy (RLHSV), group B had traditional HSV and group C as control group. Gastric acidsecretion function was tested and gastric parasympathetic and sympathetic enervation were studied byretrograde tracing the horseradish peroxidase (HRP) or by histochemical staining. After being convincedthat the modified procedure was an easier and more effective HSV on animal model, we applied thetechnique to the treatment of duodenal ulcers in 100 patients.RESULTS Significant decrease of acid secretion was found in operated dogs in both group A and B. After injection of HRP subserously into the fundus and body, no HRP positive cells were found in the vagal dorsalnucleus in group A and B but were in group C. When HRP was injected into the antrum, HRP stained cellswere found in dorsal nucleus in all three groups. The negative histochemical staining of AchE and the positivefluorescence in the fundus and body in group A and B indicate that parasympathetic nerve fibers weredestroyed completely while norepinephrinergic nerve fibers were intact. When the operation was applied topatients, no severe complications or operative mortality occurred. Patients were followed up for 6- 84months. They all had complete gastric emptying function. Ninety-four patients were graded as Visick I orⅡ. Six as Visick Ⅲ and Ⅳ. Eighty patients had been followed up with gastroscopy for two years afteroperation. Four patients had recurrent ulcers. Among them two patients were asymptomatic and the othertwo had symptoms and were treated with partial gastrectomy.CONCLUSION Compared to the classic HSV, our modified procedure is more effective clinically andconvenient technically.

作者： 刊期： 2000年第03期

AIM To investigate the epidemiological features of HCV prevalence, a seroepidemiological survey on HCVinfection has been carried out in Fujian since 1992.METHODS Using stratified multistage random cluster sampling, 3809 serum samples collected from 1237families in the diseases surveillance points were tested by UBI HCV EIA kit.RESULTS The results showed that the prevalence rate was 3.99%. The rate in male and female was3.63% and 4.25%, and in urban and rural 3.12% and 4.6% respectively (P>0.05). There was lower ratein children aged under 10 years. The highest rate was in 20 - 24 years old. The rates in different areas wereranged from 1.39% to 6.08% (P<0.05). The intrafamilial transmission was not important, indicating nointrafamilial aggregation. The superinfection of HCV with HAV, HBV and HEV were existed. The HCVinfection was slightly correlated with the history of hepatitis and transfusion.CONCLUSION It suggests that the HCV transmission among the population in Fujian is mainly sporadicinfection.

作者： 刊期： 2000年第03期

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 clinical significance of alterations of serum hyaluronic acid in rats with carbontetrachioride-induced liver fibrosis.METHODS Rat liver fibrosis model was induced by carbon tetrachloride (CC14). The rats were divided intofive groups; group 1 (control): 0 week with no CCl4-inducing; group 2, 3, 4 and 5: 3, 6, 9 and 12 weeksafter CCl4-induction respectively. Serum HA level was analysed among various liver fibrosis groups andcontrol, and then compared the HA findings with the hepatic histopathology.RESULTS During rat liver fibrosis, serum HA levels of the liver fibrosis groups (group 2: 7.98ng/mL;group 3: 20.10 ng/mL; group 4:229.73 ng/mL; group 5:324,74 ng/mL) were significantly higher thanthat of control group (group 1:0.21 ng/mL) (P<0.01), in which group 4 and group 5 are much higher1094 times (229.73ng/mL/0.21 ng/mL) and 1546 times (324.74 ng/mL/0.21 ng/mL) than group 1respectively. When compared with each other, the serum HA levels are 38 times (7.98ng/mL/0.21 ng/mL; P<0.01, group 2 vs group 1); 2.5 times (20.10ng/mL/7.98 ng/mL; P<0.01, group 3 vsgroup 2); 11.4 times (229.73 ng/mL/20.10 ng/mL; P<0.01, group 4 vs group 3); 1.4 times (324.74 ng/mL/229.73 ng/mL; P<0.01, group 5 vs group 4) respectively.CONCLUSION The results demonstrated that the dynamic alterations of serum HA play an important rolein the early clinical diagnosis and staging of liver cirrhosis.

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 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