AIM To understand the characteristics and investigate the diagnosis, treatment of intrahepatic biliarypapillomatosis.METHODS Two cases were confirmed operatively and pathologically, and the literature reviewed.RESULTS The causes of the disease are not clear, but the long-term irritations of stone and inflammationmay be considered. Despite being histologically benign, it has low-grade malignant potential, characterizedby multiple and diffusive manner, and has high rates of recurrence and malignant transformation. Jaundiceand cholangitis are the dominant manifestations. Imaging modalities are beneficial in it's diagnosis, and thescanning of choledochoscopy is of great value.CONCLUSION The management of the disease is difficult. Curative resection is the primary therapy.Curettage and drainage may lead to high recurrence. The chemotherapy and lasertherapy represent othermodalities in the treatment. Biliary papillomatosis may become a new indication for liver transplantation.

作者： 刊期： 2000年第03期

AIM To treat esophageal stricture secondary to the ingestion of corrosive materials in children using theileocolon with ileocecal valve as a substitute for esophagus.METHODS Between 1992 and 1999, isoperistaltic retrosternal ileocolic esophageal replacements wereperformed in 12 patients; 50 cadavers were studied to observe the vascularity in the ileocolic region andmetabolic indexes were measured before and after surgery or between the operative group and the normalcontrols in 20 piglet models.RESULTS A follow-up of 3 years in the 12 cases found no death in intra- and post- operative periodclinically. Cervical ileoesophageal anastomotic leaks occurred in 2 cases. The distribution pattern of venousvessel in the ileocolic region was far more constant than that of the artery. The arrangements of artery in theileocolic segment were classified into 7 types, and there was no interruption of paracolic anastomosis betweenarteries. The resections of 50 cm terminal ileum, cecum and 50 cm ascending colon affected enterohepaticcirculation of bile acid (bile salt) and the fatty metabolism in early period after surgery in piglet models.Shortening of the time and reducing of the area for water absorption after ileocolic resection resulted indiarrhea in piglet models. The loss of “bacterial barrier” role of ileocecal valve led to bacteria immigrationfrom colon to ileum and small intestinal bacterial overgrowth.CONCLUSION The ileocolic esophageal replacement taking advantage of antireflux role of the ileocecalvalve has obtained satisfactory effect. To understand the characteristics of the patterns of arteries and veinsdistribution and physiological functions of the ileocolic segment is useful in guiding clinical practice andpostoperative management and preventing postoperative complications as well.

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

作者： 刊期： 2000年第03期

AIM To observe the therapeutic effect of colloidal bismuth tartrate in an animal colitis model.METHODS Immune-complex colitis was induced in groups of rabbits by formalin, and two hours later0.85 mL heat-aggregated rabbit IgG was given intravenously through the ear cannula. Animals wereintracolonically treated with colloidal bismuth tartrate (BITNAL), and its effect was compared withsulfasalazine (SASP), indomethacin (IND) and bifidobiogen (BIFG). Animals were killed, the mucosalappearance was scored (0-4), and tissue saved for histological studies, the number of neutrophils present ininflamed colonic tissue was quantitated by the myeloperoxidase (MPO) activity assay, the production oflipoxygenase and cyclo-oxygenase products was monitored and eicosanoid production were assayed byincubation colonic specimens and the media for prostaglandin E2(PGE2), leukotriene (LTB4), thromboxaneB2(TXPe) were examined by radiommunoassay.RESULTS Immune-complex colitis was induced by formalin and IgG, colonic damage persisted for at least1 wk by macrography. Histologically, the inflammatory response included mucosal and submucosalinfiltration by polymorphonuclear leukocytes, macrophages, lymphocytes and fibroblasts, the macroscopic,persent 2 wk after IgG, was correlated with greatly increased PGE2, LTB4 and TXB2 compared with levels incontrols. Treatment with BITNAL (500 mg/kg) resulted in a lowered inflammation index, lowered MPOactivity and inhibited the increased formation of PGF-2, LTB4 and TXB2 by the inflamed colon, and IND(500 mg/kg) markedly inhibited prostanoid formation in both inflamed and control colon but did not reducetissue damage, SASP (500 mg/kg) also inhibited the formation of PGE2, LTB4 and TXB2 but the effectswere less marked. BIFG (400 mg/kg) did not significantly reduce the colonic injury and the media sythesizedby the rabbit colon.CONCLUSION BITAL provides better therapeutic effects in experimental colitis than anti-inflammatorydrug IND or SASP.

作者： 刊期： 2000年第03期

AIM To evaluate a system for bile acid formation in human hepatocytes in comparison with HepG2 cells.METHODS Hepatocytes were isolated from normal human liver tissue and were cultured in serum-freeWilliam's E medium. The medium was collected and renewed every 24 h. Bile acids and their precursors inmedia were finally analysed by gas chromatography-mass spectrometry.RESULTS Cholic acid (CA) and chenodeoxycholic acid (CDCA) conjugated with glycine or taurineaccounted for 70% and 25% of total steroids. One third of CDCA was also conjugated with sulphuric acid.Dexamethasone and thyroid hormone alone or in combination did not significantly affect bile acid formation.The addition of cyclosporin A (10 tm) inhibited the synthesis of CA and CDCA by about 13% and 30%,respectively.CONCLUSION Isolated human hepatocytes in primary culture behave as in the intact liver by convertingalmost quantitatively cholesterol to conjugated CA and CDCA. This is in contrast to cultured HepG2 cells,which release large amounts of bile acid precursors and unconjugated bile acids into the medium.

作者： 刊期： 2000年第03期

AIM To investigate the morphological and ultrastructural changes in the human gastric carcinoma cell lineBGC-823 after being treated with tachyplesin.METHODS Tachyplesin was isolated from acid extracts of Chinese horseshoe crab (Tachypleus tridentatus)hemocytes. BGC-823 cells and the cells treated with 2.0 μg/mL tachyplesin were examined respectively withlight microscope, scanning and transmission electron microscope.RESULTS BGC-823 cells had undergone restorative morphological and ultrastructural changes after beingtreated with 2.0 μg/mL tachyplesin. The cells tended to be flat and spread, and their volume enlarged,nucleo-cytoplasmic ratio decreased, the shape of nucleus became relatively regular, the number and volumeof nuleous decreased, heterchromatin decreased while euchromatin increased, the number of mitochondriaincreased with their structure relatively consistent, Golgi apparatus turned to be typical, rough endoplasmicreticulum increased, polyribosome decreased, microvilli and filopodia reduced while lamellipodia increased.CONCLUSION Tachyplesin could change the malignant morphological and ultrastructural characteristics ofhuman gastric carcinoma cells effectively and had certain effects on inducing differentiation of human gastriccarcinoma cells.

作者： 刊期： 2000年第03期

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 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 To compare the effects of intravenous route and peritoneal route on liver targeted uptake andexpression of plasmid delivered by glyco-poly-L-lysine (G-PLL).METHODS The plasmid pTM/MMP-1 which could be expressed in eukaryotic cells was bound to thegalactose-terminal glyco-poly-L-lysine (G-PLL), and then was transferred into Wistar rats by intravenousand intraperitoneal injection respectively. Afterwards the expression and distribution of the plasmid wereobserved at different time points by in situ hybridization and immunohistochemistry.RESULTS The plasmid could be expressed obviously in 24 hours after being transferred in vivo by bothintravenous and intraperitoneal route. One week later the expression began to decrease, and still could beovserved three weeks later. Although both the intravenous and intraperitoneal route could deliver theplasmid to liver targetly, the effect of the former was better as compared with that of the latter.CONCLUSION Intravenous route was better for liver targeted uptake and expression of G-PLL-boundplasmid than peritoneal route.

作者： 刊期： 2000年第03期

AIM To study the combined expression of gastrointestinal hormone substance P and anti-apoptosis gene Bcl-2 in gastric carcinoma and its significance.METHODS Substance P and Bcl-2 protein expression was examined by the S-P immunohistochemicalmethod in 33 cases of gastric carcinoma, 17 adjacent the carcinoma and 13 normal gastric mucoma.RESULTS Positive expression of SP in gastric carcinoma was higher than that of both adjacent and normalmucosa (P < 0.001). There was no statistical difference in the positive expression between adjacent andnormal mucosa (P > 0.05). The expression of bcl-2 both in gastric carcinoma and adjacent tissues werehigher than that of normal gastric mucosa (P< 0.05-0.01). But the positive expression of Bcl-2 had nostatistical significance between gastric carcinoma and adjacent tissues.CONCLUSION Both gastrointestinal hormone SP and Bcl-2 gene have synergistic expression in gastriccarcinoma, indicating that they all take part in the occurrence of gastric carcinoma. Abnormal expression ofBcl-2 gene occurred in benign gastric pathological changes, once they become carcinoma, the positiveexpression of cell is no more increased, possibly because that there is no more increase of the intensity of Bcl-2 inhibition of cell apoptosis.

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

AIM To 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 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 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

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 study the antitumor effect of Zhenhuang Injection (ZHI) on the mice bearing transplanted tumor.METHODS The solid type of H22 transplantation hepotocarcinoma, ascitic type of S-180 sarcoma and ascitictype of LⅡ malignant lymphoma of mice were treated at three doses (crude drug 1.25g/kg, 2.5g/kg,5.0 g/kg of body weight) of ZH1. The solid tumor group and ascitic tumor group were injected intravenously.and intraperitoneally. The experiment was repeated three times.RESULTS The tumor-inhibition rate of H22 hepatocarcinoma in moderate and large doses was 30.23% -35.67% (P<0.01) and 46.36%-54.07% (P<0.01) respectively; the survival rate of ascitic type of S-180sarcoma and ascitic type of LⅡ malignant lymphoma in large dose group was 77.23% - 86.91% (P<0.01)and 75.42%-79.04% (P<0.01), respectively.CONCLUSION ZHI has a certain tumor-inhibiting effect. Under the tolerant dose, the effect improveswith the increase of dose.

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