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 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 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

AIM To study the relationship between nitric oxide (NO), nitric oxide synthase (NOS) and humanhepatocellular carcinoma (HCC).METHODS Plsama NO2-/NO3- was measured by Griess reaction in 122 patients with chronic hepatitis(CH) and compensated liver cirrhosis (LC), among which 62 patients were complicated with HCC(CH = 28, LC = 34), and the rest 60 patients were not (CH = 29, LC = 31). Thirty healthy persons served asnormal controls (NC). There were no prominent differences among the groups in sex, age and the ratio ofCH to LC. The expression of inducible nitric oxide synthase (iNOS) in HCC (n = 40), CH (n = 30) and LC(n = 30) samples obtained from liver biopsy or operation was compared with that in normal liver tissues byusing immunohistochemistry. Ten normal liver tissue samples obtained from liver operation served as normalcontrols. The samples were fixed in formalin and embeded in paraffin. Anti-iNOS antibody (Santacruzcompany) was served as antibody-Ⅰ in immunohistochemical assay of iNOS in tissue.RESULTS Plasma NO2-/NO3- level in normal was 11.5 μmol/L±4.2μmol/L. The plasma level ofNO2 /NO3- in CH (58.6±17.4 μmol/L) and LC (38.7±10.6μmol/L) accompanied with HCC wasnotably higher than in those patients without HCC (CH: 24.8±9.4 μmol/L; LC: 22.3±8.7μmol/L,t=2.901, 2.756, P<0.01). Plasma NO2-/NO3- level in HCC accompanied with CH was significantlyhigher than in those accompanied with LC ( t = 2.216, P<0.05). Positive rate of iNOS in HCC, CH and LCwas 95%, 93% and 57% respectively. iNOS was not expressed in normal liver tissues. The expression level ofiNOS in HCC (χ2=17.4, P<0.001) and CH (χ2=11.64, P<0.025) was much higher than in LC.CONCLUSION Plasma NO2 / NO3- level significantly increased in patients with HCC and theimmunohistochemical staining of iNOS was positive. This suggests that the liver secrets NO in the higherlevel may participate in the carcinogenesis and progression of HCC.

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 study the change of T cell subsets and erythrocytes immune function in children with acuterotavicus enteritis (RE) and to explore its clinical significance.METHODS T cell subsets were detected by indirect immunofluorescence technique, RBC immune functionwas achieved by detecting RBC C3b receptor rosette (RBC-CR1R) and RBC immune complex rosette (RBC-ICR). The statistical significance of differences was evaluated by using analysis of variance (ANOVA).RESULTS The percentage rate of CD3 and CD4 cell and the ratio of CD4/CD8 in acute stage of RE weresignificantly lower than those of control ( P <0.01), while the percentage rate of CD8 cell remained almostunchangec Along with the improvement of clinical symptoms, the level of CD3, CD4 and CD4/CD8returned to normal in recovery stage. RBC-CR1R in acute stage of RE was significantly lower than that ofcontrol (F = 15.44, P<0.01) and returned to normal in recovery stage. RBC-ICR rose slightly in acute stageof RE, but there was no significant difference between acute stage of RE and the control (F=0.02518,P>0.05). Correlative analysis showed that RBC-CR1R was positively correlated to the percentage rate ofCD4 cell (r =0.528l, P<0.01) and the ratio of CD4/CD8 (r=0.4832, P<0.01), in acute stage of RE.CONCLUSION Cellular immune might take part in the development of RE, CD4/CD8 ratio might berelated to the prognosis of RE. The immune function of RBC reduced secondarily in acute stage of RE. It isnecessary to keep the immune function of RBC in treatment of RE in order to strengthen the patient's abilityof anti-infection.

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 evluate the curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy.METHODS Ten patients with pedicellated gastrointestinal polyps were treated with metal clips (OlympusMD-850) combining with microwave by endoscopy. Among them, gastric polyps were found in 6 cases (6polyps), colonic polyps in 4 cases(4 polyps), 9 polyps were 1.5 cm - 2 cm in size, the other one was morethan 2 cm, the diameter of pedicel was 1 cm to 1.5 cm. All patients were repeatedly examined withendoscopy to observe the curative effect at 5 to 10 days and one month after treatment.RESULTS All the 10 polyps were eradicated, 2- 4 metal clips were placed in one polyp, the succeedingcurative rate was 100%. No hemorrhage, perforation and other complications occurred.CONCLUSION The curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy is reliable and safe.

作者： 刊期： 2000年第03期

AIM To investigate the 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

AIM To study the clinical effect and mechanism of retention enema with quick-acting Kuijie powder(QAKJP) in treating chronic non-specific ulcerative colitis (CUC).METHODS A treatment group of 156 patients treated with QAKJP and a control group of 78 patientstreated with sulfasalazine orally were established randomly and their scores of main symptoms and signs weremeasured and compared before and after treatment. Animal experiments were conducted at the same time.RESULTS The total effective rate in the treatment and control group was 98.7% and 70.5% respectively,the clinical cure rate was 78.2% and 6.4% and the recurrence rate 5.3% and 20.0% respectively. Theeffectiveness of the treatment group was markedly superior to that of the control group, P<0.01.Experimental study showed QAKJB could rapidly alleviate the congestion and edema of intestinal mucosa,promote the healing of ulcer, inhibit spasm of colon and had significant antidiarrheal action and antagonisticeffect against allergic mediator histamine.CONCLUSION Retention enema with QAKJP has good effect on CUC, with low recurrence rate and notoxic or side effect.

作者： 刊期： 2000年第03期

AIM To clarify the surgical strategy for patients with stage Ⅳa primary hepatic carcinoma (PHC).METHODS Twenty-seven patients with stage Ⅳ a PHC were retrospectively studied in 1989 - 1998,including resected group (19 cases) whose all tumor nodes were resected and cytoreductive group (8 cases)whose most tumor nodules were resected and remnant nodules treated by ethanol injection. B-ultrosoundshould be used intraoperation in order to prevent from missing any tumor nodule. All the tumor nodules inthe liver should be removed, and residual nodules should be treated by ethanol injection during operation ifall the tumor nodules can not be removed. Multidisciphinary therapies were undertaken perioperatively.RESULTS The 1-, 2- and 3-year survival rates were 71.4%, 55.6% and 7.7% respectively. The 1-, 2- and3-year survival rates of the resected and cytoreductive groups were 73.3%, 53.3%, 10.0% and 66.7%,50.0%, 0% (P>0.05) respectively. The rate of complications was 22.0%, without operative and in-hospital mortality.CONCLUSION The surgical treatment included resected or cytoreductive operation plus supplementarytherapy considered to be both useful and the first choise for stage Ⅳa PHC.

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 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

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 evaluate the expression of CD44v3 and v6 protein in colorectal carcinoma and its prognosticsignificance.METHODS One hundred and twenty-one cases of formalin-fixed paraffin-embedded colorectal carcinomaspecimens were retrospectively analyzed using EnvisionTM immunohistochemical method with the monoclonalantibody CD44v3 and v6. The median follow-up time was 67.77 months and the prognostic value of theCD44v3 and CD44v6 was assessed using univariate and multivariate survival analysis.RESULTS The positive rates of CD44v3 and v6 protein were 60.3% and 57.9%, respectively. There wassignificant correlation between CD44v3 immunoreactivity and tumor location, lymph node metastasis, distantmetastasis and Duke's stage (P< 0.05, Spearman correlation test). Significant correlation between CD44v6immunoreactivity and patients' gender, lymph node metastasis, distant metastasis, Duke's stage was alsonoticed (P < 0.05, Spearman correlation test). The 5-year survival rates were 81.25% and 60.27% inCD44v3 negative and positive cases, respectively. As CD44v6, the 5-year survival rates were 80.39% and60.00% in CD44v6 negative and positive cases, respectively; these differences between the two groups ofpatients were significant (P<0.05, Log-rank test). In multivariate analysis using the Cox regression model,CD44v3 expression emerges as an independent prognostic indicator.CONCLUSION CD44v3 and v6 might play some important roles in metastasis of colorectal carcinoma, andCD44v3 expression might be a new useful independent prognostic marker of colorectal carcinoma.

作者： 刊期： 2000年第03期

作者： 刊期： 2000年第03期

AIM To investigate the protective effects and mechanism of Diltiazem (Dil) on liver, pancreas and smallintestine in hemorrhagic-shock canine.METHODS The canines were bled to a mean arterial pressure (MAP) of 5.33kPa-6.67kPa for 30min toestablish the shock model. During the shock state, the dogs received either water-soluble calcium blocker Dilor saline solution. The MAP was kept at this level for 90min, then the total blood which was bled previouslywas reperfused. The total observation time of the experiment was 240min.RESULTS Dil could significantly increase MAP from 150min to 240min (P<0.01) and the activity ofsuperoxide dismutase (SOD) of pancreas tissue (P<0.01), and it could also decrease the content ofmalondialdehyde (MDA) in liver, pancreas and small intestine tissues (P< 0.01) and the activity of SOD ofthe liver and small intestinal tissues (P<0.01) in the canines. Electron microscopic data indicated that theultrastructures of liver, pancreas and small intestine tissues were normal in Dil group.CONCLUSION Dil can protect the structure and function of the liver, pancreas and small intestinal inhemorrhagic-shock canine.

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 observe the predictive value of gastric intramucosal pH (pHi) for critical patients.METHODS The gastric intramucosal pH (pHi) of 32 ICU patients was measured with a self-madegastrointestinal tonometer, and the APACHE l score was determined simultaneously.RESULTS pHi of the nonsurvivors was significantly lower than that of the survivors (P<0.05). The pHiwas remarkably higher in the nonsepsis group than in the sepsis group (P<0.01). Only in multiple organfailure groups, pHi was found statistically lower (P<0.05).CONCLUSION pHi may be the most simple, reliable, sensitive and accurate parameter to indicate theadequacy of tissue oxygenation, and it may be widely used in ICU monitoring in near future.

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