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

作者： 刊期： 2000年第03期

AIM To investigate the diagnostic significance of cytology and telomerase activity in the exfoliated cells ofcardia obtained from endoscopic brushing in the cardiac cancer.METHODS The techniques of the qualitative TRAP-silver staining and quantitative TRAP-PCR-ELISAwere employed to detect telomerase activity in the exfoliated cells of cardia obtained from endoscopicbrushing in 72 cases with cardial lesions, cytological diagnosis was made at the same time.RESULTS Telomerase activity with cardiac cancer group (1.521 ± 0. 192) was significantly higher than thatwith cardialitis group (0.065± 0.014). Positive rate of telomerase activity detected in cardiac cancer group(88.89%) was significantly higher than that with cardialitis group (11.11%), the former was significantlyhiger than cytological examination (77.78%). The diagnostic rate of cardiac cancer reached 93.33% iftelomerase activity and cytology were examined at the same time.CONCLUSION Cytology and telomerase activity in the exfoliated cardiac cells may be an effective andsensitive methods in the diagnosis of cardiac cancer. This research can be a basis for the mass screening ofcardiac cancer.

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 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 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 explore the anti-tumor effect of indomethacin (IN) on human colon adenocarcinoma cells anddetermine the influence of indomethacin on cancer cell proliferation and apoptosis and elucidate the anti-tumor mechanism of Indomethacin.METHODS Human colon adenocarcinoma HCT116 cell line were cultured separately in vitro. Indomethacin(final concentration 100 μm - 800 gm) was administered alone or altogether with 5-Fu (50 μm). Agarose gelelectrophoresis, MTT, and Flow cytometry were used to study cell proliferation and apoptosis in humancolon carcinoma cell RT-PCR, western blot were used to detect the expression level of Bcl-2, bax gene andcdk4 protein expression in HCT116 cell lines after treated with IN for 24 hours.RESULTS Indomethacin can inhibit significantly the proliferation of HCT116 cell, change the morphology,and cause the cells to accumulate in the G0/Gl phase of the cell cycle, and induce apoptosis. The apoptosis oftumor cells was confirmed by DNA ladder formation on gel electrophoresis and sub-Gl peak on flowcytometry. These responses were time-and concentration-dependent. A synergic effect of inhibiting cancercell proliferation was observed when combined with Indomethacin and 5-Fu. RT-PCR results showed that INdown-regulated Bcl-2 mRNA expression, and did not change Bax mRNA expression. Western blot resultsconfirmed that IN inhibited Bcl-2 protein expression. No influence was found in the translation of Baxprotein. In inhibited cdk4 protein expression.CONCLUSION Our study results indicate that IN induce apoptosis of HCT116 cell by down-regulating Bcl-2expression and inhibiting cdk4 protein expression partially. This explains the mechanisms of antitumoractivity of the Indomethacin.

作者： 刊期： 2000年第03期

AIM To investigate the effect of cold preservation on rat livers by modified storage method with self-madeHYD solution.METHODS The modified method was that the vascular bed of rat livers was expended with an additional20 mL, 30 mL and 40 mL self-made HYD solution / 100 g liver. After resection of the liver, the extra HYDsolution expressed as % liver weight was entrapped via portal infusion by tying off the supra- and infrahepatic inferior vena cava. According to the amount of extra HYD solution, 40 rats were randomly dividedinto four groups: control group with conventional storage method, 20% group, 30% group and 40% group.The preservation effect of modified storage method was compared with that of conventional storage methodusing isolated perfused rat liver model.RESULTS Bile production and all the indices of hepatic microcirculation including portal perfused pressure, endothelin in the effluent, Trypan blue distribution time and histology in modified method groupswere significantly superior to those in control group (P< 0.05). The liver enzymes in 30% group weremarkedly lower than those in control group (P<0.05). The preservative efficiency of rat liver in 30% groupwas the best among the modified method groups.CONCLUSION The cold preservative efficiency with modified storage method is obviously superior to thatwith conventional storage method. It is suggested that the modified cold storage method is effective and mayhave potential for liver preservation

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 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 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 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 study the changes of IL-6,IL-2, sIL-2R and TNF ir patients with hepatocellular carcinoma(HCC)and their clinical significance.METHODS IL-6, IL-2, sIL-2R and TNF were detected by avidin-biotin-system ELISA, double-sandwichELISA respectively in 60 patients with HCC and 36 patients with liver cirrhosis (LC) and 66 healthy persons.RESULTS The levels of IL-6, sIL-2R and TNF increased, but IL-2 level was lower in patients with HCCthan that in normal controls (NC) (t test, t=8.21, 4.71, 3.87, 2.13, P<0.01 or 0.05). IL-6 level in HCCwas 10 fold higher than NC, and also much higher than LC. IL-6 level was higher in later stage than that inearlier stage. There was a positive correlation between IL-6 and sIL-2R, TNF, while no positive correlationwas found between IL-2 and IL-6, sIL-2R in HCC.CONCLUSION The remarkably higher level of IL-6 is helpful for the early diagnosis of HCC.

作者： 刊期： 2000年第03期

AIM To summarize the experience of surgical treatment of hilar cholangiocarcinoma and the results of aseries of experiments.METHODS AND RESULTS Personal perspectives of surgical treatment of hilar cholangiocarcinoma werebased on the experience of a series of patients with hilar bile duct cancer treated in the General Hospital ofPLA, Beijing from 1986 to 1999. A total of 157 cases were treated surgically, with 106 (67.5%) resections ofthe tumor , 37.6% of the resections was proved to be radical. The 1-, 2-, 3-, and 5-year survival rate of theradical resection group was 96.7%, 40.0%, 23.3% and 13.3%, respectively. No patient of the palliativeresection group lived beyond 3 years postoperatively. The recent trends of surgical management of hilar bileduct cancer were discussed. Experiments were carried out for cooperative clinicopathological study toevaluate the perineural space involvement, the neural cell adhesion molecule expression, p16 geneexpression, and the 3-dimensional reconstruction of the bile duct cancer specimens. The pathogeneticrelationship of HBV and HCV with extrahepatic cholangiocarcinoma was evaluated by histochemical and IS-PCR methods. And an inquiry into the possibility of gene therapy was made.CONCLUSION Hilar bile duct cancer rarely runs a “benign” course. It is a regional disease rather than alocal affection and may be related to HBV and HCV infection in China. It possesses the metastasing abilityalong the perineural space by a “jumping” fashion, therefore, in most cases, conventional surgical excision isbound to be unradical in the region of the porta hepatis for anatomical reasons.

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

AIM To understand the pollution status of drinking water in Cixian area and to find out a way to solute it.METHODS Contents of nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were measured andcompared with controls and national standards.RESULTS Levels of nitrate nitrogen, nitrite nitrogen and ammonia nitrogen were higher than the nationalpermissive levels by 20.60%, 50.50% and 33.30% respectively. Also the levels in Cixian are significantlyhigher than those of a controls areas of Chicheng - a county with very low incidence rate of esophagealcancer.CONCLUSION Three nitrogen levels in drinking water correlate both with the amount of N-containingfertilizer used in these areas and the mortality rates of esophageal cancer.

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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