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 describe a liver cancer = specific gene expression profile and to identify genes that showed alteredexpression between liver cancer tissues and their adjacent nearly normal tissues.METHODS The cDNA probes which were labeled with a-32P dATP were synthesized from total RNA ofliver cancer and adjacent normal tissues and hybridized separately to two identical Atlas human cancer eDNAexpression array membranes containing 588 known genes.RESULTS Autoradiographic results were analyzed by specific Atlas ImageTM (version 1. 0) software.Among the 588 genes analyzed, 18 genes were found up-regulated in cancer, including TFDP2, Aktl, E2F-3etc, and 25 genes were down-regulated in cancer, including TDGF1, BAK, LAR, etc. Expression levels ofgenes that associated with the regulation of cell proliferation, apoptosis, differentiation, cell-cellinteraction, invasion regulators and eytokines altered mostly.CONCLUSION The result obtained from Atlas microarray provides a comprehensive liver cancer-specificexpression profile. The results can lead to the identification of liver cancer-specific biomarkers and may behelpful in early diagnosis and dentifiction of target genes for designing rational therapeutic strategies.

作者： 刊期： 2000年第03期

AIM To 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 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 investigate DNA methylation status in gastric cancer and its relationship with folate metabolism.METHODS Serum before operation, the gastric mucosa from the lesion, and the surrounding area inpatients with gastric cancer and the remote normal-appearing mucosa of the resected stomach were collectedrespectively. The serum folate, mucosal tissue folate, S-adenosylmethionine ( SAM ), S-adenosylhomocysteine (SAH), and the DNA methylation levels were determined.RESULTS The tissue folate was significantly lower than that in ulcers, especially in the surrounding andnormal mucosa (0.38±0.13, 0.50±0.17 vs 0.53±0.50, 0.79±0.82ng/mg protein, P < 0.01), and itdecreased gradually in the lesion areas. The DNA methylation status showed similar decreasing trend incancers compared with the methylation increasing trend in ulcers. The SAM level ascended in the lesion areaswith a higher. concentration in cancer mueosa (63.5±43.0 vs 25.9±11.9nmol/g tissue, P < 0.01 ). Theaccumulation of SAH in the surrounding and normal mucosa of cancers was observed (17.3±24.6, 15.5±8.6vs 14.6±4.2, 10.0±1.9nmol/g tissue, P < 0.05 - 0.01). There were significantly negative correlationsbetween tissue folate and the SAM and SAH levels in the three areas.CONCLUSION Patients with gastric cancer have the regional folate deficiency in the stomach mucosa,although the serum folate level remains normal. This disturbs the local SAM and SAH metabolism withaccumulation of SAH and DNA hypomethylation which has been known as an important molecularmechanism for carcinogenesis. Folic acid can modulate DNA methylation status by its effect in one-carbongroup metabolism and thus affect the process of the carcinogenesis. Therefore, this may be an access for theprevention of gastric cancer.

作者： 刊期： 2000年第03期

AIM To increase the production of recombinant des (1 - 3) IGF- I by increasing the copy number of genecarried on an expression vector, and to partially purify the expressed des (1 - 3) IGF-Ⅰ , as well as compareits bio-activity with standard IGF-Ⅰ.METHODS Second copy of des (1 - 3) IGF-Ⅰ gene was inserted into pExSecl/IGF-Ⅰ expression vectorconstructed by our previous work and carryed already one des (1 -3) IGF-Ⅰ gene, to form PExSec1/2 (IGF-Ⅰ) expression plasmid, which carried two copies of tandem des (1 - 3) IGF-Ⅰ gene. This plasmid wastranformed into a protease-deficient E. coli strain BL21 (DE3). The engineered bacteria was cultured andinduced at low temperature. The expressed product was purified through ultra-filtration and gel-filtration.The bio-activity of partially purified protein was tested by MTT method and compared with standard IGF-Ⅰ.RESULTS The amount of des (1-3) IGF-Ⅰ expressed by pExSec 1/2 (IGF-Ⅰ) reached up to 19% -22%of the total soluble bacterial protein, which is about 7% higher than that of des (1 -3) IGF-Ⅰ expressed bypExSec1/IGF-Ⅰ. The purity of recombinant des (1 - 3) IGF-Ⅰ reached 49% and 82% respectively after thetreatments by ultra-filtration and gel-filtration. The result of MTT assay showed that the bio-activity of des(1- 3) 1GF-I after gel-filtration was about 77% of that of standard IGF-Ⅰ at the same concentration.CONCLUSION The yield of recombinant des (1 - 3) IGF-Ⅰ was increased about 7% by construction ofexpression plasmid with two copies of des (1 -3) IGF-Ⅰ gene, compared with only one copy of gene,preliminarily purified des (1 -3) IGF-Ⅰ showed relatively high biological activity, which was about 77% ofthat of standard IGF-Ⅰ.

作者： 刊期： 2000年第03期

AIM To substantiate the therapeutic effects of carbonate buffer mixture on naturally occurringgastrointestinal atony in cattle.METHODS Therapeutic effects of carbonate buffer mixture (Na2CO350 g, NaHCO3420 g, KCI 20 g, NaC1100 g, water 10 L) were observed in 120 cases of gastrointestinal atony including forestomach atony, rumenimpaction, rumen acidosis, omasum impaction and intestinal constipation. Judgement of curative effects ascure: after treated, the cases become clinically normal in general conditions, appetite, rumination, ruminalperistalsis and defecation; uncure: after giving two doses, the gasto-intestinal atony has not been eliminated.RESULTS Average cure rate of carbonate buffer mixture on above-mentioned diseases were 95%, andaverage dose was 1.4±0.5.CONCLUSION Being a new approach for treatment of gastrointestinal atony in ruminants, the carbonatebuffer mixture can eliminate the gastrointestinal atony originated from the over acidity in gastrointestinalcanal.

作者： 刊期： 2000年第03期

AIM To 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 study the nosocomial infection in the patients with liver diseases and its risk factors.METHODS A prospective survey of nosocomial infection in 848 patients with various liver diseases wascarried out in our hospital for a 24-month period.RESULTS Incidence of nosocomial infection in patients with liver diseases was 9.20%, nosocomialinfection rate in severe hepatitis was significantly higherthan in mild and moderate liver diseases. Infectionof respiratory tract accounted for 44.33%. Infection rate in abdominal cavity, intestinal tract, gallbladderand bile ducts, oral region, and other regions was 15.46%, 12.37%, 8.25%, 7.22% and 12.37%,respectively.CONCLUSION The factors related to nosocomial infection were the severity of liver diseases, cellularimmunological condition, Co-infection of hepatitis virus, severe accompanying diseases, improper medicalmanipulations and use of broad-spectrum antibiotics. Nosocomial infection obviously affects the prognosis ofliver diseases.

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

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 explore a method to control splenic embolic volume precisely for partial splenic embolization(PSE) to improve the validity and safety of PSE, and study the portal hemodynamic changes after PSE.METHODS Gelfoam particles of identical standard (2×2×1.6mm) were used as embolic material tomeasure the splenic radiographic parameters SAI (spleen activity index) was measured scanning withradioisotope technetium-99mTc sulfur colloid and splenic embolic volume was calculated with the followingformula: splenic embolic volume = [SAI(pre-PSE)-SAI(post- PSE )]/SAI(pre-PSE)×100%. The regressionequation of gelfoam particles in splenic embolic volume and splenic radiographic parameters was calculatedusing SAS (statistical analysis system) software (version 6.02). Portal hemodynamic changes were examinedby color Doppler ultrasound.RESULTS The amount of gelfoam particles was correlated with splenic embolic volume and top-bottomlength of spleen, regression equation was achieved: Y = 5.77X1 + 15.19X3-164.75, (multi-regression wasused, significant level P = 0.15). Y: number of gelfoam particles used, Xl: splenic embolic volume (%),X3: top-bottom length of spleen (cm). The diameter and blood flow volume of spleen and portal vein and thepeak velocity of spleen vein all decreased after PSE. The decreased parameters were positively correlatedwith splenic embolic volume.CONCLUSION By calculating gelfoam particles for PSE, splenic embolic volume could be controlled withinthe effective and safe limit. PSE could decrease the high dynamic circulating state of portal systemeffectively.

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

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 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 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 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

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 To establish an ideal model of gastric precancerous lesions for rats.METHODS Fifty rats were fed with carcinogen MNNG for 35 wk and heat-plaste at 60C for 20 wk, thepathological changes were observed. Data in the groups were analyzed by Ridit test.RESULTS The occurrence rate of dysplasia in rats due to MNNG and heat-damage was 65%, which wasobviously higher than that due to MNNG only. The differences between the two groups were significant.CONCLUSION The animal model made by MNNG and heat-damage was an ideal one which could be usedto investigate the pathologic mechanism of gastric precancerous lesions.

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