AIM To study the effects of heat exposure and swimming on membranous structure of the small intestinalepithelium and the biochemical indexes.METHODS The distribution of the intra-membranous particles (IMPs) in enteric epithelium of SD rats andthe number of IMPs were analyzed with freeze-etching technique and TxB2, PGFIa, PRL, CORT and totalSA (TSA) were measured with the techniques of biochemistry and radio-immunity.RESULTS Heat exposure markedly affected the distributive pattern of IMPs in intestinal epithelium andmade the numbers of IMPs on the PF and EF faces of cell membrane and nuclear membrane decreased.Swimming exacerbated the above changes. And in the meantime heat exposure resulted in the massivereleasing of the body-hurting substance as TxB2 and reducing of the body-protecting substance as PGFIa.TSA increased obviously. These changes recovered partly after heat exposure, but the number of IMPs onboth PF and EF faces and certain biochemical indexes were still not restored to the levels as in the controlgroup.CONCLUSION Heat exposure and swimming can make the cellular catabolism accelerated and anabolismreduced, then bring about the numbers of IMPs of intestinal epithelium membrane and nuclear membranedecreased, and the distribution was abnormal. TxB2, PGFIa, PRL, CORT and TSA were changedabnormally during heat exposure. And above indexes showed no notable evidence of recovery after stoppingheat exposure 4 hours-24 hours; the delayed injury was obviously presented.

作者： 刊期： 2000年第03期

AIM To investigate the effect of BCG vaccine and dipyridamole in treating hepatitis B due to their anti-virus effects.METHODS Among 602 patients with positive HBeAg, 512 were allocated to the treatment group and 90patients to the control group. There was no significant difference in disease and age between the two groups.All the patients in the treatment group with no abnormal findings by chest X-ray fluoroscopy, whose localskin scleromata diameters were less than 7 mm after the 1:2000 OT test, were given BCG vaccine 0.1 mlintracutaneously at the deltoid once a month, and simultaneously took dipyridamole 50 mg twice a day forfour to eight months. The hepatic function, B-mode ultrasound and the five markers of hepatitis B wereroutinely examined before each injection. The results at one month after the last injection in the treatmentgroup were compared with those of the control group.RESULTS The recovery rates of hepatic functions and the rates of improvement of the symptoms and signsin the treatment group were better than those in the control group. The negative transformation rates ofHBeAg and the positive transformation rates of HBeAb were 60.3% and 31.6% in the treatment group vs.13.3% and 13.0% in the control group (P<0.01, Test x2, x2=26.82, 6.81). The negative transformationrates of HBsAg and the positive transformation rates of HBsAb were 5.5% and 8.2% in the treatment groupvs. 5.6% and 9.9% in the control group (P>0.05. Test x2, x2=1.11, 0.22).CONCLUSION The application of BCG vaccine in combination with dipyridamole increased the negativetransformation rate of HBeAg and the positive transformation rate of HBeAb, improved the clinicalsymptoms, signs and hepatic function of the patients. These two drugs had significant anti-HBV effect andshowed good efficacy in the treatment of HBV infection.

作者： 刊期： 2000年第03期

AIM To evaluate the clinical significance of early nutrition support in severe head-injured patients.METHODS One hundred and forty cases (GCS≤8) were randomly divided into 5 groups: each one had 28cases with similar data in age, sex, GCS or prognosis (P>0.05, x2= 0.43). Group A were given earlyparenteral nutrition (PN) and enteral nutrition (EN); group B were given early PN and EN after 1 week;group C were given PN only for more than 2 weeks; group D were given early PN only and group E weregiven traditional delayed EN. The clinical nutritional data, the rate of complication and the progrosis wereobserved and statistical comparison (t test and Chi-square test) was made.RESULTS The severe head-injured patients could get nourishment from different ways at early stage.Groups A and B had better outcomes and their clinical data such as blood glucose, blood total goblin, bloodalbumin, lymphocyte amount were superior to that of groups D and E (P<0.05, t = 2.12) and were thesame as that of group C (P>0.05, t = 0.98), the rate of complication and the prognosis of patients werebetter than that of the other groups. Group C had similar nutritional data in early stage, but had higher rateof complication and infection after 2 weeks than group A or B ( P<0.01, x2 = 7.38). Group A had lowerrate of gastric hemorrhage.CONCLUSION Early rational nutritional support had significant effect in the severe head-injured patients.The nutritional support of early PN and EN could afford nourishment, protect and improve the gastroentericfunction, reduce the rate of complication. So it is a rational nutritional support.

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 effect of boschniakia rossica (BR) extract on expression of GST-P, p53 and p21fasproteins in early-stage chemical hepatocarcinogenesis in rats and its anti-inflammatory actions.METHODS The expression of tumor marker, placental form glutathione S-transferase (GST-P), p53 and p21ras proteins were investigated by immunohistochemical techniques and ABC method. Anti-inflammatoryactivities of BR were observed by xylene and croton oil-induced mouse ear edema, carrageenin, histamineand hot scald-induced rat pow edema, adjuvant-induced rat arthritis and cotton pellet-induced mousegranuloma formation methods.RESULTS The 500 mg/kg of BR-H2O extract fractionated from BR-Methanol extract had inhibitory effecton the formation of DEN-induced GST-P-positive foci in rat liver and the expression of mutant p53 and p21fasprotein was lower than that of hepatic preneoplastic lesions. Both CH2Cl2 and H2O extract from BR haveinhibitory effect in xylene and croton oil-induced mouse ear edema. BR-H2O extract exhibited inhibitoryeffect in carrageenin, histamine and hot scald-induced hind paw edema and adjuvant-induced arthritis in ratsand cotton pellet-induced granuloma formation in mice.CONCLUSION BR extract exhibited inhibitory effect on formation of preneoplastic hepatic foci in earlystage of rat chemical hepatocarcinogenesis. Both CH2Cl2 and H2O extract from BR exerted anti-inflammatory effect in rats and mice.

作者： 刊期： 2000年第03期

The polyamines [putrescine (PU), spermidine (SPD) and spermine (SPM)] are ubiquitous polycationiccompounds found in all prokaryotic and eukaryotic cells, are essentially involved in a variety of regulatorysteps during normal, adaptive, and malignant cell proliferation. Nearly four decades investigation about thepolyamines contributed to the synthesis and decomposition of polyamines and the active and passive enzymeswhich regulate them at different levels. This review focuses on the sources and homeostasis of intracellularpolyamines, the transport and role of the polyamines in the growth of the gastrointestinal mucosa and theirpossible mechanism. We tried to point out the gaps remaining in the story and give a working hypothesis forthe role of polyamines in gastrointestinal mucosal growth. We propose in the hypothesis that polyamine is a“key”to unlock the “door”of cell proliferation. How many “doors” between the “polyamine key” and the“real start” of proliferation? The polyamine might be the only key for cell proliferation. Another possibilityis that polyamine is the first key and its “unlocking-effect” resulting in getting another key for the next doorin the proliferation chain, for example, proto-oncogenes. To decide whether polyamine is an intermediatestep or just only one step of cell proliferation, the possible way is to keep polyamine to be a stimulus and finda way to deprive the function of proto-oncogene protein (or other possible gene expression product) to checkthe effect on the cell proliferation. Another important question is how polyamine can trigger the synthesis ofDNA in virtual. Arabinose operon model may give us some ideas to investigate about that. And furthermore,it is necessary to pay attention to the relationship between polyamine and other cell proliferation regulator,like growth factor, chalone, cAMP, cGMP, etc. Further studies are needed to investigate the mechanism ofpolyamine acted on the gastrointestinal mucosal growth.

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

作者： 刊期： 2000年第03期

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

作者： 刊期： 2000年第03期

AIM To 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 isolate, done and sequence gcys-18 overexpressed in gastric carcinoma.METHODS gcys-18 was isolated from differential display gel between GC7901 and GES-1 by mRNAdifferential display PCR, and was cloned into T vector. As a probe gcys-18 was hybridized to total RNAs ofGC7901 and GES-l, and was sequenced. Its sequence was screened against GeneBank. According to theobtained sequence, a pair of primers were designed and used to examine 26 specimens of gastric cancers andcorresponding paracancerous tissues by quantitative reverse transcriptase PCR.RESULTS gcys-18 was isolated and cloned, and confirmed to be expressed higher in GC7901 than in GES-1 by RNA dot blot; gcys-18 was 416bp, and partly similar to HEK5, and its accepted number in GeneBankwas AF071057; 18 out of 26 specimens of gastric cancers and 2 out of corresponding paracancerous tissueswere examined by RT-PCR.CONCLUSION gcys-18 may be an important expressed sequence tag in gastric cancer, and takes part inprogression of gastric carcinoma.

作者： 刊期： 2000年第03期

AIM To study the change of trace elements in the hair of patients with esophageal carcinoma and the role oftrace elements in its development and progress.METHODS The hair of 60 normal people and 126 patients was collected and was divided into groupsaccording to the patients' pathologic changes. The atomic absorption method and fluorescence method wereused to measure the trace elements of copper, zinc, iron, calcium and selenium.RESULTS Zinc in the hair of various patients: a remarkable difference was found between normal people(182mg· kg 1)and the patients (103- 81.6mg·kg 1) (t = 3.79, P<0.01 Duncan' new multiple rangemethod). There was a certain difference between simple hyperplasia and cancer (t = 3.21, P<0.01 ). As forcopper, a great difference existed between normal people (12.01mg· kg-l) and patients with dysphagia (15.16mg·kg-1) and cancer (17.02-17.15mg·kg-1) (t=2.43, P<0.05). No change of zinc and copperwas observed in cancer patients (t = 1.61, P >0.05). The ratio of zinc to copper increased with thedevelopment of pathologic change. The selenium levels in patients (0.46-0.67mg·kg-1) was below that ofnormal people (l.03mg·kg-1), while iron and calcium levels in the patients decreased with the developmentof pathologic process.CONCLUSION Both zinc and copper play an important role in the pathologic change of esophagealcarcinoma. Zinc and copper in the hair changed with development of the pathologic process. Zinc revealedpositive correlation ( r = -0. 889, P < 0.01 while copper showed negative correlation ( r = 0.921, P < 0.01 ).The ratio of copper to zinc in the hair is of great diagnostic value.

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 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 study the relationship between the lipid peroxide (LPO) and superoxide dismutase (SOD) and thepathogenesis of gastrointestinal cancers.METHODS We investigated the SOD activity and LPO levels in blood and mucosa of patients withesophageal (EC), gastric (GC) and colorectal cancer (CC), gastric ulcer (GU) and compared with normalesophagus (NE), stomach (NS) and colon (NC). respectively, 287 patients who underwent endoscopy werestudied. SOD activity of the tissue and blood was determined using SUN's adrenaline auto oxidation method.LPO levels were determined according to YU's method.RESULTS The SOD activity and LPO level in blood and mucosa are shown in the Table 1 (x±Sx).Table 1 SOD and LPO in blood and tissues of patients with gastrointestinal cancers SOD(U／mg protein) LPO(U／mg)Groups n Tissue blood Tissue BloodNormal stomachGastric ulcerGastric cancerNormal esophagusEsophageal cancerNormal colonColon cancer 60 42 43 32 52 28 30 1.90±0.18 0.64±0.40a 0.37±0.24a 1.17±0.70 0.39±0.30a 0.81±0.36 0.31±0.17b 33.70±1.73 25.50±0.67b 27.86±1.02b 30.80±3.78 28.23±10.63 20.97±4.77 19.35±7.32 0.01±0.004 0.05±0.010b 0.06±0.021b 0.014±0.005 0.061±0.033b 0.012±0.003 0.069±0.015b 0.83±0.01 0.11±0.02 0.12±0.03 0.08±0.02 0.11±0.02 0.08±0.03 0.11±0.02aP<0.001, bp<0.01 vs corresponding normal controls, respectively.CONCLUSION SOD activity of the tissue is significantly decreased in EC. GC and CC. LPO levels weresignificantly higher than those of corresponding normal tissue. These results suggest that mucosal SOD andLPO levels are closely related to the pathogenesis of the gastrointestinal cancers.

作者： 刊期： 2000年第03期

AIM To determine whether MAP can be detected in archival paraffin embedded full thickness samples ofintestinal tissue from patients in China with Crohn's disease (CD), ulcerative colitis (UC), and in controlsubjects (NIBD) having surgery for bowel cancer.METHODS Optimized procedures for the removal of paraffin, recovery of tissue and access to MAP DNA,followed by MAP-specific nested IS900 PCR. Confirmation of specific amplification by Southern blotting andDNA sequencing.RESULTS IS900 PCR positive tests identified MAP in 9 (69%) of 13 CD, 1 of 3 UC and 2 (14%) of 14NIBD in the presence of correctly reporting positive and negative sample and reagent control reactions. DNAsequence analysis of the 298bp IS900 PCR amplification product from MAP in 2 Chinese CD patientsdemonstrated 99% homology with the GenBank IS900 sequence accession number X16293.CONCLUSION Although larger numbers of Chinese samples need to be studied, these initial results areconsistent with an exposure of human populations in China to MAP, and an involvement of this pathogen inchronic inflammation of the intestine of the Crohn's disease type. The results are in agreement with similarpositive studies reported from China, from Western Europe and elsewhere.

作者： 刊期： 2000年第03期

AIM To study the expression of telomerase activity in malignant esophageal neoplasms and normal humanesophageal epithelia.METHODS Telomerase activity was assayed by the telomere repeat amplification protocol (TRAP)method. All the neoplasms and epithelia of esophagus were confirmed by routine pathological diagnosis.RESULTS Telomerase activity was assayed in 18 normal esophageal epithelial tissues and in 35 malignantneoplasms of esophagus, including 27 cases of esophageal carcinoma and 8 cases of cardiac carcinoma.Telomerase activity was detected in most of malignant neoplasms of esophagus (91.4%, 32/35) and in allthe normal esophageal epithelial tissues except one (18/19).CONCLUSION The results suggest that in addition to contributing to proliferation of immortal blast cellsand neoplastic cells, telomerase activity may also play a similar role in regeneration of normal epithelia ofhuman esophagus. The potential use of telomerase activity as a diagnostic marker in human esophagealneoplasm might not be suitable.

作者： 刊期： 2000年第03期

Advances in molecular biology made possible the discovery of the virus that causes hepatitis C. However,little is known about the fundamental aspects of hepatitis C virus (HCV) replication, primarily because arobust cell culture has not been established. As a result, the currently available drugs for the treatment ofhepatitis C are not specifically directed against HCV. Based on what is known about the molecular biology ofHCV, however, drugs can now be developed against specific viral and cellular targets. The next generationof drugs for the treatment of hepatitis C will likely be directed against non-structural HCV proteins withknown enzymatic activities, such as the proteases, RNA helicase and RNA polymerase. Others agentstargeted against the viral RNA, core protein that assembles into the virion capsid and putative cellular“receptors” that bind HCV envelope proteins are also being developed. These drugs should have fewer sideeffects than those currently available and be much more effective for the treatment of chronic hepatitis C.

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