Benefits of early postoperative jejunal feeding in patients undergoing duodenohemipancreatectomy

AIM: To study whether early postoperative enteral nutrition reduces the incidence of complications and/or improves nutritional status following duodenohemipancreatectomy (DHP).

METHODS: We studied 39 patients who underwent DHP for a peri-ampullary mass. Twenty-three patients received total parental nutrition and then started to have an oral intake of nutrition between postoperative day (POD) 7 and 14 [late postoperative enteral nutrition (LPEN) group]. Sixteen patients started to have enteral feeding through a jejunostomy catheter the day after the operation [early postoperative enteral nutrition (EPEN) group]. The incidence of complications and laboratory data at the early postoperative stage were studied in comparison between LPEN and EPEN groups.

RESULTS: Serum levels of albumin and total protein in the EPEN group were significantly higher than those in the LPEN group. The loss of body mass index was significantly suppressed in the EPEN group as compared to the LPEN group. The lymphocyte count decreased immediately after the operation was restored significantly faster in the EPEN group than in the LPEN group. The EPEN group showed significantly fewer incidences of postoperative pancreatic fistulas, as well as a significantly shorter length of hospitalization than the LPEN group. There were no significant differences in the incidences of other postoperative complications between the two groups, such as delayed gastric emptying, surgical site infection, cholangitis, and small bowel obstruction.

CONCLUSION: EPEN is a safe and beneficial opportunity for patients who have undergone DHP for a peri-ampullary mass.

Clinical significance of subcellular localization of KL-6 mucin in primary colorectal adenocarcinoma and metastatic tissues

AIM: To assess subcellular localization of KL - 6 mucin and its clinicopathological significance in colorectal carcinoma as well as metastatic lymph node and liver tissues.

METHODS: Colorectal carcinoma tissues as well as metastatic lymph node and liver tissues were collected from 82 patients who underwent colorectomy or hepatectomy. Tissues were subjected to immunohistochemical analysis using KL - 6 antibody.

RESULTS: Of the 82 colorectal carcinoma patients, 6 showed no staining, 29 showed positive staining only in the apical membrane, and 47 showed positive staining in the circumferential membrane and/or cytoplasm. Positive staining was not observed in non - cancerous colorectal epithelial cells surrounding the tumor tissues. The five - year survival rate was significantly lower in cases showing positive staining in the circumferential membrane and/or cytoplasm (63.0%) than those showing positive staining only in the apical membrane (85.7%) and those showing no staining (100%). Statistical analysis between clinicopathological factors and subcellular localization of KL - 6 mucin showed that KL - 6 localization in the circumferential membrane and/or cytoplasm was significantly associated with the presence of venous invasion (P = 0.0003), lymphatic invasion (P <  0.0001), lymph node metastasis (P < 0.0001), liver metastasis (P = 0.058), and advanced histological stage (P < 0.0001). Positive staining was observed in all metastatic lesions tested as well as in the primary colorectal carcinoma tissues.

CONCLUSION: The subcellular staining pattern of KL - 6 in colorectal adenocarcinoma may be an important indicator for unfavorable behaviors such as lymph node and liver metastasis, as well as for the prognosis of patients.

Influence of HBcAg in liver cell plasma on expression of transforming growth factor-beta 1 in liver tissue of low-grade chronic hepatitis B patients

AIM

To study the influence of HBcAg on the expression of transforming growth factor-beta 1 (TGF-beta1) in liver tissue of low-grade chronic hepatitis B (CHB) patients.

METHODS

The expression of TGF-beta1 and HBcAg in liver samples from 93 low-grade CHB patients was detected by immunohistochemistry and valuated by semi-quantitative scoring.

RESULTS

In the 93 low-grade CHB patients, HBcAg was expressed in cell plasma but not in the liver tissue. There was no significant difference between the two groups.

CONCLUSION

The expression of TGF-beta1 is not related with HBcAg expressed as plasma type in the tissues of low-grade CHB patients.

Berberine induces cell cycle arrest and apoptosis in human gastric carcinoma SNU-5 cell line

AIM

To investigate the relationship between the inhibited growth (cytotoxic activity) of berberine and apoptotic pathway with its molecular mechanism of action.

METHODS

The in vitro cytotoxic techniques were complemented by cell cycle analysis and determination of sub-G1 for apoptosis in human gastric carcinoma SNU-5 cells. Percentage of viable cells, cell cycle, and sub-G1 group (apoptosis) were examined and determined by the flow cytometric methods. The associated proteins for cell cycle arrest and apoptosis were examined by Western blotting.

RESULTS

For SNU-5 cell line, the IC50 was found to be 48 micromol/L of berberine. In SNU-5 cells treated with 25-200 micromol/L berberine, G2/M cell cycle arrest was observed which was associated with a marked increment of the expression of p53, Wee1 and CDk1 proteins and decreased cyclin B. A concentration-dependent decrease of cells in G0/G1 phase and an increase in G2/M phase were detected. In addition, apoptosis detected as sub-G0 cell population in cell cycle measurement was proved in 25-200 micromol/L berberine-treated cells by monitoring the apoptotic pathway. Apoptosis was identified by sub-G0 cell population, and upregulation of Bax, downregulation of Bcl-2, release of Ca2+, decreased the mitochondrial membrane potential and then led to the release of mitochondrial cytochrome C into the cytoplasm and caused the activation of caspase-3, and finally led to the occurrence of apoptosis.

CONCLUSION

Berberine induces p53 expression and leads to the decrease of the mitochondrial membrane potential, Cytochrome C release and activation of caspase-3 for the induction of apoptosis.

Gallbladder bile composition in patients with Crohn’s disease

AIM: To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn’s disease.

METHODS: Gallbladder bile was obtained from patients with Crohn’s disease who were admitted for elective surgery (17 with ileal/ileocolonic disease and 7 with Crohn’s colitis). Fourteen gallstone patients served as controls. Duodenal bile was obtained from ten healthy subjects before and after the treatment with ursodeoxycholic acid. Bile was analyzed for biliary lipids, bile acids, bilirubin, crystals, and crystal detection time (CDT). Cholesterol saturation index was calculated.

RESULTS: The biliary concentration of bilirubin was about 50% higher in patients with Crohn’s disease than in patients with cholesterol gallstones. Ten of the patients with Crohn’s disease involving ileum and three of those with Crohn’s colitis had cholesterol saturated bile. Four patients with ileal disease and one of those with colonic disease displayed cholesterol crystals in their bile. About 1/3 of the patients with Crohn’s disease had a short CDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin in duodenal bile. Several patients with Crohn’s disease, with or without ileal resection/disease had gallbladder bile supersaturated with cholesterol and short CDT and contained cholesterol crystals. The biliary concentration of bilirubin was also increased in patients with Crohn’s colitis probably not due to bile acid malabsorption.

CONCLUSION: Several factors may be of importance for the high risk of developing gallstones of both cholesterol and pigment types in patients with Crohn’s disease.

Changes of plasma fasting carnitine ester profile in patients with ulcerative colitis

AIM: To determine the plasma carnitine ester profile in adult patients with ulcerative culitis (UC) and compared with healthy control subjects.

METHOD: Using ESI triple quadrupole tandem mass spectrometry, the carnitine ester profile was measured in 44 patients with UC and 44 age- and sex-matched healthy controls.

RESULTS: There was no significant difference in the fasting free carnitine level between the patients with UC and the healthy controls. The fasting propionyl- (0.331 ± 0.019 vs 0.392 ± 0.017 μmol/L), butyryl- (0.219 ± 0.014 vs 0.265 ± 0.012), and isovalerylcarnitine (0.111 ± 0.008 vs 0.134 ± 0.008) levels were decreased in the UC patients. By contrast, the level of octanoyl- (0.147 ± 0.009 vs 0.114 ± 0.008), decanoyl- (0.180 ± 0.012 vs 0.137 ± 0.008), myristoyl- (0.048 ± 0.003 vs 0.039 ± 0.003), palmitoyl- (0.128 ± 0.006 vs 0.109 ± 0.004), palmitoleyl- (0.042 ± 0.003 vs 0.031 ± 0.002) and oleylcarnitine (0.183 ± 0.007 vs 0.163 ± 0.007; P < 0.05 in all comparisons) were increased in the patients with UC.

CONCLUSION: Our data suggest selective involvement of the carnitine esters in UC patients, probably due to their altered metabolism.

Interventional therapy for acute hemorrhage in gastrointestinal tract

AIM: To evaluate the diagnostic angiography and therapy for acute massive hemorrhage in gastrointestinal tract.

METHODS: Twenty-five cases of acute hemorrhage in gastrointestinal tract admitted between April 2002 and September 2004 were reviewed and analyzed by angiography and embolotherapy.

RESULTS: Fifteen patients were men and ten patients were women. The Seldinger technique and method of coaxial duct were used to get access to the bleeding region. PVA particles, gelfoam, and coils were used for embolism. All bleeding sites could be confirmed and were successfully embolized. Hemostasis was achieved in all the patients without bleeding again. The cure rate was 100%.

CONCLUSION: Interventional therapy can not only ascertain the bleeding site, but also stop the bleeding .The method is simple and the effect is certain.

Crohn's disease in Stockholm County during 1990-2001: an epidemiological update

AIM

To further assess of the incidence and localization of Crohn's disease (CD) in a well-defined population during the 1990s and to evaluate the prevalence of CD on the 1st of January 2002.

METHODS

In a retrospective population based study, all 16-90 years old citizens of Stockholm County diagnosed as having CD according to Lennard Jones' criteria between 1990 and 2001 were included. Case identification was made by using computerized inpatient and outpatient registers. Moreover private gastroenterologists were asked for possible cases. The extent of the disease and the frequency of anorectal fistulae were determined as were the ages at diagnosis. Further, the prevalence of CD on the 1(st) of January 2002 was assessed.

RESULTS

All the 1 389 patients, 689 men and 700 women, fulfilled the criteria for CD. The mean incidence rate for the whole period was 8.3 per 10(5) (95%CI 7.9 -8.8). There was no difference between the genders. The mean annual incidence of the whole study period for colorectal disease and ileocecal disease, was 4.4 (95%CI 4.0-4.7) and 2.4 (95%CI 2.1-2.6) per 10(5), respectively. Perianal disease occurred in 13.7% (95%CI 11.9-15.7 %) of the patients. The prevalence of CD was 213 per 100,000 inhabitants.

CONCLUSION

The incidence of CD has markedly increased during the last decade in Stockholm County and 0.2% of the population suffers from CD. The increase is attributed to a further increase of colorectal disease, while the incidence of ileocecal disease has remained stable.

Changing face of irritable bowel syndrome

Recent years have witnessed tremendous progress in our understanding of irritable bowel syndrome (IBS). It is evident that this is a truly global disease associated with significant symptoms and impairments in personal and social functioning for afflicted individuals. Advances in our understanding of gut flora-mucosal interactions, the enteric nervous system and the brain-gut axis have led to substantial progress in the pathogenesis of symptoms in IBS and have provided some hints towards the basic etiology of this disorder, in some subpopulations, at the very least. We look forward to a time when therapy will be addressed to pathophysiology and perhaps, even to primary etiology. In the meantime, a model based on a primary role for intestinal inflammation serves to integrate the various strands, which contribute to the presentation of IBS

Effect of resveratrol on pancreatic oxygen free radicals in rats with severe acute pancreatitis

AIM: To investigate the therapeutic effects of resveratrol (RESV) as a free radical scavenger on experimental severe acute pancreatitis (SAP).

METHODS: Seventy-two male Sprague–Dawley rats were divided randomly into sham operation group, SAP group, and resveratrol-treated group. Pancreatitis was induced by intraductal administration of 0.1 mL/kg 4% sodium taurocholate. RESV was given intravenously at a dose of 20 mg/kg body weight. All animals were killed at 3, 6, 12 h after induction of the model. Serum amylase, pancreatic superoxide dismutase (SOD), malondialdehyde (MDA), and myeloperoxidase (MPO) were determined. Pathologic changes of the pancreas were observed under optical microscope.

RESULTS: The serum amylase, pancreatic MPO and the score of pathologic damage increased after the induction of pancreatitis, early (3, 6 h) SAP samples were characterized by decreased pancreatic SOD and increased pancreatic MDA. Resveratrol exhibited a protective effect against lipid peroxidation in cell membrane caused by oxygen free radicals in the early stage of SAP. This attenuation of the redox state impairment reduced cellular oxidative damage, as reflected by lower serum amylase, less severe pancreatic lesions, normal pancreatic MDA levels, as well as diminished neutrophil infiltration in pancreas.

CONCLUSION: RESV may exert its therapeutic effect on SAP by lowering pancreatic oxidative free radicals and reducing pancreatic tissue infiltration of neutrophils.

Capsule endoscopy: improving transit time and image view

AIM

To evaluate the effect of various methods of small bowel preparation on the transit time and the quality of visualization of the entire small bowel mucosa.

METHODS

Ninety-five patients underwent capsule endoscopy (CE) by easily swallowing the capsule. They were divided into three study groups according to the preparation used: group A (n = 26) by polyethylene glycol (PEG) liter or with sodium phosphate (SP) 12 h prior to the CE study; group B (n = 29) by erythromycin 1 h prior to the CE study; and group C (n = 40) without any preparation. Visualization ranged from good to satisfactory to poor.

RESULTS

The gastric emptying time in the group prepared with erythromycin was shorter but without statistical significance and the small bowel transit time was unaffected. In elderly subjects prepared by PEG or SP, the gastric emptying time was significantly longer (163.7 min, P = 0.05). The transit times of the three sub-groups were not affected by gender or pathology. The grade of cleaning of the entire study group was 3.27+/-1.1. The erythromycin group presented significantly the worst quality of images (P = 0.05) compared to the other sub-groups. Age, gender, and pathology had no effect on the quality of the cleaning of the small bowel in the sub-groups. One (1.05%) case had no natural excretion.

CONCLUSION

Erythromycin markedly reduces gastric emptying time, but has a negative effect on the quality of the image in the small bowel. The preparation of elderly subjects with PEG or SP has a negative effect on the small bowel transit time.

Computed tomography differentiation of benign and malignant gastric wall thickness

AIM: To determine the sensitivity and specificity of the computed tomography (CT) for differentiating benign and malignant thickness of the gastric wall.

METHODS: The data were collected from 40 patients with gastric wall thickness determined by spiral CT examination, who underwent barium meal examination within 4 wk before or after the CT examination. The CT images were reviewed to determine the degree of the gastric wall thickeness and the symmetry, distribution, and enhancement of the thickened wall. The sensitivity and specificity of CT in detecting the malignant tumor were calculated through the above features.

RESULTS: Of the 40 cases, 20 were with gastritis, 4 with hiatal hernia, 3 with benign ulcer, 3 with benign gastric neoplasm, 8 with malignant neoplasm, and 2 with no abnormality. The mean thickness of the gastric wall was 14 mm (7-65 mm). All the gastric walls with thickness ≥10 mm were diagnosed as malignancy by CT, and the sensitivity rate was 100%, but the specificity rate was 43%. The sensitivity rate for focal, eccentric, and enhanced gastric wall thickness was 93%, 71%, and 43%, and the specificity rate was 8%, 75%, and 88%, respectively. Generally, the sensitivity for detecting 10 mm- or more than 10 mm-thick gastric walls, which were focal, eccentric, and enhanced, was 36%, but the specificity was 93%.

CONCLUSION: After a comprehensive consideration of focal, eccentric, and enhancing thickness, the specificity rate of CT can be greatly increased, so further examination should be performed in the near future.

Promotion effect of Zuoguiwan on bone marrow cells' forming into liver cells in mice

AIM: To observe the influence of nourishing kidney (using Zuoguiwan) on the formation of liver cells from bone marrow cells.

METHODS: The female BALB/c mice were randomly divided into kidney nourishing group (KN, treated by Zuoguiwan), Qi-Xue restorative group (QXR, treated by Bazhentang) and control group (NC, treated by normal saline). After whole body irradiation with 9.0 Gy 60Co γ-rays, the female mice were injected via the tail vein with bone marrow cells from homogenic male mice to establish bone marrow transplantation model. Zuoguiwan, Bazhentang and normal saline intragatrically given to the corresponding group at the same dose [7 g/(kg•d)] after bone marrow transplantation. The mice were sacrificed to obtain liver tissues at 2, 4, and 6 mo. Fluorescence in situ hybridization (FISH) for Chromosome Y (Sry) and albumin mRNA was used to detect liver cells derived from male bone marrow, and then the rate of positive cells was calculated.

RESULTS: The positive rates of liver cells in KN, QXR and NC group were all increased with the time increase after bone marrow transplantation. The positive rate in KN group at 6 mo was markedly elevated (18.25±3.36% vs 4.00±1.73%, 4.80±1.30%, P < 0.01). Furthermore, the positive rate in NK group was significantly higher than that in QXR group (2 mo: 4.00±1.73% vs 1.20±0.45%, P < 0.01; 4 mo: 4.80±1.30% vs 1.40±0.55%, P < 0.01; 18.25±3.36% vs 7.20±1.33%, P < 0.01) and NC group (2 mo: 4.00±1.73% vs 1.00±0.61%, P < 0.01; 6 mo: 18.25±3.36% vs 9.25±1.31%, P < 0.01) at the same time point.

CONCLUSION: Zuoguiwan can promote bone marrow cells' forming into liver cells in mice.

Application of heat-killed bifidobactera in treatment of enterogenic infection caused by dysbacteriosis in mice

AIM: To observe the curative effect of heat-killed bifi-dobactera on dysbacteriosis-induced enterogenic infe-ction in mice.

METHODS: A total of 40 mice were randomly divided into living bacterium group, heat-killed bacterium group, spontaneous recovery group, and normal control group (10 for each). After treatment with the corresponding methods, the serum indexes such as total protein (TP),

albumin (ALB), globulin (GLO), γ-Glutamyl transpepti-dase (GTT), blood urea nitrogen (BUN), lactic dehydro-genase (LDH), creatinine (CER), and tagged bacterium in the homogenate of the mice were detected.

RESULTS: The levels of TP and GLO in the heat-killed bacterium group were significantly increased (71.46±2.01 g/L vs 64.61±2.16 g/L; 35.63±1.57 g/L vs 330.73±1.03 g/L, P < 0.05), while the levels of GGT and BUN were significantly decreased (2.47±0.28 IU/L vs 7.13±1.19 IU/L; 8.32±0.71 mmol/L vs 12.05±0.64 mmol/L, P < 0.01) as compared with those in the spontaneous recovery group. The level of LDH in the heat-killed bac-terium group was significantly decreased as compared with that in the living bacterium group and the normal control group (2 561.23±61.40 vs 2 951.70±155.61, 2 895.27±104.38, P < 0.05). The numbers of the entero-bactera was markedly deceased in the renal, hepatic and pulmonary tissues of the heat-killed bacterium group in comparison with those in the spontaneous recovery group(1.19±0.37, 1.56±0.20, 1.62±0.15 vs 2.17±0.97, 2.42±0.14, 2.20±0.09, P < 0.05 or P < 0.01).

CONCLUSION: The heat-killed bifidobactera are effec-tive in the treatment of enterogenic infection caused by dysbacteriosis in mice, and the effect is the same as that of the living bifidobactera.

Association of hepatitis B virus genotypes with clinical phenotypes of hepatitis B virus infection in Beijing

AIM: To investigate the relationship between the genotypes of hepatitis B virus (HBV) and the clinical outcomes of HBV infection in Beijing area.

METHODS: A total of 1 321 patients, including those with self limited HBV infection (n = 245), chronic hepatitis B (n = 668), liver cirrhosis (n = 108) and asymptomatic carriers (n = 300), were concluded in this study. Serum samples were collected for the detection of HBV markers by enzyme linked immunosorbent assay (ELISA). A simple and precise genotyping system based on polymerase chain reaction (PCR) using type-specific primers was developed for the determination of the genotypes of HBV.

RESULTS: Of the 1 321 serum samples, 804 (60.1%) were HBV DNA positive. HBV with the genotype of B, C, and B+C covered a larger percent. The percentage of HBV with genotype A, B, C, and B+C were 0.25% (2/804), 20.77% (167/804), 69.53% (559/804) and 9.45% (78/804), while none of HBV with genotype D, E, and F was found. Of all the patients with self limited HBV infection, 14 were HBV DNA positive, and the rates of genotype B, C, and B+C were 28.6% (4/14), 64.3% (9/14) and 7.1% (1/14), respectively. Of the samples from asymptomatic carriers, 128 were HBV DNA positive, and the rates of genotype B, C, and B+C were 28.1% (36/128), 68.8% (88/128), and 3.1% (4/128), respectively. Of the patients with in chronic hepatitis B, 608 cases were positive for HBV DNA, and the percentage of genotype B, C, B+C, and A were 19.9% (121/608), 68.6% (417/608), 10.4% (68/608), and 0.3% (2/608), respectively. Of the patients with liver cirrhosis, 54 were HBV DNA positive, and the percentage of genotype B, C, and B+C were 11.1% (6/54), 88.3% (45/54), and 5.6% (3/54), respectively. The rate of genotype C in liver cirrhosis patients was markedly higher than that in the patients with chronic hepatitis B, self limited HBV infection, and asymptomatic carriers (all P <0.05). In addition, genotype distribution showed no significant differences between the age and sex of patients.

CONCLUSION: Genotype B and C are major genotypes in Beijing. HBV with genotype C is predominant in patients with HBV infection, and it may be associated with the development of liver cirrhosis.

Does Fasciola hepatica infection modify the response of acute hepatitis C virus infection to IFN-alpha treatment?

Immunologic response to acute hepatitis C is mainly a Th1 response, whereas fasciolopsiasis is associated with a diverse T-cell response. Interferon-alpha has immunomodulatory effects and enhances Th1 immune response. Fasciola infection could theoretically interfere with the Th1 immune response, even when acquired after an initial response to interferon-alpha treatment for acute hepatitis C virus (HCV) infection. We report here the case of a male patient who acquired Fasciola hepatica infection after an initial response to IFN-alpha therapy with a favorable outcome.

Influence of intestinal barrier function on pigment gallstone formation in guinea pig model

AIM: To investigate the possible action and mechanism of the intestinal barrier function in the pathogenesis of pigment gallstone.

METHODS: Eighty guinea pigs were randomly divided into three groups: normal group (CON), pigment gallstone group (PS) and intestinal mucosa protection group (GLN). Normal forage, pigment gallstone-forming forage and pigment gallstone-forming forage with supplemental intestinal mucosa protector (glutamine) were given to the animals of corresponding groups, respectively. The gallstone-forming rate, morphological changes of intestinal mucosa, intestinal permeability, serum endotoxin and biliary β-glucuronidase were detected after 8 wk.

RESULTS: The gallstone-forming rate was 73.9% in PS. In comparison with those in CON, the intestinal mucosa damage, serum endotoxin level [(1367±525)×10^-6 EU/L vs (77±43) ×10^-6 EU/L, P < 0.01] and activity of biliary β-glucuronidase (endogenous: from 209.8±47.5 vs 122.1±39.5 Fishman Unit, P < 0.01; exogenous: from 2206.6±983.9 vs 573.5±476.9 Fishman Unit, P < 0.01) were significantly increased in PS. In GLN, the gallstone-forming rate was decreased to 44.4%, which was markedly higher than that in PS (P < 0.05). The morphological changes of intestinal mucosa, intestinal permeability and serum endotoxin [(156±97)×10^-6 EU/L vs (1367±525)×10^-6 EU/L, P < 0.05] were notably decreased in GLN as compared with those in PS, and there was no significant difference in β-glucuronidase activity.

CONCLUSION: Intestinal barrier function is correlated with pigment gallstone formation. Intestinal barrier function disorder may promote pigment gallstone formation through bacteria translocation, endotoxemia and change of biliary β-glucuronidase activity.

Detection of CK20 in peripheral blood of rectal cancer patients with fluorescence quantitative polymerase chain reaction and its significance

AIM: To analyze the relations of CK20 expression in the peripheral blood with the Dukes stages and histological types, and to discuss the value of fluorescence quantitative polymerase chain reaction (FQ-PCR) for predicting the metastases and prognosis of rectal cancer.

METHODS: The peripheral blood samples were collected from 47 patients with rectal cancer, 10 patients with benign intestinal diseases, and 10 healthy volunteers. Then FQ-PCR was performed to detect the expression of CK20 mRNA in the peripheral blood.

RESULTS: There was no positive expression of CK20 mRNA in the patients with benign intestinal diseases and the healthy volunteers, which was significantly different from that in the patients with rectal cancer (72.34%, 34/47) (χ² = 37.434, P < 0.01). The level of CK20 expression in the peripheral blood of the 47 patients with rectal cancer was positively correlated with the Dukes stages of rectal cancer (r = 0.680, P < 0.01).

CONCLUSION: The level of CK20 expression is positively related with tumor stages in the peripheral blood of the rectal cancer patients. CK20 detection by FQ-PCR is more sensitive than routine histological methods in predicting the metastases and prognosis of rectal cancer.

Construction and sequence analysis of connective tissue growth factor targeted recombinant plasmids by RNA interference

AIM: To construct the recombinant plasmids expressing connective tissue growth factor (CTGF) short hairpin RNA (shRNA) by pEGFP plasmid vector.

METHODS: Three pairs of two DNA sequences containing small hairpin structure were designed and synthesized respectively, and then were formed into complementary chains by annealing. The obtained products were inserted into plasmid vector pEGFP containing U6 promoter. Then the recombinant plasmids were transformed into DH5α strain. Finally the plasmids that identified by restriction enzyme were used for sequence analysis.

RESULTS: The CTGF shRNA expression frames were successfully inserted into the plasmid vector pEGFP, and the shRNA coding sequences of the 3 obtained recombinant plasmids were consistent with the designed fragments. The cloned recombinants were identified and confirmed by endonuclease digestion and sequence analysis.

CONCLUSION: The recombinant plasmids of shRNA for CTGF are successfully constructed.

Relationship between intracellular Ca2+ and ALA-PDT induced apoptosis in SW480 cells

AIM: To investigate relationship between intracellular Ca²⁺ and apoptosis induced by aminolaevulinic acid-photodynamic therapy (ALA-PDT) in SW480 cells.

METHODS: SW480 cells were divided into control, light, ALA and ALA-PDT group. The corresponding treatment was performed in each group. The apoptosis of SW480 cells was detected by DNA fragment assay and TUNEL assay. The changes of intracelluar Ca²⁺ concentration in each group were observed by confocal laser scanning microscopy.

RESULTS: DNA ladder formation of apoptotic features was demonstrated 1 and 2 h after ALA-PDT treatment. The apoptosis index (AI) of 30 and 60 min after ALA-PDT treatment was 25.26% ± 5.04% and 50.45% ± 7.85%, respectively, which were significantly higher than those in the other 3 groups (all AI <10%, P < 0.01). The concentration of intracelluar Ca²⁺ 20 min after ALA-PDT treatment was markedly increased than that at 10 min (fluorescent intensity: 185.40 ± 18.90 vs 100.00 ± 19.83, P < 0.01), and then gradually decreased. However, the concentrations of intracelluar Ca²⁺ had no significant changes in the other 3 groups.

CONCLUSION: The increases of intracellular Ca²⁺ may play an important role in the ALA-PDT-induced apoptosis in SW480 cells.

Helicobacter pylori induces apoptosis of rat gastric epithelial cells in vitro

AIM: To investigate the effect of Helicobacter pylori (H. pylori) sonicated extract on the apoptosis of rat gastric epithelial cells as well as the expression of apoptosis-related genes in vitro.

METHODS: H. pylori sonicated extract from strain Sydney SS-1 was cultured with OUMS-37, a kind of immortalized rat gastric cell lines. Apoptosis of the cells was confirmed according to specific changes of morphology and DNA ladder 24-48 h after co-incubation. The expression of P53 protein was detected by Western blotting and the expression of bax and bcl-2 mRNA were observed by Northern blotting.

RESULTS: The specific morphology of the cells such as shrinkage, condensation, margination of nuclear chromatin and apoptotic bodies were observed under light microscope. DNA ladder was manifested by fragment analysis. Western blotting showed a dose-dependent increased expression of wild-type P53 protein and Northern blotting showed a dose-pendent increased expression of bax mRNA and reduced expression of bcl-2 mRNA in the treated cells.

CONCLUSION: H. pylori sonicated extract induces the apoptosis in vitro through up-regulation of wild-type P53 protein and bax mRNA expression, and down-regulation of bcl-2 mRNA expression, suggesting that H. pylori infection may interrupt the balance between proliferation and apoptosis of the gastric epithelial cells, which plays a key role in gastric carcinogenesis.

Effects of compound from Chinese medicine on oxidation and anti-oxidation system of rat liver with steatohepatitis induced by high-fat diets

AIM: To explore the action of oxygen stress and lipid peroxidation in the establishment of steatohepatitis and the action mechanisms of compound from Chinese medicine (CCM) in the treatment of steatohepatitis in rats fed by high-fat diets.

METHODS: Sixty male Sprague Dawley rats were randomly assigned into 6 groups. The rats fed by normal food served as the controls. The rats in model groups (Ⅰ, Ⅱ) were fed with high-fat diets, and those in medication Ⅰ and Ⅱ group were given CCM 9 and 13 wk after high-fat diets feeding. The rats in diet therapeutic group were fed with normal food 13 wk after high-fat diet feeding. The animal in control, model Ⅰ, and medication Ⅰ group were killed at 12 wk, and the rest ones were killed at 16 wk. Blood sample were collected for the detection of serum aspartate transaminase (AST), alanine aminotransferase (ALT), and glutathione perioxidase (GSH-PX), and liver tissues were obtained for the detection of malondialdehyde (MDA) contents, superoxide dismutase (SOD) activity, total antioxidative capacity (T-AOC), nitric exide (NO), inducible nitric oxide synthase (iNOS) and glutathione (GSH) levels. The histological changes were observed under light microscope.

RESULTS: Pure fatty liver was formed in the model rats at 12, and fatty hepatitis was established at 16 wk. In comparison with those of normal rats, the contents of MDA were increased (6.45±1.07, 8.38±1.32 µmol/g vs 5.08±0.91 µmol/g, P <0.01) but anti-oxide SOD (171±14, 148±26 kNU/gt vs 198±25 kNU/gt, P <0.05 and P <0.01), GSH (40.8±5.1, 35.0±9.0 mg/g vs 48.5±7.6 mg/g, P <0.05 and P <0.01), GSH-PX (11.2±1.5, 10.3±1.8 µmol/L vs 16.4±3.7 µmol/L, P <0.01) contents were decreased significantly. The severity degree of hepatic fatty degeneration aggravated with the prolonging of the high-fat diet given time. In comparison with those of model rats, the markers such as MDA, SOD, GSH, and GSH-PX etc. were all significantly improved in the medication rats (P <0.05 or P <0.01), and the degree of fatty degeneration was also alleviated. Light or moderate fatty degeneration was observed in diet therapeutic rats, and the relative markers were not notably different from those of model group.

CONCLUSION: Oxygen stress and lipid peroxidation play a key role in the establishment of nonalcoholic steatohepatitis in rats, and the compound of Chinese medince has therapeutic effect on nonalcoholic steatohepatitis by anti-lipid peroxidation.

Antitumor and radiosensitizing effect of docetaxel on human hepatocellular carcinoma and its mechanisim in vivo

AIM: To investigate the anti-human hepatocellular carcinoma (HCC) activity of docetaxel and determine the potential radiosensitizing effect of docetaxel in vivo, and to further explore the mechanism of docetaxel-induced cell growth inhibition, apoptosis and radiosensitization at gene level.

METHODS: Nude mice bearing HCC with a diameter of about 0.8 cm in the leg received 33 mg/kg docetaxel intraperitoneally, 10 Gy (5 Gy once) tumor irradiation, or both (radiation given 24 and 48 h after docetaxel treatment). The regression and regrowth of the tumors were followed until the tumor diameter reached 1.4 cm approximately. Absolute growth delay (AGD), which was defined as the time in days for tumors treated with docetaxel to grow from 0.8 to 1.4 cm in diameter minus the time in days for untreated tumors to reach the same size, was used to evaluate the antitumor effect of docetaxel. Normalized growth delay (AGD), which was defined as the time in days for tumors treated with both docetaxel and irradiation to grow from 0.8 to 1.4 cm in diameter minus the time in days for tumors treated with docetaxel alone to reach the same size, and the enhancement factor (ratio of NGD to AGD for irradiation alone) was used to assess the effect of the combined docetaxel plus radiation treatment. Real-time qutitative reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the expression of bcl-2 and p21 genes in HCC cells before and after decetaxel treatment.

RESULTS: The tumors in docetaxel treated alone and irradiation treated alone groups needed 35 and 29 d to reach 14 cm in diameter, respectively, while the ones in the control group needed 23 d. So the AGD was 12 and 6 d, respectively. The combined administration of docetaxel and irradiation resulted in significant growth delay (47 d), and the EF was 2.0, indicating that docetaxel enhanced tumor radioresponse. At 20 d, the sizes of the tumors in docetaxel treated alone group and combination of docetaxel and irradiation group were significantly smaller than those in the controls (P = 0.008, P = 0.005), and the size in the combination group was also smaller than that in the irradiation alone group (P = 0.002). Real time quantitative RT-PCR analyses revealed that mRNAs of p21 in the docetaxel treated SMMC-7721 cells at most of the time points were increased, as compared with those in the control cells. In contrast, bcl-2 expression in the docetaxel treated SMMC-7721 cells was suppressed as compared with that in the controls.

CONCLUSION: Docetaxel can inhibit the growth of HCC and enhance the tumor response to fractionated irradiation in vivo by down-regulation of bcl-2 expression and up-regulation of p21 expression..

Detection and clinical significance of autoantibodies in serum of patients with chronic Hepatitis C in Yanbian area

AIM: To analyze the positive rate of autoantibodies in patients with chronic chronic Hepatitis C and their clinical significances.

METHODS: The positive rate of autoantibodies including anti-cardiolipin (ALC), antinuclear (ANA), anti-smooth muscle (ASA), antimitochondrial (AMA) antibodies, and rheumatiod factor (RF) were detected in 100 patients with chronic Hepatitis C (79 chronic hepatitis C, 21 liver cirrhosis). And the factors such as age, gender, and liver function, between patients with autoantibodies positive and negative were compared.

RESULTS: The overall positive rate of the autoantibodies was 62.0%. The positive rate of ACL, ANA, RF, ASA, and AMA was 40.0%, 29.0%, 19.0%, 8.0%, and 3.0%, respectively. As compared with the autoantibody-negative patients, the autoantibody-positive patients were order (58.7 vs 49.7), and with worse liver function and disease status. The positive expression of autoantibody was found higher in females than those in males (79.2% vs 46.2%).

CONCLUSION: The autoantibodies are commonly found in patients with chronic hepatitis C. Its presence may infect the status of the liver function and aggravate the state of the disease.

Suppression of HCT116 cell proliferation by silencing vascular endothelial growth factor gene with RNA interference

AIM: To observe whether the vascular endothelial growth factor (VEGF) short hairpin RNA (shRNA) expressed by recombinant plasmid Pavu6+27-VEGF siRNA in cells can effectively inhibit the proliferation of human colon carcinoma cell line HCT116.

METHODS: The constructed recombinant plasmid with the expression of shRNA was transfected into the human colon carcinoma cell line HCT116, and the empty plasmid (Pavu6+27) was transfected into the same cell line as controls. After screened with G418, flow cytometry was used to detect the distribution of the HCT116 cell cycles. The inhibitory rate of the cell growth was detected by MTT assay.

RESULTS: The recombinant Pavu6+27-VEGF siRNA effectively inhibited the proliferation of the cell line HCT116, and the inhibitory rates were significantly increased as compared with those in the controls at 24, 48, and 72 h (15.32%±2.02%, 28.54%±3.29%, 40.32%±3.56% vs 5.64%±1.42%, 8.65%±2.30%, 15.32%±3.52%, P < 0.05). The ratio of cells at G0/G1 stage was markedly increased (74.37%±4.54% vs 71.13%±5.14%), while the ratio of cell at S stage was significantly decreased (11.90%±3.44% vs 14.97%±4.33%, P < 0.05 ) in the recombinant plasmid transfected cells as compared with that in the controls. The empty plasmid had no such effect on the same cell line.

CONCLUSION: The shRNA expressed by the recombinant plasmid Pavu6+27-VEGF siRNA in cells can effectively inhibit the proliferation of the cell line HCT116.

Comprehensive treatment of esophageal carcinoma under endoscopy: an analysis of 85 cases

AIM: To explore the therapeutic method for the treatment of esophageal carcinoma.

METHODS: A total of 85 esophageal carcinoma patients who lost surgical opportunity were treated with radiofrequency ablation and injection of chemotherapeutic drugs. Furthermore, some patients received stent implantation under endoscopy. The therapeutic effect of those methods was observed and analyzed.

RESULTS: The symptoms of all the patients were alleviated, and their life quality was improved. Moreover, no one was dead with 6 mo. The survival rate of 1, 2, 3, and 4 a was 80%, 64.7%, 15.3%, and 1.2%, respectively.

CONCLUSION: The comprehensive therapy under endoscopy is a safe, less painful, convenient, and effective method for treating esophageal carcinoma.

Establishment and application of polymerase chain reaction method for detection of interferon sensitivity determining region of hepatitis C virus

AIM: To establish a polymerase chain reaction (PCR) method based on the special primers of the interferon sensitivity determining region (ISDR) of hepatitis C virus (HCV), and to detect the sequence of the HCV ISDR.

METHODS: The universal outer primers and 3 suits of ISDR type-specific inner primers (A, B, C group) were designed on the basis of the nucleotide sequences of 6 typical full-genomic HCV. The HCV RNA in the serum that colleted from 27 patients infected with chronic HCV genotype 1b was tested by the established PCR method, and multi-site analysis was performed on the PCR positive products.

RESULTS: The positive rats were 37% (10/27), 30% (8/27), 4% (1/27), and 22% (6/27) in group A, group A-B, group A-C, and group A-B-C after detection by the established PCR method. For the 6 HCV RNA positive patients, HCV RNA became negative when they were treated with IFN for 6 to 12 mo, and HCV RNA was still negative in those patients 3 mo after the treatment.

CONCLUSION: The PCR method based on the ISDR of HCV is simple and reliable, and can be used in the detection of HCV ISDR in patients with hepatitis C and in the prediction of the persistent response to the IFN in HCV genotype 1b infected patients by the number of mutations within the ISDR.

Characteristic expression of γ-aminobutyric acid and glutamic acid decarboxylase in epithelial cells of rat descending colon

AIM: To detect the expression of γ-aminobutyric acid (GABA) and glutamate decarboxylases (GADs) in the epithelial growth zones of rat descending colon, and to investigate their relations with cell differentiation and proliferation.

METHODS: Immunocytochemical expression of GABA and GADs in the epithelial cells of rat descending colon was investigated by immunofluorescent staining and confocal laser scanning techniques, and the goblet cells were further revealed by wheat-germ agglutinin (WGA) histochemistry. GAD65 and GAD67 mRNAS were also detected by reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization. Furthermore, evaluation of cell kinetics in colonic epithelia was conducted by [³H]-thymidine autoradiography.

RESULTS: Immunoreactive GABA and GAD65 were distributed in the upper third of the crypts and at the luminal surface in the rat descending colon. Strong staining for GABA and GAD65 was localized mainly in the cytoplasm of epithelial cells near the neck of the crypts and along the luminal surface. Immunoreactivity of GAD67, however, was localized only on the luminal surface. In addition, GABA and GAD65 were detected at lamina propria in clonic mucosa. No staining for GABA or GADs was found in goblet cells. GAD65 and GAD67 mRNAs were both identified in the homogenates of rat descending colon, and the epithelium showed stronger hybridization signal for GAD65 mRNA than that for GAD67. Meanwhile, [³H]-thymidine labeled cells were found in the lower two-thirds of the crypts.

CONCLUSION: The expression of GABA and GADs in the maturation and function zones suggests that GABA might be involved in the differentiation and proliferation of the colonic epithelial cells.

Is colonoscopy sufficient for colorectal cancer surveillance in all HNPCC patients?

A 34-year-old male with hereditary non-polyposis colon cancer with a mutation in hMSH2 line is reported. Despite regular colonoscopic follow-up, he developed cecal cancer involving the extraluminal area. Due to sub-occlusive symptoms, the patient was submitted to further colonoscopy, however with no clear evidence of neoplasia. Thin slice multiplanar reconstruction computed tomography CT scan performed thereafter revealed a transmural mass 2.5 cm in size localized near the cecal valve. Discussion is made on the reliability of colonoscopic examinations as well as the need for further investigations in the follow-up of patients at very high risk of right-sided colon cancer, such as male hMSH2 carrier affected by hereditary non-polyposis colon cancer.

Comparison between time-resolved fluorescence immunoassay and electro-chemiluminescence immunoassay for detection of serum carcinoembryonic antigen in colorectal carcinoma

AIM: To evaluate the effect of time-resolved fluorescen-ce immunoassay (TRFIA) and electro-chemilumines-cence immunoassay (ECLIA) for detecting the serum level of carcinoembryonic antigen (CEA) and their influ-ence on the positive rate of serum CEA in patients with colorectal carcinoma.

METHODS: Serum CEA levels were detected with both TRFIA and ECLIA in 90 samples from patients with colorectal carcinoma (n = 30), non-colorectal car-cinoma (n = 30), and the healthy controls (n = 30). The data were analyzed with statistical software SPSS.

RESULTS: The level of CEA was significantly higher in the colorectal cancer group (TRFIA: 44.12±95.27 μg/L, ECLIA: 35.96±71.83 μg/L) than that in the heal-thy control group (TRFIA: 1.04±0.55 μg/L, ECLIA: 0.71±0.48 μg/L) (P <0.01). The sensitivities of TRFIA and ELCIA were 60.0% and 66.7%; the specificities were 98.3% and 100%; the accuracies were 85.6% and 88.9%; the positive predictive rates were 94.7% and 95.2%; and the negative predictive rates were 83.1% and 85.7%, respectively. The results of ELCIA were better than those of the TRFIA, and they were well correlated (r = 0.973 8). There was no significant difference between the two methods (P >0.05).

CONCLUSION: Qingre Huashi recipe can increase the expression of LDL-R mRNA in the liver tissues of rat model of dampness-heat syndrome.

Correlations of chronic hepatitis C virus infection with Xba I polymorphism of apolipoprotein B gene and serum lipid metabolism

AIM: To investigate the Xba I locus polymorphisms of apolipoprotein B (Apo B) gene and their internal correlations with chronic hepatitis C virus infection and serum lipid metabolism.

METHODS: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to analyze the genotype of the Apo B gene in 77 patients and 62 controls, according to the design of case control study. Meanwhile, the blood samples were analyzed for hepatic function and serum lipid by automatic biochemistry analyzer.

RESULTS: The frequencies of X⁺X^- and X^-X^- of Xba I locus polymorphism were different between the patients and the controls and the frequency of X⁺ allele in the patients was lower than that in the controls (0.071 vs 0.121, P = 0.136), but no statistical significance was not found. The frequency of X⁺ allele in patients with HCV RNA≥80 000 copies/L was significantly lower than that with HCV RNA<80 000 copies/L (0.048 vs 0.179, P = 0.035). Furthermore, the levels of Apo B in the patients of X⁺X^- genotype were significantly higher than those in the patients of X^-X^- genotype (P = 0.019). The serum levels of low density lipoprotein (LDL) and Apo B were negatively correlated with serum HCV RNA levels in patients with chronic hepatitis C (r = -0.460, P = 0.016; r = -0.538, P = 0.005, respectively), and the correlation with serum alanine aminotransferase (ALT) levels was not found.

CONCLUSION: The Xba I locus polymorphism of Apo B gene is not correlated with susceptibility of Chinese people to HCV, but it may affect the HCV viral load in patients with chronic hepatitis C. The variation of X⁺ allele may affect serum Apo B levels in patients with chronic HCV infection. The serum levels of LDL and Apo B are closely correlated with serum HCV RNA levels in patients with chronic hepatitis C.

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Inhibition of P-selectin L-EGF monoclonal antibody on metastasis of human gastric carcinoma in severe combined immunodeficient mice

AIM: To investigate the role of cell adhesion molecule P-selectin L-EGF monoclonal antibody (L-EGF Mab) in the inhibition of the metastasis of gastric cancer in sev-ere combined immunodeficient (SCID) mice.

METHODS: Human gastric cancer cell line SGC-7901 was orthotopically implanted into SCID mice to estab-lish metastatic model. At the 3^rd day after implantation, the mice were intravenously injected with normal saline (n = 11) or P-selectin L-EGF Mab (n = 9). At the end of the 6^th wk, pathological examinations were performed on the tissues from stomach and other possible invad-ed organs. Meanwhile, polymerase chain reaction was performed on the gastric cancer tissues.

RESULTS: The metastatic rate in the mice treated with normal saline was 81.8% (9/11), and that in the mice treated with P-selectin L-EGF Mab was 11.1% (1/9). There was significant difference between them (P <0.05). The level of P-selectin mRNA expression in the gastric can-cer with metastasis was markedly increased in com-parison with that without metastasis, and P-selectin mRNA expression in the mice treated with P-selectin L-EGF Mab was significantly lower than that in the ones treated with normal saline (cycle threshold: 20.54±2.20 vs 17.09±1.40, P <0.05).

CONCLUSION: CONCLUSION: P-selectin adhesion molecule is related to tumor metastasis, and P-selectin L-EGF Mab can inhibit the metastasis by down-regulating the express-ion of P-selectin mRNA..

Detection of nanobacteria by immune electronic microscopy

AIM: To introduce an effective method of immunogold electron microscopy for the detection of nanobacteria.

METHODS: Nanobacteria were fixed in the 25 g/L glut-araldehyde, and then were embedded in resin. After they were cut into ultrathin slices by diamond knife, an indirect immunogold electronic microscopy staining was performed on the nanobacteria using the specific antibody of nanobacteria.

RESULTS: The nanobacteria were ball- or stick-like with a length of 80-350 nm under electron microscope. Nanobacteria were combined with the specific antibo-dy. The adhesion of the immune colloidal gold granule was observed under the electronic microscopy.

CONCLUSION: The immune electronic microscopy can not only reveal the ultrastructure of nanobacteria, but also indicate its special antigenicity.

Expression and significance of leptin and transforming growth factor-α in gastric mucosa of Helicobacter pylori infected patients with chronic gastritis and gastric ulcer

AIM: To investigate the expression of leptin and trans-forming growth factor-α (TGF-α) in the Helicobacter pylori (H. pylori) infected gastric mucosa, and to explore the correlation between leptin and TGF-α.

METHODS: Immunocytochemistry was used to detect the expression of leptin and TGF-α in the mucosal biopsies from the corpus ventriculi and the gastric antrum of patients with H. pylori ⁺ and H. pylori ^- chronic gastritis and gastric ulcer.

RESULTS: Leptin was weakly positive in the corpus ventriculi mucosa of normal person. The expression of leptin and TGF-α were significantly increased in the corpus ventriculi mucosa of H. pylori + infected patients with gastritis and gastric ulcer as compared with that in the H. pylori - patients (leptin: 73.33% vs 23.08%, P < 0.05; 70.59% vs 25.00%, P < 0.05; TGF-α: 73.33% vs 15.38%, P < 0.05; 76.47% vs 25.00%, P < 0.05). The expression of leptin had no significant difference in the gastric antral mucosa between the four groups (P > 0.05). The expression of TGF-α was markedly higher in the gastric antral mucosa of patients with H. pylori + chronic gastritis than that in patients with H. pylori - gastritis (53.33% vs 7.69%, P < 0.05). The expression of leptin and TGF-α was positively correlated in the corpus ven-triculi mucosa (r = 0.80, P < 0.01).

CONCLUSION: The expression of leptin and TGF-α is positively correlated in the corpus ventriculi mucosa of H. pylori + patients with chronic gastritis and gastric ulcer.

Expression of Ss-A/Ro ribonucleoprotein 60 ku subunit and its variants in drug-resistant gastric cancer cells

AIM: To clone the encoding gene of Ss-A/Ro ribonucle-oprotein 60 ku subunit, and to detect the expression of Ss-A/Ro 60 ku subunit and its variants in the drug resi-stance gastric cancer cells.

METHODS: The encoding gene of Ss-A/Ro ribonucl-eoprotein 60 ku subunit was cloned by reverse transcri-ption-polymerase chain reaction. The expression of Ss-A/Ro 60 ku subunit and its variants in the gastric cancer cells were analyzed by semi-quantitative RT-PCR.

RESULTS: The Ss-A/Ro 60 ku subunit was successful-ly cloned, and its two transcription variants, with a length of 52 and 41 bp, respectively, were found out. The expression of Ss-A/Ro 60 ku subunit and its two variants in the SGC7901/VCR cells was higher than that in the SGC7901 ones (P = 0.000 1, P = 0.001).

CONCLUSION: The Ss-A/Ro 60 ku subunit and its variants are multi-drug resistance-related molecules.

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Effect of stress on expression of neuronal nitric oxide synthase in colonic nervous system in rats

AIM: To investigate the effect of stress on the expression of neuronal nitric oxide synthase (nNOS) in colonic nerv-ous system in rats.

METHODS: Thirty male SD rats were randomly divided into control group, stress group and NG-nitro-L-arginine methyl ester (L-NAME) group. The rat model of water immersion-restraint stress (WRS) was established. The expression of nNOS in colonic submucous plexus and myenteric plexus in the rats was examined by immuno-histochemical staining and analyzed by computer image analysis system.

RESULTS: nNOS immune-positive substance was mostly expressed in the neurons of submucous plexus and myenteric plexus. In comparison with that in contr-ol group, the gray value of nNOS positive neurons in submucous plexus and myenteric plexus was signifi-cantly decreased (P = 0.02 or P = 0.005), and the den-sity of nNOS positive neurons was increased markedly (P = 0.04 or P = 0.01) in stress group. Moreover, nNOS expression in mucosal epithelial cells and lamina pro-pria lymphocytes were also observed. In comparison with that in stress group, the gray value of nNOS posi-tive neurons in submucous plexus and myenteric plexus was increased (P = 0.04), and the density of nNOS positive neurons was decreased (P = 0.04 or P = 0.03) in L-NAME group. nNOS expression was not significantly different between the rats of L-NAME and control group (P >0.05).

CONCLUSION: WRS can increase the expression of nNOS in colonic nervous system in rats, which suggests nitric oxide (NO) may play an important role in WRS-induced function disorder of colon.

Clinicopathological significance of KAI 1 and nm23-H1 expression in gastric cancer

AIM: To investigate the expression of KAI 1 and nm23-H₁ protein in gastric cancer, and to explore the clinicopath-ological significance of KAI 1 protein in the progression of gastric cancer.

METHODS: Eighty-seven paraffin-embedded specime-ns of gastric cancer were investigated immunohistoche-mically by Envision method with rabbit anti-human KAI 1 polyclonal antibody and mouse anti-human nm23-H₁ monoclonal antibody. Statistical analysis was perform-ed using chi-square test.

RESULTS: The positive rate of KAI 1 expression in gastric cancer with lymph node metastasis (60%, 39/65) was significantly lower than that without lymph node metastasis (95%, 21/22, P < 0.05), but the rate was markedly higher in early-stage tissues of gastric cancer than that in late-stage ones (94%, 16/17 vs 63%, 44/70, P < 0.05). The patients with KAI 1 positive tumor tended to have a longer survival time (P < 0.05). The expression of nm23-H₁ was notably decreased in gastric cancer with lymph node metastasis in compari-son with that without lymph node metastasis (18% vs 77%, P < 0.05), but nm23-H₁ expression rate in early- and meta-phase gastric cancers was higher than that in late-phase gastric cancers (65% vs 26%, P < 0.05).

CONCLUSION: KAI 1 and nm23-H₁ are both associat-ed with invasive ability of gastric cancer. Furthermore, KAI 1 is correlated with prognosis of patients with gast-ric cancers. Combined detection of KAI 1 and nm23-H₁ may be helpful in predicting the prognosis and further directing the clinical therapy of gastric cancer.

Liver injury and hepatocyte apoptosis induced by chronic alcoholic intoxication in rats

AIM: To investigate the role of hepatocyte apoptosis in the pathogenesis of alcohol-induced liver diseases (ALD) in rats.

METHODS: The rat model of liver injury was induced by combination of drinking and gastric irrigation of ethanol. The morphological changes of the liver were observed by routine HE staining under light microscope. The hepatocyte apoptosis was examined by TUNEL, and the levels of serum alanine aminotransferase (ALT) and aspartate transaminase (AST) were detected by the rate method.

RESULTS: At the end of the 5^th week, the light and moderate steatosis appeared in ethanol-treated rat livers, the proportion of fatty degeneration was 40% (8/20); At the end of the 10^th week, the proportion was increased to 85%(17/20), and the morphological changes of alcoholic hepatitis (AH) were found in 45%(9/20) rats. The serum levels of ALT and AST (nkat/L) in ethanol-treated rats were significantly higher than those of the controls (5 wk: 1 017±267 vs 550±133, P < 0.05; 1 350±333 vs 967±150, P < 0.05; 10 wk: 1 500±267 vs 767±250, P < 0.05; 2 167±533 vs 850±183, P < 0.05), and ALT and AST levels at 10 wk were also higher than those at 5 wk (P < 0.05). The TUNEL indexes (%) in at 5 and 10 wk were 0.33±0.49 and 2.03±1.61 respectively (P < 0.05), and the index at 10 wk was significantly different from that of the controls (0.10±0.21, P < 0.05). Furthermore, the TUNEL index of alcoholic hepatitis was significantly higher than that of alcoholic fatty liver (3.24±1.50% vs 1.12±0.63%, P < 0.05). Both show the significant difference.

CONCLUSION: Chronic and excessive ethanol consumption can cause liver injury in rats. The amount and time of daily ethanol intake is closely related with the degrees of liver injury. Hepatocyte apoptosis may play an important role in the pathogenesis of ALD.

Activity of cytokines in dinitrochlorobenzene-induced colitis in mice

AIM: To observe the changes of serum pro-inflammatory and anti-inflammatory cytokine activities in mice with experimental colitis.

METHODS: A total of 33 BALB/c mice were randomly divided into control (n = 15) and experiment group(n = 18). After sensitized by 2, 4-dinitrochlorobenzene (DNCB) smeared on the abdominal skin, the mice in the experiment group were challenged with DNCB enema, while those in the control group were treated with ethanol. The body weight, stool viscosity and hematochezia were observed and accumulated as disease active index (DAI) score; the colon pathological score was achieved by macropathology and HE staining of section prepared for microscopy. The activity of serum IL-1, TNFa, IL-6, IL-4 and IL-10 was determined.

RESULTS: The percentage of diarrhea was 59% in the experiment mice 24 h after DNCB treatment, and serious weight loss was found, 20% mice died. Pathologically, the mice in the control group had normal histological structures and glands, and no ulcer was found except for occasional light mucosal congestion. However, the decrease in the number of glands and disturbance of tissue structure were observed in the mice of experiment group. Moreover, erosion, hemorrhage, necrosis as well as deeper ulcers were easily seen. As compared with those in the control mice, the DAI (3.82 ± 2.77 vs 1.25 ± 1.65, P <0.05), pathologic score (2.47 ± 1.33 vs 0.38 ± 0.72, P <0.05) were significantly increased in the experiment mice. The activities of pro-inflammatory cytokines such as IL-1(112.9 ± 8.3 ng/L vs 81.2 ± 16.3 ng/L, P <0.01), TNF-a(137.9 ±36.7 ng/L vs 110.3 ± 22.4 ng/L, P <0.05), and IL-6(48.2 ± 4.3 ng/L vs 36.1 ± 7.2 ng/L, P <0.01) were significantly increased, while the activities of anti-inflammatory cytokines such as IL-4 (96.7 ± 16.5 ng/L vs 130.1 ± 13.1 ng/L, P <0.01) and IL-10(107.3 ± 31.2 ng/L vs 149.8 ± 45.1 ng/L, P <0.01) were markedly lowered.

CONCLUSION: The pathological progress of colitis induced by DNCB is possiblely related with the increased activities of pro-inflammatory cytokines and decreased activities of anti-inflammatory cytokines.

Relationship between expression of gastrin, somatostatin mRNA and cell apoptosis and Bcl-2, Bax in large intestinal carcinoma

AIM: To explore the correlations the between expression of somatostatin (SS), gastrin (GAS) mRNA and cell apoptosis index (AI) and Bcl-2, Bax in large intestinal cancer.

METHODS: The expression of GAS and SS genes were detected in 62 colorectal cancer patients by nested reverse transcription polymerase chain reaction (RT-PCR), and the apoptosis of the cells was detected by TUNEL method. The protein expression of,Bcl-2, Bax, GAS, and SS were detected using immunohistochemical staining (S-P method).

RESULTS: The expression of GAS and SS mRNA and protein were basically consistent. The AI in SS high and moderate expression patients with large intestinal cancer was remarkably higher than that in SS low expression ones (q = 5.06, 3.95, both P < 0.01), while it was just opposite in GAS positive patients (q = 6.66, 6.33, P < 0.01). The positive rates of Bax and Bcl-2 expression had significant difference between SS (or GAS) high, moderate and low expression patients with large intestinal cancer (Bax: χ² = 9.24, 6.91, P < 0.05; Bcl-2: χ² = 7.17, 13.83, P < 0.05). The positive rate of Bax expression in SS high (80%, 8/10) and moderate (76.5%, 13/17) expression patients was notably higher than that in the low expression ones (40.0%, 14/35) (χ² = 5.24, 6.09, P < 0.05), but the rate of Bcl-2 expression was just opposite (χ² = 4.71, 4.70, P < 0.05). The positive rate of Bcl-2 expression in GAS high (90.9%,10/11) and moderate expression patients (86.7%,13/15) was markedly higher than that in the low expression ones (44.4%, 16/36) (χ² = 5.60, 7.69, P < 0.05), but the positive rate of Bax expression in GAS high expression patients (27.3%, 3/8) was obviously lower than that in the low expression ones (69.4%, 25/36) (χ² = 4.59, P < 0.05). Bax expression was not significantly different between moderate and low GAS positive patients. The value of GAS/SS was positively correlated with Bcl-2 expression (r = 0.34, P < 0.01), but negatively with the AI value and Bax expression (r = －0.546, P < 0.01; r = －0.299, P < 0.05).

CONCLUSION: GAS and SS play important roles in the regulation and control of cell apoptosis in large intestinal carcinoma, and the mechanism may be related to the aberrant expression of Bcl-2 and Bax.

Antisense oligonucleotides-based inhibition of gene and protein expression of tissue inhibitor of metalloproteinase-2 on experimental liver fibrosis in rats

AIM: To investigate the inhibitory effect of tissue inhibitor of metalloproteinase-2 (TIMP-2) targeted antisense oligonucleotide (asON) on the progress of experimental liver fibrosis in rats.

METHODS: Twenty-two rats were divided into asON treatment (n = 6), model (n = 6), and normal control group (n = 10). The liver fibrosis model was induced by human serum albumin (HSA). During modeling, the rats were treated with antisense oligonucleotides via tail vein. The level of TIMP-2 expression was detected by reverse transcription polymerase chain reaction (RT-PCR), in situ hybridization, immunohistochemical staining and enzyme linked immunosorbent assay (ELISA). The effect of asON on liver fibrosis was analyzed by histopathological exami-nation, immunohistochemical staining of collagenⅠand Ⅳ, and special staining of collagen fiber as well as electron microscopy.

RESULTS: The pathological grading was notably im-proved in asON group than that in model group (u = 2.071, P <0.05). The serum and tissue expression of TIMP-2 were lower in asON group than those in model group (T = 55, P <0.05; t = 3.332, P <0.05), but higher than those in the control (T = 55, P <0.05; t = 5.550, P <0.05). Image quantitative analysis for immunohistochemical staining of collagen Ⅳ showed that the value was significant decreased in asON group as compared with that in model group (t = 2.310, P <0.05), but still higher than that in the control (t = 3.623, P <0.05); The value for collagenⅠwas also decreased in asON group as compared with that in model group (t = 2.845, P <0.05). Less collagen deposition was found in the hepatic sinusoid of asON group, which was not significantly different from that of model group.

CONCLUSION: TIMP-2 targeted asON can inhibit the progress of experimental liver fibrosis in rats.

Experimental research on treatment of ulcerative colitis with integrative traditional Chinese and Western medicine

AIM: To explore the effect of the clyster treatment with integrated traditional Chinese and Western medicine on ulcerative colitis (UC), and to investigate its mechanism.

METHODS: The mouse model of UC was established, and then the rats were treated (clyster) with the combination of tin-like powder, dexamethasone, gentamicin, and berberine. Then the therapeutic effect was observed, and the mechanism of the treatment was analyzed.

RESULTS: The disease active index (DAI) and histopathologic score (HPS) of the low dose (DAI: 5.10±4.07, HPS: 8.00±6.38), the moderate dose (DAI: 0.80±1.87, HPS: 1.30±1.49), the high dose (DAI: 1.00±1.94, HPS: 0.90±1.45), and the positive control group (DAI: 5.30±4.37, HPS: 8.00±5.12) were markedly lower than those of the negative control group (DAI: 8.60±1.26, HPS: 13.20±1.69) (all P <0.05). The DAI and HPS of the moderate dose group were markedly lower than those of the low dose group and the positive control group (all P <0.05), but there was no significant difference between the moderate and high dose group (P >0.05). The levels of interleukin-4 (IL-4) of the low, moderate, and high dose group, and the positive control group were markedly lower than those of the negative control group (32.33±15.30, 25.79±6.33, 29.92±12.81, 28.45±9.30 vs 63.89±11.31, all P <0.05), but the levels of interferon-γ (IFN-γ) were markedly higher than those of the negative control group (198.38±31.46, 187.49±13.04, 188.14±14.11, 207.64±41.44 vs 127.41±21.47, all P <0.05).

CONCLUSION: The combination enema of tin-like powder, dexamethasone, gentamicin, and berberine has definite therapeutic effect on UC, which may be related with its regulation on IL-4 and IFN-γ level.

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