Survival and malignant phenotype changes of human hepatoma SMMC-7721 cell line induced by cryopreservation at -50 °C

AIM: To investigate the effect of cryopreservation at -50 °C on the human hepatoma SMMC-7721 cell line.

METHODS: With 15% DMSO as a cryoprotectant, the SMMC-7721 cells were cryopreserved at -50 °C, then thawed and recultured. The survival rate, mitotic index and LDH isoenzymes were compared between pre- and post-cryopreservation.

RESULTS: Thirteen hours after the thaw, the mitotic index of cryopreserved SMMC-7721 cells decreased by 1.09%. The mode scope of chromosome number (46-53) after cryopreservation tended to transfer to that of normal human cells, and the percentage of metaphases containing 46 chromosomes changed from 0% to 16%. LDH isoenzymes changed from H-like model (LDH3(29.3%) > LDH4 (26.8%) > LDH2 (25.3%) > LDH5 (14.9%) > LDH1 (3.6%) to M-like model (LDH4 (48.3%) > LDH5 (28.3%) > LDH3 (18.9%) > LDH2 (4.4%) > LDH1 (0%)). This suggests that the survival rate could reach over 95%.

CONCLUSION: Cryopreservation at -50 °C can be a convenient method for the cryopreservation of cell lines. However, cryopreservation at -50 °C is likely involved in the changes of the malignant phenotypes of the human hepatoma SMMC-7721 cell line, and may induce the differentiation of malignant cells.

Changes in mucosal permeability to lipopolysaccharide in the colon of chronic alcoholic rats

AIM: To evaluate the effects of chronic alcohol abuse on mucosal permeability to lipopolysaccharide (LPS) in the colon of rats.

METHODS: Escherichia coli LPS (20 mg/L) was injected into the colon of chronic alcoholic rats (n = 10) that had been supplied with Lieber diet every other day for six weeks. Before and 5, 10, 20, and 30 min after LPS injection, portal vein blood samples were obtained and the LPS levels in the blood were measured. The distribution of LPS in the colon tissues was observed with confocal laser scanning microscopy by immunofluorescence technique using a monoclonal antibody specific to the lipid A region of LPS. Normal rats were used as the controls (n = 6).

RESULTS: Before LPS injection, LPS levels in the portal vein blood of chronic alcoholic rats were significantly higher than that of the normal controls (3.56 ± 0.67 ng/L vs 2.45 ± 0.15 ng/L, P < 0.01). At 5, 10, 20, and 30 min after LPS injection, LPS levels were significantly higher than that before LPS injection (173.56 ± 3.45 ng/L, 154.78 ± 0.57 ng/L, 43.89 ± 0.67 ng/L, 45.38 ± 0.89 ng/L vs 3.56 ± 0.67 ng/L, respectively, P < 0.01). Most mucosal cells in the chronic alcoholic rats showed strong positive reactions to LPS, but in the normal rats, there were no significant changes in portal vein blood LPS levels and in the fluorescence reactions to LPS in the mucosal cells after LPS injection.

CONCLUSION: Chronic alcohol abuse results in a significant increase in LPS permeability in the colon mucosa cells of rats.

Endoscopic monitoring in small bowel transplantation

AIM: To investigate the role of endoscopic monitoring in small bowel transplantation.

METHODS: This study was conducted in two parts—an initial experimental study followed by a clinical study. In the experimental study, segmental small bowel allotransplantation was performed on white outbred pigs. Stomas were created for exteriorization of the proximal and distal ends of the intestines (Thiry-Vella loop). The grafts were monitored by endoscopy via stomas, with or without immunosuppressive therapy. For the clinical study, the whole small-bowel allograft of a woman with short bowel syndrome was endoscopically monitored via distal stoma.

RESULTS: The most common endoscopic findings of graft rejection following small bowel allotransplantation were mucosal erythema, erosion, and ulceration. Diffuse ulceration with bleeding occurred in the late phase of rejection.

CONCLUSION: Endoscopic monitoring is essential to small bowel transplantation.

Characteristics of upper digestive tract diseases in Bohai Bay fishermen

AIM: To study the characteristics of upper digestive tract diseases (UDTDs) in fishermen who live in Bohai Bay.

METHODS: An investigation was carried out in 1488 fishermen with symptoms of UDTDs (aside from liver, biliary and pancreatic diseases) during the time period between December 1991 and February 1995. This investigation included medical history evaluations, physical, gastroscopic and pathological examinations, tests for Helicobacter pylori (H. pylori) infection, and analysis of the nitrate content in their drinking water.

RESULTS: Among the 1488 subjects investigated, 1467 suffered from one or more of the 14 UDTD diseases, most of which were chronic atrophic gastritis (CAG, 1103 cases), peptic ulcers (268 cases), and cancer of the upper digestive tract (25 cases).

CONCLUSION: The incidence rate of UDTDs tends to be high among fishermen due to their particular living habits, the high nitrate content of their drinking water, etc. In addition, the clinical manifestations of UDTDs in fishermen are significantly different from those of the inland residents.

Treatment of postoperative gastric cancer with the Fuzheng Huoxue anticancer prescription

AIM: To study effects of the Fuzheng Huoxue anticancer prescription (Traditional Chinese Medicine) in treatment of gastric cancer.

METHODS: Sixty-nine patients with histologically confirmed mid- or late-stage gastric cancer were assigned to two groups. The treatment group included 35 cases (26 males and 9 females; 2 patients aged 33-40 years, 18 patients aged 41-60 years, and 15 patients aged 61-75 years; mean group age = 58.4 years). The control group included 34 cases (23 males and 11 females; 4 patients aged 33-40 years, 16 patients aged 41-60 years, and 14 patients aged 61-75 years; mean group age = 56.8 years. The two groups were not significantly different in sex, age, their clinical and pathological stages of disease or operation mode. The two groups of patients were given similar treatments; however, patients in the treatment group were given the Fuzheng Huoxue anticancer prescription. In animal studies, SGC-7901 gastric cancers cells were inoculated into the backs of 30 nude mice under sterile conditions. After inoculation, the nude mice were randomly allocated to a control group, a traditional Chinese medicine group, and a chemotherapy group (n = 10 mice per group). The total weight of the 10 mice in each group was similar. Each nude mouse in the control group received 0.5 mL of saline solution each day. Mice in the traditional Chinese medicine group received 0.5 mL of the Fuzheng Huoxue anticancer prescription (containing 1.5 g crude drug) each day, while mice in the chemotherapy group were intraperitoneally injected with 1 mg of 5-Fu once a week for 8 wk.

RESULTS: Prior to treatment, the mean OKT8 percentage among gastric patients in the treatment group was 45.94% ± 8.45%, the mean OKT4/OKT8 ratio was 0.89 ± 0.19, the mean AT-III concentration was 29.9 ± 7.9 mg/dL, the mean Fa value was 50.4% ± 24.4%, and the mean β-TG concentration was 91.0 ± 25.9 ng/dL. Prior to treatment, the mean percentage of OKT8 cells among patients in the control group was 49.21% ± 6.60%, the OKT4/OKT8 ratio was 0.94 ± 0.20, the AT-III concentration was 32.3 ± 7.2 mg/dL, the mean Fa value was 57.3% ± 24.6%, and the mean β-TG concentration was 87.5 ± 34.2 ng/dL. After treatment, the mean OKT8 percentage among patients in the treatment group was 33.52% ± 7.80%, the mean OKT4/OKT8 ratio was 1.47 ± 0.51, the mean AT-III concentration was 38.8 ± 5.5 mg/dL, the mean Fa value was 102.6% ± 31.6%, and the mean β-TG concentration was 62.3 ± 15.1 ng/dL. After treatment, the mean OKT8 percentage among patients in the control group was 42.22% ± 7.07%, the mean OKT4/OKT8 ratio was 1.12 ± 0.24, the mean AT-III concentration was 30.9 ± 8.0 mg/dL, the mean Fa value was 64.6% ± 26.9%, and the mean β-TG concentration was 67.0 ± 42.1 ng/dL. These data indicate that after treatment, the immunologic function of the T lymphocytes of gastric cancer patients in the treatment group was significantly improved (P < 0.01). Additionally, the hypercoagulability in the treatment group was also improved (P < 0.001), and the mean OKT4/OKT8 ratio, antithrombin III (AT-III) concentration, and fibrinolytic activity, etc. had all beome normalized. The one-year (86%), 3-year (69%), and 5-year (40%) survival rates in the treatment group were all higher than those in the control group (P < 0.05). The mean tumor weights in the control, traditional medicine, and chemotherapy groups were 0.895 ± 0.289 g, 0.433 ± 0.177 g, and 0.357 ± 0.142 g, respectively. The tumor-inhibition rates in the traditional Chinese medicine group and chemotherapeutic group (51.6% and 60.1%, respectively) were significantly better than that in the control group (P < 0.001). The mean tumor weight in the traditional Chinese medicine group (24.68 ± 1.93 g) was significantly higher than that in both the treatment group (22.96 ± 1.87 g) and control group (22.47 ± 2.18 g).

CONCLUSION: The Fuzheng Huoxue anticancer prescription can not only replenish vital functions (Zhengqi), correct a hypercoagulatory state, improve immunologic function, and extend patient survival times, but may also directly inhibit gastric tumor growth without producing toxic side effects.

Ultrastructural observation of the gastric mucosa in chronic gastritis patients treated by traditional Chinese medicine

AIM

To demonstrate the relationship between the ultrastructural changes of the gastric mucosa and the syndrome differentiation in chronic gastritis.

METHODS

Sixteen chronic gastritis patients with Piweixuhan (PXG, the cold of insufficiency syndrome of the spleen and the stomach) and fifteen chronic gastritis patients with Ganweibuhe (GBG, incoordination syndrome of the liver and the stomach) were treated with Jianpiwenwei decoction (JWD, invigorating the spleen and warming the stomach) or Shuganhewei decoction (SHD, dispersing the stagnated Liver Qi and regulating the stomach), respectively for three months. Before and after treatment, a gastroscopy was performed and the gastric mucosa was collected from the lesser curvature of the antrum of each patient. The ultrasections were observed and photographed under the JEM-100C X electron microscope.

RESULTS

The common ultrastructural anomalies of the two types of chronic gastritis were the plasmacyte infiltration and the lesions of the mucosal epithelial cells, chief cells and antral mucous cells. There were obvious differences between the two types. In PXG, the predominant lesion of the chief cells was swelling of the mitochondria, while in GBG the rough endoplasmic reticulum was enlarged in the chief cells and the plasmacytes. After treatment, most cases of the ultrastructural lesions reverted to normal or improved.

CONCLUSION

There was a close relationship between the ultrastructural changes of gastric mucosa and the syndrome differentiation of chronic gastritis. JWD and SHD could significantly improve the ultrastructural lesions of the gastric mucosa.

Ultrastructural observation of liver tissue ablation induced by high-intensity focused ultrasound

AIM: To observe the ultrastructural changes of liver tissues on normal rabbit ablated by high-intensity focused ultrasound (HIFU).

METHODS: A single shot of 1.1 MHz focused ultrasound at an intensity of 500 W/cm² with 20-s duration of continuous exposure was applied intraoperatively in normal rabbit livers. Ultrastructural changes of the sonoablated lesion, as viewed by light and electron microscopy, were observed.

RESULTS: Liver cells at the center of the sonoablated lesion showed irreversible degeneration immediately after HIFU treatment; electron microscopy showed that although the liver cells appeared normal histologically, irregularly shaped cavities of about 0.3-0.5 μm in diameter were present in the cytoplasm.

CONCLUSION: Thermal damages may be the main mechanism of HIFU-induced ablation of liver tissues besides cavitation effect.

Significance of monoclonal antibody SC3A expression in gastric carcinoma and precancerous lesion

AIM: To study the significance of monoclonal antibody SC3A expression in gastric carcinoma and precancerous lesions.

METHODS: Immunohistochemical staining and mucin histochemical staining were performed on paraffin-embedded sections from gastric benign and malignant lesions from 101 patients.

RESULTS: SC3A positive rate was 80.3% (57/71) in lesions of gastric carcinoma. The expression of SC3A was not related to the classification, differentiation, metastasis and or survival rates. The positive rate of SC3A in cancers secreting acid mucin (90.2%) or sulphomucin (91.3%) was higher than that in cancers without acid mucin (20.0%) or sulphomucin (60.0%) (P < 0.01). The positive rate of sulphomucin was higher in cases of intestinal metaplasia with cancer (88.9%) than that of cases of intestinal metaplasia with a benign lesion (35.3%) (P < 0.01). Additionally, the positive rate of SC3A with sulphomucin in intestinal metaplasia (60.9%) was higher than that without sulphomucin (31.3%) (P < 0.05).

CONCLUSION: SC3A monoclonal antibody might be helpful in the diagnosis of gastric cancer and the discernment of histogenesis.

Characteristics of saliva secreted by patients with TCM-Piyinxu

AIM: To investigate various characteristics of saliva secreted by patients with TCM-Piyinxu (Spleen-yin deficiency).

METHODS: Twenty-five individuals with Piyinxu (15 males and 10 females; age range 26-70 years, mean age = 45 years) diagnosed based on criteria used in traditional Chinese medicine, were compared with 20 individuals with Shenyinxu (Kidney-yin deficiency) (11 males, 9 females; age range 35-75 years, mean age = 50) and 30 normal individuals (17 males, 13 females; age range 35-65 years, mean age = 49 years). After acid stimulation, the saliva flow in each group was measured, and the levels of amylase and protein in saliva were determined using an automatic biochemical analyzer. The resultant data were analyzed using the Kruskal-Wallis test and one-way factorial ANOVA test.

RESULTS: The flow rates of saliva and amylase in Piyinxu patients (0.27 ± 0.016 mL/min and 2134.13 ± 343.51 IU/min, respectively) were lower than those in normal subjects (0.46 ± 0.027 mL/min and 3501.63 ± 1099.63 IU/min, respectively, P < 0.01), but higher than those in the Shenyinxu group (0.13 ± 0.051 mL/min and 951.62 ± 383.17 IU/min, respectively, P < 0.01). The three groups showed no significant difference in their level of total salivary protein (Piyinxu group, 3.07 ± 0.60 g/L; Shenyinxu group, 3.01 ± 0.90 g/L, and control group, 2.94 ± 1.13 g/L, P = 0.869), amount of amylase per saliva volume, or their ratio of amylase to protein in secreted saliva (P = 0.173 and P = 0.436, respectively).

CONCLUSION: Piyinxu patients showed altered rates of saliva and amylase secretion when compared with those parameters in patients with Shenyinxu and normal subjects.

Cost-effectiveness study on treatment of duodenal ulcer

AIM: To compare the efficiency of therapy with a 2-week regimen of amoxicillin plus metronidazole and six weeks of Tagamet (AMT group) vs the efficacy of therapy with 6 wk of omeprazole plus 2 wk of amoxicillin (OA group) for ulcer healing, Helicobacter pylori (Hp) eradication, and decreasing the recurrence of duodenal ulcers.

METHODS: This cost-effectiveness analysis was based on results shown in a randomized controlled trial conducted in 1995 in patients with a duodenal ulcer (OA group, 46 patients; AMT group, 43 patients) and treated at class grade III A hospitals in Shanghai, China.

RESULTS: The costs of treatment in the AMT group were less than those in the OA group for ulcer healing (￥546.25 vs ￥1296.76 per case, P < 0.01), Hp eradication (￥702.32 vs ￥1742.53 per case, P < 0.01), and decreasing ulcer recurrence (￥640.39 vs 1424.54 per case, P < 0.01). Direct costs comprised the major cost involved in treatment of duodenal ulcers. The difference in the cost of treating ulcers in the two groups was primarily due to the costs of the different drugs. There was no significant difference between the two groups regarding their direct non-medical costs and indirect costs.

CONCLUSION: When based on therapeutic effectiveness and financial costs, AMT therapy was more cost-efficient than OA therapy. AMT therapy is recommended for its low cost, acceptable ulcer healing rates, ability to cure of an Hp infection, and especially when treating patients with an ulcer < 1 cm in diameter.

Hepatitis G virus infection in patients with chronic non-A–E hepatitis

AIM: To elucidate the role of hepatitis G virus (HGV) infection in chronic non-A–E hepatitis and sequence the partial NS5 genome of HGV isolated from the serum of a Chinese patient with chronic non-A–E hepatitis

METHODS: Serum samples of patients with chronic non-A–E hepatitis were collected and total nucleic acids were extracted and subjected to reverse transcriptase-nested-polymerase chain reaction (RT-nested-PCR) using primers from the putative NS5 region of HGV genome. Then, 994bp cDNA was prepared from the positive serum, purified with electrophoresis of polyacrylamide gels, and directly sequenced using the dideoxy-mediated chain-termination method.

RESULTS: HGV-RNA was detected in 1 of the 35 patients with chronic non-A–E hepatitis. Compared with the 2 HGV isolates (PNF2161 and R10291) obtained from American patients, the HGV NS5 gene of this Beijing isolate (HG-G) showed homology of 88.0% and 89.2% respectively. On the other hand, in comparison with the West African isolate (GBV-C), the Beijing isolate showed homology of 93.5%. The patient showed persistent increase of alanine transaminase, but normal levels were achieved after interferon therapy with persistent positive HGV RNA.

CONCLUSION: HGV is one of the causes of chronic non-A–E hepatitis, but it may not be a very important cause. The nucleotide sequence of partial NS5 gene of HG-G was found to be highly homologous to the West Africa isolate.

Effects of Linomide on growth and metastasis of implanted human gastric cancer in nude mice

AIM: To elucidate the effect of angiogenesis inhibitor, Linomide, on tumor growth and metastasis in nude mice implanted with human gastric cancer.

METHODS: A metastatic model of gastric cancer was established using orthotopic implantation of histologically intact tumor tissues into the gastric wall of nude mice. Linomide (0, 80, 160 mg·kg^-1) was given p.o. every day after the implantation, and the mice were sacrificed after 10 wk to detect tumor size and metastasis. The microvessel counts were measured by immunohistochemical staining using a monoclonal antibody against Human Factor VIII related antigen.

RESULTS: Linomide treatment significantly decreased the size of the implanted tumors (control group: 1.36 ± 0.81 cm³vs Linomide treated group: 0.84 ± 0.51 cm³ and 0.62 ± 0.35 cm³, P < 0.05 and 0.01, respectively). Additionally, an antimetastatic effect of Linomide was clearly demonstrated in a dose dependent manner: mice given 80 mg·kg^-1 Linomide developed liver metastasis in 4 of 10 cases, mice given 160 mg/kg developed metastasis in only 1 of 10 mice, while it developed in 19 of 28 mice of the control group (P < 0.05 and 0.01, respectively). The number of metastatic foci was also significantly less in the treated group. Furthermore, the microvessel counts in tumors of treated mice was reduced by 33%-42% as compared with the control tumors (P < 0.01).

CONCLUSION: Linomide has a strong inhibitory activity against in vivo tumor growth and metastasis of gastric cancer, effectively suppressing the growth of the primary tumor, preventing liver metastasis, and attenuating the rate of neovascularization.

Diagnostic value of occult fecal blood testing for colorectal cancer screening

AIM: To evaluate the diagnostic value of occult fecal blood testing in mass colorectal cancer screening.

METHODS: A reverse passive hemagglutination reaction fecal occult blood test (RPHA-FOBT) and colorectal cancer risk factor quantitative method were used as preliminary screening for colorectal cancer. A 60-cm fiber optic colonoscopy was used to validate the preliminary screen and was used to detect colorectal cancer in a community of 75813 subjects.

RESULTS: Compared to the 60-cm fiber optic colonoscopy as a standard reference, FOBT has a sensitivity of 41.9%, specificity of 95.8%, Youden′s index of 0.38, and positive predictive value of 0.68%. These results increased with subject age from the first detection. A 3-year follow up in the target mass showed that all new cases had initially been FOBT-negative.

CONCLUSION: The value of FOBT as an indicator of colorectal cancer in mass screening is limited.

The effects of Astragalus membranaceus on oxygen consumption in the intestine

AIM: To investigate the effects of Astragalus membranaceus (AM) on intestinal oxygen consumption both in vivo and in vitro.

METHODS: The oxygen consumption of the intestine was measured using an arteriovenous (A-V) O₂ difference analyzer after treatment with AM in the intestinal lumen of ten healthy, anesthetized mongrel dogs. The effects of AM on the oxygen consumption of the intestinal mucosa in vitro were observed using constant volume manometers.

RESULTS: The oxygen consumption of the intestine in vivo increased significantly (P < 0.05 or P < 0.01) after treatment with AM compared to the saline control. The oxygen consumption significantly increased after treatment with the 30% AM dilution and the 50% AM dilution compared to that of the 10% AM dilution (P < 0.05). There was no significant difference between the 30% AM dilution and the 50% AM dilution (P > 0.05). The effects of AM on oxygen consumption of the intestinal mucosa in vivo were similar to those in vivo. After treatment with the 5% AM dilution and the 1% AM dilution, the intestinal oxygen consumption increased compared to the control (Krebs Ringer phosphate buffer (KRPB)) (P < 0.05 and P < 0.01, respectively). There was no significant difference between treatment with the 10% AM dilution and the KRPB control (P > 0.05).

CONCLUSION: AM improved the function of intestinal oxidative metabolism.

Preliminary study on the loss of heterozygosity at 17p13 in gastric and colorectal cancers

AIM: To evaluate the role of p53 in the development and progression of colorectal cancer and gastric carcinoma by analyzing the loss of heterozygosity (LOH) at 17p13.1 and 17p13.3.

METHODS: LOH at the p53 gene locus and 17p13.3 were examined in 22 cases of gastric carcinoma and 14 cases of colorectal cancer by Southern blot analysis.

RESULTS: Of the 22 gastrocarcinoma cases, 12 (54%) were heterozygous and LOH was detected in 6 (50%) of the 12 informative cases. In the 14 colorectal cancer cases, 10 (71%) were heterozygous, and LOH was detected in 6 (60%) of the 10 informative cases.

CONCLUSION: LOH at the p53 gene locus is a frequent event in multiple step carcinogenesis progression. The high frequency of LOH at 17p13.3 suggests that there may be another tumor suppresser gene in that chromosome region.

Construction of retroviral vectors to induce a strong expression of human class interferon gene in human hepatocellular carcinoma cells in vitro

AIM: To establish the hepatoma cell–specific expression of human interferon (IFN) gene mediated by retroviral vectors

METHODS: Human interferon α and interferon β complementary DNA (IFN cDNA) were cloned into the polylinker site of pMNSM retroviral vector to construct recombinant retroviral vectors pMNSIFNA and pMNSIFNB, with the transcription of IFN gene being driven by Simian virus 40 early region promoter (SV40) early region promoter. IFN cDNAs were also cloned into pMNAIFNA, pAMNSIFNA, and pMNAIFNB, with the transcription of IFN gene being driven by SV40 early region promoter regulated by α-fetoprotein enhancer. Next, the retroviral constructs were introduced into retroviral amphotropic packaging cells using the lipofectamine-mediated gene transfer procedure. The rate of plasmid transfection was (4-40) × 10³ colonies/μg DNA/10⁶ PA317 cells. The rate of retrovirus infection was (5-500) × 10⁴ colony forming units (CFU)/mL. Further, the recombinant retroviruses were used to infect human hepatoma cells, renal carcinoma cells, and melanoma cell lines in the presence of 4 μmg/L polybrene.

RESULTS: Northern and Dot hybridization of total RNA from the neomycin-resistant colonies and IFN expression assay indicated that human α fetoprotein enhancer induced efficient and specific transcription and expression of IFN genes driven by the promoter of different origins in human hepatoma cells, leading to high production of α fetoprotein.

CONCLUSION: Cis active element of α-fetoprotein gene can drive specific expression of IFN genes in human hepatoma cells, which provides some valuable data for the hepatoma-specific immune gene therapy.

Expression of the c-erbB-2 proto-oncogene product in gastric carcinoma and precancerous lesions

AIM: To study the relationship between the expression of the c-erbB-2 proto-oncogene product with gastric mucosal carcinogenesis and the behavior of gastric carcinoma.

METHODS: Specimens from nine normal gastric mucosa, 23 gastric mucosal dysplasia (10 slight, six moderate, seven severe), 18 early gastric carcinoma, and 30 advanced gastric carcinoma were marked with P₁₈₅ monoclonal antibody using the immunohistochemical peroxidase-avidin-biotin complex method. The relation between P₁₈₅ expression with histological type, size, and lymph node metastasis of gastric carcinoma were analyzed.

RESULTS: Normal gastric mucosa was negative for P₁₈₅; Only a few cells in the neck region of the mucosal glands were very weakly positive. Relatively high positive rates were found in the slight, moderate, and severe dysplasia specimens (50%, 83.3%, and 85.7%, respectively). A 22.2% and 56.7% P₁₈₅-positive rate was found in early gastric carcinoma and in advanced gastric carcinoma, respectively. Statistically, the P₁₈₅-positive rates in severe dysplasia and advanced gastric carcinoma were significantly higher than that in early gastric carcinoma (P < 0.05). The P₁₈₅-positive rate in the group with lymph node metastasis was significantly higher than that of the group without lymph node metastasis (59.3% vs 23.8%, P < 0.05), but P₁₈₅ expression was not related to histological type and size of gastric carcinoma.

CONCLUSION: The c-erbB-2 proto-oncogene might participate in gastric mucosal proliferation, repair, and carcinogenesis, and gastric carcinoma with P₁₈₅ expression might have a stronger potential of infiltration and metastasis.

Preparation and application of monoclonal antibodies against hepatitis C virus nonstructural proteins

AIM: To prepare hybridoma cell lines that secrete monoclonal antibodies against hepatitis C virus (HCV) recombinant proteins NS3 and NS5 and to evaluate their use in the study of HCV NS3 and NS5 antigen distribution in human liver tissue.

METHODS: Hybridoma cell lines were generated using spleen cells from BALB/C mice immunized with recombinant NS3 and NS5 proteins, following conventional protocols. Antibody-secreting cells were screened by solid phase ELISA and cloned by limited dilution. The specificity of the monoclonal antibodies was determined by testing hybridoma culture supernatants by Western blots of E. coli expressing the recombinant HCV proteins and ELISA with HCV core and hepatitis B virus (HBV) antigens. The monoclonal antibodies were employed in immunohistochemistry studies to determine the distribution of HCV NS5 and NS3 antigens in 51 paraffin embedded human liver tissue samples.

RESULTS: Eight hybridoma cell lines secreting monoclonal antibodies against HCV NS3 and NS5 proteins were generated and named 2B6, 2F3, 3D8, 3D9, 8B2, 6F11, 4C6 and 7D9. Only one of them, 2B6 (secreting antibodies against NS3 protein), cross-reacted with the C7 polypeptide, a different recombinant NS3 polypeptide. The rest of the cell lines showed no cross-reactivity with HCV core or HBV antigens. In addition, monoclonal antibodies against NS3 antigens did not cross-react with NS5 antigens, and vice versa. In immunohistochemistry studies, these monoclonal antibodies did not detect HCV antigens in specimens from patients infected only with HBV (n = 20). In HCV-infected specimens (n = 31), the rates of positive detection of NS3 and NS5 antigens were 51.6% (16/31) and 54.9% (17/31), respectively. Six of these 31 specimens were from patients infected only with HCV and half of them were positive for HCV NS3 and NS5 antigens. In specimens from patients co-infected with HBV and HCV (n = 25), the rates of NS3 and NS5 antigen positive detection were 52% (13/25) and 56% (14/25), respectively, which are similar to those obtained in samples from patients infected only with HCV. In specimens from chronic active cirrhosis patients, the rates of HCV NS3 and NS5 antigen detection were 70.6% (12/17) and 76.5% (13/17), respectively.

CONCLUSION: We successfully prepared monoclonal antibodies that are specific against recombinant HCV NS3 and NS5 proteins and could be useful for clinical immunohistochemistry diagnosis.

Changes in p53 and Waf1p21 expression and cell proliferation in esophageal carcinogenesis

AIM: To study the correlation between changes in p53 and Waf1p21 expression and cell proliferation, determined by proliferating cell nuclear antigen (PCNA), at different stages of human esophageal carcinogenesis.

METHODS: Biopsied and resected esophageal tissues from a high risk population of esophageal cancer in northern China were used in this study. All specimens were fixed in 85% alcohol and processed for routine histology. The avidin biotin peroxidase complex (ABC) method was used to detect p53, Waf1p21 and PCNA.

RESULTS: Strong nuclear staining of p53, Waf1p21 and PCNA was observed in normal esophageal epithelium and epithelia with different lesion severities. As the lesions progressed to dysplasia (DYS) and to esophageal squamous cell carcinoma (SCC), the Waf1p21 immunoreactivity percentage decreased. The number of Waf1p21-positive cells slightly increased from normal to basal cell hyperplasia (BCH), but did not further increase in DYS and SCC. The total number of Waf1p21-positive cells was lower than the number of p53-positive cells in normal and BCH esophageal epithelia and much lower in DYS and SCC. Waf1p21-positive cells were located in the third and fourth cell layers in half of the samples examined, which was 2-4 cell layers higher than the cells expressing PCNA and p53 in the same histological categories of normal, BCH and DYS.

CONCLUSION: Low Waf1p21 levels at the DYS stage may be related to a functional loss of p53. Other mechanisms may also be responsible for the decreased Waf1p21 expression in DYS and SCC.

Relationship between loss of heterozygosity of deleted in colorectal carcinoma gene microsatellites and prognosis of colorectal adenocarcinoma

AIM: To investigate the relationship between the loss of heterozygosity (LOH) of microsatellites on the deleted in colorectal carcinoma (DCC) gene and prognosis of colorectal adenocarcinoma.

METHODS: A retrospective study of 58 colorectal adenocarcinoma cases with follow-up data and paired control normal mucosal tissues from 1983 to 1985 from files from the West China University of Medical Sciences Department of Pathology was carried out by PCR microsatellite analysis. Sixteen, 35, and seven cases had well-, moderately, and poorly differentiated tumors, respectively; 11, 30, and 17 cases were staged as Dukes’ A, B, and C, respectively.

RESULTS: LOH of DCC microsatellites was detected in 18 cases (31.0%). The 5-year survival rate between LOH-positive and LOH-negative patients was 44.4% and 77.5%, respectively (P < 0.05). The results suggest that LOH of DCC microsatellites correlate with prognosis but not with differentiation (P > 0.05) and Dukes’ stage (P > 0.05) in colorectal adenocarcinoma.

CONCLUSION: LOH of DCC microsatellites may be a marker of malignancy. Combined with the traditional prognostic indicators, LOH can predict prognosis of colorectal adenocarcinoma.

Effect of remedies for enhancing resistance and relieving blood stasis on metastasis in postoperative gastric cancer and ornithine decarboxylase levels

AIM: To study the action of remedies for enhancing resistance and relieving blood stasis on metastasis in postoperative gastric cancer and its influence on ornithine decarboxylase (ODC).

METHODS: Sixty-three postoperative patients with gastric cancer were randomly divided into two groups. Thirty-one patients were treated with western medicine consisting of the FAP (5-fluorouracil, adriamycin, cisplatin) and CODP regimens (cyclophosphamide, vincristine, daunorubicin, prednisone), whereas 32 patients were treated with the FAP regimen and traditional Chinese medicine. Correlations were made between the ODC levels detected before and after treatment and other factors such as tumor diameter, infiltration depth, histological type, and lymph node metastasis.

RESULTS: The ODC levels in the gastric cancer tissue and adjacent normal gastric mucosal tissue were significantly higher in the patients than in the controls. There was an obvious correlation between increased ODC and tumor size, infiltration depth, degree of differentiation, and lymph node metastasis. Six months later, there were no significant changes in the ODC levels of the group using only Western medicine, while the ODC levels decreased markedly in the group using combined Western and traditional Chinese medicine (P < 0.01).

CONCLUSION: The effects of traditional Chinese medicine remedies on metastases in postoperative gastric cancer are related to the reduction of ODC activity.

Effect of octreotide on cell-cycle kinetics and serum carcinoembryonic antigen level in hepatic metastases of colonic adenocarcinoma

AIM: To study the inhibitory effect of somatostatin analogue (octreotide) on tumor growth.

METHODS: The influence of cell-cycle kinetics on hepatic metastases of BALB/c mice colonic adenocarcinoma (CT26) with octreotide treatment in vivo was investigated by flow cytometry. The serum carcinoembryonic antigen (CEA) levels were also determined.

RESULTS: The results showed that the proliferative index (PI) and the S-phase fraction in hepatic tumors of mice treated with octreotide decreased markedly and that the G₀/G₁ serum CEA phase fraction increased significantly in comparison with the control (P < 0.01). After administration of octreotide, the serum CEA levels were also lower than those in the control group. The incidence of liver metastases in the treated group was lower than that in the control. The body weight loss in the mice was slower and survival was longer in the treated group than in the control group. Furthermore, the changes in PI and the fraction distribution of S-phase or G₀/G_1-phase in cell cycle were closely related to the serum CEA levels.

CONCLUSION: Octreotide may be useful for inhibiting the hepatic metastases of colonic carcinoma.

Protective effect of vitamin E on age-related alterations of Kupffer cell energy metabolism

AIM: To investigate the mechanism of age-related reduction of Kupffer cell (KC) phagocytic capacity and the protective management.

METHODS: Using rhodamine 123 fluorescence density and rate of glucose utilization as parameters, we measured the mitochondrial energy metabolism status in vitro and the glucose utilization capacity of isolated rat liver Kupffer cells (KCs) from rats of various ages (6 mo, 12 mo, 18 mo and 24 mo) and the effect of vitamin E (VE) pretreatment (500 mg/kg/wk × 13 wk).

RESULTS: The rate of KC glucose utilization and the rhodamine fluorescence density of KC mitochondria of 18 mo-old untreated rats (NVEG) were significantly lower than that of 6 mo-old NVEG by 19.3% (4.0 nmol·h ± 0.4 nmol·h^-1 10.6 cells^-1vs 5.7 nmol·h ± 0.6 nmol·h^-1 10⁶ cells^-1, P < 0.05) and 19.5% (80.5 ± 6.3 vs 100.0 ± 4.7, P < 0.01) respectively; Rate of KC glucose utilization and the rhodamine fluorescence density of KC mitochondria of 6 mo-old rats were also lower than the 24 mo-old NVEG by 35.1% (3.7 nmol·h ± 0.6 nmol·h^-110⁶ cells^-1vs 5.7 nmol·h ± 0.6 nmol·h^-1 10⁶ cells^-1, P < 0.01) and 32.1% (67.9 ± 7.4 vs 100.0 ± 4.7, P < 0.01) respectively. The two parameters of 18 mo-old VE pretreated rats (VEG) were significantly higher than those of 18 mo-old NVEG, and statistically comparable to those of 6 mo-old VEG. The two parameters of the 24 mo-old VEG were significantly higher in comparison with those of 24 mo-old NVEG, but still significantly lower than those of 6 mo-old VEG.

CONCLUSION: Aging has a significantly negative effect on KC energy metabolism, which can be alleviated by VE pretreatment.

Ultrastructural cytochemical study of enzymes expressed by signet ring cells in gastric cancer

AIM: To study the ultrastructural localization of five marker enzymes (ALPase, ACPase, G6Pase, TPPase and CCOase) in gastric cancer signet ring cells to demonstrate their biologic behaviors.

METHODS: Five marker enzymes were examined in signet ring cells of seven gastric cancer patients by ultrastructural enzyme cytochemical techniques.

RESULTS: The number of corresponding organelles and the activities of marker enzymes, especially ACPase and TPPase, increased, leading to stronger mucus synthesis, secretion and digestion in gastric cancer signet ring cells. There was a lack of collagenous fibers in the stroma around the cancer nests.

CONCLUSION: Signet ring cell carcinoma is very invasive with metastasis rates due to the secretion of proteolytic enzymes.

Clinical significance of PCR in Helicobacter pylori DNA detection in human gastric disorders

AIM: To investigate the clinical significance of the PCR assay in the diagnosis of gastric Helicobacter pylori (Hp) infection.

METHODS: Hp infection in gastric antral biopsied specimens was identified by using the polymerase chain reaction (PCR) to amplify the specific Hp urease gene fragments (PCR-Hp-DNA) in 154 patients with gastrointestinal disorders. Hp urease gene oligonucleotide primers specific for Hp (16s rRNA) were used. Urease test and enzyme-linked immunosorbent assay (ELISA) for anti Hp-IgG serum were also used as controls.

RESULTS: PCR-Hp-DNA was detected in 140 (91%) of the 154 patients, where patients 114 and 125 were found infected with Hp by urease test and ELISA Hp IgG, respectively. There was a marked difference in the Hp-positive rate between the PCR-Hp-DNA and the urease test or ELISA-Hp-IgG (P < 0.05). The Hp infection rate increased with age, although a minority of infected people developed signs and symptoms of gastric disorders. Hp infection is closely related to adenocarcinoma in both the gastric antrum as well as the down body of the stomach.

CONCLUSION: PCR is a sensitive and specific method for the detection of Hp in human gastric tissues. Detection of Hp DNA in vivo using this approach might improve the clinical diagnosis and epidemiological research related to H. pylori infection.

Effect of amygdalin on proliferation of rat hepatic fat-storing cells and collagen production in vitro

AIM: To study the anti-fibrotic mechanism of amygdalin, a component of Semen Persicae, on fat-storing cells (FSC).

METHODS: Livers of normal adult rats were perfused with Pronas E and collagenase in situ. FSC were isolated by centrifugation with 11% Metrizamide. The subcultured FSC were incubated with 10^-4-10^-8 mol/L amygdalin for 72 h, and then FSC proliferation and collagen production were assayed, respectively.

RESULTS: Low doses of amygdalin reduced incorporation of L-[³H]-thymidine into FSC and L-[5-³H]-proline into secreted collagenase-sensitive proteins and cell layer-associated collagenase-sensitive proteins. the strongest effects were seen for the 10^-8 mol/L dose of amygdalin, which inhibited the proliferation of FSC by 25.0%, and decreased collagen production in medium and cell layer by 24.2% and 26.8%, respectively.

CONCLUSION: An anti-fibrotic mechanism of amygdalin is to inhibit the proliferation and collagen production of active FSC.

Characteristics of DNA repair induced by DNA polymerase β in hepatoma cells after γ-ray irradiation

AIM: To investigate the effects of DNA repair induced by DNA polymerase β in hepatoma cells after γ-ray irradiation.

METHODS: Cell nuclei were prepared from mouse model (SMMC LTNM), in which human hepatoma cells are transplanted on nude mice. The nuclei were then irradiated with ⁶⁰Co-γ rays at different dose levels or dose rates. A selective inhibitor test was then used to detect the effects of the radiation on DNA repair using N-ethylmaleimide (NEM) and ddTTP as selective inhibitors to DNA polymerases γ and β respectively.

RESULTS: ³H-TTP incorporation into irradiated nuclei or calf thymus DNA was significantly higher than that the rate at which it is incorporated into non-irradiated nuclei when either DNA polymerase β or γ was inhibited. When both NEM and ddTTP are present, the ³H-TTP incorporation in irradiated DNA was not significantly different from the non-irradiated nuclei. Furthermore, ³H-TTP incorporation into DNA of SMMC-LTNM hepatoma nuclei was higher than that of normal hepatocyte nuclei (P < 0.01). This suggests that DNA repair induced by DNA polymerase β was more active in hepatoma cell nuclei than in normal hepatocyte nuclei.

CONCLUSION: DNA polymerase β may be more responsive to DNA damage in some tumor cells than that in normal cells, which may facilitate the cells to repair DNA damages from radiation more efficiently.

Inflammatory bowel disease in the Hubei Province of China

AIM: To analyze clinical features and response to treatment in inflammatory bowel disease (IBD) patients from the Hubei Province of China.

METHODS: Clinical data was collected retrospectively from 74 patients with IBD [66 with ulcerative colitis (UC) and 8 with Crohn’s disease (CD)] admitted to The Second Hospital, Hubei Medical University from 1986 to 1995.

RESULTS: The most common symptoms in IBD patients were abdominal pain, diarrhea, blood and mucus in stool, and constipation. Extraintestinal manifestations of IBD were not common. In these patients, inflammation was predominantly located in the sigmoid and left colon in UC cases, and in the ileum and colon in CD cases. Treatment with sulphasalazine and corticosteroids was effective in 95% of UC cases; However, about 42% of UC patients showed disease recurrence during the follow-up period of 1.11 years. Five out of eight CD patients had part of their intestine removed, whereas three were treated with anti-tuberculosis drugs or the antibiotic metronidazole. Out of four patients we followed up for 1-8 years, one died of severe complications after surgery, two experienced recurrence while in treatment with drugs, and one remained in remission under sulphasalazine treatment after surgery.

CONCLUSION: Five percent of the patients reported a family history of IBD. About 34% of the patients were smokers and 32% of the patients were alcoholic. Epidemiological studies are urgently needed in the Hubei Province of China to assess the role that genetics and environmental factors play in the pathogenesis of inflammatory bowel diseases.

Radiotherapy of 180 cases of operable esophageal carcinoma

AIM: To compare the validity of radiotherapy and surgery for operable esophageal carcinoma in 180 patients with pathologically proven esophageal carcinoma who had been accepted for surgery, but for various reasons were given radical radiation therapy instead.

METHODS: The reasons for abandoning surgery were poor cardiac function (n = 21), poor pulmonary function (n = 36), poor general condition (n = 9), senility (age 69-81 years, n = 32), and refusal by the patient (n = 82). They were treated by the isocenter technique alone or anteroposterior plus isocenter irradiation at a total dose of 50-70 Gy/5-7 wk.

RESULTS: The 1-, 3-, and 5-year survival rates were 64%, 34%, and 23%, respectively. The 3- and 5-year survival rates showed that lesions in the upper third esophagus responded better than lesions in the middle and lower third (P < 0.05). The 5-year survival rate following radiation alone (44.5%) of upper third lesions was slightly better than that following surgery. The effect on lesions following radiation to middle third lesions was slightly inferior to that of surgery, and that for lower third lesions was even poorer.

CONCLUSION: The results from radiation treatment alone for operable esophageal carcinoma are similar to that of surgery.

Exploration of the immunoreactivity of the Traditional Chinese medicine Shenrouyangzhentang to vasoactive intestinal polypeptide

AIM: To study the immunoreactivity of the Chinese medicine Shenrouyangzhentang to vasoactive intestinal polypeptide (VIP) and its therapeutic mechanism.

METHODS: The immunoreactivity of the Chinese medicine Shenrouyangzhentang to VIP was detected in the plasma of 20 normal people and 20 patients with Piyinxu (Spleen Yin deficiency) using the radioimmunoassay (RIA) method.

RESULTS: The maximum binding rate B₀/T was 53.29%, the non-specific binding rate N₀/T was 1.170%, and the VIP standard curve was Y = 0.81983 + 0.44319X - 0.28927X², R² = 0.990. The VIP content in Shenrouyangzhentang was 106.6 ng/L ± 20 ng/L), while it was 90.16 ng/L ± 15 ng/L in normal human plasma and 63.25 ng/L ± 11 ng/L in the plasma of Pixinxu patients. The difference between normal plasma and Pixinxu patient plasma was statistically significant (P < 0.05).

CONCLUSION: The Chinese medicine Shenrouyangzhentang demonstrated VIP immunoreactivity similar to that of normal plasma. The (vasoactive intestinal polypeptide) VIP content in Pixinxu patient plasma was lower than that in healthy subjects (P < 0.05).

A prospective study of vertical transmission of hepatitis C virus

AIM: To prospectively study the mechanism of mother to infant transmission of hepatitis C virus (HCV).

METHODS: Using a nested PCR for detection of HCV RNA and the second generation ELISA for detection of anti-HCV, 13 pregnant women who suffered from post transfusion hepatitis C (PT-HCV) and their 15 babies were studied to evaluate mother to infant transmission of HCV.

RESULTS: The total infection rate of HCV was 86.7% in the babies, including one case of clinical HCV (7.7%), three subclinical cases of HCV (23.1%), and nine inapparent cases of HCV (69.2%). The positive rates of anti-HCV and HCV RNA declined with the age of the babies, to 7.7% for anti-HCV and 15.4% for HCV RNA at the age of three years.

CONCLUSION: Babies born to mothers infected with HCV were vertically infected with HCV at a high rate, but the consequences were not serious. Four fetuses born, born through induced labor to mothers positive for anti-HCV and HCV, were all infected by HCV, suggesting that the mother to infant transmission of HCV mainly occurred in the uterus.

Study on clinical pathology and immunohistochemistry of chronic erosive gastritis

AIM: To study the clinical pathology of chronic erosive gastritis (CEG) and determine the expression of epithelial tumor markers, oncoprotein p21 and carcinoembryonic antigen (CEA), and G cells by immunohistochemistry.

METHODS: Gastric mucosal biopsies from 40 CEG cases were examined. Histopathology and Helicobacter pylori (Hp) infection were determined by light microscopy. Thirty-one biopsies from CEG cases were immunostained with antibodies against p21, CEA, proliferation cell nuclear antigen (PCNA), and gastrin using the labeled streptavidin-biotin (LSAB) method.

RESULTS: A total of 35/40 (87.5%) CEG lesions showed antral location; 75% of the lesions were associated with different degrees of atrophic change. Twenty percent presented with mild and moderate atypia of mucosal epithelia and 27.5% showed intestinal metaplasia. Acute inflammatory changes were observed in 25% of the cases. Hp was identified in 40.0% of the specimens. Immunohistochemistry studies showed that 67.7% of the CEG mucosal epithelial samples expressed oncoprotein p21 and 29.0% expressed CEA, rates significantly higher than those observed in control samples from a chronic superficial gastritis group. However, PCNA and gastrin expression in mucosal G cells was not significantly different between CEG samples and samples from the control group (P > 0.05).

CONCLUSION: CEG is a chronic gastric mucosal proliferative lesion that expresses higher levels of p21 and CEA than control samples. Our observations suggest that antral location of the lesion and Hp infection do not participate in the pathological process of CEG.

Expression of insulin-like growth factor II and its receptor in liver cells from patients with chronic liver diseases

AIM: To study the relationship between insulin-like growth factor II (IGF-II), IGF-II receptor, and chronic liver diseases and to investigate the clinical mechanisms of human hepatocellular carcinoma (HCC) development.

METHODS: We analyzed IGF-II and IGF-II receptor poly (A)+ mRNA in dysplasia liver cell (DLC; n = 10), liver cirrhosis (LC; n = 9), and chronic active hepatitis (CAH; n = 9) specimens by Northern blot using human IGF-II and IGF-II receptor DNA probes labeled with ³²P through nick translation.

RESULTS: Expression of IGF-II in DLC samples (10/10, 100%) was higher than in CAH (3/9, 33%) and LC samples (3/9, 33%) (P < 0.01). Expression of IGF-II receptor in DLC samples (7/10, 70%) was significantly higher than in CAH (2/9, 22%) and LC samples (3/9, 33%). Data on hepatitis B virus (HBV) infection status from different chronic liver disease samples were also analyzed.

CONCLUSION: Overexpression of IGF-II and IGF-II receptor in DLC samples was associated with a preceding step to malignant phenotype hepatocyte transformation and may be of diagnostic value for early detection of hepatocellular carcinoma (HCC). Persistent HBV infection was strongly associated with abnormal IGF-II and IGF-II receptor mRNA expression, suggesting that an autocrine or paracrine mechanism is involved in the regulation of growth in liver cell carcinogenesis.

Effect of faeces trogopterorum extract B1 on the experimental gastric ulcer and gastric secretion in rats

AIM: To study the effects of extracts B1, B2, and B3 from faeces trogopterorum on the experimental gastric ulcer in rats.

METHODS: Two different animal models of gastric ulcers were used in this experiment: Shay's model (n = 72) and the reserpine-induced ulcer model (n = 76). The total volume and the pH of the gastric juices were recorded. The lesion scores of gastric mucosa were also recorded.

RESULTS: The lesion scores of gastric mucosa in the Shay’s model of animals in the WLZ-B₁ groups treated with either 40 g/kg or 80 g/kg were 8.6 ± 10.8 and 1.6 ± 1.9 respectively, which were lower than that of the 0.9% NaCl control group (47.0 ± 31.4, P < 0.05, P < 0.01). The lesion scores for the 80 g/kg group was lower compared to those of the Ran group (20.5 ± 16.4, P < 0.01). The pH of the gastric juices of the 80 g/kg group (3.425 ± 0.143) was higher than that of the 0.9% NaCl group (2.836 ± 0.632, P < 0.05). In the reserpine model, the lesion score of the 40 g/kg group of the WLZ-B₁ (20.7 ± 16.5) was also lower than that of the 0.9% NaCl control group (76.3 ± 50.6, P < 0.05).

CONCLUSION: B₁ is the most effective of the three sections in inhibiting gastric secretion, protecting gastric mucosa and preventing experimental ulceration.

Pathogenetic effects of salted pork in an area of China with high-risk for stomach cancer

AIM: To study the pathogenetic effects of salted pork (SP) (a special food in Zhuanghe City, a region of northern China that is a high-risk area for stomach cancer) on stomach cancer, and a provide scientific basis for the primary prevention of stomach cancer in this high-risk region.

METHODS: This study consisted of three distinct parts. The first part involved a study of SP mutagenicity and employed both the Ames test and micronuclei assay using V₇₉ cells. The second part included a study of SP’s effect on the gastric mucosa of residents in the Zhuanghe area who had consumed SP for more than ten years. Additionally, these studies involved an analysis of the dose effect relationship between SP and pathological changes in gastric mucosa, with a total of 300 cases analyzed. The third part of this study involved an observation of the mucosal lesions from experimental dogs by both gastroscopy and mucosal biopsy. Six healthy male dogs were selected, three were fed with SP, and the others served as controls.

RESULTS: This study revealed that SP extract could mutate Salmonella typhimurium TA₉₈ and induce an increase in both the micro nuclei rate (MNR) and micro nuclei cell rate (MNCR) of V₇₉ at a dose range of 20-80 μL/mL. There were significant dose-effect relations between SP and either MNR or MNCR. Pathological changes in the gastric mucosa of local residents who had consumed SP were significantly different from those of the control group. In people who had consumed SP for ten years, mucosal lesions were found that contained evidence of necrosis and erosion; In those who consumed SP for ten-20 years, both hyperplasia and dysplasia were seen in addition to the above lesions. In individuals who had consumed SP for 20-30 years, severe dysplasia and malignant changes were found. Furthermore, SP had damaging effect on the gastric mucosa of dogs that were fed SP. The mucosal lesions became more severe with increased feeding time.

CONCLUSION: SP is a strong mutagen and long-term SP exposure may result in repeated gastric mucosal damage and repair, ultimately leading to severe dysplasia and malignancy.

Histopathology and immunohistochemistry of large hepatocellular carcinoma with undetectable or low serum levels of alpha-fetoprotein

AIM: To explore the pathomorphological characteristics of large hepatocellular carcinoma (LHCC) with low serum alpha-fetoprotein (AFP) level.

METHODS: Specimens obtained from surgically resected LHCC with undetectable or low levels of serum AFP were fixed in formalin, embedded in paraffin, and prepared as serial sections. Routine hematoxylin and eosin as well as immunohistochemical stains (LSAB method) were used to test for expression of AFP, alpha-1-antitrypsin, epithelial membrane antigen, and vimentin. Some characteristics of the histopathological changes and immunohistochemical reactions of the cancerous tissues were observed under the light microscope.

RESULTS: The majority of the cases (19/30) of LHCC with undetectable or low levels of serum AFP were of the clear-cell-type HCC, with 2 being positive for AFP expression at the periphery of the cytoplasm.

CONCLUSION: The clear cell is the morphological manifestation of disturbance in glycogen and/or lipid metabolism of hepatoma cells. Such changes might be one of the factors hindering the synthesis of AFP and resulting in negative or low level serum AFP of the patient.

Recovery of allografted small intestine function

AIM: To investigate recovery of the allografted small intestine function after clinical small bowel transplantation (SBT).

METHODS: The structure of the graft was evaluated by endoscopic biopsy and histopathologic examination. Graft functions were assessed by D-xylose absorption, barium studies, nitrogen balance calculation, and blood and stool cultures. Nutritional status of the recipients was judged by measurement of body weight and serum protein concentrations.

RESULTS: The recipient discontinued total parenteral nutrition (TPN) and resumed oral nutrition 100 d after SBT. On oral diet, the patient maintained a normal nutritional status, gained weight by 3 kg, and had a normal serum albumin concentration (40.2 g/L ± 0.2 g/L). Satisfactory D-xylose absorption was achieved 8 wk after the operation. Nitrogen balance of the gut was maintained well and increased gradually. Serial mucosal biopsy showed normal structures 2 wk after grafting, without evidence of rejection and graft versus host diseases (GVHD). Barium studies conducted on the 10^th day and 38^th day by barium studies revealed that the grafted small bowel motility showed normal patterns of peristalsis and transit. No bacterial translocations were noted.

CONCLUSION: Function of the grafted small intestine recovered satisfactorily 100 d after transplantation, indicating good clinical outcome of SBT.

Protective effect of rhubarb on the intestinal mucosal barrier

AIM: To investigate the mechanism of rhubarb protection of the gut barrier.

METHODS: The gut barrier damage models caused by hemorrhagic shock and intraperitoneal endotoxin were used to study the protective effect of rhubarb on the intestinal mucosal barrier. Rats were randomly divided into four groups, as follows: treatment (rhubarb) group; Positive control group; Negative control group; Placebo treatment group. Plasma endotoxin, tissue superoxidedismutase (SOD) and lipoperoxide (LPO) concentrations were measured and histological analysis was performed. Rhubarb was observed to have a protective effect on the gut.

RESULTS: Rhubarb decreased intestinal permeability, attenuated endotoxin absorption (endotoxin serum levels: shock group 0.557 EU/mL ± 0.069 EU/mL vs rhubarb group 0.345 EU/mL ± 0.055 EU/mL), and decreased tissue SOD and tissue LPO levels (SOD serum, intestine and liver levels: endotoxin group 122.92 NU/mL ± 43.19 NU/mL, 292.24 NU/mL ± 88.76 NU/mL, 272.70 NU/mL ± 85.79 NU/mL vs rhubarb group 312.23 NU/mL ± 54.93 NU/mL, 391.09 NU/mg ± 98.16 NU/mg, 542.86 NU/mg ± 119.93 NU/mg; LPO content in the intestine and liver: endotoxin group 8.57 μmol/L ± 2.58 μmol/L, 86.97 μmol/L ± 46.54 μmol/L vs rhubarb group 3.05 μmol/L ± 1.13 μmol/L, 13.18 μmol/L ± 19.64 μmol/L). Gut histopathology revealed that rhubarb promoted goblet cell proliferation, increased mucus secretion and protected intestinal mucosa in the hemorrhagic shock model.

CONCLUSION: Rhubarb may protect the gut barrier by decreasing intestinal permeability, scavenging oxygen free radicals, and promoting goblet cell proliferation within the intestinal mucosa.

Expression and analysis of McAbs antigen against human hepatocellular carcinoma

AIM: To analyze the cause of tumor antigen heterogeneity and solve the problem of targeting diagnosis and therapy.

METHODS: Using flow cytometry, the expression of McAbs antigen against human hepatocellular carcinoma (HAb18, E₅, F₁₁ and HAb27) was investigated. Analyses of the antigen sites were made quantitatively on the human hepatoma cell lines (SMMC-7721; QGY-7701; BEL-7402; HHCC and 9204). In particular, expression of human hepatoma, its association with antigen HAg18, and its relation s with cell cycle in four human hepatoma cell lines using the methods of indirect immunofluorescence and dual-parameter DNA dyeing were studied.

RESULTS: The corresponding antigen of McAbs HAb18, HAb27, E₅ were expressed on the five hepatoma cell lines and F₁ was expressed only on the 7721 and 7701 hepatoma cell lines, but their mean fluorescence intensity showed different values on each cell line. HAb18 and HAb27 showed a relatively high level of expression, while E₅ and F₁₁ showed a lower level of expression. The value of AI (additivity index) was 136% for HAb18 and E₅, 108% for HAb18 and HAb27, and 118.6% for E₅ and H27As AI < 30% shows that both antibodies sites are the same, AI > 40% shows that both anti bodies sites are different, so the HAb18, HAb27 or E₅ McAbs were combined in pairs, showing that their antigen sites were different. Furthermore, HAg18 antigen was expressed very highly and the positive rate of HAg18 was 100% in all the four human hepatoma cell lines. The was a mean intensity fluorescence was 8.237 ± 1.168 for SMMC-7721; 5.627 ± 1.678 for QGY-7701; 4.378 ± 1.525 for BEL-7402 is 4.378 ± 1.525 and 7.38 ± 1.919 for HHCC. However, in the normal human liver cell (QZG), HAg18 antigen showed low expression (0.534 ± 0.018) and its positive rate was only 9%. The relationship between human hepatoma associated antigen HAb18 and the cell cycle was expressed at the lowest level in G₀-G₁ stages, a higher level in S stage and the highest level in G₂-M stage.

CONCLUSION: Analysis of the anti-hepatoma McAbs corresponding to antigen may provide the basis for targeted diagnosis and therapy. The expression heterogeneity of human hepatoma-associated antigen HAg18 is related to the stage of cell cycle in the same cell lines, but not related to the stage of cell cycle in different cell lines.

Fos expression in catecholaminergic medullary neurons induced by chemical stimulation of stomach projecting to the paraventricular nucleus of the hypothalamus in rats

AIM: To determine whether medullary catecholaminergic neurons expressing Fos induced by chemical stimulation of the stomach project to the paraventricular nucleus of hypothalamus (PVH) in rats.

METHODS: Horseradish peroxidase (HRP) was introduced stereotaxically into the PVH of rats. Histochemical analysis of coronal sections through the medulla were analyzed using triple-label immunohistochemistry to identify cells that were retrogradely labeled with HRP, Fos (ABC method), and tyrosin hydroxylase (TH) (PAP method).

RESULTS: Seven kinds of labeled neurons were found in the nucleus tractus solitarii (NTS), the ventrolateral medulla (VLM) and the reticular formation (RF) of the medulla: Fos-like immunoreactive (FosLI) neurons, TH-like immunoreactive (TH-LI) neurons and HRP retrogradely single-labeled neurons, FosLI/HRP, FosLI/TH-LI and HRP/TH-LI double-labeled neurons, and FosLI/HRP/TH-LI triple-labeled neurons.

CONCLUSION: Ascending projections from the NTS, VLM and RF to the PVH might be involved in the transmitting process of visceral noxious stimulation.

Evaluation of preoperative staging in advanced gastric cancer with MRI

AIM: To evaluate the application of magnetic resonance imaging (MRI) to the preoperative staging of advanced gastric cancer.

METHODS: An MRI (SE sequence) was preoperatively performed on 34 patients with advanced gastric cancer. The tumors were located at the cardia fundus in 11 patients, the corpus in 14, the antrum in ten and throughout the entire stomach in two. The images were analyzed and staged on the basis of the criteria proposed by Matsushita M. The results were compared with the corresponding histopathologic findings to analyze the rate of diagnostic accordance.

RESULTS: The diagnostic rate accuracy by MRI was 77.8% (seven out of nince) for T₂ tumors; 77.3% (17 out of 22) for T₃ tumors and 100% (three out of three) for T₄ tumors, with the overall accuracy equaling 79.4%. When grades T₃ and T₄ tumors were considered as a single group to determine the presence or absence of extraserosal invasion using MRI technology, the diagnostic accuracy was 88.3%. Statistically, MRI staging showed a significant correlation with the corresponding histopathologic staging using the Spearman correlation test (r_s′ = 0.743, P < 0.01). When the concordance between MRI and histopathologic staging results were studied according to tumor location, the staging accuracy was highest (90.9%) in tumors located in gastric cardia fundus.

CONCLUSION: MR imaging is moderately valuable when staging advanced gastric cancer, especially for tumors located in gastric cardia fundus.

Hepatic arterial infusion chemotherapy and embolization in the treatment of primary hepatic carcinoma

AIM: To study the effects of hepatic arterial infusion chemotherapy (HAI) or embolization (HAE) in the treatment of primary hepatic carcinoma (PHC) and the factors influencing these effects.

METHODS: A retrospective analysis of 188 patients (166 males and 22 females) with PHC treated with HAI (n = 82) or HAE (n = 106) was conducted.

RESULTS: In the group as a whole, the percentage of patients experiencing therapeutic outcomes was as follows: Symptomatic relief (59.6%); Tumor shrinkage (55%); A decrease in blood alpha fetoprotein (AFP) (37.8%) and overall survival rates at 0.5, 1.0, 2.0, and 3.0 years of 75.4%, 46%, 23.5% and 14.7%, respectively. The mean survival time in the entire group was 12.2 mo, and the longest survival period was 50 mo. In the HAI group the survival rates at 0.5, 1.0. 2.0 and 3.0 years of follow-up were 61.0%, 25.4%, 4.5% and 0%, respectively, with a mean survival time of 7.7 mo. In the HAE group the corresponding survival rates were 86.8%, 61.7%, 37.8% and 26.1%, respectively, with a mean survival time of 15.7 mo. Eighteen patients received secondary surgery. Factors that had a favorable effect on therapeutic outcomes were presence of no or only mild liver cirrhosis, presence of stage I or Stage II disease, presence of only a single tumor, a tumor size less than 10 cm in diameter, an absence cancerous thrombus within the portal vein or hepatic arterio venous fistula, and HAE treatment.

CONCLUSION: This study helped identify the effects of HAI and HAE in patients with PHC, and identified some important factors which influence such treatment.

Effects of tetrandrine and verapamil on fibroblastic growth and proliferation

AIM: To investigate the effect of tetrandrine (Tet) and verapamil (Ver) on liver fibrosis by evaluating their effects on the growth and proliferation of fibroblasts.

METHODS: Flow cytometry and imaging analysis were used to study the effects of combined and individual treatment of Tet and Ver on fibroblastic proliferation in vitro. Untreated control cells were used for comparison.

RESULTS: Compared to untreated fibroblasts, those treated with both Tet and Ver showed higher percentages of cells in the G₁ and G₂+M phase in the cell cycle of 3T6 fibroblasts (P < 0.01) and markedly elevated protein content, while those treated with Tet only showed significantly lower intracellular RNA content (1.5-2.0 μg, P < 0.01) and those treated with Ver only showed lower intracellular DNA content (15-20 μg, P < 0.01).

CONCLUSION: The inhibitory action of Tet and Ver on fibroblastic growth and proliferation might be responsible for the antifibrotic effects of these medications in liver fibrosis.

Short- and long-term effect of interferon therapy for chronic hepatitis C

AIM: To study the short and long-term effect of interferon therapy for chronic hepatitis C.

METHODS: Sixty-eight patients with chronic hepatitis C were treated with interferon (3 × 10⁶ IU, im/2 d, for a course of three months) with 1 to 5 courses of treatment and followed for 1.5 to 3 years after the therapy.

RESULTS: According to antiviral effect of interferon, 76.5% (52/68) of the cases had a complete response by the end of the first therapy course, while 20.6% (14/68) and 2.9% (2/68) had a partial response or non-response. Over a half of the patients with a complete response (27/52, 51.9%) relapsed within 6 to 10 mo after the first course. Of the original cohort, nineteen patients received two courses of therapy, while one patient received three and another three received five courses of therapy. The follow-up for these patients was between 1.5 to 3 years, at which time 29 (42.7%) of the patients sustained a complete response, with four of them having HCV RNA positive serum, while the others had either a partial (37/68, 2.9%) or non-response.

CONCLUSION: Interferon therapy had a high short-term complete response but a low long-term complete response in the treatment of chronic hepatitis C.

Immunohistochemical study of gastrin in colorectal carcinoma tissues and adjacent mucosa

AIM: To study gastrin expression in colorectal carcinoma tissues and adjacent mucosa and discuss the function of gastrin in colorectal carcinoma.

METHODS: Gastrin expression in colorectal carcinoma tissues and adjacent mucosa was examined in 58 cases using immunohistochemical and immunoelectron microscopy.

RESULTS: A total of 35.1% of colorectal carcinoma transitional mucosa (TM), 48.3% of nontypical dysplasia mucosa and 60.3% of carcinoma tissue were positive for gastrin expression (P < 0.05). Immunoelectron microscopy revealed that protein A gold (PAG) granules localized to different electron-dense secretory granules in carcinoma cells, the intercellular spaces, and the microvillar membrane surface.

CONCLUSION: Gastrin expression in colorectal carcinoma tissue and adjacent mucosa, and the release of gastrin by carcinoma may be an initiating factor in carcinoma occurrence and development. Positive gastrin expression in colorectal carcinoma tissues can serve as a differentiation marker.

Clinical and experimental study on therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions

AIM

To study the therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions.

METHODS

Thirty-six patients with gastric precancerous lesions were treated with Weixibaonizhuanwan for 3 mo. Thirteen (36.1%) patients presented with mild atrophic gastritis, 14 (38.9%) with moderate atrophic gastritis, and nine (25.0%) with severe atrophic gastritis. Twenty-two (61.1%) and 27 (75.0%) of the cases were accompanied by intestinal metaplasia (IM) and dysplasia (DYS), respectively. Twenty of the 36 patients were men and 16 were women, ranging from 30 to 67 years in age, with 61.1% of the patients being 40-59 years old. The duration of the disease in these patients ranged from 3 mo to 21 years, with 20 (55.6%) patients experiencing durations of the disease between 5 and 10 years. The clinical manifestations of the disease in these patients included fullness of the abdomen (31 cases), abdominalgia (27 cases), anorexia (30 cases), eructation (26 cases), pantothenic acid (6 cases), and loose stool (9 cases). Patients were treated with Weixibaonizhuanwan and symptom improvement, level of atrophy of the gastric mucosa, and IM and DYS progression were analyzed.

RESULTS

After a 3-mo treatment with Weixibaonizhuanwan, seven patients experienced recovery. The treatment was effective in 11 cases, improved symptoms in 13 cases, and was ineffective in five cases. The overall efficacy rate was 86.1%. In patients with mild atrophic gastritis (n = 13), 11 improved into superficial gastritis and two experienced no improvement. In 14 cases of moderate gastritis, four cases improved into superficial gastritis and seven turned into mild atrophic gastritis, with three patients experiencing no improvement. Among severe atrophic gastritis patients (n = 9), five improved into moderate atrophic gastritis after treatment and four experienced no improvement. The overall efficacy rate in chronic atrophic gastritis patients was 77.8%. Among 9 patients with IM, IM disappeared in six cases, whereas three cases showed no improvement after treatment. In cases with moderate IM (n = 10), IM disappeared in two, turned into mild IM in five, and showed no change in three. Out of four cases with IM, one case turned into moderate IM and three showed no change. The overall efficacy rate in IM patients was 63.6%. Out of 16 cases of mild DYS, DYS disappeared in 11, whereas five cases showed no change. Out of nine cases of moderate DYS, DYS disappeared in two and turned into mild DYS in five cases, with two patients experiencing no change after treatment. No improvement was observed in the two cases of severe DYS after treatment. The overall efficacy rate in DYS patients was 66.7%. After treatment, expression of carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen (PCNA) in gastric mucosa significantly decreased (P < 0.01). Before treatment, cancer staging of these patients by positive CEA expression was I, II, III, and IV in 13, 12, 9, and 2 cases, respectively. After treatment, the number of cases per stage changed to 25, 7, 3, and 1, respectively. Similarly, before treatment, staging by positivity of PCNA expression was I, II, III, and IV in 16, 11, 10, and 4 cases, respectively, and changed to 21, 9, 5, and 1, respectively, after treatment.

CONCLUSION

The use of Weixibaonizhuanwan in the treatment of gastric precancerous lesions showed promising therapeutic effects in patients after 3-mo treatments.

Effect of muscarinic blocker on enhancing the action of fructus aurantii immaturus on intestinal myoelectric activity in dogs

AIM: To investigate the effect of fructus aurantii immaturus (FAI) on small intestinal electrical activity in dogs.

METHODS: The effect of FAI was observed using a computerized electrophysiological method with the migrating myoelectric complex as a criterion. Fasted, healthy, and conscious dogs were given 100% FAI concentrated solution by gastrostogavage, and as soon as the effect on small intestinal electrical activity appeared, atropine was injected intramuscularly.

RESULTS: The enhancing action of FAI was inhibited significantly by atropine, a cholinergic receptor antagonist. Both the number of spike bursts per cluster and the number of spikes per minute in phase II and III and the general cycle were decreased (P < 0.01), although the duration of phase II and the general cycle was prolonged.

CONCLUSION: The effect of FAI might be related to the muscarinic receptors.