Modern medicine is in the new phase of transform from biomedical model to bio-psycho-social medical model. Biological factors interact with the social and psychological factors. We should think highly of not only biological factor but also social factor and psychological factor in the prevention and treatment of gastrointestinal tumor. It is an important mission of medical workers to carry out new medical model in clinical practice.

Objective To study the efficacy and safety of sedation for gastroscopy with a combined use of propofol and midazolam compared to a control, non-sedative group , with the goal of establishing a method of painless gastroscopy. Methods One thousand nine hundred fifteen patients in sedative group were given intravenous propofol and midazolam . Patients feeling and discomfort, operators satisfaction and operative duration were compared with the control group ( n = 640, without sedation ) . The changes of blood pressure, heart rate and blood oxygen saturation were recorded and analysed. Results One thousand nine hundred patients(99. 2% ) in sedative group and 224 patients(35. 0% ) in control group did not complain any discomfort and pain during gastroscopy(P

Objective:To study effects of psychological intervention and sedativn on stress response to gastroscopy.Methods:86 patients for gastroscopy were randomly divided into three groups:29 patients in group of psychological intervention watched video materials about psychological intervention before gastroscopy;29 patients in sedative group were given intravenous midazolam and propofol.; 28 patients in control group were no psychological intervention or sedation. Patient's discomfort and changes of blood pressure(BP),heart rate(HR) , saturation of pulse oxygen(SpO 2) were recorded. The level of norepinephrine(NE), adnephrin(E), dopamine(DA) and cortisol(CS)in serum were detected.Results:The incidence of cough,nausea and vomiting, and restlessness in group of psychological intervention and in sedative group was lower as compared with the control group. BP,HR,NE,E and CS in control group rose significantly during the procedure while that of patients in group of psychological intervention and in sedative group was no significant change.Conclusion:The psychological intervention or sedation with midazolam and propofol can reduce stress response to gastroscopy.

Objective To discuss and analyze the clinical relationships between the gene polymorphism of vitamin D receptor and adiponectin with the susceptibility of non-alcohol fatty liver disease(NAFLD).Methods One hundred and two cases of NAFLD were selected as the observation group,and other 100 healthy volunteers were selected as the control group.The gene polymorphism of vitamin D receptor and adiponectin in the two groups was detected,then the genotype distribution and allele frequencies of vitamin D receptor and adiponectin were compared between the two groups,then their relationship with the susceptibility of NAFLD was analyzed.Results The genotype distribution situation of vitamin D receptor BsmI site,adiponectin 45 and 276 sites had statistically significant difference between the observation group and control group(P＜0.05).The B allele frequency of BsmI site of vitamin D receptor in the observation group was far lower than that in the control group,and the allele frequencies of 45-T and 276-G of vitamin D receptor in the former were far higher than those in the latter,and the differences between the two groups were statistically significant(P＜0.05).The multivariate unconditional Logistic regression analysis showed that vitamin D receptor:bb genotype,adiponectin 45 locus:TT genotype and ALT,TG,complicating hypertension history and HOMA-IR all were the independent risk factors in NAFLD patients.Conclusion The genotype distribution of different sites of vitamin D receptor and adiponectin has obvious abnormality in the patients with NAFLD,and both are closely related with the NAFLD susceptibility.

Objective: To investigate the effect of hydrogen sulifde (H2S) on the expression of CSE, NF-κB, and IL-8 mRNA in GES-1 cells withHelicobacter pylori (H. pylori) infection and to explore its mechanism on gastric mucosa inlfammation caused byH. pylori.
Methods: GES-1 cells were cultured for 24 h and divided into a control group (neitherH. pylori nor NaHS), anH. pylori group, a NaHS group (which was further divided into 4 groups at 50, 100, 200, or 400 μmol/L NaHS), andH. pylori + NaHS group (which was further divided into 4 groups at 50, 100, 200, or 400 μmol/L NaHS). Each group was then cultured for 3, 6, or 12 h. The expression of CSE, NF-κB, and IL-8 mRNA was measured by RT-PCR, and their correlation was analyzed. Results: The expression of CSE, NF-κB, and IL-8 mRNA in GES-1 cells in theH. pylori group was higher than that in the control group. The expression of CSE in the 200 μmol/L NaHS group and 400 μmol/L NaHS group was lower than that of the control group (P<0.05), whereas the expression of NF-κB and IL-8 in all NaHS groups had no statistical differences compared with the control group (P>0.05). The expression of CSE, NF-κB, and IL-8 mRNA in all groups of NaHS,H. pylori + 200 μmol/L NaHS group, andH. pylori + 400 μmol/L NaHS group was lower than that in theH. pylori group (P<0.05). There was positive correlation among the expressions of CSE, NF-κB, and IL-8 mRNA in theH. pylori group, theH. pylori + 200 μmol/L NaHS group, and theH. pylori +400 μmol/L NaHS group (P<0.05).
Conclusion:H. pylori can induce NF-κB and IL-8 mRNA expression and upregulate CSE mRNA expression. At 200 and 400 μmol/L, NaHS can suppressH. pylori-induced NF-κB and IL-8 mRNA expression and ameliorate the morphology ofH. pylori-induced GES-1 injury, which may protect gastric epithelial cells byH. pylori infection.

Objective To observe the effects of hydrotalcite on histological ulcer healing quality in patients with Helicobacter pylori (Hp) positive active gastric ulcer .Methods A total of 145 patients with H p positive active gastric ulcer were divided into two groups .The control group was treated with esomeprazole ,amoxicillin and furazolidone triple therapy .The treatment group was treated with above triple therapy and hydrotalcite .After four-week treatment ,gastroendoscopy was repeated .The sections of gastric biopsy specimens were stained with hematoxylin-eosin (HE) staining ,Van Gieson staining , Alcian blue-periodic acid stiff (AB-PAS ) staining , streptavidin-perosidase (SP ) immunohistochemistry staining and computer imaging analysis technology were applied to observe maturity type of mucosal structure at the margin of ulcer ,the content of collagen and neutral mucus ,and the changes of expression of epithelial growth factor receptor (EGFR) and basic fibrobast growth factor (bFGF) before and after treatment .Paired samples t test was performed for comparison before and after treatment .F test and Chi-square test were used for comparison between two groups .Results The percentage of maturity type of regenerated mucosal structure of treatment group was 62 .9% (39/62) ,however that of control group was 40 .6% (26/64) ,and the difference was statistically significant (χ2 =13 .09 , P=0 .03) .Compared with those before treatment , the content of collagen in granulation tissue and neutral mucus in regenerated mucosa increased in both groups after treatment , and the increase was more significant in treatment group ((55 .1 ± 10 .4)% and (45 .8 ± 7 .1)% ,respectively);and the differences were statistically significant (F= 12 .85 and 18 .17 ,both P<0 .01) .Compared with those before treatment ,the percentage of EGFR and bFGF positive cells of both two groups increased , and the increase was more significant in treatment group ((49 .5 ± 8 .4)% and (48 .8 ± 9 .4)% ,respectively) ,and the differences were statistically significant (F=12 .17 and 18 .73 ,both P<0 .01) .Conclusion Hydrotalcite combined with anti-H p triple therapy can improve the maturity degree of structure and function of regenerated mucosa at the margin of ulcer in patients with H p positive active gastric ulcer and then improve the healing quality of ulcer .

Objective To determine the effect of different types of Helicobacter pylori(H, pylori) on the gap junction intercellular communication (GJIC) in GES-1 cells, and investigate the types of H. pylorirelated to the dysfunction of GJIC. Methods Different types of H. pylori clinical strains were isolated and cultured, including the East Asian CagA-positive H. pylori( East Asian CagA +H. pylorl), Western CagA-positive H. pylori( Western CagA +H. pylori), and the CagA-negative H. pylori (CagA-H. pylori). We co-cultured these H. pyloristrains with GES-1 cells for 24 and 48h, respectively. The control group was cultured without any H. pylorifor 24 and 48 h. Change of the GJIC function in GES-1 cells was detected by the scrape-loading dye transfer (SLDT) technique. The cell proliferation of each group was examined by the methyl thiazolyl tetrazolium bromide (MTT) assay. Results The control group showed better GJIC function in the GES-1 cells, and the fluorescent dye migrated 4 - 5 rows to the adjacent cells at 24 and 48 h. Compared with the control group, the GJIC function of GES-1 cells in the CagA - H. pylori group decreased and the fluorescent dye migrated 3 rows to the adjacent cells. Compared with the control group and the CagA- H. pylori group, the GJIC function of GES-1 cells in the Western CagA + H. pylori group decreased and the fluorescent dye migrated 1 - 2 rows to the adjacent cells. The East Asian CagA * H. pylori group showed no GJIC function or weak GJIC function, and most of the fluorescent dye was confined to the area of scratched single row cells and only a few migrated 1 -2 rows to the adjacent cells. Difference in the cell proliferation between the CagA - H. pylorigroup and the control group was not significant. The cell proliferation of the Western CagA + H. pylori group and the East Asian CagA + H. pylori group at bacterium-to-cell ratio of 100:1 and 200:1 was higher than that of the control group. The cell proliferation of the East Asian CagA +H. pylori group at bacterium-to-cell ratio of 400:1 was significantly lower than that of the control group at 48 h. Conclusion H. pylorican inhibit the GJIC function in GES-1 cells, which may be associated with CagA +H. pylori, especially with East Asian CagA +H. pylori. The effect of H. pylori on the proliferation of GES-I cells is related to virulence factor CagA.

To observe the effect of Helicobacter pylori(H.priori) on cell gap junction ultrastructure of gastric epithelial cells,and to explore carcinogenic mechanism of H.priori from the changes of cell gap junction,BGC-823 cells were co-cultured with different H.prlori strains for 24 h and 48 h.The cell gap junction ultrastructure was observed under transmission electron microscope with sample preparation of fixation and embedding in situ.In 70 patients with gastric eancer(GC),H.priori was detected by rapid urease test,basic fuchsin stain and 14C-urea breath test.The CagA gene of H.prlori was determined by PCR and the cell gap junction ultrastructure was observed under transmission electron microscope.More cell gap junctions and junction complexes of BGC-823 cells were found in control group without H.priori.Groups with H.priori had less number of cell gap junctions,less number of junctions/unit perimeter,shorter length of junctions/unit perimeter,and bigger width of the intercellular space,comparing to control groups without H.priori(P＜ 0.001 or P＜ 0.005).The number of cell junctions and the number of junctions/unit perimeter in the groups co-cultured with NCTC J99,GC 01 and NCTC 11639(CagA+) were less than that in the groups co-cultured with NCTC 12908(CagA-)(P ＜0.001 or P＜0.05),and the length of junctions/unit perimeter in the groups co-cultured with NCTC J99 and GC 01 was shorter than that in the groups co-cultured with NCTC 12908 (P＜ 0.001).In patients with GC,the number of cell junctions,the number of junctions/unit perimeter and the length of junctions/unit perimeter in group H.priori infection were all less than those in group without H.prior/infection(P ＜0.001),and that in CagA+ H.prlori group were less than that in CagA- H.prlori group,but its smallest width of the intercellular space was longer than that in CagA- H.prlori group.The above results showed that the changes of cell gap junction of gastric epithelial cells were associated with H.prlori infection especially CagA+ H.prlori infection.

Objective:The study was attempted to improve the manipulation and eliminate patient's fear for gastroscopy combined with intravenous injection.Methods:A total of 1350 patients wasrandomized into test group (n=1100 given intraveous protofol and midazolam)and the control (n=250,without anesthetics).Patient's feeling,heart rate,blood oxygen saturation,blood pressure,operative duration and operator' satisfaction were recored and analysed.Results:Data in test group showed less complaints,easier manipulation,high satisfaction and no difference in operative duration and blood oxygen saturation as compared with the control.After intravenous administration of protofol and midazolam,patient's heart rate and blood pressure (systolic and diastolic pressure) significantly decreased.Conclusions:With intravenous use of protofol and midazolam,gastroscopy can be achieved effectively,painlessly and safely.

OBJECTIVE: To analyze the clinical characteristics of nonalcoholic fatty liver disease. METHODS: We compared the weight, waistline, blood pressure, fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), uric acid (UA), and complication of cholecystolithiasis of 210 patients with nonalcoholic fatty liver disease who were diagnosed either clinically or by B ultrasound and/or CT (NAFLD group) and 248 normal persons (control group) from January 2008 to June 2009 in Third Xiangya Hospital. RESULTS: The weight, weight index, waistline, blood pressure, FPG, TG, ALT, and UA in the NAFLD group were higher than those in the control group (P<0.01). Patients with nonalcoholic fatty liver disease had higher incidence of cholecystolithiasis (P<0.01). CONCLUSION The occurrence of nonalcoholic fatty liver disease is related to weight, weight index, waistline, blood pressure, FPG, TG, ALT, UA, and cholecystolithiasis.
Adult ; Aged ; Blood Chemical Analysis ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Case-Control Studies ; Cholecystolithiasis ; complications ; Fatty Liver ; blood ; complications ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Waist Circumference