In order to study the clinical features and therapeutic status of ulcerative colitis(UC) in south China.Method A retrospective analysis was performed in 141 patients with UC diagnosed in past 12 years.Results The most frequent age at onset of disease was 20～45 years and the second was 57～67.Diarrhea and bloody stools were the most common symptoms which were present in 87.2% and 87.9% of cases.Severe complications and colon carcinoma were few in the cases.There was significant correlation in the extent of colonic involvement,the severity of illness and extracolonic manifestations.Severe complication and total colitis were more frequently seen in the patients with extracolonic manifestations than that in the patients without extracolonic manifestations(P

14,and/or pH4% of the total time at 24-hour esophageal pH metry were considered to be pathologic acid reflux(GERD).All patients underwent a diagnostic test by receiving lansoprazloe 30mg or placebo twice daily for 7 days through a cross-over design.A symptom reduction of over 75% was considered positive.Results 18(17%) cases of esophagitis were found in 104 patients by endoscopy.83(80%) patients experienced a typical symptom hearburn.87(84%) patients showed pathologic acid reflux detected from pH metry and they were considered to be GERD.85(82%) of 104 patients had positive result in therapeutic test.There was a significant correlation between both the diagnosis obtained from a trial of lansoprazole and the diagnosis obtained from pH metry(P

Objective To investigate the relationship of Helicobacter pylori(Hp) and gastric cancer in animal.Methods Ninety of two-grade Wistar male rats were randomly divided into experimental group and control group.In 12 weeks after the rats of experimental group were infected with SS1 Hp strain,animal in two groups were then randomly subdivided into blank ,MNNG subgroup and MNNG+NaCl subgroup,15 rats in each subgroup.Animals in the MNNG and MNNG+NaCl subgroups received 100?g/ml of MNNG in the drinking water,and in the MNNG+NaCl still received 10% NaCl 1 5ml,two times a week for ten months.The blank received water plus libitum.All animals were sacrificed in two months after the above treatment.Histopathological features of the glandular stomach were assessed by HE stainning.Results By the end of the study ,87 rats were survival,3 rats died from the mistakes of perfusion of NaCl.Hp was detected in all infected rats.Adenocarcinoma had developed in the antrum of one experimental rat in the MNNG+NaCl subgroup. Adenomatous hyperplasia were observed in two groups,but its incidence in the MNNG and MNNG+NaCl subgroups of the experiment were 40% and 57 14% respectively,higher than that of the control(6 67% and 15 38%)(P0 05).Conclusions We demonstrated that long-term Hp infection could induce the chronic active and atrophic gastritis in animal model,increase the sensitivity of glandular gastric mucosa to carcinogen,and promote the incidence of pre-carcinomatous lesion.

Objective To evaluate the diagnostic potential of capsule endoscopies (CE) for suspected small bowel diseases. Methods From September 2002 to June 2003, 23 patients (12 males, 11 females ) , age ranged 10 to 75 years old, with suspected small bowel diseases, were referred to our department to perform CE using Given M2A Video Capsule System. All patients had undergone previous negative endo-scopic evaluation at least once with esophago-gastro-duodenoscopy and total colonoscopy. Additional diagnostic work-up including small bowel enteroclysis, selective angiography, scintigraphy and puch enteroscopy, were performed, totally 36 procedures. Two endoscopists independently reviewed capsule images to arrive a consensus diagnosis. The initial diagnostic yield was quantified, and the value of CE was assessed. Of the 23 patients, 18 suffered from obscure gastrointestinal bleeding, 3 abdominal pain, and 2 chronic diarrhea. Results Twenty-four studies in 23 patients were evaluated. During CE patients have not complained of any uncomfortable feeling, only one patient had repeated the procedure because the capsule lodged at the inferior segment of esophagus near the Z line. Of the 23 patients, 20 had positive findings with a diagnostic yield of 86. 8% . The positive findings included inflammatory lesions in 10 patients (Crohns disease 7 , aphthous ulcer 3 ) , vascular abnormalities 9 ( phlebectasis 6, angioma 2, angiodysplasia 1) , submucosal nodulation 2 , diverticula 2, jejunal stromal tumor 1. Four of 23 patients had more than one lesion. Diagnosis of 6 patients was confirmed by surgery and /or pathology. Nineteen capsules passed in the direction with the camera facing forward, while the other 4 backward. Generally, it delayed in passing through the pylorus and ileocecal valves. Capsules reached cecum in 17 patients (73. 9% ) . Conclusion CE provided clearly the small intestinal images, and is an efficient tool in diagnosing small bowel diseases with a high diagnostic yield.

Objective To test the hypothesis that locally direct gene transfer of human vascular endothelial growth factor(phVEGF) 165 could passivate hepatic venous metallic stents by accelerating endothelialization and augmenting biocompatibility of endovascular stent. Methods The complexes of pAdTrackCMV and lipofectamine was smeared homogeneously to the surface of stent coating with poly-1-lysine. Bare stainless steel stents were used as controls. All stents were implanted into the hepatic right vein by the procedure of transjugular intrahepatic venous stent deployment. Results At the end of 1 week after implantation, the site -specific expression of phVEGF was detected by RT-PCR. Green fluorescence and the expression of phVEGF gene were detected in the transfered stented vessel of the treatment group. These phenomena were not observed in the control group. Scanning electron microscopy revealed that the endothelialization of stent was more pronounced in the treatment group than that in control group. At the end of 8 weeks after implantation, quantitative angiography analysis showed the degree of internal diameter stenosis was less severe in the treatment group compared with the control group. Mean neointima thickness, mean neointima areas and percent cross-sectional area narrowing in treatment group was significantly fewer than that in the control group, respectively. Immunohistochemistry analysis revealed that the proliferation of vascular smooth muscle cells was more active in control group than that in the treatment group. Conclusions Local gene transfer of phVEGF165 can passivate endovascular stents by accelerating stents endothelization and enhancing their biocompatibility in hepatic vein, resulting in reducing thrombus formation and attenuating intimal hyperplasia.

Objective To examine the chemo-preventive effect of cyclooxygenase-2(COX-2) inhibitor (celecoxib) in an animal model of stomach carcinogenesis. Methods Eighty-six male Wistar rats were divided into six groups. The rats were given water alone (group A, n=5), N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) (group B, n=16), 3 mg/kg of indomethacin daily (group C, n=16), 5 mg/kg of celecoxib daily (group D, n=17), 10 mg/kg of celecoxib daily (group E, n=16) or 20 mg/kg of celecoxib daily (group F, n=16). The animals in group B to F were given 10% sodium chloride (in the initial 6 weeks) and drinking water containing MNNG (100 ?g/ml) to induce gastric adenocacinoma. All animals received treatment for 40 weeks, and were sacrificed after death or at week 48. Gastric tumor was evaluated histologically. Results Among 86 rats, 26 rats died, and 60 rats completed the experiment. The incidences of gastric cancer were found 0 (0%) in group A, 12 (75.0%) in group B, 11 (68.8%) in group C, 12 (70.6%) in group D, 3(18.8%) in group E, and 5(31.3%) in group F. There were significant differences in tumor incidence (P=0.002), multiplicity (P=0.001) and volume (P=0.009) among different groups. When compared with group B, the group E had the greatest reduction in tumor incidence (P=0.004), tumor multiplicity ( P=0.006) and mean tumor volume (P=0.02). Treatment with indomethacin had no significant effect on tumor development. Conclusion While treatment with indomethacin had no significant effect on tumor development, treatment with celecoxib reduced gastric cancer incidence and growth in rats.

Objective To investigate the coping characters in patients with irritable bowel syndrome(IBS) by measuring the scores of life events, characteristic copings and coping styles. Methods Compared with those in health controls and peptic ulcer(PU) patients, Life Event Scale and Coping Style Questionnaire were used to evaluate 41 consecutive patients with IBS. Results IBS had a higher score of negative life events (43.92? 5.75 )than health controls (23.45?2.73, P =0.025) and PU(25.43?2.98, P =0.035). IBS also had a higher score of negative coping styles(40.79?8.01) than health controls (35.52?7.60, P =0.010) and PU(36.41?8.41, P =0.045). There was significant difference between IBS and health controls in the coping styles for fancying and withdrawal( P

[Objective] To observe the effects of Changyanqing, a Chinese prescription with the actions of regulating qi and activating blood, strengthening spleen-qi and clearing away heat, on ulcerative colitis (UC) and to explore its therapeutic mechanism . [ Methods ] Forty mice were randomized into Changyanqing group ( Group A ), salicylazosulfapyridine group (Group B), Changyanqing and salicylazosulfapyridine (Group C) and model group (Group D). Mouse models with UC were induced by dextran sulfate sodium (DSS). Effects of Changyanqing on disease activity index (DAI) and intestinal myeloperoxidase (MPO) content were observed. [Results] Changyanqing reduced DAI and MPO activity and its effect was similar to that of salicylazosulfapyridine. [ Conclusion ] Changyanqing exerts a better effect in treating DSS-induced UC and one of its therapeutic mechanisms may be related to the reduction of MPO activity.

Objective To evaluate the effect of csomeprazole with different dosage and usage regimes on intragastric pH of healthy volunteers. Methods It was a randomized, open-label, three-way crossover study. Fifteen healthy volunteers received esomeprazole with 3 different dosages (20 mg or 40 mg once daily or 20 mg twice daily) with 5 days each. Twenty-four continuous ambulatory intragastric pH was recorded at day 5 of each regime. Results The mean time of intragastric pH above 4 was higher in regime of 20 mg twice daily [(21.16 ±2.45) hours ] than that in regimes of 20 mg once daily [(18. 70±4.19) hours] and 40 mg once daily [(19.27±2.68 ) hours] (P<0.05). The percentages of the sleeping and active period that pH remained above 3,4,5 were significantly higher in regime of 20 mg twice daily(day time:95.0%±7.5% ,92.0%±10.6% ,86.7% ± 14.5% ;night time:93.2%± 13.1% ,87.8%±20.3% ,78.6%±28. 9 % )compared with regimes of 40 mg once daily(day time:87.9%±9.5% ,83.5%±11.7%,75.6%±15.50%, night time:75. 7%±20. 8%,66. 9%±23. 8%,53. 3%±30. 3%) and 20 mg once daily(day time: 85.1 % ± 16.3 %, 81.1 %± 18. 1%, 71.5 % ± 20.3 % ; night time: 72.9 % ± 30.5 %,67.2 % ± 31.9 %, 55.7 % ± 31.8 % ) (P< 0.05 ). Esomeprazole maintained intragastric pH above these pH thresholds for a similar propotion of sleeping and active periods with 40 mg once daily and 20 mg once daily.Conclusions Esomeprazole has strong inhibitory effect on intragastric acid. The regime of 20 mg twice daily is superior to 40 mg once daily and 20 mg once daily in both day and night time acid inhibition.There is no difference between esomeprazole 40 mg once daily and 20 mg once daily.

Objective To characterize the clinical features and outcome of massive lower gastrointestinal hemorrhage in patients with Crohn's disease.Methods The clinical data form 13 patients Who identified as Crohn's disease accompanied by massive lower gastrointestinal hemorrhage between 1998 and 2007 were retrospectively analyzed.Results The ratio of men to women was 3.3 : 1.Bleeding was the first symptom of disease in foor patients.The lesion was involved in small howel in 10 cases.The origin of bleeding was identified in 8 cases.Four patients received surgical operation and none of them died,while 9 patients received medical treatment and 3 of them died.Totally 10 patients were followed up for 6 to 94 months.Eight patients had recurrent massive hemorrhage,and two of them subsequently required surgery.One patient died after surgery.All patients who had recurrent massive bleeding and still survival were characterized by recurrent bleeding as only or major clinical feature,and they were all with small bowel involvement.Conclusions Diagnostic and therapeutic approach of massive lower gastrointestinal hemorrhage in Crohn's disease is very challenging.It is possible that there exists a particular phenotype of Crohn's disease that presents a tendency of bleeding recurrence,whose bleeding probably related to small bowel lesions.