Objective To investigate the therapeutic effect of combined administration of lactobacilli and clostridium butyricum on acute mice ulcerative colitis, and explore its therapeutic mechanism.Methods Dextran sulfate sodium (DSS)-induced mice model of acute ulcerative colitis was established. After administration of lactobacilli and clostridium butyricum, the pathological change of tunica mucosa coli was observed and the expression levels of tumor necorisis factor (TNF-α) and tissue factor (TF) were measured.Results Lactobacilli and clostridium butyricum significantly alleviated the damage of tunica mucosa coli and suppressed the expression of TNF-αand TF. By comparison, there were the lightest histological damage and the lowest expression of TNF-αand TF when lactobacilli and clostridium butyricum were administrated combined.Conclusion Both lactobacilli and clostridium butyricum show therapeutic effect on DSS-induced mice ulcerative colitis. The coordinate repression on expression of TNF-αand TF may be the molecular mechanism of the co-effect on mice UC.

0.05).Multivariate analysis showed that the recurrence was related to the number and diameter of the tumors,with the hazard ratios being 1.877(P=0.001)and 1.391(P=0.029 4),respectively;injection of MMC had no influence on the recurrence.There was no significant difference in the time of disease-free survival(DFS)between the 2 groups,with the median time of DFS of MMC injection group being 5 months and of control group being 3 months after the first operation(P=0.125 3).The recurrence rates in the MMC group and control group were 65.79% vs 68.57%(P=0.800 4) 6 months after operation,81.58% vs 94.29%(P=0.099 0)1 year after operation,89.47% vs 97.14%(P=1.679 55) 2 years after operation and 92.11% vs 97.14%(P=0.344 7)3 years after operation.Conclusion: Injection of 10mg MMC via great omentum vein during resection of IHCC may have no definite effect on the recurrence of IHCC;however,perspective study is needed to verify this finding.

Objective To deepen the clinicians' impression on the Laurance-Moon-Bardet-Biedl syndrome(LMBBS),we made a summary in the incidence and clinical manifestations of the disease in China comparing with foreigners.Methods We made evidence-based meta-analysis about the 2 cases reports in 1987 and 2003 in our hospital and literature review of 462 cases in foreign countries and 94 cases in China.Results LMBBS patients,with more frequency of consanguinity and family history,retinal dystrophy,mental retardation,obesity,polydactyly,hypogenitalism,often had many complicated and variable clinical manifestations.Conclusion To avoid intrafamiliy marriage would reduce the incidence rate.The diagnostic criteria and ascertainment methods introduced recently do benefit the early diagnosis in their childhood period.

Objective To investigate the expressions of acetylcholine and norepinephrine of the central nervous system in a rat model of irritable bowel syndrome (IBS), and to explore the possible roles of the classical neurotransmitters of the central nervous system in the pathogenesis of IBS. Methods The rat model of IBS was reproduced by intragastric instillation of 2.0ml water at 0-4℃ in male Wistar rats for two weeks. Both the model group and the control underwent rectal distention, then were sacrificed by deep anesthesia. Sections of the posterior horn of the spinal cord and hypothalamus were obtained and processed immunohistochemically using anti-tyrosine hydroxylase (TH) and acetylcholinesterase (AchE) antibodies respectively, and the staining results were analyzed semi-quantitatively using computerized color image analyzer. The statistical difference of the opacity density and immunoreactive areas between two groups was compared by t-test. Results Immunoreactive area, opacity density of AchE immunoreactive tissues in the posterior horn of the spinal cord and hypothalamus of the model group were all significantly higher than those in control group (P0.05). Conclusions The expressions of acetylcholine in the spinal cord and hypothalamus in the rat model of C-IBS were abnormal, which suggested that cholinergic nervous system in the central nervous system may play some roles in the pathogenesis of IBS.

Evidence-based medicine emphasizes making project of diagnosis and therapy on the basis of the most objective research results. The current condition in which domestic medicine is dominant in hepatobiliary surgery and teaching needs to be changed urgently. The procedure of application of evidence-based medicine in teaching of hepatobiliary surgery is explained by an actual example. Evidence-based medicine plays an important role in teaching and quick progress in all of the hepatobiliary surgery.

Objective To evaluate the role of intravasc ular ultrasound (IVUS) in determining strategy for coronary artery stenosis of intermediate severity.Methods The study population consisted of 75 patients who had de novo coronary lesions of intermediate severity (40% to 70% diameter stenosis) in coronary angiography. IVUS examination was performed in all patients using standard methodology. Minimal lumen cross-sectional area (MLA) ≤ 4.0- mm 2 or percent area stenosis≥60% were identified as an IVUS index of functionally severe coronary stenosis, and used as an indication of coronary stenting. Major adverse cardiac events (cardiac death, acute myocardial infarction and recurrent angina) and the use of nitrates were recorded during follow-up. Results There were 44 patients (59%) with functional coronary artery stenosis, and all underwent successful coronary stenting. Acute coronary syndromes, soft plaque and positive coronary arterial remodeling were more common compared with the remaining 31 patients (41%) only treated medically. During a mean of (14?7) months of follow-up, there was no cardiac death and acute myocardial infarction. Readmission occurred in 5 patients (11%) due to in-stent restenosis in patients with interventional therapy and 4 patients (13%) due to exacerbation of coronary artery stenosis in patients with medical therapy. The use of nitrates was discontinued in 18(41%) and 14(45%) patients treated with interventional therapy and medical therapy, respectively. Conclusions It is valuable to perform IVUS examination in clinical decision making for intermediate coronary artery stenosis. IVUS criteria of MLA≤ 4.0- mm 2 or area stenosis≥60% may be a reliable index of functional coronary stenosis, determining the therapeutic strategy in patients with intermediate coronary artery stenosis.

Objective To evaluate the significance of color Doppler EUS in the pancreatic pseudo-cysts drainage. Methods EUS - guided cystoenterostomy was performed in 3 patients. A needle and drainage tube was inserted in a one - step procedure into the cyst through the accessory channel of echoendoscope under EUS. The nasal plastic drainage tube was released immediately after insertion. Results When gastric ulcer and bleeding or the bulge of stomach were not found endoscopically in all patients . The needle with its stylet inserted through the gastric wall into the cyst at the site with minimal distance between them . The mean size of the pseudocysts was approximately 8 cm located at pancreatic tail ,body or the junction of them. In 3 cases but one, the blood flow signal around the cyst was not found . No significant echo of laminated structure between gastric and cyst wall was found . After aspiration or installation of naso-cystic drainage catheter, abdominal pain remitted at 2 days, 2 days and 3 days; the sonography demonstrated that cyst size decreased began from 3rd day ,and the cyst obliterated at 14 and 30 days after drainage. The only complication was found in one patient with gastric mucosal ooze, which recovered after noradrenaline spray . Infection or perforation never occurred. No recurrence of pseudocysts observed at a mean follow - up period of 3. 6 months (range 2-7 months). Conclusions The EUS-guided drainage of pancreatic pseudocysts in one-step is a rather simple and practical procedure with minimal risk of hemorrhage and infection.

Objective To evaluate the clinical efficacy of coroflex (BRAUN, Germany) intracoronary stent. Methods To retrospectively analyze the immediate angiographic and clinical follow-up outcomes of 81 patients (pts) receiving coroflex intracoronary stenting. Results 88 coroflex intracoronary stents were implanted in 81 pts. According to ACC/AHA classification, 38 lesions were type A-B 1, 50 lesions were type B 2-C. 52 lesions were de novo, 22 were suboptimal results after PTCA and 14 lesions were bailout for dissections. Stent deployment was successful in 82/88 (93.2%). High-pressure (16-18 atm) balloon was used for stent deployment in 3 lesions with severe calcification. Dissection was occurred at distal of stent in 2 lesions but no inducing flow reduction. Angiography showed TIMI 2 grade after intracoronary stenting in 1 diffused lesion. There were no adverse events occurred during hospital stay. Clinical follow-up of in 75 pts were conducted for 7.5?3.0 (3-13) months, there were no cardiac death or myocardial infarction reported. Complain of angina (CCS class Ⅰ) occurred in 17 pts (22.7%). Repeat angiography was performed in 7 pts, there were 2 in-stent restenosis with successful revascularization. Conclusion Coroflex intracoronary stenting appears to be safe and effective in the treatment of coronary lesions with favorable outcomes.

Objective To evaluate the clinical efficacy of cutting balloon angioplasty (CBA) for treating lesions in small coronary arteries. Methods The diameter for reference of coronary artery is less than 2.7mm which is considered as “small vessel”. CBA procedures were performed on 25 lesions in 22 patients. Results The procedure was successfully obtained in 21 lesions(84%). Seven severe stenotic lesions (diameter of stenosis≥90%) underwent dilatation with small conventional balloon(1.5 mm diameter). Bail out stenting was performed in 2 lesions because of severe dissections. Failure of cutting balloon to pass through the stenosis in one lesion. During follow up, 5 patients had recurrence of coronary angina and 3 of them underwent coronary angiography for check up, In stent restenosis (ISR) occurred in one patient, which was successfully redilated using CBA. One patient had total occlusion of the diagonal branch with ISR of LAD. One patient developed new lesion in other coronary artery.Conclusions CBA is safe and effective, and provides a new therapeutic strategy for lesions in the small coronary arteries.

Objective Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) of pancreatic lesions is being increasingly used. The aim of the study was to evaluate its safety, accuracy, and clinical utility in the diagnosis of pancareatic diseases. Methods EUS-guided FNA was performed in 21 patients (13 men and 8 women) with pancreatic lesions (16 head/neck, 5 body/ tail) detected by CT scanining, unltrasonography or clinically suspected diagnosis.Three patients with unresectable pancreatic cancer underwent EUS-guided celiac plexus neurolysis(CPN) for pain-relieving. Results The lesions detected by CT scanning (19 cases) and ultrasonography(16 cases) were all confirmed by EUS. Adequate specimens were obtained by EUS-guided FNA in 18 of 21 lesions and final diagnosis in these subjects was pathologically confirmed. EUS-guided FNA had a sensitivity of 85.0%, specificity of 100.0% and accuracy of 85.7% for diagnosis of pancreatic lesions. The final diagnosis was not obtained in three patients due to inadequate specimens. Three patients with pancreatic carcinoma were decreased in pain scores after EUS-CPN. Two cases with complication of mild pancreatitis or post-FNA fever were found. Conclusions EUS-guided FNA of the pancreas was a safe and effective modality for diagnosis and treatment of pancreatic lesions.