Objective To compare the therapeutic result of endoscopic po lypectomy with colectomy for polypoid malignant colorectal tumor. Methods A tot al of 61 cases of polypoid malignant colorectal tumor including thirty－ nine pa tients treated by endoscopic polypectomy and surveillance,twenty－ two patients treated by colectomy.Follow－ up ranged from 28 to 168(mean 64) months. Results During the follow－ up period,one patient died relating to this disease,two rec urred at the original site,and one metastasized to the liver.The distribution of the adverse outcome had no significant statistical difference between the group of endoscopic polypectomy and colectomy;significant difference existed between the sessile and pedunculated malignant polyps (P=0.006),as well as between favou rable(carcinoma invading the muscularis mucosa or above,limited to the head of t he pedunculated polyp,polypectomy margin negative,and well and moderately differ entiated)and unfavourable(without those criteria) histologic characteristics(P=0 .002).Conclusion The polypoid malignant colorectal tumors with favourable his tologic characteristics could be treated by endoscopic polypectomy alone,tumors with unfavourable histologic characteristics should be treated by colectomy.

Objective To evaluate the relationships between the unstable coronary lesions and the levels of serum C-reactive protein(CRP) and urico-acid (UA).Methods 205 patients with primary diagnoses as coronary heart disease were examined by selective coronary angiography,and in the mean time ,the serum CRP and UA levels were measured.These patients were grouped the control,the unstable coronary lesion group and stable coronary lesion group according to the extent of coronary artery atherosclerosis stenosis.All data were undergone statistical analysis.Results The serum CRP level in unstable coronary lesion group was higher than that in stable coronary lesion group(P0 05).Conclusions The serum CRP level is significantly positive relation with the unstable coronary lesions.The serum UA level is not association with the unstable coronary lesions.

Objective To screen polymorphisms and mutations in the promoter region of WD gene.Methods DNA from peripheral blood was obtained from 71 subjects of 36 family (48 WD patients,23 patients first-degree relatives) and 20 healthy people from Feb.2001 to Feb.2004.DNA sequence of the genes was analyzed by PCR amplification and direct genomic sequencing.Results There were three polymorphisms at positions-190,-78,+260(transcription start site as +1) of the promoter region of WD gene.Normal controls,WD patients and patients’ first-degree relatives all showed the polymorphisms;three of 48 WD patients presented C→T base substitution mutations at the same position -183:two were homozygous mutation,while the other was heterozygous.Normal control subjects and patients' relatives didn’t show this kind of mutation.Conclusion It suggests that the mutation of the promoter region is one of WD pathogenesis.

OBJECTIVE:To study the influence of butylphthalide on the pharmacokinetics of aspirin in rats. METHODS:20 rats were randomly divided into control group(vegetable oil 0.4 ml/rat+aspirin 10 mg/kg)and trial group(butylphthalide 80 mg/kg+aspirin 10 mg/kg) intragastrically,once a day,for consecutive 10 days. Blood samples were collected before the last medication and 10,20,40,60,120,240,360,480,600 and 720 min after medication,0.2 ml each time. The blood concentration of drugs was determined by HPLC,and pharmacokinetics parameters were calculated by DAS 2.0 software. RESULTS:Main pharmacokinet-ic parameters of aspirin in control group vs. trial group were as follows as cmax of (28.68 ± 6.08) vs. (29.33 ± 4.25)μg/ml;t1/2 of (2.48±0.67)vs.(1.60±0.36)h;AUC0-720 min of(188.71±24.29)vs.(140.31±15.08)μg·h/ml;CL/F of(0.05±0.01)vs.(0.07± 0.01)L/(h·kg);there were significant differences in t1/2,AUC0-720 min and CL/F(P<0.05). CONCLUSIONS:Butylphthalide has no significant effect on the absorption and distribution of aspirin in rats,but can strengthen its metabolism and elimination.

Objective To investigate the nutrition statuses of thiamine and riboflavin and their relationship with the antioxidant capacity and blood glucose and lipids levels in the middle-aged and elderly. Methods Totally 314 subjects aged above 40 years old from communities in Shanghai were enrolled. The 3-day survey of 24-hour's diet recall was made to evaluate the daily nutrient intakes using a nutrition assessment software provided by CDC China. Thiamine and riboflavin levels were detected by urine load test. Fasting blood glucose ( FBG), total choles-terol (TC), triglyceride (TG), superoxide dismutase (SOD) activity and malondialdehyde (MDA) were deter-mined by commercial kits. Results The average daily intakes of thiamine and riboflavin were (0. 82 + 0. 36) and (0. 91 +0.48) rag, respectively. The middle-aged and elderly whose intakes of thiamine and riboflavin reached recommended nutrient intake (RNI) level accounted for 11.8% and 17.2%, while those lower than 60% RNI ac-counted for 51.3% and 49. 4%, respectively. Urine load test showed the deficiency rates of thiamine and ribofla-vin were 65.0% and 58.6%, respectively. Compared with the normal group, plasma MDA, FBG, TC, and TG levels progressively increased and SOD activity decreased in insufficient and deficient groups; the plasma MDA, FBG, and TC levels were significantly different between normal group and thiamine deficient group ( P < 0. 05 ).The FBG and TC levels were negatively correlated with the status of thiamine ( r = - 0. 246, r = - 0. 154, P <0. 05). The MDA and TG levels were negatively correlated with the status of riboflavin ( r = - 0. 136, r =-0. 297, P <0. 05). Conclusions The nutrition statuses of thiamine and riboflavin are poor in the middle-aged and elderly in Shanghai. The nutritional statuses of thiamine and riboflavin are positively correlated with the antioxi- dant capacities and are negatively correlated with the level of FBG, TC, and TG.

Objective To study the relationship between trace elements and blood lipids and glucose in Shanghai adults. Methods Totally 245 subjects aged above 18 years from two communities in Shanghai were en-rolled into this study. Blood trace elements (Fe, Zn, Cu, Mg, Pb, Mn, and Cd) were examined with atom ab-serption spectrophotometry. Body mass index (BMI), waist hip rate (WHR), and blood pressure (SBP, DBP)were also determined. Results Compared with the normal control group, plasma Fe and Mn levels were signifi-cantly lower while Zn and Zn/Cu levels were significantly higher in hyperlipemia group (P <0.05 or P <0. 01 ) ;plasma Zn, Zn/Cu, and Mn levels were significantly lower while Cu and Pb levels were significantly higher in dia- betes mellitus group (P <0. 05 or P <0. 01 ) . A tendency of lower Mg and higher Cd levels were also found in both disease groups, but there were no statistical significance ( P >0. 05 ). Conclusions The metabolism of trace elements is abnormal in patients with hyperlipemia and diabetes mellitus. Intervention of these trace elements disor-der may be valuable in the prevention and treatment of these diseases.

Objective To explore the current condition of psychological problems of patients in cardiology clinic. Methods A total of 347 patients in the cardiology clinic of Prof. HU Da-yi were screened by self-rating depression scale(SDS),Self-rating anxiety scale(SAS),Hamilton rating scale for depression(HRSD)and Hamilton anxiety scale(HAMA). Results The rates of patients with somatic disease only or with psychological disorder only were 52.4%and 12.7%, the rate of somatic disease accompanied with psychological disorder was 27.7%. For the patients with psychological problems, there were 31 cases with depression(8.9%),62 cases with anxiety(17.9%),and 28 cases(8.1%) suffering from mixed depression and anxiety the diagnosis of cardiovascular disease,functional disease or digestive disease was always used by doctors for the patients with psychological problems only,as they always did not accept the diagnosis of psychological disorder. Conclusions It is very common that patients in cardiology clinic department suffered from psychological problems. The patients with psychological disorder only were easily misdiagnosed as somatic disease especially cardiovascular disease.

Objective To investigate the protective effects of ulinastatn on the lungs in patients with lung cancer undergoing lobectomy. Methods Forty ASA Ⅱ or Ⅲ patients with stage Ⅲ lung cancer, aged 50-64 yr weighing 53-70 kg undergoing lobectomy were randomly divided into 2 groups ( n = 20 each): control group (group C) and ulinastatin group (group U). In group U ulinastatin 10 000 U/kg in 20 ml normal saline was infused iv over 30 min immediately after induction of anesthesia. The patients were premedicated with diazepam 10 mg and scopolamine 0.3 mg im. Anesthesia was induced with midazolam 0.05 mg/kg, fentanyl 4 μg/kg, TCI of propofol (Cp 4 μg/ml) and vecuronium 0.12 mg/kg and maintained with TCI of propofol (Cp 2-3 μg/ml) and intermittent iv boluses of fentanyl and vecuronium. The patients were intubated with double-lumen tube. Correct position of the tube was checked with fiberoptic bronchoscope. One-lung ventilation (OLV) was performed (VT 6-8 ml/kg, RR 10-16 bpm, I:R 1:2, FiO2 100% ). PETCO2 was maintained at 35-45 mm Hg. Arterial blood samples were taken before anesthesia (T0, baseline), at 0.5 h and 1 h of OLV (T1, T2 ) and 4 h and 24 h after operation (T3, T4 )for blood gas analysis and determination of plasma TNF-α, IL-6 and IL-10 concentrations. Respiratory index (RI)was calculated. (RI= PA-a O2 /PaO2 ).Results Compared with the baseline values at To, plasma TNF-α and IL-6 concentrations and RI at T1-4 and plasma IL-10 concentrations at T1-3 were all significantly increased in group C,while in group U plasma TNF-α and IL-6 concentrations at T2,3 and plasma IL-10 concentrations and RI at T1-4 were all significantly increased ( P ＜ 0.05 ). Plasma TNF-α and IL-6 concentrations and RI were significantly lower while plasma IL-10 concentration was significantly higher in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin 10 000 U/kg can effectively protect the lungs in patients with lung cancer undergoing lobectomy by attenuating systemic inflammatory response.

Objective 　To study the sequence and structure of intron 8 in WD gene in order to further understand the relationship between intron 8 and WD. Methods　We utilized polymerase chain reaction (PCR) to the amplification of exon 8-intron 8-exon 9 which were then sequenced by a dideoxy chain termination methon in 10 normal controls and 32 members of 11 families(20 WD patients and 10 of their relative). The results were analyzed by the computer. Results　The sequence of intron 8 was 703 bp with the G　+　C content of 42.7%. There were one short tandom repeats, 7 direct and inverted repeats in it. An open reading frame coded with 82aa was found at 323 base pairs of downstream of a TATAbox. There were two DNA polymorphisms at 408 and 487 nucleotides. The sequence analysis showed that the 5end has the sequence of 5-GTAAC, 3end has the sequence of CCTAG-3, and branchpoint of 5-TTTCGA-3.Conclusions　The sequences and structures of intron 8 in WD familiess members are not different from normal controls. Our data suggest that the WD gene intron 8 might not play an important role in the pathogenesis of WD.

Objective To investigate the expressions of CD133 and CD44 and their prognostic significance in gastrointestinal stromal tumors (GIST).Methods Streptavidin perosidase (SP) method of immunohistochemistry was used to detect expressions of CD133 and CD44 proteins in 42 cases of GIST, and the relationship between their expressions and tumor size, mitotic count were analyzed by univariate and multivariate factor analyses.Results The expressions of CD133 and CD44 proteins in GIST were 21.4％ (9/42) and 78.6％ (33/42), respectively.The expressions of CD133 and CD44 proteins were significantly correlated with tumor size and mitotic count (P ＜ 0.05).Univariate factor analysis showed that the overall survival of GIST patients with positive CD133 protein (23.2 months) was shorter than that of patients with negative CD133 protein(63.1 months) (P ＜ 0.05).The overall survival of GIST patients with negative CD44 protein (23.2 months) was shorter than that of patients with positive CD44 protein (63.3 months) (P ＜ 0.05).Multivariate factor analysis showed that tumor size, mitotic count and CD44 protein were independent prognostic indicators for survival time after operation.Conclusions The positive expressions of CD133 and CD44 proteins might be the prognostic factors of GIST patients.