Purpose To explore the clinical characteristics of small intestinal tumors and its diagnosis. MethodsRetrospective analysis of cases. ResultsLdomyoma was most common among the benign small intestinal tumors(12/17),adenocarcinomawas most common among the malignant small intestinal tumors(45/ 76). The feature of the small intestinal tumors could be hemorrhage, abdominal pain, abdominal mass, fever and jaundice. Upper gastrointestinal tract barium oontrast study was performed in 28 cases,and the results of 21 cases were positive. Mesenteric arteriography was performed in 9 cases. It was confirmed by surgery that the results matched with the lesions. ConclusionsMesenteric arteriography is of great value in diagnosis of the small intestinal tumors endoscope retrograde cholangiopancreatography(ERCP), CT are also helpful.

Objective To establish a new Helicobacter pylori(H.pylori) infection model which is more stable and to find the relationship between H. ~pylori infection and gastric carcinogenesis induced by nitrosourea. Methods A total of 94 Balb/c mice were divided into four groups. Two groups of mice were inoculated with H.pylori, among which one group of mice received continuous N-methyl-N-nitrosourea(MNU) administration via the drinking water. The third group were only given MNU, and the forth as control. After 36 weeks, all the mice were ~sacrificed . The infection of H.pylori in gastric mucosa of the mice was analyzed by rapid urease test, ~Giemsa staining and culture. The histopathological changes in the gastric mucosa of mice were assessed in ~H-E stained sections. Results The total infection rate of H.~pylori in Balb/c mice was 93.9%. All the mice in group with H.pylori infection alone had chronic gastritis, in which 20.0% was atrophic gastritis. In the group of mice with H.pylori infection and MNU intake, all had chronic gastritis, and among them 23.1% had atrophic gastritis, 42.3% corpus dysplasia and 57.7% antrum dysplasia. In this group, two mice (7.1%) with low differentiated adenocarcinoma were found. Compared with control group, two groups with H. ~pylori infection only and H. ~pylori plus MNU intake reached statistical difference in the view of inflammatory latitude (P

Human gastric cancer cells (MKN-45) were transfected with pULB3238 (a plasmid carrying MVMp NS gene). After the NS gene expressed, some of the NS-transfectants were died. The other cells were survived. In comparison with those of control MKN-45, the survived NS- transfected MKN-45 cells had the following characterizations: (a). nucleus/cytoplasm ratio reduced; (b). generation time prolonged;(c). adhesion ability between cells increased;(d). cloning efficiency decreased;(e). formation of tumors in nude mice suppressed. To investigate the possible mechanisms of above mentioned change of NS-transfectants, the effect of NS on the expression of some cytokine genes were explored. RNA dot blot indicated that the NS might enhance the expression of IL-l?(2.7 times), IL-1/?(4.6 times) IL- 6 nuclear factor (2.5 times) and had no effect on the expression of IL-6. The results suggested that the antineoplastic activity of parvoviruses may be medicated by NS interfere with the expression of cytokines in the host cells.

Background:The clinical presentation of eosinophilic gastroenteritis( EG)is nonspecific and has not received much concern by physicians and pathologists. The diagnosis of EG was delayed in many cases. Aims:To explore the clinical features of EG. Methods:The clinical,laboratory,endoscopic and radiologic features and treatment in patients who were diagnosed as EG from October 2011 to September 2013 in Zhongshan Hospital, Fudan University were analyzed retrospectively. Results:Median age of 10 EG patients was 41. 9 years. Four patients had a history of allergy or asthma. The time from onset to diagnose was 25 days on average. The most common symptoms were abdominal pain with bloating, diarrhea or vomiting. Eight patients had hypereosinophilia. Abdominal CT revealed uniform edema or stratified thickness of intestinal wall or ascites in 7 patients. Endoscopy revealed erythema,edema and erosion in antrum,duodenum or jejunum in 6 patients. All cases were confirmed as having eosinophilic infiltration by mucosal biopsy or examination of ascites. Seven patients were successfully treated with corticosteroid. One patients experienced relapse after discontinuing corticosteroids during following up. Conclusions:EG may be more common than previously recognized and should be considered in the differential diagnosis of unexplained abdominal pain with peripheral eosinophilia or uniform edema or stratified thickness of intestinal wall. Multiple biopsies in multiple sites including descending duodenum and pathological examination for finding eosinophil infiltration are the keys to confirm the diagnosis. Corticosteroids are effective in relieving symptoms and improving eosinophilia.

Objective:To conduct health economic evaluation of Chinese population-based screening and opportunistic testing strategies for the prevention of Helicobacter pylori ( H. pylori)-related diseases. Methods:The Markov models of H.pylori infection caused non-ulcer dyspepsia, peptic ulcer (PU) and gastric cancer were established. The cost and effects of the population-based screening, opportunistic testing, and non-intervention strategies in 100 000 population of our country were simulation calculated. Wilcoxon signed rank test was used for statistic analysis. Single factor sensitivity analysis was performed to analyze the impact of single parameter uncertainty on cost-effectiveness. Probability sensitivity was used to analyze the impact of common uncertainty of all parameters on cost-effectiveness. Results:Compared with opportunistic testing strategy and non-intervention strategy, the total cost of population-based screening strategy was reduced by 0.43 million yuan(-6.63 million yuan to 7.19 million yuan) and 4.45 million yuan(-8.60 million yuan to 27.93 million yuan), quality adjusted life years (QALY), life years and asmptomatic months were prolonged by 888.00 (479.86 to 1 574.10) and 3 032.78 (1 756.04 to 5 007.84), 651.82 (294.73 to 1 211.94) and 1 868.64 (1 045.88 to 3 148.34), 28 381.91 (19 109.54 to 43 736.72)and 102 537.13 (58 649.18 to 176 868.77) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 115 cases(52 cases to 232 cases) and 464 cases(266 cases to 803 cases), 74 cases(33 cases to 148 cases) and 260 cases(149 cases to 453 cases), 46 cases(25 cases to 72 cases) and 369 cases(210 cases to 710 cases), 80 cases(42 cases to 126 cases) and 501 cases(331 cases to 772 cases) respectively, and the differences were statistically significant ( Z=1.99, 10.54, 27.39, 27.39, 27.37, 27.39, 27.39, 27.39, 27.21, 27.28, 27.22, 27.28, 27.38, 27.39, 27.39 and 27.39, all P<0.05). Compared with the non-intervention strategy, the opportunistic testing strategy reduced the total cost by 3.89 million yuan(-2.79 million yuan to 18.18 million yuan), QALY, life years and asymptomatic months were prolonged by 1 764.77 (888.70 to 3 406.62), 1 044.16 (524.46 to 1 912.75) and 62 568.69 (30 054.07 to 129 892.76) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 311 cases(164 cases to 563 cases), 164 cases (87 cases to 301 cases), 325 cases(162 cases to 644 cases) and 399 cases(234 cases to 684 cases) respectively, and the differences were statistically significant ( Z=14.20, 27.39, 27.38, 27.39, 27.25, 27.25, 27.39 and 27.39, all P<0.01). The results of singlefactor sensitivity analysis showed that the uncertainty of any parameter did not affect the cost-effectiveness of three strategies. The results of probability sensitivity analysis indicated that the probability of cost-effectiveness advantage of the population-based screening strategy was 100% and the common uncertainty of all parameters had no effect on cost-effectiveness. Conclusions:For preventing H.pylori-related diseases, the population-based screening strategy has the lowest average cost and the best average effect. However, non-intervention strategy has the highest average cost and the worst average effect. Population-based screening strategy is worthy of promotion throughout China, and opportunistic testing strategy has a higher clinical practical value.

Objective To comprehensively evaluate the clinical and radiological features of patients with Klebsiella pneumonia liver abscess (KLA) in order to improve treatment. Methods Data of 197 patients with KLA (n=106) or non-KLA (n=56) between March 2001 and January 2009 were collected and retrospectively analyzed on the aspects of underlying diseases, clinical manifestations, laboratory tests, pathogenic and imaging examinations. Results In comparison with non-KLA patients, the underlying diseases such as diabetes (53. 77% vs 25.00%, P = 0. 001) and hepatic adipose infiltration (16. 04% vs 5, 36%, P<0.05) were more common in KLA patients.Whereas the clinical presentations including abdominal pain (57. 14% vs 40. 57%, P<0. 05),hypodynamia (46.43% vs 19.81%, P=0. 001) and hepatomegaly (14.29% vs 4.72%, P<0. 05)were more severe in non-KLA patients than in KLA patients, however, the fasting blood glucose was higher in KLA patients than in non-KLA patients [(7.84±0.36) mmol/L vs (5.76±0.30) mmol/L,P=0. 001] on the admission. In addition, the abscess of KLA often appeared alone in the right lobe of the liver and was liable to generate air cavity (32. 88% vs 13.51%, P<0.05), un-smooth rim (71.23% vs 40.54% ,P<0.05) and dynamic septum enhancement (41.10% vs 16.22% ,P<0.01) in comparison with non-KLA. Conclusions Klebsiella pneumonia has emerged as the main pathogen of pyogenic liver abscess. The patients with KLA are often complicated with diabetes and fatty liver, as well as high prevalence of air cavity. The CT findings may be helpful for prompt treatment of Klebsiella pneumonia liver abscess.

BACKGROUND: 5-fluorouracil (5-Fu) is universally used as an antineoplastic agent in gastrointestinal cancer, but the side effect of it confined further clinical application. OBJECTIVE: To determinate mice plasma concentration curves for 5-Fu and its chitosan (CS)-polyaspartic acid (Pasp) nanoparticles, and to investigate their primary pharrnacokinetics. DESIGN, TIME AND SETTING: Randomization control animal trials were performed in the Department of Gastroenterology, Zhongshan Hospital of Fudan University between October 2006 and June 2007. MATERIALS: Totally 180 female Kunming mice were obtained from the Department of Laboratory Animal, Fudan University. 5-Fu (purity 99%) was purchased from Shanghai Xudong Haipu Pharmaceutical Co, Ltd (Shanghai, China). Two kinds of CS-Pasp-5-Fu particles were offered by Department of Macromolecular Science, Key Laboratory of Molecular Engineering of Polymers of Educational Ministry, Fudan University (Shanghai, China). METHODS: Kunming mice were randomly divided into three groups and each group was administrated with 5-Fu or either type of its CS-Pasp-5-Fu nanoparticlos. The plasma concentrations of 5-Fu were evaluated by high performance liquid chromatography after 15 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours, 16 hours, 24 hours and 48 hours of the administration. The pharmacokinetic parameters were computed utilizing 3P97. MAIN OUTCOME MEASURES: Relative recovery, absolute recovery and the stability of samples. RESULTS: The peak concentration of 5-Fu group occurred within 15 minutes and then decreased rapidly. The No.1 nanoparticles group's peak concentration occurred 6 hours after the administration and the effective concentration time lasted for about 14 hours. No.2 nanoparticles group's concentration curve was double-apex, the apexes occurred around the 2 hours and 16 hours, the concentration decreased at the 24 hours after the administration. Both of the two kinds of the nanoparticles groups' peak concentration of 5-Fu in plasma are lower than the 5-Fu group, The half-life times were prolonged and the areas under curve were higher. CONCLUSION: Compared to 5-Fu, the CS-Pasp-5-Fu nanoparticles are controlled released.

Background and purpose:Traditional Chinese medicine with notable effect and little adverse reaction is increasingly concerned about the medical profession because of its great potential and advantage in treating pancreatic carcinoma. In this experiment, we studied the effects of oridonin on apoptosis and cytoskeletal protein F-actin in human pancreatic carcinoma SW1990 cells. Methods:SW1990 cells in culture medium were treated with different concentrations of oridonin. The inhibitory rate of the cells was measured by MTT assay. Morphology of cell apoptosis was observed by DAPI stain and cell apoptotic rate was detected by lfow cytometry (FCM). The morphological changes of F-actin were observed by laser confocal microscopy. Results:The growth of human pancreatic carcinoma SW1990 cells was signiifcantly inhibited by oridonin. Apoptosis morphological changes including condensation of chromatin and nuclear fragmentation were observed clearly by DAPI stain. The early apoptotic rate of SW1990 cells treated with 25, 50μmol/L oridonin was signiifcantly higher than that of the control group (3.78±0.46, 9.51±0.63 vs 0.73±0.06, P<0.05), and the late apoptotic rate and cell necrosis rate were also signiifcantly higher than that of the control group (14.40±1.78, 20.53±2.54 vs 4.16±0.31, P<0.05). F-actin was showed from polymerization to depolymerization after oridonin treatment. Conclusion:Oridonin can obviously inhibit the proliferation and induce apoptosis of SW1990 cells. The mechanisms may involve the depolymerization of F-actin after treatment with oridonin.

Objective To study the effect of magnetic doxorubicin stealth liposome on human gastric cancer xenografts in nude mice.Methods Human gastric cancer cell line MKN-45 was implanted into 36 nude mice.Different kinds of drug were injected through the caudal vein of tumor bearing nude mice divided into 6 groups .Permanent magnet was put into tumor in targeting group.Results The growth speed of tumor in the group of MDL (+) significantaly slowed down than other groups.The rate of tumor restrain in tumor weight and tumor volume of MDL (+) group were 71% and 70%, which were remarkably higher than those of the DOX and MDL (-) group (all P

Objective To prepare chitosan-polyaspartic acid-5 fluorouracil (CTSPasp-5FU) nanoparticles and to investigate its anti-neoplastic effect and toxicity.Methods CTS-Pasly5FU nanopartieles were synthesized by ion gelatifieation.BALB/C nude mice were injected with gastric carcinoma cell line SGC- 7901 mass subcutaneously near nape to establish human gastric carcinoma model.Then they were randomly al- located into chitosan-polyaspartie acid -5fluorouracil(CTS-Pasp-SFU,containing 5-FU 1.25mg/kg) group, 5-FU (1.25mg/kg) group and normal saline group.Tumor weight was measured and the colony forming unit- granulocyte and maerophage (CFU-GM) was investigated.Results The drug content of CTS-Pasp-5FU was 40.2% and the encapsulation efficiency was 34.9%.Compared with normal saline group,tumor volume of 5-FU group and CTS-pasp-5-FU group were significantly decreased 21 days after treatment (P