Objective To study the effects of intragastric ice water stimulation on bowel sensitivity, mast cells (MCs), the serum contents of serotonin (5-HT), leukotriene B 4 (LTB 4 ), histamine(HA)and bradykinin (BK) in rats, and explore the possible pathogenesis of cold drinks-induced irritable bowel syndrome (IBS). Methods 40 Wistar rats aged 4 weeks were randomly divided into two groups. Twenty rats of group A as experimental group were gavaged 0-4℃ ice water for 14 days, and the rats of group C as control group were not treated. On day 28, the group A and group C were again divided into two subgroups, respectively, i.e. A1, A2, C1, and C2. In the rats of subgroups A1 and C1, a balloon was introduced into the rectum of each animal, and number of abdominal withdrawal reflexes (AWR) was recorded after the balloon was distended for 3 minutes to assess bowel sensitivity. One hour after rectal distention, blood sample of each rat was collected from the heart for the measurement of the contents of 5-HT, LTB 4 , HA and BK in serum by enzyme linked immunoadsorbent assay (ELISA). Tissues harvested from the ileocecal junction and colon were sectioned and stained with haematoxylin-eosin (HE) for routine pathological examination, and with the improved toluidine blue method for the identification of MCs. Results The number of AWR to 1.0ml balloon distention in subgroup A 1 was significantly lower than that in subgroup C 1 (P0.05). Routine pathological examination did not show abnormality in both subgroups. In group A 1 , the numbers of MCs in the ileocecal junction and colon were significantly higher than those of group C 1 (P0.05). Conclusion The stimulation of the stomach with ice water results in lowering of bowel sensitivity, increase of MCs and elevation of serum contents of 5-HT, LTB 4 and HA, and the results might imply that cold stimulation of the stomach might play a role in the pathogenesis of IBS.

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.

Objective To investigate the quality of life(QOL),gastrointestinal symptoms and mental status of patients with irritable bowel syndrome(IBS),and to find out the possible factors affecting the patients' QOL.Methods The questionnaires which included three forms were sent to 55 IBS patients and 40 healthy controls recruited from the authors' clinical department.IBS was diagnosed according to the Rome II criteria,and patients with organic diseases were excluded from this study.The nine-item scores of QOL in all cases were calculated by using the disease-specific form included in the questionnaire of QOL.The mental-psychological status in all cases was evaluated by using the Hospital Anxiety and Depression Scale(HAD).The gastrointestinal symptoms in IBS patients were recorded and graded according to the Gastrointestinal Symptom Rating Scale(GSRS).The data mentioned above were analyzed with regression model.Results Patients with IBS had statistically significant lower scores(P

0.05).These findings indicate that severe burns can destroy the coupled phosphorylation in the mitochondria and impair their capability to produce ATP.Immediate fluid infusion after burns can protect the mitochondrial function effectively.

ObjectiveTo determine the effect of peroral endoscopic myotomy (POEM) on esophageal manometry in patients with achalasia.MethodsEsophageal manometric data of 3 patients with achalasin before and after POEM was retrospectively analyzed.ResultsThe post-POEM lower esophageal sphincter pressure (LESP) and upper esophageal sphincter residual pressure (UESRP) were significantly lower than those of before ( P ＜ 0.05 ).The average post-POEM lower esophageal sphincter residual pressure (LESRP) decreased (P ＞0.05),with significant decrease to normal level in 2 patients and almost unchanged (above normal) in the other.The esophageal aperistalsis remained after POEM in all 3 patients.The lower esophageal sphincter relaxing rate (LESRR) remained lower than normal after POEM as before.The average upper esophgeal sphincter pressure (UESP) decreased after POEM without statistical significance.ConclusionPOEM can improve the outcomes of esophageal manometry in patients with achalasia in the short term.

Objective To develop a new method to detect A (TA)n TAA polymorphism in the UGT1A1 gene promoter by fluo‐rescence real‐time quantitative PCR (RQ‐PCR) .Methods Genomic DNA was extracted from peripheral blood in 16 patients with Gilbert′s syndrome and 66 healthy individuals .The polymorphic A(TA)n TAA sequence in the UGT1A1 gene promoter was deter‐mined by DNA sequencing .A pair of primers and two TaqMan probes labeled with either 5′FAM or VIC reporter dye incorporated a 3′minor groove binder were designed .The A(TA)n TAA polymorphisms in the UGT1A1 gene promoter were identified by RQ‐PCR for all research subjects .The sensitivity and specificity of RQ‐PCR for detecting the A(TA)nTAA polymorphisms were veri‐fied by DNA sequencing method .Results The homozygous A(TA)7TAA polymorphism was found in the promoter region of the UGT1A1 gene in all 16 patients with Gilbert′s syndrome by using RQ‐PCR .The homozygous A(TA)6TAA polymorphism was foundin46healthysubjects,whiletheheterozygousA(TA)6TAA/A(TA)7TAApolymorphismwasfoundinother20healthysub‐jects .All A(TA)nTAA polymorphisms in the promoter region of the UGT1A1 gene identified by RQ‐PCR were consistent with that of DNA sequencing .Conclusion It is a sensitive ,specific and simple method to detect the A (TA)n TAA polymorphisms in the promoter region of the UGT1A1 gene by RQ‐PCR ,which can be promoted and applied in clinic .

Objective To investigate the potential effectiveness of a computer-based gastrointestinal (GI) endoscopy simulator in assessing the competence of GI endoscopy trainees.Methods Fifty trainees working in the endoscopy center of General Hospital of Chinese PLA between February 2009 and October 2011 were enrolled.These participants were divided into four groups based on their prior endoscopic experience:novices (no endoscopy experience),intermediate experienced (≤200 colonoscopies or ≤ 500 gastroscopies),experienced (201-1000 colonoscopies or 501-2000 gastroscopies),and experts (＞ 1000 colonoscopies or ＞ 2000 gastroscopies).Assessment of endoscopic skills was performed during a hand-eye coordination task (Endo Bubble level 1) and was based on parameters measured by the computer system including time to finish,average time between two bubbles,number of times wall touched.Results When GI trainees were categorized by their prior gastroscopy number,the time to finish of each group were (302.43 ± 108.96)s,(188.00 ± 59.88) s,135.00 (40.00) s,150.00 (69.00) s,and the average time between two bubbles were (14.29 ± 5.47) s,(8.82 ± 3.28) s,6.00 (2.00) s,7.00 (4.00) s,respectively.Pairwise comparison showed that except experienced and experts groups (P ＞ 0.05),there were significantly differences between remaining groups (P ＜0.01).However,based on the colonoscopic experiences,the time to finish of each group were 220.00(91.00)s,127.00(28.25)s,155.50(81.00)s,150.00(58.50)s,respectively,which were significantly different between each two groups (P ＜ 0.01).Average time between two bubbles of each group were 10.00 (4.00) s,5.50 (1.50) s,7.00 (3.75) s,7.00 (3.50) s,respectively,which were found significantly different among whole groups (P ＜ 0.05 or P ＜ 0.01),but there were no differences between novice and experienced trainees and between intermediate experienced and experts groups.In contrast,the number of wall-touch was insufficient for assessment.Except the significant difference between novice and experienced group (P ＜ 0.05) as categorized by gastroscopy experience,there were no values to differentiate the trainees of different practical competence on gastroscopy or colonoscopy.Conclusion The parameter,time to finish,during a hand-eye coordination task using a virtual reality simulator might be able to differentiate the competence of operators,which was used prior to training in real-life endoscopy,but lack of accurate discriminatory function between experienced and experts.

Objective To investigate the demethylation and changes in gene expression of programmed death receptor-1 ( PD-1) caused by methylation inhibitor 5- azacytidine (5-Zac) in lymphocyte series Molt-4 cells and its mechanism. Methods Molt-4 cells were cultured in different concentrations of 5-Zac(0, 5, 10 Umol/L)for 72 h, ratio of cell expressing PD-1 and apoptosis rate were detected by FCM, transcription of PD-1 gene mRNA was detected by RT-PCR. Molt-4 cell DNA of all groups were disposed by sodium bisulfite, PD-1 gene promoter fragment binded with transcription factor Brn-2 was amplified by PCR,these amplification fragments were transformed into E. coli. Positive clones were selected by sequencing,methylation status of the fragments binded with transcription factor Brn-2 was examined. Results S-Zac could increase the PD-1 expression of Molt-4 cells. PD-1 expression rate in 0 μmol/L 5-Zac( 1. 13%±0.01% ) treated cells was found more lower than that in both 5 μmol/L and 10 μmol/L 5-Zac treated cells (18. 96% ±1. 87% , 63. 09% ± 6. 25% , P < 0. 05 ) , and they showed concentration-dependent (P <0.01). Cells apoptosis rate and PD-1 mRNA expression were also observed increased significantly with 5-Zac treating. Demethylation probability of CG points showed significant difference between transcription factor Brn-2 binding site and other four locations (P < 0.05 ). Conclusion 5 -Zac inhibits cell grouth in human lymphoid cell series Molt-4 by inducing PD-1 gene expression and promoter demethylation. PD-1 gene promoter binding transcription factor Brn-2 fragment CG point demethylation may be one of the important mechanisms in 5-Zac treated Molt-4 cells.

ObjectiveTo explore linkage relationship between polymorphisms of (AC)n (AT)xTy and mutations in the β-globin gene in patients with mild β-thalassemia.MethodsThe subjects were 89 mild β-thalassemia patients with known mutations and 110 healthy subjects from People's Hospital of Baoan District of Shenzhen from February 2009 to July 2010.Genomic DNA was extracted from peripheral leukocytes.Sequence of the BP1 binding site upstream of the β-globin gene was amplified by polymerase chain reaction,polymorphisms of (AC)n (AT)xTy were determined by DNA sequencing.Allelic frequencies of (AC)n (AT)xTy between mild β-thalassemia patients and healthy subjects were compared using x2 test.Mutation rates between two groups were also compared using x2 test for subjects carrying same haplotype. Linkage relationship was conducted according to allelic frequencies and mutations. Results Analysis of the (AC)n(AT) xTy polymorphisms of the BP1 binding site upstream of the β-globin gene showed 9 different genotypes: (AC)2( AT)7T7,( AC)2( AT)8T5,( AC)3( AT)7T5,( AC)2( AT)9T5,( AC)2(AT)8T9,(AC)3(AT)8T5,(AC)2(AT)10T3,(AC)2(AT)7T5 and (AC)2(AT)11T3.The (AC)2(AT)7T7 and (AC)2 (AT)8T5 genotypes were common for patients with mild β-thalassemia.Allele frequencies of (AC)2(AT)7T7,(AC)3 ( AT)7T5 and ( AC)2( AT)8T9 were 38.8％ (69/178),11.8％(21/178),9.0％ ( 16/178 ) for mild β-thalassemia patients,and 24.1％ ( 53/220),5.4％ ( 12/220),3.2％(7/220)for healthy subjects, respectively, there were significant differences between mild β-thalassemia patients and healthy subjects (x2 =9.966,4.371,6.093,P ＜ 0.05 ).Allele frequency of (AC)2(AT)9T5 was 10.1％ (18/178) and 33.2％ (73/220) for mild β-thalassemia patients and healthy subjects,frequency of (AC)2 (AT)9T5 was significandy lower in mild β-thalassemia patients than in healthy subjects (x2 =29.691,P ＜0.01 ).Allele frequency of (AC)2(AT)8T5 was 25.3％ (45/178) and 29.1％(64/220) for mild β-thalassemia patients and healthy subjects,there wasn't significant difference between patients and healthy subjects (x2 =0.718,P ＞0.05).The mutation rates of codon41/42(-TTCT) and IVSⅡ-654(C→T) were 59％ (10/17) and 29％ (5/17) for mild β-thalassemia patients carrying (AC)2(AT)7T7 allele,and 29％ (4/14) and 57％ (8/14) for patients carrying ( AC)2 (AT)8T5 allele.There were not significant differences between codon41/42(-TTCT) mutation rate and IVS-Ⅱ-654(C→T) mutation rate (x2 =2.982,2.333,P ＞ 0.05 ) for mild β-thalassemia patients carrying ( AC)2 ( AT)7T7 and ( AC)2(AT)8T5 allele.ConclusionsAllele of (AC)2(AT)7T7,(AC)3(AT)7T5 and (AC)2(AT)8T9 are in linkage disequilibrium with β-thalassemia.Most mild β-thalassemia patients carrying (AC)2 (AT)7T7 allele are caused by codon41/42 (-TTCT) mutation in the β-globin gene,and IVS-Ⅱ-654 (C→T) is a major mutation for patients carrying (AC)2(AT)8T5 allele.

ObjectiveTo evaluate the effects of double plates in the treatment of humeral intercondylar fractures.MethodsFrom January 2004 to March 2011,31 patients with humeral intercondylarfractures were reviewed.According to AO/Müller classification,there were three patients with type C1 fractures,16 with type C2 and 12 with type C3.Trans-olecranon osteotomy or trans-triceps-side approach and internal fixation by standard method of AO double plates were performed in all patients.ResultsAll 31patients were followed up for 12 -18 months,which showed fracture healing 6-12 months after surgery.According to the Cassebaum scoring system,the effects were evaluated as excellent in seven patients,good in 19,fair in four and poor in one,with excellence rate of 87％. ConclusionDouble plates is proved to be a good choice for humeral intercondylar fractures,since it can obtain satisfactory outcome with solid fixation,stable mechanical properties,few complications and facilitation for early rehabilitation.