ObjectiveTo investigate the relationship between colorectal neoplasia and nonalcoholic fatty liver disease (NAFLD).MethodsData of 809 patients who had undergone colonoscopy and epigastric CT scan in the same period were reviewed for gender,age,history of diabetes,hypertension,hyperlipidemia,NAFLD,colonoscopy and pathology results.Correlation of colorectal adenoma (CRA),colorectal carcinoma (CRC) and NAFLD were studied with multivariate Logistic analysis.Results NAFLD (P ＜0.0001,OR 2.06,95％ CI 1.53-2.76) was the independent risk factor for CRA,where the incidence of CRA was higher than that in the control group.ConclusionPatients with NAFLD is the risk population of colorectal adenomas.

Objective To explore the relation between IL-10 promoter region gene polymorphism and irritable bowel syndrome (IBS).Methods By polymerase chain reaction combined with restrition fragment length polymophism (PCR-RFLP),gene type of IL-10 promoter -1082 and -819 sites in 313 IBS patients and 281 controls was analyzed.Results The distribution of IL-10-1082 and-819 allele frequencies in IBS group,control group and total was in accordance with Hardy-Weinberg equilibrium law.The frequency of IL-10-819 T allele in diarrhea subtype (79.8％) and mixed IBS subgroup (77.1％) was significantly higher than that in control group (65.7％).There were no significant differences in IL-10-1082 A/G allele frequency between each subtypes and control group (P＞0.05),however there was statistically difference between diarrhea subtype and mixed IBS subgroup (P＜0.05).The frequency of-819 T/T genotype in IBS group (51.1 ％ )was significantly higher than that of control group (40.2％),the frequency of C/T genotype was significantly lower than that of control group,and the difference was statistically significant (all P＜0.05).The IL-10-819 T/T allele frequency of all IBS subtypes was significantly higher than that of control group; however C/T allele genotype frequency of all IBS subtypes was significantly lower than that of control group,and the difference was statistically significant (all P ＜ 0.05). There was no significant difference of C/C allele genotype between subtypes (P＜0.05).There was no significant difference of -1082 allele genotype between IBS group and control group (P＞0.05).The frequency of -1082 A/A genotype in diarrhea subtype of IBS patients (93.3％) was significantly higher than that of mixed IBS subtype (82.4％),while the frequency of A/G genotype was lower than that of mixed IBS subtype,and the difference was statistically significant (all P ＜ 0.05 ); there was no significant difference between other IBS subtypes and control group (P＞0.05).Conclusion IL-10-819 promoter T/Tgenotype may be related to IBS pathogenesis.

Objective To investigate the prevalence of subclinical hepatic encephalopathy(SHE) in patients with cirrhosis. Methods One hundred and seventy five consecutive cirrhotic patients(mean age 53 years, range 27～72) without any overt clinical encephalopathy were screened for SHE using number connection test A(NCT A) and symbol digit test(SDT) with age corrected normal value, which have been developed in 356 persons without liver disease and are defined as the mean?2 standard deviation. Results Fifty patients(28.6%) were abnormal in both NCT A and SDT, 16(9.1%) were abnormal only in SDT and 34(19.4%) only in NCT A. Taken together, two tests diagnosed SHE in 100 patients(57.1%). The prevalence of SHE increased from 46.8% and 53.0% in Child Pugh grade A and B, to 76.6% in Child Pugh grade C. Conclusions SHE was found in 57.1% of cirrhotic patients without overt clinical encephalopathy, which was linked to the severity of liver cirrhosis.

Objective To assess the incidence of noctu rnal acid breakthrough(NAB) and its' relationship with Helicobacter pylori(H. pylori) infection in patients with duodenal ulcer. Methods Forty duodenal ulcer patients were randomly allocated in to five groups. Patients were treated by intravenous injection of omeprazole 40 mg twice daily(group 1), once daily(group 2), omeprazole 20 mg twice daily oral ly(group 3), omeprazole 20 mg once daily orally(group 4), and intravenous inject ion of cimetidine 600 mg twice daily (group 5) all for 5 days. Intragastric pH o ver 24 hours was consecutively recorded on the fifth day for each patient. Results The mean intragastric pH, median intragastric pH, nocturn al mean pH and nocturnal median pH in group 1(6.9?0.7,7.3?0.8,6.8?0.9,7.1? 0 .7) were significantly higher than those of group 2 (5.3?1.6,5.6?1.7,4.9?1. 5,4.3?1.7),group 4(4.8?0.7,4.8?1.0,4.7?0.8,4.5?0.8), and group 5(4.4?2.4 ,4.5?2.5,4.6?2.7,4.3?2.1), but not higher than group 3(6.2?0.7,6.3?0.8,6. 4?1.1,6.4?0.8). High intragastric pH was produced in all five groups. The frac tion time of pH below 4.0 in group 1(3.1%) and group 3(4.5%) were significantly fewer than that in the other three groups(group 2,27.8%; group 4, (32.4)%, and group 5,48.2%) respectively. NAB occurred in 1 patient from two omeprazole twice dai ly groups(6.3 %, group 1 and 3) and in 9 patients from two omeprazole once daily groups((56.3 %,) group 2 and 4,P

Objective To assess the incidence and management of nocturnal acid breakthrough (NAB). Methods Forty patients with duodenal ulcer confirmed by gastroscopy were randomly divided into five groups, eight patients in each group. Patients were treated by the following strategies for a course of 5 days: group A (omeprazole 20 mg per day orally in the morning), group B (omeprazole 20 mg twice a day orally in the morning and at 4 p.m), group C (intravenous injection of omeprazole 40 mg twice a day in the morning and at 4 p.m), group D (omeprazole 20 mg per day orally in the morning plus ranitidine 150 mg at bed time) and group E (omeprazole 20 mg twice a day orally in the morming and at 4 p.m plus ranitidine 150 mg at bed time) respectively. Intragastric pH over 24 hours was recorded on the morning of the fifth day for each patient. Results In comparison with that in group A, intragastric pH was higher in the other four groups. The mean intragastric pH and mean nocturnal pH each in group B (6.2?0.7, 6.4?1.1), group C (6.9?0.7, 6.8?0.9), group D (6.0?0.7, 5.9?0.7) and group E (5.8?0.5, 6.1?0.5) were significantly higher than those in group A (4.8?0.7, 4.7?0.8, P

Objective To evaluate the efficacy of high intensity focused ultrasound (HIFU) combined with ultrasound contrast agent on rabbit liver, and to investigate the possibility of ultrasound contrast agents enhancing the effect of HIFU on rabbit liver. Methods Thirty-two rabbits were averagely divided into two groups according to their body mass. Rabbits in group Ⅰ were irradiated by HIFU alone on the liver, and those in group Ⅱ were treated by irradiation of HIFU after intravenous injection of a ultrasound contrast agent. The used treatment time, frequency, power and the distance from focus to the skin surface were identical in the two groups. The changes of ultrasound image were recorded at the 20 s, 2 min and 5 min after treatment. Four rabbits in each group were slaughtered for morphological and pathological examination immediately and on the 2nd, 3rd and 7th day after the treatments, respectively. Results The ultrasonic gray scale differenced in the HIFU alone group were ( 20.12? 12.4)s (20 s), ( 16.8? 9.3)min (2 min) and ( 15.1? 11.9)min (5 min). Compared with those in the enhanced HIFU group were ( 63.9? 29.4)s, ( 60.0? 25.9)min, ( 59.3? 28.7)min, respectively(P

0.05). However in OAC group, there were significant differences between EM and IM(P0.05). Conclusions RAC and OAC triple therapy could eradicate H. pylori effectively. The efficacy of rabeprazole-based triple therapy was less affected by the CYP2C19 genotype. The eradication rates of H. pylori in PM and IM were higher than that in EM.

Objective To evaluate the diagnostic efficacy of double-balloon push enteroscopy in small bowel disorders. Methods From July 2003 to March 2004, 38 patients with presentation of gastrointestinal upset and underwent a previous negative gastroscopy, colonoscopy, gastrointestinal barium and/or angiography were enrolled in this study. Enteroscopy via oral or rectum was done in 30 patients while in the other 8 patients full access to the small bowel was attempted by the two-way method, firstly via upper GI and then the lower GI. Results Positive diagnostic yield was made in 33 patients (86. 8% ). These disorders included Crohn's disease (7/38) , multiple ulcerations (5/38) , arteriovenous malformation (4/38) , multiple diverticula (4/38) , varices (3/38) , malignant stromal tumor (2/38) , ileitis (2/38) , and 1 case in each of moderate-differentiated adenocarcinoma, Ankylostoma duodenale, ascariasis, eosinophilic enteritis, anas-tomotic stricture and tuberculosis. The procedures were carried out satisfactorily in all patients but 2 failed from the intolerance of patients. Complication never occurred. Conclusion Double-balloon push enteroscopy has the superiority in direct visualization of whole small intestine with high positive findings and safety but with high technical demand in manipulation.

Objective To evaluate the short-term effect and safety of endoscopic pyloromyotomy for congenital hypertrophic pyioric stenosis(CHPS).Methods Twelve infants,including 8 boys and 4 girls,mean age(57.5±14.4)days,who were diagnosed as CHPS,underwent endoscopic pyloromyotomy by using an ultra-thin gastroscope.Incisions were made from the duodenal to the antral side of the pylorus by an endoscopic electrosurgical sphincterome or a needle knife.Results These 12 patients underwent 13 endoscopic operations.Vomiting ceased in 1-10 days in 11 cases,of which one patient's vomiting was recurrent 35 days after the first procedure,which was improved 10 days later after another endoscopic operations.Another one did not stop vomiting because of cytomegalovirus hepatitis,whose symptoms were relieved after secondary treatment.No complications were observed except for minor melena in one case after the therapy.Conclusion Endoscopicall pyloromyotomy in CHPS is effective and safe in short-term follow-up.

Objective To investigate the prevalence,incidence,death causes and natural course of nonalcoholic fatty liver disease (NAFLD) as well as the risk factors of NAFLD development in population of Guangdong province.Methods On the basis of previous epidemiological survey in 2005,3545 subjects were followed up (medium 4 years) for death causes.Of which,624 subjects (re-survey group) received interview,physical examinations,biochemical tests and ultrasonography again.The natural course and the risk factors of the NAFLD were analyzed.Results Of 3543 subjects,219subjects were failed to followed up and 4 out of 467 NAFLD patients (8.6‰) died of cardiovascular and cerebrovascular diseases during follow-up period.In rest 2857 subjects,22 (7.7‰) died of cardiovascular/cerebrovascular diseases and cancers.However,there were 117 NAFLD patients in resurvey group at the baseline.The NAFLD remained in 51 (43.6%) patients,aggravated in 26 (22.2%),alleviated in 21 (18.0%) and regressed in 19 (16.2%) at the endpoint.Meanwhile 185(36.5 %) out of 507 normal subjects developed NAFLD at the endpoint.The standard prevalence of NAFLD increased from 10.5% (2005) to 22.6% (2009,P<0.05).The standard incidence was 4.9% per year with male (5.1%) being higher than female (4.7%,P<0.05).The cumulative incidence was significantly higher in urban cities (43.1%) than in rural areas (27.4%,P<0.05).Cox proportional hazards regression showed that the age (OR= 1.893),waist circumference (OR=2.512),waist-to-hip ratio (WHR,OR= 1.400),body mass index (BMI,OR=2.581) and serum cholesterol levels (OR = 1.587) were associated with the development of NAFLD (P < 0.05).Multivariate regression logistic analysis revealed that age and BMI were associated factors for NAFLD.Decreased waist circumference was prone to remission.Conclusions The higher prevalence and incidence of NAFLD were noted in population of Guangdong province.The NAFLD patients mainly died of cardiovascular/cerebrovascular diseases,but not liver disease.Obesity,aging and dyslipidemia are high risk factors for NAFLD development.