As a kind of new technology, ethical issues are inevitable in medical and non-medical gene en-hancement application. It is unrealistic to unilaterally support or object to the research and application of medical and non -medical gene enhancement. Based on standardizing the ethical principle of gene enhancement tech-niques, we should build management measures of the research, development and application that adapted to ethi-cal, social and legal standards, so that we can draw on the advantages and avoid the disadvantages, and use gene enhancement reasonably and bring benefits to mankind and society.

A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.
Aged ; Carcinoma ; complications ; diagnosis ; Humans ; Male ; Maxillary Sinus ; microbiology ; pathology ; Mycoses ; complications ; Nose Neoplasms ; complications ; diagnosis ; Sinusitis ; microbiology

Objective To investigate the influence of endoscopic retrograde cholangiography (ERC), endoscopic retrograde pancreatography (ERP), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and endoscopic biliary stenting on postoperative pancreatitis. Methods 412 patients referred to ERCP were divide into 7 groups, there were both biliary and pancreatic ducts group (ERCP), biliary duct contrast filling group (ERC), pancreatic duct contrast filling group (ERP), ERCP plus biliary stenting group (stent), ERC plus stent, ERCP plus EST and stone extraction (SE) group, and ERC plus EST and SE group. And the differences of postoperative serum amylase in 4 hours and in 24 hours as well as clinical symptoms were compared among different groups. Results The incidence of postoperative hyperamylasaemia in 4 hours and 24 hours were 17.7% and 4.4% respectively. The incidence of postoperative acute pancreatitis was 3.9%, and ERP group had the highest incidence of postoperative acute pancreatitis among the 7 groups. Conclusions Repeated pancreatic duct contrast filling during ERCP manipulation is the main risk factor for postoperative pancreatitis, and therapeutic ERCP such as EST, stent and SE does not increase the incidence of postoperative pancreatitis.

Objective To explore the potential role of the expression of cytokine-induced neutrophil chemoattractant (CINC)gene in the pathogenesis of acute lung injury(ALI)in early severe acute pancreatitis(SAP). Methods SAP was induced by retrograde injection of 5% sodium taurocholate into the bili-pancreatic duct. Wet to weight ratio and myeloperoxidase(MPO) content of lungs were measured. Pathological changes in the pancreas and lungs were observed. Intrapulmonary expression of CINC gene was assessed by reverse transcription polymerase chain reaction(RT-PCR). Results Compared with that in controls,intrapulmonary expression of CINC gene?wet to weight ratio,and MPO of lungs were increased greatly in twelve hours. The CINC mRNA expression in lungs was significantly correlated with the severity of lung injury,wet to weight ratio,and MPO of lungs. Conclusion Overpexpression of CINC mRNA in the lungs might play an important role in the pathogenesis of ALI in early SAP.

Objective To construct a recombinant live attenuated Salmonella typhimurium nucleic acid vaccine carrying Helicobacter pylori ( H. pylori ) hpaA gene and to detect its immunogenicity. Methods hpaA gene fragment was amplified by polymerase chain reaction (PCR) from the genomic DNA of the standard H. pylori strain and cloned into pUCmT vector. DNA sequence of the amplified hpaA gene was assayed,then cloned into the eukaryotic expression vector pIRES through enzyme digestion and ligation reactions. The recombinant plasmid was used to transform Escherichia coli DH5?,and the positive clones were screened with PCR reaction and restriction enzyme digestion. Then,the recombinant pIRES-hpaA was transformed to LB5000,then the recombinant plasmid was transformed to SL7207,and the recombinant strain was passaged repeatedly. Finally,recombinant pIRES-hpaA was transfected to COS-7 cells with Lipofectamine TM 2000. The immunogenicity of expressed hpaA protein was determined with SDS-PAGE Western blot. Results The hpaA gene fragment of the 750 base pair was amplified from the genomic DNA,and it was consistent with the sequence of the H. pylori hpaA by sequence analysis. It was confirmed by PCR and restriction enzyme digestion that Helicobacter pylori hpaA gene was inserted into the eukaryotic expression vector pIRES and a stable recombinant live attenuated Salmonella typhimurium nucleic acid vaccine carrying Helicobacter pylori hpaA gene was successfully constructed,and specific strip of hpaA expressed by pIRES-hpaA could be detected with Western blotting. Conclusion The recombinant attenuated Salmonella typhimurium nucleic acid vaccine strain expressing HpaA protein with immunogenicity was constructed,it might be helpful for further investigation concerning the immune action of the nucleic acid vaccine in vivo .

Objective To study clinical characteristics and prognosis of patients with liver injury of acute pancreatitis.Methods 290 cases of acute pancreatitis admitted between January 2001 to October 2003 were reviewed and analyzed retrospectively.Results Through comparing different types of AP with liver injury and C-reactive protein (CRP) changes,it was found that the more severe AP was,the more significant liver injury was;and liver injury of severe AP had some connection with CRP(.P.

0. 05 ) . Conclusion The cagG gene of Hp was quite conservative, most of the Hp strains in Chinese patients were cagG positive, it has no specific predisposition to different disorders and shows no significant correlation to the extent of gastric mucosal inflammation. Therefore cagG can' t be served solely as a related pathogenic gene for certain diseases.

Objective The clinical efficacy of pancreatic stent in treating chronic pancreatitis was summarized. Methods The stents were applied in 14 patients with chronic pancreatitis and ductal stricture manifested clinically and roentgenographically. Postoperative abdominal pain, changes in appetite, body weight and fat in stools were observed in follow－ ups. Results The stents, 5～ 10F in caliber, were successfully placed in all patients with first attempt. They were followed up for 210 days ( ranging 28～ 520 days ). The early (3 months ) results showed that the pain remitted in 13/14 (92.9％ ) and 11/13 (84.6％ ) of cases respectively. While abdominal pain persisted in 2 cases inspite of the stents. Along with pain remission the appetite and presence of fat in stools improved associated with increase in body weight. The stents drainage maintained for a median to 256 days (ranging 90～ 520 days) Transient hyperamylasemia occurred in 3 cases. Translocation and occlusion of the stent was found in 1 occasion each on the 98 and 520 day respectively. No other serious complication was detected. Conclusion It is assumed that pancreatic stent is effective to treat chronic pancreatitis with ductal stricture.

Objective To study the technique of double stent drainage on biliary and pancreatic ducts obstruction,and to assess its clinical effectiveness.Methods Firstly,ERCP was done on all patients to investigate the locus and extent of the stricture or obstruction,in order to choice the stent with suitable diameter and length.Then the stents placed into biliary and pancreatic ducts though the guidewires those was inserted into the ducts already.After the operation,the level of serum amylase and clinical symptoms such as jaundice,abdominal pain and diarrhea were observed to assess the therapeutic effect.Results 14 patients diagnosed as biliary and pancreatic ducts stricture or obstruction were treated successfully with this method(5 patients suffered from ampulla cancer,4 carcinoma of head of pancreas,3 carcinoma of duodenum papilla,2 chronic inflammation of head of pancreas).Thirteen patients were placed with 14 plastic biliary stents in their biliary ducts(each was placed with one stent except one with 2 stents),and one patient was placed with metal stent.At the same time,14 pancreatic stents were placed into pancreatic ducts of these patients.The rate of jaundice extinction in 2 weeks,1 month and 3 months after the operation was 50 percent,71 percent and 93 percent respectively.The rate of abdominal pain remission in 2 weeks after operation was 75 percent.Among 7 diarrhea patients ,the clinical symptoms disappeared in 5 patients and were significantly improved in 2 patients one month after the operation.The obstruction and displacement of stents had not been observed in all patients within 3 months after the operation.The complications related to operation had not been observed in all patients within 3 months after the operation.Conclusions The therapy with double stent drainage in biliary and pancreatic duct stricture is safe and effective.It can relieve jaundice and abdominal pain,decrease biliary pressure and improve the exocrine dysfunction of pancreas.

Objective To investigate the occurrence of early complications of diagnostic and therapeutic ERCP and its treatment .Methods Occurrence,kind,treatment and outcome of early complications of diagnostic and therapeutic ERCP were respectively reviewed in 8 579 cases in our hospital between January 1977 and December 1999.Results 112 cases had early complications(1.31%).In diagnostic ERCP morbidity of early complications was 1.30%(95/7290) and it was 1.32%(17/1289)in therapeutic ERCP.Of them,acute pancreatitis occurred in 38 cases(0.44%),billiary infection 30 cases(0.35%),bleeding of digestive tract 26 cases(0.30%),drug reaction 8 cases(0.09%),stone and basket incarceration 5 cases(0.06)%,intestinal perforation 1 cases (0.01%) and retroperitoneal pneumatosis 1 cases(0.01%).Of them,106 patients were cured by conservative therapy.Operations were performed in 5 patients.1 patient died.Conclusion In diagnostic ERCP acute pancreatitis is the most common complication,which may be related to difficulty of cannulation,repeated developing and inappropriately injecting contrast medium. In therapeutic ERPC bleeding of digestive tract is the most common complication ,which is related to the procedure ,jaundice and diabetes.Most of complications can be cured by conservative therapy,but a minority needs operation.