Objective To evaluate clinical and endoscopic characteristics of ischemic colitis (IC), and to explore the methods for the early diagnosis of IC. Methods Thirty six patients diagnosed as IC in Hua dong Hospital from June 1975 to December 2000 were reviewed. All patients underwent colonoscopy with biopsy within 5 days of symptoms, and repeated the exam in 2 weeks to 2 months. Results Of the 36 cases (12 men and 24 women, average age 60.5 years old, range 35 84), 31 were over 50 years of age. IC usually presented with sudden onset of left lower quadrant abdominal pain, diarrhea and hematochezia. Patients' ischemic lesions were most often on the left colon. It consisted transient or reversible colitis in 30 cases, stricture colitis in 5 cases and gangrene colitis in only 1 case. Morphologic changes varied with the duration and severity of the injury. Conclusion Colonoscopy with biopsy is the main method for the diagnosis of IC. It should be performed in the early stage of the onset of symptoms.

AIM: To explore the effects of glucocorticoids on fracture healing in a rat model of tibial fracture. METHODS: Sixty three months old female SD rats were divided into control and glucocorticoid-treated group. A glucocorticoid-induced osteoporosis model was established by intramuscular injection of prednisolone acetate (5 mg·kg~(-1)·d~(-1) for 3 weeks), in which the tibial was osteotomized by a wire saw as fracture healing model and internal fixed with a Kirschner pin. The rats were scarified at different time points after operation. The callus formation was monitored over a period of 6 weeks by histological method, bone mineral density (BMD) detection and biomechanical examination. Western blotting was used to measure the expression of type II collagen. RESULTS: A glucocorticoid-induced osteoporosis model was successfully established and conformed by BMD measurement. The formation of primary callus was observed in both groups 3 days after fracture. At 2 weeks after injury, the glucocorticoid-treated group had a lower BMD and less cartilage matrix as compared to control group. An increase in bone callus and chondrogenesis was observed at 4 to 6 weeks after fracture in glucocorticoid-treated group as compared to control group. The expression of type II collagen was delayed in glucocorticoid-treated group. Biomechanical measurement showed that the actual maximum load was increased by 35.8% in control group as compared to glucocorticoid-treated group at 6th week. CONCLUSION: These results indicate that chondrogenesis and transformation from cartilage callus to bony callus are delayed by glucocorticoids. The retardation of collagen Ⅱ production may be the reason for the inhibition of fracture healing.

Objective To evaluate the clinical and endoscopic features of ulcerative colitis(UC). Methods The cases of UC were collected from 1975 to 2001. According to the diagnostic criteria of Chengdu conference, 486 and 490 patients were diagnosed as UC in our hospital from 1975 to 1994 and from 1995 to 2001 respectively. Their records were retrieved and the data were analyzed for sex, age, presentation, the course of the illness and lesion range. Results In the two groups from 1975 to 1994 and from 1995 to 2001, the proportion of patients diagnosed as UC under colonoscopy was increased from 3.51% to 4.44%. The ratio of male to female was 1.67 and 1.25 respectively. The mean age at the diagnosis increased from 42.4 years old to 51.5 years old, and the peak age was between 30 and 49 years old, between 40 and 49 years old and greater than 60 years old respectively. The typical clinical manifestations of UC were bloody mucopurulent stool, diarrhea and abdominal pain. Proctosigmoiditis or proctitis was found in 269 patients (55.4%) and 316(64.5%), left side colitis in 84(17.3%) and 68(13.9%), pancoltitis in 58( 11.9% ) and 70(14.3%) respectively. In the two groups, there were 437( 89.9% ) and 443(90.4%) patients who had the course of less than 10 years respectively. The definitive diagnosis of UC was dependent on biopsy. Conclusions The lesions of UC are commonly located in the left side colon, the course of UC is short, the age of onset is relatively high in the middle and old aged group, and the prevalence of both malignancy and complications is low. Colonoscopy with biopsy is considered to be the major means for the diagnosis of UC.

High density lipoprotein cholesterol ( HDL-C) has received extensive attention because of its cardiovascular protective effects.Recent studies showed that HDL could promote reverse cholesterol transport ( RCT ) , be anti-inflammatory and antioxidant, and induce angiogenesis. Apolipoptrotein A-I (apoA-I), the most abundant protein of HDL, plays a pivotal role in the HDL mediated-functional activities.Short peptides based on the amphiphilic alpha helix structure of apoA-I have been designed and aimed at imitating the function of apoA-I.The function and metabolism of these mimetic peptides depend on their amino acids component and sequence , and have been proved to exert protection in against cardiovascular disease , infection, inflammation and oxidative damage, metabolic syndrome and tumor.Clinical trials confirmed their benefits, but high cost put them out of the practical applications..

Objective To evaluate the effect of colonoscopy with a transparent hood on the adenoma detection rate.Methods A prospective randomized controlled trial was performed.A total of 376 patients,who underwent colonoscopy for screening colorectal polyps,were randomly allocated to 2 groups:transparent hood group (TH group,n =190) and conventional colonoscopy group (CC group,n =186).Only one endoscopist performed all the colonoscopy examinations,recorded the withdrawal time,bowel preparation status,the number,shape,location,size of adenoma when withdrawing the endoscope.All the adenoma were removed under the colonoscopy.The pathological results were recorded,and the data and relative factors were analysed.Results A total of 317 adenomas were detected in 175 patients:172 adenomas in 99 patients of TH group,145 adenomas in 76 patients of CC group.Total ADR was 46.54％.ADR of TH group was 52.11％ and ADR of CC group was 40.86％ (P =0.029).A total of 40 adenomas were found behind the fold,32 in TH group and 8 in CC group(P ＜ 0.01).In cecum and transverse colon,there were more adenomas in TH group than in CC group.In cecum,there were 23 adenomas found in TH group,6 adenomas in CC group(P ＜0.05).In transverse colon,there were 46 adenomas in TH group,25 adenomas in CC group (P ＜ 0.05).In descending colon and rectum,there were more adenomas in CC group than in TH group.In descending colon,there were 16 adenomas TH group,and 30 adenomas in CC group.In rectum,there were 14 adenomas in TH group,24 adenomas in CC group(P ＜0.05).There was no significant difference in size or shape of adenomas found between two groups.Conclusion Colonoscopy with transparent hood for screening can increase the adenoma detection rate,especially the adenoma behind the fold.

Chinese materia medica (CMM) plays an important role both in the disease prevention and therapy system and also in natural drug screening. Biotechnology exhibits applicable prospects in modern research of CMM with progress of natural science and technologies. Amplification fragment length polymorphism (AFLP), restriction fragment length polymorphism (RFLP), random amplification polymorphism of DNA (RAPD), and microsatellite DNA have been used to discriminate and breed herbal varieties. Genetic transformation and techniques of tissue and cell culture are explored to protect herbal resouces and to produce active components or parts on a commercial scale. High throughput technologies of proteome and biochip are expected to probe molecular targets and routes of CMM with the changes of proteome and gene expression. The results can be helpful to novel drug development and secondary exploitation, so as to promote the modernization process of CMM.

Objective To investigate the diagnostic accuracy of 13C urea breath test (13C-UBT)in the diagnosis of Helicobacter pylori (Hp) infection in patients with gastric remnant.Methods A total of 94 gastric remnant patients (gastric remnant group) and 100 non-gastric remnant patients (control group) received 13C-UBT.According to the course of the disease,the gastric remnant group were divided into group 1 (29 cases,≤5 years),group 2 (33 cases,6 to 10 years) and group 3 (32cases,＞10 years).Before surgery,the diagnosis of Hp infection was according to 13C-UBT and gastric mucosa tissue staining.After surgery,the diagnosis was according to gastric mucosa tissue staining.The applying value of 13C-UBT in gastric remnant patients was evaluated.The consistency of results between 13C-UBT and gastric mucosa tissue staining were evaluated by the Kappa test.Results In gastric remnant group,the Hp infection rate after surgery (37.2％) was obviously lower than that before operation (79.8％;x2 =35.058,P＜0.01) and that of control group (77.0％).After surgery,the Hp infection rate of patients with Billroth Ⅱ gastrectomy (24.4％) was lower than that of patients with Billroth Ⅰ gastrectomy (47.2％ ; x2 =5.133,P=0.023).Before surgery,the Hp infection rate of gastric remnant subgroups were similar (P＞0.05).With the extension of the postoperative course,the Hp infection rate gradually decreased in gastric remnant subgroups (group 1:58.6％,group 2:36.4％,group 3:18.8％; x2=7.839,P=0.021).Setting the cut-off point at 2.0‰ in the gastric remnant group and 3.5‰ in the control group,the accuracy rate of diagnosis was the highest (92.6％ and 96.0％).There was good consistency between the results of 13C-UBT and gastric mucosa tissue staining (Kappa =0.84,P＜0.01).Conclusion With suitable operation and standard,13C-UBT may be a easy,safe and effective assay applied in the gastric remnant patients.

ObjectiveThe efficacy and safety of nitrous oxide-sedated transnasal gastroscopy for high-risk patients of intravenous anesthesia were evaluated. MethodsA total of 157 patients were randomly assigned to the nitrous oxide group ( n =80) and the oxygen group ( n =77). Heart rate, blood oxygen saturation, blood pressure and electrocardiogram were monitored. Complications in both groups were recorded.Satisfaction degrees of patients and endoscopy physicians were evaluated with a questionnaire and visual analog scale (VAS) score. The questionnaire questions for physicians included the procedure evaluation ( steady, ok, unsteady). Patients' questionnaire questions included discomfort (light, moderate, severe), the patients' tolerance ( fine, moderate, weak) and the patients' willingness to undergo a second procedure. Statistical analysis was performed between the two groups. ResultsSix of the toal 157 patients were removed because of the operation failure (difficulty in access to nasal cavity in 5 patients and nose bleeding in one patient), 151 patients underwent the transnasal gastroscopy successfully and completed the questionnaires. In experimental group, there were 37 males and 41 females (mean age was 67.7 years, ranging 16-88 years, 7 patients were grade 1 of ASA, 61 were grade 2, and 11 were grade 3). In the control group, there were 36 males and 37 females (mean age was 67.9 years, ranging 17-86 years, 6 patients were grade 1 of ASA, 57 were grade 2, and 9 were grade 3). There was no differences in sex, average age and ASA grade between the two groups (P ＞ 0. 05 ). There was no difference in the mean operation time between the two groups, either (200. 1 s vs 200. 3 s) ( P ＞ 0. 05 ). There were no significant differences between the two groups in changes of blood oxygen saturation, blood pressure, electrocardiogram and complication rates ( P ＞ 0. 05 ).Both physicians' and patients' positive evaluations of the experimental group were more than that of the control (P ＜ 0. 05 ), while physicians' and patients' negative evaluations of the experimental group were less than the control (P ＜0. 05). VAS of physicians' satisfaction in the experimental group was higher than that of the control group (84 vs 70, t =14. 67, P ＜ 0. 05), and VAS of patients' satisfaction in the experimental group was superior to the control group (82 vs 71, t =11.56, P ＜ 0. 05). The number of patients wiring to undergo a second procedure in the experimental group was higher than that of the control (89. 7％ vs 69. 9％, P ＜ 0. 05). ConclusionNitrous oxide-sedated transnasal endoscopy is an effective and safe procedure for high risk patients of intravenous anesthesia.

ObjectiveTo assess the diagnostic value of EUS for pancreatic neuroendocrine tumors.MethodsClinical data of 26 patients with final diagnosis of pancreatic neuroendocrine tumors,who had underwent EUS and EUS-FNA,were retrospectively analyzed.Results On EUS,pancreatic neuroendocrine tumors presented as hypoechoic masses with clear margins and rich blood flow.Of the 26 pancreatic lesions,3 were in the head,2 in unicate process,2 in neck,11 in body and 8 in tail.The tumors presented with function in 16 ( mean size 9 mm),and on function in 10 ( mean size 29 mm).EUS-FNA yeilded positive results in 22 patients and negative in 4.The accuracy rate of EUS for preoperative localization was 100％ in 23 patients who underwent surgery.ConclusionEUS can provide accurate preoperative localization and pathologic evidence for pancreatic neuroendocrine tumors.