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.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

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.

Objective To compare the volume kinetics of lactated Ringer' s solution during induction of general and epidural anesthesia in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,aged 66-86 yr,weighing 45-86 kg,undergoing elective surgery,were studied.In epidural anesthesia group (n =20),lactated Ringer' s solution was infused intravenously starting from 10 min before epidural anesthesia was performed with local anesthetics.In general anesthesia group (n =20),lactated Ringer' s solution 1000 ml was infused intravenously over 60 min starting from 20 min before induction of anesthesia.Arterial blood samples were obtained every 5 min for measurement of hemoglobin concentrations.The plasma dilution,volume increase,and volume expansion efficacy were calculated.Results The plasma dilution,volume increase and volume expansion were significantly higher at 30-60 min of lactated Ringer' s solution infusion in general anesthesia group than in epidural anesthesia group (P ＜ 0.05 or 0.01).Conclusion The volume expansion of lactated Ringer' s solution is greater in elderly patients during induction of general anesthesia than that during induction of epidural anesthesia.

Rhizome atractylodes macrocephalae is the dry roots of Atractylodes macrocephala Koidz. It is one of commonly used Chinese medicine. In the ″Shennong's Herbal″, it was listed as the top grade. It mainly contains volatile oil, atractylenolides, atractylodes polysaccharides, glycosides and amino acids.And it has the medical functions of good for spleen and intestine, diuretic and dehumidifi?cation, hidroschesis, miscarriage prevention and soon.In order to provide references for further devel?opment and utilization, this paper systematic arranged the Chinese medicine atractylodes chemical composition, pharmacological effects, processing technology and effect of processing technology on chemical composition and pharmacological action.

AIM: To clarify the protective effect of long-term administration of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor fluvastatin on ventricular remodeling after myocardial infarction (MI) in rats and its mechanisms. METHODS: Myocardial infarction were established by ligated left coronary anterior artery in SD rats, 24 hours after the operation, the survival rats were treated by gavage fluvastatin (20 mg?kg~(-1)?d~(-1)) or distilled water for 8 weeks. Doppler echocardiography, homodynamic and cardiac histomorphometry were used to assess the ventricular remodeling and cardiac function. The plasma levels of total cholesterol (Tch), creatinine (Cr), glutamic-oxal (o) acetic transaminase (AST), lipid peroxidation (LPO), glutathione perioxidase (GSH-PX), nitrogen monoxide (NO_2~-/NO_3~-) were detected. RESULTS: The Tch, Cr and AST were not significant difference in groups. Left ventricular end-diastole pressure, right relative weight, left ventricular posterior wall thickness, collagen volume fraction and the lung weight were decreased in AMI+fluvastatin group compared to AMI group (P

AIM: To determine the relevance of NADPH oxidase subunit p22hox and the expression of superoxide anion on ventricular remodeling in myocardial infarction (MI) rats. METHODS: MI of Sprague-Dawley rats were established by left anterior descenting coronary artery ligation. 8 weeks after MI, Doppler echocardiography, hemodynamic study and histomorphometry were performed to analyze the ventricular remodeling. The level of thiobarbituric acid reactive substance in plasma and myocardium were measured, and the distribution of superoxide anion was observed with laser scanning confocal microscope. The expression of p22phox mRNA and protein level was detected by RT-PCR and immunohistochemistry. RESULTS: The left ventricular remodeling was significant in MI rats, also the level of thiobarbituric acid reactive substance increased in the plasma and non-infarcted myocardium. The expressions of p22-phox mRNA and protein levels, and superoxide anion increased in infarcted and non-infarcted myocardium in MI rats. CONCLUSION: Our results suggest that the expression of NADPH oxidase and its derived superoxide anion may take part in left ventricular remodeling through oxidative stresss after MI.

OBJECTIVE To investigate the effect of phosphotyrosine interaction domain containing 1 (PID1, NYGGF4) onpromotion of IR and HCC, and explore its underlying mechanisms. METHODS Lentivirus were used to mediate the knockdown of PID1 in HFD induced IR mouse model as well as ob/ob mice. Intraperitoneal glucose and insulin tolerance were performed 4 weeks after lentivirus injection. Hydrodynamics-based transfection was applied to induce the liver specific overexpression of PID1. Flow cytometry was exerted to detect the proportion and function of immune cells.qRT-PCR and Western blot were used to detect the expression of downstream pathways of PID1. Liquid chromatography-mass spectrometry (LC-MS) and co-immunoprecipitation (Co-IP) were conducted to identify proteins interacting with PID1.Chromatin immunoprecipitation(ChIP)was operated to measure the modification of H3K4me3 of PID1 promoter.RESULTS PID1 restriction improved insulin resistance,hyperglycemia and fatty liver. Conversely, hepatic knockdown of PID1 attenuated liver xenografted tumor growth. Moreover,PID1 liver-specific protooncogenes via hydrodynamics-based transfection established a primary hepatocellular carcinoma mouse model,induced an immunosuppressive environment,with the reduction of CD3+,CD4+,CD8+T cells,retarded maturation of dendritic cells(DCs),pronounced differentiation of regulatory T cells(Tregs),and recruitment of MDSC.In addition,PID1 overexpression activated prolifer-ation related genes, promoted anti-inflammatory genes, suppressed pro-inflammatory genes, induced glycolysis and lipid metabolism genes to facilitate tumorigenesis in liver. Importantly, PID1 exerted its tumor-promoting function through binding to epidermal growth factor receptor(EGFR)and activation of downstream KRAS/ERK pathway.As such,PID1 exist trimethylation of histone H3 at lysine 4(H3K4me3) modification and IR up-regulated the expression of PID1 by activation the H3K4me3 modification. CONCLUSION PID1 is a new gene that exerts both liver cancer-promoting and insulin resistance inducing function.IR accelerates liver cancer development and progression partially dependent on the activation of PID1.

Background:Colonoscopy is considered as a standard method for detecting various kinds of colorectal polyps. However,conventional colonoscopy( CC)still has the chance to miss some lesions. Literatures have already reported that transparent hood assisted colonoscopy( THAC)can improve the detection of colorectal polyps. However,the effect of black hood assisted colonoscopy( BHAC)on detection of colorectal polyps is still unclear. Aims:To evaluate the effect of BHAC on detection of colorectal polyps. Methods:A total of 1 076 patients underwent CC and BHAC from Sept. 2014 to April 2015 at Huadong Hospital Affiliated to Fudan University were enrolled in this prospective randomized controlled study. Baseline characteristics,cecal intubation time,withdrawal time,number of polyps,detection rate of polyps,location, size,morphology and pathological diagnosis of polyps between two groups were compared. Results:Compared with CC group,cecal intubation time was significantly shorter in BHAC group than in CC group[(6. 31 ± 3. 51)min vs.(7. 05 ± 4. 15)min,P=0. 002]. No significant differences in withdrawal time and rate of cecal intubation were found between two groups(P>0. 05). Detection rate of polyps was significantly higher in BHAC group than in CC group(65. 4% vs. 48. 7%,P=0. 004). No significant differences in size,morphology of polyps were found between two groups(P>0. 05). Conclusions:Compared with CC,BHAC could significantly improve the detection of colorectal polyps,and shorten cecal intubation time.

Objective To develop a candidate reference method for the measurement of progesterone in human serum.Methods The serum sample is mixed with the internal standard [3,4-~(13)C_2] progesterone.After extraction with n-hexane and purified by a aqueous solution of 2-Hydroxypropyl-?- cyclodextrin (HP-?-CD),the serum progesterone and labeled progesterone are converted to the 3-enol heptafluorobutyrate and analyzed by gas chromatography mass spectrometry (GC/MS) with selected ion monitoring.The concentration of serum progesterone is calculated by bracketing method.Results The results gave coefficients of variation (CVs) of 0.69% to 2.12%.The analytical recoveries ranged from 98.3% to 100.1%.The results of measuring certified reference materials of serum progesterone are agree with the target value.Conclusion The procedure for measuring progesterone in serum is a highly accurate and precise method and may be used as a candidate reference method for serum progesterone assays.