Objective To observe the change of peripheral blood lymphocytes subsets in patients with active ulcerative colitis (UC) and explore its clinical significance. Methods The clinical data and lymphocyte subsets of 40 active UC patients who admitted to the Department of Gastroenterology, Peking University First Hospital,from June 2007 to January 2010 were retrospectively analyzed. Patients who had previously used immunosuppressants or tumor necrosis factor monoclonal antibody were excluded. Seventy-nine subjects with health examination served as controls. Peripheral blood lymphocyte subsets detected included total T cells, CD4 + T cells, CD8 + T cells, B cells, and NK cells. Only the first detection results of UC patients were used for analysis. Results The proportion of total T cells for UC patients (73.60% ± 8.35% ) was significantly higher than the controls (69. 76% ±7.37%) (P =0.012). CD8+T cell ratio (35.53% ± 10.99%) was significantly higher than the controls ( 30. 56% ± 6. 75 % ) ( P = 0. 011 ). When the UC patients were stratified according to inflammatory involvement,the total T cells, CD8 +T cell, and NK cell ratio were significantly different among pancolitis, non-pancolitis, and the controls ( all P ＜ 0. 05 ). When the UC patients were stratified according to the disease course, the total T cells and CD8 + T cell ratio were significantly different among chronic recurrent/persistent, onset, and the controls ( both P ＜ 0.05 ). When the UC patients were stratified according to the extraintestinal manifestations, the total T cells and CD8 + T cell ratio were significantly different among those with extraintestinal manifestations, those without extraintestinal manifestations, and the controls ( both P ＜ 0.05 ). Conclusions The proportion of total T cells and CD8 + T cells increase in UC patients. Such immune abnormalities are even more distinctive in those UC patients who suffer from pancolitis or chronic recurrent/persistent type or those with extraintestinal manifestations.

Objective To investigate the clinical features of adult inpatients with abdominal type Henoch-Schonlein purpura(HSP)and to compare them with those without gastrointestinal symptoms.Methods The adult inpatients with HSP during January 2000 and December 2005 were reviewed retrospectively,and the clinical features of those with or without abdominal pain were compared.Results Sixty-three patients were included.Thirty-two patients(50.8%)complained of abdominal pain.Of these patients,43.8% had peri-umbilical colicky pain,40.6% middle-upper abdominal pain and 15.6% lower abdominal pain.The other clinical manifestations included nausea/vomiting(15.6%),positive feces occult blood test(50.0%)and elevated blood/urine amylase(25.0%).EGD showed mucosal congestion,red macula,erosion and ulceration mainly in the descending duodenum.Colonscopy showed inflammatory and ulcerative lesions at distal ileum and rectosigmoid.The biopsy pathology showed non-specific inflammatory cell infiltration.There were no differences in age,gender,allergic history and predisposing infection between those with abdominal pain and those without abdominal symptoms.The patients with abdominal pain had more mixed-type HSP(78.1% vs 22.6%,P

Objective Effects of melatonin and serotonin on ethanol induced ulceration in the rat stomach were investigated. Methods Serotonin was injected subcutaneously, then melatonin solution and finally ethanol was put into the ex vivo gastric lumen to prepare the experimental models. Glandular mucosal blood flow (GMBF) and the gastric mucosal injury were observed. Results Melatonin and serotonin administration did not induce observable gastric mucosal of damage in the ex vivo stomach, but the serotonin reduced glandular mucosal blood flow (GMBF) with dose dependence in this organ. Ethanol reduced GMBF and induced visible glandular mucosal damage. The latter effect was prevented by melatonin pretreatment. Serotonin pretreatment aggravated the gastric mucosal injury and GMBF changes induced by ethanol, but these effects were partially reversed by melatonin. Conclusion The findings indicate that the GMBF and gastric injury are related, the reduction in GMBF, however, may not be the sole factor responsible for ulceration. The antagonistic effects of melatonin on serotonin action on the stomach suggest that melatonin may play a modulator role for serotonin action on the gastrointestinal tract.

Objective To observe the effect of atropine and N-nitro-L-arginine methyl ester (L-NAME) on the pressure of lower esophageal sphincter (LESP) regulated by electro-acupuncturing (EA) at Zusanli acupoint (He-Sea, st 36) of stomach meridian and explore the neural mechanism of EA. Methods Forty-eight rats were divided into six groups:control group, EA group, atropine group, atropine+EA group, L-NAME group and L-NAME+EA group. LESP was observed and recorded by using three-channel perfusion manometric measurement system. Results LESP increased significantly under or after EA at Zusanli acupoint. Cholinergic M receptor blocker partly abolished the influence of EA on LESP, but EA could restore the decreased pressure of cholinergic M receptor blocked rats. Nitric oxide synthase (NOS) inhibitor increased LESP, and EA could make it higher. Conclusions The main efferent pathway of regulating effect of EA at Zusanli acupoint on LESP is via the chlinergic nerve of vagus, and other mechanism possibly exits.

SUMMARY The patient, an 18-year-old girl, was found to have strong positive purified protein derivative of tuberculin (PPD) test and calcified focus in her liver 2 years ago. She denied fever, cough, sputum, weight loss, night sweats, fatigue, and anorexia. After admission, physical examination, laboratory tests, CXR, abdominal CT, colonoscopy and gynecological examination were all normal except for the liver lesions. Percutaneous needle biopsy was performed under sonographic guidance and pathological examination showed caseous granuloma. She was diagnosed as primary liver tuberculosis and the lesions decreased after 2 months’ therapy of isoniazid, rifampicin and ethambutol. Primary liver tuberculosis could be asymptomatic and manifestated as calcified focus; percutaneous needle biopsy and pathological examination is helpful for the diagnosis. The asymptomatic liver lesions are still an indication for anti-tuberculosis therapy.

Objective To investigate the relationship among the activity of diseases , the alteration of intestinal flora and the serum immuoglobulin (Ig) in patients with ulcerative colitis (UC) and to further evaluate the clinical value of fecal cue ratio in assessing humoral immune abnormalities. Methods Clinical data of 401 UC patients admitted in Peking University First Hospital from January 2013 to May 2015 were analyzed. According to Mayo index , patients were divided into inactive and active groups , and the active group was further divided into the mild, moderate and severe group. Serum immunoglobulin (IgG, IgM, IgA, C3 and C4) and fresh fecal bacteria cue proportion were measured. Statistical analysis was made to find the relevance among the above indexes. Results With the increase of disease activity , the intestinal flora imbalance aggravated (Spearmann correlation coefficient equals 0.295, P < 0.05) and serum IgM decreased significantly. However, serum C3 increased obviously. Serum C4 increased in mild to moderate group but decreased significantly in severe group. With the aggravation of intestinal flora imbalance , serum IgM and IgA decreased but C3 increased (P < 0.05). Conclusions The measurement of intestinal flora cue proportion, Ig, C3 and C4 may contribute to better determining the severity of diseases and provide beneficial information for therapy.

AIM: To establish an HPLC method of determining paeonol and cinnamaldehyde in Jiarong Tablet. METHODS: Column:Kromasil C_(18)(200 mm?4.6 mm I.D,5 ?m);mobile phase:MeOH-H_2O(65∶35);detection wavelength was at 288 nm;flow rate was 1.0 mL/min. RESULTS: The calibration curve showed a good linea-rity within the ranges of 0.003 6830.018 412 ?g for cinnamaldehyde,0.097 92-0.489 6 ?g for paeonol.(CONCLUSION:)The method is accurate and can be used for the quality control of Jiarong Tablet.

Objective To determine the effect of proinflammatory cytokines including interleukin-lbeta (IL-1β) and tumor necrosis factor-Alpha (TNF-α) on human serotonin transporter (SERT) in human enterocyte-like cell line Caco-2.Methods Caco2 cells were cultured for 5 days,then were divided into control group.IL-1β treated group (50 ng/ml) and TNF-α treated group (50ng/ml) for 2.24,48 and 72 hours.The expression of SERT mRNA was detected by RT-PCR at 2,24 and 48 hours and its protein expression was measured by Western blotting at 24,48 and 72 hours.Results The expression of SERT mRNA at 2,24 and 48 hours was lower both in IL-1β treated group (1.393±1.184,1.064±0.625 and 1.013±0.415,respectively) and TNF-α treated group (1.000±0.000,0.829±0.162and 0.945±0.147,respectively) in comparison with control group (2.282±1.367,1.586±0.421 and 1.86 ±O.496,respectively).There was significant difference among three groups (P<0.01).The expression of SERT protein at 24,48 and 72 hours was lower in IL-1β treated group and TNF-α treated group than in control group.Conclusions The IL-1β and TNF-α can inhibit the expressions of SERT mRNA and protein in Caco-2 cells,which indicates that IL-1β and TNF-α may change visceral sensitivity by influencing peripheral 5-hydroxytryptamine levels.

Objective To assess the expression of TNFα, IL-1β and the serotonin transporter (SERT) in adult rats of chronic visceral hypersensitivity induced by colon irritation during postnatal development, and to provide evidence to clarify the complex relationship between inflammatory cytokines and SERT among visceral hypersensitivity. Methods Sixteen neonatal male Sprague-Dawley rats were randomly separated into two groups undergoing different treatments. The irritated group ( n = 8 ) was received intracolonic injections of acetic acid(0.5%) between postnatal days 8 and 21 and another group ( n = 8 )was received colonic infusion with 0. 9% saline served as control. When they became adults( ages 7 weeks),the threshold intensity for a visually identifiable contraction of the abdominal wall and body arching were recorded during rectal distention (RD) to evaluate visceral hypersensitivity. Histological evaluation and MPO activity assay were performed to quantify the inflammation. The expression of cytokine of colon was assessed through immunohistochemistry. The expression of SERT was examined by Western blot. Results Histological examination of the tissues showed no significant structural damage or loss of crypts. The MPO levels in both groups were similar[(0. 497 ±0. 570) unit/g vs (0. 623 ±0. 739) unit/g, P =0.724]. The threshold to elicit a distinctive abdominal muscle contraction in response to RD decreased from (0.40 ±0. 14) ml in the control group to (0. 19 ±0.06)ml in the irritated group. And the threshold for bodying arching decreased from (0.91 ± 0. 26 ) ml in the control group to ( 0. 47 ± 0. 13 ) ml in the irritated group (P ＜ 0. 01 ). Cytokine immunoreactivity was increased in the irritated group when compared to the control group (TNFα: 0. 194 ±0. 001 vs 0. 182 ±0. 001, P ＜0. 01; IL-1β: 0. 196 ±0. 002 vs 0. 185 ±0.001, P＜0. 01 ), while SERT expression were reduced in the irritated group (0. 298 ±0. 038 vs 0. 634 ±0. 200, P＜0. 05). Conclusion There is an increase in the proinflammatory cytokines and a decrease in the SERT expression associated with the presence of chronic visceral hypersensitivity, both of them may play an important role in the pathogenesis of visceral hypersensitivity.

Achalasia of cardia caused by neuromuscular dysfunction at esophagus-stomach junction is a functional disease of esophageal dynamic dysfunction. It is characterized by absence of peristalsis of esophageal body and failure of the lower esophageal sphincter to relax. The methods of therapy include botulinum toxin injection, stent placement, laparoscopic Heller myotomy and balloon dilatation. However,these methods have some shortages,such as easy to recur, causing larger trauma,etc. . With the development of technology of endoscopy,a new method peroral endoscopic myotomy ( POEM)is widely used in clinical practice,and it can used in some special patients such asⅢ type achalasia,pediatric and elderly patients,as well as sigmoid-type achalasia. This article reviewed the current status and progress of POEM in treatment of achalasia of cardia.