Aim To probe into the best conditions for the establishment of endometriosis model in rats by the orthogonal experiment method.Methods Autotransplantation was used to establish the endometriosis model in rats by the orthogonal experiment method in which four main factors were considered to optimize the condition of model,according to the volume of heterotopic endometrium.Results The para ligament of uterus was the best place for transplanting.Both dissecting muscular layer and injecting estrin played an important role in the establishment of endometriosis model in rats. The value of four factors decreased progressively according to the injection of estrin,the dissection of muscular layer,the direction of endometrium implantation and oestrus.Conclusions By optimizing the condition for the establishment of endometriosis model in rats by orthogonal experiment,the volume of heterotopic endometrium was improved.A technology platform for pharmacodynamics research was thus offered.

Objective To observe the change of neuropeptide of the infant patients with post infection cough (PIC) and explore the possible pathogenesis and diagnostic value.Methods Fifty-two cases with PIC in our hospital were selected as PIC group,while thirty infant patients with bronchopneumonia as pneumonia group.Phlegm cells classification and substance P(S P),neurokinin(NKA),neurokinin (NKB),calcitonin gene-related peptide (CGRP) concentration of the patients in both groups were compared.Results Phlegm cells classification of the two groups showed that,compared with the PIC group,the neutrophils,macrophages,and lymphocytes of the infant patients in the pneumonia group were obviously higher (P ＜ 0.05).After anti-infection treatment,the neutrophils,macrophages and lymphocytes of the infant patients in the pneumonia group were obviously lower(P ＜ 0.01).The phlegm cells classification of the PIC group had not changed significantly before and after treatment (P ＞ 0.05).After treatment,the phlegm cells classification of both groups had no significant difference (P ＞ 0.05).During the progress of treatment,there was no evident change for the eosinophils (P ＞ 0.05).Neuropeptide of the two groups showed that,before treatment,the SP and CGRP of the patients in the PIC group were (538.4 ±432.2) ng/L,(123.6 ±70.2) ng/L,and that in the pneumonia group were (613.2 ± 345) ng/L,(156.2 ± 82.6) ng/L.There was no significant difference (P ＞ 0.05).After treatment,the SP and CGRP of the PIC group were (552.8 ± 421.7) ng/L,(133.5 ± 81.3) ng/L,and there was no significant difference (P ＞0.05).While the SP and CGRP of the patients in the pneumonia group were (156.2 ± 131.2) ng/L,(741.2 ± 35.4) ng/L,they were obviously lower (P ＜ 0.01).There was statistical difference compared with the PIC group after treatment (P ＜ 0.01).The NKA and NKB had not changed significantly before and after treatment.Conclusion Airway neurogenic inflammation mediated SP and CGRP plays a key role in the acute and chronic infections.The increase of SP and CGRP is closely related to the morbidity of PIC.So SP and CGRP is a reference index for early detection of PIC.

ObjectiveTo detect the changes of gastroesophageal reflux disease (GERD) with high resolution endoscopy,and to explore its diagnostic value for nonerosive reflux disease (NERD). Methods From April 2007 to January 2008, consecutive out-patients visiting the Department of Gastroenterology due to continuous or recurrent symptoms of acid reflux, heartburn, cardiac-like chest pain for at least three months and volunteer healthy controls were recruited to the study. The subjects were classified into the normal group ( n =48 ), the NERD group ( n =70), the erosive esophagitis (EE) group ( n =70), and the Barrett esophagus (BE) group ( n =48). All subjects underwent endoscopy, and the shape of Z-lines, the shape of mucosal pits, mucosa roughness above Z-line and the shape of mucosal blood vessels were observed. The NERD changes were analyzed with optimal scale. ResultsZ-line shape of NERD group showed a significant difference from that of EE and BE groups ( P ＜ 0. 01 ), which was not different from that of normal controls ( P ＞0. 01 ). The shape of mucosal pits of NERD group was different from that of EE and BE (P ＜0. 01 ), which also was not different from that of control (P＞0. 01 ). Roughness of the mucosa above Z-line of NERD group was different from other 3 groups (P ＜0. 05). And the shape of mucosal blood vessels of NERD was different from the control (P＜0. 05), but was not from two others. Features of NERD relative images were thin,straight and spiral blood vessels, bar-like pits, plat mucosa, round, smooth and wide tooth-like Z-line and mucosa of white particle hypertrophy. ConclusionHigh resolution endoscopic features of most NERD patients are cloudy, white and rough mucosal surface, with white particular hypertrophy, spiral vascular dilation, extending to Z-line. These features can be indicators of NERD.

Objective To investigate the effect of intravenous infusion of hyper-oxygenated solution (HOS) on small intestinal ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty-four rabbits of both sexes,weighing 2.5-3.2 kg,were randomly divided into 3 groups ( n =8 each):sham operation group (group S),I/R group,and HOS group.Small intestinal I/R was produced by clamping the superior mesenteric artery (SMA) for 1 h followed by 2 h of reperfusion in I/R and HOS groups,while the SMA was only clamped in group S.HOS was infused intravenously at a rate of 20 ml· kg-1 ·h -1 via the auricular vein starting from the time immediately after clamping the SMA in group HOS and the equal volume of normal saline was infused instead of HOS in group I/R.Blood samples were obtained from the inferior vena cava at 2 h of reperfusion to detect the concentration of serum lactic acid.The animals were then sacrificed and the small intestine was removed for determination of the malondialdehyde (MDA) content,and activities of superoxide dismutase (SOD),catalase (CAT) and glutathione peroxidase (GSH-Px) in intestinal tissues and for microscopic examination.The pathological changes of the intestinal epithelia were observed and the damage.to the mucous membrane was scored.The internal organs were removed and bacterial translocation from gut to the internal organs was observed.Results Compared with group S,the level of MDA and lactic acid,and rate of bacterial translocation were significantly increased,and the activities of SOD,CAT and GSH-Px were significantly decreased in groups I/R and HOS ( P ＜ 0.05).Compared with group I/R,the level of MDA and lactic acid,rate of bacterial translocation,and activities of SOD,CAT and GSH-Px were significantly decreased in group HOS ( P ＜ 0.05).Conclusion Intravenous infusion of HOS can reduce small intestinal I/R injury in rabbits.

ObjectiveTo investigate the diagnostic value of transgastic peritoneoscopy for ascites of unknown aetiology.MethodsTransgastric peritoneoscopy was performed on 7 patients with ascites of unknown aetiology.Diagnosis and complications were both recorded.ResultsDiagnosis of all the 7 patients were confirmed after transgastric peritoneoscopy,among whom 6 ( 85.7％ ) were found to have tuberculosis peritonitis,and 1 ( 14.3％ ) with liver disease.All patients recovered after the operation.No intraoperative or postoperative complications occurred.ConclusionTransgastric peritoneoscopy is a valuable diagnostic method for ascites of unknown aetiology.

ObjectiveTo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of laterally spreading tumors (LST).MethodsESD was applied to remove 32 colorectal LSTs larger than 2 cm.The characteristics of the tumors and clinical results including en bloc resection rate,procedure time,complication and recttrrence rates were retrospectively evaluated.Results The lesions ranged from 2.5 cm to 8.0 cm,with a mean diameter of 4.1 ± 2.1 cm.En bloc resection wasachieved in 29 patients (90.6％ ) with a mean operation time of 75.7 ±66.0 min.Immediate arerial bleeding occurred in 5 ( 15.6％ ) cases but was stopped successfully by clips or coagulations.Late bleeding occurred in 2 ( 6.2％ ) and perforations in 3 (9.4％ ),which were closed successfully by clips without surgery.Pathological diagnosis revealed low-grade intraepithelial dysplasia in 19 (59.4％ ),high-grade intraepithelial dysplasia in 6 ( 18.8％ ),and carcinomas in 7 (21.9％).The lesions were restricted in mucosal layer in 25 (78.1％ ),infiltrating into sm1 layer in 5 ( 15.6％ ) and sm2 layer in 2 (6.2％ ),and the later 2 were referred to surgery.Twenty patients were followed up for 3-12 months,and no local recurrence was found..ConclusionESD was an effective and safe therapy for colorectal LST larger than 2 cm.

Objective To compare the diagnostic value of magnifying chromoendoscopy with probebased confocal laser endomicroscopy (pCLE) for differentiation of neoplastic from non-neoplastic colorectal polyps. Methods A total of 16 consecutive patients, who were diagnosed as having polyps with endoscopy between December 2009 and January 2010 at Nanfang Hospital, were included in this study. The pit pattern of the polyp was first determined with magnifying chromoendoscopy in all patients. Then, confocal images of the polyps were recorded and subsequently analyzed offline. Using pathological diagnosis as golden standard,the sensitivity and specificity of the two methods were compared. Results A total of 26 polyps from 16 patients were found. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of magnifying chromoendoscopy was 94. 1%, 77.8%, 88. 8%, 87. 5% and 88.4%, respectively,while those of pCLE were 100. 0%, 88. 8%, 94. 4% ,100. 0% and 96. 1%, respectively. There was no significant difference between pCLE and magnifying chromoendoscopy. Conclusion In differentiation between neoplastic and non-neoplastic colorectal lesions, pCLE shows higher sensitivity and specificity than does magnifying chromoendoscopy, although without significant difference. pCLE can be used as a new real time method to determine the property of colorectal polyps.

Objective To compare the differences of clinical characteristics between genotype B and C chronic hepatitis B(CHB)patients and to summarize clinical factors related to genotype C hepa- titis B virus(HBV)infection.Methods Seventy eight CHB patients who were diagnosed with genotype B or C infection by liver puncture biopsy and genotyping were enrolled.Their serum HBV DNA levels were detected.Severe hepatitis,liver cirrhosis,hepatocellular carcinoma and HBeAg positive rate were analyzed to determine the pathologic inflammation and fibrosis degree of liver tissue.Chi square test and Logistic multiple regression analysis were employed for the statistical analysis.Results The serum albumin and pre-protein were lower in genotype C CHB patients than that in genotype B.The alanine aminotrans- ferase,total bilirubin and prothrombin time were higher in genotype C CHB patients than that in genotype B.The rates of genotype C patients increased significantly with the grade of liver necroin- flammation progressing from GO to G4(1.8%,11.1%,20.4%,33.3%,33.3%) and the stage of liver fibrosis progressing from SO to S4(5.6%,5.6%,14.8%,33.3%,40.7%),but the rates of genotype B patients did not change significantly with the grade of liver necroinflammation(16.7%, 25.0%,25.0%,20.8%,12.5%)and stage of liver fibrosis progressing(16.7%,29.2%%,20.8%, 16.7%,16.7%).There was statistical significance in grades of liver necroinflammation(X~2= 11.49,P=0.022)and stages of liver fibrosis(X~2=13.56,P=0.006)between genotype B and gen- otype C patients.The rates of genotype C CHB patients were higher than,similar with and lower than the rates of genotype B patients of HBV DNA level above 1.0?10~6 copy/mL,between 5.0?10~2-1.0?10~6 copy/mL and under 5.0?10~2 copy/mL,respectively(51.8% vs 12.5%,35.2% vs 45.8% and 13.0% vs 41.7%).There was statistical significance of HBV loads between genotype B and genotype C patients(X~2=13.25,P=0.001).HBeAg positive rate in genotype C patients was significantly higher than that in genotype B patients(61.1% vs 25.0%,X~2=8.67,P=0.003).The rates of decompensated cirrhosis,compensated cirrhosis and no-cirrhosis in genotype C patients were higher than,similiar with and lower than the rates in genotype B patients,respectively(40.7% vs 4.2%,22.2% vs 20.8% and 37.0% vs 75.0%).There was statistical significance of the rate of cirrhosis between genotype B and genotype C patients (X~2=12.47,P=0.002).Conclusions The degree of liver necroinflammation and fibrosis,the HBeAg positive rate and the incidence of cirrhosis are all related with genotype C HBV infection.

Objective To study the therapeutic effect of rheum(Chinese herbal medicine) preparation made by using ultrasonic technique on pro-inflammatory cytokines and sepsis in rats.In order to offer novel measure for the treatment of critically ill patients.Methods Firstly, rheum sterile solution was prepared through ultrasonic technique.Secondly, fifty healthy male SD rats were randomly(random number) divided to CLP group and rheum group.Moderate degree of sepsis model was established by using cecal ligation and puncture(CLP).Rats in group rheum received the liquid rheumpreparation via intragastric administration, while rats in group CLP received saline instead.The 7-day survival rate was recorded and was compared between two groups.In addition, another fifty-four rats were randomly(random number) divided to sham group, CLP group and rheum group(n=18 in each group).CLP was performed to induce sepsis in CLP group and rheum group.Then rats in rheum group received rheum sterile solution via intragastric administration, while rats in CLP group received saline instead.At 12 hours, 24 hours and 48 hours after modeling, six rats in each group were randomly sacrificed.Serum TNF-α and HMGB1 levels were detected by ELISA method.Levels of RAGE, HMGB1 and NF-κB P65 in small intestine were detected by Western Blot.Results Level of anthraquinones extracted from rheum by ultrasonic technique was higher than that by conwentional decoction method.The 7-day survival rate of rats in rheum group(76%) was higher than that in CLP group(48%)(P<0.05).Compared with sham group, serum TNF-αand HMGB1 levels in CLP group and rheum group were significantly increased(P<0.05).TNF-α was significantly lower in rheum group than that in CLP group at each interval(P<0.05).At 12 hours after modeling, there was no significant difference in serum HMGB1 level between CLP group and rheum group(P>0.05).At 24 hours and 48 hours after modeling, serum HMGB1 levels were significantly lower in rheum group than those in CLP group(P<0.05).Compared with sham group, protein levels of HMGB1, RAGE and NF-κB in small intestine were elevated in CLP group and rheum group at 48 hours after modeling(P<0.01), while protein levels of above biomarker were higher in CLP group than those in rheum group(P<0.05).Conclusions Rheum sterile solution could down-regulate the level of pro-inflammatory cytokines, modulate the inflammatory response, and improve the survival rate in rats with sepsis.

OBJECTIVE To determine the clinical distribution and drug resistance characteristics of pathogens from nosocomial infection cases to provide the gist for clinical therapy.METHODS Pathogens isolation,identification and drug resistance tests were conducted to samples,which were gathered from respective departments in our hospital between Jan 2007 to Dec 2007.Then,MRSA tests were performed for Staph Staphylococcus and ESBLs-producing G-bacilli were also detected.RESULTS Among 5382 pathogen strains from 12571 samples,3390 strains were G-bacilli(62.98%),953 strains were G+ bacteria(17.71%) and 1039 strains were fungi(19.31%).The most common species among 4343 strains pathogens except fungi were Pseudomonas aeruginosa(20.5%),Acinetobacter baumanni(11.2%),Klebsiella pneumoniae(10.8%),Escherichia coli(8.6%) and Staphylococcus aureus(8.3%).The clinical departments with higher infective rate were Department of Neurosurgery,Department of Respiratory Disease,ICU,Department of Hepatobiliary Surgery,and Department of Pediatrics in order.Drug resistance results showed that the resistance rates of S.aureus to clindamycin,Quinolones and Tetracyclines were about 50%,but no S.aureus was resistant to vancomycin,linezolid and teicoplanin.The resistance rates of G-bacilli to imipenem,meropenem and azithromycin were lower,but with more than 30% of resistance rates to others common antibiotic drugs.CONCLUSIONS The pathogens in nosocomial infection are mainly the opportunistic pathogenic bacteria and mostly G-bacilli.The infection due to fungi shows an increasing trend.It should pay attention to the pathogenic detection and rational use of antimicrobial agents.