Inflammatory bowel disease(IBD) is a recurrent chronic nonspecific intestinal inflammatory disease which can be seen at any age.Its pathogenesis is not clear and the incidence is increasing.Intestinal mucosal barrier has the function to isolate intestinal contents and internal environment which can prevent pathogens invade to lamina propria mucosae and maintain organic homeostasis and normal activities.Impairment of intestinal barrier is a key event in various gastrointestinal diseases,such as IBD.The dysfunction of intestinal mucosal mechanic barrier,immunologic barrier and biologic barrier or their interactions all can induce gastrointestinal diseases.Identifying the specific mechanism of intestinal mucosal barrier impairment in pathogenesis of IBD,maintaining and restoring intestinal barrier function is becoming a new strategy in the treatment of IBD.

Objective To study the influence of microinflammation factors on the pregnancy outcome in gestational diabetes mellitus (GDM) patients.Methods Forty-eight GDM women with abnormal hsCRP and IL-6 concentration were selected as study group another 36 GDM women with normal concentration as control group.The difference of the two groups in common data and outcomes of pregnancy were retrospectively analyzed.Results There were significant difference in hypertensive disorders,prom,premature delivery,intra-uterine asphyxia,mega fetus,uterine-incision delivery and fetus hypoglycemia hypocalcemia between two groups (P ＜0.05).Conclusions Microinflammation factors have promote influence on the development and outcomes of GDM.Early diagnosis and impose intervention may have positive effect.

Intestinal mucosal barrier has the function to isolate intestinal contents and internal environment,prevent foreign antigens and pathogens invading to lamina propria mueosae and can maintain organic homeostasis and normal activities.Impairment of the intestinal barrier is a key event in various gastrointestinal diseases.Probiotics are live microorganisms which ingested and reach the intestines in sufficient numbers to confer benefit to the host.It can improve or prevent many gastrointestinal diseases.The main reason is probiotics can maintain intestinal barrier function in various paths.This paper reviews its mechanisms of action.

Objective To investigate the correlation between occurrence time and condition severity in patients of bronchial asthma complicated with allergic rhinitis. Methods The 583 outpatients with asthma in an asthma clinic during 1996-2002 were divided into simple asthma group (Group Ⅰ with 292 cases) and asthma complicated with allergic rhinitis group (Group Ⅱ with 291 cases), and their data were compared and statistically analyzed. Results The proportion of those complicated with other diseases, e.g. , nasal polyp, sinusitis, atopic dermatitis, and with a history of allergy, e.g. , food allergy, drug allergy and positive skin allergic test, was significantly higher in the Group Ⅱ than that in the Group Ⅰ ( P

Individual susceptibility to cancer induced by environmental agents may be influenced by polymorphic metabolic genes responsible for the activation or detoxification of carcinogens．The association between genetic polymorphisms in cytochrome P4501A1 (CYP1A1) and lung cancer susceptibility has been extensively studied．The various CYP1A1 alleles exhibit population frequencies that depend on race and ethnicity．An increased risk of lung cancer in Asians was found to be associated with genetic polymorphisms in CYP1A1．However，reports from Caucasians are not consistant，probably suggesting the ethnic-sepecific effect of the polymorphisms in the locus on the cancer．Evidence also exists for the association between levels of carcinogen-DNA adducts or frequency of oncogene and tumor suppressor gene mutations and CYP1A1 polymorphisms．These findings provide a better understanding of the relationship between CYP1A1 and lung cancer susceptibility．

Educational narrative is the application of narratology in the field of education.This paper introduced the definition of educational narrative and its characteristics of life,situationality and reflexivity,and then discussed the applicableness of the application of educational narrative in the medical ethics education.Based on this,it proposed the effectiveness means,namely that to improve theory quality and enhance the ability of narration,clarify the narrative theme and select material carefully,take care of medical students' growth and listen to their voice.

ObjectiveTo investigate the effect of age and gender on the position of termination of the conus medullaris (CMT).MethodsOne thousand three hundred and thirty-nine patients aged 4-89 yr scheduled for lumbar magnetic resonance imaging examination were selected.The position of CMT was determined using Visart 1.5 T or Magnetom Trio 3.0 T magnetic resonance imaging instrument.Results Five hundred and ninety-four male patients and 745 female patients were enrolled in the study.There was no significant difference in the percentage of CMT located at the L2,3 intervertebral disc level between female (1.2％) and male (0.5％) patients (P＞0.05),and female patients had a lower mean CMT than male patients (P＜0.01).There was no correlation between age and mean CMT in patients aged ≤19 yr (P＞ 0.05).There was a positive correlation between age and mean CMT in female patients aged≤20 yr (r =0.076,P＜0.05),but there was no correlation between age and mean CMT in male patients aged ≤ 20 yr (P＞0.05 ).ConclusionFemale patients have a lower mean CMT than male patients,and there is still a risk when performing spinal anesthesia,although the probability that CMT located at the L2,3 intervertebral disc level is low in female and male patients.The position of CMT is lower with increased age in adult female patients,but it is not related to age in adult male patients.

ObjectiveTo study the etiology, preoperative diagnosis and treatment of nonocclusive mesenteric ischemia(NOMI). MethodsClinical data of 3 cases of NOMI from 1992 to 1998 were analyzed retrospectively. ResultsMajor clinical presentations were abdominal pain, gastrointestinal bleeding and abdominal irritation. None was correctly diagnosed preoperatively. Partial ileectomy in 2 cases and right colectomy in 1 case was performed with a mortality of 2/3. Conclusion Early diagnosis and accurate assessment of the bowel viability in exploration were quite difficult. Resection of the infarcted bowel or ′second-look procedure′ were recommended if necessary.

Objective To Study the effect of splenectomy plus endoscopic varices ligation (SEVL) in the treatment of portal hypertension. Methods SEVL was carried out in 38 patients with portal hypertension from January 2000 to June 2002. The authors compared hemodynamic parameters and gastric emptying time before and after the operation. The incidence of upper gastrointestinal bleeding, the disappearance rate of esophageal varicosis, the outcomes of portal hypertensive gastropathy (PHG) and the incidence of complications were recorded at postoperative 3 weeks, 6 months, 12 and 18 months, respectively. Results Postoperatively, the free portal pressure, portal flow volume and velocity were significantly reduced in all the cases ( P 0.05). Portal thrombosis was seen in 6 cases (6/38, 15.8%). Conclusions SEVL has little influence on gastric emptying and PHG, offering a high disappearance rate of varicosis and a low incidence of complications.

Objectives To investigate the treatment and curative effect on paranasal sinuses and bronchitis in children. Methods Treatment of 62 cases of paranasal sinuses and bronchiolitis was retrospectively analyzed. Antibiotics was used in conventional treatment group (n=23). On top of conventional treatment, conventional plus topical treatment group (n=39) was additionally treated with nasal inhaled corticosteroids, sinus puncture, adenoid or tonsil surgery, etc. Results In conventional treatment group and conventional plus topical treatment group, the total effective rate of treatment for more than 8 weeks was 86.96%and 100.00%respectively, the effective rate for those treated for 4-8 weeks was 39.13%and 61.54%respectively. There was signiifcant difference in the effective rate of treatment for more than 8 weeks and for 4-8 weeks (both P<0.05) between two groups. Signiifcant difference also existed between the effective rate of treatment for more than 8 weeks and for 4-8 weeks (P<0.05) in each group. Conclusions Childhood sino-bronchitis should be treated not only with conventional treatment, but also with cor-rect topical treatment for local pathological changes in nasal sinus and nasopharynx. Longer treatment is needed for children with recurrent chronic sino-bronchitis.