Current goals of ulcerative colitis treatment include rapid remission,steroid-sparing remission,endoscopic mucosal healing,reduction in hospitalization and surgery and improvement in quality of life.The treatment principle is rational medications according to the severity,activity and extent of the disease with individualized and comprehensive treatment.The medications conventionally used are 5-ASA,GCS and IS.Newly developed biological agents like Anti TNF-?(infliximab)are used in severe UC and refractory cases.Traditional Chinese Medicines have been used in more than 80% of UC cases and will play a great role in the future.The indications for surgery include acute perforation,massive hemorrhage,toxic megacolon,malignancy and refractory cases for medical therapy.

Objective To investigate the effect of pioglitazone on oxazolone-induced colitis and to clarify the mechanism of apoptosis by Fas/Fas ligand(FasL). Methods Eighteen BALb/c mice of ulcerative colitis induced by oxazolone enema were equally allocated into 3 groups. The mice in group 1 were sacrificed 3 days after enema,lamina propria mononuclear cells(LPMC) were isolated from freshly obtained colonic specimens and treated in vitro with pioglitazone (40 ?mol/L),the annexin-V-FITC was used for detection of apoptosis,and Fas/FasL expression was assayed by flow cytometry. Meanwhile,untreated mice were served as normal controls. Mice in group 2 (control group) and 3 (experiment group) were treated with methylcellulose or pioglitazone(20 mg?kg -1 ?d -1 ) 3 days after enema and were administrated for consecutive 7 days. The colonic inflammation including disease activity index (DAI),macroscopic and histological changes,myeloperoxidase(MPO) activity and levels of interleukin (IL)-4,IL-5 were evaluated. Results Apoptosis of LPMC,expression of Fas and FasL in normal and colitis mucosa were 12.89?1.23,70.63?6.24,8.59?5.47 and 4.25?0.84,62.60?5.85,23.75?10.23,respectively. After treated with pioglitazone,both apoptosis of LPMC and expression of Fas increased,while FasL expression decreased (40.58?10.32,83.98?11.38 and 10.04?5.21 respectively). In group 2 and group 3,the macroscopic and microscopic score,MPO activity,IL-4 and IL-5 level were 2.50?0.55,8.83?0.75, 3.81?0.17,216.46?34.32,102.28?25.74 and 0.33 ?0.52,4.00?0.63,1.25?0.16,179.36?18.15,61.65?17.45,respectively. Conclusion The results indicate that pioglitazone treatment can significantly attenuate colonic inflammation,and it might be related to the apoptosis of LPMC through Fas and FasL.

Objective: To investigate the therapeutic effects of Bawei Xilei San (BWXLS), a compound traditional Chinese herbal medicine, on mice with oxazolone-induced colitis and to explore the mechanisms. Methods: Thirty-two BALB/c mice were randomly divided into 4 groups (8 for each): normal control group, untreated group, hydrocortisone group and BWXLS group. Except for the mice in the normal control group, all mice were intrarectally administered with 3.0% oxazolone to induce colitis. Then the mice in the normal control group and untreated group were administered with 0.9% carboxymethyl cellulose sodium solution. Mice in the BWXLS group were intrarectally administered with 0.2 mg/g BWXLS and hydrocortisone group with 0.02 mg/g respectively for 5 days. The body weight and stool consistency and occult or gross blood were recorded to calculate the disease activity index (DAI). The mice were sacrificed at the 6th day. The macroscopic and histological changes of the colon were evaluated. The expressions of Toll-like receptor 4 (TLR4), nuclear factor-kappaB (NF-kappaB), and epithelial tight junction protein occludin were assessed by immunohistochemical method. The level of tumor necrosis factor-alpha (TNF-alpha) in colonic mucosa was evaluated by enzyme-linked immunosorbent assay. Results: The DAI, and macroscopic and histological changes in the BWXLS group were improved as compared with those in the untreated group (P<0.05) but were similar to those in the hydrocortisone group. The expression of occludin was significantly increased (P<0.05) while the expressions of TLR4, NF-kappaB and TNF-alpha were significantly decreased in the BWXLS group as compared with the untreated group, and were similar to those in the hydrocortisone group (P>0.05). Conclusion: Up-regulating the expression of occludin and down-regulating the expressions of TLR4 and NF-kappaB, and hence inhibiting TNF-alpha expression and improving the mucosa barrier function may be part of the mechanisms of BWXLS in treating oxazolone-induced colitis in mice.

Objective To investigate the expressions of 5-lipoxygenase (5-LOX) protein and mRNA in colon mucosa of ulcerative colitis (UC) and to analyze its correlation with endoscopic and histological grading. Methods The biopsies from 32 UC patients and 26 healthy controls were collected, and the expressions of 5-LOX mRNA and protein in colonic mucosa was determined by real-time fluorescent quantitative reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry assay, respectively. The endoscopic and histological grading of 32 UC patients were also recorded. Results According to endoscopic grading, there were 10 cases of grade Ⅰ , 19 of grade Ⅱ and 3 of grade Ⅲ in 32 UC patients, and there were 19 cases of grade Ⅰ , 9 of grade Ⅱ and 4 of grade Ⅲ according to histological grading. The expressions of 5-LOX mRNA and protein in UC patients were significantly higher than those in healthy controls (P ＜0. 05 ). The rate of 5-LOX protein expression increased with endoscopic and histological grades, which was also positively correlated with endoscopic grades ( P ＜ 0. 05 ), but not with histological grades ( P ＞0. 05 ). Conclusion The expressions of 5-LOX mRNA and protein in colon mucosa from UC patients might be a marker for disease activity. 5-LOX may play a pivotal role in inflammation of UC and be a target site for treatment.

Objective To investigate the expression and significance of human β-defensin-2 (HBD2),TNFα and IL-1βin ulcerative colitis(UC).Methods Thirty-five patients with active UC diagnosed by the department of gastroenterology in West China Hospital were included in this study.Ulcerative colitis disease activity index(UCAI)was assessed and the pathological grades of UC were classified.Immunohistochemistry assay and real-time quantitative PCR were used for the expression of HBD2,TNFα,IL-1β in colonic mucosa of UC.Results Among the 35 patients with UC,10 cases were mild.13 moderate and 12 severe.Of the 35 cases.there were 11 with grade Ⅰ.13 grade Ⅱ and 11 grade Ⅲ lesion according to Truelove criteria.The score of UCAI had positive correlation with pathological grading (r=0.890,P＜0.01).The expressions of HBD2,TNFα,IL-1β in colonic mucosa of UC with immunohistochemistry and real-time quantitative PCR were significantly higher than those in healthy control (P＜0.05);the expressions increased gradually with the severity of pathological grade and there was a higher expression of them in inflamed area than in non-inflamed(P＜0.05).A good positive correlation was also found between HBD2 and other inflammatory cytokines.Conclusions It is shown that there is a higher expression of HBD2 in colonic mucosa as compared with healthy control.a higher expression of it in inflamed area than in non-inflamed area and a positive correlation of expression between HBD2 and pro-inflammatory cytokines such as TNFα and IL-1 β,implying that HBD2 and pro-inflammatory cytokines are interdependent and interactive playing an important role in magnifying and aggravating inflammatory injury in UC.

p53 gene mutations and their expression in protein levels of colorectal adenomas, carcinomas and regional lymph nodes metastasis were detected by PCR-SSCP and AB-PAP immunohistochemical analysis, respectively. The results showed that p53 gene mutations were detected in 25% colorectal adenomas, 80% carcinomas and 100% regional lymph nodes metastasis. Meanwhile, p53 proteins were detected at rates of 75%, 60% and 57% in these three groups, respectively. It is suggested that p53 gene mutations occur frequently at late stage of progression to colorectal adenoma-carcinoma sequence and may relate to its metastasis, while the accumulation of p53 protein may be a specific genetic alteration initiated from adenomatous stage. Thus, the biological significances of the two genetic alterations are different. Investigations of these concomitantly would be helpful in understanding the malignant potential of adenoma and evaluation of its staging.

Adult ; Humans ; Male ; Recurrent Laryngeal Nerve ; abnormalities

0.05). It's concluded that PCNA immunohistochemicai staining is valuable in early detection of malignant potential of adenomas, also it may be helpful in distinguishing the degree of adenomatous dysplasia.

Objective To analyze the diagnosis, therapy and prognosis of the most severe type ulcerative colitis or critical ulcerative colitis. Methods Forty cases of severe ulcerative colitis in recent 18 years in our hospital were reviewed. Based on the criteria from literatures, a self generated criterion was used to identify the critical ulcerative colitis, i.e.: ① bloody stool≥9 times/d;② body temperature≥38?C;③ pulse rate≥90 beats/min;④ Hb

Objective To evaluate the preventive and therapeutic effects of heparin on dextron sulphate sodium (DSS)-induced colitis in mice. Methods The normal mice (n=16) which had been received DSS orally for 7 days were randomized into two groups, the preventive group with heparin subcutaneous administration, and the control group with normal saline subcutaneous administration. The DSS-induced colitis mice (n=16) were randomized into two groups, the treatment group with heparin and the control group with normal saline subcutaneous injection for 7 days. The preventive and therapeutic effects of heparin were assessed by disease activity index (DAI), histological score, TNF-? mRNA expression using hybridization in situ, and Martius scarlet blue (MSB) fibrin staining used to identify microvascular thrombi. Results Microvascular thrombi in the prevention group significantly decreased compared with those in the controls. Microvascular thrombi were positive in 4 of 8 controls, none in the prevention group (P=0.038). Histological score and TNF-? mRNA in the treatment group significantly decreased compared with those in the controls. Histological score of rectum and transverse colon, and expression of TNF-? mRNA in the treatment group and those in the controls were 1.33 and 1.85(P