Objective To evaluate the diagnostic potential of capsule endoscopies (CE) for suspected small bowel diseases. Methods From September 2002 to June 2003, 23 patients (12 males, 11 females ) , age ranged 10 to 75 years old, with suspected small bowel diseases, were referred to our department to perform CE using Given M2A Video Capsule System. All patients had undergone previous negative endo-scopic evaluation at least once with esophago-gastro-duodenoscopy and total colonoscopy. Additional diagnostic work-up including small bowel enteroclysis, selective angiography, scintigraphy and puch enteroscopy, were performed, totally 36 procedures. Two endoscopists independently reviewed capsule images to arrive a consensus diagnosis. The initial diagnostic yield was quantified, and the value of CE was assessed. Of the 23 patients, 18 suffered from obscure gastrointestinal bleeding, 3 abdominal pain, and 2 chronic diarrhea. Results Twenty-four studies in 23 patients were evaluated. During CE patients have not complained of any uncomfortable feeling, only one patient had repeated the procedure because the capsule lodged at the inferior segment of esophagus near the Z line. Of the 23 patients, 20 had positive findings with a diagnostic yield of 86. 8% . The positive findings included inflammatory lesions in 10 patients (Crohns disease 7 , aphthous ulcer 3 ) , vascular abnormalities 9 ( phlebectasis 6, angioma 2, angiodysplasia 1) , submucosal nodulation 2 , diverticula 2, jejunal stromal tumor 1. Four of 23 patients had more than one lesion. Diagnosis of 6 patients was confirmed by surgery and /or pathology. Nineteen capsules passed in the direction with the camera facing forward, while the other 4 backward. Generally, it delayed in passing through the pylorus and ileocecal valves. Capsules reached cecum in 17 patients (73. 9% ) . Conclusion CE provided clearly the small intestinal images, and is an efficient tool in diagnosing small bowel diseases with a high diagnostic yield.

Objective To investigate the effects of oral recombinant attenuated Salmonella ophimurium urease B subunit and catalase in the treatmeat of H.pylori infection in a H.pylori infected mouse model. Methods Thirty C57BL/6 mice were randomized into three groups and challenged twice by oral administration of H.pylori in three days. Four weeks after the second challenge, the mice were immunized by oral administration of recombinant attenuated Salmonella typhimurium urease B subunit (group A), recombinant attenuated Salmonella typhimurium catalase (group B), or saline (group C) respectively, and all mice were sacrificed 4 weeks after the immunization. The stomachs were collected for rapid urease test, modified Giemsa stain and quantitative culture to observe the gastric H.pylori densities, and HE stain was performed to assess the presence of inflammation. Lymph cells from the spleens were served for lymphoproliferation assay. Results Gastric H.pylori densities of group A, B and C were 1.58?10 5 CFU/g, 4.88?10 5 CFU/g and 1.92?10 6CFU/g respectively. H.pylori densities of therapeutic groups were significantly decreased ( P

Objective Compared with corresponding monovalent vaccine and pure vaccine vector, live attenuated Salmonella typhimurium expressing bivalent antigens of Helicobacter pylori (H. pylori) , UreB/HpaA was constructed by introducing a flexible and tenacious linker into urease subunit B (UreB) and HpaA of H. pylori and its protection against H. pylori infection in mice was then investigated. Methods UreB/hpaA fusion gene was amplified form H. pylori genomic DNA using sequence overlap extension PCR (SOE-PCR). UreB/HpaA bivalent live vaccine was constructed using attenuated Salmonella typhimurium vaccine vector SL3261, and its stability in vivo was observed in C57BL/6 mice. Evaluation of protection against H. pylori infection was performed in native female C57BL/6 mice by oral immunization with a single dose of the live SL3261 vaccine strain expressing UreB/HpaA (10 8 CFU). Results Sequencing results showed that encoding sequence (GGTGGAGGC) of three glycine residues was inserted into the position between ureB and hpaA fusion gene as an adapter. Bivalent live vaccine strain could be recovered from spleen and Peyer's patches for a longer time (at least 10 days). Bivalent live vaccine induced marked elevation of the levels of serum specific IgG1 and IgG2A in mouse. The immune protection rate of UreB and HpaA bivalent live vaccine was 77.3% (17/22). However only 50.0% (12/24) of the mice immunized with SL3261 vaccine strain expressing UreB and 43.5% (10/23) of the mice immunized with SL3261 vaccine strain expressing HpaA were completely protected against H. pylori challenge. Conclusions Oral immunization of mice with bivalent UreB/HpaA live vaccine could induce protective immunity against H. pylori , and the protection rate of bivalent vaccine appears to be higher than that of monovalent vaccine.

Objective:Investigated the effect of recombinant urease A subunit and catalase vaccines on protection against Helicobacter pylori (HP) infection Methods:Recombinant plasmids expressing UreA or KatA were constructed Expression was induced with IPTG,analyzed by SDS PAGE and Western blot UreA and KatA were purified with Bulk GST purification module Results:The recombinant plasmids could express GST UreA and GST KatA fusion proteins,which accounted for 35% and 19% of total bacteria proteins respectively,and could specially react with antibody against GST The purity of the purified UreA and KatA was over 95% Conclusion:The work laid a foundation for further studies of HP vaccine The recombinant vaccines may play an important role in preventing and treating HP infection and related diseases

AIM: To study the role of endothelin-1 (ET-1) in portal hypertension (PHT) induced by endotoxin. METHODS: Collagenase in situ perfusion was adopted to separate hepatic stellate cells (HSCs). HSCs was cultured on concretized collagen. ET-1 anti-sense oligonucleotide was added into the culture medium and then LPS was also added up to the concentration of 1 000 ?g/L. The diameters of the concretized collagen were measured. Sense and mis-sense oligonucleotide were applied as control. ET-1 in the culture medium was detected by radioimmunoassay and ET-1 mRNA in HSCs was detected by RT-PCR. ?-actin of HSCs was detected by Western blotting. RESULTS: The diameter of concretized collagen on which HSCs pretreated with ET-1 anti-sense oligonucleotide was 93.3%?3.8% the size of the primary. The diameter of concretized collagen of the control groups were 70.1%?4.8% and 70.5%?3.9% (P

OBJECTIVETo construct and identify a lentiviral vector of RNA interference targeting human Notch-1 gene.

METHODSTo determine the Notch-1 gene sequences, three RNAi target sequences (shRNA1-3) were designed in accordance with the RNAi sequence design principles and cloned into the lentiviral vector pLenOR-THM by endonuclease BamH I restriction, EcoR I double digestion, and T4 DNA-ligase ligation. After the transformation into competent DH5alpha bacteria, the candidate clones were identified by Kpn I and EcoR I double digestion and DNA sequencing. The recombinant and three packaging plasmids were co-transfected into human embryonic kidney cell line 293T cells by lipofectamine to produce the lentiviral particles. The viral titer was determined. The 293T cells were infected by the lentiviral particles obtained, and transfection efficiency was assessed using a fluorescent microscope. The lentiviral vector particles were also transfected into ACC-M cells. The Notch-1 expression in the transfected cells was assayed by quantitative reverse transcription polymerase chain reaction (QRT-PCR) and Western blot analysis.

RESULTSThe lentiviral RNAi vector pLenOR-THM-Notchl for Notch-1 gene was constructed successfully. Strong green fluorescence was observed in the 293T cells under fluorescent microscope after co-transfection of the cells with the four plasmids of lentiviral vector. The virus in the supernatant reached a titer of 5.8 x 10(8) TU x mL(-1). The transfection efficiency of the collected virus exceeded 90% in 293T cells with 1 as a multiplicity of infection. The third lentiviral vector was found to significantly inhibit the Notch-1 expression at the mRNA and protein levels.

CONCLUSIONThe lentiviral RNAi vector of Notch-1 has been successfully constructed and identified.

Cell Line ; Genetic Vectors ; Humans ; Lentivirus ; Plasmids ; RNA Interference ; RNA, Messenger ; RNA, Small Interfering ; Receptor, Notch1 ; Transfection

Abstract Physical health of contemporary children and adolescents decreasing due to physical inactivity. After review of the implementation of physical activity promotion among children and adolescents at home, this paper analyzes the possible reasons of physical activities neglected, constrained and occupied by the family, school and community, and proposes an integrated supportive environment for physical activities among "family school community", so as to promote physical activity among children and adolescents and improve their physical health accordingly.

Objective To investigate the efficacy of implantation of radioactive iodine-125 (125I) seeds combined with chemotherapy in treatment of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC).Methods Ninety patients with stage Ⅲb and Ⅳ NSCLC were divided into two groups.The combined group (n=43) received chemotherapy with TP (paclitaxe plus cispla tin) or GP (gemcitabine plus cisplatin) 3 days after 125I particles implantation,and the control group (n=47) only received TP or GP chemotherapy.The effective rate,1-year and 2-year survival rate,the median survival time were compared between the 2 groups.Results The total effective rates of the combined group and the control group of stage Ⅲ b NSCLC were 84.00％ and 48.28％,and the effective rates of stage Ⅵ NSCLC were 72.22％ and 33.33％ (both P＜0.05).The 1-year and 2-year survival rate of the combined group and control group of stage Ⅲb NSCLC were 67.80％,36.00％ and 37.90％,13.83％,respectively (both P＜0.05).The median survival time was 15.7 months and 8.6 months.However,the survival rates of the combined group and the control group of stage Ⅳ NSCLC were 44.44％,16.70％ and 22.22％,11.10％,respectively,while the difference was not statistically significant (P＞0.05).The median survival time was 8.9 and 6.0 months.Conclusion The implantation of radioactive 125I seeds combined with chemotherapy can obtain a significant efficacy in the treatment of stage Ⅲb and stage Ⅳ NSCLC.For patients with stage Ⅲb NSCLC,combined therapy can improve the survival rate.

Objective:To evaluate the influence of different detector widths and signal acquisition positions of wide-detector CT in different scanning modes on CT number and noise, and to provide a basis for reasonable selection of scanning modes and related parameters in clinical practice.Methods:The body dose phantom was scanned by GE Revolution CT. The scan was performed with detector widths of 40, 80 and 160 mm in sequential scanning mode and with detector width/pitch combinations of 40 mm/0.516, 40 mm/0.984, 80 mm/0.508 and 80 mm/0.992 in spiral scanning mode. The phantom was placed at the central and peripheral of the selected detector widths, and the adjacent positions between two axial scans. The images of the phantom were evaluated subjectively and the CT numbers and SDs were measured. The differences between the measured values at different imaging parameters were compared. The multi-group Friedman test was used to compare CT numbers and SD under different scanning parameters in sequential scanning mode, and the Wilcoxon test was used to compare CT numbers and SD in spiral scanning mode.Results:There was no statistically significant difference in the geometric shapes of the phantom images obtained at any combination of parameters. In sequential scanning mode, the differences at different detector widths were statistically significant (χ 2=14.00, P=0.001) with CT numbers at 40 mm and 160 mm greater than CT numbers at 80 mm ( P<0.05). The differences at different signal acquisition positions were statistically significant (χ 2=12.04, P=0.002) with CT numbers at peripheral and adjacent greater than CT numbers at central ( P<0.05). In spiral scanning mode CT numbers at detector width at 80 mm were greater than CT numbers at 40 mm ( Z=-2.10, P=0.036). For SD, the differences at different detector widths were statistically significant in sequential scanning modes (χ 2=8.17, P=0.017) with SD at 160 mm greater than SD at 80 mm ( P<0.05). The differences at different signal acquisition positions were statistically significant (χ 2=13.50, P=0.001) with SD at peripheral greater than SD at central ( P<0.05). In spiral scanning mode SDs at pitches 0.984 and 0.992 were greater than SDs at 0.516 and 0.508 ( Z=-2.66, P=0.008). There were no significant differences among other groups. Conclusion:The selection of scanning mode, detector width and signal acquisition position of wide-detector CT will affect the image CT numbers and SDs.

Objective:To investigate the clinical characteristics of choledocholithiasis com-bined with periampullary diverticulum and influencing factor for difficult cannulation of endoscopic retrograde cholangiopancreatography (ERCP).Methods:The retrospective case-control study was conducted. The clinical data of 1 920 patients who underwent ERCP for choledocholithiasis in 15 medical centers, including the First Hospital of Lanzhou University, et al, from July 2015 to December 2017 were collected. There were 915 males and 1 005 females, aged (63±16)years. Of 1 920 patients, there were 228 cases with periampullary diverticulum and 1 692 cases without periampullary diverticulum. Observation indicators: (1) clinical characteristics of patients with choledocholithiasis; (2) intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis; (3) influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Clinical characteristics of patients with choledocholithiasis. Age, body mass index, cases with complications as chronic obstructive pulmonary disease, diameter of common bile duct, cases with diameter of common bile duct as <8 mm, 8?12 mm, >12 mm, diameter of stone, cases with number of stones as single and multiple were (69±12)years, (23.3±3.0)kg/m 2, 16, (14±4)mm, 11, 95, 122, (12±4)mm, 89, 139 in patients with choledocholithiasis combined with periampullary diverticulum, versus (62±16)years, (23.8±2.8)kg/m 2, 67, (12±4)mm, 159, 892, 641, (10±4)mm, 817, 875 in patients with choledocholithiasis not combined with periampullary diver-ticulum, showing significant differences in the above indicators between the two groups ( t=?7.55, 2.45, χ2=4.54, t=?4.92, Z=4.66, t=?7.31, χ2=6.90, P<0.05). (2) Intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis. The balloon expansion diameter, cases with intraoperative bleeding, cases with hemorrhage management of submucosal injection, hemostatic clip, spray hemostasis, electrocoagulation hemostasis and other treatment, cases with endoscopic plastic stent placement, cases with endoscopic nasal bile duct drainage, cases with mechanical lithotripsy, cases with stone complete clearing, cases with difficult cannulation, cases with delayed intubation, cases undergoing >5 times of cannulation attempts, cannulation time, X-ray exposure time, operation time were 10.0(range, 8.5?12.0)mm, 56, 6, 5, 43, 1, 1, 52, 177, 67, 201, 74, 38, 74, (7.4±3.1)minutes, (6±3)minutes, (46±19)minutes in patients with choledocholithiasis combined with periampullary diverticulum, versus 9.0(range, 8.0?11.0)mm, 243, 35, 14, 109, 73, 12, 230, 1 457, 167, 1 565, 395, 171, 395, (6.6±2.9)minutes, (6±5)minutes, (41±17)minutes in patients with choledocholithiasis not combined with periampullary diverticulum, showing significant differences in the above indicators between the two groups ( Z=6.31, χ2=15.90, 26.02, 13.61, 11.40, 71.51, 5.12, 9.04, 8.92, 9.04, t=?3.89, 2.67, ?3.61, P<0.05). (3) Influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Results of multivariate analysis showed total bilirubin >30 umol/L, number of stones >1, combined with periampullary diverticulum were indepen-dent risk factors for difficult cannulation in patients with periampullary diverticulum who underwent ERCP for choledocholithiasis ( odds ratio=1.31, 1.48, 1.44, 95% confidence interval as 1.06?1.61, 1.20?1.84, 1.06?1.95, P<0.05). Results of further analysis showed that, of 1 920 patients undergoing ERCP for choledocholithiasis, the incidence of postoperative pancreatitis was 17.271%(81/469) and 8.132%(118/1 451) in the 469 cases with difficult cannulation and 1 451 cases without difficult cannula-tion, respectively, showing a significant difference between them ( χ2=31.86, P<0.05). In the 1 692 patients with choledocholithiasis not combined with periampullary diverticulum, the incidence of postopera-tive pancreatitis was 17.722%(70/395) and 8.250%(107/1 297) in 395 cases with difficult cannula-tion and 1 297 cases without difficult cannulation, respectively, showing a significant difference between them ( χ2=29.00, P<0.05). In the 228 patients with choledocholithiasis combined with peri-ampullary diverticulum, the incidence of postoperative pancreatitis was 14.865%(11/74) and 7.143%(11/154) in 74 cases with difficult cannulation and 154 cases without difficult cannulation, respectively, showing no significant difference between them ( χ2=3.42, P>0.05). Conclusions:Compared with patients with choledocholithiasis not combined with periampullary divertioulum, periampullary divertioulum often occurs in choledocholithiasis patients of elderly and low body mass index. The proportion of chronic obstructive pulmonary disease is high in choledocholithiasis patients with periampullary diverticulum, and the diameter of stone is large, the number of stone is more in these patients. Combined with periampullary diverticulum will increase the difficult of cannulation and the ratio of patient with mechanical lithotripsy, and reduce the ratio of patient with stone complete clearing without increasing postoperative complications of choledocholithiasis patients undergoing ERCP. Total bilirubin >30 μmol/L, number of stones >1, combined with periampullary diverticulum are independent risk factors for difficult cannulation in patients of periampullary diverticulum who underwent ERCP for choledocholithiasis.