Inflammatory bowel disease( IBD)includes ulcerative colitis( UC)and Crohn’s disease( CD),its incidence is increasing yearly in our country. With the progress of molecular biology,genetics,the understanding of IBD is deepen,however,the exact pathogenesis of IBD is still not fully clear,and it may be related to gene,environment, immunity,microorganism. Studies have shown that smoking,vitamin D,sex hormones,emotions,diet may be related with the occurrence of IBD. This article reviewed the role of environmental factors in IBD.

Crohn’s disease( CD)is a gastrointestinal progressive granulomatous disease with unknown etiology. It is characterized as active stage alternating with remission stage,long-term course with many complications,sometimes needing surgery and having the tendency of relapse in patient ’s whole life. Therefore,it is important to define an effective therapeutic endpoint to ameliorate the natural course of CD. This article reviewed the progress in defining treatment endpoint of CD.

Object To study the augmentation of the T activated killer (T AK) cell proliferating and tumor killing activities of the polysaccharide fraction from Rhodiola kirilowii (Regel) Regel, Lycium barbarum L., Hedysarum polybotrys Hand. Mazz., Glehnia littoralis F. Schmidt ex Miq., Rehmannia glutinosa (Gaert.) Libosch. ex Fisch. et Mey. and Aloe barbadensis Mill. in vitro. Methods The T AK cells were induced by anti CD 3 antibody (CD 3McAb) and rIL 2 from human peripheral blood mononuclear cells (PBMC). The effects of the above six plant polysaccharides (1～100 ?g/mL) on the proliferation of T AK cell, the cytotoxicity to Raji cells and L 1210 cells, and the IL 2 receptor (IL 2R) expression in T AK cells were determined. Results The six polysaccharides alone had no obvious effect on the proliferation of T AK cells. In the presence of rIL 2 and CD 3McAb, they could reinforce the proliferation of T AK cells and its tumor killing activities against Raji cells and L 1210 cells at a different extent, and a 21%～68% increase of IL 2R expression in T AK cells was observed. Conclusion The plant polysaccharides significantly enhance the proliferation and the tumoricidal activities of T AK cells and the enhancing actions related to the increase of IL 2R expression.

Objective To investigate the relationship between serum homocysteine (HCY)levels and oxidative stress in pa-tients with coronary heart disease (CHD).Methods According to the diagnostic criteria of CHD in 2010 (WS 319-2010)is-sued by the Ministry of Health,79 patients with CHD in Xi’an Central Hospital from June 2014 to December 2014 were se-lected as the experimental group,and 5 5 cases of healthy physical examination for the same period were selected as the nor-mal control group.The levels of oxidative stress marker malondialdehyde (MDA)and the activity of antioxidant enzyme su-peroxide dismutase (SOD)in serum were detected to analyze the state of oxidative stress.The levels of serum HCY were de-tected,and the correlation between HCY levels and MDA levels and SOD activity was analyzed.Results The levels of MDA in the CHD group were significantly higher than that in the control group,while SOD activity was significantly lower than that in the control group,the differences were statistically significant (t=3.112,2.684,all P<0.05).The levels of HCY in the CHD group were significantly higher than that in the control group,the difference was statistically significant (t=3.268,P<0.05).In the CHD group,the levels of HCY were positively correlated with the levels of MDA (r=0.236,P<0.05),and negatively correlated with SOD activity (r=-0.221,P<0.05).Conclusion Serum HCY levels were increased and oxidative stress reaction was enhanced in patients with CHD.Oxidative stress was associated with elevated serum HCY levels.Serum HCY levels and oxidative stress played an important role in the occurrence and development of CHD.

Objective To investigate the clinical value of the combined detection of manganese superoxide dismutase (Mn-SOD)genetic polymorphism and lipoprotein phospholipase A2 (Lp-PLA2)in the early diagnosis of coronary heart disease (CHD).Methods 92 cases of coronary heart disease patients and 78 cases of healthy control group were selected.The activ-ity of Lp-PLA2,the activity of Mn-SOD and genotype of Mn-SOD 9 Ala/Val genetic polymorphism were detected in the ser-um of each group via the use of colorimetry,continuous monitoring technique and gene-sequencing method respectively and then the correlation of serum Mn-SOD,Lp-PLA2 and Mn-SOD genetic polymorphism with CHD were analyzed.Results The Lp-PLA2 activity in serum of CHD groups with Mn-SOD 9 VV genotype was statistically significantly higher than that of patients with the AV+AA genotype (P<0.01).The serum Mn-SOD activity in patients with VV genotype was signifi-cantly lower than that of those with AV+AA genotype (P<0.01).Conclusion Combined detection of Mn-SOD 9 Ala/Val genetic polymorphism and Lp-PLA2 activityin the serum can provide an important foundation for the diagnosis and predic-tion of coronary heart disease.

Objective To investigate the effects of transcutaneous electro acupuncture stimulation (TEA) on esophageal motility of patients with refractory gastroesophageal reflux disease (RGERD) by high resolution manometry (HRM),and to provide a new treatment option for RGERD.Methods From February 2014 to June 2015,a total of 45 patients with RGERD were enrolled.TEA instrument was used for electro acupuncture stimulation at the points of Zusanli and Neiguan.HRM was carried out before and after treatment.The changes of HRM parameters such as lower esophageal sphincter pressure (LESP),distal contractile integral (DCI),and amplitude of 3 cm,7 cm above lower esophageal sphincter (LES),esophageal body velocity and contractile front velocity (CFV) were also compared.The paired-samples t test was performed for statistical analysis.Results According to LESP value,45 patients were divided into low LESP group (10 patients) and normal LESP group (35 patients).According to parameter of esophageal motility function,patients were divided into esophageal dysmotility group (25 patients) and normal esophageal motility group (20 patients).After TEA treatment,the LESP of lower LESP group was (14.83± 4.17) mmHg (1 mmHg =0.133 kPa),which was higher than that before treatment ((9.54 ±2.42) mmHg),and the difference was statistically significant (t=4.92,P=0.001).LESP of esophageal dysmotility group was (19.04±5.91) mmHg,which was higher than that before treatment ((16.20±6.09) mmHg),and the difference was statistically significant (t=4.92,P=0.001).There was no statistically significant difference in LESP of normal LESP group and normal esophageal motility group before and after treatment (both P＞0.05).After treatment,DCI of esophageal dysmotility group was (530.76±215.53) mmHg· cm· s,which was higher than that before treatment ((363.92 ± 279.17) mmHg · cm · s),and the difference was statistically significant (t=2.86,P＜0.05).There was no statistically significant difference in esophageal body velocity,amplitude of 3 cm,7 cm above LES andCFV before and after treatment (all P＞0.05).There was no statistically significant difference in all of the esophageal motility parameters in normal esophageal motility group before and after treatment (all P＞0.05).Conclusion TEA can increase LESP and DCI in RGERD patients with esophageal motility dysfunction,improve contraction of entire esophagus and raise esophageal clearance capacity.

Objective To investigate the correlation between serum HCY (Homocysteine) and carotid artery stenosis,plaque stability in patients with ischemic cerebrovascular disease.Methods 154 patients with ischemic cerebrovascular disease in Tangdu Hospital were enrolled in the study from June to December 2016.The serum levels of HCY were detected.CT angiography (CTA) was uesd for patients with neck vascular scanning.According to the difference of serum HCY level,patients were divided into 80 cases of high HCY group (observation group) and 74 cases of normal HCY group (control group).The degree of carotid artery stenosis,number and stability of plaque were compared between the two groups and the correlation between serum HCY level and degree of carotid artery stenosis and plaque stability were analyzed.Results The total stenosis rate in the observation group was significantly higher than that in the control group,the moderate stenosis rate and severe stenosis rate in the observation group were significantly higher than those in the control group,with the statistically significant differences (x2 =5.594～ 22.506,all P＜0.05).The levels of serum HCY in mild,moderate and severe stenosis group were 13.16 ± 6.73,15.19± 5.93 and 26.13 ±11.18 μmol/L respectively.The levels of H CY in moderate stenosis group and severe stenosis group were significantly higher than that in mild stenosis group,and the levels of HCY in severe stenosis group was significantly higher than that in moderate stenosis group,with the statistically significant differences (t=2.684～ 5.270,all P＜0.01).The rate of carotid plaque in the observation group was significantly higher than that in the control group,and the differences statistically significant (x2 =25.053,P＜0.01).The rate of unstable plaque and mixed plaque in the observation group was significantly higher than that in the control group,and the rate of stable plaque was significantly lower than that in the control group (x2 =4.067～ 14.95,all P＜0.05).The levels of serum HCY in stable plaque group,mixed plaque group and unstable plaque group were 16.14±5.49,21.91 ± 6.32 and 26.74 ± 10.59 μmol/L respectively.The levels of HCY in mixed plaque group and unstable plaque group were significantly higher than that in stable plaque group,and the differences were statistically significant (t=4.370,4.628,all P＜0.01).The level of HCY in unstable plaque group was significantly higher than that in mixed plaque group,and the difference was statistically significant (t =2.249,P＜ 0.05).Conclusion Serum HCY levels were closely related to carotid artery stenosis and plaque stability.Hyperhomocysteinemia can increase the incidence and degree of carotid artery stenosis as well as the number of carotid plaques and unstable plaques.

Objective To investigate the correlation between HCY (Homocysteine),folate,vitamin B12 and head and neck vascular stenosis in patients with ischemic cerebrovascular disease.Methods 225 patients with ischemic cerebrovascular disease in Tangdu Hospital of the Fourth Military Medical University were enrolled in the study from April 2016 to October 2016.The serum levels of HCY,folate and vitamin B12 were detected.CT angiography (CTA) was uesd for patients with head and neck vascular scanning.According to whether the presence of vascular stenosis,patients were classified as no vessel stenosis group and vascular stenosis group.According to the degree of stenosis,patients were classified as no vascular stenosis group,mild moderate stenosis group and severe stenosis group.Results The HCY levels in the vascular stenosis group were significantly higher than no vessel stenosis group,while the levels of folate and vitamin B12 were significantly lower than no vessel stenosis group,the differences were statistically significant (t=9.656,7.140 and 8.350,all P＜0,01).The HCY levels in mild moderate stenosis group and severe stenosis group were significantly higher than no vessel stenosis group,and the HCY levels in severe stenosis group were significantly higher than mild moderate stenosis group,the differences were statistically significant (t=6.108,9.401 and 5.273,all P＜0.01).The folate levels in mild moderate stenosis group and severe stenosis group were significantly lower than no stenosis group,the differences were statistically significant (t=5.574 and 5.988,all P＜0.01).The vitamin B12 levels in mild moderate stenosis group and severe stenosis group were significantly lower than no stenosis group,the differences were statistically significant (t=4.548 and 7.816,all P＜0.01).The degree of head and neck vascular stenosis and serum levels of HCY were positively correlated (r=0.331,P＜0.01).The degree of head and neck vascular stenosis and levels of vitamin B12 were negatively correlated (r=-0.279,P＜0.05).Conclusion The levels of HCY,folate and vitamin tB12 were closely related to the degree of head and neck vascular stenosis.HCY,folate,vitamin B12 and head and neck CTA play important roles in patients with ischemic cerebrovascular disease clinically.

BACKGROUND: Pathological changes of pulmonary emphysema are not reversible according to the existent pathogenesis of pulmonary emphysema. Research over many years report that injury of pulmonary blood capillary may take part in new pathogenesis of pulmonary emphysema based on lung volume reduction operation and bronchial lumen occlusion. Mesenchymal stem cells (MSCs) have multi-directional differentiation potencies, such as the differentiation into vascular endothelial cells. Therefore, MSCs may promote pulmonary vascularization and repair pulmonary tissue.OBJECTIVE: To observe the effect of MSCs transplantation on pathological changes of arterial blood gas and pulmonary tissue in model rats with pulmonary emphysema, and investigate the therapeutic effects on MSCs on pulmonary emphysema and the pathogenesis of pulmonary emphysema.DESIGN: Randomized controlled animal study.SETTING: The Second Hospital of Shanxi Medical University.MATERIALS: Thirty healthy Wistar rats, 6 weeks old, of either gender, weighing 180-200 g. They were provided by Physiological Experiment Animal Center, Shanxi Medical University. All rats were randomly divided into MSCs treatment group, model group and control group with 10 rats each.METHODS: The experiment was carried out in the Physiological Laboratory of Shanxi Medical University from April 2005 to April 2006. Rats in the MSCs treatment group and in the model group were anesthetized and intratracheally perfused with 250 U/kg Porcine pancreatic elastase (PPE) to establish pulmonary emphysema models; while, rats in the control group were perfused with saline. The models were successfully established 4 weeks later. All rats were anesthetized and then femur and tibia were obtained to separate and culture MSCs in vitro. Immunocytochemistry was used to detect the expression of CD71 in order to evaluate MSCs. Bromium azacytidine-labeled MSCs were inserted along caudal vein into rats in the MSCs treatment group; while, rats in the model group and control group were inserted with the same volume of PBS solution.MAIN OUTCOME MEASURES: ① Changes of arterial blood gas in the three groups; ② Pulmonary tissue was used for pathological sections in order to calculate mean alveolar number, mean alveolar area and mean linear intercept; ③Immunocytochemical staining was used to measure numbers of CD34+ cells so as to determine proliferation of alveolar blood capillary.RESULTS: Three rats in all died during the model establishment, while another 3 rats were supplied. Therefore, an overall number of 30 rats were involved in the final analysis. ① Culture and evaluation of MSCs: At 3 days after inoculation, MSCs were generally adherent to walls and fusiformly shaped. In the third generation, the expression of CD71 was observed on the surface of MSCs.② Comparisons of arterial blood gas in the three groups: There were no significant differences in pH value, PO2, PCO2 and SaO2 in the three groups (P ＞ 0.05). ③ Pathological changes of pulmonary tissue: Pathological changes in the MSCs treatment group were milder than those in the model group;meanwhile, mean alveolar number in the MSCs treatment group was more than that in the model group, and there was significant difference between them (F=80.201, P＜ 0.05). While mean alveolar area and mean linear intercept in the MSCs treatment group were smaller than those in the model group, and there were significant differences (F =26.755,26.875, P ＜ 0.05). ④ Comparisons of CD34+ expression in pulmonary tissue: Relative positive area of CD34+ in the MSCs treatment group and model group was smaller than that in the control group (F =20.411, P ＜ 0.05), but that in the MSCs treatment group was larger than that in the model group, and there was significant difference between them (F=20.411, P＜ 0.05).CONCLUSION: MSCs can reverse the pathological changes of pulmonary emphysema; on the other hand, the decrease of the number of pulmonary capillary maybe one of the important pathogeneses of pulmonary emphysema.

Objective To investigate the advantages, indications and efficiency of video-assited thoraco-scopic sugery in spontaneous pneumothorax. Methods 31 patients with spontaneous pneumothorax underwent video-assited thoracoscopic sugery, performed with endoscopic manual suture without use of endoscopic cutters. Results All patients were cured without recurrence. Conclusions Video-assited thoracoscopic sugery is the first choice in treating spontaneous pneumothorax,with minimal trauma,less bleeding. Endoscopic manual suture can obviously re-duce the treatment cost.