ObjectiveTo investigate the relationship between colorectal neoplasia and nonalcoholic fatty liver disease (NAFLD).MethodsData of 809 patients who had undergone colonoscopy and epigastric CT scan in the same period were reviewed for gender,age,history of diabetes,hypertension,hyperlipidemia,NAFLD,colonoscopy and pathology results.Correlation of colorectal adenoma (CRA),colorectal carcinoma (CRC) and NAFLD were studied with multivariate Logistic analysis.Results NAFLD (P ＜0.0001,OR 2.06,95％ CI 1.53-2.76) was the independent risk factor for CRA,where the incidence of CRA was higher than that in the control group.ConclusionPatients with NAFLD is the risk population of colorectal adenomas.

Objective To explore the relation between IL-10 promoter region gene polymorphism and irritable bowel syndrome (IBS).Methods By polymerase chain reaction combined with restrition fragment length polymophism (PCR-RFLP),gene type of IL-10 promoter -1082 and -819 sites in 313 IBS patients and 281 controls was analyzed.Results The distribution of IL-10-1082 and-819 allele frequencies in IBS group,control group and total was in accordance with Hardy-Weinberg equilibrium law.The frequency of IL-10-819 T allele in diarrhea subtype (79.8％) and mixed IBS subgroup (77.1％) was significantly higher than that in control group (65.7％).There were no significant differences in IL-10-1082 A/G allele frequency between each subtypes and control group (P＞0.05),however there was statistically difference between diarrhea subtype and mixed IBS subgroup (P＜0.05).The frequency of-819 T/T genotype in IBS group (51.1 ％ )was significantly higher than that of control group (40.2％),the frequency of C/T genotype was significantly lower than that of control group,and the difference was statistically significant (all P＜0.05).The IL-10-819 T/T allele frequency of all IBS subtypes was significantly higher than that of control group; however C/T allele genotype frequency of all IBS subtypes was significantly lower than that of control group,and the difference was statistically significant (all P ＜ 0.05). There was no significant difference of C/C allele genotype between subtypes (P＜0.05).There was no significant difference of -1082 allele genotype between IBS group and control group (P＞0.05).The frequency of -1082 A/A genotype in diarrhea subtype of IBS patients (93.3％) was significantly higher than that of mixed IBS subtype (82.4％),while the frequency of A/G genotype was lower than that of mixed IBS subtype,and the difference was statistically significant (all P ＜ 0.05 ); there was no significant difference between other IBS subtypes and control group (P＞0.05).Conclusion IL-10-819 promoter T/Tgenotype may be related to IBS pathogenesis.

0.05). However in OAC group, there were significant differences between EM and IM(P0.05). Conclusions RAC and OAC triple therapy could eradicate H. pylori effectively. The efficacy of rabeprazole-based triple therapy was less affected by the CYP2C19 genotype. The eradication rates of H. pylori in PM and IM were higher than that in EM.

Objective To investigate the prevalence of subclinical hepatic encephalopathy(SHE) in patients with cirrhosis. Methods One hundred and seventy five consecutive cirrhotic patients(mean age 53 years, range 27～72) without any overt clinical encephalopathy were screened for SHE using number connection test A(NCT A) and symbol digit test(SDT) with age corrected normal value, which have been developed in 356 persons without liver disease and are defined as the mean?2 standard deviation. Results Fifty patients(28.6%) were abnormal in both NCT A and SDT, 16(9.1%) were abnormal only in SDT and 34(19.4%) only in NCT A. Taken together, two tests diagnosed SHE in 100 patients(57.1%). The prevalence of SHE increased from 46.8% and 53.0% in Child Pugh grade A and B, to 76.6% in Child Pugh grade C. Conclusions SHE was found in 57.1% of cirrhotic patients without overt clinical encephalopathy, which was linked to the severity of liver cirrhosis.

Objective To assess the incidence of noctu rnal acid breakthrough(NAB) and its' relationship with Helicobacter pylori(H. pylori) infection in patients with duodenal ulcer. Methods Forty duodenal ulcer patients were randomly allocated in to five groups. Patients were treated by intravenous injection of omeprazole 40 mg twice daily(group 1), once daily(group 2), omeprazole 20 mg twice daily oral ly(group 3), omeprazole 20 mg once daily orally(group 4), and intravenous inject ion of cimetidine 600 mg twice daily (group 5) all for 5 days. Intragastric pH o ver 24 hours was consecutively recorded on the fifth day for each patient. Results The mean intragastric pH, median intragastric pH, nocturn al mean pH and nocturnal median pH in group 1(6.9?0.7,7.3?0.8,6.8?0.9,7.1? 0 .7) were significantly higher than those of group 2 (5.3?1.6,5.6?1.7,4.9?1. 5,4.3?1.7),group 4(4.8?0.7,4.8?1.0,4.7?0.8,4.5?0.8), and group 5(4.4?2.4 ,4.5?2.5,4.6?2.7,4.3?2.1), but not higher than group 3(6.2?0.7,6.3?0.8,6. 4?1.1,6.4?0.8). High intragastric pH was produced in all five groups. The frac tion time of pH below 4.0 in group 1(3.1%) and group 3(4.5%) were significantly fewer than that in the other three groups(group 2,27.8%; group 4, (32.4)%, and group 5,48.2%) respectively. NAB occurred in 1 patient from two omeprazole twice dai ly groups(6.3 %, group 1 and 3) and in 9 patients from two omeprazole once daily groups((56.3 %,) group 2 and 4,P

Objective To assess the incidence and management of nocturnal acid breakthrough (NAB). Methods Forty patients with duodenal ulcer confirmed by gastroscopy were randomly divided into five groups, eight patients in each group. Patients were treated by the following strategies for a course of 5 days: group A (omeprazole 20 mg per day orally in the morning), group B (omeprazole 20 mg twice a day orally in the morning and at 4 p.m), group C (intravenous injection of omeprazole 40 mg twice a day in the morning and at 4 p.m), group D (omeprazole 20 mg per day orally in the morning plus ranitidine 150 mg at bed time) and group E (omeprazole 20 mg twice a day orally in the morming and at 4 p.m plus ranitidine 150 mg at bed time) respectively. Intragastric pH over 24 hours was recorded on the morning of the fifth day for each patient. Results In comparison with that in group A, intragastric pH was higher in the other four groups. The mean intragastric pH and mean nocturnal pH each in group B (6.2?0.7, 6.4?1.1), group C (6.9?0.7, 6.8?0.9), group D (6.0?0.7, 5.9?0.7) and group E (5.8?0.5, 6.1?0.5) were significantly higher than those in group A (4.8?0.7, 4.7?0.8, P

Objective To evaluate the efficacy of high intensity focused ultrasound (HIFU) combined with ultrasound contrast agent on rabbit liver, and to investigate the possibility of ultrasound contrast agents enhancing the effect of HIFU on rabbit liver. Methods Thirty-two rabbits were averagely divided into two groups according to their body mass. Rabbits in group Ⅰ were irradiated by HIFU alone on the liver, and those in group Ⅱ were treated by irradiation of HIFU after intravenous injection of a ultrasound contrast agent. The used treatment time, frequency, power and the distance from focus to the skin surface were identical in the two groups. The changes of ultrasound image were recorded at the 20 s, 2 min and 5 min after treatment. Four rabbits in each group were slaughtered for morphological and pathological examination immediately and on the 2nd, 3rd and 7th day after the treatments, respectively. Results The ultrasonic gray scale differenced in the HIFU alone group were ( 20.12? 12.4)s (20 s), ( 16.8? 9.3)min (2 min) and ( 15.1? 11.9)min (5 min). Compared with those in the enhanced HIFU group were ( 63.9? 29.4)s, ( 60.0? 25.9)min, ( 59.3? 28.7)min, respectively(P

Objective To evaluate the diagnostic efficacy of double-balloon push enteroscopy in small bowel disorders. Methods From July 2003 to March 2004, 38 patients with presentation of gastrointestinal upset and underwent a previous negative gastroscopy, colonoscopy, gastrointestinal barium and/or angiography were enrolled in this study. Enteroscopy via oral or rectum was done in 30 patients while in the other 8 patients full access to the small bowel was attempted by the two-way method, firstly via upper GI and then the lower GI. Results Positive diagnostic yield was made in 33 patients (86. 8% ). These disorders included Crohn's disease (7/38) , multiple ulcerations (5/38) , arteriovenous malformation (4/38) , multiple diverticula (4/38) , varices (3/38) , malignant stromal tumor (2/38) , ileitis (2/38) , and 1 case in each of moderate-differentiated adenocarcinoma, Ankylostoma duodenale, ascariasis, eosinophilic enteritis, anas-tomotic stricture and tuberculosis. The procedures were carried out satisfactorily in all patients but 2 failed from the intolerance of patients. Complication never occurred. Conclusion Double-balloon push enteroscopy has the superiority in direct visualization of whole small intestine with high positive findings and safety but with high technical demand in manipulation.

BACKGROUND: The pathogenesis of hepatic encephalopathy is still not completely clear at present, and the theory of ammonia poisoning may be the most powerful, the mechanism for lactulose in decreasing ammonia is clearer, and there are many studies on hepatic encephalopathy treated by lactulose at home and aboard, but the comparative studies on the long-term and short-term treatment of lactulose and placebo control treatment are still in lack. OBJECTIVE: To given long-term and short-term treatment of lactulose to patients with minimal hepatic encephalopathy, and compare the effect on the quality of life (QOL) of the patients with minimal hepatic encephalopa thy. DESIGN: A case-control observation. SETTING: Department of Geriatrics, Guangzhou First People's Hospital. PARTICIPANTS: Sixty patients with minimal hepatic encephalopathy, who were abnormal in the number connection test (NCT), digital symbol test (DST) and/or evoked potential examination and cooperated with the treatment, were selected from the patients with cirrhosis treated in the De partment of Geriatrics of Guangzhou First People's Hospital between June 1998 and March 2002, and they were randomly divided into control group (n=20), short-term lactulose group (n=20) and long-term lactulose group (n=20). METHODS: All the patients were given vitamin B for 24 weeks, two tablets for each time, three times a day; besides, the patients in the short term lactulose group and long-term lactulose group were orally adminis tered with lactulose (15-90 mL per day) for 8 and 24 weeks respectively. They were assessed with WHOQOL-BREF at the end of 0, 8, 16 and 24 weeks respectively, the incidence rate of hepatic encephalopathy was observed, and the ammonia conc entration in blood was detected at the same period.MAIN OUTCOME MEASURES: The changes of QOL and ammonia concentration in blood during the treatment were observed.RESULTS: During the treatment, one case in the control group lost to the follow-up, one case in the short-term lactulose group died from traffic accident, and two cases in the long -term group quitted because they could not endure the side effect of diarrhea, and totally 56 cases finished the treatment and entered the analysis of results. ① The incidence rate of hepatic encephalopathy at 6 months was 40%(8/20), 30%(6/20), 5%(1/20) in the control group, short-term lactulose group and long-term lactulose group respectively, and it was significantly lower in the long-term lactulose group than in the control group and short-term lactulose group (P ＜ 0.05), but there was no significant difference between the short-term lactulose group and control group (P ＞ 0.05). ② At 8, 16 and 24 weeks after treatment,the score of environment in QOL had no significant difference among the control group, short-term lactulose group and long-term lactulose group (P ＞ 0.05), but there were significant differences in the scores of physiology,psychology and social relationship (P ＜ 0.05); At 8 weeks, there were more obvious differences in the long-term lactulose group and short-term lactulose group than in the control group, but no significant difference between the long and short-term lactulose groups; At 16 weeks, there were more obvious differences in the long-term lactulose group than in the short-term lactulose group and control group, but no significant difference between the short-term lactulose group and control group; At 24 weeks, the long-term lactulose group had more improvements than in the control group and short-term lactulose group. ③ At 16 and 24 weeks after treatment, the ammonia concentrations in blood were significantly decreased in the long-term lactulose group as compared with the control group and short-term lactulose group.CONCLUSION: The long-term treatment of lactulose can improve the QOL of patients with minimal hepatic encephalopathy, eventually reduce the incidence of hepatic encephalopathy and decrease the ammonia concentration in blood; However, the short-term treatment of lactulose could not.

Objective To retrospectively investigate the clinical features and incidence trends of hypertriglyceridemic acute pancreatitis (HLAP) in Guangzhou First People's Hospital for 20 years.Methods The medical records of 1 362 patients,who were admitted to Guangzhou First People's Hospital with acute pancreatitis during January 1991 to December 2010,were reviewed and 99 patients met the HLAP criterion.These patients were divided into four groups according to years (1991 ～ 1995,1996 ～2000,2001 ～2005,and 2006 ～2010).The incidence and clinical features were compared among the 4 groups.Results Among the 99 patients,there were 61 males and 38 females,the mean age was (44 ± 12) years old,and young male was predominant in HLAP.HLAP accounted for 7.3％ of all AP patients,and the incidence was increased 1.5 times during the 20 years period (5.4％,5.7％,6.7％,and 8.3％ respectively).The serum amylase level was (513.3 ±462.7) mmol/L,TG level was (12.7 ± 7.0) mmol/L,Ranson score was (1.2 ± 1.1),CTSI score was 2.2 ± 1.1,incidence of SIRS was 36.4％,and the incidence of MODS was 18.2％,and the incidence of pancreatic pseudocyst was 5.1％,but the incidence and mortality of SAP was not changed with time.The incidence and mortality of SAP of HLAP were significantly higher than those of acute biliary pancreatitis (20.2％ vs 8.5％,6.1％ vs 2.8％).The rate of blood purification increased from 0 to 10.7％,and the hospital stay was decreased from 26 d to 14 d,and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Incidence of HLAP is increased gradually,with a trend towards more severe disease,but the prognosis is improved.