The incidence of colorectal cancer( CRC)increases rapidly in recent years. The role of dietary structure in CRC pathogenesis has caught much attention. This review summarizes the relationship between dietary fiber intake and risk of CRC. Accumulating evidence reveals that up to 90% CRC can be prevented by improvement of dietary structure,and high fiber intake(10-35 g/d)decreases 10%-17% of risk of CRC. All kinds of dietary fiber have preventive effect. So far, dietary fiber intake in Chinese people does not reach the recommended level. Optimization of dietary structure,increase intake of whole grains,vegetable and fruit,addition of fiber to daily food are effective approaches for prevention of CRC.

The necessity and feasibility of antiviral therapy in patients with liver cirrhosis have caught much attention.By summarizing the rel-evant guidelines/consensus statements and evidence-based medicine data in recent years,the advances in indications,strategies,drug op-tions,and benefit/risk in antiviral therapy for hepatitis B virus (HBV)-and hepatitis C virus (HCV)-related cirrhosis are reviewed.The data reveal that for both HBV-and HCV-related cirrhosis,successful treatment may suppress viral replication,improve patients′conditions, delay disease progression,prolong survival,reduce complications,and create better conditions for surgical and minimally invasive operations for hepatocellular carcinoma.Because of the good safety of nucleos(t)ide analogues (NA),it is recommended that patients with HBV-related cirrhosis (including those in decompensation stage and with complications)should receive NA as soon as possible.As interferon may cause many adverse reactions,antiviral therapy for HCV-related cirrhosis becomes more difficult than that for HBV-related cirrhosis.Careful se-lection of indications is necessary.Standardization of the strategies for antiviral therapy is important in the treatment of liver cirrhosis.

Hepatoprotectors including antioxidant supplements(Vit E,silymarin,GSH,betaine,ect.)and others(essentiale,UDCA,tiopronin,Glycyrrhiza preparation,pentoxifylline,ect.)have been considered reasonable approaches to nonalcoholic fatty liver disease(NAFLD).However the evidence-based medicine shows that they can improve symptoms and decrease aminotransferases levels.There is no sufficient evidence to support their effect on the improvement of histological changes and the natural history of NAFLD.These kinds of medicines with 1 to 2 drugs being selected in one prescription are recommended to the patients with nonalcoholic steatohepatitis(NASH).Basic regimens for the treatment should be concomitant to enhance their efficacy.

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.

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 investigate the prevalence, clinical features and complications of gastrointestinal diverticula in Chinese people. Methods 551 patients with gastrointestinal diverticula were analyzed retrospectively. Results Among the 551 patients, 58.6% were over 60 years, and 11.6% were below 40 years. The incidence of esophageal diverticula, gastric diverticula, duodenal diverticula, jejunoileal diverticula and diverticula of the large intestine was 2.5%, 1.8%, 71.7% , 12.7% and 11.3% respectively. There were 6 and 11 patients, 9 and 6 patients, 69 and 271 patients, 1 and 24 patients, and 21 and 33 patients who were diagnosed by endoscopy and double contrast barium examination respectively. Among the 14 esophageal diverticula patients, the incidence of midesophageal diverticula (78.6%) was higher than that in pharyngoesophageal diverticula (11.2%). Among the 62 diverticula of the large intestine patients, the incidence of right side diverticula (56.5%) was higher than that of left side diverticula (38.7%). Almost esophageal diverticula and gastric diverticula were asymptomatic, while about half of the diverticula of the small and large intestine was symptomatic. The incidence of cholelithiasis and pancreatitis in patients with duodenal diverticula was 34.2% and 10.1% respectively. And the incidence of cholelithiasis and pancreatitis in descending segment was significantly higher than that in non descending segment ( 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

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 explore the relationship between smoking, alcohol drinking and gallstone disease in general male population in Guangdong. Methods Each subject received a questionnaire and took an upper abdominal ultrasound examination in a cross-sectional study. Results The prevalence of gallstone disease became higher with the increase of amount of cigarette smoking per day (trend test ?2=5.542, P=0.019) and with the total amount of cigarette smoking in their life (trend test ?2=7.302, P=0.007), these significance remained after controlling well-known risk factors for gallstone disease such as age and body mass index (BMI) (OR=1.269,95%CI: 1.018~1.580 for cigarette smoking per day and OR=1.295, 95%CI: 1.020~1.646 for total ). Little to moderate alcohol drinking (

0.05),but the relative levels of the mRNA of TNF-? and leptin were significantly down-regulated(P