Objective To observe the protective effects of ligustrazine on glutamate-induced injury in cultured hippocampal neurons. Methods Primarily cultured hippocampal neurons from fetal rats were incubated with ligustrazine (1 mmol/L) for 12 hours,then glutamate (1 mmol/L) was added for 20 minutes to induce injury. Cell viability was detected by MTT assay,and the change in LDH activity was determined by biochemical method. Finally,the expression of AchE in the cultured neurons was assayed by immuocytochemistry. Results Ligustrazine improved the survival rate of hippocampal neurons injured by glutamate,inhibited the release of LDH from the kytoplasm injured by glutamate. The expression of AchE in the injured neurons was promoted by pretreatment of ligustrazine. Conclusion Ligustrazine can significantly exert protective effects on the hippocampal neuron injury induced by glutamate.

Objective To evaluate the methods and effects of modified surgical treatment for Amold-Chiari Ⅰ malformation complicated with syringomyelia.Methods Twelve patients with ArnoldChiari Ⅰ malformation complicated with syringomyelia,underwent a modified surgical treatment,effects were observed.Results During the first follow-up,sensation and motion function were significantly improved in 10 cases,unchanged in 2 cases.During the second follow-up,2 cases previously unchanged were improved,while the other were with no change.During the first follow-up,lesion showed on MRI disappeared in 5 cases,reduced in 4 cases,no significant change in 3 cases,no case extend,3 cases with hydrocephalus ventricle was significantly reduced.The second follow-up,MRI showed that there was no change compared with the first follow-up.Conclusion The remove of the pia mater of tonsillar hernia + reconstruction the cisterna magna have good effect on surgical therapies for Arnold-Chiari I malformation complicated with syringomyelia.

Objective To investigated the distribution of intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAAs), and to examine the influence of age, gender and aneurysm diameters on the ILT formation. Methods Morphological analysis of ILT in AAA of 103 consecutive patients was undertaken with helical CT angiography. ILT shape, distribution and thickness of ILT were recorded and analyzed in correlation with age, gender and aneurysm diameters. Results ILT were found in 66.9% of all the patients. ILT was always situated in the area away from the main axis of AAA. The incidence of ILT in female group (n=13) was much lower than that in male group (n=90) (15.5% vs 77.4%, P

Objective To evaluate clinical and endoscopic characteristics of ischemic colitis (IC), and to explore the methods for the early diagnosis of IC. Methods Thirty six patients diagnosed as IC in Hua dong Hospital from June 1975 to December 2000 were reviewed. All patients underwent colonoscopy with biopsy within 5 days of symptoms, and repeated the exam in 2 weeks to 2 months. Results Of the 36 cases (12 men and 24 women, average age 60.5 years old, range 35 84), 31 were over 50 years of age. IC usually presented with sudden onset of left lower quadrant abdominal pain, diarrhea and hematochezia. Patients' ischemic lesions were most often on the left colon. It consisted transient or reversible colitis in 30 cases, stricture colitis in 5 cases and gangrene colitis in only 1 case. Morphologic changes varied with the duration and severity of the injury. Conclusion Colonoscopy with biopsy is the main method for the diagnosis of IC. It should be performed in the early stage of the onset of symptoms.

Objective To evaluate the clinical and endoscopic features of ulcerative colitis(UC). Methods The cases of UC were collected from 1975 to 2001. According to the diagnostic criteria of Chengdu conference, 486 and 490 patients were diagnosed as UC in our hospital from 1975 to 1994 and from 1995 to 2001 respectively. Their records were retrieved and the data were analyzed for sex, age, presentation, the course of the illness and lesion range. Results In the two groups from 1975 to 1994 and from 1995 to 2001, the proportion of patients diagnosed as UC under colonoscopy was increased from 3.51% to 4.44%. The ratio of male to female was 1.67 and 1.25 respectively. The mean age at the diagnosis increased from 42.4 years old to 51.5 years old, and the peak age was between 30 and 49 years old, between 40 and 49 years old and greater than 60 years old respectively. The typical clinical manifestations of UC were bloody mucopurulent stool, diarrhea and abdominal pain. Proctosigmoiditis or proctitis was found in 269 patients (55.4%) and 316(64.5%), left side colitis in 84(17.3%) and 68(13.9%), pancoltitis in 58( 11.9% ) and 70(14.3%) respectively. In the two groups, there were 437( 89.9% ) and 443(90.4%) patients who had the course of less than 10 years respectively. The definitive diagnosis of UC was dependent on biopsy. Conclusions The lesions of UC are commonly located in the left side colon, the course of UC is short, the age of onset is relatively high in the middle and old aged group, and the prevalence of both malignancy and complications is low. Colonoscopy with biopsy is considered to be the major means for the diagnosis of UC.

Objective To evaluate the effect of colonoscopy with a transparent hood on the adenoma detection rate.Methods A prospective randomized controlled trial was performed.A total of 376 patients,who underwent colonoscopy for screening colorectal polyps,were randomly allocated to 2 groups:transparent hood group (TH group,n =190) and conventional colonoscopy group (CC group,n =186).Only one endoscopist performed all the colonoscopy examinations,recorded the withdrawal time,bowel preparation status,the number,shape,location,size of adenoma when withdrawing the endoscope.All the adenoma were removed under the colonoscopy.The pathological results were recorded,and the data and relative factors were analysed.Results A total of 317 adenomas were detected in 175 patients:172 adenomas in 99 patients of TH group,145 adenomas in 76 patients of CC group.Total ADR was 46.54％.ADR of TH group was 52.11％ and ADR of CC group was 40.86％ (P =0.029).A total of 40 adenomas were found behind the fold,32 in TH group and 8 in CC group(P ＜ 0.01).In cecum and transverse colon,there were more adenomas in TH group than in CC group.In cecum,there were 23 adenomas found in TH group,6 adenomas in CC group(P ＜0.05).In transverse colon,there were 46 adenomas in TH group,25 adenomas in CC group (P ＜ 0.05).In descending colon and rectum,there were more adenomas in CC group than in TH group.In descending colon,there were 16 adenomas TH group,and 30 adenomas in CC group.In rectum,there were 14 adenomas in TH group,24 adenomas in CC group(P ＜0.05).There was no significant difference in size or shape of adenomas found between two groups.Conclusion Colonoscopy with transparent hood for screening can increase the adenoma detection rate,especially the adenoma behind the fold.

Macrophages,as an important member of innate immune system,constitute a major component of the microenvironment of tumours,and play an important role in the occurrence and development of tumor.According to particular phenotypes and functions,macrophages can be divided into M1 macrophages and M2 macrophages.In the research of breast cancer,lung cancer,gynecological malignancies,researchers have found that tumor-associated macrophage has the similar phenotype and function of M2 macrophages.Tumor-associated macrophage can promote the formation of new blood vessels and lymphatic vessels in tumor tissue,thus contributing to the occurrence and development of tumor.The relation between tumor-associated macrophage and poor prognosis was also be found.The tumor microenvironment can affect the phenotype and function of macrophages,such as TGF,IL-10 and PGE-2.This paper reviewed the role and mechanism of macrophages in the tumorigenesis.

Objective To review the clinical features of drug-induced liver injury (DILI) in elderly Chinese patients.Methods A literature search was conducted with the key wordsdrug-induced liver injury ordrug-induced liver disease andelderly; four Chinese medical databases were used:including Chinese Biomedical Literature Database (CBM),Chinese Science and Technology Periodical Database (VIP),Wanfang Database and China National Knowledge Infrastructure (CNKI),from when the bases established to December 2011.Data from retrieved literatures of retrospective controlled studies of DILI were analyzed by SPSS 14.0 software.Results Five studies met the inclusion criteria,including 275 elderly patients (aged group) and 602 non-elderly patients (non-aged group) with DILL There was no significant difference in gender between the two groups (P ＞ 0.05).Clinical manifestations of jaundice,fatigue,anorexia,and skin itching were more commonly seen in the aged group (P ＜ 0.01).Cholestatic hepatic injury occurred more frequently in the aged group than in the non-aged group [24.9％ (61/245) vs.18.8％ (102/245),P ＜ 0.05],while hepatocellular type occurred more frequently in the non-aged group [64.3％ (350/544) vs.55.1％ (135/245),P ＜ 0.05].More DILI were induced by Chinese herb medicine and cardiovascular drugs in the aged group than in the non-aged group [47.0％ (79/168) vs.35.9％ (93/254) and 8.3％ (14/168) vs 1.2％ (3/259) respectively,P ＜ 0.05].As for the prognosis,there was no significant difference in clinical cure and improvement rate between the two groups [84.4％ (141/167) vs.81.5％ (291/357),P ＞0.05].Conclusion The elderly are more sensitive to the drugs and have a high risk of DILI.Prevention and timely diagnosis and treatment of DILI are particularly important for elderly patients.

Objective To investigate the diagnostic accuracy of 13C urea breath test (13C-UBT)in the diagnosis of Helicobacter pylori (Hp) infection in patients with gastric remnant.Methods A total of 94 gastric remnant patients (gastric remnant group) and 100 non-gastric remnant patients (control group) received 13C-UBT.According to the course of the disease,the gastric remnant group were divided into group 1 (29 cases,≤5 years),group 2 (33 cases,6 to 10 years) and group 3 (32cases,＞10 years).Before surgery,the diagnosis of Hp infection was according to 13C-UBT and gastric mucosa tissue staining.After surgery,the diagnosis was according to gastric mucosa tissue staining.The applying value of 13C-UBT in gastric remnant patients was evaluated.The consistency of results between 13C-UBT and gastric mucosa tissue staining were evaluated by the Kappa test.Results In gastric remnant group,the Hp infection rate after surgery (37.2％) was obviously lower than that before operation (79.8％;x2 =35.058,P＜0.01) and that of control group (77.0％).After surgery,the Hp infection rate of patients with Billroth Ⅱ gastrectomy (24.4％) was lower than that of patients with Billroth Ⅰ gastrectomy (47.2％ ; x2 =5.133,P=0.023).Before surgery,the Hp infection rate of gastric remnant subgroups were similar (P＞0.05).With the extension of the postoperative course,the Hp infection rate gradually decreased in gastric remnant subgroups (group 1:58.6％,group 2:36.4％,group 3:18.8％; x2=7.839,P=0.021).Setting the cut-off point at 2.0‰ in the gastric remnant group and 3.5‰ in the control group,the accuracy rate of diagnosis was the highest (92.6％ and 96.0％).There was good consistency between the results of 13C-UBT and gastric mucosa tissue staining (Kappa =0.84,P＜0.01).Conclusion With suitable operation and standard,13C-UBT may be a easy,safe and effective assay applied in the gastric remnant patients.

Objective To investigate the role of renin angiotensin system (RAS) in pathogenesis of nonalcoholic fatty liver disease (NAFLD).Methods Twenty-four Wistar rats were evenly divided into control group and model group.The rats of control group were fed with normal diet,and model group were with high-fat diet.Rats were killed at the eighth week and serum liver function,blood lipid,glucose and insulin were tested.The liver tissues were stained with HE and Picro acid-Sirius red for pathological observation.The liver tissue concentration of angiotensin Ⅱ was determined by ELISA method and the expression of TGF-β1 in liver tissue was examined by immunohistochemistry.Results After eight weeks high fat feeding,weight,liver index,liver function,blood lipids and serum insulin of model group were significantly higher than those of control group (weight:(463.50±22.72) g vs.(404.29±10.32) g; liver index:(3.75±0.21) g vs.(2.66±0.15) g; ALT:(79.8±8.6) U/L vs.(58.8±11.6) U/L; AST:(200.01±51.72) U/L vs.(150.30±37.27) U/L; total cholesterol:(3.67±0.48) mmol/L vs.(1.50±0.23) mmol/L; triglycerides:(2.06±0.40) mmol/L vs.(0.71±0.34) mmol/L; insulin:(17.37±2.89) pmol/L vs.(11.08±2.12) pmol/L),and all the differences were statistically significant (P＜0.01).The histopathological results of model group indicated liver steatosis,inflammatory reaction in part of lobule and portal area and significant fibrosis in part of liver tissue.The liver tissue angiotonin Ⅱ concentration of model group [(32.80 ± 2.81)pg/ml] was higher than that of control group [(22.83 ± 1.75) pg/ml,t =9.559,P＜0.01].The immunohistochemistry results showed that the expression of TGF-β1 of model group was obviously higher than that of control group (Z=-2.540,P =0.011 ).Spearman correlation analysis revealed that the increasing degree of angiotensin Ⅱ concentration was positively correlated with liver steatosis scores (r=0.644,P=0.002) and the expression of TGF-β1 (r=0.470,P=0.037).Conclusion The concentration of angiotensin Ⅱ and TGF-β1 increased in the livers of model rats,which indicated that RAS may participate in the pathogenesis and progress of NAFLD.