Clinical significance of PCR in Helicobacter pylori DNA detection in human gastric disorders

AIM: To investigate the clinical significance of the PCR assay in the diagnosis of gastric Helicobacter pylori (Hp) infection.

METHODS: Hp infection in gastric antral biopsied specimens was identified by using the polymerase chain reaction (PCR) to amplify the specific Hp urease gene fragments (PCR-Hp-DNA) in 154 patients with gastrointestinal disorders. Hp urease gene oligonucleotide primers specific for Hp (16s rRNA) were used. Urease test and enzyme-linked immunosorbent assay (ELISA) for anti Hp-IgG serum were also used as controls.

RESULTS: PCR-Hp-DNA was detected in 140 (91%) of the 154 patients, where patients 114 and 125 were found infected with Hp by urease test and ELISA Hp IgG, respectively. There was a marked difference in the Hp-positive rate between the PCR-Hp-DNA and the urease test or ELISA-Hp-IgG (P < 0.05). The Hp infection rate increased with age, although a minority of infected people developed signs and symptoms of gastric disorders. Hp infection is closely related to adenocarcinoma in both the gastric antrum as well as the down body of the stomach.

CONCLUSION: PCR is a sensitive and specific method for the detection of Hp in human gastric tissues. Detection of Hp DNA in vivo using this approach might improve the clinical diagnosis and epidemiological research related to H. pylori infection.

Effect of amygdalin on proliferation of rat hepatic fat-storing cells and collagen production in vitro

AIM: To study the anti-fibrotic mechanism of amygdalin, a component of Semen Persicae, on fat-storing cells (FSC).

METHODS: Livers of normal adult rats were perfused with Pronas E and collagenase in situ. FSC were isolated by centrifugation with 11% Metrizamide. The subcultured FSC were incubated with 10^-4-10^-8 mol/L amygdalin for 72 h, and then FSC proliferation and collagen production were assayed, respectively.

RESULTS: Low doses of amygdalin reduced incorporation of L-[³H]-thymidine into FSC and L-[5-³H]-proline into secreted collagenase-sensitive proteins and cell layer-associated collagenase-sensitive proteins. the strongest effects were seen for the 10^-8 mol/L dose of amygdalin, which inhibited the proliferation of FSC by 25.0%, and decreased collagen production in medium and cell layer by 24.2% and 26.8%, respectively.

CONCLUSION: An anti-fibrotic mechanism of amygdalin is to inhibit the proliferation and collagen production of active FSC.

Characteristics of DNA repair induced by DNA polymerase β in hepatoma cells after γ-ray irradiation

AIM: To investigate the effects of DNA repair induced by DNA polymerase β in hepatoma cells after γ-ray irradiation.

METHODS: Cell nuclei were prepared from mouse model (SMMC LTNM), in which human hepatoma cells are transplanted on nude mice. The nuclei were then irradiated with ⁶⁰Co-γ rays at different dose levels or dose rates. A selective inhibitor test was then used to detect the effects of the radiation on DNA repair using N-ethylmaleimide (NEM) and ddTTP as selective inhibitors to DNA polymerases γ and β respectively.

RESULTS: ³H-TTP incorporation into irradiated nuclei or calf thymus DNA was significantly higher than that the rate at which it is incorporated into non-irradiated nuclei when either DNA polymerase β or γ was inhibited. When both NEM and ddTTP are present, the ³H-TTP incorporation in irradiated DNA was not significantly different from the non-irradiated nuclei. Furthermore, ³H-TTP incorporation into DNA of SMMC-LTNM hepatoma nuclei was higher than that of normal hepatocyte nuclei (P < 0.01). This suggests that DNA repair induced by DNA polymerase β was more active in hepatoma cell nuclei than in normal hepatocyte nuclei.

CONCLUSION: DNA polymerase β may be more responsive to DNA damage in some tumor cells than that in normal cells, which may facilitate the cells to repair DNA damages from radiation more efficiently.

Inflammatory bowel disease in the Hubei Province of China

AIM: To analyze clinical features and response to treatment in inflammatory bowel disease (IBD) patients from the Hubei Province of China.

METHODS: Clinical data was collected retrospectively from 74 patients with IBD [66 with ulcerative colitis (UC) and 8 with Crohn’s disease (CD)] admitted to The Second Hospital, Hubei Medical University from 1986 to 1995.

RESULTS: The most common symptoms in IBD patients were abdominal pain, diarrhea, blood and mucus in stool, and constipation. Extraintestinal manifestations of IBD were not common. In these patients, inflammation was predominantly located in the sigmoid and left colon in UC cases, and in the ileum and colon in CD cases. Treatment with sulphasalazine and corticosteroids was effective in 95% of UC cases; However, about 42% of UC patients showed disease recurrence during the follow-up period of 1.11 years. Five out of eight CD patients had part of their intestine removed, whereas three were treated with anti-tuberculosis drugs or the antibiotic metronidazole. Out of four patients we followed up for 1-8 years, one died of severe complications after surgery, two experienced recurrence while in treatment with drugs, and one remained in remission under sulphasalazine treatment after surgery.

CONCLUSION: Five percent of the patients reported a family history of IBD. About 34% of the patients were smokers and 32% of the patients were alcoholic. Epidemiological studies are urgently needed in the Hubei Province of China to assess the role that genetics and environmental factors play in the pathogenesis of inflammatory bowel diseases.

Radiotherapy of 180 cases of operable esophageal carcinoma

AIM: To compare the validity of radiotherapy and surgery for operable esophageal carcinoma in 180 patients with pathologically proven esophageal carcinoma who had been accepted for surgery, but for various reasons were given radical radiation therapy instead.

METHODS: The reasons for abandoning surgery were poor cardiac function (n = 21), poor pulmonary function (n = 36), poor general condition (n = 9), senility (age 69-81 years, n = 32), and refusal by the patient (n = 82). They were treated by the isocenter technique alone or anteroposterior plus isocenter irradiation at a total dose of 50-70 Gy/5-7 wk.

RESULTS: The 1-, 3-, and 5-year survival rates were 64%, 34%, and 23%, respectively. The 3- and 5-year survival rates showed that lesions in the upper third esophagus responded better than lesions in the middle and lower third (P < 0.05). The 5-year survival rate following radiation alone (44.5%) of upper third lesions was slightly better than that following surgery. The effect on lesions following radiation to middle third lesions was slightly inferior to that of surgery, and that for lower third lesions was even poorer.

CONCLUSION: The results from radiation treatment alone for operable esophageal carcinoma are similar to that of surgery.

Exploration of the immunoreactivity of the Traditional Chinese medicine Shenrouyangzhentang to vasoactive intestinal polypeptide

AIM: To study the immunoreactivity of the Chinese medicine Shenrouyangzhentang to vasoactive intestinal polypeptide (VIP) and its therapeutic mechanism.

METHODS: The immunoreactivity of the Chinese medicine Shenrouyangzhentang to VIP was detected in the plasma of 20 normal people and 20 patients with Piyinxu (Spleen Yin deficiency) using the radioimmunoassay (RIA) method.

RESULTS: The maximum binding rate B₀/T was 53.29%, the non-specific binding rate N₀/T was 1.170%, and the VIP standard curve was Y = 0.81983 + 0.44319X - 0.28927X², R² = 0.990. The VIP content in Shenrouyangzhentang was 106.6 ng/L ± 20 ng/L), while it was 90.16 ng/L ± 15 ng/L in normal human plasma and 63.25 ng/L ± 11 ng/L in the plasma of Pixinxu patients. The difference between normal plasma and Pixinxu patient plasma was statistically significant (P < 0.05).

CONCLUSION: The Chinese medicine Shenrouyangzhentang demonstrated VIP immunoreactivity similar to that of normal plasma. The (vasoactive intestinal polypeptide) VIP content in Pixinxu patient plasma was lower than that in healthy subjects (P < 0.05).

A prospective study of vertical transmission of hepatitis C virus

AIM: To prospectively study the mechanism of mother to infant transmission of hepatitis C virus (HCV).

METHODS: Using a nested PCR for detection of HCV RNA and the second generation ELISA for detection of anti-HCV, 13 pregnant women who suffered from post transfusion hepatitis C (PT-HCV) and their 15 babies were studied to evaluate mother to infant transmission of HCV.

RESULTS: The total infection rate of HCV was 86.7% in the babies, including one case of clinical HCV (7.7%), three subclinical cases of HCV (23.1%), and nine inapparent cases of HCV (69.2%). The positive rates of anti-HCV and HCV RNA declined with the age of the babies, to 7.7% for anti-HCV and 15.4% for HCV RNA at the age of three years.

CONCLUSION: Babies born to mothers infected with HCV were vertically infected with HCV at a high rate, but the consequences were not serious. Four fetuses born, born through induced labor to mothers positive for anti-HCV and HCV, were all infected by HCV, suggesting that the mother to infant transmission of HCV mainly occurred in the uterus.

Study on clinical pathology and immunohistochemistry of chronic erosive gastritis

AIM: To study the clinical pathology of chronic erosive gastritis (CEG) and determine the expression of epithelial tumor markers, oncoprotein p21 and carcinoembryonic antigen (CEA), and G cells by immunohistochemistry.

METHODS: Gastric mucosal biopsies from 40 CEG cases were examined. Histopathology and Helicobacter pylori (Hp) infection were determined by light microscopy. Thirty-one biopsies from CEG cases were immunostained with antibodies against p21, CEA, proliferation cell nuclear antigen (PCNA), and gastrin using the labeled streptavidin-biotin (LSAB) method.

RESULTS: A total of 35/40 (87.5%) CEG lesions showed antral location; 75% of the lesions were associated with different degrees of atrophic change. Twenty percent presented with mild and moderate atypia of mucosal epithelia and 27.5% showed intestinal metaplasia. Acute inflammatory changes were observed in 25% of the cases. Hp was identified in 40.0% of the specimens. Immunohistochemistry studies showed that 67.7% of the CEG mucosal epithelial samples expressed oncoprotein p21 and 29.0% expressed CEA, rates significantly higher than those observed in control samples from a chronic superficial gastritis group. However, PCNA and gastrin expression in mucosal G cells was not significantly different between CEG samples and samples from the control group (P > 0.05).

CONCLUSION: CEG is a chronic gastric mucosal proliferative lesion that expresses higher levels of p21 and CEA than control samples. Our observations suggest that antral location of the lesion and Hp infection do not participate in the pathological process of CEG.

Expression of insulin-like growth factor II and its receptor in liver cells from patients with chronic liver diseases

AIM: To study the relationship between insulin-like growth factor II (IGF-II), IGF-II receptor, and chronic liver diseases and to investigate the clinical mechanisms of human hepatocellular carcinoma (HCC) development.

METHODS: We analyzed IGF-II and IGF-II receptor poly (A)+ mRNA in dysplasia liver cell (DLC; n = 10), liver cirrhosis (LC; n = 9), and chronic active hepatitis (CAH; n = 9) specimens by Northern blot using human IGF-II and IGF-II receptor DNA probes labeled with ³²P through nick translation.

RESULTS: Expression of IGF-II in DLC samples (10/10, 100%) was higher than in CAH (3/9, 33%) and LC samples (3/9, 33%) (P < 0.01). Expression of IGF-II receptor in DLC samples (7/10, 70%) was significantly higher than in CAH (2/9, 22%) and LC samples (3/9, 33%). Data on hepatitis B virus (HBV) infection status from different chronic liver disease samples were also analyzed.

CONCLUSION: Overexpression of IGF-II and IGF-II receptor in DLC samples was associated with a preceding step to malignant phenotype hepatocyte transformation and may be of diagnostic value for early detection of hepatocellular carcinoma (HCC). Persistent HBV infection was strongly associated with abnormal IGF-II and IGF-II receptor mRNA expression, suggesting that an autocrine or paracrine mechanism is involved in the regulation of growth in liver cell carcinogenesis.

Effect of faeces trogopterorum extract B1 on the experimental gastric ulcer and gastric secretion in rats

AIM: To study the effects of extracts B1, B2, and B3 from faeces trogopterorum on the experimental gastric ulcer in rats.

METHODS: Two different animal models of gastric ulcers were used in this experiment: Shay's model (n = 72) and the reserpine-induced ulcer model (n = 76). The total volume and the pH of the gastric juices were recorded. The lesion scores of gastric mucosa were also recorded.

RESULTS: The lesion scores of gastric mucosa in the Shay’s model of animals in the WLZ-B₁ groups treated with either 40 g/kg or 80 g/kg were 8.6 ± 10.8 and 1.6 ± 1.9 respectively, which were lower than that of the 0.9% NaCl control group (47.0 ± 31.4, P < 0.05, P < 0.01). The lesion scores for the 80 g/kg group was lower compared to those of the Ran group (20.5 ± 16.4, P < 0.01). The pH of the gastric juices of the 80 g/kg group (3.425 ± 0.143) was higher than that of the 0.9% NaCl group (2.836 ± 0.632, P < 0.05). In the reserpine model, the lesion score of the 40 g/kg group of the WLZ-B₁ (20.7 ± 16.5) was also lower than that of the 0.9% NaCl control group (76.3 ± 50.6, P < 0.05).

CONCLUSION: B₁ is the most effective of the three sections in inhibiting gastric secretion, protecting gastric mucosa and preventing experimental ulceration.

Pathogenetic effects of salted pork in an area of China with high-risk for stomach cancer

AIM: To study the pathogenetic effects of salted pork (SP) (a special food in Zhuanghe City, a region of northern China that is a high-risk area for stomach cancer) on stomach cancer, and a provide scientific basis for the primary prevention of stomach cancer in this high-risk region.

METHODS: This study consisted of three distinct parts. The first part involved a study of SP mutagenicity and employed both the Ames test and micronuclei assay using V₇₉ cells. The second part included a study of SP’s effect on the gastric mucosa of residents in the Zhuanghe area who had consumed SP for more than ten years. Additionally, these studies involved an analysis of the dose effect relationship between SP and pathological changes in gastric mucosa, with a total of 300 cases analyzed. The third part of this study involved an observation of the mucosal lesions from experimental dogs by both gastroscopy and mucosal biopsy. Six healthy male dogs were selected, three were fed with SP, and the others served as controls.

RESULTS: This study revealed that SP extract could mutate Salmonella typhimurium TA₉₈ and induce an increase in both the micro nuclei rate (MNR) and micro nuclei cell rate (MNCR) of V₇₉ at a dose range of 20-80 μL/mL. There were significant dose-effect relations between SP and either MNR or MNCR. Pathological changes in the gastric mucosa of local residents who had consumed SP were significantly different from those of the control group. In people who had consumed SP for ten years, mucosal lesions were found that contained evidence of necrosis and erosion; In those who consumed SP for ten-20 years, both hyperplasia and dysplasia were seen in addition to the above lesions. In individuals who had consumed SP for 20-30 years, severe dysplasia and malignant changes were found. Furthermore, SP had damaging effect on the gastric mucosa of dogs that were fed SP. The mucosal lesions became more severe with increased feeding time.

CONCLUSION: SP is a strong mutagen and long-term SP exposure may result in repeated gastric mucosal damage and repair, ultimately leading to severe dysplasia and malignancy.

Histopathology and immunohistochemistry of large hepatocellular carcinoma with undetectable or low serum levels of alpha-fetoprotein

AIM: To explore the pathomorphological characteristics of large hepatocellular carcinoma (LHCC) with low serum alpha-fetoprotein (AFP) level.

METHODS: Specimens obtained from surgically resected LHCC with undetectable or low levels of serum AFP were fixed in formalin, embedded in paraffin, and prepared as serial sections. Routine hematoxylin and eosin as well as immunohistochemical stains (LSAB method) were used to test for expression of AFP, alpha-1-antitrypsin, epithelial membrane antigen, and vimentin. Some characteristics of the histopathological changes and immunohistochemical reactions of the cancerous tissues were observed under the light microscope.

RESULTS: The majority of the cases (19/30) of LHCC with undetectable or low levels of serum AFP were of the clear-cell-type HCC, with 2 being positive for AFP expression at the periphery of the cytoplasm.

CONCLUSION: The clear cell is the morphological manifestation of disturbance in glycogen and/or lipid metabolism of hepatoma cells. Such changes might be one of the factors hindering the synthesis of AFP and resulting in negative or low level serum AFP of the patient.

Recovery of allografted small intestine function

AIM: To investigate recovery of the allografted small intestine function after clinical small bowel transplantation (SBT).

METHODS: The structure of the graft was evaluated by endoscopic biopsy and histopathologic examination. Graft functions were assessed by D-xylose absorption, barium studies, nitrogen balance calculation, and blood and stool cultures. Nutritional status of the recipients was judged by measurement of body weight and serum protein concentrations.

RESULTS: The recipient discontinued total parenteral nutrition (TPN) and resumed oral nutrition 100 d after SBT. On oral diet, the patient maintained a normal nutritional status, gained weight by 3 kg, and had a normal serum albumin concentration (40.2 g/L ± 0.2 g/L). Satisfactory D-xylose absorption was achieved 8 wk after the operation. Nitrogen balance of the gut was maintained well and increased gradually. Serial mucosal biopsy showed normal structures 2 wk after grafting, without evidence of rejection and graft versus host diseases (GVHD). Barium studies conducted on the 10^th day and 38^th day by barium studies revealed that the grafted small bowel motility showed normal patterns of peristalsis and transit. No bacterial translocations were noted.

CONCLUSION: Function of the grafted small intestine recovered satisfactorily 100 d after transplantation, indicating good clinical outcome of SBT.

Expression and analysis of McAbs antigen against human hepatocellular carcinoma

AIM: To analyze the cause of tumor antigen heterogeneity and solve the problem of targeting diagnosis and therapy.

METHODS: Using flow cytometry, the expression of McAbs antigen against human hepatocellular carcinoma (HAb18, E₅, F₁₁ and HAb27) was investigated. Analyses of the antigen sites were made quantitatively on the human hepatoma cell lines (SMMC-7721; QGY-7701; BEL-7402; HHCC and 9204). In particular, expression of human hepatoma, its association with antigen HAg18, and its relation s with cell cycle in four human hepatoma cell lines using the methods of indirect immunofluorescence and dual-parameter DNA dyeing were studied.

RESULTS: The corresponding antigen of McAbs HAb18, HAb27, E₅ were expressed on the five hepatoma cell lines and F₁ was expressed only on the 7721 and 7701 hepatoma cell lines, but their mean fluorescence intensity showed different values on each cell line. HAb18 and HAb27 showed a relatively high level of expression, while E₅ and F₁₁ showed a lower level of expression. The value of AI (additivity index) was 136% for HAb18 and E₅, 108% for HAb18 and HAb27, and 118.6% for E₅ and H27As AI < 30% shows that both antibodies sites are the same, AI > 40% shows that both anti bodies sites are different, so the HAb18, HAb27 or E₅ McAbs were combined in pairs, showing that their antigen sites were different. Furthermore, HAg18 antigen was expressed very highly and the positive rate of HAg18 was 100% in all the four human hepatoma cell lines. The was a mean intensity fluorescence was 8.237 ± 1.168 for SMMC-7721; 5.627 ± 1.678 for QGY-7701; 4.378 ± 1.525 for BEL-7402 is 4.378 ± 1.525 and 7.38 ± 1.919 for HHCC. However, in the normal human liver cell (QZG), HAg18 antigen showed low expression (0.534 ± 0.018) and its positive rate was only 9%. The relationship between human hepatoma associated antigen HAb18 and the cell cycle was expressed at the lowest level in G₀-G₁ stages, a higher level in S stage and the highest level in G₂-M stage.

CONCLUSION: Analysis of the anti-hepatoma McAbs corresponding to antigen may provide the basis for targeted diagnosis and therapy. The expression heterogeneity of human hepatoma-associated antigen HAg18 is related to the stage of cell cycle in the same cell lines, but not related to the stage of cell cycle in different cell lines.

Protective effect of rhubarb on the intestinal mucosal barrier

AIM: To investigate the mechanism of rhubarb protection of the gut barrier.

METHODS: The gut barrier damage models caused by hemorrhagic shock and intraperitoneal endotoxin were used to study the protective effect of rhubarb on the intestinal mucosal barrier. Rats were randomly divided into four groups, as follows: treatment (rhubarb) group; Positive control group; Negative control group; Placebo treatment group. Plasma endotoxin, tissue superoxidedismutase (SOD) and lipoperoxide (LPO) concentrations were measured and histological analysis was performed. Rhubarb was observed to have a protective effect on the gut.

RESULTS: Rhubarb decreased intestinal permeability, attenuated endotoxin absorption (endotoxin serum levels: shock group 0.557 EU/mL ± 0.069 EU/mL vs rhubarb group 0.345 EU/mL ± 0.055 EU/mL), and decreased tissue SOD and tissue LPO levels (SOD serum, intestine and liver levels: endotoxin group 122.92 NU/mL ± 43.19 NU/mL, 292.24 NU/mL ± 88.76 NU/mL, 272.70 NU/mL ± 85.79 NU/mL vs rhubarb group 312.23 NU/mL ± 54.93 NU/mL, 391.09 NU/mg ± 98.16 NU/mg, 542.86 NU/mg ± 119.93 NU/mg; LPO content in the intestine and liver: endotoxin group 8.57 μmol/L ± 2.58 μmol/L, 86.97 μmol/L ± 46.54 μmol/L vs rhubarb group 3.05 μmol/L ± 1.13 μmol/L, 13.18 μmol/L ± 19.64 μmol/L). Gut histopathology revealed that rhubarb promoted goblet cell proliferation, increased mucus secretion and protected intestinal mucosa in the hemorrhagic shock model.

CONCLUSION: Rhubarb may protect the gut barrier by decreasing intestinal permeability, scavenging oxygen free radicals, and promoting goblet cell proliferation within the intestinal mucosa.

Fos expression in catecholaminergic medullary neurons induced by chemical stimulation of stomach projecting to the paraventricular nucleus of the hypothalamus in rats

AIM: To determine whether medullary catecholaminergic neurons expressing Fos induced by chemical stimulation of the stomach project to the paraventricular nucleus of hypothalamus (PVH) in rats.

METHODS: Horseradish peroxidase (HRP) was introduced stereotaxically into the PVH of rats. Histochemical analysis of coronal sections through the medulla were analyzed using triple-label immunohistochemistry to identify cells that were retrogradely labeled with HRP, Fos (ABC method), and tyrosin hydroxylase (TH) (PAP method).

RESULTS: Seven kinds of labeled neurons were found in the nucleus tractus solitarii (NTS), the ventrolateral medulla (VLM) and the reticular formation (RF) of the medulla: Fos-like immunoreactive (FosLI) neurons, TH-like immunoreactive (TH-LI) neurons and HRP retrogradely single-labeled neurons, FosLI/HRP, FosLI/TH-LI and HRP/TH-LI double-labeled neurons, and FosLI/HRP/TH-LI triple-labeled neurons.

CONCLUSION: Ascending projections from the NTS, VLM and RF to the PVH might be involved in the transmitting process of visceral noxious stimulation.

Evaluation of preoperative staging in advanced gastric cancer with MRI

AIM: To evaluate the application of magnetic resonance imaging (MRI) to the preoperative staging of advanced gastric cancer.

METHODS: An MRI (SE sequence) was preoperatively performed on 34 patients with advanced gastric cancer. The tumors were located at the cardia fundus in 11 patients, the corpus in 14, the antrum in ten and throughout the entire stomach in two. The images were analyzed and staged on the basis of the criteria proposed by Matsushita M. The results were compared with the corresponding histopathologic findings to analyze the rate of diagnostic accordance.

RESULTS: The diagnostic rate accuracy by MRI was 77.8% (seven out of nince) for T₂ tumors; 77.3% (17 out of 22) for T₃ tumors and 100% (three out of three) for T₄ tumors, with the overall accuracy equaling 79.4%. When grades T₃ and T₄ tumors were considered as a single group to determine the presence or absence of extraserosal invasion using MRI technology, the diagnostic accuracy was 88.3%. Statistically, MRI staging showed a significant correlation with the corresponding histopathologic staging using the Spearman correlation test (r_s′ = 0.743, P < 0.01). When the concordance between MRI and histopathologic staging results were studied according to tumor location, the staging accuracy was highest (90.9%) in tumors located in gastric cardia fundus.

CONCLUSION: MR imaging is moderately valuable when staging advanced gastric cancer, especially for tumors located in gastric cardia fundus.

Hepatic arterial infusion chemotherapy and embolization in the treatment of primary hepatic carcinoma

AIM: To study the effects of hepatic arterial infusion chemotherapy (HAI) or embolization (HAE) in the treatment of primary hepatic carcinoma (PHC) and the factors influencing these effects.

METHODS: A retrospective analysis of 188 patients (166 males and 22 females) with PHC treated with HAI (n = 82) or HAE (n = 106) was conducted.

RESULTS: In the group as a whole, the percentage of patients experiencing therapeutic outcomes was as follows: Symptomatic relief (59.6%); Tumor shrinkage (55%); A decrease in blood alpha fetoprotein (AFP) (37.8%) and overall survival rates at 0.5, 1.0, 2.0, and 3.0 years of 75.4%, 46%, 23.5% and 14.7%, respectively. The mean survival time in the entire group was 12.2 mo, and the longest survival period was 50 mo. In the HAI group the survival rates at 0.5, 1.0. 2.0 and 3.0 years of follow-up were 61.0%, 25.4%, 4.5% and 0%, respectively, with a mean survival time of 7.7 mo. In the HAE group the corresponding survival rates were 86.8%, 61.7%, 37.8% and 26.1%, respectively, with a mean survival time of 15.7 mo. Eighteen patients received secondary surgery. Factors that had a favorable effect on therapeutic outcomes were presence of no or only mild liver cirrhosis, presence of stage I or Stage II disease, presence of only a single tumor, a tumor size less than 10 cm in diameter, an absence cancerous thrombus within the portal vein or hepatic arterio venous fistula, and HAE treatment.

CONCLUSION: This study helped identify the effects of HAI and HAE in patients with PHC, and identified some important factors which influence such treatment.

Effects of tetrandrine and verapamil on fibroblastic growth and proliferation

AIM: To investigate the effect of tetrandrine (Tet) and verapamil (Ver) on liver fibrosis by evaluating their effects on the growth and proliferation of fibroblasts.

METHODS: Flow cytometry and imaging analysis were used to study the effects of combined and individual treatment of Tet and Ver on fibroblastic proliferation in vitro. Untreated control cells were used for comparison.

RESULTS: Compared to untreated fibroblasts, those treated with both Tet and Ver showed higher percentages of cells in the G₁ and G₂+M phase in the cell cycle of 3T6 fibroblasts (P < 0.01) and markedly elevated protein content, while those treated with Tet only showed significantly lower intracellular RNA content (1.5-2.0 μg, P < 0.01) and those treated with Ver only showed lower intracellular DNA content (15-20 μg, P < 0.01).

CONCLUSION: The inhibitory action of Tet and Ver on fibroblastic growth and proliferation might be responsible for the antifibrotic effects of these medications in liver fibrosis.

Short- and long-term effect of interferon therapy for chronic hepatitis C

AIM: To study the short and long-term effect of interferon therapy for chronic hepatitis C.

METHODS: Sixty-eight patients with chronic hepatitis C were treated with interferon (3 × 10⁶ IU, im/2 d, for a course of three months) with 1 to 5 courses of treatment and followed for 1.5 to 3 years after the therapy.

RESULTS: According to antiviral effect of interferon, 76.5% (52/68) of the cases had a complete response by the end of the first therapy course, while 20.6% (14/68) and 2.9% (2/68) had a partial response or non-response. Over a half of the patients with a complete response (27/52, 51.9%) relapsed within 6 to 10 mo after the first course. Of the original cohort, nineteen patients received two courses of therapy, while one patient received three and another three received five courses of therapy. The follow-up for these patients was between 1.5 to 3 years, at which time 29 (42.7%) of the patients sustained a complete response, with four of them having HCV RNA positive serum, while the others had either a partial (37/68, 2.9%) or non-response.

CONCLUSION: Interferon therapy had a high short-term complete response but a low long-term complete response in the treatment of chronic hepatitis C.

Immunohistochemical study of gastrin in colorectal carcinoma tissues and adjacent mucosa

AIM: To study gastrin expression in colorectal carcinoma tissues and adjacent mucosa and discuss the function of gastrin in colorectal carcinoma.

METHODS: Gastrin expression in colorectal carcinoma tissues and adjacent mucosa was examined in 58 cases using immunohistochemical and immunoelectron microscopy.

RESULTS: A total of 35.1% of colorectal carcinoma transitional mucosa (TM), 48.3% of nontypical dysplasia mucosa and 60.3% of carcinoma tissue were positive for gastrin expression (P < 0.05). Immunoelectron microscopy revealed that protein A gold (PAG) granules localized to different electron-dense secretory granules in carcinoma cells, the intercellular spaces, and the microvillar membrane surface.

CONCLUSION: Gastrin expression in colorectal carcinoma tissue and adjacent mucosa, and the release of gastrin by carcinoma may be an initiating factor in carcinoma occurrence and development. Positive gastrin expression in colorectal carcinoma tissues can serve as a differentiation marker.

Clinical and experimental study on therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions

AIM

To study the therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions.

METHODS

Thirty-six patients with gastric precancerous lesions were treated with Weixibaonizhuanwan for 3 mo. Thirteen (36.1%) patients presented with mild atrophic gastritis, 14 (38.9%) with moderate atrophic gastritis, and nine (25.0%) with severe atrophic gastritis. Twenty-two (61.1%) and 27 (75.0%) of the cases were accompanied by intestinal metaplasia (IM) and dysplasia (DYS), respectively. Twenty of the 36 patients were men and 16 were women, ranging from 30 to 67 years in age, with 61.1% of the patients being 40-59 years old. The duration of the disease in these patients ranged from 3 mo to 21 years, with 20 (55.6%) patients experiencing durations of the disease between 5 and 10 years. The clinical manifestations of the disease in these patients included fullness of the abdomen (31 cases), abdominalgia (27 cases), anorexia (30 cases), eructation (26 cases), pantothenic acid (6 cases), and loose stool (9 cases). Patients were treated with Weixibaonizhuanwan and symptom improvement, level of atrophy of the gastric mucosa, and IM and DYS progression were analyzed.

RESULTS

After a 3-mo treatment with Weixibaonizhuanwan, seven patients experienced recovery. The treatment was effective in 11 cases, improved symptoms in 13 cases, and was ineffective in five cases. The overall efficacy rate was 86.1%. In patients with mild atrophic gastritis (n = 13), 11 improved into superficial gastritis and two experienced no improvement. In 14 cases of moderate gastritis, four cases improved into superficial gastritis and seven turned into mild atrophic gastritis, with three patients experiencing no improvement. Among severe atrophic gastritis patients (n = 9), five improved into moderate atrophic gastritis after treatment and four experienced no improvement. The overall efficacy rate in chronic atrophic gastritis patients was 77.8%. Among 9 patients with IM, IM disappeared in six cases, whereas three cases showed no improvement after treatment. In cases with moderate IM (n = 10), IM disappeared in two, turned into mild IM in five, and showed no change in three. Out of four cases with IM, one case turned into moderate IM and three showed no change. The overall efficacy rate in IM patients was 63.6%. Out of 16 cases of mild DYS, DYS disappeared in 11, whereas five cases showed no change. Out of nine cases of moderate DYS, DYS disappeared in two and turned into mild DYS in five cases, with two patients experiencing no change after treatment. No improvement was observed in the two cases of severe DYS after treatment. The overall efficacy rate in DYS patients was 66.7%. After treatment, expression of carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen (PCNA) in gastric mucosa significantly decreased (P < 0.01). Before treatment, cancer staging of these patients by positive CEA expression was I, II, III, and IV in 13, 12, 9, and 2 cases, respectively. After treatment, the number of cases per stage changed to 25, 7, 3, and 1, respectively. Similarly, before treatment, staging by positivity of PCNA expression was I, II, III, and IV in 16, 11, 10, and 4 cases, respectively, and changed to 21, 9, 5, and 1, respectively, after treatment.

CONCLUSION

The use of Weixibaonizhuanwan in the treatment of gastric precancerous lesions showed promising therapeutic effects in patients after 3-mo treatments.

Effect of muscarinic blocker on enhancing the action of fructus aurantii immaturus on intestinal myoelectric activity in dogs

AIM: To investigate the effect of fructus aurantii immaturus (FAI) on small intestinal electrical activity in dogs.

METHODS: The effect of FAI was observed using a computerized electrophysiological method with the migrating myoelectric complex as a criterion. Fasted, healthy, and conscious dogs were given 100% FAI concentrated solution by gastrostogavage, and as soon as the effect on small intestinal electrical activity appeared, atropine was injected intramuscularly.

RESULTS: The enhancing action of FAI was inhibited significantly by atropine, a cholinergic receptor antagonist. Both the number of spike bursts per cluster and the number of spikes per minute in phase II and III and the general cycle were decreased (P < 0.01), although the duration of phase II and the general cycle was prolonged.

CONCLUSION: The effect of FAI might be related to the muscarinic receptors.

Alterations in p53 expression and cell proliferation in esophageal epithelia among patients from geographical areas with high or low incidence of esophageal cancer

AIM: To study changes in p53 expression and cell proliferation in esophageal epithelia of subjects from high or low esophageal cancer incidence areas in Henan Province to understand their molecular basis.

METHODS: Esophageal endoscopic mucosa biopsies were acquired and histopathological examinations were performed on 220 subjects from high esophageal cancer incidence areas and 50 subjects from low incidence areas in Henan Province. Esophageal epithelia were diagnosed as normal, basal cell hyperplasia or dysplasia based on cell morphology and tissue structure. Immunohistochemistry avidin biotin peroxidase complex (ABC method) was performed to analyze alterations in p53 and proliferating cell nuclear antigen (PCNA) expression in normal epithelia and epithelia with different lesion severities. The numbers of p53-positive and PCNA-positive cells were counted.

RESULTS: p53- and PCNA-positive nuclei were present in esophageal epithelia from subjects from both high and low incidence areas. The number of PCNA-positive cells gradually increased with lesion severity for both the high and low incidence areas. The number of p53-positive cells was higher in high incidence areas compared to low incidence areas, and rapidly increased with lesion severity. p53 expression positively correlated with PCNA expression.

CONCLUSION: The number of both p53- and PCNA-positive cells increased with lesion severity. p53 expression was higher in subjects from high esophageal cancer incidence areas compared to those from low incidence areas. These results may shed light into the molecular basis for the geographical distribution of esophageal cancer.