AIM To evaluate the usefulness of ultrasound monitoring acute fluid accumulation in acute pancreatitis.METHODS Six hunclred and twenty-seven patients with acute pancreatitis were undergone ultrasonographicexamination. All examinations were performed by the attending doctors. The first scans were performed onthe first or second day after admission to our hospital, if there were acute fluid accumulation inperipancreatic spaces including the lesser sac, pararenalspaces, peritoneal cavity, or even thoracic cavity,then the follow-up scans were routinely performed 3 - 7 days following the initial scan and this interval wasdependent upon the severity of acute pancreatitis, and partieulanly noticed the changes of pancreas and thefluid mentioned above. Continuous variables were analyzed by t test, Discrete variables were analyzed by the,x2 test and rank sum test using SPSS, P<0.05 was considered significant.RESULTS Acute fluid accumulation was fouad in 57.5% of 627 patients among them 14.4% evolved intocomplications and 85.6% resolved spontaneously. The most frequent sites of fluid accumulation are theperitoneal cavity and the left hemithorax, followed by the lesser sac and right hemithorax (x2 = 738,P<0.0001); the hospital stay was longer as the quantity of acute fluid accumulation increased (P<0.0001, t = 2.2 - 4.2 ). There was no fluid accumulation in mild AP and more than 2 sites in severe AP (P<0.0001, x2 = 147.8).CONCLUSION The number of sites as well as the duration of fluid accumulation are proportional tohospital stay and the severity of AP.

AIM To study the relationship among typing of Traditional Chinese Medicine (TCM) and Helicobacterpylori infection, expression of oncogene and tumor suppresser genes in gastric cancer and precancerouslessions.METHODS According to TCM typing, 120 patients with chronic superficial gastritis, intestinal metaplasia,atypical hyperplasia and gastric cancer were divided into 4 groups: 21 patients with coexistence of cold andheat syndrome (group R), 22 patients with in coordination between the liver and the spleen (group U), 29patients with deficiency of the spleen-yin (group I) and 48 patients with insufficiency of the spleen-yang(group H). Protein expression of c-myc, p21 and p53 were detected immunohistochemically, and Hp wereconfirmed by modified Giemsa method.RESULTS The Hp infection of the group H was significantly higher (72.9%) than that of group R(38.1%, P<0.01) and group U (40.9%, P<0.01). Expression of c-myc, p21 and p53 were significantlyrelated to Hp infection and severity of gastric mucosa lesions (group H>group I>group U>group R).CONCLUSION Hp infection, expression of oncogene and tumor suppresser genes were related to TCMtyping. These parameters were helpful in identification of symptoms and signs and TCM differentiationdiagnosis.

AIM To study the comprehensive prevention and treatment of gastric cancer among high-risk population inthe high risk areas.METHODS A gastrocarcinoma mass screening was performed in 16 villages of Zhuanghe region. About50 000 population were involved and 3033 cases aged above 35 suffering from gastric diseases, and/or hadfamily history of gastric cancer were screened. Clinical epidemiological investigation, double-contrast X-ray,serum pepsinogen monitor, gastroscopic biopsies and histopathologic examinations were adopted in thescreening.RESULTS The ratio of the examined patients with gastric disorder reached up to 82% and 32 patients withgastric cancer were detected (1.06%) and 18 cases were early gastric cancer (56.25%). Patients with gastriccancer were treated successively. Aside from gastric cancer, several gastric lesions were also detected, whichlaid a good foundation for further interventional treatment. It was also found in the examination that93.97% of the local residents were addicted to salted pork and more than 60% of the residents had Hpinfection.CONCLUSION Gastric diseases, Hp infection of gastric mucosa and eating salted pork are very common inZhuanghe region. These are very dangerous factors causing gastric cancer. It is feasible to quit eating saltedpork and eradicate Hp infection and cure precancerous diseases.

AIM In order to evaluate the diagnostic parameters of characteristic pathologic change in the liver biopsyspecimens, we developed a numerical scoring diagnostic standard.METHODS Ten of the eleven categories of characteristic pathologic lessions appearing in acute hepatitisand 11 categories in chronic hepatitis were selected. Each of them was graded 3 scales, then the essentialscore and scale score were set up. Adding up to all the numerical scores of individual components, formed thetotal scores of histological chronic activity index (HCAI) and histological acute activity index (HAAI). Onethousand and eight patients with various liver dieases were studied,and compared with conventional readingsand Knodell'HAI through F analysis and q test.RESULTS The HAAI of acute, subacute, and chronic severe hepatitis was 43.56±9.08, 51.63±12.13,and 65.45±17.51 respectively. There was significant difference between each other (P<0.01). TheirHCAI was 14.44±8.31, 57.39±10.98, and 58.14 12.24 respectively. HAAI of mild, moderate, andsevere chronic hepatitis was 18.57±7.00, 26.43±7.49, and 35.58±11.47 respectively (P<0.01), andHCAI was 13.2±6.90, 40.29±10.99, and 50.02±9.78 respectively. There was signficant difference(P<0.01). The HAAI of active liver cirrhosis and silent liver cirrhosis was 64.96±16.60 and 31.17±9.07respectively, the difference being significant (P < 0.01), and HCAI was 66.00±9.62 and 69.84±8.93, withno significant difference (P >0.05).CONCLUSION The diagnostic standard of histological activity index that we set up, was more useful aseither an alternative or supplement to the conventional terminology and KnodellHAI.

AIM To study the expression of cathepsin B in gastric carcinoma and its relationship with pathologic type.METHODS The cathepsin B expression in 54 specimens of human gastric adenocarcinoma was studied byimmunohistochemistry.RESULTS The cathepsin B expression was detected in 33/54 (61.1%) specimens of human gastriccarcinoma and in 3/54 (5.6%) of normal tissue (P<0.01). There was no obvious correlation between theexpression of cathepsin B and pathologic type of gastric adenocarcinoma.CONCLUSION There is a high expression of cathepsin B in human gastric adenocarcinoma.

AIM To probe into the feasibility and theoretic basis for the treatment of chronic hepatitis with hyperbaricoxygenation (HBO).METHODS Sixty cases of chronic hepatitis were randomly distributed into an experimental group (n=30)and a control group (n =30). The experimental group was treated with HBO for 6 courses. The controlgroup was treated with commonly used drugs in clinic for 60 days. The function and blood stream graph ofliver were examined and the liver biopsies were made before and after treatment. The routine paraffin slidesof liver tissue were cut, stained with HE, and observed under optical microscope. The ultrathin slides fromparaformaldehyde and glutaraldehyde fixed liver tissue were cut, stained with lead citrate, and observedunder transmission electric microscope. The HBsAg and HBcAg in the experimental group were detected bythe ABC immunohistochemical method before and after treatment.RESULTS In the experimental group the ALT, SB, γ-GT, AKP, IgG and IgM in blood (P< 0.05) and thedegeneration and necrosis of hepatocytes (P<0.05) were remarkably decreased, the mean contractive waveof blood stream in the liver (P<0.05) and the blood stream in the right ramus of janitrix (P<0.05) weresignificantly increased, and the swelling of mitochondria, the increased lysosomes, the generation of Kupffer's cells, the infiltration of lymphocytes in portal area and the capillary generation were remarkably alleviated(P<0.05), but the fibrosis and fat-storing cells did not reduce (P>0.05) in the liver, and the expression ofHBsAg and HBcAg in the liver was not lowered (P<0.05) after the treatment with HBO.CONCLUSION The treatment with HBO for chronic hepatitis was effective and recommendable.

AIM To find out if there is any difference in human primary liver carcinogenesis between Han and minorityethnic patients in Xinjiang.METHODS Expression of p53, c-erbB-2, H-rasp21 protein and proliferating cell nuclear antigen (PCNA)in tumor tissues of 50 patients (Hah 38, minorities 12) with primary hepatic carcinoma (HCC) was detectedby immunohistochemistry (LSAB).RESULTS The positive frequency of p53, c-erbB-2, H-rasp21 and PCNA expression was 46.0% (23/50,70.0% (35/50), 68.0% (34/50) and 82.0% (41/50) in tumor tissues; 4.0% (2/50), 22.0% (11/50),64.0% (32/50) and 52.0% (26/50) in peritumor respectively with a significant difference, except for H-rasp21 (P<0.05) between tumor and non-tumor tissues. Combined the three oncogenes alteration, 26%(13/50) tumor tissues had positive immunoreactivity, but peritumor and normal liver were negative. Thepositive p53, c-erbB-2, H-rasp21 protein expression was 39.5 % ( 15 / 38), 60.5 % (23 / 38) and 39.5 % ( 15 /38) in tumors of Han patients; 66.7% (8/12), 100% (12/12) and 75.0% (9/12) in minority patientsrespectively. A statistical difference between Han and minority cancer samples was observed (P< 0.05).CONCLUSION Overexpression of p53, c-erbB-2 and H-rasp21 in human primary liver carcinoma is animportant biomarker of genetic alteration. The different frequency of these oncogenetic changes may reflectsome environmental factors or/and ethnic hereditary affecting the liver carcinogenesis. The special life styleof Han, Uygur, Kazak and Mongolia nationalities in Xinjiang may also involve the etiopathogenesis of thisdisease.

AIM To select a test method for specifical, sensitive and rapid identification of LT+ E. coli.METHODS Stool samples inoculated into LB solution were cultured for 4 hours at 35℃. 10 μ boiled culturesolution was taken to template. Two oligonucleotide primers were used in a polymerase chain reaction (PCR)procedure to amplify a highly conserved DNA sequence of the A subunit of the heat-labile enterotoxin.Detection of the 110 bp amplified product can be done by agarose gel electrophoresis. Thirty strains ofknown bacteria (LT+ E. coli (EC-129), ST+ E. coli (EC-130)and LT+ ST+ E. coli (EC-142), Salmonellatyphimurium , Salmonella typhi , Salmonella paratyphi A, Salmonella group C, Shigella sonnei , Enterobacteraerogenes, Alcaligenes sp, Providencia rettgeri, Proteus mirabilis, Morganella morganii, Pseudomouasaeruginosa, Aeromonas hydrophila, Klebsiella pneumoniae, Citrobacter diversus, Enterobacter cloacae, 12strains of E. coli isolated from bile samples ) and 108 diarrhea samples were detected. A total of 108 diarrheasamples were compared with LT probe hybridization, modified Eleck (M-Eleck) and ELISA simultaneously.RESULTS By PCR, of the 30 strains of bacteria, only LT+ E. coli and LT+ ST+ E. coli were positive; in40 of the 108 diarrhea samples, 20 were positive and in the other 68 samples from infants, only five werefound to be positive. Of the 25 positive samples by PCR, 23 were also found to be positive in the other 3tests; 1 was found to be positive by M-Eleck and ELISA. Of the 83 negative samples by PCR, the samenegative results were found by M-EIeck and ELISA, but 2 were found to be positive by LT probehybridization. The overall coincidence rate was about 95%. Analysis of correlation showed a significantdifference between PCR and other three tests (P<0.01) and analysis of difference showed no significantdifference (P>0.05) between them. In the detection of LT+ E. coli by means of PCR, the minimumnumber of target bacteria required was 50 CFU. The whole test was finished in 7 hours.CONCLUSION Detection of LT+ E. coli by PCR showed that the method is specific, sensitive and rapid.

AIM The hepatic content of collagens (type I, Ⅲ and Ⅶ) and laminin (LN) in rat model of experimentalliver fibrosis was observed to find out their roles in the pathogenesis of liver fibrosis.METHODS The experimental rat model was established by immunological injury induced by injectinghuman albumin. Histopathological and immunohistochemical methods were used to measure the hepaticcontent of collagens and laminin in the fibrotic rat livers.RESULTS The hepatic contents of collagens (type I, Ⅲ, Ⅶ) and LN in the fibrotic rat livers weresignificantly increased as compared with those in the control group, and they were found to be mainlylocalized in the portal space, central veins and fibrous septa. Electron microscopic study showed that pro-collagens were present around the “activated” hepatic stellate cells (HSC) and the hepatocytes atrophied.CONCLUSION Pathological deposition of collagens (type Ⅰ, Ⅲ and Ⅶ ) and laminin was the fundamentallesion of liver fibrosis. HSC may be the major cellular source of collagens (type Ⅰ, Ⅲ and Ⅶ) and laminin inthe liver tissue.

AIM We introduce a new highly selective vagotomy (HSV) procedure which can completely destroy anyexisting variant vagal fibers innervating the proximal stomach.METHODS Twenty-eight dogs were divided into three groups: group A had retrograde liberated highlyselective vagotomy (RLHSV), group B had traditional HSV and group C as control group. Gastric acidsecretion function was tested and gastric parasympathetic and sympathetic enervation were studied byretrograde tracing the horseradish peroxidase (HRP) or by histochemical staining. After being convincedthat the modified procedure was an easier and more effective HSV on animal model, we applied thetechnique to the treatment of duodenal ulcers in 100 patients.RESULTS Significant decrease of acid secretion was found in operated dogs in both group A and B. After injection of HRP subserously into the fundus and body, no HRP positive cells were found in the vagal dorsalnucleus in group A and B but were in group C. When HRP was injected into the antrum, HRP stained cellswere found in dorsal nucleus in all three groups. The negative histochemical staining of AchE and the positivefluorescence in the fundus and body in group A and B indicate that parasympathetic nerve fibers weredestroyed completely while norepinephrinergic nerve fibers were intact. When the operation was applied topatients, no severe complications or operative mortality occurred. Patients were followed up for 6- 84months. They all had complete gastric emptying function. Ninety-four patients were graded as Visick I orⅡ. Six as Visick Ⅲ and Ⅳ. Eighty patients had been followed up with gastroscopy for two years afteroperation. Four patients had recurrent ulcers. Among them two patients were asymptomatic and the othertwo had symptoms and were treated with partial gastrectomy.CONCLUSION Compared to the classic HSV, our modified procedure is more effective clinically andconvenient technically.