[Effect of Feridex-GFP double-labeled BMSC transplant on the damaged liver under the condition of constant magnetic field].

OBJECTIVE: To evaluate the effect of the bone marrow mesenchymal stem cells (BMSCs) transplant through peripheral vein, portal vein and hepatic artery into liver under the condition of constant magnetic field and to analyze the therapeutic effect on liver function recovery. METHODS: BMSCs were isolated, purified and induced to differentiate into liver-like cells, which were double labeled by Feridex-GFP. The double-labeled BMSCs were transplanted into liver through different ways including peripheral vein, portal vein and hepatic artery with or without constant magnetic field in vitro. The rats were sacrificed at the 1st, 2nd, 3rd and 4th week after the transplant. ALB, ALT, AST were tested. The liver tissue biopsy was collected. GFP-positive cells in liver were observed by fluorescence microscopy. RESULTS: Double-labeled BMSCs could be transplanted into liver through all ways. GFP expression was found in liver in all groups at the 4th week and the liver functions were improved. Based on the long term efficacy, the liver functions recovered more rapidly in the portal vein + constant magnetic field group and the hepatic artery + constant magnetic field group. CONCLUSION: BMSCs transplantation can reduce acute liver damage. The first choice for BMSCs transplantation was via portal vein or hepatic artery under the condition of constant magnetic field. The second choice was via peripheral vein alone or under the condition of constant magnetic field.

[Influence of endoscopic variceal ligation on liver function and risk factors of rebleeding].

OBJECTIVE: To investigate the influence of endoscopic variceal ligation (EVL) on liver function and analyze the risk factors of rebleeding after EVL. METHODS: A total of 137 cirrhotic patients with esophageal varices who received EVL were retrospectively analyzed, and divided into group A, B, and C according to the Child-Pugh scores of liver function. We compared the liver function 1 week preoperatively and postoperatively. The patients were further divided into a rebleeding group and a non-rebleeding group after the EVL, and risk factors about rebleeding were analyzed. RESULTS: There was no significant difference on ALT, AST, T-Bil, and D-Bil either preoperatively or postoperatively in group A, B, and C (P>0.05). Thirteen patients (9.49%) rebled after the EVL. The course of disease, liver function, prothrombin time, and mass ascites were the risk factors of rebleeding. CONCLUSION: EVL has no obvious effect on liver function, and the course of disease, liver function, prothrombin time and mass ascites are risk factors of rebleeding after EVL.

Sedation, analgesia, and cardiorespiratory function in colonoscopy using midazolam combined with fentanyl or propofol.

BACKGROUND AND AIMS: The use of sedatives during colonoscopy remains controversial because of its safety concerns. We compared cardiorespiratory function and sedative and analgesic effects in sedative colonoscopy, using combinations of midazolam with either fentanyl or propofol. METHODS: Eligible patients (n = 480) received 1.0-2.0 mg midazolam alone (n = 160), midazolam combined with either 50-100 mg fentanyl intramuscularly (n = 160), or 0.5-2.5 mg/kg propofol intravenously, as premedication for sedative colonoscopy. Pulse rate, blood pressure, and saturation of peripheral oxygen (SpO(2)) were monitored. Levels of sedation and analgesia were semi-quantitatively scored using visual analog scales, and amnesia profiles were qualitatively evaluated. RESULTS: Combining midazolam with either fentanyl or propofol resulted in acceptable sedative and analgesic effects compared to treatment with midazolam alone (P < 0.001), with the combination with propofol giving more favorable results. More patients receiving the propofol combination became amnestic to the procedure than patients receiving the fentanyl combination. However, midazolam combined with propofol disturbed the pulse rate (P < 0.05) and blood pressure (P < 0.001) more significantly than a combination with fentanyl, or midazolam alone. CONCLUSION: The combination of midazolam with either fentanyl or propofol allowed patients to undergo colonoscopy under comparable sedative and analgesic conditions. The combination with fentanyl had a significantly lower effect on pulse rate and blood pressure. The combination with propofol produced superior amnestic effects.

[Influence of age on sedation for colonoscopy in adults].

OBJECTIVE: To investigate the efficacy and risk of midazolam and propofol for sedation during colonoscopy procedures in adults of different age groups. METHODS: A total of 180 patients undergoing colonoscopy were allocated to 3 groups: a young adult group (n=45, 18-44 years), a mid-aged group (n=78,45-64 years) and an elderly group (n=57, 65-80 years). All patients were premedicated with midazolam 0.02-0.03 mg/kg and propofol 0.5-2.5 mg/kg. The pulse rate, arterial pressure, and oxygen saturation for each patient were monitored continuously before, during and after the procedure. RESULTS: The doses of midazolam and propofol for the young adults were significantly higher than that for the mid-aged and the elderly (P<0.01). Based on the view of gastroenterologists, the satisfied rate of sedation quality was significantly higher in the elderly group than that in the young or the mid-aged group (P<0.01). There were significant changes in the arterial pressure in all groups compared with the baseline level (P<0.01), but there was no significant difference among the 3 groups. Other parameters such as heart rate, saturation of O2, and the rate of severe adverse reaction among the 3 groups were not significantly different (P>0.05). CONCLUSION: Higher dose of midazolam and propofol is needed to obtain the sedation quality in young adults. Whereas for the elderly, properly reducing the dose of midazolam and propofol may still keep the sedation quality during colonoscopy procedures.

[Capsule endoscopy in the diagnosis of intestinal diseases].

OBJECTIVE: To determine the efficiency and safety of capsule endoscopy for patients with intestinal diseases. METHODS: Given M2A capsule endoscopy (CE) was performed on 81 patients with obscure gastrointestinal bleeding and obscure abdominal pain, and the clinical data were analyzed. RESULTS: In the 81 patients, 9 showed negative finding, CE didn't reach the small intestine in 1 patient. In the other 71 patients, 132 intestinal lesions were detected, and the total positive rate of CE for intestinal diseases was 88.75%. The findings consisted of 36 intestinal inflammation, 24 angiopathy, 16 protuberant lesions, 15 mutipolypi in the intestine, 12 blood in the intestine, 11 single or multiple ulcers, 6 ascarid in the intestine, 5 diverticula, 1 ankylostomiasis, 1 intestinal dysplasia with internal fistula, and the 5 intestinal Crohn's disease. Ten patients with protuberant lesion were verified by surgical operation and pathology, and the 5 stromal tumors diagnosed by CE were confirmed by pathological examination, while no one of Crohn's disease, lymphoma and angioma was diagnosed correctly by CE. All images of CE were good. All the patients had no complications. CONCLUSION: Capsule endoscopy is a safe and effective procedure, with a high positive rate, but the diagnostic yield is limited, which can be used for intestinal diseases.

[Efficacy and security of sedation in upper gastrointestinal endoscopy in snoring patients].

OBJECTIVE: To investigate the efficacy and security of different administrations of propofol on the sedation in upper gastrointestinal endoscopic procedures in snoring patients. METHODS: A total of 1,117 patients with snoring in ASA I-II level, who underwent gastroscopy and received propofol as sedation, were assigned to Group A, Group B, and Group C.These groups had different administration methods of propofol. The dose of propofol, response to endoscopic procedures, changes of oxygen saturation of arterial blood (SPO2), incidence of severe respiratory depression and sedation quality assessed by operators were observed. RESULTS: The incidence of transient decline in SPO2 in Group A, B, and C were 50.4%, 3.1%, and 18.5%, respectively. The doses of propofol of Group A, B, and C were (108.50±18.02) mg, (57.50±7.50) mg, and (79.80±10.02) mg, respectively, with significant difference (P<0.05). The incidence of severe respiratory depression in Group A was 1.2%, but Group B and C were 0%. Compared with Group A(100%) and C(100%), the satisfaction rate of sedation quality in Group B was 74%, with significant difference (P<0.05). CONCLUSION: During the upper gastrointestinal endoscopic procedures, snoring patients are premedicated with propofol in various uses by steps or one slow administration. Both methods are safe and effective to reduce the incidence of severe respiratory depression, and patients have no memory of the procedure.

[Propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy].

OBJECTIVE: To explore the application of propofol combined with midazolam intravenous anesthesia in pediatric upper gastrointestinal endoscopy. METHODS: A total of 497 ASA I~II patients who received sedative upper gastrointestinal endoscopy were assigned to a children group (2-14 years) and an adults group (18-65 years).The 2 groups were treated with midazolam (0.02-0.03 mg/kg, iv) and propofol(0.6-0.7 mg/s,iv) with an interval of 3-5 minutes. Enterscopy was inserted at light sleep, relaxing muscles, and disappearance of eyelash relaxation. Combining of pro-endoscopy, reaction to intravenous administration, dose of propofol, reaction to endoscopy, time of returning to consciousness, changes of SpO2, R, HR, and BP, and sedative quality were evaluated. RESULTS: Good sedation of the 2 groups after intravenous administration was observed. Rate of combining of pro-endoscopy in children was lower (42%) than that in adults(100%). The incidence of restlessness, hyperphasia, temporary decreasing of SpO2, dose of propofol of per kilogram weight, time of returning to consciousness in the children were 82.7%, 17%, 2.4 mg/kg, and (17.5+/-3.2) min, respectively, which were all higher in the adults [9%, 4%, 1.4 mg/kg, and (9.5+/-1.3) min, P<0.01]. HR and BP decreased in the 2 groups, and recovered rapidly after the endoscopy. There was no significant difference between the 2 groups(P>0.05). CONCLUSION: It is safe and effective to use propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy.

[Effect of various uses of propofol on the upper gastrointestinal endoscopy].

OBJECTIVE: To investigate the efficacy and security of different uses of propofol on the sedation during the upper gastrointestinal endoscopic procedures. METHODS: Four hundred patients who underwent gastroscopy received midazolam and propofol as sedation. Patients were divided to 4 groups with different intervals between midazolam and propofol: Group A and D with the interval of 30 seconds to 1 minute, Group B and C with 3 to 5 minute interval. All patients were premedicated with midazolam and propofol at 16 approximately 25 mg/10s (Group A and B) and 6 approximately 7 mg/10s (Group C and D). RESULTS: The doses of propofol of Group A,B,C, and D were (111.90+/-22.43),(102.20+/-15.99),(73.05+/-13.08) and (80.90+/-17.36)mg respectively, with significant difference(P<0.01). The time of return to consciousness decreased markedly in Group C and D [(9+/-1), (10+/-2)min ], and that of Group A and B was [(14+/-5), (13+/-3)min ]. There was significant difference between Group C, D and Group A, B(P<0.01). CONCLUSION: The dose of propofol and the time of return to consciousness depend on the rate of administration and the interval between midazolam and propofol. Appropriate rate and interval can produce safer and more effective sedation for the upper gastrointestinal endoscopic procedure.

[Effect of prostaglandin E1 on the expression of tissue inhibitor of metalloproteinase-1 in experimental liver fibrosis rats].

OBJECTIVE: To investigate the effect of prostaglandin E1 (PGE1) on the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) in experimental liver fibrosis rats. METHODS: The liver fibrosis model was established by carbon tetrachloride. Rats were divided into a control group and PGE1-treated group. The pathological changes of the liver tissue from the two groups, the semi-quantitative analysis of hepatitic activity in HE stain sections, the pathological image quantitative analysis of the fibrosis degree, TIMP-1 positive cells, and the content of collagen were synthetically analysed. RESULTS: The mark changes of liver pathology in HE stain sections were that the degree of hepatitic activity in the PGE1-treated group was obviously lower than that in the control group (P < 0.05). The fibrosis degree, TIMP-1 positive cells and the collagenous fibers decreased in the PGE1-treated group (P <0.05). CONCLUSION: PGE1 has an anti-hepatofibrosis effect in the experimental rats, the inflammation of liver is light, and the proliferation of collagenous fibers can be restrained, whose mechanism is probably associated with the suppression of TIMP-1 expression caused by PGE1.

Enterotoxigenic Escherichia coli infection alters intestinal immunity in mice.

Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrhea in humans and piglets. However, research regarding alterations of intestinal immunity following ETEC infection remains limited and the results controversial. The present study investigated the effects of ETEC on the expression levels of pro­inflammatory cytokines and innate immune regulators from plasma cells, goblet cells and Paneth cells, and the activation of toll­like receptor 4-nuclear factor (NF)­κB and mitogen­activated protein kinase (MAPK) pathways using reverse transcription­quantitative polymerase chain reaction and western blot analysis, in a mouse model infected with a porcine isolated ETEC strain. ETEC infection significantly reduced the expression of pro­inflammatory cytokines in the mouse jejunum (P<0.05). Additionally, ETEC infection significantly affected the expression of immune regulators of plasma cells, goblet cells and Paneth cells in the mouse intestine (P<0.05). ETEC influenced the intestinal immunity via the NF­κB and MAPK signaling pathways. In conclusion, ETEC colonization affects intestinal immunity as observed in a mouse model. This study provides a greater understanding of the pathogenesis of ETEC infection in animals and humans.

miR-124 and miR-506 inhibit colorectal cancer progression by targeting DNMT3B and DNMT1.

miR-124 and miR-506 are reportedly down-regulated and associated with tumor progression in many cancers, but little is known about their intrinsic regulatory mechanisms in colorectal cancer (CRC). In this study, we found that the miR-124 and miR-506 levels were significantly lower in human CRC tissues than in controls, as indicated by qRT-PCR and in situ hybridization histochemistry. We also found that the overexpression of miR-124 or miR-506 inhibited tumor cell progression and increased sensitivity to chemotherapy in vitro. Increased miR-124 or miR-506 expression also inhibited tumor cell proliferation and invasion in vivo. Luciferase reporter assays and western blotting were used to determine the association between miR-124, miR-506 and their target genes, DNMTs. We further identified that miR-124 and miR-506 directly targeted DNMT3B and indirectly targeted DNMT1. The overexpression of miR-124 and miR-506 reduced global DNA methylation and restored the expression of E-cadherin, MGMT and P16. In conclusion, our data showed that miR-124 and miR-506 inhibit progression and increase sensitivity to chemotherapy by targeting DNMT3B and DNMT1 in CRC. These findings may provide novel avenues for the development of targeted therapies.

[Five-day rabeprazole-based triple therapy for helicobacter pylori infection].

OBJECTIVE: To evaluate the efficacy of a 5-day rabeprazole-based triple therapy regimen for helicobacter pylori infection, and to improve the eradication rates of antibiotic-resistant Helicobacter pylori with rabeprazole plus clarithromycin and furazolidone. METHODS: We selected 95 H. pylori-positive patients with gastric or duodenal ulcers or erosive gastritis and randomized them into 2 groups. The patients were given a 7-day triple standard therapy and 5-day triple standard therapy, consisting of rabeprazole 10 mg twice daily, clarithromycin 500 mg twice daily and furazolidone 100 mg twice daily. H. pylori status was checked by rapid urease test or 14C urea breath test and histology before and 4 weeks after the therapy. RESULTS: The eradication rate of H. pylori for patients under the 5-day treatment vs. 7-day treatment were 77.8% vs. 82% by per protocol and 94.4% vs. 97.6% by intention to treat analysis (no significant comparisons). The ulcer and erosion healing rate was 97.6% vs. 97.8% (no significant comparisons). No major side-effects were reported. CONCLUSION: The 5-day rabeprazole-based triple therapy( combined with clarithromycin and furazolidone) for helicobacter pylori infection is an effective regimen with excellent patient acceptability and compliance.

[Clinical observation of recombinant growth hormone therapy for liver cirrhosis with hypoproteinemia].

OBJECTIVE: To assess the effect of recombinant growth hormone (rhGH) therapy for liver cirrhosis patients with hypoproteinemia. METHODS: Fifteen patients with liver cirrhosis were treated with rhGH (4 U per day) for 7 days and 15 controls were given human albumin (10 g) for every other day (altogether 3 times). Albumin was measured one day before the treatment, and on day 1, 10, 14, and 28 after the treatment. RESULTS: After 7 days of rhGH administration, the albumin level of the patients was significantly higher and the function lasted longer than those of patients treated with human albumin (P < 0.05). CONCLUSION: Exogenous rhGH in treating hypoproteinemia in patients with liver cirrhosis is more effective than human albumin.