Ability of lactulose breath test results to accurately identify colorectal polyps through the measurement of small intestine bacterial overgrowth

BACKGROUND While colorectal polyps are not cancerous,some types of polyps,known as adenomas,can develop into colorectal cancer over time.Polyps can often be found and removed by colonoscopy;however,this is an invasive and expensive test.Thus,there is a need for new methods of screening patients at high risk of developing polyps.AIM To identify a potential association between colorectal polyps and small intestine bacteria overgrowth(SIBO)or other relevant factors in a patient cohort with lactulose breath test(LBT)results.METHODS A total of 382 patients who had received an LBT were classified into polyp and non-polyp groups that were confirmed by colonoscopy and pathology.SIBO was diagnosed by measuring LBTderived hydrogen(H)and methane(M)levels according to 2017 North American Consensus recommendations.Logistic regression was used to assess the ability of LBT to predict colorectal polyps.Intestinal barrier function damage(IBFD)was determined by blood assays.RESULTS H and M levels revealed that the prevalence of SIBO was significantly higher in the polyp group than in the non-polyp group(41%vs 23%,P<0.01;71%vs 59%,P<0.05,respectively).Within 90 min of lactulose ingestion,the peak H values in the adenomatous and inflammatory/hyperplastic polyp patients were significantly higher than those in the non-polyp group(P<0.01,and P=0.03,respectively).In 227 patients with SIBO defined by combining H and M values,the rate of IBFD determined by blood lipopolysaccharide levels was significantly higher among patients with polyps than those without(15%vs 5%,P<0.05).In regression analysis with age and gender adjustment,colorectal polyps were most accurately predicted with models using M peak values or combined H and M values limited by North American Consensus recommendations for SIBO.These models had a sensitivity of≥0.67,a specificity of≥0.64,and an accuracy of≥0.66.CONCLUSION The current study made key associations among colorectal polyps,SIBO,and IBFD and demonstrated that LBT has moderate potential as an alternative noninvasive screening tool for colorectal polyps.

Simultaneously metastatic cholangiocarcinoma and small intestine cancer from breast cancer misdiagnosed as primary cholangiocarcinoma:A case report

BACKGROUND Cholangiocarcinoma and small intestine cancer are common clinical malignancies,but metastatic cholangiocarcinoma and small intestine cancer are rare,especially simultaneous metastatic cholangiocarcinoma and small intestine cancer from breast cancer.Since the clinical presentation of metastatic cholangiocarcinoma and small intestine cancer does not differ from primary tumor,it may lead to misdiagnosis preoperatively.CASE SUMMARY A 66-year-old woman was admitted to our hospital for further treatment due to abdominal pain and jaundice.Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography showed an occupying lesion of the bile duct,considering a high possibility of primary bile duct tumor.Therefore,we performed a radical bile duct cancer surgery and cholecystectomy,and multiple tumors in the small intestine were found and removed during the surgery process.Postoperative pathology showed metastatic bile duct cancer and small intestine cancer from tumors in other parts.The patient underwent a right total mastectomy and axillary lymph node dissection because of right breast cancer 2 years ago.Combining with the immunohistochemical results,the patient was finally diagnosed as metastatic cholangiocarcinoma and metastatic small intestine cancer from breast cancer.Postoperatively,the patient received four cycles of chemotherapy and targeted therapy with docetaxel,capecitabine and trastuzumab.Unfortunately,the patient eventually died from tumor progression,thoracoabdominal infection,and sepsis 5 mo after surgery.CONCLUSION Simultaneous metastatic cholangiocarcinoma and small intestine cancer from breast cancer are rare and the prognosis is extremely poor.Improving preoperative diagnostic accuracy is beneficial to avoid excessive surgical treatment.Treatment should be aimed at relieving biliary obstruction and abdominal pain,and then supplemented with chemotherapy and targeted therapy to control tumor progression and prolong the patient’s life.

Protective effects of Ligustrazine,Kakonein and Panax Notoginsenoside on the small intestine and immune organs of rats with severe acute pancreatitis

BACKGROUND:Severe acute pancreatitis (SAP) is characterized by fatal pathogenic conditions and a high mortality.It is important to study SAP complicated with multiple organ injury.In this study we compared the protective effects of three traditional Chinese medicines (Ligustrazine,Kakonein and Panax Notoginsenoside) on the small intestine and immune organs (thymus,spleen and lymph nodes) of rats with SAP and explored their mechanism of action.METHODS:One hundred forty-four rats with SAP were randomly divided into model control,Ligustrazine-treated,Kakonein-treated,and Panax Notoginsenoside-treated groups (n=36 per group).Another 36 normal rats comprised the sham-operated group.According to the different time points after operation,the experimental rats in each group were subdivided into 3-,6-and 12-hour subgroups (n=12).At various time points after operation,the mortality rate of rats and pathological changes in the small intestine and immune organs were recorded and the serum amylase levels were measured.RESULTS:Compared to the model control groups,the mortality rates in all treated groups declined and the pathological changes in the small intestine and immune tissues were relieved to different degrees.The serum amylase levels in the three treated groups were significantly lower than those in the model control group at 12 hours.The pathological severity scores for the small intestinal mucosa,thymus and spleen (at 3 and 12 hours) in the Ligustrazine-treated group,for the thymus (at 3 and 12 hours) and spleen (at 3 and 6 hours) in the Kakonein-treated group,and for the thymus (at 3 hours)and spleen (at 3 hours) in the Panax Notoginsenoside-treated group were significantly lower than those in the model control group.The pathological severity scores of the small intestinal mucosa (at 6 and 12 hours) and thymus (at 6 hours) in the Ligustrazine-treated group were significantly lower than those in the Kakonein-and Panax Notoginsenoside-treated groups.CONCLUSIONS:All the three traditional Chinese drugs significantly alleviated the pathological changes in the small intestine and immune organs of SAP rats.Ligustrazine was the most effective one among them.

AN ANALYTICAL SOLUTION FOR THE MODEL OF DRUG DISTRIBUTION AND ABSORPTION IN SMALL INTESTINE

According to the physiological and anatomical characteristics of small intestine,neglecting the effect of its motility on the distribution and absorption of drug and nutrient,Y.Miyamoto et al.proposed a model of two-dimensional laminar flow in a circular porous tube with permeable wall and calculated the concentration profile of drugby numerical analysis.In this paper,we give a steady-state analytical solution of the above model including deactivationterm.The obtained results are in agreement with the results of their numerical analysis. Moreover the analytical solution presented in this paper reveals the relation among the physiological parameters of the model and describes the basic absorption rule of drug and nutrient through the intestinal wall and hence pro- vides a theoretical basis for determining the permeability and reflection coefficient through in situ experiments.

The impact of synbiotic administration through in ovo technology on the microstructure of a broiler chicken small intestine tissue on the 1^(st) and 42^(nd) day of rearing

Background： Application the innovative method which is in ovo technology provides a means of modulating the immune system at early embryonic stages. The aim of study was to determine influence of the in ovo stimulation, on d12 of incubation, with synbiotics（synbiotic 1-L. salivarius IBB3154 ＋ Bi^2tos, Clasado Ltd. and the synbiotic 2-L. plantarum IBB3036 ＋ lupin RFOs） on the microstructure of duodenum, jejunum and ileum in the 1^（st） and 42^（nd）day of rearing.Results： On the 1^（st） day of chickens life, in the duodenum of both experimental groups（SYN1 and SYN2）, a significantly higher and wider intestinal vil i as wel as a significantly larger absorbent surface of these villi were found in comparison with the Control group（P ≤ 0.01）. On the 42^（nd）day of rearing the beneficial effect of synbiotic 1 was reflected by the numerical y higher vil i（no statistical differences） with a larger surface（P ≤ 0.01） in the duodenum in the SYN1 group compare to the Control group. In the jejunum on the 1^（st） day of life, in the SYN1 group, significantly higher vil i than in the Control group, with a simultaneous decrease in the depth of crypts（P ≤ 0.01）, and also the largest width of vil i and their absorbent area（P ≤ 0.01） in comparison to the other groups were found. On the 42^（nd）day of life, in the jejunum, an increase in the height of the vil i whilst reducing the crypt depth in the SYN2 group was found（P ≤ 0.01）. In turn, in the SYN1 group, there were significantly more neutral goblet cel s observed compared with the control group（P ≤ 0.05）. In the ileum of 1-day-old chickens, the widest vil i（P ≤ 0.05） and the deepest crypts（P ≤ 0.01） were found in the SYN2 group. In the same group, there was also the least amount of neutral goblet cel s in comparison to the other groups（P ≤ 0.05）.Conclusions： We observed that synbiotic 1 and 2 beneficial y affected the examined characteristics on the 1^（st） and 42^（nd） day of life. The obtained results al ow us to conclude that the use of synbiotics significantly affect gut structure which should contribute to improvement in nutrient absorption by the gut.

Risk factors for small intestinal adenocarcinomas that are common in the proximal small intestine

The frequency of primary small intestinal adenocarcinoma is increasing but is still low.Its frequency is approximately 3%of that of colorectal adenocarcinoma.Considering that the small intestine occupies 90%of the surface area of the gastrointestinal tract,small intestinal adenocarcinoma is very rare.The main site of small intestinal adenocarcinoma is the proximal small intestine.Based on this characteristic,dietary animal proteins/lipids and bile concentrations are implicated and reported to be involved in carcinogenesis.Since most nutrients are absorbed in the proximal small intestine,the effect of absorbable intestinal content is a suitable explanation for why small intestinal adenocarcinoma is more common in the proximal small intestine.The proportion of aerobic bacteria is high in the proximal small intestine,but the absolute number of bacteria is low.In addition,the length and density of villi are greater in the proximal small intestine.However,the involvement of villi is considered to be low because the number of small intestinal adenocarcinomas is much smaller than that of colorectal adenocarcinomas.On the other hand,the reason for the low incidence of small intestinal adenocarcinoma in the distal small intestine may be that immune organs reside there.Genetic and disease factors increase the likelihood of small intestinal adenocarcinoma.In carcinogenesis experiments in which the positions of the small and large intestines were exchanged,tumors still occurred in the large intestinal mucosa more often.In other words,the influence of the intestinal contents is small,and there is a large difference in epithelial properties between the small intestine and the large intestine.In conclusion,small intestinal adenocarcinoma is rare compared to large intestinal adenocarcinoma due to the nature of the epithelium.It is reasonable to assume that diet is a trigger for small intestinal adenocarcinoma.

Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review

BACKGROUND Extramedullary plasmacytoma(EMP)of the gastrointestinal tract is an extremely rare disease.Clinical manifestations of EMPs are varied and depend on the location and progression of the tumor.CASE SUMMARY Here,we firstly report a case of intestinal perforation with abdominal abscess caused by EMP of the small intestine in a 55-year-old female patient.The patient received emergency surgery immediately after the necessary preoperative procedures.During the operation,EMP was found to have caused the perforation of the small intestine and the formation of multiple abscesses in the abdominal cavity.Partial resection of the small intestine with peritoneal irrigation and drainage was performed.EMP was finally confirmed by postoperative histopathology and laboratory tests.Additionally,we performed a literature review of gastrointestinal EMP to obtain a deeper understanding of this disease.CONCLUSION EMP of the small intestine may have spontaneous perforation,which requires emergency surgery.Surgical resection can obtain good therapeutic effects.

PRIMARY TUMORS OF THE SMALL INTESTINE (ANALYSIS OF 102 PATIENTS)

Primary tumors of the small intestine are uncommon and a correct preoperative diagnosis is extremely difficult. From 1964 to 1983, 102 cases of this disease were detected surgically at our hospital. In order to investigate the problems involved in diagnosis and treatment, a comprehensive analysis of small intestinal tumors is made in this paper.

Multiple chronic non-specific ulcer of small intestine characterized by anemia and hypoalbuminemia

A female patient with anemia and hypoalbuminemia was admitted to our hospital due to an over 20-year history of recurrent dizziness,fatigue and ankle edema.She was diagnosed as multiple chronic nonspecific ulcer of the small intestine characterized by non-specific histology and persistent gastrointestinal bleeding.

Intussusception due to hematogenous metastasis of hepatocellular carcinoma to the small intestine:A case report

BACKGROUND The commonest sites of extrahepatic metastases from hepatocellular carcinoma(HCC)are the lungs,bones,adrenal glands,and regional lymph nodes.Hematogenous metastasis to the gastrointestinal(GI)tract is a rare condition in patients with HCC,and the prognosis is usually poor.We report,herein,an extremely rare case of a patient with intussusception due to hematogenous metastasis of HCC to the ileum and his long-term survival with multidisciplinary therapy.CASE SUMMARY The patient was a 71-year-old man with a history of chronic hepatitis B,who had undergone three surgeries for HCC.He was treated with sorafenib for peritoneal metastases of HCC.He was admitted to our hospital with chief complaints of abdominal pain and vomiting.Abdominal contrast-enhanced computed tomography imaging revealed a small intestinal tumor,presenting with intussusception and small bowel obstruction.Conservative treatment was started,but due to repeated exacerbation of symptoms,surgery was planned on the 28th d of hospitalization.Partial ileal resection without reducing the intussusception and end-to-end anastomosis was performed.On histological examination,tumor cells were not observed on the serosal surface,but intravascular invasion of tumor cells was seen.Immunohistochemistry was positive for immunohistochemical markers,and a diagnosis of hematogenous metastasis of HCC to the ileum was made.He remains alive 82 mo after the first surgery.CONCLUSION Prognosis of HCC patients with GI tract metastasis is usually poor,but in some cases,multidisciplinary therapy may prolong survival.

Massive bleeding in small intestinal mucosa-associated lymphoid tissue lymphoma associated with COVID-19 infection:a case report

The increased risk of mucosa-associated lymphoid tissue(MALT)lymphoma is closely associated with chronic antigenic stimulation,with infection being the most common cause of recurrence.Lesions are usually associated with the gastrointestinal tract,and the involvement of small intestinal is rare.Recent studies have established a close relationship between novel coronavirus 2019(COVID-19)and the occurrence and progression of various diseases.This article presents a rare case of a small intestinal MALT lymphoma.The patient was initially admitted with COVID-19 pneumonia and subsequently developed gastrointestinal bleeding during hospitalization.Medical and endoscopic treatments were ineffective,and an emergency exploratory laparotomy was performed.The affected segment of the small intestine was excised,and a pathological biopsy confirmed the diagnosis of MALT lymphoma.This case underscores the significance of raising clinical awareness of this condition among health care professionals.

Evaluating the accuracy and reproducibility of ChatGPT-4 in answering patient questions related to small intestinal bacterial overgrowth

BACKGROUND Small intestinal bacterial overgrowth(SIBO)poses diagnostic and treatment challenges due to its complex management and evolving guidelines.Patients often seek online information related to their health,prompting interest in large language models,like GPT-4,as potential sources of patient education.AIM To investigate ChatGPT-4's accuracy and reproducibility in responding to patient questions related to SIBO.METHODS A total of 27 patient questions related to SIBO were curated from professional societies,Facebook groups,and Reddit threads.Each question was entered into GPT-4 twice on separate days to examine reproducibility of accuracy on separate occasions.GPT-4 generated responses were independently evaluated for accuracy and reproducibility by two motility fellowship-trained gastroenterologists.A third senior fellowship-trained gastroenterologist resolved disagreements.Accuracy of responses were graded using the scale:(1)Comprehensive;(2)Correct but inadequate;(3)Some correct and some incorrect;or(4)Completely incorrect.Two responses were generated for every question to evaluate reproducibility in accuracy.RESULTS In evaluating GPT-4's effectiveness at answering SIBO-related questions,it provided responses with correct information to 18/27(66.7%)of questions,with 16/27(59.3%)of responses graded as comprehensive and 2/27(7.4%)responses graded as correct but inadequate.The model provided responses with incorrect information to 9/27(33.3%)of questions,with 4/27(14.8%)of responses graded as completely incorrect and 5/27(18.5%)of responses graded as mixed correct and incorrect data.Accuracy varied by question category,with questions related to“basic knowledge”achieving the highest proportion of comprehensive responses(90%)and no incorrect responses.On the other hand,the“treatment”related questions yielded the lowest proportion of comprehensive responses(33.3%)and highest percent of completely incorrect responses(33.3%).A total of 77.8%of questions yielded reproducible responses.CONCLUSION Though GPT-4 shows promise as a supplementary tool for SIBO-related patient education,the model requires further refinement and validation in subsequent iterations prior to its integration into patient care.

Effects of dietary supplementation of Artemisia argyi aqueous extract on antioxidant indexes of small intestine in broilers

The present study was conducted to investigate the effect of Artemisia argyi aqueous extract(AAE) on antioxidant indexes in the small intestine. A total of 192 Arbor Acre broiler chickens(one-day-old) were randomly divided into 4 treatments with 6 replicates of 8 chickens. These 4 diets were formulated by adding 0, 500,1,000 and 2,000 mg/kg AAE to the basal diet. The results showed as follows: 1) compared with the control, the total antioxidant capacity(T-AOC) in ileum for the 2,000 mg/kg treatment group was significantly increased at 21 days of age(P < 0.05); the T-AOC levels in jejunum and ileum were significantly increased in broilers supplemented with 500 mg/kg AAE at 42 days of age(P < 0.05), and the T-AOC levels in jejunum and ileum were significantly improved in 1,000 mg/kg treatment group(P < 0.01), 2) At 21 days of age, supplementation of 500 mg/kg AAE significantly increased the catalase(CAT) activity of small intestine, and the glutathione peroxidase(GSH-Px) activity of jejunum was improved(P < 0.01), meanwhile, the GSH-Px activity of duodenum and the total superoxide dismutase(T-SOD) activity of duodenum and jejunum were significantly higher than those of the control group(P < 0.05); supplementation of 1,000 mg/kg AAE significantly increased the CAT activity of duodenum and ileum and the GSH-Px activity of duodenum and jejunum(P < 0.05), and the ileum GSH-Px activity was significantly increased(P < 0.01); supplementation of 2,000 mg/kg AAE significantly increased the CAT activity of duodenum and ileum(P < 0.05). At 42 days of age, supplementation of 500 mg/kg AAE significantly increased the GSH-Px activity of ileum and the T-SOD activity of duodenum(P < 0.05),meanwhile, the T-SOD activity of jejunum was significantly increased(P < 0.01); supplementation of1,000 mg/kg AAE significantly increased the CAT activity of jejunum and the T-SOD activity of ileum(P < 0.01), and the GSH-Px activity of jejunum was significantly increased(P < 0.05); supplementation of2,000 mg/kg AAE significantly increased the T-SOD activity of ileum(P < 0.05), but significantly decreased the CAT activity of ileum and the GSH-Px activity of jejunum(P < 0.05). 3) The malondialdehyde(MDA) levels of 3 AAE supplementation groups were significantly decreased at 21 and 42 days of age(P < 0.05). The results suggested that dietary supplementation with AAE could improve the antioxidative capacity of small intestine in broilers.

3D organoids derived from the small intestine:An emerging tool for drug transport research

Small intestine in vitro models play a crucial role in drug transport research.Although conventional 2 D cell culture models,such as Caco-2 monolayer,possess many advantages,they should be interpreted with caution because they have relatively poor physiologically reproducible phenotypes and functions.With the development of 3 D culture technology,pluripotent stem cells(PSCs)and adult somatic stem cells(ASCs)show remarkable self-organization characteristics,which leads to the development of intestinal organoids.Based on previous studies,this paper reviews the application of intestinal 3 D organoids in drug transport mediated by P-glycoprotein(P-gp),breast cancer resistance protein(BCRP)and multidrug resistance protein 2(MRP2).The advantages and limitations of this model are also discussed.Although there are still many challenges,intestinal 3 D organoid model has the potential to be an excellent tool for drug transport research.

Small bowel autotransplantation combined with pancreato-duodenectomy for enormous cavernous hemangioma of the small intestine mesentery

Recent advances in transplantation techniques have allowed pancreatoduodenectomy, distal gastrectomy,hemicolectomy and small bowel autotransplantation to be the therapy of choice for enormous cavernous hemangioma of the small intestine mesentery. There have been a few case reports about small bowel autotransplantation combined with pancreatoduodenectomy for enormous mesenteric cavernous hemangioma of small intestine. The present surgical methods for enormous cavernous bemangioma of the small intestine mesentery mainly included tumor excision and/or small bowel resection. However, these therapies are not effective for those patients in whom the angiocavemoma has infiltrated the mesenteric artery or pancreas, and these patients often give up therapy. It is recognized that enormous cavernous hemangioma of the small intestine mesentery is a benign lesion, and patients may have an excellent prognosis after complete resection of the lesion.

Glutamine,glutamate,and aspartate differently modulate energy homeostasis of small intestine under normal or low energy status in piglets

Weaning stress may cause reduced energy intake for maintenance of mucosal structure.Gln,Glu,and Asp are major energy sources for the small intestine.This study investigated whether Gln,Glu,and Asp improve the intestinal morphology via regulating the energy metabolism in weaning piglets.A total of 198 weaned piglets were assigned to 3 treatments:Control(Basal diet+1.59%L-Ala);T1(Basal diet+1%L-Gln+0.5%L-Glu+0.1%L-Asp);T2(Low energy diet+1%L-Gln+0.5%L-Glu+0.1%L-Asp).Jejunum and ileum were obtained on d 5 or 21 post-weaning.T1 enhanced growth performance.T1 and T2 treatments improved small intestinal morphology by increasing villus height,goblet cell number and decreasing crypt depth.Days post-weaning affected the efficacy of T2,but not T1,on energy metabolism.At normal energy supplementation,Gln,Glu,and Asp restored small intestinal energy homeostasis via replenishing the Krebs'cycle and down-regulating the AMPK(adenosine monophosphate activated protein kinase)pathway.As these are not sufficient to maintain the intestinal energy-balance of piglets fed with a low energy diet on d 5 post-weaning,the AMPK,glycolysis,beta-oxidation,and mitochondrial biogenesis are activated to meet the high energy demand of enterocytes.These data indicated that Gln,Glu,and Asp could restore the energy homeostasis of intestinal mucosa of weaning piglets under normal energy fed.Low energy feeding may increase the susceptibility of piglets to stress,which may decrease the efficacy of Gln,Glu,and Asp on the restoration of energy balance.These findings provide new information on nutritional intervention for insufficient energy intake in weaning piglets.

Primary Squamous Cell Carcinoma of the Small Intestine： Pathogenesis and Clinical Features

Relative to the length and surface area of the gastrointestinal tract, malignant tumors of the small intestine are remarkably rare, with a global incidence of〈1 per 100,000 population. Among the forty different histological subtypes of small intestinal cancers, primary squamous cell carcinoma （SCC） is exceptionally rare with only occasional case reports in literature. The present study reported a case of primary SCC of the small intestine and reviewed all cases reported in English literature to provide a systematic overview of this rare disease.

Current opinion on the regulation of small intestinal magnesium absorption

Magnesium(Mg^(2+))has an important role in numerous biological functions,and Mg^(2+)deficiency is associated with several diseases.Therefore,adequate intestinal absorption of Mg^(2+)is vital for health.The small intestine was previously thought to absorb digested Mg^(2+)exclusively through an unregulated paracellular mechanism,which is responsible for approximately 90%of total Mg^(2+)absorption.Recent studies,however,have revealed that the duodenum,jejunum,and ileum absorb Mg^(2+)through both transcellular and paracellular routes.Several regulatory factors of small intestinal Mg^(2+)uptake also have been explored,e.g.,parathyroid hormone,fibroblast growth factor-23,apical acidity,proton pump inhibitor,and pH-sensing channel and receptors.The mechanistic factors underlying proton pump inhibitor suppression of small intestinal Mg^(2+),such as magnesiotropic protein dysfunction,higher mucosal bicarbonate secretion,Paneth cell dysfunction,and intestinal inflammation,are currently being explored.The potential role of small intestinal microbiomes in Mg^(2+)absorption has also been proposed.In this article,we reviewed the current knowledge on the mechanisms and regulatory factors of small intestinal Mg^(2+)absorption.

ABSORPTIVE FUNCTION OF SEGMENTAL ALLOTRANSPLANTED SMALL INTESTINES IN PIGS

Ten outbred pigs were each operated on for three times. First, a 130 cm length of terminal ileum of each pig was isolated on its vascular pedicle as a Thiry-Vella loop. One week later, the solitary ileal segments were transplanted heterotopically in two pigs. And after 28 days of heterotopic transplantation, the transplanted intestine was interposed into continuity of host intestine as orthotopic transplant. During the experiment, tests were made on 6th day after the first operation (period 1), the 14th (II), 28th (III) day after heterotopic transplantation, and 3 weeks after interposition (IV) respectively for the levels of glucose, palmitate and leucine. Additionally, at period I, III, and IV, a 3 cm length of intestinal mucosa was excised for morphologic observation and determination of DNA, RNA and protein contents. After heterotopic transplantation, the absorptive function of transplanted intestine was severely impaired for two weeks. The absorption of glucose! and palmitate was partially recovered by period III, at which time leucine level had return to normal. At period IV, the absorptive function of glucose and leucine had surpassed normal levels, while palmitate had risen to the level of pretransplantation. After transplantation, at period III, DNA, RNA and protein contents were well below normal. Three weeks after orthotopic transplantation, RNA and protein had risen to normal level, while DNA content remained below normal, The morphologic changes during the experiment were correlated with the changes of contents in RNA, protein and DNA. The area, height, width of villi and the area, depth, width:of crypt were below normal at III and recovered by 3 weeks after orthotopic transplantation (period IV), but were still lower than the levels at pretransplantation. Crypt depths were deeper than those of pretransplantation.