Combined human growth hormone and lactulose for prevention and treatment of multiple organ dysfunction in patients with severe chronic hepatitis B

AIM: To evaluate the efficiency and safety of combined recombinant human growth hormone (rhGH) and lactulose for treatment and/or prevention of multiple organ dysfunction in patients with chronic severe hepatitis B. METHODS: Forty-eight inpatients with chronic severe hepatitis B were randomly divided into rhGH group (n = 28)and control group (n = 20). In rhGH group, 4-4.5 IU of rhGH was injected intramuscularly once daily for 2-4 wk,and 100 mL of enema containing 30 mL of lactulose, 2 g of metronidazole and 0.9% saline was administered every 2 d for 2-4 wk. Their symptoms and complications were noted. Liver and kidney functions were analyzed by an Olympus analyzer. Serum GH, IGF-1, IGFBP1 and IGFBP3 were measured by ELISA.RESULTS: Clinical symptoms of 90% of these patients in rhGH group were obviously improved. The total effectiveness in rhGH group was better than that in control group (75% vs40%, P＜0.05). After 2- and 4-wk treatment of rhGH respectively, serum albumin (26.1±4.1 vs 30.2±5.3,31.9±5.1 g/L), prealbumin (79.6±28.0 vs 106.6±54.4,108.4±55.0 g/L), cholesterol (76.3±16.7 vs 85.6±32.3,96.1±38.7 mg/dL), and IGFBP1 (56.8±47.2 vs 89.7±50.3ng/mL after 2 wk) were significantly increased compared to control group (P＜0.05). However, serum GH was decreased. The increase of serum IGF1 and IGFBP3 after rhGH treatment was also observed.CONCLUSION: rhGH in combination with lactulose may be beneficial to the prevention and treatment of multiple organ dysfunction in patients with chronic severe hepatitis.

Effect of 2-(3-carboxy-1-oxopropyl) amino-2-deoxy-D-glucose on human esophageal cancer cell line

AIM: TO determine whether 2-(3-carboxy-l-oxopropyl) amino-2-deoxy-D-glucose (COPADG), a derivative of D-amino-glucose, inhibited the growth of human esophageal cancer cell line Eca-109. METHODS: Effects of COPADG on Eca-109 cells cultured in RPMI 1640 medium were examined by a tetrazoliumbased colorimetric assay (MTT assay). RESULTS: COPADG inhibited the growth of Eca-109 cells in a dose- and time-dependent manner; the maximumin hibition rate was 83.75%. CONCLUSION: COPADG can directly inhibit the proliferation of Eca-109 cells, which may serve as the experimental evidence for development of new drugs for esophageal cancer therapy.

Characterization of focal hepatic lesions with contrast-enhanced C-cube gray scale ultrasonography

AIM: To characterize enhancement patterns of focal hepatic lesions using C-cube gray scale sonography with a microbubble contrast agent and to evaluate its usefulness in differential diagnosis of hepatic lesions.METHODS: Fifty-four patients with 58 focal hepatic lesions were examined with Levovist-enhanced C-cube gray scale sonography. The final diagnosis of hepatic lesions was 29primary liver cancers, 4 metastases, 8 hemangiomas, 12focal nodular hyperplasias, 2 inflammatory pseudotumors of the liver and 3 angiomyolipomas. The initiation time of enhancement in various lesions and enhancement duration after administration of contrast agent were compared.Vascular findings in lesions were classified as peripheral enhancement, homogenous enhancement, mosaic enhancement and no enhancement depending on microbubble signals in the lesion relative to the liver parenchyma.RESULTS: The initiation time of enhancement in hemangioma (48±12 s) was significantly later compared to other lesions (P＜0.05). The enhancement duration of malignancies (69±33 s in primary liver cancer, 61±23 s in metastasis) was significantly shorter compared to benign lesions (P＜0.05).Intranodular enhancement appearing at arterial phase and decreasing at portal venous phase was considered characteristic for malignancy. Intranodular enhancement did not appear earlier than the liver parenchyma, and peripheral enhancement pattern was regarded as positive findings for hemangioma. Intranodular enhancement appeared in the arterial phase, and homogenous enhancement pattern sustained in the whole portal venous phase were regarded as positive findings for focal nodular hyperplasia. No microbubble signals appeared in two inflammatory pseudotumors of the liver.CONCLUSION: C-cube gray scale sonography can demonstrate dynamic intranodular enhancement in various focal hepatic lesions. The information provided by this methodology may be useful in the differential diagnosis of hepatic lesions.

H. pylori Infection - An Overview

Comparison of the two recently identified genome sequences has revealed that, of the～1500 genes, some 60 % can be assigned a predicted function, while another 20 % have homologues of unknown identity. The remainder has no currently identified homologues. Of singular importance is the 'pathogenicity island' of which the cagA-gene is a marker. The vacA-gene is outside the pathogenicity island and is a true cytotoxin. The cag pathogenicity island encodes proteins associated with cell signaling and secretion systems for delivery of virulence factors to target cells. Certaingenotypes, particularly the cag-A positive,

Gastro-entero-hepatology in the New Millennium

The global prospects for gastroenterology are excellent. The subspecialty involves the largest area of body surface, the largest endocrine organ, the largest neuronal organ (with 200 million neurones), and the largest immune organ (with 50 % of all lymphocytes); it includes by far the largest number of diseases, many still unexplored, and the largest oncological patient load. Gastroenterology/hepatology lies at the cross-roads between internal medical and surgical specialties.