cy, including improvement in tumor imaging parameters, decrease in serum α-fetoprotein (AFP) levels, symptom relief (i.e. Karnofsky Performance Status and numerical rating scales) and response rates, and long term efficacy, including an increase in survival rates and improvement of quality of life (QOL), was monitored. Results: Tumor imaging parameters, serum AFP levels and symptom scores improved significantly in the HIFU group compared with the control group (all P < 0.05). In the HIFU group, a complete and a partial response were achieved in 28.5% (n = 43) and 60.3% (n = 91) of cases, respectively, while the rates were 0% and 16.7% (n = 5), respectively, in the control group. The overall response rate (88.8%) was significantly greater in the HIFU group (16.7%) than in the control group (P < 0.01). In addition, the 1- and 2-year survival rates were 50.0% and 30.9%, respectively, in the HIFU group, which were significantly greater than those (3.4% and 0%, respectively) in the control group (both P < 0.01). The QOLscore was 83.1 ± 8.0 at 3 months after HIFU, which was significantly greater than the pre-HIFU score (67.7 ± 5.9) and the score at 3 months after treatment (69.0 ± 8.5) in the control group (both P < 0.05). No severe complications occurred during and after HIFU. Conclusion: HIFU is an effective and safe ablation therapy with satisfactory short and long term efficacy for patients with advanced HCC.

The aims of this study were to investigate the relationship of the genetic polymorphisms of serotonin reuptake transporter (SERT) to the clinical subtypes of irritable bowel syndrome (IBS), and the influence of the genetic polymorphisms on the efficacy of tegaserod in the Chinese patients with constipation IBS (C-IBS). The genetic polymorphisms were analyzed in 87 IBS patients and 96 controls, then 41 C-IBS patients were received tegaserod for a 4 weeks treatment. Primary efficacy variable was the responder rate measured with Subject’s Global Assessment of Relief. Secondary efficacy assessed the changes of individual symptoms weekly. There was no significant difference of genotype frequencies between the whole IBS and control group. However the frequency of L/L genotype in the 5-HT transporter gene linked polymorphic region was significantly higher in the C-IBS subgroup than in control group (25.0% vs. 7.3%). The responder rates of tegaserod in S/S (85.0%) and L/S (70.0%) were significantly higher than in L/L genotype (36.4%). All secondary variables were also significantly improved in S/S and L/S group compared to L/L group. This small sample size study suggested a hypothesis that people with L/L genotype were vulnerable for development of C-IBS, and C-IBS patients with L/L genotype responded poorly to routine dosage of tegaserod treatment.

目的 观察靶向小鼠肿瘤坏死因子α(TNF-α)基因的小干扰RNA对体外小鼠巨噬细胞系RAW264.7表达TNF-α的抑制作用。方法: 采用化学法合成针对TNF-αmRNA不同位点设计的3条siRNA序列和一条带有荧光标记的BLOCK-ITTM Fluorescent Oligo（修饰的荧光标记的dsRNA）通过脂质体包裹后将其分别转染至小鼠巨噬细胞系RAW264.7，同时设立一个无任何靶基因的siRNA做为阴性对照（siRNA4）。荧光显微镜下观察siRNA的转染效率；用实时荧光定量 PCR和ELISA法分别检测siRNA对TNF-α的mRNA和蛋白表达的抑制作用。结果内毒素刺激后6 h ,巨噬细胞表达TNF-αmRNA 和合成分泌的TNF-α量均增加,于9 ～12 h 达 高峰。利用荧光标记的Oligo观察到siRNA转染效率达72%～80%。siRNA1-4转染巨噬细胞后，与未转染组（TNF-αmRNA 0.2935±0.1470，蛋白2104±32pg/ml）相比，siRNA2、3可见内毒素刺激的TNF-αmRNA（0.1576±0.0308、0.1140±0.0277）和TNF-α蛋白表达[(1355± 348)pg/ml、（817±138）pg/ml]均减少（均P< 0.05），其中siRNA3的抑制率非常显著，达61.2%(P< 0.01)。阴性对照siRNA4对细胞基因及蛋白表达无影响。结论内毒素可刺激小鼠巨噬细胞TNF-α的合成。化学合成siRNA转染小鼠巨噬细胞有较高的转染效率，能有效抑制 TNF-αmRNA及蛋白的表达。

目的：亚临床型肝性脑病（SHE）是肝病常见并发症，但国内资料甚少。本研究拟建立人群 智力测验的正常值，并调查肝硬化代偿期病人SHE 的发病率。方法：用数字连接试验A 部（NCT-A） 和数字符号试验（SDT）检测409 例确诊的无肝性脑病的连续肝硬化病人，并和356 例健康人及416 例慢性病毒性肝炎的病人进行对照，以确保这两测验联用的准确性。两测验的各年龄组正常值为健 康人群的均分数±2 标准差为界限。结果：健康人群和肝炎组NCT 和SDT 分值无显著差异（P>0.05），在所有年龄组肝硬化病人的NCT 和SDT 值均显著高于健康人和肝炎组（P<0.05）。以健康人的均数± 2 标准差为正常界限值，119 例（29.1%）肝硬化病人NCT 及SDT 两者均异常；53 例（13.0%）仅SDT 异常；36 例（8.8%）仅NCT 异常，合计共208 例（50.9%）有1 项或以上的异常。以Child-Pugh 肝 功能分级计算，A 级和B 级的异常率为39.9%和55.2%，明显低于C 级的71.8%（P<0.05）。按NCT 和 SDT 量表要求校正年龄和居住地后，其他因素如肝硬化病因，病人文化水平，烟酒习惯等和SHE 检 出率无关。结论：智力试验NCT 和SDT 是筛查SHE 的简单，可靠方法。两试验联用调查代偿期肝硬 化SHE 检出率为50.9%，SHE 的发病率随肝功能恶化而显著增加

目的 探讨5-羟色胺转运体（SERT）基因启动子区域（5-HTTLPR）与第2 内含子可变数目串联重 复序列(VNTRs)多态性在正常人及肠易激综合征(IBS)患者的分布，及其对替加色罗治疗便秘型IBS（C-IBS） 疗效的影响。方法 用PCR 检测87 例IBS 和96 例对照者外周血两个基因的多态性；给予41 例C-IBS 患者 4 周替加色罗6mg，每日2 次，治疗前后评估临床症状及便秘程度。结果 IBS 组5-HTTLPR 基因型频率是 S/S：52.9%，S/L：31.0%，L/L：16.1%；对照组分别为57.3%, 35.4%, 7.3%; IBS 组VNTRs 基因型频率是 STin2.10/10：2.3%，STin2.12/10：17.2 %，STin2.12/12：80.5%；对照组分别为2.1%, 11.4％, 86.5%； 两组差异均不显著 (P>0.05),但C-IBS 组的L/L 频率比对照组显著高(25.0% 比 7.3%, P<0.05)。治疗后 症状缓解率S/S 型 85.0%，S/L 70.0%均显著优于L/L 36.4%（P<0.05）；主体症状评分和单个症状（排便 次数、粪便性状、便后排空感等）改善S/S 和L/S 型均优于L/L 型（P<0.05）。结论 SERT 基因多态性总体 与IBS 发病不相关，但L/L 型更易患C-IBS。替加色罗对C-IBS 的疗效受基因型影响, L/L 型疗效较差。

目的 研究大肠癌CHD5 mRNA 的表达水平及与临床病理的关系。 方法 采用SYBR Green Ⅰ实 时定量RT-PCR 技术检测38 例大肠癌及相应癌旁和远端正常组织中CHD5 mRNA 的表达。 结果 38 例大肠癌 组织及癌旁和远端正常组织均可检测到CHD5 mRNA 的表达，癌组织表达量[0.0007（0.0002,0.0058）]明显 低于癌旁[0.0127（0.0035,0.1042）]和远端正常组织[0.0148（0.0047,0.0855）]（P＜0.001）；CHD5 mRNA 表达量随肿瘤浸润深度，淋巴结转移和Dukes 分期而降低，差异均有统计学意义（P＜0.05）。 结论 CHD5 mRNA表达在大肠癌降低和其侵犯程度负相关，CHD5 可能为抑癌基因。

Background/Aims: Peroxisome proliferator-activated receptors-γ (PPAR-γ) and its co-activator-1α (PGC-1α) are involved in the regulation of lipid and glucose metabolisms. This study aimed to investigate the genetic polymorphisms of PPAR-γ and PGC-1α in Chinese people and their influence on plasma adiponectin levels and non-alcoholic fatty liver disease (NAFLD) susceptibility. Methods: Ninety-six patients with NAFLD and 96 healthy controls were included. The single nucleotide polymorphisms (SNPs) of C161T PPAR-γ and Gly482Ser PGC-1α genes were analysed by polymerase chain reaction and restriction fragment length polymorphism. Result: The CC, CT and TT genotypic distributions of the NAFLD group were significantly different from those of controls (55.2, 39.6, 5.2 vs. 74.0, 25.0, 1.0%; P = 0.015). The allelic frequencies of C and T were also different between the two groups (P = 0.004). As for the PGC-1α gene, there was no difference of the genotypic and allelic frequencies between the two groups (P>0.05). In NAFLD patients, the plasma adiponectin concentrations were lower in the PPAR-γ CT/TT genotypes compared with those in the CC genotype group (3.0±0.6 vs. 4.3±0.9, P = 0.02). Multivariate logistic regression analysis showed that CT/TT genotypes of PPAR-γ, TG, waist hip ratio, hypoadiponectinaemia and homoeostasis model assessment (HOMA)-IR were the risk factors for NAFLD. Conclusion: SNPs in the PPAR-γ, but not PGC-1α, gene are associated with NAFLD susceptibility possibly through the adiponectin pathway.

AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province, China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province, China. Questionnaires, designed by co-working of epidemiologists and hepatologists, included demographic characteristics, current medication use, medical history and health-relevant behaviors, i.e. alcohol consumption, smoking habits, dietary habits and physical activities. Anthropometric measurements, biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects, 609 (17.2%) were diagnosed having FLD (18.0% males, 16.7% females, P > 0.05). Among them, the prevalence of confirmed alcoholic liver disease (ALD), suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%, 1.8%, and 15.0%, respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age, gender and residency, the standardized prevalence of FLD in adults was 14.5%. Among them, confirmed ALD, suspected ALD and NAFLD were 0.5%, 2.3%, and 11.7%, respectively, and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%, P < 0.001). However, the opposite phenomenon was found over eth age of 50 years (20.6% vs 27.6%, P < 0.05). Multivariate and logistic regression analysis indicated that male gender, urban residency, low education, high blood pressure, body mass index, waist circumference, waist to hip ratio, serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD, especially NAFLD, is prevalent in South China. There are many risk factors for FLD.