胃癌核仁组成区相关蛋白的研究

本研究应用核仁组成区相关嗜银蛋白(AgNOR)染色技术,在光镜及电镜下观察了37例胃粘膜活检标本。光镜定量观察显示,不典型增生及胃癌(高分化与低分化)上皮AgNOR 数目均显著多于正常和炎症病变上皮,胃癌组AgNOR 均值显著高于不典型增生组,但两组中AgNOR 数值有一定程度的重叠。电镜观察见AgNOR 颗粒位于细胞核仁区,胃癌上皮AgNOR 颗粒排列分散,散布于整个核仁区,而正常胃粘膜上皮AgNOR 颗粒分布集中。结果提示,胃粘膜上皮AgNOR 数目及形态的表现对于胃良恶性病变的判断很有助益。     

胃粘膜异型增生AgNOR的图象分析研究

本文用图象分析方法对20例胃癌、64例各级异型增生及24例正常胃粘膜石蜡切片标本的细胞核仁组成区嗜银蛋白(AgNOR)进行了定量观察。结果表明，AgNOR颗粒随病变程度加重而增多。本文显示．应用图象分析技术检测AgNOR颗粒一对正常胃粘膜与异型增生、各级异型增生之间及异型增生与胃癌之间的鉴别诊断．具有实际意义。     

人胃癌组织中rasP＿（21）表达水平的研究

本文应用抗ｒａｓＰ２１单克隆抗体，对７５例胃癌、３８例胃良性病变和２２例正常胃粘膜组织的Ｈａ－ｒａｓ基因产物Ｐ２１的表达进行免疫组织化学分析。结果表明胃癌组织Ｐ２１平均阳性细胞率为５２．２％，良性病变为６．３％，正常胃粘膜组织为２，３％。胃癌组织中有６８（９１％），良性病变有４倒（１０．５％），正常胃粘膜有１例其含Ｐ２１、颗粒的细胞数超过２０％。高分化、中等分化及乳头状腺癌其Ｐ２１量似乎比低分化或未分化腺癌及粘液腺癌多，良性病变的胃息肉、胃炎、胃溃疡等Ｐ２１量低于肿瘤组织，但仍高于正常胃粘膜。结果提示Ｐ２１的表达在胃粘膜细胞癌变的过程中具有某种作用。     

胃粘膜活检标本核仁组成区嗜银蛋白计数的临床意义

采用嗜银染色技术研究了正常、炎症、不典型增生胃粘膜、胃癌及癌旁粘膜（距癌１ｃｍ内）组织核仁组成区嗜银蛋白（ＡｇＮＯＲ）变化。结果显示：轻、中、重度不典型增生组织ＡｇＮＯＲ数量相差显著（Ｐ＜０．０５或０．０１），胃癌组织ＡｇＮＯＲ数量高于胃良性病变，不同分化程度的癌组织ＡｇＮＯＲ计数无差异。癌旁组织与正常、炎症胃粘膜组织无差异。笔者认为ＡｇＮＯＲ计数有助于鉴别良、恶性组织，提高病理诊断的准确性。ＡｇＮＯＲ与肿瘤组织学分级无关。     

ICAM-1/LFA-1的表达和胃癌TNM分期关系的研究

为研究 ICAM-1、LFA-1在正常胃粘膜中及胃癌中的表达 ,并评价其表达与胃癌 TNM分期的关系 ,对正常胃粘膜组织 2 0例 ,胃癌组织 75例按 TNM分期分为 、 、 、 组 ,标本 SABC免疫组化染色后 ,对阳性结果进行了分析。结果显示 ,正常胃粘膜组中 ICAM-1表达率高于胃癌组 ( P<0 .0 5 ) ,L FA-1表达率两组间差别无显著性 ( P>0 .0 5 ) ;ICAM-1表达率 组为 71.4% ( 15 /2 1) , 组为 40 .9% ( 9/2 2 ) , 组为 17.6% ( 3 /2 2 ) , 组为 10 % ( 1/10 ) , 组与 组间、 组与 组间比较均有显著性差异 ( P<0 .0 5 )     

基质金属蛋白酶-7基因在溃疡型胃癌中的表达

目的探讨胃癌早期诊断的有效标志物及敏感方法。方法用逆转录聚合酶链式反应(RT-PCR)检测基质金属蛋白酶-7(M M P-7)m RN A在20例正常黏膜、18例胃溃疡组织、20例溃疡型胃癌组织中的表达。结果18例胃溃疡组织M M P-7m R NA表达阳性6例,与正常黏膜对照有显著性差异(χ2=5.06,P<0.05);20例溃疡型胃癌M M P-7m RNA表达阳性16例,与溃疡组和正常对照有非常显著性差异(χ2=8.46,P<0.01)。结论M M P-7m R NA有望成为一种肿瘤生物学恶性行为标志物,为胃癌早期病变提供信息,且具有较高的特异性和敏感性。     

幽门螺杆菌感染对胃癌组织核仁组成区嗜银蛋白的影响

对胃正常、炎症和癌及癌旁组织进行连续病理切片，用Ｗａｒｒｔｈｉｎ－Ｓｔａｒｒｙ法检测组织中幽门螺杆菌感染，同时用嗜银染色技术显示组织核仁组成区嗜银蛋白变化。结果显示幽门螺杆菌感染与胃癌组织核仁组成区嗜银蛋白计数无关，而与胃粘膜活动性炎症相关。提示幽门螺杆菌感染不是直接致癌因素。     

CML患者外周血T淋巴细胞Ag-NORs的测定及意义

目的探讨慢性粒细胞白血病(CML)患者外周血T淋巴细胞核仁形成区嗜银蛋白(Ag-NORs)的表达特点及其临床意义。方法应用计算机图像分析系统对48例CML患者及36例正常人外周血T淋巴细胞Ag-NORs含量进行测定。结果各期CML患者外周血T淋巴细胞Ag-NORs含量均明显低于正常人(P<0.01),且加速期和急变期均明显低于慢性期(P<0.01),但加速期和急变期之间无显著性差异(P>0.05)。结论外周血T淋巴细胞Ag-NORs检测对CML的诊断和预后评估具有一定的临床意义。     

血清胃蛋白酶原和胃泌素-17联合检测在老年胃癌及萎缩性胃炎中的临床意义

目的探讨血清胃蛋白酶原(PG)Ⅰ、PGⅡ和胃泌素-17(G-17)与老年胃黏膜病变的关系。方法选取老年患者136例,对照组即慢性非萎缩性胃炎31例,慢性萎缩性胃炎33例,胃癌30例,胃溃疡24例。十二指肠球部溃疡18例。用ELISA法定量检测血清PGⅠ、PGⅡ和G-17浓度,并计算PGR(PGⅠ/PGⅡ)值。结果慢性萎缩性胃炎及胃癌组PGⅠ水平和PGR明显降低并低于其它良性病变组(P<0.05),G-17浓度明显高于对照组(P<0.05)。萎缩性胃炎组PGⅠ水平及PGR值与萎缩程度相关,重度萎缩组PGⅠ、PGR明显低于轻度萎缩组(P<0.05)。进展期胃癌组PGⅠ、PGR水平明显低于早期胃癌组(P<0.05)。结论血清PGⅠ、PGR和G-17水平与老年患者萎缩性胃炎和胃癌有关,可以作为老年高危病人胃黏膜萎缩、癌变的筛查指标。     

幽门螺旋杆菌感染对胃粘膜病变的临床、病理观察

目的：评价幽门螺旋杆菌(HP)对胃粘膜病变的影响。方法：对6年前胃粘膜嗜银染色确诊为HP感染的患者56例，采用根治HP后复查HP及胃粘膜病理改变。HP阴性者32例，仅复查胃粘膜病理改变。结果：56例HP阳性患者中，32例经抗HP治疗4周后转阴，14例仍为HP阳性并对6年间3次胃镜病理检查进行比较一年后复查胃镜病理，在HP阳性组中胃粘膜肠上皮化生加重的患者增加，而HP阴性组无1例加重。结论：根除HP感染可以减轻患者炎症程度，同时阻止胃粘膜肠上皮化生的发展。     

PDS型功能性消化不良患者胃排空研究

目的研究餐后不适综合征（PDS）型功能性消化不良（FD）患者与健康人胃排空的差异。方法按照罗马Ⅲ诊断标准,选择PDS型FD患者34例纳入试验组,健康志愿者21例纳入对照组。对所有受试者进行核素胃排空检测,观察胃半排空时间（GET1/2）和120min胃排空率（GE120）。结果试验组GET1/2（106±26）min高于对照组GET1/2（78±14）min,2组间差异有统计学意义（t=5.066,P〈0.01）;试验组GE120（56±13）min低于对照组GE120（71±11）min,2组间差异有统计学意义（t=-4.221,P〈0.01）。但是试验组症状积分与胃排空之间无相关性（P〉0.05）。结论PDS型FD患者较健康人易存在胃排空延迟。     

牛乳铁蛋白对实验性胃黏膜损伤及胃溃疡大鼠模型的影响

目的 观察牛乳铁蛋白对实验性大鼠胃黏膜损伤及胃溃疡的保护作用。方法 建立无水乙醇、幽门结扎致大鼠胃黏膜损伤模型,水浸应激、乙酸灼烧致大鼠胃溃疡模型,测定模型大鼠胃黏膜损伤程度、溃疡面积、溃疡指数,以及胃黏膜中氨基己糖、PEG₂含量和血流动力学的变化,观察牛乳铁蛋白对实验性胃黏膜损伤和胃溃疡的保护作用。此外,通过连续喂养正常大鼠牛乳铁蛋白,观察其对大鼠胃液量、胃液酸度和胃蛋白酶活性的影响。结果 牛乳铁蛋白能降低乙醇及幽门结扎致胃黏膜损伤大鼠的溃疡指数,增加乙醇致胃黏膜损伤大鼠受损胃黏膜的氨基己糖和PEG₂含量以及血流量。同时,牛乳铁蛋白还能降低水浸应激以及乙酸灼烧致胃溃疡大鼠胃部的溃疡面积。此外,连续灌胃高剂量牛乳铁蛋白能抑制正常大鼠胃液分泌,减少胃液酸度。结论 牛乳铁蛋白对实验性胃黏膜损伤及胃溃疡大鼠模型胃黏膜损伤具有保护作用。     

Gastric pH Influences the Appearance of Double Peaks in the Plasma Concentration-Time Profiles of Cimetidine After Oral Administration in Dogs

The plasma concentration-time profiles of cimetidine often exhibit two peaks following oral administration of a single dose in the fasted state, while the concurrent administration of some antacids results in a lower extent as well as rate of absorption. In the present work, absorption of cimetidine after a single dose in the fasted state was studied as a function of gastric pH in male beagle dogs to determine whether gastric pH plays a role in the double peak phenomenon and/or can account for the decrease in bioavailability when antacids are coadministered. The extent of absorption of cimetidine was not influenced significantly by gastric pH, indicating that elevation of gastric pH is not the cause of decreases in the bioavailability of cimietidine when it is administered with antacids. Distinct double peaks or plateaux were noted in 8 of 10 plasma profiles when the gastric pH was 3 or below. Irregular absorption behavior was observed in 2 of 6 profiles in the pH range of 3 to 5, while single peaks were observed in all 10 profiles when the gastric pH was maintained at pH 5. It was concluded that gastric pH is a major factor in the generation of cimetidine double peaks. Changes in gastric pH also resulted in changes in the apparent kinetics of absorption. Below pH 5, absorption mostly followed zero-order kinetics (9 of 16 profiles) or a more complex kinetic process involving at least two components to the absorption phase (5 of 16 profiles). At gastric pH 5, however, absorption followed first order kinetics in 7 of 10 profiles. These differences in kinetics of absorption are postulated to arise from variations in gastric emptying as a function of pH and/or carryover effects of gastric pH into the upper intestine.     

Gastric function measurements in drug development

The function of the stomach includes initiation of digestion by exocrine secretions such as acid and pepsin, which are under the control of the endocrine secretion of hormones that also coordinate intestinal motility. The stomach also stores and mechanically disrupts ingested food. Various techniques have been developed to assess gastric physiology, the most important of which is assessment of acid secretion, as well as gastric motility and gastric emptying. The influence of drugs on gastric function and the effect of gastric secretion and mechanical actions on the bioavailability of novel compounds are of critical importance in drug development and hence to clinical pharmacologists. The control of acid secretion is essential in the treatment of peptic ulcer disease as well as gastrooesophageal reflux disease (GORD); pH-metry can be used to determine the necessary dose of an acid suppressant to heal mucosal damage. Disturbed gastric myoelectric activity leading to gastroparesis can cause delayed gastric emptying, often found in patients with diabetes mellitus. Electrogastrography (EGG) may be used to evaluate the influence of prokinetics and other drugs on this condition and aid in determining effective therapy.     

醋氨己酸锌抗实验性胃溃疡作用

对醋氨己酸锌的抗实验性动物胃溃疡作用进行了研究，结果表明，醋氨己酸锌显著的抑制小鼠水浸应激性胃溃疡形成，对无水乙醇所致的大鼠胃粘膜损伤具有明显的保护作用，且显著减轻幽门结扎大鼠胃粘膜的损伤，同时，对大鼠幽门结扎大后６ｈ的胃液进行分析，３００ｍｇ／ｋｇ醋氨己酸锌增加胃液分泌量，降低游离酸和总酸量，醋氨己酸锌并具有抑制胃蛋白酶活性的作用。     

幽门螺杆菌相关性胃疾病血清PG测定及意义

为研究血清胃蛋白酶原 (pepsinogen,PG)亚群 (PG 、PG )含量与幽门螺杆菌 (Helicobacter pylori,Hp)相关性胃疾病的关系 ,选取体检健康者 3 0例 (对照组 )和疾病组 14 4例 (实验组 ) ,其中慢性浅表性胃炎 47例 ,慢性萎缩性胃炎 3 5例 ,胃溃疡 40例 ,胃癌 2 2例。采用快速尿素酶试验 (RUT)及病理切片法检测幽门螺杆菌感染 ,采用放射免疫法 (RIA)检测血清胃蛋白酶原含量 ,旨在研究胃相关性疾病患者以上指标的变化情况。结果显示 ,RUT法检测幽门螺杆菌阳性率 (79.17% )高于病理切片法 (4 0 .2 8% ) ,两者有显著性差异 (P<0 .0 1) ;幽门螺杆菌在慢性浅表性胃炎、慢性萎缩性胃炎及胃溃疡患者中有较高的阳性率 ,胃癌组患者 Hp感染率低于胃炎及胃溃疡组 ;在血清 PG含量检测中 ,胃癌组低于对照组、浅表性胃炎组及胃溃疡组 (P<0 .0 1) ,胃癌组 PG /PG 比值低于对照组及浅表性胃炎组 (P<0 .0 1) ,Hp(+ )组 PG 、PG 含量均高于 Hp(-)组。     

胃癌术后空肠造瘘行肠内营养的护理分析

目的对胃癌术后患者进行空肠造瘘行肠内营养的护理分析。方法回顾分析我院收治的450例胃癌患者的临床资料。分析肠外营养和肠内营养对患者的不同影响,对术后的排气排便时间,血红蛋白,外周淋巴细胞计数和并发症的发生率进行观察分析。结果肠内营养组术后的排气排便时间均较肠外营养缩短,血红蛋白和外周淋巴细胞计数指标的恢复速度比肠外营养组要迅速。肠内营养组的术后并发症发生率明显低于肠外营养组。结论胃癌患者术后进行肠内营养助于恢复小肠功能,加速改善营养状态,降低并发症的发生率。     

娑罗子提取物对阿司匹林致胃溃疡作用的研究

目的研究娑罗子提取物（SAE）对阿司匹林所致胃溃疡的保护作用,为阿司匹林安全用药提供依据。方法用阿司匹林制备溃疡模型,小鼠连续5天灌胃给予SAE（3.5、7、14mg/kg）或在制备溃疡模型前、后不同时间点灌胃给予SAE（7mg/kg）,于显微镜下观察胃溃疡指数。结果与模型组比较,SAE（7、14mg/kg）显著降低溃疡指数（P〈0.05）。制备溃疡模型同时给予SAE（7mg/kg）可以明显降低溃疡指数。结论娑罗子提取物对阿司匹林所致胃溃疡有预防作用。     

Gastric motor effects of endothelins in the lower brainstem of the rat

To characterize the modulatory effect of endothelin on brainstem control of gastric motor function, endothelin-1 (ET-1) and endothelin-3 (ET-3) were applied to the surface of the dorsal medulla oblongata in α-chloralose and xylazine anaesthetized, artificially ventilated Sprague-Dawley rats, while intragastric pressure and contractility of the pyloric circular and greater curvature longitudinal muscles as well as blood pressure were monitored. Endothelin-1 and ET-3 equipotently (at the same range of doses) increased intragastric pressure and stimulated contractility of the gastric circular muscle as well as increasing arterial blood pressure. All the gastric effects of endothelins were abolished by bilateral vagotomy at the midcervical level. These results demonstrate that endothelins have vagally mediated gastrointestinal effects in the lower brainstem of the rat and support a role for endothelins in gastrointestinal regulation. This paper was presented at the Section of IUPHAR GI Pharmacology Symposium on ‘Biochemical pharmacology as an approach to gastrointestinal disorders (basic science to clinical perspectives)’, October 12–14, 1995, Pécs, Hungary.