X线胃精细钡气造影在胃癌临床诊断中的价值

目的探析胃癌诊断中运用X线胃精细钡气造影检查的临床价值。方法选取2015年1月~2016年1月我院收治的胃癌患者81例为研究对象,术前对其进行X线胃精细钡气造影检查,并与术后病理结果进行比较分析。结果所有患者均顺利完成X线胃精细钡气造影检查,患者81例中,诊断为胃癌或者疑似胃癌70例,其中浸润型胃癌10例(14.29%),蕈伞型胃癌15例(21.43%),为溃疡型胃癌45例(64.29%);6例诊断为良性胃溃疡或者糜烂性胃炎;漏诊5例(6.17%),诊断胃癌的准确率为86.42%。结论在胃癌的临床诊断中,运用X线胃精细钡气造影检查,可以使检出率提高,有助于早发现、早治疗。     

老年人与青年人胃癌的临床病理特点分析

目的 比较老年人与青年人胃癌的临床病理特点，提高胃癌的临床诊治能力。方法 总结近十年来本院收治胃癌806例，对老年人（≥60岁）和青年人（≤35岁）胃癌的临床病理资料进行分析。结果 老年组胃癌男性明显多于女性（男女之比为3.6:1)，以胃体部癌及贲门胃底部癌多见，病程相对较长，预后较好。青年组胃癌则女性多于男性（男女之比为1：1.6)，以胃窦部癌及胃体部癌多见，且病程短，预后差。结论 老年人胃癌的发病率高，掌握其临床病理特点，提高老年人胃癌的诊断率，阻止其向晚期发展，是提高生存率的重要环节。     

青老年胃癌548例临床对比分析

目的探讨青老年人胃癌的相关特点.方法统计我院内镜检出、病理证实的原发性胃癌(胃癌)1576例,其中35岁以下青年人胃癌(青年组)86例,60岁以上的老年人胃癌(老年组)462例,就其检出率、性别、易发部位、病变类型、病理分型、临床诊断(首诊)等方面,进行对比分析.结果检出率青老年组检出率分别占同期胃癌的5.46%及29.32%;性别青年组男女之比为0.761,老年组男女之比为6.831;易发部位青年组以胃窦部为多发,占43.02%,老年组以贲门胃底为多发,占40.26%;病变类型(Borrman分型)青年组以Ⅲ型多见,占39.18%,老年组以Ⅱ型多见,占41.86%;病理分型两组均以未分化、低分化腺癌多见,分别占65.11%及47.40%,但两组比较仍以青年人多见(P<0.01);临床诊断(首诊)青老年组误诊率分别为59.30%及18.62%.结论青老年人胃癌在检出率、性别、易发部位、病变类型、病理分型、临床诊断(首诊)均存在明显差异.     

青年人胃癌41例分析

目的探讨青年人胃癌的临床、病理、内镜特点及胃镜对胃癌的诊断意义。方法总结分析了我院1992年9月～2007年9月经胃镜（或手术）及病理确诊的青年人胃癌41例患者的临床资料。结果41例青年人胃癌中，上腹痛者35例，肿瘤位于胃窦部者18例，胃体胃角部13例，病理以腺癌多见。结论青年胃癌发病女性多于男性，临床晚期病例多，早期诊断率低，病理组织学分化差，胃镜及病理检查是诊断胃癌可靠、有效的方法，手术仍是治疗最有效的手段。     

老年人胃癌与青年人胃癌临床对比分析

目的　研究老年人胃癌与青年人胃癌的特点及异同点 ,为早发现、早诊断和早治疗提供依据。方法　对老年人及青年人胃癌进行详细问诊、体检、内镜检查及组织学检查 ,对结果分析。结果　老年组与青年组 ,男性均多于女性 ,但青年组性别差异相对小 ,腹痛是两组的共同点 ,但消化不良和体重下降老年人明显多于青年人 (P <0 0 1) ,老年人胃癌以胃底贲门部多 ,青年人以胃窦部多 (P <0 0 1) ,青年人胃癌恶性程度高、分化差、进展快。老年人则分化相对较好、恶性程度相对较低。结论　老年人胃癌与青年人胃癌在性别、临床、内镜和组织病理上都有不同之处 ,应根据这些特点力争做到早发现、早诊断及早治疗。     

胃癌419例临床X线分析

目的为了提高对胃癌X线诊断水平.方法回顾性分析我院1980/1999年确诊的419例胃癌(胃底贲门癌137例,胃窦癌152例,胃体癌91例,胃角癌15例,全胃癌13例,残胃癌11例),结合临床表现,手术所见,病理活检对内镜与钡餐检查进行比较,并分析胃钡餐检查误、漏诊原因.结果经胃钡餐造影检出胃癌298例,与病理符合率71.12%,误、漏诊121例(28.88%).X线钡餐与主要表现为①癌肿区粘膜皱襞紊乱、中断、破坏;②胃壁增厚,僵硬,蠕动,扩张度消失;③不规则充盈缺损及癌性龛影.204例同时进行内镜检查,检出胃癌167例,检出率81.86%结论内镜检查明显优于胃钡餐造影检查,尤其对早期胃癌诊断更显示其优越性.提出在行胃钡餐检查时,双对比法与传统法密切结合,是避免胃钡餐检查误、漏诊的有效和可靠方法     

主动脉夹层的影像学诊断——Ⅰ.X线平片诊断的评价

本文分析了120例经血管造影、磁共振成像和(或)手术、病理证实的主动脉夹层的X线平片征象及其诊断评价。全组X线平片诊断符合率为67.5%。Ⅰ和Ⅲ型为72%和71.3%,Ⅱ型为50%。急性和亚急性病例为69.2%,慢性病例为62.8%,慢性Ⅲ型夹层平片征象须与同样部位的主动脉瘤样扩张鉴别。升主动脉高度扩张。同为Ⅰ、Ⅱ型夹层和马凡氏征主动脉病变的基本征象,后者又常并发升主动脉夹层,X线平片对两者的鉴别很少帮助,确诊应作超声心动图和造影检查。本文提出慢性主动脉夹层的诊断进程是放射—临床,而急性和亚急性夹层的诊断进程是临床—放射。     

早期贲门癌的X线诊断(附42例分析)

本文报道经手术病理证实的早期胃癌42例,着重分析讨论X线诊断。所有病例均经胃镜和胃低张双对比造影检查(下称双对比造影)。根据本组病例分析,综合早期贲门癌双对比检查所见的主要X线表现有5点:①贲门正常形态消失及粘膜破坏;②不规则形小溃疡;③呈小息肉样或数个小颗粒样阴影;④小模糊钡斑或异常积钡和糜烂;⑤贲门舒张度差或和有痉挛狭窄。并对早期贲门癌的X线检查方法进行了讨论。     

54例贲门癌双对比造影X线诊断体会

５４例贲门癌双对比造影Ｘ线诊断体会淄博矿务局中心医院（２５５１２０）戴春田我院近年来经手术或胃镜病理证实贲门癌５４例。现就胃双对比造影诊断贲门癌作一分析。并浅谈体会。临床资料：男４７例，女７例；年龄４９～７８岁。发病时间１个月～１年。临床表现为吞咽困...     

老年人胃癌162例分析

目的探讨老年人胃癌的临床、胃镜、幽门螺杆菌及病理特点。方法我院胃镜室2003年12月-2008年12月对确诊的162例老年人胃癌的临床表现、胃镜检查、幽门螺杆菌及病理分型进行分析。结果老年人胃癌的检出率为0。98％，男性多于女性，病程长，临床症状不典型，癌肿多发于贲门、胃底部，胃镜分型以Bormann分型Ⅱ型为主，快速尿素酶试验阳性率为85％，病理分型以高分化腺癌多见，而低分化腺癌相对较低。结论胃镜检查是确诊胃癌的重要手段，规范根除幽门螺杆菌可降低胃癌的发生率，掌握老年人胃癌的特点，有助于早期诊断及治疗，以提高患者的生存率。     

维尼安防治绝经后及老年妇女骨质疏松的临床观察

目的 探讨维尼安减缓不同绝经年限的妇女骨量丢失的作用机制。方法 对绝经后妇女和老年妇女分别给予维尼安用药3个月，并于给药前后分别进行桡骨骨矿含量（BMC)的测定、血清碱性磷酸酶（AKP）、雌二醇（E2）、降钙素（CT）的测定。结果 维尼安给药前后两组妇女BMC和血清E2的水平未见明显的变化，但血清CT的水平给药后较给药前有不同程度的升高，尿Ca/Cr比值和血清AKP的水平给药后较给药前显下降（P＜0.05及P＜0.01)。结论 维尼安可能通过刺激甲状腺C细胞来增加CT的分泌从而抑制骨质的吸收，维护其骨矿含量的相对稳定。     

藐小棘隙吸虫尾蚴在体内、体外成囊与囊蚴生物学活性实验研究

目的观察藐小棘隙吸虫尾蚴在体内、体外成囊和囊蚴生物学活性以及硝酸银对尾蚴体外成囊的抑制作用。方法尾蚴经或不经硝酸银处理后,观察其在金鱼体内和 Locke's 液等实验溶液中成囊情况;囊蚴在37℃0.1%去氧胆酸钠脱囊液中孵育1h 进行脱囊;同时用两种来源的囊蚴人工感染终宿主新西兰兔,比较其新西兰兔的感染力。结果尾蚴在其第二中间宿主金鱼鱼鳃中1h 即发育为成熟的囊蚴;尾蚴在 Locke's 液、生理盐水、人胃液、人工胃液等溶液中也能发育成囊蚴,24h 成囊率分别为74.28%、44.94%、8.37%和10.79%。尾蚴在0.7×-1.2×Locke's 液和0.7%-1%NaCl 溶液中成囊率较高,但体外形成的正常囊蚴以 Locke's 液最多(正常囊蚴率>50%)。体内形成的1日龄囊蚴、体外形成的正常和异常囊蚴(1日龄)在脱囊液中1h 的脱囊率分别为88.53%、88.60%和84.95%,差异无显著性。异常囊蚴室温下一般在10d内死亡,而正常囊蚴在4℃、0.5×Locke's 液中保存3个月后70%仍能脱囊。体内、体外形成的囊蚴对西兰兔的感染力相似。尾蚴经1uM 硝酸银处理后在 Locke's 液和生理盐水中的成囊率分别为16.25%和6.69%,与对照组相比差异有高度显著性意义(P<0.01);硝酸银处理的尾蚴经多次洗涤后在很大程度上恢复体外成囊(在上述两种溶液中成囊率分别64.80%和39.36%),成囊率与对照组差异无显著性。结论尾蚴在体外能形成具有生物学活性的囊蚴,特别是在人胃液中发育成囊蚴的发现有助于阐明该尾蚴直接感染终宿主的机制。硝酸银处理能可逆地抑制尾蚴在体外成囊,因此推测尾蚴体表的感觉乳突在尾蚴成囊过程中可能起关键作用。这一发现为囊蚴形成机制的研究提供了新思路。     

IN VIVO AND IN VITRO ENCYSTMENT OF ECHINOCHASMUS LILIPUTANUS CERCARIAE AND BIOLOGICAL ACTIVITY OF THE METACERCARIAE

Aim To explore if Echinochasmus liliputanus cercariae can develop into metacercariae both invivo and in vitro and biological activity of the metacercariae,then to determine the effects of silver ni-trate on eereariae encystation in vitro.Methods Cereariae of Echinochasmus liliputanus from Bellamyaaeruginosa snails treated with or without silver nitrate were used to infected goldfish,the second inter-mediate host,or to incubated in many different solutions for 24 h to record the encystation rates.Themetacercariae formed both in vivo and in vitro were then used to infected New Zealand rabbits to testtheir infectivity to its definitive hosts or to exeyst in 0.1% sodium deoxycholate excystation medium at37℃ for 1 h.Results In vivo encystment of cercariae occurred in the gills of goldfish.However,thecercariae were also able to encyst in vitro in Locke's solution,NaCl solution,artificial gastric juice orhuman gastric juice with eneystation rates of 74.28 %,44.94 %,8.37 % and 10.79 %.0.7×-1.2×Locke's or 0.7%-1.2% NaCl solution was shown to be appropriate for in vitro encystment to occurwithin 24 hour,however,full- strength Locke's solution was shown to be optimal.The one- day- oldencysted metacereariae formed in vivo showed 88.53 % exeystation when treated in 0.1% sodium de-oxycholate exeystation medium at 37℃ for 1h.The metacercariae formed in vitro,however,showed88.60% and 84.95% excystation for normal and abnormal ones respectively.While abnormal cysts atroom temperature usually die within 10 days,about 70% normal cyst,both in vivo and in vitro,canstill excyst after stored in 0.5×Locke's at 4℃ for 3 mouths.Cysts formed in vivo and in vitro were e-qually infective to rabbits.1 uM silver nitrate had a dramatic effect on the cercariae encysting in vitro.When treated with silver nitrate,the cereariae encystation rates decreased to 16.25% in Locke's solu-tion and 6.69% in NaCl solution,however,the encystment was largely restored wben the cercariaewere washed to remove Ag .Conclusion The finding of E.liliputanus cercariae encysting in vitro,especially in human gastric juice,might be helpful in elucidating mechanisms of the definitive hosts in-fected by the cercariae directly.The encystment of the cercariae in vitro could be inhibited when thecercariae were treated with 1 uM silver nitrate.As silver nitrate binds to the papillae,especially to theciliated papillae,on the cercarial surface,it is suggested that papillar chemoreceptors may be involved inencystment of the cercariae.     

细胞凋亡及C-myc蛋白表达与胃癌发生的关系

目的:了解胃癌及癌前病变的细胞凋亡与 C-myc 表达的关系。方法:采用原位末端标记法(TUNEL)检测细胞凋亡。采用 LSAB 免疫组化法检测 C-myc 蛋白表达。结果慢性活动性胃炎、胃溃疡、轻度不典型增生、重度不典型增生、早期胃癌、进展期胃癌的凋亡指数分别为16.8%±12.3%、24.1%±20.0%、19.31%±6.4%、15.7%±15.2%、10.1%±9.1%和6.3%±6.0%,进展期胃癌显著低于早期胃癌和不典型增生(p<0.05)。而 C-myc 蛋白的阳性表达率分别为15.6%、20.7%、35.3%、50.0%、66.7%。胃癌和重度不典型增生的阳性表达率明显高于胃溃疡和活动性胃炎(p<0.01),进展期胃癌明显高于轻度不典型增生(p<0.05)。在胃癌患者中,C-myc 阳性组与阴性组凋亡指数分别为8.2%±6.0%和3.5%±2.1%,两组比较有显著差异(p<0.05)。结论:在胃粘膜不典型增生、早期胃癌到进展期胃癌的发展中,细胞凋亡逐渐受到抑制。其 C-myc 蛋白的阳性表达率有逐渐升高的趋势.尤胃癌和重度不典型增生有较高的阳性表达率。C-myc 阳性的胃癌有更高的凋亡指数。     

甲硝唑与替硝唑应用及研究进展

甲硝唑(Metronidazole) 甲硝唑,又名灭滴灵,Flagyl.广泛应用于治疗毛滴虫感染、贾第虫病、阿米巴病和其他原虫感染等.对厌氧菌具有选择性抗菌活性,是治疗和预防厌氧菌感染的主要药物之一;对幽门螺旋杆菌亦有抗菌作用,已成为治疗幽门螺杆菌感染联合用药之一.目前,其应用范围日渐广泛.     

DEMONSTRATION OF CYTOKERATIN IN ENDOTHELIAL CELLS OF THE SYNOVIAL MICROVASCULATURE IN SITU AND IN VITRO

We have used a panel of anti-cytokeratin antibodies and immunofluorescencemicroscopy to examine synovial tissue from a variety of largeand small joints in patients with various rheumatic conditions,including RA, OA, AS, pigmented villonodular synovitis (PVNS)and tenosynovitis (TS). In every case we regularly found bloodvessels with endothelia which express cytokeratin. Positivestaining was obtained with a guinea pig anti-keratin antibody,with monoclonal antibody 8.13 and with a monoclonal antibodyspecific for keratin 18. Staining of endothelial cells was confirmedby double labelling with antibodies to cytokeratin and factorVIII/von Willebrand factor. We also detected a polypeptide correspondingto cytokeratin 18 (MW 45 000) by Western blotting of synovialtissue. In addition we have isolated pure populations of synovialendothelial cells in culture and demonstrate an extensive cytokeratinintermediate filament network which co-localizes with vimentinfilaments. An understanding of the role of the cytokeratin 18network in synovial endothelium may be important for our understandingof endothelial changes in synovial disease. KEY WORDS: Cytokeratin 18, Endothelium, Synovium, Rheumatoid arthritis     

CORTICOTROPIN-LIKE PEPTIDES IN CENTRAL NERVES AND IN ENDOCRINE CELLS OF GUT AND PANCREAS

Extrapituitary corticotropin-like peptides have been found in central nerves and in gastrointestinal and pancreatic endocrine cells. Previous biological and immunological data strongly indicate that the immunoreactivity present in the central nerves represents corticotropin (A.C.T.H.) or a closely related peptide. In some areas of the brain, the distribution of A.C.T.H. nerves parallels that of nerves containing the endogenous opioid ligand, enkephalin. Since A.C.T.H. fragments bind to the opioid receptor the two neuronal peptides may interact. The antiserum used demonstrates the COOH-terminus of the A.C.T.H. molecule, which is devoid of adrenocortical stimulatory activity. A COOH-terminal A.C.T.H.-peptide, corticotropin-like intermediate peptide (C.L.I.P.), originally isolated from the pars intermedia, has been shown to stimulate release of pancreatic insulin. The presence of C.L.I.P.-like molecules in gut and pancreatic endocrine cells may indicate that C.L.I.P.'S insulin-releasing activity is physiologically important. Further, the occurrence of A.C.T.H.-related molecules in such cells may account for the ectopic A.C.T.H. syndrome associated with some tumours of gut and pancreas.     

大骨节病区与非病区儿童发中硼,锗元素含量变化初探

初步调查了大骨节病区与非病区儿童发中硼,锗元素含量的变化及与补硒的关系。方法：用ＩＣＰ－ＭＳ法测定陕西省彬县大骨节病区和非病区儿童５组１５０名６－１４岁男童发中硼,锗元素含量。结果：硼、锗元素依非病区,病区健康和大骨节病必而递减。