胃肠道疾病患者胃泌素RIA的临床应用

我们对15例胃癌、31例胃溃疡、98例胃炎、14例胃窦炎患者及30例正常人血清胃泌素水平进行了测定,现将结果报告如下。 材料和方法 一、正常对照组:经临床体检、胃肠透视、B超、胃镜检查无胃肠道疾病的健康人30例(男20例,女10例),年龄20～50岁。 二、胃肠道疾病组:经胃肠透视、胃镜、B超和病检确诊者158例,其中慢性萎缩性胃炎58例慢性浅表性胃炎40例,胃溃疡31例,胃癌15例,胄窦炎14例。 三、方法:胃泌素试剂盒由北京海军总医院提供。操作均按说明书。所有患者均空腹抽血离心分离血清待用。测量仪器为西安262厂生产的FJ-2008/200型γ免疫计数器。 结果 本文36例正常对照组空腹血清胃泌素含量为69.50±31.17ng/L,胃肠道疾病组空腹血清胃泌素含量均高于正常对照组2～4倍(p<0.01)结果见表1。     

胃蛋白酶原Ⅰ和胃蛋白酶Ⅱ在胃癌筛查中的诊断价值

目的 探讨在进行胃癌筛查过程中,分析胃蛋白酶原Ⅰ (PGⅠ)以及胃蛋白酶原Ⅱ(PGⅡ)的诊断应用价值.方法 选择2012年5月至2014年5月胃癌患者15例,萎缩性胃炎患者20例,胃溃疡患者23例,浅表性胃炎患者25例以及健康体检人员80例.利用胶乳增强免疫透射比浊法分别测定实验人员的PG Ⅰ与PGⅡ含量,最终得出PGR.结果 PGⅠ:胃癌37.13±18.59ng/mL;萎缩性胃炎39.27±16.29ng/mL;胃溃疡180.42±61.27ng/mL;浅表性胃炎128.12±14.65ng/mL;健康体检人员120.19±16.96ng/mL;同健康对照组进行比较,胃癌组以及萎缩性胃炎组患者低于其明显(P ＜0.05);PGⅡ:胃癌20.67±9.59ng/mL;萎缩性胃炎患者16.35±16.89ng/mL;胃溃疡患者22.95±13.46ng/mL;浅表性胃炎8.05±4.04ng/mL;健康体检人员11.85±9.65 ng/mL;每组之间差异无统计学意义(P＞0.05).在PG Ⅰ与PGⅡ阳性检出率方面,胃癌组与萎缩性胃炎组明显高于其他组(P＜0.05).结论 对体检人员的PG Ⅰ与PGⅡ进行测定,对于胃癌疾病以及萎缩性胃炎疾病的筛查以及诊断能够提供充分依据,表现出显著价值.     

血清PG和MG7-Ag联合检测在胃癌诊断中的应用研究

目的探讨血清胃蛋白酶原(PG)及其亚群(PGI、PGI/PGⅡ)和胃癌相关抗原(MG7-Ag)的联合检测对胃癌的诊断价值及预后判断的意义。方法采用增强免疫比浊法检测PG及ELISA法检测MG7-Ag在各受试者血清中的含量。结果胃癌组的血清PGI、PGI/PGⅡ(PGR)含量明显低于各对照组(P<0.01);萎缩性胃炎组血清PGI、PGR含量明显低于健康对照组、胃溃疡组及浅表性胃炎组(P<0.05);胃溃疡组和浅表性胃炎组的血清PGI含量明显高于健康对照组(P<0.05)。胃癌组血清MG7-Ag含量明显高于各对照组(P<0.01);萎缩性胃炎组血清MG7-Ag含量明显高于健康对照组、胃溃疡组及浅表性胃炎组(P<0.05)。联合检测阳性率最高为90%。胃癌患者术后PGI含量很低,MG7-Ag含量也明显降低(P<0.01),但当胃癌复发后PGI及MG7-Ag含量均明显升高(P<0.05)。结论血清MG7-Ag和PG的含量变化有助于胃癌的诊断、判断胃癌的复发及转移。     

应用单克隆抗体检测血中胃癌相关抗原的初探

本文应用鼠抗人胃癌单克隆抗体(GMG1:10-2)建立双抗体夹心ELISA法,并对134例正常人及140例临床病人血中胃癌相关抗原(GCAA)的表达进行了测定。结果表明正常人血清中GCAA的OD值为0.058±0.026(X+SD),以其X±2SD值做为正常人上限来进行阳性判定。慢性浅表性胃炎的阳性检出率为8.8％;慢性萎缩性胃炎的阳性检出率为20％;胃溃疡的阳性检出率     

血清卷曲螺旋蛋白49对胃癌诊断的价值

目的 研究血清卷曲螺旋蛋白49(coiled-coil domain containing protein 49,CCDC49)对胃癌诊断的价值。方法 选取胃癌组患者和慢性胃炎组患者共288例,其中胃癌患者147例,慢性胃炎患者141例。采用双抗体夹心酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)测定血清CCDC49水平,统计分析血清蛋白CCDC49的诊断灵敏度、特异性,评估血清CCDC49在胃癌诊断中的临床价值。结果 胃癌组的CCDC49水平为0.251(0.124～1.103)ng/mL,慢性胃炎组的CCDC49水平为0.158(0.080～0.386)ng/mL。萎缩性胃炎组、浅表性胃炎组的CCDC49水平分别为0.164(0.094～0.553)ng/mL和0.133(0.034～0.237)ng/mL。胃癌组血清CCDC49水平高于慢性胃炎组,差异有统计学意义(P<0.05);胃癌组CCDC49水平与浅表性胃炎组差异有统计学意义(P<0.05);胃癌组CCDC49水平与萎缩性胃炎组差异无统计学意义(P>0....     

肝硬化及消化性溃疡患者血浆中NPY水平变化的初步观察

应用放免法测定了28例胃溃疡,31例十二指肠溃疡以及30例肝硬化患者血浆中NPY的含量分别为:46.52±6.12ng/L、45.42±6.27ng/L、45.82±6.92ng/L均明显低于正常对照组(71.88±8.67ng/L)。结果提示:血浆中NFY的改变与上述疾病的发生、发展可能有着密切的关系。     

病毒性肝炎患者血清中游离胰岛素样生长因子1检测

目的检测慢性病毒性肝炎、肝硬化和慢性重型肝炎患者血清中的游离胰岛素样生长因子1(IGF-1)水平变化,分析IGF-1与患者的病情和预后关系.方法应用酶联免疫吸附法(ELISA)检测43例慢性肝炎、20例肝硬化和12例慢性重型肝炎患者血清游离IGF-1水平,并与肝功能指标进行对照.结果慢性重型肝炎、肝硬化和慢性肝炎患者血清游离IGF-1水平分别为(0.23±0.18)ng/ml、(0.37±0.24)ng/ml和(1.15±0.72)ng/ml,慢性重型肝炎、肝硬化患者明显较慢性肝炎低.5例血清游离IGF-1<0.2ng/ml的慢性重型肝炎患者均死亡,4例>0.3ng/ml者存活,3例在0.2～0.3ng/ml之间,其中2例死亡,1例好转.白蛋白在30g/L以下患者的血清游离IGF-1浓度显著低于白蛋白在31g/L以上的患者.结论血清游离IGF-1水平与病情程度、白蛋白合成有密切相关,并可作为判断慢性重型肝炎预后的一个重要指标.     

血浆与血小板中NPY、NT在慢性肾功能衰竭患者血液透析中的变化及意义

采用RIA法检测40例慢性肾功能衰竭(CRF)患者血液透析(以下简称血透)过程中,血浆和血小板中神经肽Y(NPY)、神经降压素(NT)的含量变化及其临床意义。并以30例健康人作为对照。结果显示,①CRF患者血透前血浆NPY、NT含量分别为432.34±52.27ng/L、138.44±80.35ng/L;血透后分别为324.52±48.16ng/L、211.6±124.69ng/L。②CRF患者血透前血小板中NPY、NT含量分别为34.86±18.82ng/L、41.12±24.12ng/L;血透后分别为66.97±21.81ng/L、14.89±12.56ng/L。结果表明,CRF患者存在NPY及NT分泌异常。NPY与NT作为体内重要的神经递质,参与了肾脏病及其并发高血压的病理生理过程。     

慢性重型乙型肝炎患者外周血单核细胞Toll样受体4的变化及其与IL-6的关系

目的： 探讨慢性重型乙型肝炎患者外周血单核细胞Toll样受体4（TLR4）的变化情况及其意义。 方法： 用流式细胞仪检测30例正常对照、31例慢性乙型肝炎患者和30例慢性重型乙型肝炎患者外周血单核细胞表面TLR4的表达，ELISA法检测上述患者血清白细胞介素6（IL-6）的水平。 结果： 正常对照组、慢性乙型肝炎组和慢性重型乙型肝炎组外周血单核细胞TLR4的平均免疫荧光强度分别为2.3±1.1、3.7±2.3 和6.9±4.1，慢性重型乙型肝炎组外周血单核细胞TLR4表达显著高于正常对照组和慢性乙型肝炎组（P<0.05），慢性乙型肝炎组与正常对照组比较无统计学差异；3组外周血清IL-6水平分别为(11.5±7.2) ng/L、(40.8±31.2) ng/L和(77.6±33.3) ng/L，各组间比较均具有显著差异（P<0.05）；慢性重型乙型肝炎组外周血单核细胞TLR4表达水平与血清IL-6表达水平呈显著正相关，相关系数γ=0.618，P<0.05。结论： TLR4可能与慢性乙型肝炎重型化有关。     

急性冠脉综合征患者OX40配体表达的变化

目的： 探讨急性冠脉综合征（ACS）患者外周血单核细胞表达OX40配体（OX40L）及血清可溶性OX40L（sOX40L）水平变化的临床意义。方法: 应用流式细胞术和双抗夹心酶联免疫测定法（ELISA）分别对正常对照组30例、稳定心绞痛（SA）40例（包括20例PTCA）、不稳定心绞痛（UA）50例、急性心肌梗死（AMI）30例患者血单核细胞表达OX40L及血清可溶性sOX40L水平进行检测。结果: UA组［(67.1±12.3)MFI］及AMI组［(70.2±18.3)MFI］血单核细胞表达OX40L,血清sOX40L水平［(35.7±8.4)ng/L,(38.1±10.5)ng/L］明显高于SA组［(23.1±6.7)MFI, (13.6±4.1)ng/L］和对照组［(20.8±8.1)MFI,(12.8±3.6)ng/L］。AMI患者血清sOX40L水平与UA组无明显差异,但AMI发病后24 h sOX40L有一升高峰值。PTCA后血清sOX40L明显高于PTCA前, 但血单核细胞表达OX40L无差异。结论: OX40L表达可能参与ACS的发生机制,且可能是冠脉斑块不稳定的活动性标志物。     

胃粘膜再生型异型增生及其癌前意义的重新认识

通过胃粘膜的损害与胃癌发生关系的实验研究,发现胃粘膜反复损害,常导致不全修复及再生型异型增生。后者有4个类型,即Ⅰ型(糜烂面型)、Ⅱ型(粘膜内型)、Ⅲ型(溃疡边缘型)及Ⅳ型(舌状型)。其中尤以Ⅱ型为多见。结果显示:①在不同实验组再生型异型增生的出现频率与腺癌发生率互为一致;②与始发癌在形态上可见移行过渡;③在异型病变的局部出现早期癌变;④由Ⅱ型癌变而来的早期胃癌常保持着癌巢为大量纤维组织所分隔和包绕的形态特征。本研究论证了再生型异型增生为胃癌的一型重要癌前病变。这型病变亦见于人体材料,因此认为有关其癌前意义应予以重新认识。     

Syndromic gastric polyposis and hereditary gastric cancers

Although the majority of gastric carcinomas are sporadic neoplasms, approximately 10% show familial aggregation, and a hereditary cause is determined in 1–3% cases. Of these, hereditary diffuse gastric cancer (HDGC) is the most recognized predisposition syndrome. Although rare, some of the less commonly reported syndromes (including polyposis syndrome), also confer a markedly increased risk for development of gastric cancer. Identification and characterization of these syndromes requires a multidisciplinary effort involving oncologists, surgeons, genetic counselors, and pathologists.     

Multiple gastric lipomas: Report of an asymptomatic case found at autopsy

Gastric lipomas are uncommon lesions, usually single and located in the antrum. Common symptoms include upper digestive bleeding, anemia, and intestinal obstruction. Alternatively, they may remain asymptomatic, and detectable only at autopsy. A case of a 72-yearold man, who died of myocardial infarction, was found at autopsy to have multiple gastric lipomas of the corpus and antrum, with a single lesion measuring 10˜6.5˜3 cm.     

Acute cellular rejection grading scheme for human gastric allografts

The control of acute cellular rejection (ACR) in multivisceral transplantation improves long-term survival, but monitoring this process can be challenging because different allografts can display varying forms and degrees of rejection. Criteria for ACR of small bowel and liver have been established, but a systematic analysis for ACR in stomach is lacking. For this reason we have developed a comprehensive grading scheme for the evaluation of gastric allograft rejection. The grading scheme was designed to individually grade a variety of changes in the surface epithelium, lamina propria, and glandular structures. The individual values are cumulated, and the final score determines assignment of the rejection grade. The ACR grades range from no evidence of acute cellular rejection to severe rejection. We performed a retrospective study based on 70 gastric allograft biopsies from 20 patients who received multivisceral transplantation from 1995 to 2001. We found that the scoring system showed no significant interobserver variability and allowed for an accurate designation of the ACR grade to the gastric allografts. We found with this grading system that neither clinical symptoms nor gastric endoscopic findings could serve as specific indicators of gastric ACR. Our results also showed that there were differences in the occurrence and intensity of acute rejection between the stomach and other transplanted organs, suggesting that ACR can occur independently among different allografts of the same host. In conclusion, we find that this scheme for grading ACR in gastric transplants is objective and reproducible. This grading system will likely allow for improved correlation between gastric ACR grade and clinical symptoms, as well as improve interobserver uniformity within and between institutions.     

比较研究人正常,增生性胃粘膜和胃癌时对酶标凝集素的反应

本文用酶标凝集类,对35例胃手术病人的正常胃粘膜、增生性胃粘膜、小肠化生和胃癌等与凝集素的反应,在光镜上作了比较观察。结果表明正常胃粘膜的上皮细胞对PNA、DBA和ConA均为阴性。而胃小凹上皮PNA和DBA则为阳性。增生肥大的胃粘膜、上皮细胞和胃小凹上皮对PNA和DBA均匀阳性反应,其染色强度在胃小凹上皮有所增强。化生的胃粘膜,PNA阳性,但DBA阴性。胃腺的主细胞仅对ConA染色。壁细胞能选择性地与DBA结合,有的壁细胞也能与PNA结合。癌细胞与凝集素反应的能力比增生性粘膜减弱,可能是由于癌细胞缺少糖苷化作用酶的关系,     

The value of NOR numbers in neoplastic and non-neoplastic epithelium of the stomach

Using a silver staining technique, nucleolar organizer region-associated proteins (AgNORs) have been studied in paraffin sections of 15 benign gastric ulcers, seven early gastric cancers, 13 gastric adenocarcinomas and 10 control cases. A significant difference in the mean number of AgNORs per nucleus was found when control and benign groups were compared with the malignant group. However, there was an overlap between each category. Further studies are warranted to determine if this may be of value in differentiating regenerative epithelium from early malignancy.     

胃癌组织中NF-κB和COX-2的表达及临床意义

目的：探讨核因子-κB（nuclear factor-kappa B，NF-κB）和环氧合酶-2(cyclooxygenase-2，COX-2)的表达与胃癌发生发展的关系，为开展以NF-κB和COX-2为靶标的胃癌防治提供理论依据。方法：采用免疫组织化学染色法（SP法）检测对照组10例正常胃黏膜及实验组50例胃癌组织中NF-κB和COX-2的表达情况，分析它们在不同组织中的表达、相互关系及与胃癌的关系。结果：实验组NF-κB和COX-2的表达阳性率明显高于对照组（P<0.001）；NF-κB表达与胃癌淋巴结转移、分化程度有关（P<0.05），COX-2 表达与淋巴结转移有关（P<0.05）；胃癌组织中NF-κB与COX-2的表达呈正相关关系，相关系数r=0.5238 （P<0.01）。结论：NF-κB和COX-2参与胃癌的形成，且与胃癌的侵袭、转移及预后有一定的关系。NF-κB与COX-2表达呈正相关，提示它们在胃癌的发生发展中起协同作用。     

An electron-autoradiographic method of investigating RNA synthesis in gastric gland cells

An electron-autoradiographic method of investigating pieces of gastric mucosa obtained during clinical biopsy, and incubated with uridine-5-³H is suggested. It was concluded from a comparison of sections with electron-microscopic autoradiographs prepared after injection of uridine-5-³H into the intact animal and with the results of control sections treated with ribonuclease that the suggested method reflects RNA synthesis in the gastric gland cells.Department of Pathological Anatomy, A. V. Vishnevskii Institute of Surgery, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR N. A. Kraevskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 86, No. 7, pp. 115–116, July, 1978.     

Possible mechanism underlying the effect of Semax on the formation of indomethacin-induced ulcers in rats

Intraperitoneal injection of Semax (synthetic analogue of ACTH4-7, MEHFPGP) in a dose of 50 mg/kg produced a protective effect on rats with experimental indomethacin-induced ulcers. Experiments on narcotized rats showed that Semax in the studied dose had no effect on basal blood flow in the stomach, but prevented reduction of blood flow induced by indomethacin. The antiulcer effect of Semax is probably related to improvement of blood flow in the gastric wall disturbed by indomethacin.