大剂量干扰素辅助治疗口腔黏膜恶性黑色素瘤的效果及安全性研究

目的 研究大剂量干扰素辅助治疗口腔黏膜恶性黑色素瘤的临床效果,探讨治疗应用的安全性。方法 选取我院于2017年11月～2018年11月收治的80例口腔黏膜恶性黑色素瘤患者作为研究对象,按照治疗方法不同分为两组,每组40例。对照组患者仅采用单纯手术治疗,治疗组在此基础上采用大剂量干扰素辅助治疗。观察两组患者生存情况、疾病复发情况以及毒副反应。结果 治疗组患者生存期限及无复发生存期明显长于对照组,治疗组复发率为5.00%,明显低于对照组的22.50%,差异有统计学意义(P0.05)。两组患者毒副反应比较差异无统计学意义(P0.05)。结论 口腔黏膜恶性黑色素瘤患者予以大剂量干扰素辅助疗法安全有效,值得临床推广。     

常见植物药对结肠癌的防治作用及其作用机制

植物药对结肠癌具有良好的防治作用。姜黄素、多糖(苹果多糖、香菇多糖)、皂苷(重楼皂苷、人参皂苷)、白藜芦醇、槲皮素等植物药可通过不同信号通路抑制结肠癌细胞的增殖,促进细胞凋亡。此外,植物药还具有抗炎、抗氧化、抗血管生成、减轻化疗药物不良反应、逆转肿瘤细胞耐药等作用。了解植物药对结肠癌的防治作用及其可能的作用机制,能为结肠癌的临床防治提供更多的理论依据及治疗思路。     

High-definition optical magnification with digital chromoendoscopy detects gastric mucosal changes in dyspeptic-patients

BACKGROUND Accurate detection of gastric infection by Helicobacter pylori(H.pylori) and premalignant lesions are important for effective provision of treatment,preventing the development of gastric neoplasia.Optical enhancement systems with optical magnification improved the identification of mucosal superficial and vascular patterns in patients with dyspepsia.AIM To evaluate an optical enhancement system with high-definition magnification,for diagnosis of normal gastric mucosa,H.pylori-associated gastritis,and gastric atrophy.METHODS A cross-sectional,nonrandomized study from November 2015 to April 2016 performed in a single-tertiary academic center from Ecuador.Seventy-two consecutive patients with functional dyspepsia according to the Rome III criteria,were tested for H.pylori using a stool antigen test and were assigned to an Hp+group or an Hp-control group.Esophagogastroduodenoscopy with highdefinition optical magnification and digital chromoendoscopy was performed,and patients were classified into 4 groups,in accordance to the microvasculararchitecture pattern of the mucosa.Interobserver and intraobserver agreement among operators were calculated.RESULTS Of the 72 participants,35 were Hp+ and 37 were Hp-.Among 10 patients with normal mucosal histology in biopsy samples,90% had a Type I pattern of microvascular architecture by endoscopy.Among participants with type IIa and type IIb patterns,significantly more were Hp+ than Hp-(32 vs 8),and most(31 out of 40) had histological diagnoses of chronic active gastritis.Two of the three participants with a histological diagnosis of atrophy had a type III microvascular pattern.The type I pattern predicted normal mucosa,type IIa–IIb predicted H.pylori infection,and type III predicted atrophy with sensitivities of 90.0%,91.4%,and 66.7%,respectively.The intraobserver and interobserver agreements had kappa values of 0.91 and 0.89,respectively.CONCLUSION High-definition optical magnification with digital chromoendoscopy is useful for diagnosis of normal gastric mucosa and H.pylori-associated gastritis with high accuracy,but further studies are needed to determine whether endoscopic diagnosis of gastric atrophy is feasible.     

Stat3显性负性基因调控人结肠癌细胞增殖与凋亡的分子机制

目的 探讨转染Stat3（转录信号传导子和激活子3）显性负性基因Stat3β质粒阻断人结肠癌细胞系SW480细胞的Stat3信号传导通路对人结肠癌细胞增殖和凋亡的影响及可能的机制.方法 应用阳离子脂质体向人结肠癌细胞系SW480细胞中转染携带Stat3β基因的质粒,四唑盐法检测细胞增殖能力,流式细胞术检测细胞周期和细胞凋亡,反转录聚合酶链反应检测Stat3靶基因cyclinD1、bcl-xL mRNA表达情况.数据统计分析采用独立样本t检验.结果 转染Stat3β质粒36 h后,SW480细胞的增殖受到显著抑制（t=5.216,P=0.006）;G0/G1期的细胞比例由40.37%上升至67.25%,S期细胞由44.68%下降至31.23%;发生早期凋亡的细胞比例由5.34%上升至24.42%;同时cyclin D1、bcl-xLmRNA表达水平较对照组显著下降（t=5.228,P=0.010;t=3.517,P=0.025）.结论 转染携带Stat3β基因的质粒可以通过下调Stat3靶基因的表达抑制人结肠癌细胞的增殖,促进凋亡,为以Stat3为靶点的结肠癌基因治疗提供了实验基础.     

Basic fibroblast growth factor and epidermal growth factor reverse impaired ulcer healing of the rabbit oral mucosa

BACKGROUND: The therapies for refractory ulcers on the oral mucosa are symptomatic and very unsatisfactory. We hypothesized that application of growth factors might be able to achieve successful remission of the lesion. We evaluated the effects of systemic administration and topical application of epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) on impaired wound healing of ulcers in the rabbit gingiva. METHODS: Almost uniform round ulcers could be created on the gingiva of the rabbits by chemical injury with acetic acid. When the submandibular glands were removed or i.v. injection of cisplatin (CDDP) and peplomycin sulfate was performed before ulcer formation, healing of the ulcers took longer than in untreated rabbits. To ascertain whether or not human EGF and bFGF affect rabbit cells, we first examined the effects of EGF and bFGF on the proliferation of the cells derived from rabbit gingiva. We then applied EGF or bFGF in these impaired healing models. RESULTS: EGF and bFGF promoted proliferation of the fibroblasts, and EGF also promoted proliferation of the keratinocytes isolated from gingival tissue of rabbits in vitro. Systemic injections of EGF and bFGF in rabbits, which had their submandibular glands removed, and topical application of bFGF accelerated healing of ulcers created in rabbits injected with CDDP and peplomycin sulfate. The ability of bFGF to promote the healing of ulcers was much greater than that of EGF. CONCLUSION: Basic FGF may be effective for refractory oral mucosal lesions.     

电针对狗血浆与胃黏膜组织中NO和NOS的影响及其意义

目的　观察电针对狗幽门压力、胃黏膜血流量的调控作用及其与血浆、胃黏膜组织中一氧化氮 (NO) ,一氧化氮合酶 (NOS)水平变化的关系 ,以探讨电针对胃黏膜保护作用的机制。方法　将 2 0只狗随机分为 4组 :空白对照组、非经非穴组、上巨虚组、足三里组 (每组 5只 )。采用胃压测量仪、激光多普勒血流仪监测幽门压力、频率及胃黏膜血流量的变化 ,同步测定血浆及胃黏膜组织中NO ,NOS含量 ,并观察变化规律。结果　电针后足三里组幽门括约肌总压力、基础压下降、频率下降 (P <0 .0 5 ) ,胃黏膜血流量显著升高 (4 .5 1± 0 .73→ 6.90± 1.0 1,P <0 .0 1) ,血浆及胃黏膜组织中NO ,NOS含量显著升高 (P <0 .0 5 ) ,上巨虚组仅幽门括约肌总压力下降 ,血浆NO含量上升。但足三里组各项监测指标变化趋势更明显 ,其他组变化无显著性。结论　电针可使狗幽门压力、频率下降 ,使胃黏膜血流量增加 ,与影响幽门压力、胃黏膜血流量的某些活性物质的含量改变有关 ,并具有一定的经络和穴位特异性。     

Angiodysplasia as the cause of massive lower gastrointestinal hemorrhage in a young adult

PURPOSE: This study was undertaken to clarify the importance of bleeding vascular ectasia of the colon as the etiology of massive lower gastrointestinal hemorrhage in patients 40 years of age or younger. METHODS: An otherwise healthy 21-year-old male was admitted to a tertiary medical center with massive lower gastrointestinal hemorrhage. Technetium-labeled red blood cell scan, selective visceral angiography, and colonoscopy identified the source of bleeding as vascular abnormality of the descending colon. Segmental colonic resection was performed. RESULTS: Histologic review of the specimen demonstrated a vascular ectasia. The patient recovered uneventfully and has had no further stigmata of hemorrhage. A review of the literature was undertaken to make clear the significance of vascular ectasia as the source for massive colonic hemorrhage in the young adult. CONCLUSION: This is the first report that documents histologically a vascular ectasia as the source of massive lower gastrointestinal hemorrhage in an otherwise healthy patient less than 40 years of age. Vascular ectasia is an uncommon cause of lower gastrointestinal hemorrhage in the young adult.The Chief, Bureau of Medicine and Surgery, Navy Department, Washington, DC, Clinical Investigation Program sponsored this report #84-16-1968-532, as required by HSETCINST 6000.41A. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.     

460例胃癌纤维胃镜活检标本的病理观察

本文分析了460例胃癌胃粘膜活检资料,结果:男:女为2.36:1:51～60岁年龄组发病率最岛(37.17％);发生部位以胃窦部最多见,占46.74％;组织学分类以低分化腺癌最多,占51 52％;在伴随病变中,畅化生的检出率为21.74％,胃腺囊为35％,胃粘膜上皮异型增生为32.61％。本组材料提示,不完全性大肠型肠化生、异型胃腺囊及胃粘膜中度以上异型增生与胃癌有密切关系。