胆总管一期缝合术（附350例报告）

目的探讨胆总管一期缝合技术及适应证。方法回顾总结采用传统、小切口、腹腔镜三种术式共350例胆总管探查及取石，术中用胆道镜确切判断胆总管内无残余结石，胆管下端乳头开口通畅后一期缝合胆总管。结果13例胆漏，无胆总管损伤、术后出血、残余结石及死亡。328例f93．7％）随访1～19年无一例胆管狭窄及结石复发。结论用胆道镜技术探查胆总管及取石，在选择适应证后胆总管一期缝合术是一安全可靠的术式。     

miR-137与胃癌侵袭能力的关系研究

目的:探讨胃癌组织mi R-137的表达及其与胃癌细胞侵袭能力间的关系。方法:用q RT-PCR检测胃癌组织与癌旁组织mi R-137的表达,分析mi R-13表达与胃癌临床病理特征的关系;分别用q RT-PCR与Transwell侵袭实验检测3种胃癌细胞(AGS、SGC7901、BGC823)及正常胃黏膜细胞(GES1)mi R-137的表达与穿膜。结果:胃癌组织中mi R-137表达量明显低于癌旁组织(P<0.05),mi R-137表达与胃癌患者T分期有关,T分期越高mi R-137表达量越低(P<0.05);各胃癌细胞mi R-137表达量均低于正常胃黏膜细胞,且胃癌细胞侵袭力越强胃癌细胞mi R-137表达量越低(P<0.05);穿膜细胞数与mi R-137表达量之间呈明显负相关(r=-0.8881,P<0.05)。结论:胃癌组织mi R-137表达降低,且mi R-137表达量越低提示胃癌细胞侵袭能力越强。     

我院强化病区药品管理措施

目的：探讨医院病区药品使用和管理的合理化及规范化,保证用药安全。方法：制定病区药品的目录及基数、标识、质量、存放、特殊药品、高危药品、急救车药品等管理项目及实施细则,并检查落实、监督改进。结果：经过1年多的实践验证,病区药品使用和管理规范化水平明显提高。结论：病区药品规范化管理可有效减少药品损耗,提高临床用药质量,保证用药安全。     

Expression and significance of HIF-1α and ET-1 in gastrointestinal stromal tumors

Objective To explore the expression and the value of HIF-1α,and ET-1 in judging the prognosis of gastrointestinal stromal tumors (GISTs). Methods The expression of HIF-1α, and ET-1 protein was examined in 76 GISTs by immunohistochemistry S -P methods. Results There was a positive correlation between the expression of HIF-1 α and ET-1 ( P < 0.05 ). The positive expression rate of HIF-1 α and ET-1 was 73.68% (50/76) ,and 65.79% (50/76) respectively,which was related with histologicial grade, tumor diameter, infiltration and metastasis, nuclear division rating of GISTs ( P < 0.05 ), but had no relationship with patients' age, gender, initial position of the tumor ( P > 0.05 ). There was statistically sig-nificant difference in the expression of HIF-1 α and ET-1 in the following groups:among the three classes of very low-risk and low-risk, middle-risk, high-risk, bewteen the diameter < 2 cm and > 5 cm (P < 0.05). The more malignant degree and larger diameter, the more highly positive expression rate ( P < 0.05 ). The positive expression in the groups with infiltration and metastasis, and nuclear division ≥5/50 HP was sig-nificantly higher than the groups without infiltration and metastasis, and nuclear division < 5/50 HP (P < 0.05). Conclusion The expression of HIF-1α had a significant correlation with ET-1. HIF-1α,and ET-1 expression was closely related with the prognosis of GISTs,and can serve as important predictors for survival.     

人胃肠间质瘤细胞系的建立及其生物学特性

目的：从切除的人小肠间质瘤(gastrointestinal stromal tumors, GIST)组织建立一株间质瘤细胞系,初步鉴定其生物学特性。方法：取人小肠间质瘤组织切成小块,置于含10%胎牛血清、青霉素、链霉素和庆大霉素的RPMI 1640培养基中进行培养,待细胞长满90%汇合面后消化传代培养,并进行形态学、生长动力学、免疫组织化学（免疫组化）及致瘤性等生物学特性研究。结果：成功建立GIST细胞系,命名为GIST-H1 细胞系。该细胞系已在体外培养生存1年,传60余代。免疫组织化学分析显示该细胞CD117（+）,SMA（+）,dog-1（+）,CD34（-）及S-100（-）;该细胞系体外生长的倍增时间为47.5 h;软琼脂集落形成率为24.8%;透射电镜下可观察到该细胞富含线粒体和内质网,多数细胞表面无绒毛,胞核呈卵圆形;染色体核型分析为非整倍体,众数为60~98条;该细胞接种至裸鼠皮下后致瘤性为100%。结论：间质瘤细胞系在体外长期培养后已永生化,形成了可连续传代的细胞系,且具有明显的间质瘤细胞恶性表型特征。     

腹腔镜胆囊切除术中转小切口胆囊切除术临床应用

目的探讨腹腔镜胆囊切除术（LC）中转小切口胆囊切除术（MC）临床应用。方法对2 235例LC中转56例MC作回顾分析,LC改MC主要技术是将原剑突下斜行10 mm戳孔沿肋缘下向右延长至5～6 cm进行直视下小切口操作。结果 56例LC例中转为MC操作后均比较顺利切除胆囊,仅4例急性胆囊炎炎症明显,出血量300～400 mL,全组无严重并发症。结论 LC中转MC后操作容易、安全,而且不失微创的理念,对患者有利。     

大肠癌患者外周血淋巴细胞粘着斑激酶表达的临床意义

目的：探讨大肠癌患者外周血淋巴细胞粘着斑激酶(FAK)的表达及其临床意义。方法 结果 结论 方法：应用流式细胞仪(flow cytometry, FCM)检测40例大肠癌患者及20例正常人外周血淋巴细胞中FAK的表达。结果：大肠癌患者外周血淋巴细胞FAK阳性表达率为60.0%，与正常人(25.0%)比较，差异有显著性意义(P＜0.05)。并且外周血淋巴细胞FAK表达与大肠癌临床分期、组织学分化程度、淋巴转移有关。结论：大肠癌患者外周血淋巴细胞FAK异常表达与荷瘤状况有关，对大肠癌的早期诊断、临床分期、组织学分型、淋巴转移的预测等可能有一定帮助。     

闭孔疝的术前诊断和手术治疗14例临床分析

目的探讨闭孔疝术前诊断和手术方法,为临床诊断和治疗闭孔疝提供参考依旧。方法对我院1985-2005年收治闭孔疝14例闭孔疝的病史,临床表现,影像学检查及手术情况进行回顾性分析。结果早期病例9例均是以发生绞榨性肠梗阻剖腹探查明确诊断,手术采取直接拉拢修补。近期病例5例术前诊断闭孔疝,手术采用B rad补片修补。结论闭孔疝手术中注意闭孔神经压迫症状,特别是Howsh ip-Romberg征对本病有重要意义,腹部CT扫描为标准方法,手术采用补片修补操作简便,安全,可靠。     

Expression and significance of HIF-1α and ET-1 in gastrointestinal stromal tumors

Objective To explore the expression and the value of HIF-1α,and ET-1 in judging the prognosis of gastrointestinal stromal tumors (GISTs). Methods The expression of HIF-1α, and ET-1 protein was examined in 76 GISTs by immunohistochemistry S -P methods. Results There was a positive correlation between the expression of HIF-1 α and ET-1 ( P < 0.05 ). The positive expression rate of HIF-1 α and ET-1 was 73.68% (50/76) ,and 65.79% (50/76) respectively,which was related with histologicial grade, tumor diameter, infiltration and metastasis, nuclear division rating of GISTs ( P < 0.05 ), but had no relationship with patients' age, gender, initial position of the tumor ( P > 0.05 ). There was statistically sig-nificant difference in the expression of HIF-1 α and ET-1 in the following groups:among the three classes of very low-risk and low-risk, middle-risk, high-risk, bewteen the diameter < 2 cm and > 5 cm (P < 0.05). The more malignant degree and larger diameter, the more highly positive expression rate ( P < 0.05 ). The positive expression in the groups with infiltration and metastasis, and nuclear division ≥5/50 HP was sig-nificantly higher than the groups without infiltration and metastasis, and nuclear division < 5/50 HP (P < 0.05). Conclusion The expression of HIF-1α had a significant correlation with ET-1. HIF-1α,and ET-1 expression was closely related with the prognosis of GISTs,and can serve as important predictors for survival.     

内镜微创保胆取石术临床分析

目的 探讨内镜微创保胆取石术的技术及意义.方法 1997年6月～2007年10月经右上腹肋缘下做3～4cm斜形切口,术中纤维胆管镜取石,一期缝合胆囊手术126例.结果 126例术后恢复均顺利,无1例并发症发生.随访117例(92.9%),时间1～10年,31例(26.5%)胆囊复发结石.结论 内镜微创保胆取石技术安全可行,保留胆囊有积极意义,但远期结石复发率高是不能回避的问题.