康脑灵胶囊对血管性痴呆模型大鼠体内自由基代谢影响的研究

血管性痴呆（VD）是我国也是世界上老年性痴呆的主要类型之一，其病理机制和治疗方法是目前国际研究探讨的热点。血管性痴呆系大脑皮层获得性高级神经系统机能的全面损害，是以健忘、呆笨为主要临床表现的一种脑机能衰退性疾病。在国际流行病学调查中，老年发病率为40％-48％，我国老年人口的增长速度甚快，血管性痴呆年发病率亦在逐步上升。     

步长脑心通治疗糖尿病周围神经病变临床观察

糖尿病周围神经病变是糖尿病常见的慢性并发症之一，对患者的危害很大，且临床缺乏确切有效的治疗方法，近年来随着神经电生理学检查等新技术在临床的开展应用，其发病率有增加的趋势。为了探寻有效的治疗途径，笔者于2005年2月至2006年10月运用步长脑心通胶囊治疗糖尿病周围神经病变患者40例，对比观察治疗后的临床症状及神经传导速度变化，现总结如下。     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.     

181例胃肠间质瘤的临床病理及预后分析

目的探讨胃肠间质瘤（GIST）的临床诊治经验,分析其病理特征和影响GIST预后的因素,方法回顾性分析1999年1月至2007年12月间经手术治疗的181例GIST患者的临床病理及随访资料,根据FJetcher推荐的生物学行为分级法进行分组,比较不同因素对生存率的影响并进行预后分析。结果本组GIST病变部位：胃107例（59．1％）,小肠51例（28．2％）,结直肠等其他部位23例（12．7％）;伴有肝转移7例。172例（95．0％）术前通过影像学检查明确病灶部位,其中胃镜53．5％（92／172）,CT 34,3％（59／172）,超声内镜或胶囊内镜17．4％（30／172）。瘤体长径0．5～30．0cm不等,平均7．0cm。CD117阳性171例（94．5％）,CD34阳性156例（86．2％）。外科手术完全切除176例,其中合并联合脏器切除26例;姑息性切除或活检术5例。全组患者1、3、5年生存率分别为95．2％、87．9％和78．5％。单因素分析显示,年龄、肿瘤大小、肿瘤原发部位、核分裂像数目、FIetcher分级和是否合并联合脏器切除对生存率有影响（P〈0．05）;多因素分析显示,Fletcher分级和肿瘤大小是影响预后的因素。术后有8例高危患者和3例复发转移患者服用伊马替尼后病情稳定。结论内镜和CT是GIST有效的诊断手段,用FIetcher分级法来判断GIST的生物学行为和预测预后是简单、有效的方法,外科手术仍是目前GIST的主要治疗方法,而结合靶向治疗将成为改善GIST预后的重要手段。     

全身皮神经标本的制作

皮神经广泛分布于全身各处的浅筋膜和皮肤，数量繁多。全面地显示全身的皮神经，不论对教学、科研还是临床应用都具有重要意义。我们经过长期实践，多次改进操作方法，制作出的皮神经标本内容齐全，整洁美观，现将方法简介如下，以供同仁参考。     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.     

Notch1和NUMB在胃癌组织中的表达水平及其意义

目的 研究Notchl和NUMB在胃癌组织中的表达情况及其与胃癌临床病理特征的关系.方法 采用Real-time PCR和Western blotting检测胃癌肿瘤组织和相应正常组织内Notch1和NUMB的表达.结果 Notchl mRNA在胃癌中的平均表达水平是正常胃组织的1.67倍(P<0.05),且与肿瘤的分...     

达芬奇手术系统辅助腹腔镜胃癌根治术的研究进展

随着微创外科技术的发展,腹腔镜胃癌根治术逐渐成为了安全可行的手术方法。然而,复杂的手术操作、过高的技术要求限制了腹腔镜胃癌根治术的进一步发展。达芬奇手术系统的技术优势有助于解决腹腔镜手术中的这一难题。本文就近年达芬奇手术系统辅助腹腔镜胃癌根治术的研究进展作一综述。     

呃逆辨治简易三步曲探幽

中医药治疗呃逆方法众多,疗效显著,目前主要有针灸疗法、穴位按压、穴位注射、口服中药等治疗。西医治疗呃逆往往是镇静、促进胃肠动力等对症治疗,疗效难以持久。单纯运用中医某一疗法各有其优点,但存在局限性,本文通过综合前人经验并结合个人体会运用三步法来辨治呃逆,简便易行,疗效显著。一般认为对于新发的呃逆,可选用经验穴进行针刺(如内关、翳风、足三里、攒竹穴等),但是针刺对得气的要求比较高,且许多患者畏惧针刺,实施起来依从性较差,而且临床运用往往不方便,而指针攒足穴方法简单,疗效显著,往往一次见效,对于顽固性呃逆需要配合穴位注射、口服中药治疗。运用三步法辨治呃逆,通俗易懂,患者易于接受,无特殊不良反应,值得基层推广。     

食管鳞癌脑转移患者的临床特征和影响因素及其对生存的影响

目的 探讨食管鳞癌脑转移患者的临床特征、影响因素及其对生存的影响。方法 回顾性分析2000年12月—2015年12月我院收治的食管鳞癌脑转移67例患者的临床病理资料，分析食管癌脑转移与临床病理特征及生存率的相关性。结果 食管鳞癌脑转移瘤个数与T分期、N分期呈正相关（P<0.05）。全组患者中位生存期为9.65月；Logistic回归分析显示N2、N3分期是食管鳞癌患者发生脑转移的危险因素，N0、N1期患者出现脑转移的风险更低（P<0.05）。Log rank生存分析显示，脑转移瘤个数为1的食管鳞癌患者的预后优于脑转移瘤个数为2和3的患者（P<0.05）；N0+N1期患者预后好于N2和N3期的患者（P<0.05）；多因素Cox回归模型显示，T3+T4、N3、是否做全脑放疗是影响食管鳞癌脑转移患者的预后独立影响因素（P<0.05）。结论 食管鳞癌脑转移瘤数量与T、N分期呈正相关。N分期越晚，脑转移风险越大。T、N分期越晚，食管鳞癌脑转移患者预后越差。全脑放疗可以获得更大的生存获益。