核因子kB在大鼠胃缺血再灌注损伤中的表达及意义

目的研究核因子kB（NF-kB）在大鼠胃缺血再灌注损伤中的表达及意义。方法采用大鼠胃缺血再灌注（gustric ischemia/reperfusion, CI／R）模型（夹闭腹腔动脉30min后再灌注），分别于再灌注0．5、1、3、24h取胃，计算胃黏膜损伤指数。应用免疫组化、Western blot方法检测胃黏膜NF-kB p65。结果大鼠GUR后引起胃黏膜损伤，再灌注1h时损伤最明显，随后降低，24h接近正常。GI／R后胃黏膜NF—kB阳性细胞数和蛋白表达量增多，与胃黏膜损伤变化规律一致。结论NF-kB在大鼠CI／R损伤过程中发挥着重要作用。     

40例胃占位病变的X线及超声诊断

分析了经病理证实的４０例胃占位病变的Ｘ线及超声资料，旨在探讨超声及其与Ｘ线结合在胃占位病变中的价值。结果提示，超声和Ｘ线各有优缺点，二者结合使用，可互相取长补短，对提高胃占位病变的诊断质量，帮助临床制定合理的治疗方案有肯定价值。     

胃癌的危险因素调查及癌前病变动态观察

报道温州地区胃癌高发区瑞安塘下的致癌危险因素的调查情况,结果表明它是由多种致癌危险因素的综合影响。作者应用内镜活检在18000例慢性胃病患者中查出癌前病变(高危人群)1132例,经3月～14年活检随访,表明胃癌前病变有一定的可逆转性;癌变率较高的是胃溃疡(GU)+不典型增生(ATP)组、GU+慢性萎缩性胃炎(CAG)组及CAG+ATP组均为4.1％;总癌变率为3.1％。早癌检出率占胃癌总数的48.6％,为门诊早癌检出率的6.8倍。此方法简单、经济实用。     

高位食管癌切除颈部胃食管重建术的临床应用和初步评价

本文报道了我院自1988年至1994年间采用高位食管癌切除颈部胃食管重建术治疗高位食管癌23例的结果，其中男14例，女9例，年龄35－70岁，平均年龄52岁，病变位于颈段者11例，上胸段者12例。2，3，5年生存率分别为62．5％，55．1％，33．3％。同时介绍了手术要点和该术式的优点，并提出了吻合口瘘的预防措施。     

CARNEY'S TRIAD

A 26 year old female presented with partial expression of Carney's triad. This is the first Australian report of the condition. The role of surgery and the need for vigilance to detect the occurrence of the complete triad are stressed.     

Effect of meal volume on gastric emptying

Abstract While the volume of a liquid meal has been identified as the principal accelerator of gastric emptying of liquids, the relationship between meal volume and gastric emptying of solids has been controversial. With solid foods, the need to reduce solid foods into small particles (trituration) before passage might obscure the effect of meal volume on solid propulsion. To distinguish trituration from driving force as the rate-limiting factor for emptying, 75 (1.6 mm) nylon spheres were fed along with different amounts of steak meals (150, 300 and 600 g), or alternatively, 50, 100 or 200 (1.6 mm) nylon spheres were fed to six dogs with 300 g steak meals. To examine the effect of meal volume on gastric emptying, we studied the effect of different meal volumes on the speed of gastric emptying of liquids (150, 300, 600 and 1200 ml of phosphate buffer) and solids (150, 300 and 600 g of cooked beef steak) in five dogs with duodenal fistulas. Intestinal inhibition was eliminated by diverting all chyme through the fistulas. In the absence of intestinal feedback, we found that gastric emptying of steak and spheres were different in that steak emptying was independent of meal volume (g min^-1 was constant across 150–600 g) while sphere emptying was affected by the number of spheres in the stomach and that liquid emptying was dependent on the meal volume (ml min^-1 increased across 150–1200 ml). Thus, meal volume accelerated gastric emptying provided the process is not rate-limited by trituration.     

胃癌患者胃液中5-羟色胺含量的检测及临床意义

本文应用高效液相色谱与荧光分光光度计联机法检测55例胃液内5-羟色胺的含量,共分为正常、溃疡病、萎缩性胃炎、胃癌等4个组。其结果正常组含量为48.70±49.3ng/ml,溃疡病组含量为76.26±127.06ng/ml,慢性萎缩性胃炎组含量为197.29±128.4ng/ml,胃癌组含量为191.80±124.2ng/ml。4组之间进行对比分析,正常组和溃疡病组之间差异不明显(P>0.05),而萎缩性胃炎和胃癌两组与前两组之间差异均显著(P<0.01),但萎缩性胃炎和胃癌之间未见差异(P>0.05)。这充分证明5-羟色胺(5-HT)在萎缩性胃炎和胃癌的胃液中含量是很高的。对于胃癌和慢性萎缩性胃炎的诊断及与其它慢性胃病的鉴别诊断中可能起到很重要的作用。     

增殖细胞核抗原(PCNA)与胃癌预后关系的免疫组化研究

应用ＳＬＡＢ免疫酶标法在石蜡切片上半定量分析增殖细胞核抗原（ＰＣＮＡ）的表达与７３例胃癌患者预后的关系，探讨其临床应用价值。结果表明，以ＰＣＮＡ阳性细胞５０％为界线，阳性率＞５０％者术后生存期较短，５年生存率较低，而淋巴结转移率则较高。提示ＰＣＮＡ检测可作为胃癌预后判断的良好指征。     

Curative resection of gastric cancer: Limitation of peritoneal lavage cytology in predicting the outcome

Patients with stage T3N0～2M0 gastric carcinoma (n = 108) were studied for relevant prognostic factors. Peritoneal lavage cytology (PLC) was performed in all. In univariate analysis, 5-year survival rates were better with smaller serosal invasion (diameter <3.0 cm vs. ≥3.0 cm, 61% vs. 37%, P < 0.05) and fewer metastatic nodes (≤5 vs. ≥6, 57% vs. 29%, P < 0.05). In multivariate analyses, only these two factors were significant. The predictive value of PLC was not shown in both univariate and multivariate analyses. Peritoneal recurrence occured in 14 (22%) of 77 patients with negative PLC, and in 3 (18%) of 17 with positive PLC, the difference being not significant. Our results indicate that PLC is insensitive in predicting the development of peritoneal recurrence. Its role in the estimation of survival is limited, as many will die of visceral or locoregional recurrence if not of peritoneal dissemination.     

胃癌高系家族成员胃蛋白酶原C基因多态性及其诊断意义的探讨

采用限制性酶切片段长度多态性分析法，检测在胃癌高发区庄河检出的１９例胃癌高系家族成员胃蛋白酶原Ｃ基因多态性，发现三种常见片段及一种稀有片段。对其中４例携带稀有片段的受检者进行了胃镜追踪观察，２．５年后发现１例早期胃癌。本文对此作了初步探讨。