hMLH1、hMSH2、c-Myc、PTEN在残胃癌中的表达和意义

目的:比较正常胃黏膜、残胃炎、胃癌、残胃癌中hMLH1、hMSH2、c-Myc及PTEN蛋白表达情况,探讨上述蛋白在残胃癌发生、发展中的作用。方法:用免疫组化SP法检测hMLH1、hMSH2、c-Myc、PTEN蛋白在20例正常胃黏膜、20例残胃炎、38例胃癌、18例残胃癌组织中hMLH1、hMSH2、c-Myc、PTEN蛋白的表达情况。结果:在残胃癌中hMLH1、hMSH2蛋白的阳性率分别为50.0%,44.4%,分别低于正常胃黏膜组织100.0%,100.0%(P<0.01)。胃癌中hMLH1、hMSH2的表达阳性率为68.4%,63.2%,与残胃癌相比无显著差异(P>0.05)。c-Myc蛋白在残胃炎黏膜组织的表达阳性率(45.0%)要高于正常胃黏膜(0.0%)(P<0.05),而残胃癌中的表达阳性率(61.1%)与胃癌中的表达(55.3%)差异无显著性(P>0.05)。PTEN蛋白在残胃癌(44.4%)和胃癌(47.4%)中的表达均下调,两组之间差异无统计学意义(P>0.05)。结论:残胃癌的发生可能与错配修复系统失活有关,癌基因c-myc激活和抑癌基因PTEN的失活也参与了残胃癌的发生、发展。     

45例残胃癌诊治的临床分析

目的:探讨残胃癌的临床病理特征,诊治方法及预后相关因素.方法:分析我院近20年来收治的45例残胃癌的临床病理资料.结果:残胃癌位于吻合口28例,贲门9例,其它部位8例;组织学类型:未分化腺癌1例;低分化腺癌36例;中分化腺癌7例;高分化腺癌1例.根治性切除组1、3、5年生存率分别为100%、78.8%、47.2%;非根治性切除组非治愈性切除患者的1、3、5年生存率分别为62.5%、25.0%和0.未切除的10例患者,均于2年内死亡,平均生存时间为12个月.各期病例5年生存率分别为Ⅰ期100.0%、Ⅱ期75.0%、Ⅲ期17.8%、Ⅳ期0.结论:残胃癌多发生于BillrothⅡ式胃大部切除术后10年以上.残胃癌的预后与病理分期和能否行根治性切除密切相关.     

残胃癌的外科治疗

目的总结和分析残胃癌的外科诊治特点。方法回顾分析我院1991年1月至2005年6月行外科治疗的55例残胃癌患者资料。结果手术切除率为83．64％,根治性切除率为58．18％。行根治性切除患者的3年生存率为40．62％,5年生存率为21．88％。结论根治性外科治疗及病期是决定残胃癌患者预后的关键。     

残胃再发贲门癌的再手术治疗

目的　本文旨在研究残胃再发贲门癌的再手术治疗。本组１４ 例病例均符合（１）第一次因胃癌行下半胃切除;（２）第二次手术证实原吻合口无复发灶。方法　术前根据Ｘ光钡餐检查,Ｂ超、ＣＴ和纤维胃镜对病灶切除率和切除范围进行术前评估,以减少开胸探查率;估计须作全胃切除或首次行毕氏Ⅱ式者以胸腹联合切口为好,其余可作左胸切口;消化道重建的原则是尽量切除瘤体,尽量减少创伤。结果　本组病灶切除率８３％ ,未发生严重并发症及院内死亡。切除者一年生存率为７７％ ,２年为４４％ ,３年为１１％ 。结论　对残胃再发贲门癌只要病人一般情况允许,术前评估正确,仍应积极手术,关键于在早期诊断和早期手术。     

城市残存鼠生态特征——Ⅱ.城市残存鼠种群生态位的研究

本文用物种生态位宽度及每一对物种之间的生态位重叠值,分析城市中不同建筑物住宅以及住宅、工厂企业、宾馆等不同环境点的残存鼠,在空间与时间资源上的利用和分摊方式。结果观察到:不同住宅建筑物残存鼠的空间生态位宽度较大,重叠值亦较高;而在住宅及宾馆等不同环境点的残存鼠空间生态位宽度及重叠值均较低。据18个月调查,残存鼠时间生态位宽度均较大;而住宅及工厂企业等不同环境点的鼠类时间生态位重叠值均较低。由于残存鼠在不同生态位维度上对资源的分摊与利用存在着差异,从而使三种鼠(小家鼠、黄胸鼠和褐家鼠)在城市生态系统中,形成了一定的共存局面。     

Ornithine Decarboxylase Activity of the Mucosa of the Gastric Remnant Using Endoscopic Biopsy Specimen,Comparison Between B-I and B-II.

Abstract: In this study, the stomal portion of the gastric remnant mucosa following a gastrectomy for gastric cancer was examined endoscopically and histopathologically. The ODC activity was assayed from biopsies from the stomal portion of the gastric remnant and from the greater curvature. The results obtained can be summarized as follows: 1. Endoscopic changes in the stomal mucosa (redness) were found significantly more often in patients following a B-II than in patients who had had a B-I. Histopathological changes consisting of glandular dilatation and an irregular glandular structure were detected in many of the stomal mucosal specimens. 2. The ODC activity was significantly higher in the stomal portion of the remnant stomach tlian in the greater curvature. As for the stomal portion, ODC activity was significantly higher following a B-II titan following a B-I. In summary, the present findings suggest that active cell proliferation occurs in the gastric remnant mucosa, particularly in the region of anastomosis, and that an enhancement of cell proliferation kinetics plays a role in the pathogenesis of primary cancer in the stomal portion of the remnant stomach.     

A Retrospective Study on the Influence of Apolipoprotein E and Serum Lipids in Progressive Renal Failure

Background: Progression of renal failure is associated with altered lipoprotein metabolism. Apolipoprotein E polymorphism is an important genetic marker for dyslipidemia. The main purpose of this retrospective study was to examine the influence of apolipoprotein E polymorphism and serum lipids level on the progression rate in a group of patients with kidney diseases of diverse etiology. Methods: Progression rate, with regard to apolipoprotein E polymorphism and initial serum creatinine value, median (162 μmol/l), was determined by reviewing the charts of 385 patients on renal replacement therapy with a median follow-up time of 4.85 years. Results: Progression rate was negatively correlated to serum cholesterol in the group with type 2 diabetes (p= 0.001). In addition, the urine albumin excretion rate (UAER) was higher in type 2 diabetics carrying the ɛ2 allele (2.1 g/l) as compared to non-ɛ2 allele carriers (1.2 g/l) (p=0.009). Although serum cholesterol in patients with autosomal dominant polycystic kidney disease (ADPKD) carrying the apolipoprotein ɛ4 allele was 5.87 ± 1.0 mmol/l, which was significantly higher compared to non-ɛ4 carriers, 4.97 ± 1.1 mmol/l (p=0.026), progression rate was similar in the two groups, 4.4 ± 0.8 μmol/l/year. An increase in the relative frequency of the apolipoprotein ɛ4 allele was found in patients with ADPKD (0.29), as compared to (0.16) in the rest of the diagnostic groups (p=0.0023). In addition, in the whole study population a positive correlation was found between progression rate and underlying disease (p < 0.005), UAER (p < 0.005) and blood pressure (p < 0.005). Conclusions: The results of the present study indicate that the decline of renal function in patients with diabetes type 2 may not be associated with levels of plasma cholesterol, but with triglyceride lipoproteins, considered remnant lipoproteins. Any association between cholesterol and apolipoprotein ɛ4 allele with progression in ADPKD may not necessarily be straightforward since this disease is influenced by other genetic and unidentified factors.     

A repeated pancreatectomy in the remnant pancreas 22 months after pylorus-preserving pancreatoduodenectomy for pancreatic adenocarcinoma

We report a case of a repeated curative pancreatic resection in the remnant distal pancreas 22 months after pylorus-preserving pancreatoduodenectomy (PpPD). The patient was a 52-year-old woman with a past history of PpPD for adenocarcinoma of the head of the pancreas 22 months prior to the present operation. The original tumor was histopathologically diagnosed as a papillary adenocarcinoma with clear surgical margin at the surgical cut end of the pancreas (R0, International Union Against Cancer [UICC] classification). Twenty months after the PpPD, a follow-up computed tomography (CT) scan showed multiple low-density lesions in the body and tail of the pancreas without any other distant metastasis. A second operation, curative resection of the remnant pancreas, with splenectomy and distal gastrectomy, was performed. The second tumor was a papillary adenocarcinoma, the same diagnosis as that of the first tumor, and it also showed similar histopathological findings, including immunohistochemical staining of Ki-67 and p53 protein, and the same pattern of K-ras point mutation. The patient is considered to have shown a rare, unique pancreatic cancer with metachronous carcinogenesis in the remnant pancreas.