Gastritis cystica polyposa: report of 7 cases and literature review

Gastritis cystica polyposa (GCP) is a rare inflammatory disease of the gastric remnant that usually develops after partial gastrectomy. It is defined by the presence of polyps on anastomotic gastric mucosa and at histopathological examination, by the presence of mucosal and submucosal cysts with foveolar hyperplasia. The disease is characterized by the frequency of gastro-intestinal bleeding and possibility of carcinomatous association. We report seven cases of GCP collected over 5 years (1994-1999). Diagnosis was made 9 to 45 years after partial gastrectomy and Finsterer. The patients were 52 to 72 years old. Revealing symptoms were cardiac failure, cardiac ischemia, melena, severe anemia and epigastric pain. For one patient, GCP was discovered casually. Endoscopic examination showed in all patients; the presence of several polyps sized between 3 to 15 mm on the perianastomotic gastric remnant. Histology examination of the polyps showed microscopic features of GCP in all cases. In one patient, there was a mild glandular atrophy with extensive intestinal metaplasia and mild dysplasia. Helicobacter pylori was present only in this case.     

Morphologic and clinical aspects of chronic gastric erosions

Chronic erosions of the stomach are mostly papular lesions of the gastric mucosa with large base, 0.5-1 cm in diameter, often with superficial central depression covered with fibrin, less frequently without it. The typical site of lesion is the antrum the chronic erosions are here manifold, solitary forms are infrequent. In the course of 5694 gastroduodenoscopies the authors observed in 198 patients (5.2%) typical endoscopic picture of chronic erosions. In biopsy samples volcano-type lesions of the mucous membrane characteristic of the disease were found. According to the results the chronic erosions of the stomach are lesions of aspecific symptomatology, the disturbance of the mucosal barrier cannot be made probable. It is important to know the morphological characteristics of the rather frequent independent entity also for separating it from adenomas. Malignant transformation was not found in the material of the authors.     

Experimental gastric cancer induced by N-methyl-N'-nitro-N-nitrosoguanidine in rats

MNNG-induced experimental gastric cancer developed in the pyloric glandular region. Many of the tumors produced were well or moderately differentiated adenocarcinomas of elevated type. According to the degree of depth invasion, a majority of the tumors were classified as early-stage lesions invading within submucosal layer. There were two poorly differentiated lesions, which were both recognized as serosal neoplastic involvements. The tumors were positively stained by toluidine blue (pH 4.1) to indicate the presence of stroma. The Brdu-LI determined for gastric mucosal epithelial cells was significantly higher in the MNNG-treated group than in the untreated control group. However, the LI for cancer tissue in the MNNG-treated group did not significantly differ from that for gastric mucosa in the same group.     

钛夹联合内镜下黏膜切除术治疗重度胃黏膜脱垂症的临床观察

目的：观察钛夹联合内镜下黏膜切除术对重度胃黏膜脱垂症的治疗效果及安全性。方法：对53例经胃镜确诊的重度胃黏膜脱垂症患者采用钛夹联合内镜下黏膜切除术治疗,并分别于术后4周、8周行临床症状随访和胃镜复查。结果：53例患者治疗成功率100％,4周有效率98．1％,8周有效率100％,无出血、穿孔等并发症发生。结论：钛夹联合内镜下黏膜切除术治疗重度胃黏膜脱垂症疗效确切,安全性高,是目前比较先进的微创治疗方法之一。     

Helicobacter pylori-associated chronic atrophic gastritis involving the gastric body and severe disease by Vibrio cholerae

Evidence has associated chronic infection by Helicobacter pylori with chronic gastritis, low gastric acid production and an increased risk of life-threatening cholera. However, the relationship of specific patterns of histological damage in the gastric mucosa associated with H. pylori infection and the occurrence of cholera has not been described. The purpose of this study was to compare the gastric pH and histopathological findings in gastric biopsies taken from patients with severe diarrhoeal disease due to Vibrio cholerae with those taken from a control (cholera-negative) population. Thirty-five H. pylori-positive patients who had severe dehydration from culture-confirmed cholera (cases) and 40 patients with H. pylori but with no history of cholera (controls) were recruited. Gastric pH was measured and multiple biopsies were taken from the gastric antrum and body for histopathological examination. The results revealed that patients with severe cholera had a significantly higher prevalence of hypochlorhydria at endoscopy compared with controls. Furthermore, cases had significantly more chronic atrophic gastritis (45.7% vs. 12.5%; P=0.002) and intestinal metaplasia (37.1% vs. 2.5%; P<0.01) in the gastric body than controls. Our findings suggest that the nature and location of these gastric lesions may predispose a subset of H. pylori-infected individuals to severe disease by V. cholerae.     

PTEN基因在胃癌组织中的表达及临床意义

目的研究正常胃粘膜、慢性萎缩性胃炎（伴肠化）、胃癌组织中抑癌基因PTEN的ⅢRNA和蛋白的表达情况,探讨其在在胃癌发生、发展中的作用及临床意义。方法（1）收集2011年11月--2012年11月期间内蒙古医学院第三附属医院病理和内窥镜结合确诊的正常胃组织30例、慢性萎缩性胃炎（伴肠化）30例．手术切除的45例胃癌标本并经病理确诊。（2）所有患者术前均未接受放、化疗和其他针对性抗肿瘤治疗,无其它肿瘤病史。（3）通过实时荧光定量PCR及Western印迹技术检测PTENmRNA及其蛋白在胃粘膜不同组织中的相对表达,所有数据采用SPSSl3．0统计软件包进行处理,统计学方法采用单因素方差分析及t检验,以P〈O．05为差异有统计学意义。结果（1）PTENmRNA在正常胃粘膜、慢性萎缩性胃炎（伴肠化）、胃癌中表达量分别为（1．902±0．981、1．158±0．241、0．740±0．221）,三组相比差异有统计学意义（F=3．292,P=O．041）。胃癌组织中PTENmRNA表达量分别与正常胃粘膜组织、慢性萎缩性胃炎（伴肠化）组相比,差别均有统计学意义（t=4．451,P=O．001;t=3．007,P=O．041）;（2）PTEN蛋白在正常胃粘膜、慢性萎缩性胃炎（伴肠化）、胃癌中表达量分别为（2．001i0．67I、1．141±0．326、0．599±0．220）,三组相比差异有统计学意义（F=4．122,P=O．030）。胃癌组织中PTEN蛋白的表达量与正常胃粘膜、慢性萎缩性胃炎（伴肠化）组相比,差别均有统计学意义（t=4．301,P=O．001;t=3．123,p-0．040）。结论PTEN基因在胃癌组织中表达降低和缺失与胃癌的发生密切相关,提示PTEN基因的表达可能为临床早期诊断胃癌提供新的指标。     

The "watermelon" stomach as a rare cause of upper gastrointestinal bleeding]

The watermelon stomach is a rare subtype of the gastric vascular malformations of unknown origin. It can usually be observed with autoimmune diseases, but in can be associated with other conditions. It is significant, since it can cause chronic iron-deficiency anaemia or sometimes serious acute blood loss. The typical endoscopic picture is linear red streaking of the antrum with convergence at the pylorus with visible tortuous small vessels. Histological examination is frequently not diagnostic. It demonstrates specific features including dilated mucosal capillaries with focal thrombi, dilated submucosal venous plexus and fibromuscular hyperplasia of the lamina propria. Therapy mostly is endoscopic, but some medical possibilities are also known. In their paper they report two cases of watermelon stomach, the lesions were successfully treated with oestrogen-progesterone compounds.     

胃癌及胃癌前疾病患者血清及组织癌胚抗原检测的意义

目的 检测胃癌、胃癌前疾病患者血清与胃组织癌胚抗原(CEA),为胃癌及胃癌前疾病的诊断、监测提供参考指标.方法 采用放射免疫法测定胃癌(111例)、胃癌前疾病(167例,其中慢性萎缩性胃炎104例,胃溃疡31例,胃黏膜肠上皮化生32例)患者血清CEA,免疫组化SP法测定胃组织CEA,并与浅表性胃炎(31例)对照.结果 胃癌组织中CEA阳性率(89.2%,99/111)明显高于胃癌前疾病[慢性萎缩性胃炎52.9%(55/104),胃黏膜肠上皮化生53.1%(17,32),胃溃疡48.4%(15/31)]及浅表性胃炎组织(19.4%,6/31),P＜0.01;胃癌与胃癌前疾病及浅表性胃炎的血清CEA阳性率比较差异有统计学意义(分别为19.8%、1.9%、0),P＜0.01;胃癌前疾病与浅表性胃炎的血清CEA阳性率比较差异无统计学意义,P＞0.05.结论 胃组织中CEA阳性有助于胃癌的诊断.并可作为监测胃癌前疾病的指标之一;血清CEA水平对胃癌有一定的诊断价值,对胃癌前疾病的诊断价值不大.     

Cell proliferation in ventromedial hypothalamic lesioned rats inhibits acute gastric mucosal lesions

AimThe role of mucosal layer thickness on prevention of acute gastric mucosal lesions (AGMLs) was examined in ventromedial hypothalamic (VMH)-lesioned rats.Materials and methodsThe incidence of AGMLs after 48-h fasting and 60% ethanol injection into the stomach after 24-h fasting, aggressive factors (gastric acid and serum gastrin) and defensive factors [hexosamine, gastric mucosal blood flow (GMBF), serum thiobarbituric acid reacting substances (TBARS), and thickness of the gastric mucosal layer] were evaluated in VMH-lesioned rats. The effects of cell proliferation on the gastric mucosal layer of these rats were evaluated by H–E staining and immunostaining with proliferating cell nuclear antigen (PCNA).ResultsAfter 48-h fasting, no AGMLs were observed in VMH-lesioned and sham VMH-lesioned rats (controls). With 60% ethanol administration after 24-h fasting, the numbers of AGMLs were similar in the two groups, but the ulcer index, a marker of ulcer formation, was lower in VMH-lesioned rats compared to that in sham VMH-lesioned rats. VMH-lesioned rats showed increased gastric acid secretion and serum gastrin compared to sham VMH-lesioned rats, indicating an increase in aggressive factors in VMH-lesioned rats. The two groups had similar levels of gastric mucosal hexosamine, GMBF, and gastric mucosal TBARS, but VMH-lesioned rats had an increased thickness of the mucosal cell layer, indicating an increase in defensive factors in these rats. Histologically, VMH-lesioned rats had an increased total mucosal cell layer, especially for the surface epithelial cell layer, and an increased PCNA-labeling index, a marker of cell proliferation, especially in the proliferative zones of gastric mucosa, indicating increased cell proliferation in the proliferative zone of the gastric mucosa.ConclusionVMH-lesioned rats are resistant to AGML formation due to increased cell proliferation in gastric mucosa through elevating the levels of defensive factors over those of aggressive factors.     

超声内镜指导下黏膜下挖除术治疗胃固有肌层间质瘤

目的 观察超声内镜指导下黏膜下挖除术治疗胃固有肌层间质瘤的疗效及安全性.方法 经超声内镜初步诊断为来源于胃固有肌层的间质瘤19例,超声内镜明确病变来源、回声、大小、血供等情况后行黏膜下挖除治疗,观察其疗效及并发症.结果 18例病变完整挖除,1例挖除失败.术中出现穿孔2例,经钛夹封闭创面治愈.术中有少量出血,经热活检钳钳夹或氩气凝固止血,出血停止.无迟发性出血.结论 黏膜下挖除术治疗胃固有肌层间质瘤安全有效,术前行超声内镜检查进行严格评估具有重要价值.     

接尘煤工慢阻肺临床及支气管黏膜病理研究

目的：探讨影响接尘煤矿工人慢性阻塞性肺疾病临床疗效的因素。方法：选取2010年1月-2013年4月本院呼吸内科住院的93例慢阻肺患者及煤工尘肺患者作为研究对象,将其随机分为接尘煤工慢阻肺组35例、非煤工慢阻肺组30例及煤工尘肺组28例。所有患者填写慢阻肺患者自我评估测试问卷（CAT）评估病情,患者支气管镜检查知情同意书签字后,进行支气管镜检查及活检,通过对各组患者支气管镜下的大体观察及活检组织学改变对比研究;对前两组慢阻肺患者使用相同治疗方案,观察其临床疗效。结果：使用相同治疗方案发现,接尘煤矿慢阻性组的CAT和FEV1均明显低于非煤工慢阻肺组,差异均有统计学意义（P〈0.05）。接尘煤矿慢阻肺组的大气道黏膜改变与煤工尘肺组大致相同,但程度较轻。而与非煤工慢阻肺组比较,其表现出特殊变化：如黏膜表面发黑区、管腔狭窄变形、黏膜下纤维组织增生等。结论：支气管形态及组织学改变是导致接尘煤矿工人慢性阻塞性肺疾病患者比相同病情的非煤矿工人慢性阻塞性肺疾病患者的临床治疗效果差的主要原因。     

上食管胃黏膜异位症的临床与病理分析

目的研究上食管胃黏膜异位症的临床症状与病理特征的关系。方法以在某医院进行胃镜检查的15713人为研究对象,在常规内镜操作中经食管上段时,观察到边界清楚的红色黏膜,取检进行病理学检查。结果症状表现为下咽不利的患者有18例,其中贲门型胃黏膜有14例,胃底型黏膜3例;局部烧灼感或者疼痛的患者有11例,其中贲门型胃黏膜有1例,胃底型黏膜有9例;其病理学类型存在明显差异。结论上食管胃黏膜异位症的症状与病理学类型相关。     

鸟氨酸脱羧酶对早期胃癌的诊断意义

目的探讨鸟氨酸脱羧酶(ODC)在不同胃疾病中的动态表达情况并对其在胃癌前疾病及胃癌诊断中的价值作出评价。方法采用免疫组织化学染色检测134例胃黏膜标本中ODC的表达情况,其中浅表性胃炎32例,萎缩性胃炎(伴肠化生)28例,异型增生26例,胃癌48例。结果ODC抗原在浅表性胃炎、萎缩性胃炎、异型增生和胃癌胃黏膜中阳性表达分别为34.4%、42.9%、65.4%和91.7%,从浅表性胃炎到萎缩性胃炎或异型增生再到胃癌,ODC阳性表达率依次逐渐升高,差异有统计学意义(P0.01)。结论ODC表达与胃黏膜细胞恶性程度呈正相关,与胃疾病的发生发展有良好的相关性,对于癌前疾病的诊断,对胃癌筛查、早期诊断具有一定的参考价值。     

幽门螺杆菌感染与C反应蛋白水平的相关性研究

目的:幽门螺杆菌感染可能引起全身炎症反应,本研究旨在探讨慢性胃炎、胃溃疡、胃癌患者中HP感染与血清C反应蛋白(CRP)水平的相关性。方法:选取行胃镜检查及碳-14呼气试验检查的慢性胃炎患者70例,胃溃疡患者64例,胃癌患者62例,并行血清CRP水平检测。结果:慢性胃炎HP阳性组的CRP水平为(11.28±2.12)mg/L,阴性组为(8.09±1.26)mg/L,两者比较差异有统计学意义(P0.05)。胃溃疡组HP阳性组的CRP水平为(16.32±3.62)mg/L,阴性组为(13.21±2.08)mg/L,两者比较差异有统计学意义(P0.01)。恶性胃溃疡HP阳性组的CRP水平为(20.65±6.58)mg/L,阴性组为(16.12±5.86)mg/L,两者比较差异有统计学意义(P0.05)。胃溃疡组血清CRP浓度高于慢性胃炎组,差异有统计学意义(P0.05),胃癌组血清CRP水平高于慢性胃炎及胃溃疡组,差异有统计学意义(P0.05)。结论:血清CRP水平在幽门螺杆菌感染的患者中增高,表明HP感染可以影响血清CRP水平,同时CRP可以作为判断HP相关性胃疾病患者病情严重程度指标之一。     

低分子肝素治疗肺源性心脏病急性加重期患者的疗效观察

目的观察低分子肝素(LMWH)对继发于COPD的肺源性心脏病急性加重期患者肺动脉压(PASP)、血气分析及住院日的影响。方法将152例患者随机分为LMWH治疗组及对照组,2组均给予控制感染、氧疗等常规治疗,治疗组加用LMWH皮下注射10d。检测患者入院及住院11d时PASP、血气分析结果,记录患者达到出院标准时的住院日。结果治疗10d后,治疗组PASP明显降低(u=3.37,P<0.01)、PaO2明显增加(u=2.60,P<0.01),其PaCO2、住院日明显下降,统计学数值分别为(u=2.12,P<0.05)、(u=8.53,P<0.01)。2组结果差异具有统计学意义。结论 LMWH对继发于COPD的肺源性心脏病急性加重期患者可明显改善患者PASP、血气分析,缩短住院日。     

乙型肝炎病毒感染对慢性乙型肝炎病毒感染者胃粘膜病变的影响

目的 通过研究慢性乙型肝炎病毒感染者胃粘膜及血清中乙肝病毒标志物的存在情况,以探讨乙型肝炎病毒感染对慢性乙型肝炎病毒感染者胃黏膜病变的影响.方法 对60例慢性乙型肝炎病毒感染者用酶联免疫吸附法(ELISA)检测血清中HBsAg、HBeAg、anti-HBs、anti-HBC、anti-HBC,免疫组织化学法(Envis...     

Is gastric ulceration different in normal and malnourished rats?

Protein malnutrition can adversely affect all tissues. The aim of the present study was to test the hypothesis that protein deprivation influences gastric ulcer formation, as well as metabolism and organ growth, in rats. In the present study, there was a significant reduction in the body and organ weight of rats fed a low-protein diet (P<0.001). Malnourished rats were less susceptible to ulceration of the gastric mucosa in ethanol and indomethacin models of acute gastric ulcers when compared with rats fed a normoproteic diet (17 % protein). Mucus production and prostaglandin E2 formation increased in malnourished rats, possibly explaining the lower number of acute ulcers in these animals. Pylorus ligature altered gastric juice composition (increased pH and gastric volume, and decreased total acid concentration) in the animal group fed a low-protein diet compared with the group fed a diet containing 17 % protein (P<0.05). The gastric mucosa was more damaged in malnourished rats than in normal rats evaluated for 14 d after acetic acid injection (P<0.001). Malnourished rats exhibited resistance to acute gastric lesions, owing to an increase in prostaglandin GE2 release and mucus secretion, which protected their gastric mucosa. This phenomenon was not seen in subchronic gastric ulceration.     

Ménétrier's disease and gastric carcinoma

The authors report 4 cases of Menetrier's disease associated with gastric adenocarcinoma and one case of low-grade dysplasia. The patients (3 men and 2 women) were aged between 53 and 81 years. In three cases the diagnosis was established by histological examination of the exicised tumor; in one case it was based on microbiopsy specimen; and in another case on a gastric tissue specimen. The authors review the anatomo-clinical features of this association and raise the problem of the relationship between Menetrier's disease, dysplasia and cancer.     

Early gastric cancer--two case reports

Gastric cancer is a serious disease with a high mortality rate. Early diagnosis of the disease improves its prognosis. We report two cases of early gastric cancer and we specify the clinical, endoscopic, histologic and therapeutic aspects of the disease. This study is about two female patients, respectively, 36 and 70 years old. The diagnosis of early gastric cancer was based on pathologic examination of the resected stomach. The two patients are in remission 2 years and 6 months later, respectively. The diagnosis of early gastric cancer is often made on nonspecific symptoms. Oeso-gastro-duodenoscopy shows gastric mucosal anomalies. Pathologic examination of gastric biopsies confirm the diagnosis of adenocarcinoma. Endoscopic ultrasound is essential; it specifies the submucosal infiltration and evaluates the lymph node invasion. Surgery is the primary treatment but in some cases endoscopic mucosal resection provides good long-term results. Early diagnosis of adenocarcinoma improves the prognosis of the disease, which remains poor nowadays.     

抑癌基因P16和肝细胞生长因子在早期胃癌中的表达及意义

目的 本研究通过免疫组化方法分别检测正常胃组织、不典型增生胃组织和早期胃癌组织中P16和HGF蛋白表达,旨在探讨二者在不同胃组织中表达的相关性及意义.方法 运用免疫组化方法检测50例胃组织腊块P16和HGF蛋白表达情况.结果 (1)在由正常胃粘膜到不限性增生到早期胃癌的演进过程中,HGF蛋白表达呈上升趋势,P16蛋白表...