幽门螺杆菌CagA基因株致病机理及与胃十二指肠疾病的关系

幽门螺杆菌（Ｈｐ）的毒力决定其致病能力。感染了Ｈｐ的人群大部分无症状，只有少数人表现不同程度的症状，可能是感染了不同毒力的菌株所致。有细胞毒相关蛋白（ＣａｇＡ）基因的均为高毒株，与消化性溃疡、萎缩性胃炎、胃癌密切相关。对ＣａｇＡ＾＋株深入研究有助于加深对Ｈｐ致病机理的认识。     

胃十二指肠疾病患者的胃排空功能

了解常见胃十二指肠疾病患者的液体胃排空情况．方法采用放射性核素９９ｍＴＣ标记的液体试餐法，对正常人１８例及慢性胃十二指肠疾病患者４５例，进行液体胃排空功能测定．结果十二指肠溃疡组（ｎ＝１３）胃半排空时间为２８１ｍｉｎ±１４０ｍｉｎ，较正常对照组３９７ｍｉｎ±１４７ｍｉｎ明显缩短（Ｐ＜００５）．ＦＤ及ＣＡＧ组与对照组比较无显著差异（Ｐ＞０２０）．结论ＤＵ患者液体胃排空加快，合并幽门变形者胃排空延缓     

胃十二指肠疾病幽门螺杆菌检出的意义

目的:研究幽门螺杆菌(Hp)与消化性溃疡及慢性胃炎致病的关系。方法:因胃十二指肠疾病而做胃镜的患者,采取胃粘膜进行组织快速检菌,一分钟尿素酶(1min UT)试验和血清间接免疫荧光法进行检菌分析。结果:对5000例胃及十二指肠疾病Hp的组织检出率为88.1％。1min UT阳性率为62.9％,两种检菌法有显著差异(P<0.01)。十二指肠溃疡Hp检出为96.0％,胃癌和萎缩性胃炎Hp感染率为50.0％和59.2％,而1min UT只有41.5％阳性率。结论:胃癌和萎缩性胃炎均有粘膜层萎缩,腺体减少、粘液分泌功能降低,Hp茵不能适应强酸环境下生存。十二指肠溃疡和慢性胃炎多伴引起幽门口水肿和幽门变型,胃排空减缓。是导致Hp茵高检出率的重要因素。     

胃空肠同步吻合治疗胃十二指肠疾病

1987-1993年行胃空肠同步吻合术(以下简称同部组)治疗胃十二指肠溃疡及胃癌30例,并设对照组进行随访对比观察,现分析报告如下。 1 对象和方法 1.1 对象 ①同步组:男27例,女3例。年龄19-71岁,平均42.5岁。急诊手术11例(其中十二指肠溃疡穿孔、腹膜炎4例,出血休克2例。胃溃疡出血休克3例,胃十二指     

马边地区胃十二指肠疾病患者Hp感染状况

马边地区胃十二指肠疾病患者Ｈｐ感染状况江懋明四川省乐山市中医院西内科６１４０００ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＧａｓｔｒｉｔｉｓ／ｍｉｃｒｏｂｉｏｌｏｇｙＰｅｐｔｉｃｕｌｃｅｒ／ｍｉｃｒｏｂｉｏｌｏｇｙＨｅｌｉｃｏｂａｃｔｅｒｉｎｆｅｃｔｉｏｎｓ...     

延边地区幽门螺杆菌与胃十二指肠疾病

幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ）在胃十二指肠疾病发病中的作用已明确．我们研究Ｈｐ与组织活检观察延边地区Ｈｐ与胃十二指肠疾病性质、类型、程度的关系．１　材料和方法１．１　材料　我院１９９３０１／１９９９０２做内镜取胃粘膜活检标本１９９１例,６８７２组织块．男９９８例,女９９３例,年龄１２岁～８１岁,平均４２岁．取材部位胃窦部１８５０例,胃体１９０例,贲门６６例．１．２　方法　一般在不同部位取３块～４块组织,１块用ＨｐＵＴ试剂盒（福建三强生物化工有限公司提供）检测Ｈｐ,其…     

胃癌及消化性溃疡患者胃窦粘膜胃肠激素的变化

目的探讨胃癌及消化性溃疡（ＰＵ）患者胃窦粘膜胃肠激素变化的意义．方法内镜及活检确诊的浅表性胃炎（ＣＳＧ）１０例，胃溃疡（ＧＵ）１５例，十二指肠溃疡（ＤＵ）１２例，胃癌（ＧＣ）６例．胃镜下取胃窦粘膜，用ＲＩＡ法测定胃泌素（Ｇａｓ）、生长抑素（ＳＳ）、Ｐ物质（ＳＰ）的含量，各组间进行比较．结果胃窦粘膜ＳＳ含量在ＧＵ，ＤＵ，ＣＳＧ，ＧＣ组分别为２５１ｐｇ／ｍｇ±１９４ｐｇ／ｍｇ（以下同），４７０±１７９，５３２±２１１及１２９３±５２３。其中ＧＵ组低于其余各组（Ｐ＜００５），而ＧＣ时则显著升高（Ｐ＜００１）．ＳＰ含量在ＤＵ组显著降低，与ＧＵ，ＣＳＧ，ＧＣ比较分别为４７９±１５７ｖｓ７６５±４１５，７８９±３９０及８０１±３４６，Ｐ＜００５；ＧＣ患者Ｇａｓ水平显著高于ＣＳＧ组，为４６４５±２９４４，ｖｓ２７６８±１５７２，Ｐ＜００１．结论胃粘膜中Ｇａｓ，ＳＳ，ＳＰ含量的变化可能在ＰＵ及胃癌的发病机理中起重要作用．     

根除Hp前后胃粘膜多胺含量变化的意义

目的探讨成功根除幽门螺杆菌（Ｈｐ）感染后，胃粘膜组织学及多胺（腐胺、精脒和精胺）含量变化的意义．方法Ｈｐ阳性患者５６例，其中男３９例，女１７例；胃溃疡７例，十二指肠溃疡１８例，慢性胃炎３１例．根除Ｈｐ前和根除治疗４ｗｋ～６ｗｋ后胃粘膜多胺含量及其组织学变化，同时设Ｈｐ阴性患者２０例作对照．结果Ｈｐ阳性患者胃窦粘膜蛋白多胺含量（μｍｏｌ／ｇ）明显高于阴性患者（腐胺０９６±０４９ｖｓ０４１±０３１，精脒２０１±０４８ｖｓ０８３±０３７，精胺２５８±０５７ｖｓ１３３±０４２，Ｐ＜００１）．Ｈｐ根除后就显著下降（腐胺０４８±０４０ｖｓ０９４±０４２，精脒１１１±０３４ｖｓ１９８±０３９，精胺１５３±０５５ｖｓ２６６±０４４，Ｐ＜００５）．胃窦部粘膜腐胺和精脒含量高于胃体部（腐胺０９９±０３１ｖｓ０５９±０２４，精脒２０７±０３８ｖｓ１３０±０３４，Ｐ＜００５）．组织学检查显示根除Ｈｐ感染后炎细胞浸润程度明显降低．结论根除Ｈｐ感染能够降低胃粘膜的增殖活性，从而降低胃癌的危险性．     

胃组织中5种微量元素水平的分析

胃组织中５种微量元素水平的分析刘燕燕王桂铮郭春林包头医学院第一附属医院内蒙古包头市０１４０１０ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＳｔｏｍａｃｈｎｅｏｐｌａｓｍｓ／ｍｅｔａｂｏｌｉｓｍＳｔｏｍａｃｈｕｌｃｅｒ／ｍｅｔａｂｏｌｉｓｍＧａｓｔｒｉｔｉｓ／ｍｅ...     

胃液中维生素C与幽门螺杆菌和胃十二指肠疾病

目的研究胃液中维生素Ｃ（ＶｉｔＣ）浓度与幽门螺杆菌（Ｈｐ）感染和胃、十二指肠疾病的关系。方法抽取病人空腹胃液和血液，用高铁还原法测定血浆和胃液中的ＶｉｔＣ浓度；Ｈｐ通过尿素酶试验和病理ＷＳ染色确定。结果Ｈｐ阳性病人胃液中ＶｉｔＣ浓度明显低于Ｈｐ阴性病人；胃液中ＶｉｔＣ浓度与慢性胃炎的炎症程度无关，但在活动性胃炎病人胃液中ＶｉｔＣ浓度明显低于非活动性胃炎病人；与非溃疡性消化不良病人相比，活动期胃溃疡和十二指肠溃疡病人的ＶｉｔＣ浓度明显降低。结论Ｈｐ感染可导致胃液中ＶｉｔＣ浓度降低，这可能是Ｈｐ与胃癌和消化性溃疡的发生相关联的重要因素     

Characteristics of upper digestive tract diseases in Bohai Bay fishermen

AIM: To study the characteristics of upper digestive tract diseases (UDTDs) in fishermen who live in Bohai Bay.METHODS: An investigation was carried out in 1488 fishermen with symptoms of UDTDs (aside from liver, biliary and pancreatic diseases) during the time period between December 1991 and February 1995. This investigation included medical history evaluations, physical, gastroscopic and pathological examinations, tests for Helicobacter pylori (H. pylori) infection, and analysis of the nitrate content in their drinking water.RESULTS: Among the 1488 subjects investigated, 1467 suffered from one or more of the 14 UDTD diseases, most of which were chronic atrophic gastritis (CAG, 1103 cases), peptic ulcers (268 cases), and cancer of the upper digestive tract (25 cases).CONCLUSION: The incidence rate of UDTDs tends to be high among fishermen due to their particular living habits, the high nitrate content of their drinking water, etc. In addition, the clinical manifestations of UDTDs in fishermen are significantly different from those of the inland residents.     

老年人上消化道出血134例临床分析

目的探讨老年人上消化道出血及导致死亡的病因。方法回顾性总结分析上消化道出血老年患者１３４例，并与同期非老年患者１２０例比较。结果老年人上消化道出血病因中主要为酸相关疾病（十二指肠溃疡、胃溃疡、胃炎、十二指肠炎、食管炎）７１例，占７３．９％；胃癌１４例，占１４．５％。发生低血压或休克，老年组１８例，非老年组８例（Ｐ＜０．０５）。使用阿司匹林或非甾体类抗炎药物，老年组２８例，显著高于非老年组（７例，Ｐ＜０．０１）。老年组死亡１８例，病死率为１３．４％，其中１５例因全身慢性疾病恶化和出血后并发症死亡；非老年组死亡６例，病死率为５．０％（Ｐ＜０．０１）。结论酸相关疾病是老年人上消化道出血的主要病因，其次为胃癌。全身慢性疾病恶化和出血后并发症是影响老年人上消化道出血预后的重要因素，特别是肺部感染、心脑血管疾病是主要的死亡原因。     

Correlation between expression of MMP-9 and MMP-3 in Helicobacter pylori infected patients with different gastroduodenal diseases

Background and study aims

Helicobacter pylori (H. pylori) has been implicated in the pathogenesis of most important gastro-duodenal diseases, such as gastritis, peptic ulcer disease (PUD) and gastric cancer. H. pylori upregulates the expression and activity of several matrix metalloproteinases (MMPs) in the gastric mucosa, but the role of MMP-3 and MMP-9 in infected patients with H. pylori have not been clearly defined yet. We examined mucosal MMP-3 and MMP-9 mRNA levels in gastric mucosa of H. pylori infected patients and evaluated the effects of virulence factors cagA and vacA allelic variants on these levels. We also determined correlation between mucosal MMP-3 and MMP-9 mRNA levels and types of disease.

Characterics of upper digestive tract diseasesin fishermen of the Bohai Bay

ＣｈａｒａｃｔｅｒｉｃｓｏｆｕｐｐｅｒｄｉｇｅｓｔｉｖｅｔｒａｃｔｄｉｓｅａｓｅｓｉｎｆｉｓｈｅｒｍｅｎｏｆｔｈｅＢｏｈａｉＢａｙＷＡＮＧＹｕａｎＢｅｎ１，ＷＡＮＧＹｕａｎＰｉｎｇ１，ＺＯＵＪｉｎｇ１，ＢＡＩＢａｏＪｉｅ２，ＲＥＮＧｕｏＣｈｕ...     

Bone mineral density infringement in patients with digestive system diseases

THE AIMS: To develop criteria for prediction of disorders of bone metabolism and improve prevention and treatment of osteopenia in gastroenterological patients on the basis of pathogenic features of its development. Recent literature data show that a number of digestive diseases exacerbate the risk of osteopenia/osteoporosis in patients with population risk factors. Reduced bone mineral density in patients with certain diseases of the digestive system occurs equally in both cortical and trabecular bone tissue, indicating the polyetiology osteopenia in this group of patients.     

2型糖尿病患者骨密度变化及相关危险因素分析

目的研究2型糖尿病（T2DM）患者骨密度（BMD）变化情况。方法测定336例T2DM患者BMD,采用不同诊断标准,统计骨质疏松症（0P）检出率;对比OP组与非OP组生化指标差异并进行相关性分析。结果以低于峰值BMD2．5s及2．0s为诊断标准,OP检出率分别为8．90％和17．26％。BMD与年龄负相关（P〈0．01）,与BMI正相关（P〈0．05）,与女性绝经年数负相关（P〈0．01）。40-49岁组BMD与DM病程相关（P〈0．05）。结论年龄越大、BMI越低,绝经年数越长,越易发生骨质疏松。T-Score≤-2．0SD诊断OP可能适合本地区T2DM患者,但需进一步积累资料证实。     

Bone mineral density and bone turnover in patients with psoriatic arthritis

Psoriasis is a common inflammatory skin disease, and conflicting data have been published about osteoporosis and bone turnover markers in patients with psoriatic arthritis. The aim of this study was to assess bone mineral density (BMD) and bone turnover markers in psoriatic patients with and without peripheral arthritis and to investigate the relationship between clinical parameters and markers of bone turnover. Forty-seven patients (24 women, 23 men) with psoriasis were included to the study. Demographic data and clinical characteristics were recorded. Erythrocyte sedimentation rate and C-reactive protein were assessed as disease activity parameters. BMD was determined for lumbar spine and total hip by dual X-ray absorptiometry (DXA). Serum Ca, P, alkalen phosphatase (ALP), and serum type I collagen cross-linked C telopeptide (CTX) were measured as bone turnover markers in all patients. The patients were divided into two groups according to their peripheral arthritis status. The clinical and laboratory variables, as well as bone mass status of the groups, were compared with each other. Eighteen patients had peripheral arthritis. All the female patients were premenopausal. None of the patients had radiologically assessed axial involvement. There was no significant difference between the BMD levels of psoriatic patients with and without arthropathy. One patient (5%) had osteoporosis, and nine (50%) patients had osteopenia in arthritic group, while eight (27.5%) patients had osteopenia in patients without arthritis. Serum CTX, ALP, Ca, and P levels were not significantly different in arthritic than in non-arthritic patients (p > 0.05). In patients with psoriatic arthritis, the duration of arthritis was negatively correlated with BMD values of lumbar spine and total femur and serum CTX levels, suggesting an association of increased demineralization with the duration of joint disease. In conclusion, psoriatic patients with peripheral arthritis with longer duration of joint disease may be at a risk for osteoporosis, which can require preventative treatment efforts.     

甲亢患者骨密度、骨代谢指标及维生素D受体的变化

本研究发现甲状腺功能亢进症 (甲亢 )患者腰椎、股骨颈、Ward三角和大转子区骨密度降低 ,血清钙、血清磷、血清碱性磷酸酶及血清骨钙素升高 ,血淋巴细胞内维生素D受体 (VDR)含量降低。FT3与FT4与骨密度呈负相关。提示甲亢导致高转换型骨丢失 ,它可引起骨密度降低 ,骨代谢指标及VDR含量异常。