十二指肠-胃反流物成分对胃黏膜的影响

目的:探讨原发性十二指肠胃反流(DGR)是否造成胃黏膜的病理性损害以及十二指肠液中各种成分与动态pH的变化和胆红素吸收值(ABS)的关系。方法:应用带胃管的便携式pH监测仪和Bilitec2000,同步监测14例原发性病理性DGR患者和15名健康志愿者的胃内24h胆汁反流和pH变化情况。根据胃内pH和ABS的对应变化,实时抽吸胃液送检,测出胃液中胆汁酸(BA)、总胆红素(TBIL)、淀粉酶(AMY)和脂肪酶(LIP)的浓度。结果:ABS与TBIL、BA以及pH值与AMY浓度呈正相关。重度胃炎组的BA高于轻、中度组。白天胃液中AMY和LIP分别高于夜间;而夜间的BA、TBIL和DBIL较高。结论:胃腔内的pH值变化主要是胰液反流而非胆汁反流所致。胃黏膜的损伤程度主要与BA的反流有关,胰液反流对胃黏膜的损伤弱于胆汁反流。胃腔中TBIL可以作为胆汁反流性胃炎的监测指标,而不是诱发或导致胃炎的因素。     

Heterotopic gastric mucosa of the duodenum mimicking a duodenal cancer

Heterotopic gastric mucosa of peculiar shape and located in the duodenum bore a close resemblance to superficial ulcerating cancer. Radiographic survey showed a flexible lesion with a mucosal pattern resembling area gastrica. Endoscopy revealed its color to be indistinguishable from that of the normal duodenal mucosa. These may be characteristic features of this abnormality.     

食管癌患者胃黏膜病变与术后胃排空延迟的相关性研究

目的观察食管癌患者的胃黏膜病变与术后胃排空延迟的相关性。方法对987例经手术治疗的食管癌患者中,术后出现严重胃排空延迟的26例患者的术前、术中、术后进行观察、治疗及护理,分析食管癌患者胃黏膜病变与术后出现的严重胃排空障碍之间的相关性。结果发现术后出现胃排空障碍的食管癌患者术前和术后均存在较严重的胃黏膜病变。结论术后出现的严重胃排空障碍与患者术前即已经存在的和术后的胃黏膜病变密切相关,通过重视对胃黏膜疾病的术前、术后治疗及护理,对术后胃排空延迟的恢复大有益处。     

LAT-1 functions as a promotor in gastric cancer associated with clinicopathologic features

L-type amino-acid transporter 1 (LAT-1) is a member of system L-type transporters, essential for cells maintenance and proliferation. However, the role of LAT-1 remains illegible in gastric cancer (GC). In this study, we found that LAT-1 was aberrantly up-regulated in both GC cell lines (MKN-45, MGC-803 and CRL-5974) and human GC specimens. The expression characteristic of LAT-1 in GC was significantly associated with clinicopathologic features such as tumor size, lymph node metastasis, local invasion and TNM stage. By suppressing the expression of LAT-1 in MKN-45 cells, the cell cycle was arrested in G0/G1 phase, and the ability of cell proliferation was significantly decreased in vitro. Moreover, the cell migration and invasion of MKN-45 cells was significantly impaired by knocking down LAT-1. Thus, our results suggest that LAT-1 may function as an oncogene in GC, which provides us a new biomarker in GC and perhaps a potential target for GC prevention, diagnose and therapeutic treatment.     

Evidence for the interaction between antacid and gastric mucosa using an "artificial stomach" model including gastric mucosa.

In light of evidence that certain aluminum-based antacids adhere to the gastric mucosa, we modified our previously described "artificial stomach" (AS) model by including a piece of hog stomach and compared the antacid activity of six aluminum-containing antacid products in the model with and without gastric mucosa. The activity of three of these, Maalox, Riopan and Supralox, was not significantly different in the two systems. In contrast, the activity of the other three, Aludrox, Phosphalugel and Simeco, was significantly greater with mucosa. Antacid activity of one product from each set (Supralox, Phosphalugel) was evaluated in two in vivo methods in human volunteers. For both antacids, results in vivo were similar to those obtained with the AS-containing mucosa. Without mucosa, in vivo and in vitro results were dissimilar for Phosphalugel, thus validating the modified AS. The difference between the two sets of antacids can be explained by 1) the fact that the Al:Mg ratio in the set affected by mucosa is greater than that of unaffected antacids, and 2) a weaker antacid load than in unaffected Supralox. We suggest that in an acid milieu, aluminum ions in antacids like Aludrox, Phosphalugel and Simeco are bound to sialic acid residues in mucus glycoproteins, thus retarding the transit of these antacids through both the AS and the real stomach and prolonging their activity in both situations. When the Al:Mg ratio is low or when the amount of antacid salts is large, aluminum ions tend to be buried in complexes, giving them less chance to interact with gastric mucus, so they transit the stomach more quickly.     

Tiam-1和PTEN在胃癌组织中表达的相关性及意义

目的探讨胃癌组织中Tiam-1和PTEN蛋白表达的相关性及临床病理意义。方法应用免疫组织化学法检测57例胃癌患者手术切除的胃癌及其癌旁组织中Tiam-1和PTEN的蛋白表达水平。结果 Tiam-1蛋白在胃癌组织中表达阳性率（77.2%）高于癌旁组织（7.0%）（χ2=57.576,P=0.000）;PTEN蛋白在胃癌组织中表达阳性率（64.9%）低于癌旁组织（98.2%）（χ2=21.072,P=0.000）;Tiam-1表达水平与胃癌组织分化程度低、TNM分期高以及淋巴结转移呈正相关（P〈0.05）;PTEN表达水平与胃癌组织分化程度低、TNM分期高及淋巴结转移呈负相关（P〈0.05）;二者表达与年龄、性别及肿瘤直径均无相关性（P〉0.05）;Tiam-1与PTEN的表达呈明显负相关（r=-0.312,P=0.018）。结论联合检测Tiam-1和PTEN对胃癌侵袭、转移及预后评估有一定价值。     

内镜黏膜下剥离术和黏膜切除术治疗 早期胃癌的临床对比分析

目的 探讨内镜黏膜下剥离术（ESD）及内镜下黏膜切除术（EMR）治疗早期胃癌的临床疗效。 方法 对该院2008年1月~2013年1月行内镜黏膜下剥离术及内镜下黏膜切除术后病理证实为癌前病变及早期胃癌的67例患者进行回顾性分析。将两组病灶整块切除率、组织学治愈性切除率、手术时间、并发症发生率、复发率等指标进行比较。 结果 ESD组病灶整块切除率为93.5%（29/31）,治愈性切除率为77.4%（24/31）,均高于EMR组的50.0%（18/36）及41.6%（15/36）,差异有显著性（P　<0.05）。ESD组局部复发率为3.2%（1/31）,低于EMR组[19.4%（7/36）],差异有显著性（P　<0.05）。平均手术时间ESD组为（59.3±16.8）min,长于EMR组[（31.7±17.8）min]（P　<0.05）。术中穿孔率ESD组高于EMR组,发生率分别为3.2%（1/31）和0.0%（0/36）,但差异无显著性。术中出血发生率两者差异无显著性,发生率分别为9.6%（3/31）及11.1%（4/36）。 结论 与EMR相比,ESD病灶整块切除率及组织学治愈性切除率高,局部复发率低,是治疗早期胃癌的安全有效方法。     

替吉奥一线治疗老年复发或转移胃癌的临床研究

目的观察替吉奥(S-1)一线治疗老年复发或转移胃癌的近期疗效、无进展生存期(TTP)、总生存期(OS)及不良反应。方法 68例经病理组织学确诊的复发或转移老年胃癌患者随机分为试验组与对照组。试验组服用S-1。对照组静脉滴注5-Fu。用药直到疾病进展或不良反应不能耐受,中位治疗周期为8个周期(2~16周期)。结果试验组有效率、疾病控制率和1年生存率高于对照组。试验组TTP及OS明显优于对照组。主要不良反应包括:恶心呕吐、腹泻、贫血、粒细胞减少等,2组不良反应均较轻微。结论 S-1是复发转移的老年胃癌有效的治疗方案,使用方便,无需住院,且有效率不低于5-Fu,生存期方面优于5-Fu持续滴注治疗方案。是老年复发转移胃癌患者值得推荐的一线化疗方案。     

Electrophoretic separation of high-density lipoprotein choelsterol evaluated and compared with the modified lipid research clinic procedure.

We evaluated a new agarose-gel-electrophoretic procedure (Corning) (I) for separating and quantitating of high-density lipoprotein cholesterol (HDLC), comparing it with the modified Lipid Research Clinics (LRC) procedure (heparin 183 kilounits/L, MnCl2 92 mmol/L) (II). Method I was insensitive to an HDLC concentration of 50 mg/L, but gave a linear dose-response curve between 130 and 1200 mg/L. Method II is sensitive to 50 mg/L and linear from 50--1200 mg/L. The within-plate CV for the Corning method varied from 26.2% for an HDLC of 168 mg/L to 6.8% for 580 mg/L. Within-day between-plate CV for the Corning method ranged from 22.1% at 155 mg/L to 8.0% at 651 mg/L, compared to 3.0 and 0.8% for the modified LRC procedure. Between-day CV for method I was 20, 12.6, 4.3, and 3.5% for HDLC concentrations of 175, 435, 542, and 678 mg/L, respectively; for method II it was 14, 5, 3.5, and 2.6%, respectively. Analysis of HDLC in 100 patients by both procedures showed mean HDLC values to be significantly lower (mean + SD, 27.8 +/- 1.7 mg/L; p less than 0.001) by method I. In 46 patients with HDLC less than 450 mg/L, this difference was accentuated (mean + SD = 40.5 +/- 2.6 mg/L) and clinically significant. Electrophoretic methods offer a promising further alternative method for HDLC separation and quantitation, but the negative bias, present limited sensitivity, and lack of precision at less than 450 mg/L indicate that they are not yet optimal for routine clinical use for patients with values less than 450 mg/L.     

Body knowledge and concerns of children with cancer as compared with the knowledge and concerns of other children

This is a report of a comparative study of body-related knowledge and concerns expressed by three groups of school-age children with (a) a diagnosis of cancer, (b) a chronic or acute orthopedic problem of the extremities, and (c) no serious health problem. Information was obtained from interviews using the Gellert index of Body Knowledge, a sentence-completion test, and a freehand drawing of a house. Data were examined using distributive and comparative statistics. The meaning and clinical usefulness of the findings are discussed.