中华消化杂志

<正>《中华消化杂志》以广大消化科医师为主要读者对象,兼顾腹部外科、消化内镜等相关专业,及时报道消化科领域领先的科研成果和临床诊疗经验,以及对消化科临床有指导作用、且与消化科临床密切结合的基础理论研究,对从事消化科专业的临床医师有指导作用。欢迎临床医师、科研和教学人员踊跃来稿。本刊已正式启用稿件     

中华消化杂志

《中华消化杂志》以广大消化科医师为主要读者对象,兼顾腹部外科、消化内镜等相关专业,及时报道消化科领域领先的科研成果和临床诊疗经验,以及对消化科临床有指导作用、且与消化科临床密切结合的基础理论研究,对从事消化科专业的临床医师有指导作用。欢迎临床医师、科研和教学人员踊跃来稿。本刊已正式启用稿件远程处理系统,请访问中华医学会网站(http://www.cma.org.cn)     

第四届海峡两岸消化论坛暨世界华人消化高峰论坛会讯

<正>由卫计委海峡两岸医药卫生交流协会消化病学专家委员会、两岸关系和平发展协同创新中心、台湾消化系医学会、台湾消化系内视镜医学会、香港消化病学会、香港消化内镜学会、厦门市医学会主办,厦门大学附属中山医院、台湾大学医学院附设医院、香港中文大学威尔斯亲王医院共同承办的第四届海峡两岸消化论坛暨世界华人消化高峰论坛于2013年11月21~24日在厦门国际会议中心成功举办。     

第五届海峡两岸消化论坛暨世界华人消化高峰论坛征文通知

正为促进海峡两岸消化病学学术繁荣、增进世界华人消化专业医师的相互了解,由海峡两岸医药卫生交流协会消化病学专家委员会、两岸关系和平发展协同创新中心、台湾消化系医学会、台湾消化系内视镜医学会、香港消化病学会、香港消化系内视镜学会、厦门市医学会主办,厦门大学附属中山医院、台湾大学医学院附设医院、香港中文大学威尔斯亲王医院共同承办的第     

致谢世界华人消化杂志编委

本期文章审稿中(包括退稿),我刊编委付出了宝贵的时间和大量的精力,提高了《世界华人消化杂志》的学术质量,在此表示衷心感谢!     

致谢世界华人消化杂志编委

本期文章审稿中(包括退稿),我刊编委付出了宝贵的时间和大量的精力,提高了《世界华人消化杂志》的学术质量,在此表示衷心感谢!曹洁副教授第二军医大学微生物学教研室陈卫昌教授苏州大学附属第一医院消化内科程爱群主任医师上海华东医院普外科党双锁副教授西安交通大学第二医院感染科     

胆囊息肉样病变612例临床分析

目的分析总结胆囊息肉样病变的临床、病理、诊断等特征．方法我院及中华医学会第七届全国胆道外科学术会议资料共报道胆囊息肉样病变６１２例进行分析和总结．结果胆囊息肉样病变６１２例占同期胆囊切除术的４２％；３０岁～５０岁占７８５％；结石合并率２８５％；病理类型中以胆固醇息肉最多，占５３７％；腺瘤性息肉恶变率极高，达２８５％；临床表现无特异性，Ｂ超的诊断率最高，达９２５％．结论胆囊息肉样病变患者相对年轻；病理类型以胆固醇类多见，腺瘤性息肉易恶变，特别是合并结石的息肉；临床诊断以Ｂ超为首选     

胆囊息肉样病变恶性倾向的临床病理分析

目的探讨胆囊息肉样病变恶性倾向的危险因素、超声造影表现及其在鉴别良、恶性息肉样病变中的应用。方法收集356例胆囊息肉样病变的手术病理与术前超声的资料,回顾性分析其临床和病理特征。结果手术病理结果显示,假瘤样息肉是胆囊息肉的最主要病理类型335例(94.1%),其次为良性腺瘤和恶变息肉,分别是12例(3.4%)和9例(2.5%)。在胆囊息肉恶变组中,年龄>50岁居多(占88.9%),其息肉病理类型以乳头状或乳头管状腺瘤为主(OR=17.5,P<0.01)。随着息肉的增大,恶性率逐渐增加。息肉直径≥2cm时,恶性率≥50.0%。结合手术病理结果分析发现,合并胆囊结石是影响胆囊息肉超声诊断的重要因素,彩色多普勒血流显像(CDFI)指标是预测良恶性息肉的独立因素。结论年龄>50岁、胆囊直径增大以及CDFI指标是胆囊息肉恶性倾向的危险因素。     

胆囊息肉样病变203例临床分析

目的　探讨胆囊息肉样病变 (PLG )的临床若干问题 ,提高其诊疗水平。方法　腹部B超检出胆囊息肉样病变患者 2 0 3例 ,其中 3 0例经腹腔镜或剖腹胆囊摘除术 ,对其临床表现与病理特点进行比较。结果　 3 0例患者中男性 12例 ,女性 18例 ,年龄 2 8～ 62岁 ,平均年龄 3 8岁。有症状者 16例 ,占 5 3 .3 3 %。真性肿瘤 5例 ( 16.66% ) ,息肉样病变 2 5例 ( 83 .3 3 % ) ,胆囊增厚 18例( 60 .0 % ) ,合并结石者 4例 ( 13 .3 % )。结论　胆囊息肉样病变属胆囊良性肿瘤 ,但少数有恶变危险 ,建议对单发性胆囊息肉样病变直径≥ 10mm或多发性的直径≥ 12mm、直径 <10mm ,但胆囊壁显著增厚 ( >4mm)及 (或 )伴有结石、有较明显的临床症状和B超动态检查息肉短期增大者应手术治疗。     

胆囊息肉样病变的临床流行病学特点及其易感性因素

目的:探讨青岛地区胆囊息肉样病变(polypoid lesion of gallbladder,PLG)的临床流行病学特点及其易感性因素.方法:选择2009/01-2009/12在本院健康体检中心体检的27400人作为调查对象,采用分层随机整群抽样法,对1678例超声诊断PLG患者进行临床流行病学调查,并抽取1700人非PLG者作为对照组.采用多因素非条件Logistic回归分析生活方式、行为因素、空腹血糖(FPG)、三酰甘油(TG)、胆固醇(CHO)和体质量指数(BMI)、脂肪肝、胆囊炎、胆囊结石和胆囊癌等,以OR值为PLG易感性因素.分析PLG直径>10mm行胆囊切除术219例患者的超声病理学特点以及手术治疗良性非肿瘤性PLG合理性.结果:27400人健康体检中,资料完整27301人,应答率为99.64%.经超声诊断PLG者1678例,发病率6.15%,其中男性59.95%(1006/1678),女性40.05%(672/1678),男女比例1.5∶1;30-59岁占64.96%(1090/1678).P L G单发37.72%(633/1678),多发62.28%(1045/1678);直径≤10mm占...     

胆囊息肉样病变103例临床及病理分析

目的　探讨胆囊息肉样病变 (PLG)的临床表现、影像学、病理学特点。方法　对 10 3例PLG患者的临床、影像学、病理学及术后随访资料作统计分析。结果　胆固醇性息肉 5 4例 ,炎性息肉 34例 ,未见息肉 7例 ,胆囊肿瘤性息肉 (NPG) 8例 (腺瘤 6例、腺癌 2例 )。在直径≤ 5mm、6～ 10mm、11～ 15mm、>15mm组 ,NPG分别为 0(0 / 2 2 )、3例 (3/ 6 4 )、4例 (4 / 16 )、1例 (1/ 1) ,腺癌 2例直径均≥ 15mm ,NPG在直径 >10mm组多于≤ 10mm组。NPG中单发 6例 (6 / 8) ,非NPG中单发 2 7例 (2 7/ 95 )。术后中长期并发症发生率 32 8% (19/ 5 8)。结论　PLG应先做定期B超随访 ,出现下述表现之一者宜切除胆囊 :直径 >10mm、单发广基、随访中增大、伴有胆囊结石、症状明显或其它影像学检查提示NPG。     

大肠息肉与胆囊息肉样病变的相关性

目的:探讨大肠息肉与胆囊息肉样病变(polypoid lesions of the gallbladder,PLG)的相关性.方法:随机选取我院行结肠镜检查的患者211例,分为大肠息肉组(n=111)和对照组(n=100),利用超声检查对大肠息肉组PLG的发生情况进行观察,并与对照组进行对比分析.结果:大肠息肉组PLG的发生率明显高于对照组(x2=13.60,P<0.001);男女性大肠息肉组间PLG的发生率无差异:按大肠息肉的病理类型进行分层比较显示非腺瘤性大肠息肉组PLG的发生率高于对照组(x2=3.86,P<0.05),而腺瘤性大肠息肉组PLG的发生率明显高于对照组(x2=19.04,P<0.001),且高于非腺瘤性大肠息肉组(x2=3.94,P<0.05).结论:大肠息肉与PLG之间可能存在一定的相关性.     

Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

AIM:To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder(PLGs) as well as malignant PLGs.METHODS:A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm,as was determined by preoperative trans-abdominal ultrasonography or endoscopic ultrasonography.We ana-lyzed the medical,laboratory,radiologic data and the pathologic results.RESULTS:In 210 cases,146 had non-neoplastic po...     

Analysis of risk factors for polypoid lesions of gallbladder among health examinees

AIM: To investigate the prevalence and risk factors of polypoid lesions of gallbladder (PLG) among the health examinees in the Shanghai region, China.METHODS: A total of 11 816 subjects who underwent health examinations in our hospital between August 2010 and February 2011 were analyzed retrospectively. Among them, there were 7174 men and 4642 women. PLG was diagnosed by the real-time ultrasonography. Those with the body mass index (BMI) ≥ 28 were considered to be obese. Blood biochemical indices were detected with the fully automatic biochemical analyzer and hepatitis B surface antigen (HBsAg) was tested by the automated enzyme immunoassay. The correlations between the prevalence of PLG and age, sex, BMI, serum cholesterol (T-Cho), triglycerides (TG), blood sugar, HBsAg, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), gallstone and fatty liver were investigated. After univariate analysis of 11 variables, stepwise logistic regression analysis was performed to explore the risk factors of PLG.RESULTS: There was a significant difference in sex, T-Cho, HBsAg, HDL-C, LDL-C and fatty liver between the PLG-positive group and the PLG-negative group (332/163 vs 6842/4479, P = 0.003; 22/473 vs 295/11 026, P =0.013; 92/403 vs 993/10 328, P = 0.001; 47/448 vs 332/10 989, P = 0.001; 32/463 vs 381/10 940, P = 0.001; 83/412 vs 3260/8061, P = 0.001). No significant difference was found in the age, BMI, TG, blood sugar and gallstone between the two groups (47.3 ± 26 vs 45.1 ± 33, P = 0.173; 59/436 vs 1097/10 224, P = 0.102; 52/443 vs 982/10 339, P = 0.158; 17/478 vs 295/11 026, P = 0.26; 24/471 vs 395/10 926, P = 0.109). Logistic regression analysis showed that the sex, HBsAg and HDL-C were independent risk factors for the development of PLG in a descending order of HDL-C > HBsAg > sex.CONCLUSION: In healthy people, the male gender, positive HBsAg, and low HDL-C confer higher risks of PLG development.     

Prevalence and risk factors of gallbladder polypoid lesions in Chinese petrochemical employees

AIM:To investigate the prevalence and risk factors of polypoid lesions of the gallbladder (PLGs) in petrochemical employees in Ningbo, Zhejiang Province, China. METHODS:All active and retired employees aged 20-90 years (n = 11098) of a refinery and chemical plant in eastern China were requested to participate in a health survey. The participants were subjected to interview, physical examination, laboratory assessments and ultrasonography. All the participants were invitedto have a physical examination after a face-to-face interview. Fasting blood samples were obtained from the antecubital vein, and the samples were used for the analysis of biochemical values. Abdominal ultrasonography was conducted. RESULTS:A total of 10461 (7331 men and 3130 women) current and former petrochemical employees attended for screening. The overall prevalence of postcholecystectomy, gallstones and PLGs was 0.9%, 5.2% and 7.4%, respectively. Compared with the increased prevalence of either gallstones or post-cholecystectomy in older persons, PLGs were more common in the middle-aged, peaking in those aged 40-59 years. Excluding the patients with gallstones, gallstones mixed with PLGs, or those who had undergone cholecystectomy, in the remaining 9828 participants, the prevalence of PLGs in men (8.9%) was significantly higher than that in women (5.5%, P < 0.001). The analyzed risk factors with increased OR for the development of PLGs were male gender (OR = 1.799, P < 0.001), age ≥ 30 years (OR = 2.699, P < 0.001) and hepatitis B surface antigen (HBsAg) positivity (OR = 1.374, P = 0.006). CONCLUSION:PLGs are not rare among Chinese petrochemical employees. Male gender, HBsAg positivity, and middle age are risk factors for developing PLGs.