Reduction of oral acetaldehyde levels using a controlled-release chlorhexidine chip as a prevention strategy against upper digestive tract cancer

Increasing evidence indicates a strong relationship exists between harmful habits like smoking and alcohol drinking and upper digestive tract cancer. In addition, smokers and alcohol drinkers also exhibit high salivary levels of carcinogenic acetaldehyde, the first metabolite of alcohol. This compound has been indicated as a major cancer causing factor in the upper digestive tract, especially among alcohol drinkers. Interestingly, acetaldehyde is produced from alcohol present in the epithelia by mucosal alcohol dehydrogenases (ADH) in the upper digestive tract. However, much higher levels derive from the bacterial oxidation of alcohol by the oral microflora. In this respect, the reduction of oral microbes can become a fundamental factor in diminishing the risk of cancer. In this article, we hypothesize that the antimicrobial agent chlorhexidine, formulated as controlled-release chip, and fixed by a dental device, (i.e., a modified orthodontic bracket), may be the most rational strategy for reducing acetaldehyde production by microflora.     

急性上消化道出血的诊断及治疗

目的 探讨急性上消化道大出血病人的诊断及治疗。方法 本组326例急性上消化道大出血病例，其中211例采用了内科药物保守治疗，全身静脉用药＋局部用药；115例采用外科手术治疗。胃大部切除及全胃切除83例，胃癌姑息切除16例，肝硬化门奇断流术12例，分流术2例，胆囊切除、胆道取石术2例。结果 326例病人，19例胃癌中16例死亡，手术死亡2例，其余14例分别于术后6～12个月后死亡；39例肝硬化门脉高压食道胃底静脉曲张破裂出血，12例门奇断流手术后，1例于3年后再次行了断流术，1例术后并发胃瘘死亡；2例分流术后1例于1年后因肝昏迷死亡；8例肝癌于出院后6～8个月死亡；211例经内科药物保守治疗治愈出院。结论 急性上消化道大出血是胃肠道疾病的严重危及生命的合并症，因其病因复杂，出血程度和部位的不同，其治疗方法和治疗途径各异。要按不同的年龄、病情行内科抢救，保守治疗无效者要果断采用外科手术治疗才能获得较好效果。     

门静脉高压症反复上消化道出血的外科治疗

目的 探讨经胸贲门周围血管离断术治疗的门静脉高压症引起的反复上消化道出血。方法 回顾性分析我院肝炎后肝硬化门静脉高压症并上消化道反复出血患者136例，均经胸行贲门周围血管离断术。结果 痊愈出院130例，急诊手术死亡4例，择期手术死亡2例。结论 经胸贲门周围血管离断术治疗门静脉高压症引起的反复上消化道出血与其它手术方式相比，具有操作清晰，断流更加彻底、安全，急诊止血率高、死亡率低、并发症少、长期生存率高等优点，值得临床推广。     

326例上消化道溃疡穿孔诊治体会

目的探讨胃十二指肠溃疡穿孔的特征和治疗方法。方法回顾本院1995-2009年收治的胃十二指肠溃疡穿孔患者病例资料,对年龄、发病至就诊时间、治疗等进行分析。结果共收治胃十二指肠溃疡穿孔患者共326人。有240例可见不同程度的隔下游离气体,其中25例经胃管注气后再行腹部立卧位X线检查发现隔下游离气体,阳性率为81.29%。消化性溃疡患者中,35岁以下所占比重逐渐下降,而55岁以上患者的比率逐渐增加,老年性患者使用非甾体类消炎药的比率随时间的推移逐渐增加。269例行单纯穿孔缝合术,18例行胃大部分切除术,穿孔缝合＋高选迷走神经切断6例,保守治疗33例。结论根据病史、体征和积极的腹部X线一般可诊断。消化性溃疡的患者中,老年人的比率呈现逐渐增高的趋势,可能与老年性患者非甾体类消炎药使用机率的增加有关。上消化道溃疡穿孔行单纯缝合修补操作简单、安全、并发症少,术后结合正规内科治疗,效果满意。     

The role of various sections of the digestive tract in the excretion of radioactive calcium

Summary Excretion of radiocalcium with digestive fluids was studied in long-term experiments on dogs after intravenous injection of this substance. Investigations were carried out on experimental animals with isolated portions of the stomach, of the small and large intestine, as well as with exteriorized bile and pancreatic ducts. As established, the greatest amount of Ca⁴⁵ was excreted with bile (up to 1% of the dose administered) and by the large intestine fistula (0.2–0.4% of that administered). The least amount of Ca⁴⁵ was excreted with the stomach juice (0.02% of the injected dose).(Presented by Active Member of the Akad. Med. Nauk SSSR P. D. Gorizontov) Translated from Byulleten Éksperimental'noi Biologii i Meditsiny, Vol. 56, No. 8, pp. 68–70, August, 1963     

抗氧化蛋白与消化道肿瘤关系的研究进展

抗氧化蛋白Peroxiredoxins是有机体内抗过氧化的重要成员,该类蛋白包含保守的半胱氨酸残基,通过与硫氧化蛋白的协同作用消除组织及细胞内的有害过氧化物。目前多种消化道肿瘤如肝癌、胃癌、胰腺癌等组织中均发现有高表达的抗氧化蛋白,推测其可能是肿瘤的潜在标志物,且已有实验证实,抑制抗氧化蛋白表达可增加消化道肿瘤对放射、化学治疗的敏感性。     

上消化道颗粒细胞肿瘤10例临床病理学分析

目的探讨上消化道颗粒细胞瘤的临床病理学特点以及治疗和预后。方法观察10例上消化道颗粒细胞瘤的临床、组织形态学以及免疫组织化学等特征。结果患者平均年龄40.5岁,男女比例为7∶3。9例上消化道颗粒细胞肿瘤位于食管,1例位于胃。肿块多位于黏膜层至黏膜下层。组织学上,肿瘤细胞呈紧密的巢状或片状,多呈浸润性生长,但常无坏死。细胞呈圆形、多边形或梭形,细胞质丰富且含有多量呈PAS-D阳性的嗜双色性颗粒状物质,细胞核小、圆而居中,核分裂象少见。免疫谱示肿瘤细胞均呈弥漫强阳性表达nestin和S-100,多呈CD68差异性阳性表达,而CK、CD117、CD34、desmin和SMA均阴性。经随访12～54个月,10例肿瘤均未见复发和转移。结论上消化道颗粒细胞肿瘤少见,但特征性的组织学和免疫组织化学特征有助于诊断,多行内窥镜下或手术切除治疗,常具有良性的临床经过。     

巢蛋白在人胚胎消化管的表达

目的　通过研究不同时期人胚胎消化管巢蛋白的表达及其变化探讨巢蛋白在消化管发育过程中的作用。 方法　取3~8月人胚胎食管、胃和小肠,常规石蜡切片,采用免疫组织化学法检测巢蛋白在胚胎消化管中的表达及分布。 结果　各胎龄段（3~8月）消化管均有巢蛋白的表达。巢蛋白在消化管主要表达在固有层、黏膜下层和肌层内的微血管和毛细血管壁上,且巢蛋白的表达随胎龄的增加而减少。与发育早期组相比,发育中期、晚期胚胎食管、胃和小肠组织中巢蛋白的表达显著减少（P<0.05）,差异有统计学意义。而在发育中期和发育晚期巢蛋白的表达无显著性差异（P>0.05）。 结论　巢蛋白在胎儿消化管壁的微血管和毛细血管的管壁上表达,且随着胎儿发育,其表达逐渐减少,提示巢蛋白在这些器官组织的血管形成过程中起作用。     

Cancer as a tissue: The significance of cancer‐stromal interactions in the development,morphogenesis and progression of human upper digestive tract cancer

We review the significance of cancer‐stromal interactions (CSIs) in the development, morphogenesis and progression of human gastric and esophageal cancer based on the data obtained from co‐culture experiments. Orthotopic fibroblasts in the gastric cancer stroma not only promoted their growth by cancer cells but were also responsible for the mobility, morphogenesis and epithelial‐to‐mesenchymal transition (EMT) of the cancer cells through CSI. Bone marrow‐derived mesenchymal stem cells could be part of the origin of cancer‐associated fibroblasts (CAFs) of the gastric cancer providing an advantageous microenvironment for the restoration of cancer stem cells with the induction of the EMT. Tumor‐associated macrophages (TAMs) may differentiate from bone marrow‐derived monocytes/macrophages within the tumor microenvironment of esophageal cancer and participate in the growth and the progression of esophageal squamous cell carcinomas (ESCCs). Macrophages infiltrated into the intraepithelial neoplastic lesions of the esophagus may function as a biological promoter by promoting the growth and motility of squamous epithelia. Tumor cells build up “cancer as a tissue” by taking advantage of the existing network of growth factors, cytokines and chemokines through the interactions of TAMs, CAFs and cancer cells themselves.