功能性空肠间置代胃术在进展期贲门癌根治术中的应用

目的探讨贲门癌的最佳术式。方法52例贲门癌患者均行全胃切除术,并将其随机分为Roux-en-Y空肠代胃术(RY)组和功能性空肠间置代胃术(FJI)组,分别于术后1个月、3个月、6个月、12个月进行随访,根据Spitzer生活质量量表和chew-wunwu特殊症状量表随访并测定相应指标。结果两组患者在进食困难、胃灼热感方面差别有显著性意义(P<0.05),而其余指标间差别无显著性意义(P>0.05)。结论功能性空肠间置代胃术是一种较为合理的消化道重建方式,能提高患者术后的生活质量。     

双重室性逸搏致特殊心电现象3例

完全性房室传导阻滞时,心室通常由1个起搏点所控制,而同时起源于心室不同部位或左右心室两个部位组成的双源性室性逸搏心律较为少见,其心电图表现较多变,现将我们遇到的3例报告如下.     

河南贲门癌高发区癌组织浸润淋巴细胞CD4和CD8及δγT的表达及意义

目的:探讨河南高发区贲门癌组织浸润淋巴细胞CD4、CD8和δγT的表达变化特征及其意义。方法:采用ABC和组织病理学方法,分析20例贲门癌组织和20例正常贲门对照组淋巴细胞CD4、CD8和δγT的表达状况。结果:贲门癌组织比正常组织CD8(68·05±29·85vs51·85±18·20,P=0·045)和δγT免疫阳性细胞数(7·50±4·24vs4·90±2·65,P=0·025)升高;贲门癌组织CD4免疫阳性细胞数比正常组织降低(68·35±28·73vs89·75±35·34,P=0·042);但是,正常组织CD4 /CD8 细胞比值明显高于贲门癌组织(1·88±0·76vs1·01±0·06,P=0·000)。结论:贲门癌患者免疫功能异常,可能与贲门癌变有关。     

河南食管癌高发区青年食管癌和癌前病变组织中STAT3的表达及意义

目的 探讨河南高发区青年食管癌和癌前病变组织中STAT3的表达及意义，加深对食管癌变机理的了解。方法 采用免疫组化卵白素-生物素-过氧化物酶复合物（ABC）法和组织病理学方法，分析STAT3在36例食管癌和癌旁组织中的变化特征和规律。结果 从正常食管上皮→基底细胞过度增生→间变→至鳞状细胞癌的演变过程中，随着病变程度的加重，STAT3蛋白阳性表达率呈现下降趋势，分别为86％（12／14）、88％（28／32）、55％（11／20）和75％（27／36），其中基底细胞过度增生与间变（P=0．008）的阳性率差异具有统计学意义。STAT3蛋白在高分化鳞癌组织中的阳性率最高89％（16／18），中、低分化鳞癌组织阳性率逐渐下降，分别为60％（6／10）和63％（5／8），但差异无统计学意义。结论 STAT3蛋白在癌变早期阶段表达变化显著，并随癌变程度加重和癌组织分化程度下降而呈现阳性表达率下降的趋势，提示STAT3是食管癌变早期的重要分子事件，并可能是食管癌变重要分子基础之一。     

房早揭示右束支内双径路传导一例

房性早搏常伴室内差异传导(VAb),但VAb心搏呈反文氏现象实属少见。我们遇到1例报告如下: 女性,72岁,临床诊断:肺心病。心电图示V_1导联奇数P为窦性,P—R间期0.12s,QRS波群呈rS型,时限0.08s。偶数P提前出现与窦性P不同,P’—R间期0.16s,联律间期基本恒定,P’下传QRS波群呈R逐渐降低→rSr’型,时限0.11→0.09s,这种心电图变化不能用     

绿脓杆菌制剂对人肝癌MHCC97L细胞增殖和侵袭能力的影响

Objective To investigate the effects of Pseudomonas aeruginosa vaccine (PA) on proliferation and invasiveness of the hepatocellular carcinoma cell line MHCC97L with metastatic potential. Methods Proliferation, growth curve, plate efficiency, flow cytometry, transwell invasion assay, cell motility assay, scarification test, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP2) protein activity were evaluated after cells were treated with PA at various concentrations. Results PA can inhibit the proliferation and plate efficiency of MHCC97L cell markedly in a dose-dependent manner. The IC50 of cells treated with PA for 48 h and 72 h was 3.1 ×108/ml and 1.9 × 108/ml, respectively. The doubling time increased and plate efficiency decreased gradually when cells treated with 0.5 × 108/ml, 1 × 108/ml and 2 × 108/ml PA (P＜0.01). PA could induce cell cycle arrest at the G1 phase in a dose-dependent manner by flow cytometric analysis. The average amount of invading cell per field in cell invasion assay and motility assay were 4. 8 ± 1.3 and 8. 8±2.2 when cells treated with 1× 108/ml PA, which was significantly lower than that of control group (8. 6±2. 1 and 15. 6±1.2 ) (P＜0.01) Scarification test showed that the metastatic ability of cells treated with 1 × 108/ml PA significantly lower than that in the control group. Comparison between cells treated with 1 × 108/ml PA and control group, no remarkable difference was found regarding expression of VEGF and MMP2 in supernatant of cell culture. Conclusion PA can inhibit proliferation and plate efficiency of HCC cell line MHCC97L, which is in part mediated by the cell cycle arrest at the G1 phase. PA could inhibit invasiveness of HCC cell line MHCC97L, which is unrelated to the VEGF and MMP2 protein activity.     

消炎痛抑制肝细胞肝癌生长转移的研究

Objective To study the effects of indomethacin on proliferation and invasion of hepatocellular carcinoma (HCC) cell line MHCC97L with metastatic potential and the effect of indomethacin on the growth and metastasis of HCC. Methods (1) In vitro; Proliferation, Transwell invasion assay, cell motility assay, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) protein activity were evaluated after cells were treated with 0. 2 mmol/L indomethacin. (2)In vivo: Mice bearing xenografts in the liver were randomly divided into control and indomethacin groups. At the end of sixth week, the mice were killed and tumor volume, inhibitory rate, immunohistochemistry assay (IHA) and metastasis were evaluated. Results (1)In vitro; 0. 2 mmol/L indomethacin could inhibit the proliferation of MHCC97L cells markedly (P ＜0. 01). The average amount of invading cells per field in cell invasion assay and motility assay was 2. 2 ± 1. 3 and 4.4 ± 1. 1 respectively in indomethacin group, significantly less than in control group ( 11. 4 ± 1. 9 and 12. 8 ± 1. 8 respectively, P ＜0. 01). The expression of VEGF and MMP-2 in cells treated with indomethacin was significantly lower than in control group (P ＜0. 01). (2)In vivo; Tumor volume, incidence and number of lung metastases in control and indomethacin groups were (1700 ±422) mm3 and (1170 ± 585) mm3 (P ＜ 0. 05), 75% and 50% ( P ＞ 0.05), 2. 92 ± 2. 07 and 1.33 ±1.56 (P＜0. 05) , respectively. Inhibition rate in indomethacin group was 31.2%. IHA showed that the expression of VEGF, MMP-2, and cyclooxygenase-2 ( COX-2) was down-regulated in indomethacin group (P ＜0.01). Conclusion Indomethacin could inhibit the growth and metastasis of HCC, which was in part mediated by down-regulation of VEGF and MMP-2.     

食管贲门双源癌患者癌组织中mdm2,CyclinD1和p16蛋白的表达

目的:探讨食管贲门双源癌组织中mdm2、CyclinD1和p16蛋白的表达.方法:采用免疫组化ABC法,对河南食管癌高发区30例双源癌患者食管鳞癌(SCC)和贲门腺癌(GCA)组织中mdm2、CyclinD1和p16蛋白的表达进行检测.结果:30例双源癌患者SCC组织中mdm2、CyclinD1和p16蛋白阳性率分别为57%(17/30)、45%(13/29)和24%(7/29),CCA组织中分别为73%(22/30)、33%(10/30)和17%(5/30),SCC和GCA组织中3种蛋白的阳性率差异均无统计学意义(P均＞0.05).SCC和GCA组织中mdm2、CyclinD1和p16蛋白表达的一致性差异无统计学意义(P均＞0.05).结论:食管和贲门双源癌存在较高的mdm2、CyclinD1和p16蛋白表达一致性改变,提示河南食管癌高发区食管贲门双源癌可能具有相似的发病因素和分子机制.     

交界区逸搏心律伴右束支直接显示性双向文氏现象

患者男,76岁,临床诊断:陈旧性前间壁心肌梗塞。,心电图(V_(1—a)～V_(1—c)系连续记录)示:P—P略有不整,含QRS的P—P间距小于不含QRS的P—P间距(相差大于0.02s),频率约86次/min,但频率较慢,为35次/min,P与QRS无关。QRS波群起始部有q波。QRS波群形态呈系列性变化,R_(1～6)呈RBBB图形,R波振幅逐渐增高,畸形逐搏明显,时限从0.12s至0.16s;R_(7、12)图形固定不变(中行),R_(13～18)(下行)与R_(1～6)(上行)呈相反的改变,从CRBBB型演变成IRBBB型。从     

肝动脉介入热灌注化疗栓塞联合GT引导下射频消融治疗肝脏恶性肿瘤

[目的]探讨肝动脉介入热灌注化疗栓塞联合CT引导下射频消融（RFA）治疗肝脏恶性肿瘤的临床应用价值。[方法]48例肝脏恶性肿瘤随机分为联合组（24例）和对照组（24例）,联合组采取肝动脉介入热灌注化疗栓塞联合RFA治疗,对照组仅行肝动脉介入热灌注化疗栓塞治疗。治疗后通过影像学及相关肿瘤标志物等进行疗效评价。[结果]联合组和对照组临床治疗有效率分别为70.8%和41.6%;两组患者甲胎蛋白（AFP）下降率和转阴率分别为66.7%、33.3%和30.7%、0。[结论]肝动脉介入热灌注化疗栓塞联合RFA是肝脏恶性肿瘤的一种有效治疗方法。