胃癌根治术后淋巴结转移率与患者预后的关系

目的探讨淋巴结转移率对胃癌患者预后预测的意义。方法回顾性分析我院238例胃癌根治术患者的术后病理资料,分析胃癌患者预后和UICC/AJCC N分期及淋巴结转移率的关系。结果患者术后5年累计生存率为42.0%,UICC/AJCC N分期和淋巴结转移率均是胃癌患者的预后预测因素。根据UICC/AJCC N分期系统,获得淋巴结总数大于15枚和少于15枚的同一N分期患者术后5年生存率存在显著差异。但根据淋巴结转移率分期系统,淋巴结总数大于15枚和少于15枚的同一淋巴结转移率分期患者预后无显著差异。结论淋巴结转移率是胃癌患者的简单、可靠的预后预测因素,可以防止获得淋巴结总数不足导致的N分期降低。     

ERCP术后胰腺炎的诊断与治疗

目的探讨ERCP术后并发胰腺炎的诊断与治疗。方法回顾性分析2824例行ERCP患者的有关临床资料。统计高淀粉酶血症与PEP的发生率,观察ERCP后血淀粉酶变化的规律。结果高淀粉酶血症与PEP是ERCP后最常见的并发症,本组总发生率达87．3％。结论ERCP术后并发胰腺炎一般较轻,经保守治疗后均能恢复。重症胰腺炎的发生率较低,但愈后较差。     

Antipyretic Effect of Herba Ephedrae-Ramulus Cinnamomi Herb Pair on Yeast-Induced Pyrexia Rats: A Metabolomics Study

Objective: To investigate the antipyretic mechanism of Herba Ephedrae(Eph)-Ramulus Cinnamomi(RC) herb pair on yeast-induced pyrexia in rats. Methods: Totally 30 qualified male SD rats were randomly assigned to the normal control(NC) group, the pyrexia model(model) group, the Eph, RC and Eph-RC treatment groups by a random digital table, 6 rats in each group. Each rat received a 20% aqueous suspension of yeast(10 m L/kg) except the NC group. The 3 treatment groups were administered 8.1, 5.4 and 13.5g/kg Eph, RC and Eph-RC respectively at 5 and 12h after yeast injection, the NC group and the model groups were administered equal volume of distilled water. Rectal temperatures were measured at 0,6,8,10,12,15,18,24 and 30h and urine was collected prior to yeast injection and at 6, 10, 18, 24, 30, and 36 h after yeast injection. Then urine metabolomic profiling by gas chromatography tandem mass spectrometry, coupled with multivariate statistical analysis and pattern recognition techniques were used to explore the antipyretic effects of Eph-RC. Partial least squares discriminate analysis was used to analyze the metabolomics dataset including classification and regression in metabolomics plot profiling. Results: Compared with the NC group, rectal temperatures were significantly higher in the model group(P0.01), while 3 treatment groups decreased significantly compared with the model group(P0.05 or P0.01). Rectal temperatures of Eph-RC-treated rats started to go down at 6 h, and markedly decreased at 8, 12, 15, 18 and 24h(P0.05 or P0.01), while those of the Eph and RC groups had decreased firstly at 8 h and were markedly lower at 12h(P0.05 or P0.01). Seventeen potential biomarkers related to pyrexia were confirmed and identified, including pyruvic acid, L-phenylalanine, L-tyrosine, phenylacetic acid, hippuric acid, succinic acid, citrate and so on. Eight potential alterations of metabolic pathways including phenylalanine metabolism, citrate cycle, tryptophan metabolism, biosynthesis of valine, leucine and isoleucine, were identified in relation to the antipyretic effects of Eph-RC using MetPA software. Conclusion: The antipyretic effect of Eph-RC herb pair on yeast-induced pyrexia in rats involved correction of perturbed amino acid, fatty acid, and carbohydrate metabolism according to the metabolic pathway analysis with MetPA.     

人参皂苷CK对胃癌细胞株SGC-7901及其内源性VEGF的影响

目的 研究人参皂苷CK对胃癌SGC-7901细胞增殖、细胞周期的影响及其对内源性分泌的血管内皮细胞生长因子(VEGF)的作用。方法 以50、25、12.5、6.25、3.125、1.5625μg/ml的人参皂苷CK作用于胃癌细胞株SGC-7901,通过MTT法检测人参皂苷CK对细胞的抑制作用;采用流式细胞术检测细胞周期和细胞凋亡;ELISA定量检测细胞培养液中内源性VEGF的含量变化。结果 MTT法显示人参皂苷CK对胃癌细胞株SGC-7901有抑制作用,并且呈浓度、时间依赖关系;SGC 7901细胞经人参皂苷作用后出现明显凋亡峰,且细胞周期被阻滞在G0/G1期;人参皂苷CK处理组VEGF含量低于对照组(P<0.05),高浓度组低于低浓度组(P<0.05),且随着作用时间延长,VEGF含量降低。结论 人参皂苷CK可通过诱导凋亡抑制胃癌细胞株SGC-7901生长,并可抑制SGC 7901细胞内源性分泌VEGF,人参皂苷CK可能成为一种潜在的抗胃癌药物。     

造血干细胞移植治疗消化系统肿瘤进展

造血干细胞移植（HSCT）通过造血和免疫重建功能可支持患者接受大剂量化疗（HDC）和放疗，并通过其移植物抗肿瘤（GVT）反应，提高治疗中晚期消化系统肿瘤的疗效。     

单侧甲状腺结节216例的临床分析

目的探讨甲状腺腺叶切除术治疗单侧甲状腺结节的效果.方法回顾性分析216例单侧甲状腺结节病人的临床资料.结果216例患者施行甲状腺腺叶切除或腺叶加峡部切除术.术后病理检查诊断为滤泡状和乳头状囊性腺瘤178例,结节性甲状腺肿30例,甲状腺癌8例.术后随访3月～3a,无1例复发,无甲状腺功能减退症状发生,临床疗效满意.结论单侧甲状腺结节常规施行腺叶切除术是一种安全有效的治疗方式.     

特殊染色在非临床药物安全性评价中的应用

病理学诊断中特殊染色具有重要的应用价值,通过长期的改进与创新特殊染色能够有针对性地对组织成分进行染色,使组织病理学评价更加完善精确。非临床药物评价中常用的特殊染色法有结缔组织染色的Masson三色染色法、肌肉染色的磷钨酸苏木素染色法、糖原染色的过碘雪夫染色法、脂质类染色的油红O染色法、色素类染色的Masson-Fontana染色法,以及神经组织染色和病理沉着物染色等,综述特殊染色的主要内容及应用中注意事项。     

内镜治疗结直肠癌合并肠梗阻28例的体会

目的 探讨内镜治疗结直肠癌合并肠梗阻的价值.方法 回顾性分析云南省肿瘤医院2005年7月～2008年7月内镜治疗的28例结直肠癌合并肠梗阻患者的临床资料.其中,病变位于横结肠1例,降结肠14例,乙状结肠3例,高位直肠10例.结果 内镜支架置入28例,成功22例(78.5%),解除梗阻20例(71.4%),并发穿孔2例,支架脱出1例,二期再手术3例.无治疗相关的死亡.结论 内镜治疗结直肠癌并肠梗阻具有安全、有效、微创的特点,特别适合于肿瘤位于降结肠、乙状结肠和高位直肠的患者.     

残胃癌的临床病理特征

目的 探讨残胃癌的临床病理特征及其治疗方法.方法 回顾性分析9年间收治的25例良性病变行胃次全切除术后发生残胃癌手术患者的病理和临床资料.结果 残胃癌男女比例约为5:1,发生于首次手术后12～35年,平均24.5年,首次手术为Billroth Ⅱ式者占80.0%.患者就诊时为进展期,淋巴结转移以残胃大弯侧、空肠系膜为主.均行手术治疗,行根治性手术切除14例(56.0%),姑息性切除11例(44.0%).术后辅以辅助化疗18例.随访3～12年,1,3,5年总体生存率分别为72.0%,56.0%,36.0%.根治性手术后为78.5%,71.4%,50.0%;姑息性手术后为63.6%,36.3%,18.1%(P＜0.05).手术联合化疗组的5年生存率为44.4%(8/18),显著高于单纯手术治疗组的14.3%(1/7)(P＜0.05).结论 残胃癌以手术联合辅助化疗的治疗方案仍能获得较好的临床效果.