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71.
门脉高压性胃病患者的胃壁血气变化 总被引:1,自引:0,他引:1
作者观测了43例门脉高压症患者股动脉血PO2、胃网膜有动静脉胃壁支血PO2、胃壁支静脉及肘静脉血pH、HCO3-和胃网膜右静脉压力,其中23例并有非出血期门脉高压性胃病。结果表明:①门脉高压症患者的股动脉血PO2低于对照组;②门脉高压症患者胃网膜右动静脉胃壁支血氧分压差低于对照组,胃网膜右静脉压力高于对照组,胃壁支静脉血pH和HCO3-低于对照组和同组肘静脉血。并有门脉高压性胃病者这些变化更为显著。提示门脉高压性胃病的发病机制在于门脉系压力增高、胃粘膜下动静脉短路开放、胃粘膜缺血缺氧和胃壁局部酸中毒。 相似文献
72.
Reduced Expression of nm23 Is Associated with Metastasis of Human Gastric Carcinomas 总被引:7,自引:0,他引:7
Reduced expression of nm23 gene is implicated in high metastatic potential In a variety of malignancies. To elucidate the role of nm23 in human gastric carcinomas, we examined loss of heterozygosity (LOH) of nm23 gene by Southern blotting, nm23 mRNA expression by Northern blotting and nm23 protein expression by Western blotting as well as immunohistochemistry in both primary and metastatic tumors. LOH of nm23 gene was found in 2 (8%) out of the 23 informative gastric carcinomas. Twenty-two (84%) out of the 26 cases expressed nm23 mRNA at higher levels in primary tumor tissue than in corresponding non-neoplastic mucosa. No obvious correlation was observed between clinico-pathological features and LOH of nm23 gene or nm23 mRNA expression. On the other hand, 52% of the gastric carcinomas showed reduction of nm23 immunoreactivity in the metastatic tumor of regional lymph nodes, as compared to the primary tumor. Interestingly, 71% of the gastric carcinomas showed weaker nm23 immunoreactivity in the liver metastasis than in the primary tumor. These results suggest that nm23 overexpression is linked with development of gastric carcinomas and the decrease in expression of nm23 participates in metastasis. 相似文献
73.
OBJECTIVE: Many patients with haemorrhoids are investigated because of the fear of missing colorectal cancer (CRC). The aim of this study was to determine whether a primarily clinical approach regarding the need for investigation was safe and did not miss patients with CRC. PATIENTS AND METHODS: Data was collected prospectively on 589 consecutive patients with the principle diagnosis of haemorrhoids at first clinic visit. All had clinical assessment including rigid sigmoidoscopy and were treated by phenol injection or banding. They were categorized for (1) no review unless symptoms persisted -'One Stop SOS' (2) outpatient review or (3) investigation. To check for the development of CRC they were contacted by postal questionnaire or telephone interview with a minimum of one year from diagnosis and treatment. All 589 patients were cross-referenced with the Pathology database and the Hospital Information Services System. RESULTS: Four hundred and sixty-nine (80%) answered the questionnaire; 352 patients (60% of the total group) fell in the 'one stop SOS' outpatient category; 95 (16%) patients were followed up to review response to treatment for large haemorrhoids; 105 (18%) were investigated with barium enema (12%), flexible sigmoidoscopy (4%), colonoscopy (1%) and miscellaneous (1%); 37 (6%) patients were either given a haemorrhoidectomy date or referred on with a different diagnosis. No patients selected for 'one-stop' treatment developed CRC. Five (0.8%) patients were diagnosed with CRC after appropriate investigation was instituted for suspicious symptoms. One patient with distal transverse colon cancer had a delayed diagnosis as she was investigated initially by flexible sigmoidoscopy. CONCLUSION: Most patients with the primary diagnosis of symptomatic haemorrhoids do not need investigation. 相似文献
74.
BACKGROUND AND AIM: Peptic ulcer disease is believed to be less common and less severe as a result of modern medical treatment. We therefore examined changes in the admission rates for patients with duodenal ulcer and gastric ulcer, both emergency (for haemorrhage, perforation or severe pain) and for elective surgery, before and since the introduction of the new advances in therapy. These admission indices reflect disease prevalence and severity. PATIENTS AND METHODS: We identified admission rates during 1972--2000 within the Trent Regional Health Authority, UK (population 4.7 million), from computerised patient information using diagnostic search codes ICD8-10 and expressed as rates per million resident population. Drug expenditure details were obtained from the Department of Health. RESULTS: Emergency admission rates as a whole changed little, a decline in the young being offset by an increase in the elderly. Haemorrhage was the most common reason (approximately 115 per million for duodenal ulcer and 87 for gastric ulcer) throughout [compared with perforation (80 and 21) and pain (90 and 68)]. In contrast, elective surgery has almost disappeared; this reduction began before the introduction of modern treatment. CONCLUSION: Emergency admission rates for duodenal and gastric ulcer for complications or severe pain have fluctuated over the last three decades but with little overall change. In contrast, elective surgery has declined dramatically, as a result of advances in treatment but also from changes in the natural history. 相似文献
75.
目的 探讨腹腔内注射OK - 4 32增强腹腔免疫功能的机制。方法 选择非炎症和非肿瘤手术患者作为实验对象 ,实验组分别于手术前 72小时、4 8小时和 2 4小时腹腔内注射 4KE的OK - 4 32。开腹后采集腹腔内巨噬细胞 ,并用人胃癌MKN1细胞作为靶细胞对巨噬细胞的癌细胞毒性进行分析。同时采集大网膜 ,对大网膜乳斑的数量和面积进行了观察分析。结果 OK - 4 32显著增加了腹腔内巨噬细胞的数量 (P <0 .0 5 )、增强了巨噬细胞的吞噬活性和酶活性 (P <0 .0 5 )、增加了NO的分泌和巨噬细胞的癌细胞毒性 (P <0 .0 5 ) ,以及大网膜乳斑的数量和面积 (P <0 .0 5 )。结论 手术前腹腔内注射OK - 4 32可以作为预防癌细胞腹腔内种植转移的有效方法。 相似文献
76.
逆转录-聚合酶链反应检测胃癌淋巴结微转移 总被引:1,自引:0,他引:1
目的 检测胃癌常规病理检查阴性的淋巴结微转移的发生及与其它临床参考指标的关系。方法 利用逆转录-聚合酶链反应(RT-PCR)方法检测68枚胃癌胃周淋巴结癌胚抗原(CEA)mRNA基因表达,同时比较RT-PCR与免疫组化(IHC)方法的检测敏感性。结果 CEAmRNA RT-PCR是一种很敏感的方法,可以检测1/10^6个转移的癌细胞;检测19例胃癌患者取材的68枚胃周淋巴结,IHC阳性率28%(19/68),RT-PCR阳性率57%(39-68),两组之间差异有非常显著性意义(P<0.01);RT-PCR阳性率与胃部临床参考指标密切相关,且随着病期进展而增大。结论 CEA mRNA RT-PCR是比免疫组化更敏感的方法,可以预测胃癌淋巴结微转移,能够有效地避免已有微小转移的患者被漏诊。 相似文献
77.
BorrmannⅣ型胃癌的临床特征和外科治疗 总被引:2,自引:0,他引:2
目的探讨BorrmannⅣ型胃癌的临床特征和治疗方法。方法回顾性总结29例BorrmannⅣ型胃癌的临床资料,分析本型胃癌的临床表现、病理特点以及手术治疗的特殊性。结果全部患者均有上腹饱胀、隐痛不适、食欲不振,同时伴有明显的进行性消瘦,短期内体重明显减轻等临床症状。术前病理确诊为本型胃癌者24例。5例患者胃镜诊断为浅表型胃炎。获根治性切除22例,姑息性远侧胃切除者3例,放弃手术者4例。其1、2、3年生存率分别为38.9%、8.3%、0%。结论(1)BorrmannⅣ型胃癌是一种恶性程度极高的胃癌,其具有独特的生物学特性,治疗效果差,生存期短,预后不佳。(2)对BorrmannⅣ型胃癌应强调以根治性全胃切除和联合脏器切除为主的综合治疗方法。 相似文献
78.
Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery 总被引:1,自引:0,他引:1
Vincent W. Vanek M.D. C.N.S.P. F.A.C.S. Michele Catania R.N. B.S.N. Kimberly Triveri R.D. L.D. Robert W. Woodruff Jr M.D. 《Surgery for obesity and related diseases》2006,2(1):839-22
BACKGROUND: The purpose of this study was to analyze the frequency and results of preoperative biliary and gastrointestinal (GI) evaluation of patients undergoing Roux-en-Y gastric bypass (RYGB). METHODS: Retrospective review of the preoperative evaluation of 144 consecutive RYGB patients. RESULTS: Cholecystectomy had already been performed in 43 (30%) patients; 22% of those patients with an intact gallbladder had cholelithiasis. Ten patients (7%) had an upper GI x-ray (UGI), and 94 patients (65%) had an esophagogastroduodenoscopy (EGD). Abnormalities were found in 40% of the UGIs and 84% of the EGDs. A total of 96 patients (67%) were tested for Helicobacter pylori; 11% were positive. Twenty-one patients (15%) underwent preoperative colonoscopy; 48% were abnormal, but most of the abnormalities were not clinically significant. Three patients had barium enema x-ray, which was normal in all cases. CONCLUSIONS: The preoperative biliary and GI evaluation of bariatric surgery patients should include a routine ultrasound of the gallbladder. Routine preoperative EGD will detect a significant number of abnormalities that should be treated, but should rarely alter the bariatric surgical procedure or result in denial of bariatric surgery. Many abnormalities will be asymptomatic. Patients should be routinely screened for H. pylori and, if positive, treated before bariatric surgery. Lower GI evaluation should be performed selectively based on the patient's symptoms, physical findings, and guidelines for colorectal cancer and polyp screening. 相似文献
79.
128例老年胃癌患者围手术期临床特点分析及护理对策 总被引:2,自引:0,他引:2
目的:提高对老年胃癌患者围术期护理的认识。方法:对128例≥65岁胃癌患者与同期〈65岁212例胃癌患者围术期各方面资料进行对比分析。结果:≥65岁组术前合并症多,全胃及联合脏器切除比例高、创伤大,术后非手术相关并发症多,患者文化水平较低,社会支持水平低。结论:对老年胃癌患者应重视术前的全面评估和充分准备,争取和利用患者的社会支持系统,采取灵活多样的形式进行健康教育,术后重视呼吸系统、心血管系统并发症及手术相关并发症(吻合口瘙、胃排空障碍、胰腺炎、胸腔积液或腹腔积液等)的预防和护理。 相似文献
80.