Performance Characteristics and Comparison of Two Immunochemical and Two Guaiac Fecal Occult Blood Screening Tests for Colorectal Neoplasia

A new immunochemical test for stool Hb, FlexSureOBT, was compared with the immunochemical HemeSelect andguaiac Hemoccult II and Hemoccult SENSA tests. Blindeddevelopment of test cards smeared with stools having added human blood showed betteranalytical sensitivity of FlexSure OBT (0.2 ml blood/100g feces), than Hemoccult SENSA (0.5 ml) or HemoccultII (1.0 ml). All four stool tests were prepared by 403 subjects having endoscopic examinations.The guaiac tests and FlexSure OBT were easy to prepareand develop. The positivity rate of Hemoccult SENSA was8.7%, Hemoccult II 6%, FlexSure OBT 4.2%, and HemeSelect 3.4%. In this mainly asymptomatic(97%) population, 98% were free of clinicallysignificant neoplasia (five had cancers, three hadadenomas 1.0 cm). Sensitivity for cancers oradenomas 1.0 cm was similar for all tests (62.5-86%, NS) andHemoccult SENSA had the lowest specificity (92% vs95-98%, P < 0.05); but both Hemoccult II andHemoccult SENSA had significantly lower predictivepositive values (21% and 14%) than either FlexSure OBT(29%) or HemeSelect (50%) (P < 0.05). If bothHemoccult SENSA and FlexSURE OBT were positive in thesame subjects (1.7%), sensitivity for cancer or adenomas 1.0 cm (50%) was not significantly betterthan guaiac tests, but specificity (99.2%) andpredictive positive (57%) values were improved (P <0.05). In this population, guaiac tests were assensitive as immunochemical tests for clinically significantcolorectal neoplasia, but with significantly lowerpredictive positive values. A combination of a sensitiveguaiac test (Hemoccult SENSA) and a specificconfirmatory test for human Hb (FlexSure OBT) provided highspecificity, comparable to HemeSelect.     

结肠损伤的一期手术治疗

目的 探讨结肠损伤的术式选择。方法 对手术治疗的７８例结肠损伤病人的临床资料进行回顾性分析。结果 ７８例中单纯损伤７例,合并伤７１例,一期手术治疗６３术后发生肠瘘１例,治愈６２例,死亡１例,二期手术治疗１５例,再次术后发生肠瘘１例,治愈１３例,死亡２例,结论 结肠损伤一期手术治疗是一种理想的可行的手术方式。严格掌握手术适应症,完善围手术期处理十分重要。     

~(131)抗CEA单抗治疗结肠腺癌肝转移裸鼠对CEA水平影响的研究

目的　探索应用1 31 I标记抗CEA单抗治疗结肠腺癌肝转移后对荷瘤裸鼠血清、腹水和癌组织中CEA水平的影响。方法　在建立人结肠腺癌裸鼠肝转移后 10min(早期治疗组 )、10d(中期治疗组 )、2 0d(晚期治疗组 )经尾静脉注射1 31 I标记抗CEA单抗 ;并以模型建立后经尾静脉注射1 31 I标记的正常小鼠IgG作为对照组。于接种癌细胞 4周后 ,采集血、腹水和癌结节 ,分别检测其CEA含量。结果　早期治疗组的血、腹水和癌结节中CEA水平均明显低于对照组 (P <0 .0 1) ;早期治疗组与晚期治疗组则无显著性差异 (P >0 .0 5 )。结论　早期应用1 31 I标记抗CEA单抗能有效地降低荷瘤裸鼠的血清、腹水和癌结节中CEA水平     

创伤性结肠损伤的处理

目的 探讨创伤性结肠损伤的诊断和处理方法,提高早期确诊率和治疗成功率,降低并发症和死亡率。方法 回顾性分析我院１９９３～１９９８年期间３２例结肠操作的临床资料。结果 早期确诊２４例（７５％）,误诊８例（２５％）。３２例结肠损伤中行单纯结肠一期缝合修补２４例,一期结肠切肠吻合５例,共２９例,一期手术率９０．６％。损伤肠段修补或切除加近端造瘘３例,造瘘率９．４％。并发症４例,占１３．８％;全组病例无死     

Decreased Dopamine Receptor Expression and Its Second-Messenger cAMP in Malignant Human Colon Tissue

As an important enteric neurotransmitter, therole of dopamine as a mitotic inhibitor as well as aprotective factor of epithelial cells of stomach andcolon indicates its significance in malignant growth of gastrointestinal tract. Our previous resultshave shown significant alteration of dopamine receptorsin human malignant stomach tissues. The presentexperiments, therefore, evaluate DA content, itsreceptor expression, and its second-messenger cAMP inhuman malignant colon tissues to evaluate its role.Results demonstrate a significant decrease of dopaminecontent, its receptor expression, and itssecond-messenger cAMP in malignant tissues of human colon. Theseresults may provide insight into the role of dopamine asan enteric neurotransmitter on malignant growth of humancolon and may also suggest a therapeutic approach targeting dopamine receptors and itssignal transduction.     

体表结肠电引导电极定位的观测研究

53例153幅钡灌肠X线照片测量结果及有关解剖学资料显示:①升、降结肠属腹膜间位器官,其后面有结缔组织附着腹腔后外侧壁,体表投影位置相对固定,个体差异亦不大,脐水平腋后线腰部是安放表面电极引导升,降结肠肠电的适宜位置;②乙状结肠中段以下肠管常复杂绕曲,而乙状结肠起始部邻近肠段则少有绕曲、位置变异较小,左髂前上棘—耻骨联合连线中外1/3交点垂线内侧约4.4cm处适宜安放电极引导体表乙状结肠肠电;③横结肠活动度大,位置高度因人而异,本组受检者横结肠在正中线上偏高偏低最大相差达23cm;因而,未以适当方法确认横结肠实际投影位置时,不宜在腹壁随意固定电极引导横结肠肠电。     

Induction of Mineralocorticoid Receptor by Sodium Butyrate in Small Intestinal (IEC6) and Colonic (T84) Epithelial Cell Lines

Mineralocorticoid action is essential forcolonic sodium and water absorption and is mediated viamineralocorticoid receptors in the upper half of coloniccrypts. On the other hand, it has been established that sodium butyrate inducesdifferentiation-like phenomenon in vitro. The aim ofthis study is to investigate whether this bacterialproduct participates in the regulation of gene andprotein expression of mineralocorticoid receptor in vitro. IEC6and T84 cells were stimulated by sodium butyrate andRNAs extracted. Gene expression of mineralocorticoidreceptor was evaluated by northern blotting orsemiquantitative RT-PCR. Protein expression was determined inT84 cells using immunohistochemistry. To investigatewhether MR induction was associated with cellulardifferentiation, we also measured alkaline phosphatase in situ. The mineralocorticoid receptor genewas induced by sodium butyrate in both IEC6 and T84cells. Immunoreactivity increased in butyrate-treatedT84 cells, but receptorcontaining cells were notuniformly distributed and often formed clusters.Induction of alkaline phosphate activity was alsodemonstrated in both IEC6 and T84 cells. Double stainingby immunoreactivity and alkaline phosphatase activityclearly demonstrated the colocalization of both afterbutyrate treatment. In conclusion, sodium butyrateup-regulates gene and protein expression of thefunctionally important mineralocorticoid receptor inepithelial cells, after induction by differentiation-likecondition in vitro.     

Motor Responsiveness of Proximal and Distal Human Colonic Muscle Layers to Carbachol and Neurotensin

A regional heterogeneity of the responsivenessto neurohumoral agents has been demonstrated in proximaland distal colon. The aim of this study was to comparethe motor responsiveness of circular and longitudinal muscles from ascending and sigmoid colon tocarbachol and neurotensin. Ascending colon circularmuscle was more sensitive to carbachol than sigmoidcolon circular muscle (P < 0.05). Moreover, thepotency for the carbacholstimulated contraction wasgreater in ascending colon circular than longitudinalmuscle (P < 0.05). The potency for carbachol andneurotensin stimulations was similar in longitudinal and circular muscles of both sections,respectively. However, the ascending colon circularmuscle had a greater potency to neurotensin thanlongitudinal muscle (P < 0.03). Longitudinal musclewas more sensitive to the effects of neurotensin insigmoid than ascending colon (P < 0.01). On a molarbasis, neurotensin was approximately fivefold morepotent than carbachol in producing similar contractions. These data suggest that these agents stimulatehuman colon smooth muscle according to region and typeof muscle layer.     

New Biodegradable Hydrogels Based on Inulin and α,β-Polyaspartylhydrazide Designed for Colonic Drug Delivery: In Vitro Release of Glutathione and Oxytocin

Succinic derivatives of inulin (INU–SA) with two different degrees of derivatization (20% and 30%, mol/mol) were cross-linked with α,β-polyaspartylhydrazide (PAHy) to obtain INUPAHy hydrogels. Cross-linking was performed using N-ethyl-N-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC) and N-hydroxysulfosuccinimide (NHSS) as coupling agents and by varying the reaction time (4 h, 8 h and 24 h). All samples prepared were characterized by FT-IR analysis and swelling measurements in different media. In vitro assays, performed in the presence of inulinase, demonstrated the degradability of the prepared hydrogels. Cell compatibility was evaluated using Caco-2 cells through both direct and indirect assay. Glutathione (GSH) and oxytocin (OT), both potential agents for the treatment of colonic inflammation, were entrapped into a INUPAHy hydrogel and their release was evaluated in simulated gastrointestinal fluids. The obtained results suggest that GSH- and OT-loaded INUPAHy hydrogels are potentially useful for the oral treatment of inflammatory bowel disease.