Is endoscopic one‐piece mucosal resection essential for early gastric cancer?

Background: Endoscopic mucosal resection (EMR) is widely accepted as a minimally invasive treatment for early gastric cancer (EGC) in Japan. However, the criteria for EMR must be strictly adhered to otherwise patients will miss the chance for additional therapy. We assess the important factor in expanding the indication of EMR. Methods: We investigated 1101 EGCs that had been resected by EMR at the National Cancer Center Hospital (NCCH), Tokyo, Japan, according to the indication recommended by Japanese Gastric Cancer Association (JGCA) and the expanded indication proposed by NCCH. Curability and local recurrence of the EMRs were assessed related to the applied indication and the number of resected specimens. Results: The recurrence rate of non‐evaluable resection was higher than that of evaluable resection (P < 0.0001). Eighty‐three lesions among 772 lesions in the JGCA group were non‐evaluable. Thirty‐seven leisons among 329 lesions in the NCCH group were non‐evaluable. There was no difference in the rate of non‐evaluable resection between JGCA and NCCH groups (P = 0.8329). However, the rate of curative resection was lower in the NCCH group than in the JGCA group (P = 0.0009). In piecemeal resection, there was no difference in the rate of non‐evaluable resection between JGCA and NCCH groups (P = 0.0527). In one‐piece resection, the rate of non‐evaluable resection was lower in the NCCH group than the JGCA group (P = 0.0137). Conclusion: Based on our series of cases, we propose one‐piece resection as a gold standard for EMR because it enables accurate histological evaluation, even in the EMR, according to the expanded indication.     

RNA干扰及其在胶质瘤基因治疗中的应用

RNA干扰（RNA interference。RNAi）是双链RNA（double—stranded RNA，dsRNA）降解特异性靶基因转录出的mRNA。从而抑制靶蛋白表达的现象。自从二十世纪九十年代发现RNAi这一现象以来，RNAi已被广泛应用于研究基因功能、信号转导通路和基因治疗等方面。随着分子生物学、分子遗传学等学科的发展．发现了许多与肿瘤发生、发展和预后密切相关的基因。经过大量临床前期试验表明，针对特异性靶基因的小干扰RNA（short／small interfering RNA．siRNA）治疗胶质瘤是行之有效的。为基因治疗胶质瘤提供了新的思路。[第一段]     

对大肠癌术后早期炎性肠梗阻诊治的探讨

目的：探讨大肠癌术后早期炎性肠梗阻的特点及治疗方法；方法：分析10例大肠癌术后出现早期炎性肠梗阻的临床表现并进行综合保守治疗；结果：10例患者保守治疗全部成功；结论：术后早期炎性肠梗阻是一种非细菌性炎性肠梗阻，以发生在术后早期，腹胀、呕吐明显，腹痛轻或无为主要临床特点，治疗应采用保守治疗。     

星形胶质细胞瘤伽玛刀治疗的疗效与影响因素

目的分析星形胶质细胞瘤伽玛刀(γ-刀)治疗的疗效与影响因素.方法回顾性分析48例星形胶质细胞瘤病人的γ-刀治疗结果.以性别、有无普通放疗经过、有无化疗经过、边缘剂量、病灶的平均直径、病变的病理等级、影像学上有无相对较清楚的边界为治疗结果影响因素,判定标准以病灶缩小为有效,采用logistic回归模型,确定多因素条件下治疗结果的影响因素.结果有效32例(66.7%),logistic回归模型分析表明:病理等级和病灶平均直径为与肿瘤控制有关的影响因素.结论γ-刀对星形胶质细胞瘤的治疗有一定的意义.     

小切口胆囊切除术108例临床观察

本文报告腹部切口５－８ｃｍ的小切口胆囊切除术１０８例，与同期大切口胆囊切除术相比，具有创伤较小、恢复较快、并发症少、切口疤痕小的优点，虽不如腹腔镜胆囊切除术（ＬＣ）的疼痛轻、恢复快，但并症比ＬＣ少，只要适应症选择得当，在术者的经验和技术较成熟的情况下，不昔为一种可供选择的方法。     

Laparoscopic feeding jejunostomy: also a simple technique

Summary Placement of feeding tubes is a common procedure for general surgeons. While the advent of percutaneous endoscopic gastrostomy has changed and improved surgical practice, this technique is contraindicated in many circumstances. In some patients placement of feeding tubes in the stomach may be contraindicated due to the risks of aspiration, gastric paresis, or gastric dysmotility. We describe a technique of laparoscopic jejunostomy tube placement which is easy and effective. It is noteworthy that this method may be used in patients who have had previous abdominal operations, and it has the added advantage of a direct peritoneal view of the viscera. We suggest that qualified laparoscopic surgeons learn the technique of laparoscopic jejunostomy.     

小包装全氟丙烷气体动力学实验研究

为检验塑料小包装全氟丙烷气体（C3F8）在不同包装和储存方法时浓度变化，将装有5～7mlC3F8的聚氯乙烯小袋，根据不同储藏温度和外包装方法随机分成四组：（1）22℃聚乙烯外包装，（2）36℃聚乙烯外包装，（3）22℃铝箔真空外包装，（4）-29℃聚乙烯外包装；每一组C3F8小袋气体存放一定时间后，应用气相色谱分析方法进行浓度测量。结果：第3组C3F8浓度最高和稳定，第2组浓度随放置时间降低最明显，第4组是临床应用气体的储藏和包装方法，其30天样本浓度和第3组相等，但放置一年时浓度降低。结果显示：塑料小包装C3F8予以铝箔真空外包装是一种可行的方法，利于C3F8运输和普及；聚乙烯外包装的C3F8，应放在-29℃保存，时间不超过一年。     

实验性小肠动脉出血的垂体后叶素灌注治疗

经动脉导管灌注垂体后叶素治疗１０条犬小肠出血的实验研究结果表明，垂体后叶素灌注治疗的效果与出血部位累及的血管大小及出血速率有关。还提示垂体后叶素对较大血管引起的出血灌注治疗无效，其引起血管的收缩作用主要在末梢小血管。     

Obturator hernias — Report of seven cases

Summary Obturator hernias comprise a rare group of abdominal hernias. They are often diagnosed when the small bowel has become obstructed and the patients are operated on without the causes of the obstruction being known. Although many techniques for closure of the defect are available, there is no agreement at the present time as to which is the procedure of choice.     

X-刀立体定向放射治疗颅内肿瘤的近期疗效分析

目的:分析立体定向X-刀放射治疗颅内肿瘤后的近期疗效,并进行阶段性工作总结。材料和方法:53例不同类型脑瘤患者,以CT、MR、DSA图像资料作为定位依据,用德国Brain LAB治疗计划系统设计三维优化方案,西门子MD-2型直线加速器旋转照射。结果:53例患者经X-刀治疗后,近期均取得了满意效果,诸如以卡氏评分法评价,临床症状有所改善;以CT增强扫描复查观察,肿瘤大小趋于缩小或消失。结论:立体定向放射治疗后的追踪观察表明,只要严格掌握适应症,精确定位,精确计划,精心治疗,X-刀是一种安全、有效、无痛苦的治疗脑肿瘤的方法。它可起到改善临床症状,提高患者生活质量,延长生存期限的作用。