CLCA1在结肠癌组织中的表达及临床意义

目的:探讨CLCA1在结肠癌组织中的表达水平及其与肿瘤进展和预后的关系。方法:随机选取西安交通大学第一附属医院及第四军医大学西京医院行手术切除的临床结肠癌病例239例，应用免疫组织化学方法检测结肠癌组织及癌旁组织中CLCA1的表达情况，使用统计学方法分析CLCA1在结肠癌中的表达与肿瘤临床病理特征及预后的相关性。结果:CLCA1 在肿瘤中的表达较癌旁组织显著降低（P＜0.05），CLCA1在结肠癌中表达与原发肿瘤浸润深度、淋巴转移和肿瘤TNM分期显著相关（P＜0.05），而且CLCA1低表达组患者总体生存期较高表达组显著缩短（P＜0.001），多因素分析显示CLCA1的表达可作为结肠癌的独立预后因素。结论:CLCA1在结肠癌中表达下调，CLCA1的低表达与肿瘤的侵袭转移和临床预后密切相关，有望作为结肠癌个体化治疗靶点。     

结肠镜诊断结肠憩室30例临床体会

目的分析结肠憩室的内镜诊断情况,探讨结肠憩室病的发病情况以及临床特点。方法收集我科2011-2013年内镜下诊断的结肠憩室病30例患者资料进行分析。结果结肠憩室以右半结肠多见,其次为乙状结肠居多;来院就诊者以年龄在60岁者为多,且年龄越大,伴发憩室出血的几率越大。结论当患者出现不明原因的腹痛、便血、腹泻、便秘、急腹症时,应及时做结肠镜检查,以除外结肠憩室病变,指导临床治疗,减少误诊、漏诊的发生。     

Pharmacognostic studies of stem,roots and leaves of Malva parviflora L.

ObjectiveTo establish quality control parameters of a locally occurring medicinal plant, Malva parviflora which is utilized as folk medicine in Sialkot area in Pakistan.MethodsIn pharmacognostic studies different types of evaluations were carried out that focus on microscopic, macroscopic, fluorescence analysis and organoleptic evaluations.ResultsThe distinguishing characters of stem were the presence of parenchyma, cork cells, irregular shape calcium oxalate crystals, simple and compound starch granules and fusiform fibers with pits. Root microscopic characters were presence of simple and spherical starch granules with rounded or slit hilum, groups of lignified xylem fibers, reticulate vessels, and sieve tissues. Leaves microscopy indicated the presence of paracytic stomata, lignified fibers having pits, spiral and annular vessels, numerous sclereids while in fruit microscopy epicarp, thin walled cells endocarp, thin walled parenchyma and collenchyma of mesocarp and abundant thick walled endospermic cells containing aleurone grains and micro rosette crystals. Macroscopic study of leaves showed, 5-7 lobed reniform-shape, glabrous-surface, reticulate-venation in the leaves. Macroscopic features of roots showed type of root-taproot, surface-glabrous and stem was 1-10 dm tall simple to branched and may be prostrate or ascending. Similarly fruit was of schizocarp type.ConclusionsThis study provides the scientific data for the proper identification and establishment of standards for the use of Malva parviflora.     

大柴胡汤治疗大肠癌的猜想

大柴胡汤出自仲圣《伤寒论》，历代医家对其条文注疏不尽相同，但大多数医家对其治疗消化系统疾病的观点认同，因柴胡剂在三阳病篇出现，易多与肝胆疾病相联系，而其条文所述症状，又与现代西医学胰脏疾病相似，故大多对此方的治疗范围规定在肝胆胰脏疾病之中，笔者早期阅读美国汉唐中医学院倪海厦教授讲述《伤寒论》，倪氏指出其方与肝脏及大肠之间有着极为密切的联系，并照搬原方治愈教例大肠癌患者，笔者在此将试论大柴胡汤调节肝与大肠之关系及治疗大肠癌的猜想。     

左半结肠癌破裂一期切除吻合并结合5-FU术中灌洗的临床观察

目的 探讨左半结肠癌破裂一期切除吻合并术中结合5-Fu灌洗的临床疗效观察.方法 对20例左半结肠癌急性破裂的病例的治疗进行回顾分析,其中,16例术中结合5-FU灌洗并行一期切除吻合术.结果 本组病例疗效满意,无围手术期死亡.16例结合5-FU灌洗并行一期切除吻合术后并发症:吻合口瘘1例,切口感染2例,肠粘连1例.结论 通过术中肠腔减压,结合5-FU灌洗和抗生素的应用,结合支持治疗,可以减少术后结肠癌的复发和转移,在左半结肠癌破裂行一期切除吻合术中应用是安全和可行的.     

A lifelong exposure to a Western-style diet,but not aging,alters global DNA methylation in mouse colon

BACKGROUND/OBJECTIVESPrevious studies have indicated that when compared to young mice, old mice have lower global DNA methylation and higher p16 promoter methylation in colonic mucosa, which is a common finding in colon cancer. It is also known that a Western-style diet (WSD) high in fat and calories, and low in calcium, vitamin D, fiber, methionine and choline (based on the AIN 76A diet) is tumorigenic in colons of mice. Because DNA methylation is modifiable by diet, we investigate whether a WSD disrupts DNA methylation patterns, creating a tumorigenic environment.SUBJECTVIES/METHODSWe investigated the effects of a WSD and aging on global and p16 promoter DNA methylation in the colon. Two month old male C57BL/6 mice were fed either a WSD or a control diet (AIN76A) for 6, 12 or 17 months. Global DNA methylation, p16 promoter methylation and p16 expression were determined by LC/MS, methyl-specific PCR and real time RT-PCR, respectively.RESULTSThe WSD group demonstrated significantly decreased global DNA methylation compared with the control at 17 months (4.05 vs 4.31%, P = 0.019). While both diets did not change global DNA methylation over time, mice fed the WSD had lower global methylation relative to controls when comparing all animals (4.13 vs 4.30%, P = 0.0005). There was an increase in p16 promoter methylation from 6 to 17 months in both diet groups (P < 0.05) but no differences were observed between diet groups. Expression of p16 increased with age in both control and WSD groups.CONCLUSIONSIn this model a WSD reduces global DNA methylation, whereas aging itself has no affect. Although the epigenetic effect of aging was not strong enough to alter global DNA methylation, changes in promoter-specific methylation and gene expression occurred with aging regardless of diet, demonstrating the complexity of epigenetic patterns.     

结肠癌术后同步放化疗的可行性分析

目的：探讨结肠癌术后行同步放化疗的可行性。方法回顾性分析16例结肠癌术后同步放化疗患者的毒副反应发生情况。结果16例患者中，5例出现Ⅱ度消化道急性放射反应，均未出现其他急性放射反应。结论结肠癌根治术后患者行同步放化疗是可以耐受的。     

The tumour–stroma ratio in colon cancer: the biological role and its prognostic impact

The tumour microenvironment consists of a complex mixture of non‐neoplastic cells, including fibroblasts, immune cells and endothelial cells embedded in the proteins of the extracellular matrix. The tumour microenvironment plays an active role in tumour behaviour. By interacting with cancer cells, it influences disease progression and the metastatic capacity of the tumour. Tumours with a high amount of stroma correspond to poor patient prognosis. The tumour–stroma ratio (TSR) is a strong independent prognostic tool in colon cancer and provides additional value to the current clinically used tumour–node–metastasis classification. The TSR is assessed on conventional haematoxylin and eosin‐stained paraffin sections at the invasive front of the tumour. Here we review studies demonstrating the prognostic significance of the TSR in solid epithelial tumours with a focus on colon cancer. Moreover, the biological role of the tumour microenvironment during tumour progression and invasion will be discussed, as well as the attempts to target the tumour stroma for therapeutic purposes. We suggest that the TSR can be implemented with little effort and without additional costs in current routine pathology diagnostics owing to its simplicity and reliability.