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排序方式: 共有816条查询结果,搜索用时 15 毫秒
141.
Lei Huang A-Man Xu Qiang Peng 《International journal of clinical and experimental pathology》2015,8(2):1929-1937
Objectives: To investigate CD147 and matrix metalloproteinase-9 (MMP-9) expressions in type II/III adenocarcinoma of esophagogastric junction (AEG), and their clinicopathological significances. Methods: Seventy-four patients clinically and pathologically diagnosed with type II/III AEG were analyzed, each undergoing radical total gastrectomy and Roux-en-Y esophagojejunostomy. The avidin streptavidin-perosidase immunohistochemistry technique was used to detect CD147 and MMP-9 in type II/III AEGs and 20 para-tumor controls, and their correlations with clinicopathological data and their reciprocal relationship were then analyzed. Kaplan-Meier survival analysis was conducted to reveal their prognostic significances. SPSS 20.0 was used for data analysis. A difference was statistically significant with P < 0.05, and very significant with P < 0.01. Results: In type II/III AEG CD147 and MMP-9 were mainly expressed on cellular membrane of in tumor cell cytoplasm. MMP-9 expression was significantly stronger at tumor-stroma junction and front edge of invasion. Their positive rates were significantly higher in malignant tissues than para-tumor tissues (P < 0.01 for both). There existed a significant positive correlation between both expressions (P < 0.05). They were significantly more highly expressed in cancers with lymphatic metastasis (P < 0.01 for both), at TNM III/IV stages (P < 0.01 for both), and with poor differentiation grade (P < 0.05 for both). Higher CD147 and MMP-9 expression rates were correlated with inferior postsurgical survivals (P < 0.05 for both). Conclusions: CD147 and MMP-9 could be novel biomarkers for type II/III AEG, and potentially predict tumor progression and prognosis. They are worth further investigation. 相似文献
142.
143.
目的 探讨加速康复外科理念(ERAS)在门脉高压症患者围手术期的临床应用价值。方法 随机将80例门脉高压症患者分成两组,40例在围手术期采用ERAS理念管理,另40例在围手术期采用传统处理方案处理。结果 ERAS组患者术后24 h和48 h疼痛评分分别为(2.1±0.6)分和(2.2±0.6)分,显著低于对照组[(3.7±0.8)和(3.0±0.6),P<0.01];ERAS组术后肛门排气时间、术后拔管时间和术后住院时间分别为(2.4±0.5) d、(5.2±0.8) d和(8.5±2.2) d,显著短于对照组[(3.5±0.7) d、(7.6±3.0) d和(11.6±5.3) d,P<0.01];术后第5 d,ERAS组血清谷丙转氨酶、总胆红素和白蛋白水平分别为(27.6±11.3) U/L、(18.3±6.2) μmol/L和(41.8±5.4) g/L,与对照组的[(48.6±44.3) U/L、(23.3±11.5) μmol/L和(37.1±5.1) g/L比,差异显著(P<0.01);ERAS组术后19例(47.5%)出现并发症,显著低于对照组的29例(72.5%)(P<0.05)。结论 应用ERAS在门脉高压症患者围手术期管理中安全有效,可加快患者术后康复。 相似文献
144.
Deok‐Bog Moon Sung‐Gyu Lee Shin Hwang Chul‐Soo Ahn Ki‐Hun Kim Tae‐Yong Ha Gi‐Won Song Dong‐Hwan Jung Gil‐Chun Park Young‐In Yoon Hwui‐Dong Cho Jae‐Hyun Kwon Yong‐Kyu Jung Su‐Min Ha 《Transplant international》2019,32(5):535-545
Simultaneous splenectomy (SSPX) in adult living donor liver transplantation (ALDLT) has definitely beneficial roles such as portal flow modulation in small‐for‐size graft and correction of hypersplenism‐related pancytopenia, and so on, but disastrous complications after SSPX often occur. For the first time, we devised unique and innovative splenic devascularization (SDV) procedure to alleviated untoward effects of SSPX but to maintain its benefits for the indicated patients. From April 2013 to December 2014, 520 recipients underwent ALDLT, and the SSPX and SDV were simultaneously performed in 62 (11.9%) and 61 (11.7%) patients, respectively. The most common indication was hypersplenism‐related pancytopenia (n = 101), small‐for‐size graft (n = 14), hepatitis C virus (HCV) (n = 7), and splenic artery aneurysm (n = 1). Postoperative small‐for‐size graft syndrome (SFSS) was absent in both SSPX and SDV, and preoperative pancytopenia was improved in both groups since postoperative 1 week, although SSPX was more substantial than SDV. Preoperative splenic volume (706.2 ± 282.9 ml) after SDV significantly decreased to 425.5 ± 204.4 ml on 1 month, respectively. In contrast to SDV, SSPX resulted in longer operation time and higher incidence of postoperative complications including mortality. In conclusion, SDV can replace SSPX during ALDLT without hampering its beneficial roles seriously, but get rid of splenectomy‐related lethal complication. 相似文献
145.
146.
Jia-Bin Wang Man-Qiang Lin Ping Li Jian-Wei Xie Jian-Xian Lin Jun Lu Qi-Yue Chen Long-Long Cao Mi Lin Chao-Hui Zheng Chang-Ming Huang 《European journal of surgical oncology》2017,43(12):2333-2340
Background
The purpose of this study was to evaluate the prognosis of patients with Siewert type II/III adenocarcinoma of the esophagogastric junction (AEG) with parapyloric lymph node (No. 5 and 6 lymph nodes, PLN) metastasis and to determine the need for PLN dissection for patients with type II/III AEG.Methods
A total of 1008 patients with type II/III AEG who underwent a transabdominal total gastrectomy were enrolled. The long-term surgical outcome of PLN-positive patients and the therapeutic value of PLN dissection were analyzed.Results
There was no significant difference in the incidence of PLN metastasis between type II and III cancers (5.7% vs. 8.5%, P > 0.05). PLN metastasis was a significant prognostic factor for type II/III cancers (HR 1.63; P = 0.001). Among type II/III cancers, the 5-year survival of patients with PLN-positive cancers was much lower than that of patients with PLN-negative cancers (21.3% vs. 60.8%, P < 0.001). Even after radical resection, the 5-year survival of patients with stage I–III PLN-positive cancers was similar to that of patients with stage IV cancers without PLN metastasis (23.5% vs. 23.1%, P > 0.05). In the analysis of the therapeutic value of lymph node dissection in each station for type II and III cancers after radical resection, lymph nodes with the lowest therapeutic value index after No. 12a were No. 5 and 6 lymph nodes.Conclusions
Patients with type II/III AEG with PLN metastasis have a poor prognosis, similar to patients with stage IV disease. PLN dissection offers marginal therapeutic value for patients with type II/III AEG. 相似文献147.
目的 观察免疫肠内营养对Siewert Ⅱ/Ⅲ型食管胃结合部腺癌患者接受不同重建方式后恢复、免疫功能、营养状况、 生存质量的影响。方法 将42 例 Siewert Ⅱ / Ⅲ型食管胃结合部腺癌患者随机分为 PG+ 空肠间置组和 TG 组,手术后均采取 免疫肠内营养治疗。检测术前1 天、术后5 天相关的营养和免疫血清指标,比较和分析术后恢复情况、生存质量和免 疫功能、营养状况。结果 PG+ 空肠间置组和 TG 组手术后肠道通气时间、术后 5 天体重变化、腹腔感染、吻合口瘘等并发 症的发生无显著差异。术后5 天检测PG+ 空肠间置组血清总蛋白、清蛋白、前清蛋白、IgG、IgA 水平以及CD3+、CD4+、 CD4+/CD8+ 与 TG 组比较,无显著差异(P > 0.05)。术后12 个月PG+ 空肠间置组术后体重变化、血红蛋白较TG 组明 显改善(P < 0.05)。PG+ 空肠间置组和 TG 组反流症状发生率均较低(P > 0.05)。结论 早期使用免疫肠内营养,对比 Siewert Ⅱ / Ⅲ型食管胃结合部腺癌患者行PG+ 空肠间置术后和TG 术后的营养状况和免疫功能,证明PG+ 空肠间置组显优势。 相似文献
148.
目的:观察贲门周围壁内外双重断流术对门静脉高压症患者近远期肝功能的影响。方法:回顾性分析1989年1月—2008年1月我院367例行贲门周围壁内外双重断流术的门静脉高压症患者手术前后门静脉的血流变化,比较术前和术后1周和1、6、12个月谷丙转氨酶(ALT)、血清胆红素(TB)、血浆总蛋白(TP)、血浆白蛋白(ALB)等肝功能指标。结果:术前平均自由门静脉压为(36.2±4.2)cmH2O,术后为(31.4±3.3)cmH2O,差异有统计学意义(P〈0.05)。术后门静脉血流速度和血流量较术前显著降低,肝动脉血流速度和血流量较术前显著升高,差异均有统计学意义(P〈0.05)。术后1、3月肝功能各指标较术前无明显改变(P〉0.05),术后6、12月肝功能各指标较术前明显改善(P〈0.05)。结论:贲门周围壁内外双重断流术能适度降低门静脉压力,同时强化肝动脉灌注,对维持门静脉高压症患者术后近期肝功能、改善术后远期肝功能具有重要作用。 相似文献
149.
目的:探讨脾切除联合贲门周围血管离断术的改进方法。方法:采取改进的原位脾切除术,在保持脾脏原位状态下紧贴脾脏离断脾蒂及脾周韧带,最后离断脾上极的胃短血管。在贲门周围血管离断时采取紧贴胃及食管分离的选择性血管离断术,保留迷走神经前后干。经脾静脉插管并于术后向脾静脉内持续滴注肝素盐水以预防门静脉系血栓形成。结果:用该法治疗31例,术后门静脉自由压力(FPP)平均下降8cm水柱,手术出血量平均420mL,无手术死亡,术后近期无胃排空障碍及门静脉血栓形成。随访12~36个月,无复发出血及肝性脑病,术后6个月彩超发现门静脉矢状部血栓3例(9.68%)。结论:三贴近法脾切除加贲门周围血管离断术出血少,可有效降低门静脉压力;经脾静脉插管滴注肝素盐水可有效降低术后门静脉血栓发生率。 相似文献
150.
目的 目的 探索晚期血吸虫病微创外科处理, 以及在贲门周围血管离断术中更安全精确、 损伤更小的方法。 方法 方法
应用腹腔镜和现代腔镜配套器械开展脾切除, 同时施行胃左静脉的胃支结扎, 以及食管旁静脉垂直进入食管壁的穿支静
脉结扎。结果 结果 14例患者均在处理脾蒂前分离脾动脉主干并夹闭。其中1例中转开腹, 原因为分离脾静脉时破裂出血所
致。无死亡病例。结论 结论 晚期血吸虫病门脉高压脾功能亢进患者经套管针 (Trocar) 腹壁孔将脾脏捣碎夹出, 无需扩大切
口取脾, 保证了真正意义上的微创。 相似文献