MUC1粘蛋白在进展期胃癌中的表达及临床意义

目的检测MUC1粘蛋白在进展期胃癌中的表达,探讨其对胃癌预后的意义.方法采用免疫组化SP法,应用抗MUC1粘蛋白核心蛋白抗体(DF3抗体)检测60例胃癌根治标本及对照组20例胃正常黏膜组织标本MUC1粘蛋白表达.采用χ2检验及Kaplan-Meier生存曲线进行统计分析.结果 MUC1粘蛋白阳性表达率55%(33/60).有淋巴结转移胃癌组MUC1粘蛋白阳性表达率为71.0%(22/31),无淋巴结转移组MUC1粘蛋白阳性表达率为37.9%(11/29),组间差别显著(P<0.05).按PTNM分期,Ⅰ期胃癌的MUC1粘蛋白阳性表达率为20%,Ⅱ期表达率68.8%,Ⅲ期表达率53.3%,Ⅳ期表达率78.6%,Ⅰ期与Ⅱ、Ⅲ、Ⅳ期间存在显著统计学差异(P<0.05).经Kaplan-Meier法生存曲线统计表明,MUC1阳性表达组5年生存状况较MUC1阴性组差(Log-Rank检验,P=0.037).结论在进展期胃癌中MUC1粘蛋白表达与淋巴结转移相关,随着胃癌的进展MUC1表达呈上升趋势;MUC1粘蛋白表达提示预后不良.     

食管内翻拔脱术治疗食管癌贲门癌19例分析

目的　探讨食管内翻拔脱术在食管癌、贲门癌外科治疗中的地位。方法　 19例食管癌、贲门癌病人接受了食管内翻拔脱术 ,其中食管鳞癌 15例 ,颈段 3例 ,胸中段 6例 ,胸下段 6例 ;贲门腺癌 4例。 0期 1例 ;Ⅰ期 4例 ;Ⅱa期 4例 ;Ⅱb期 1例 ;Ⅲ期 9例。 3例因有上消化道手术史行结肠代食管。结果　 19例均获切除 ,食管切缘阴性 ,无手术死亡。术后声音嘶哑 1例 ,心律失常1例 ,双侧胸腔积液 1例 ,左侧气胸伴左膈下脓肿 1例 ,5例出现小的颈部吻合口瘘。结论　食管内翻拔脱术扩大了食管癌、贲门癌的手术适应证 ,使某些常规手术高危患者重新获得手术机会。     

Iatrogenic diaphragmatic hernia due to laparoscopic gastric banding

A patient developed a huge diaphragmatic hernia following laparoscopic gastric banding. Almost the entire stomach was incarcerated within the left chest. Segmental necrosis of the greater curvature of the stomach necessitated partial gastrectomy. The postoperative course was uneventful. The etiology, diagnosis and treatment of this previously undescribed complication of laparoscopic gastric banding are addressed in relation to the present case.     

Ghrelin does not stimulate gastrointestinal motility and gastric emptying: an experimental study of conscious dogs

Ghrelin is a peptide that was discovered in endocrine cells of the stomach. However, its action in regulating the fasted and fed motor activity of the digestive tract is not fully understood. In the present study, we examined the effects of an intravenous (i.v.) injection of canine ghrelin on the physiological fasted and fed motor activities in the stomach, duodenum, jejunum and colon of freely moving conscious dogs. An i.v. injection of canine ghrelin released growth hormone in a dose-dependent manner; however, it did not stimulate the motor activity of the digestive tract in either the fasted or the fed state. Moreover, an i.v. injection of high-dose canine ghrelin significantly reduced the motility index in the gastric body in the fasted state. Ghrelin did not accelerate gastric emptying, either. These results differ from previous reports dealing with rodents. It is significant that such results were obtained in research with dogs, which are larger animals.     

TH胶胃冠状静脉栓塞术治疗门脉高压症

11例TH胶胃冠状静脉栓塞术临床治疗结果表明:(1)11例中的4例急性上消化道大出血患者均在12h左右出血基本停止,随访近一年未再发生出血现象。(2)10例半年后复查肝功能均有不同程度改善。(3)一年后复查食道钡餐透视X线平片发现8例患者食道静脉曲张有不同程度减轻。(4)11例中1例因术中急性肝功能衰竭死亡。因此我们认为此术式操作简便,手术创伤小、较易推广,是治疗门脉高压症合并食管胃底静脉曲张出血的一种有效方法。     

Helicobacter pylori infection and gastric emptying of solids in humans

Helicobacter pylori has been implicated in a number of upper gastrointestinal illnesses. In a controlled study, we have investigated the relationship between H. pylori infection and gastric emptying of solids in two groups of patients with chronic symptoms of dyspepsia. In the first group, 19 patients with non-ulcer dyspepsia and H. pylori infection underwent a standard test of gastric emptying after ingestion of 500 μCi of Tc-labelled chicken liver. The results were compared to a control group of 16 uninfected volunteers. We also studied a second group of 20 patients with previously diagnosed idiopathic gastroparesis for the prevalence of H. pylori infection and its relationship to symptom severity and rates of gastric emptying. In the first group of patients, the half-time of gastric emptying was significantly less among the infected patients compared to the uninfected volunteers (108 ± 9 vs. 142 ± 14 min, P < 0.05). In the second group of patients with gastroparesis, the prevalence of H. pylori was not significantly different among these patients than among 21 age and sex matched controls (20% vs. 38%, P = 0.32). Gastric emptying was markedly slow in all 20 patients in the second group but less so among the four with H. pylori infection. Symptom scores were no different between infected and uninfected patients. We conclude that H. pylori infection is not associated with abnormally slow gastric emptying. On the contrary, gastric H. pylori infection appears to be associated with mildly accelerated emptying of solids compared to normal controls. Idiopathic gastroparesis and dyspepsia related H. pylori infection are separate but sometimes overlapping disorders.     

胃癌患者红细胞免疫功能的变化

运用简单形态学方法测定了３０例胃癌患者红细胞免疫功能，结果表明：胃癌患者红细胞Ｃ３ｂ受体花环率及肿瘤红细胞花环率显著低于正常对照（Ｐ＜０．０１）及慢性良性胃病患者（Ｐ＜０．０１），而免疫复合物花环率则高于正常人（Ｐ＜０．０１）及慢性良性胃病患者（Ｐ＜０．０１）；Ⅲ、Ⅳ期胃癌患者肿瘤红细胞复合物花环率明于低于Ⅰ、Ⅱ期患者（Ｐ＜０．０１）；贲门癌肿瘤红细胞花环率显著低于胃窦（体）癌患者（Ｐ＜０．０１）     

胃癌单克隆抗体-丝裂霉素C结合物的制备及其细胞毒特征

作者报道胃癌单克隆抗体MG11-丝裂霉素C(MMC)结合物的制备及其对肿瘤细胞的杀伤作用。首先用戊二酐处理MMC,于MMC上引入羧基,MMC衍生物与N羟基琥珀酰亚胺及2,2′-二环已基碳二亚胺反应,得到MMC活性酯,后者与抗体反应将MMC引入抗体中。经测定,每克分子抗体中引入约6～7克分子药物,结合物对人胃癌细胞KATⅢ具有较强的选择性杀伤作用,在0.56μg/ml水平(药物浓度)对肿瘤细胞杀伤牢达60％,优于游离药物(51％)及无关抗体结合物(9.3％),提示选用的胃癌单抗对MMC具有较好的导向作用。     

Acute volaemic changes modify the gastroduodenal resistance to the flow of saline in anaesthetized dogs

The effect of acute and sequential volaemic changes on the gastroduodenal flow of saline was assessed in 23 anaesthetized dogs following two different experimental protocols. Hypervolaemia, by i. v. infusion of saline, induced a gradual decrease on gastroduodenal flow which amounted to 76% below control values (P < 0.001) when volaemic expansion attained 5% of body weight. This effect was volume dependent (17% increase on gastroduodenal flow per volume of infused saline equivalent to 0.5% of body weight, P < 0.001), lasted for at least 90 minutes after infusion was completed and was also obtained by expanding previously bled animals. Hypovolaemia due to bleeding was followed by an increase on gastroduodenal flow of about 88% above control values (P < 0.05) when haemorrhage was equal to 3% of body weight. This effect was also volume dependent (23 % increase on gastroduodenal flow per volume of blood shed equivalent to a 0.5% of body weight, P < 0.01) and was reversed after blood volume was restored. These modifications in the resistance of the gastroduodenal segment to the flow of liquid due to acute volaemic changes suggest that the extracellular fluid volume modulates the contractile activity of the gastroduodenal portion of the gut possibly to set a gastroduodenal handling of liquid adequate to cope with volaemic imbalances.     

T3期胃癌CD34与新生血管形成及淋巴结转移的关系

目的研究T3期胃癌CD34与胃癌新生血管形成及淋巴结转移的关系.方法随机选取胃癌手术标本41例,其中T3N0M020例,T3N1M021例,分别进行特异性抗体免疫组化染色,并采用Image Pro Plus 5.0图像软件分析数据,计算胃癌组织CD34微血管密度(MVD)和其他相关抗体(CD44、Ⅳ型胶原、层黏蛋白)的表达,并进行统计学分析.结果CD34 MVD计数(CD34表达强度),在T3N0M0和T3N1 M0肿瘤组分别为43.10±18.22和56.24±28.36,两组比较有显著差异(P＜0.05);CD44、Ⅳ型胶原、层黏连蛋白的表达强度,T3N0M0和T3N1M0肿瘤组比较无显著差异(P＞0.05).结论CD34与T3期胃癌组织新生血管形成及淋巴结转移的关系密切,可作为诊断T3期胃癌淋巴结转移的参考指标.