Gd-DOTA as a gastrointestinal contrast agent for gastric emptying measurements with MRI

Current MR meal markers may interfere with gastric motility and secretion restricting the use of MRI in the measurement of gastric physiology. We therefore evaluated Gd-DOTA as a liquid phase marker, in vitro by determining dissociation, and adherence to the solids, and in vivo by simultaneous MRI (0.35 T scanner, multiple T₁-weighted sections of the upper abdomen) and double indicator (perfusion marker PEG 4000, meal marker ^99mTc-DTPA) measurements of emptying and secretion, following ingestion of 500 ml 10% glucose. In vitro Gd-DOTA was stable at a pH > 2 with < 2% dissociation at 24 h during incubation with HCI. Dissociation during incubation with HCI was linearly dependent on H⁺ concentration (0.77 < pH < 2.02). Less Gd-DOTA was absorbed onto the solid phase than ^99mTc-DTPA (25% cf 36%). in vivo Gd-DOTA marked gastric contents provided strong positive contrast. Similar emptying curves were observed with both MRI and double-indicator techniques (r = 0.987, P < 0.001). Gd-DOTA has the potential to be a useful liquid phase contrast agent in MR studies on gastric function.     

胃癌组织中KAI1、nm23及P53的表达及其临床意义

目的:探讨正常胃黏膜、不典型增生胃黏膜及癌组织中KAI1、nm23及P53蛋白的表达．方法:应用SP法免疫组化检测22例正常胃黏膜,65例不典型增生胃黏膜及74N胃癌组织中的KAI1、nm23及P53蛋白的表达．结果:正常胃黏膜、不典型增生胃黏膜及胃癌组织中,KAI1和nm23阳性率呈降低趋势,组间差异性有统计学意义(x2=20．885, P<0．001;x2=29．133,P<0．05):P53蛋白阳性表达率呈增加趋势,组间差异性有统计学意义(x2=21．954,P<0．001)．Fisher精确概率检验显示:在胃癌组中不同的浸润深度、有无淋巴结转移和脉管侵犯组内KAI1、nm23及 P53组阳性表达率的差异性有统计学意义(x2 =20．885,P<0．001;x2=29．133,P<0．05;x2= 21．954,P<0．001);而在年龄、性别组间的差异性无统计学意义．Spearman等级相关分析显示 KAI1与nm23表达呈正相关(r=0．859,P<0．05); KAI1与P53表达呈负相关(r=-0．859,P<0．05), nm23与P53表达呈负相关(r=-0．874,P<0．05) 结论:抑癌基因KAI1与nm23的缺失以及P53 蛋白的过表达可能是胃癌发生、发展及浸润和转移的重要原因之一．     

食管贲门癌术后早期肠内营养支持的应用研究

目的研究食管贵门癌切除术中放置鼻肠营养管进行早期肠内营养，在维持机体营养、促进恢复履在防治术后并发症的作用。方法将90例管责门癌病人随机分为A、B两组，A组术后常规静脉输液，B组术中放置鼻肠营养管，术后第1天给予肠内营养。两组病人监测术前、术后第10天的体重、肠功能恢复排气时间、疲劳评分，吻合口瘘反感染并发症的发生率。结果两组病人在体重、肠功能恢复方面存在明显差异（P〈0．05），在术后并发症方面差异明显（P〈0．01）。结论鼻肠营养管进行早期肠内营养具有易于维持机体营养，促进机体康复，尽快恢复正氮平衡，减少术后并发症的优点。     

紫杉醇联合希罗达治疗晚期胃癌的初步观察

目的 观察联合希岁达与紫杉醇治疗晚期胃癌的疗效与毒副反应。方法 对68例晚期胃癌患者进行回顾性统计分析。结果 CR6％，PR47％，NC22％，PD25％。症状缓解率81％。一年总生存率72％。平均缓解时间5．5月。化疗副反应包括恶心呕吐（86％），手足综合征（45％）；Ⅰ、Ⅱ度骨髓抑制（55％）及Ⅲ、Ⅳ度骨髓抑制（12％）；无化疗相关死亡。结论 希罗达加紫杉醇方案对晚期胃癌疗效较好，毒副作用较轻。     

机械通气患者体位改变插入胃管效果与分析

目的提高有创机械通气患者插入胃管的成功率,减少因反复插管所致的并发症,减轻患者痛苦,提高护士的工作效率。方法把有创机械通气的60例患者,随机分为观察组30例和对照组30例,观察组采取改变常规的“去枕头后仰位”为“抬高床头70°~80°角,头正位”插入胃管,对照组采取常规的去枕头后仰卧位的体位方法插入胃管。结果对照组一次插管成功率为6.66%,观察组一次插管成功率为90%,经统计学分析,差异有显著意义(P<0.01)。结论有创机械通气患者改变常规的“去枕头后仰位”为“抬高床头70°~80°角,头正位”后一次插入胃管成功率明显提高。     

进展期胃癌术后辅助性化疗的10年随访结果

报告１０２例进展期胃癌术后患者，随机进行３组不同化疗方案并经平均随访１０．７年的结果。所有病例均为１９８３年５月到１９８５年５月间手术者。术后随机给予单一５－ＦＵ、５－ＦＵ＋ＣＣＮＵ和ＭＴＸ＋ＭＭＣ＋５－ＦＵ三组不同化疗。随访至１９９４年１２月止，死亡７７例，存活２５例。结果３、５和１０年总生存率分别为４２．１％；２９．４％和２４．５％。三组间比较，总自下而上率并无显著差异（Ｐ〉０．０５），但中位     

Simultaneous noninvasive evaluation of gastric emptying and orocaecal transit times

Summary The aim of the study was to use a novel combination of two methods for the simultaneous evaluation of two effects of oral cisapride in 10 diabetic patients with autonomic neuropathy; gastric emptying time was measured by following radio-opaque markers and orocaecal transit time by the sulphasalazine-sulphapridine method. The study was of double-blind, randomized, placebo-controlled, cross-over design.It was possible to evaluate the effect of a prokinetic drug on gastric emptying and orocaecal transit times using these two noninvasive techniques at the same time. Cisapride significantly reduced both the gastric emptying (1.2 h versus 2.1 h) and orocaecal tansit (5.9 h versus 7.7 h) times.     

微囊化吲哚美辛片剂的研讨

以明胶-CAP 为囊材,经复凝聚法制备吲哚美辛微囊,再按所筛选的最佳处方制备微囊化片剂。该片与市售片相比,体外 T_(50)延长约5.6倍,家兔体内达峰时间滞后,能明显减轻对大鼠胃的刺激性。     

胃癌术后胆囊结石形成的研究进展

胃癌是消化道的常见肿瘤，手术切除仍是其主要治疗手段。胃癌术后除了常见的并发症外，患者胆囊结石的发病率明显升高，部分需要二次手术，其结石原因涉及神经、体液等多方面因素，本文就胃癌手术对胆囊结石形成的研究进展作一综述。