胃肠粘膜外翻缝合加浆肌层缝合的研究

胃肠、胆肠及肠肠吻合,采用粘膜外翻缝合外加浆肌层缝合256例,与同期采用Albert-Lambert缝合318例对比。结果:外翻缝合育操作简单、顺手、省时、线头残留少等优点。     

Gln与rhGh对肝硬化病人肠黏膜屏障的影响

目的观察Gln与rhGh各单独应用及联合应用对肝硬化病人小肠黏膜屏障形态学和功能学的影响。方法20个肝硬化病人随机分成四组,给予等氮等热量营养支持7d,Gln+rhGh组口服Gln[0.3g/(Kg·d)]和皮下注射rhGh(10U/d);Gln组口服Gln;rhGh组应用皮下注射rhGh;CONT对照组应用相应安慰剂。观察治疗前后患者小肠黏膜通透性和十二指肠黏膜绒毛高度和隐窝深度的变化,分别比较。结果Gln+rhGh组治疗后小肠黏膜通透性有显著性的降低(P<0.05),且显著低于其他三组(P<0.05);十二指肠黏膜绒毛高度和隐窝深度有显著性的增高(P<0.05),且显著高于其他三组(P<0.05)。结论Gln与rhGh联合应用能减低肠道黏膜的通透性和维持其形态学的完整。     

功能性消化不良患者胃排空障碍与胃肠激素的关系

目的 探讨功能性消化不良(FD)患者胃排空障碍与胃肠激素间的关系。方法 对54例四患者进行胃排空检查，根据结果将其分为胃排空延缓的FD组(FDD组)和胃排空正常的四组(FDN组)，另以17名正常人作为对照组。用放免法测定受试者血浆(空脂和餐后)、胃窦十二指肠粘膜组织的神经降压素(NT)和胃动宗(MTL)含量。结果 FDD组空脂和餐后血浆、胃窦和十二指肠粘膜组织的NT含量均明显高于对照组及FDN组。各组试餐前后血浆NT增幅差异无显著性。FDD组空脂和餐后血浆、胃窦和十二指肠粘膜组织的MIL含量均明显低于对照组及FDN组。各组十二指肠粘膜组织MTL含量均明显高于胃窦粘膜。结论 FD患者胃排空障碍与NT、MIL密切相关。NT、MIL在FD的发病机制中可能具有一定作用。     

125I粒子组织间种植对人胃癌裸鼠移植瘤的杀伤作用

目的 观察不同剂量^125I粒子对人胃癌裸鼠移植瘤的杀伤作用及组织损伤。方法 建立人胃癌BGC-823细胞裸鼠皮下移植瘤模型，随机分为对照组和实验组，将不同剂量（100、120、140Gy）地^125I粒子植于实验组。30、60d：比较移植瘤抑瘤率，病理组织学、局部皮肤反应、裸鼠体重及白细胞计数。结果30d，100、120、140Gy组抑瘤率分别为51．93％、79．18％、90．22％，病理组织学反应程度多为RCRG2（45．83％），各实验组组间除120Gy与140Gy（P〉O．05）组外，及分别与对照组比较，差异有统计学意义（P〈0．05）；局部皮肤反应各实验组与对照组比较，差异有统计学意义（P〈0．05），各实验组组间差异无统计学意义（P〉0．05）。60d，各组抑瘤率分别为97．97％、100％、96．69％，病理组织学反应程度以RCRG1居多（62．5％），与对照组比较，差异均有统计学意义（P〈0．05），各实验组组间差异无统计学意义（P〉0．05）；局部皮肤反应随剂量增高而加重，各实验组组间及其分别与对照组比较，差异有统计学意义（P〈0．05）。结论 不同剂量的^125I粒子在不同时间对人胃癌裸鼠皮下移植瘤有显著杀伤作用，但120Gy和140Gy组随剂量累积，损伤明显增加。提示100Gy可能是治疗人胃癌裸鼠皮下移植瘤的有效剂量。     

术后镇痛泵加新斯的明对胃肠功能影响

目的探讨术后硬膜外持续镇痛泵中加入新斯的明对剖宫产术后胃肠功能的影响。方法选择行剖宫产产妇240例,根据麻醉医师分组的不同将产妇分为两组,观察组126例,术后持续镇痛泵中加入麻醉药和新斯的明1.0mg;对照组114例,镇痛泵中仅有麻醉药,两组麻醉药配伍相同。观察两组产妇术后麻醉镇痛效果、肛门排气时间及腹泻、腹胀、大便失禁、恶心、呕吐等并发症发生情况。结果观察组肛门排气时间为(26.92±10.98)h,对照组为(33.78±12.61)h,两组比较差别有高度显著性(P<0.01);镇痛效果:观察组优为93.55%,对照组优为93.75%,两组比较差别无显著性(P>0.05);观察组恶心、干呕发生率为6.35%,明显低于对照组的19.3%(P<0.05),无一例发生呕吐,对照组有两例发生呕吐,三例发生腹胀;两组均无腹泻及大便失禁发生。结论术后硬膜外持续镇痛泵中加入新斯的明能促进胃肠功能,减少胃肠道并发症,有望为术后胃肠道并发症的防治提供一条新途径。     

靶向性蛋白激酶B1和环氧合酶-2 shRNA腺病毒载体的构建和在人胃癌细胞的表达

Objective To construct a short hairpin RNA (shRNA) adenovirus vector targeting protein kinase BI (PKB1/Akt1) and cyclooxygenase-2 (COX-2) and observe their expression in human gastric carcinoma cell line SGC-7901. Methods Akt1 and COX-2 shRNA expression frames were sub-cloned to pGSadeno adenovirus vector by homologous recombination technology to construct pGSadeno-Aktl + COX-2 ( pGSadeno-A + C) vector. Furthermore after screening and amplification,recombinant ade-novirus vector was digested with Pacl and transfected into HEK293 cells. The replication adenovirus rAd5-A + C was packed and amplified in the HEK293 cells, and its titer was detected. After human SGC-7901 cells in vitro were transfected by rAd5-A + C,Akt1 and COX-2 mRNA and protein expression levels were detected by real-time PCR and Western blot respectively. Compared with rAdS-A + C,SGC-7901 and gen-eral rAd5-HK were selected as the negative controls. Results The recombinant adenovirus rAd5-A + C was constructed successfully and its titer reached 1.0 ×1010 pfu/ml. Aktl and COX-2 mRNA expression was downregulated significantly, and their ACt values ( 12.26±0.05 and 5.41±0.09 respectively ) were higher than rAd5-HK group (10.63±0.02 and 3.75 +0.08 respectively) and control group (10.57± 0.02 and 3.73±0.08 respectively) (P <0.01 ). There was no significant difference between rAd5-HK and control groups (P >0.05). Aktl and COX-2 protein expression was downregulated by 70.5% and 63.7% respectively ( P < 0.01 ) in rAd5-HK group as compared with control group ( P > 0.05 ). Conclu-sion The shRNA aclenovirus vector targeting Akt1 and COX-2 can specifically inhibit Akt1 and COX-2 expression,and this may be a new strategy in gastric carcinoma gene therapy targeting Akt1 and COX-2.     

直肠癌癌旁移行粘膜细胞动力学变化

应用氚－胸腺嘧啶核苷体外双标记放射自显影法，对１５例直肠癌旁移行粘膜与非移行粘膜作细胞动力学的比较观察。结果表明，移行粘膜的标记指数与非移行粘膜比差异非常显著（Ｐ＜０．０１），在细胞增殖周期和ＤＮＡ合成期时间亦有差别。提示移行粘膜细胞增殖异常，可视为潜在癌前期粘膜。     

癌胚抗原及粘液组织化学在胃癌中表达的研究

对60例胃癌进行了粘液组织化学和癌胚抗原免疫组织化学研究。结果表明:胃癌发病率肠型和胃肠混合型占多数。60例胃癌中含大肠型粘液者占50例,而单纯含胃型粘液为极少数。癌胚抗原分布方式,肠型胃癌与胃肠混合型胃癌比较无显著差异性(P>0.05)。癌胚抗原的阳性率,胃肠混合型胃癌高于肠型胃癌,两者之间有非常显著差别(P<0.01)。认为选用能显示硫粘蛋白和氧乙酰基唾液酸粘蛋白的粘液组织化学方法,作为胃癌组织分型和确定胃粘膜肠化性质,对癌前病变诊断有一定价值。     

Exogastric neurilemmoma presenting as acute abdomen: Role of computed tomography in diagnosis

A case of subserosal gastric neurilemmoma is hereby presented. This reported case is unique in its clinical presentation including the appearance of acute abdomen and fever subsequent to unremarkable and uneventful upper gastrointestinal endoscopy. The tendency of neurilemmoma to cause mucosal ulceration with fistula formation probably led to this clinical presentation. The role of computed tomography in establishing diagnosis of exogastric tumor is emphasized.     

Effects of sulglycotide on endogenous prostaglandin synthesis in human antral mucosa

The effect of sulglycotide, a polysulphated glycopeptide isolated from pig duodenum, on PGE2, 6-ketoPGF1 alpha and TxB2 production from isolated biopsy specimens of human antral mucosa was investigated in vitro, in comparison with carbenoxolone. In addition to a tendency toward increased PGE2 production just short of statistical significance, both sulglycotide and carbenoxolone significantly increased 6-ketoPGF1 alpha accumulation in the incubation medium. TxB2 levels were not significantly modified by the two drugs. Therefore, changes in the prostanoid production by human antral mucosa could, at least partially account for the cytoprotective effects of sulglycotide in man.