A CASE OF EARLY GASTRIC CANCER ACCOMPANIED BY DIEULAFOY ULCER IN A YOUNG WOMAN

A case of early gastric carcinoma accompanied by Dieulafoy ulcer is presented. The patient, a 26‐year‐old female, visited our emergency room with chief complaints of massive hematemesis and tarry stool. The initial endoscopic examination revealed a superficial depressed lesion with a faded color accompanied by a tiny ulcer with converging folds at the anterior wall of the middle gastric body. Although no active bleeding vessel was found at that time, the patient was admitted to our hospital for further check‐ups and treatment. On the 6th hospital day, she developed massive hematemesis resulting in shock. Urgent endoscopy, this time, disclosed an exposed bleeding vessel at the small ulcer floor previously mentioned, and endoscopic hemostasis was achieved. Since, however, a biopsy at initial examination from the surrounding depressed area proved carcinoma, a partial distal gastrectomy was subsequently carried out. Histological examination of the resected specimen confirmed the diagnosis of carcinoma limited to the mucosa and submucosa along with findings consistent with Dieulafoy ulcer. This is a rare case of combination of early cancer and Dieulafoy ulcer particularly in such a young patient. A review of the literature is also presented.     

溃疡散预防消化性溃疡复发临床观察

目的 :观察溃疡散对消化性溃疡的抗复发治疗的临床效果。方法 :随机将 80例患者分成溃疡散治疗组 (4 2例 )和雷尼替丁对照组 (38例 )并同时观察两组患者治疗前后溃疡复发情况。结果 :治疗后治疗组溃疡复发率明显低于对照组 ,P <0 .0 1,两组对比有非常显著性差异。结论 :治疗组能明显的改善患者临床症状和降低消化性溃疡复发率。     

Cdx2和PTEN在胃粘膜肠上皮化生及肠型胃癌组织中的表达

目的：观察Cdx2及PTEN在胃粘膜病变中的表达。方法：以正常胃粘膜作为对照，用免疫组化的方法检测Cdx2和PTEN在胃粘膜肠上皮化生和肠型胃癌组织中的表达情况。结果：Cdx2在正常胃粘膜中没有表达，在肠上皮化生和肠型胃癌组织中明显增高，在肠型胃癌组织中Cdx2和PTEN水平显著低于肠上皮化生，两者表达模式相似。在不同类型肠化生中，小肠型肠化生Cdx2水平明显高于结肠型肠化生，而PTEN没有显著差异。结论：Cdx2为肠上皮化生的特异性标志物，并与PTEN在肠型胃癌的多步骤多阶段过程中可能起到重要作用，而PTEN可能对Cdx2的表达起到正相调节作用。     

胃癌及肠化组织的微卫星不稳定性

目的 :探讨微卫星不稳定性 (MSI)在胃癌及肠化组织中的发生规律及其在胃癌发生过程中的作用。方法 :对 30例胃癌、4 0例肠上皮化生的石蜡标本分别提取病变及相应正常组织的DNA ,应用银染PCR SSCP技术检测 5个微卫星位点的不稳定性。结果 :胃癌组织MSI的发生率为2 3 3% ,胃窦癌MSI的发生率显著高于贲门癌 (P =0 0 4 4 )。肠化组织MSI发生率 2 0 % ,MSI全部出现在中度以上肠化组织中 (P =0 0 13) ,且更多见于女性 (P =0 0 4 4 )。结论 :MSI是胃癌多步骤发生过程中的早期分子事件 ,在胃癌的发生中可能具有重要作用。     

Signal-to-noise ratio effects in quantitative cerebral perfusion using dynamic susceptibility contrast agents.

Theoretical and simulation evidence is presented in support of the idea that the optimal manner of determining blood flow from MR perfusion studies is not necessarily obtained by setting experimental conditions to maximize either the arterial input or the measured tissue concentration level for a particular echo time (TE). The noise power in the contrast concentration curve is associated with its peak because of the nonlinear relationship between the contrast concentration and MR signal intensity curves. The optimum signal-to-noise ratio (SNR), SNR(C), for a particular contrast concentration curve can be obtained when the experimental concentration level and TE are adjusted to produce an MR intensity curve whose signal loss is 63% of the precontrast MR signal intensity. It is demonstrated that the stability of the singular valued decomposition (SVD) deconvolution approach to determine blood flow parameters is increased when the tissue curve maximum signal loss is in the range of 40-80%. The accuracy and stability of the SVD-determined blood flow parameters are affected by deviations from these optimum conditions in a manner that depends on the mean transit time (MTT) associated with the residue function. It is recommended that the experimental TE value be set so that neither the tissue nor the arterial curves are placed a region of rapidly deteriorating SNR(C).     

煤焦沥青诱发大鼠肺癌的实验研究——Ⅱ.形态学观察

本文对煤焦沥青诱发大鼠肺癌过程中的病理形态学所见作了报道。整个过程可以分为三个阶段:1.异物反应阶段;2.异常增生和鳞状化生阶段;3.癌肿发生发展阶段。文中对每一个阶段的病理组织学改变做了详细描述。煤焦沥青诱发的大鼠肺癌的特征如下:1.癌肿全都发生在肺的周边部位;2.绝大多数癌肿的组织类型都是高分化鳞状细胞癌;3.多发性,数个至数十个大小不等的肿块布满全肺;4.癌变各个不同阶段的改变可在同一肺脏中出现;5.转移癌较少见。     

胃癌患者胃液可溶性白细胞介素-2受体初步研究

应用双抗体夹心ELISA法对87例消化道疾病患者胃液可溶性白细胞介素-2受体(sIL-2R)水平进行测定。结果表明,胃癌患者胃液sIL-2R水平明显高于慢性浅表性胃炎及十二指肠溃疡患者(P相似文献   

Blood flow variation and energy metabolism in the gastric mucosa following 7．5％ hypertonic saline resuscitation

Ｂｌｏｏｄｆｌｏｗｖａｒｉａｔｉｏｎａｎｄｅｎｅｒｇｙｍｅｔａｂｏｌｉｓｍｉｎｔｈｅｇａｓｔｒｉｃｍｕｃｏｓａｆｏｌｌｏｗｉｎｇ７．５％ｈｙｐｅｒｔｏｎｉｃｓａｌｉｎｅｒｅｓｕｓｃｉｔａｔｉｏｎＷａｎｇＪｕｎｙｉ（王俊义）；ＷｕＧｕｏｓｈｅｎｇ；（吴...     

胃粘膜上皮“适应性细胞保护”机制防止胃肿瘤发生的作用

投用致癌剂的对照组其胃肿瘤发生率为22.2％。若同时给予40％Z醇液空腹灌胃,则胃肿瘤发生率达55.9％。如在给乙醇液前15分钟,先给予4％的辣椒煎液灌胃,则胃肿瘤发生率只有20.0％,相近于对照组的水平(后2组差别有极显著意义,P<0.01)。这种给损伤剂(乙醇)之前先给予微刺激剂(辣椒)所产生的胃粘膜的保护作用,是通过促使胃粘膜上皮细胞合成内源性前列腺素(PGs)来实现的,是一种“适应性细胞保护”机制。这种保护胃粘膜的作用可降低胃肿瘤的发生率。     

Surgical results of performing R4 gastrectomy for gastric cancer located in the upper third of the stomach

Because gastric cancers located in the upper third of the stomach are difficult to detect at an early stage, the surgical results remain poor. We performed R4 gastrectomy as a radical procedure for 25 patients, involving complete resection of the latero-aortic and interaorticovenous lymph modes above and below the left renal vein, in combination with the ordinary R2 or R3 gastrectomy (the R4 group). These patients were compared with 156 others who underwent R2 gastrectomy alone (the R2 group). There were no significant differences in operation time, blood loss, or the incidence of complications between the two groups; however, when the survival rates of the patients with tumors invading beyond the subserosa were compared, the 5-year survival rate was found to be significantly higher in the R4 group than in the R2 group. Furthermore, in patients with para-aortic nodal involvement, a significant survival advantage was observed in the R4 group, as compared with the R2 group. These results suggest that the R4 gastrectomy is a rational approach for patients with advanced gastric cancer located in the upper third of the stomach.