内镜下全腹膜外Sublay修补在腹壁疝中的应用

目的评价腹壁疝内镜下全腹膜外Sublay(TES)手术的效果并总结经验。方法回顾性总结国内10所医院自2016年3月至2019年7月115例腹壁疝内镜下TES手术的患者资料。分析患者情况、疝的特点、手术经过和结果。结果115例计划实施TES的患者中,因严重腹膜破损中转为IPOM修补患者1例,其余均成功手术。可以缝合缺损患者108例(94.74%),需要永久补片固定患者15例(13.16%)。放置引流患者76例(66.67%),中位手术时间为144 min,术中无严重并发症发生。随访时间3~45个月,总并发症发生率为20例(17.54%),其中出现血清肿患者5例(4.38%)。绝大多数患者术后仅出现轻微疼痛,未出现慢性疼痛。结论在腹壁疝的治疗中,对熟悉腹壁解剖的外科医师而言,TES是一种有效、安全的修复手段。在熟悉手术的基础上适应症可逐步拓展。     

胆道梗阻解除术后肾水通道蛋白2表达变化的实验研究

目的明确水通道蛋白2（aquaporin 2 protein,AQP2）在梗阻性黄疸梗阻解除术后大鼠肾脏的表达情况。方法采用蛋白质印迹（western blotting）法及RT-PCR方法检测在梗阻性黄疸梗阻解除后不同时间的大鼠肾脏AQP2及其mRNA的水平。结果AQP2蛋白水平在0h,24h,72h随时间推移逐渐降低,1周时明显高于解除梗阻0h的水平．但所有实验组均较正常对照组（假手术组）低（P〈0．05）。而AQP2的mRNA水平在梗阻性黄疸梗阻解除后0h．24h,72h随时间推移逐渐性升高,1周时回落,但比0h水平还要高,然而所有实验组均较正常对照组（假手术组）高（P〈0．05）。结论梗阻性黄疸梗阻解除术后肾功能在早期受损逐渐加重,AQP2蛋白水平下调．而AQP2基因水平上调。1周时这些结果仍未恢复正常。AQP2在梗阻性黄疸梗阻解除术后肾功能的变化上可能起到了重要的作用。     

腹腔镜Nissen和Toupet胃底折叠术治疗食管裂孔疝合并胃食管反流病的术后效果评价

目的探讨腹腔镜Nissen和Toupet胃底折叠术治疗食管裂孔疝合并胃食管反流病的疗效和术后并发症。 方法回顾性分析2014年7月至2016年7月,在中国医科大学附属盛京医院行腹腔镜下食管裂孔疝修补联合胃底折叠术的57例食管裂孔疝合并胃食管反流病患者的临床资料,其中24例行Nissen胃底折叠术式(Nissen组),33例行Toupet胃底折叠术式(Toupet组)。观察并比较2组患者的术后抗反流效果及发生术后并发症情况。 结果57例均顺利完成腹腔镜下手术,无中转开腹,手术时间68～115 min,平均手术时间(75.8±6.4)min;术中出血量15～30 ml,平均出血量(22±5)ml;2组患者均使用补片行食管裂孔疝修补术;术后24 h进流食,术后平均住院日(10.5±3)d。2组患者手术时间,出血量,住院日无明显差别。57例患者均得到随访,随访时间为6个月至2.5年,平均随访时间为18个月。术后均未出现反酸,烧心等胃食管反流病典型症状,无复发病例。Nissen组术后有2例(8.2%)患者出现吞咽困难,Toupet组术后有8例(24.2%)出现吞咽困难,Toupet组术后并发症发生率明显高于Nissen组。术前伴有胃食管反流病的患者行胃镜检查均有不同程度的食管炎症,所有患者术后均复查胃镜、食管测压及食管24 h pH值监测。复查结果显示,2组患者术后较术前食管下括约肌压力均有明显改善,食管下括约肌长度也均明显延长。 结论腹腔镜下Nissen术式在术后出现吞咽困难发生率上少于Toupet术式,但2种术式抗反流效果无明显差异。     

Hvin和Ki-67蛋白在胆管癌组织中表达的意义

Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.     

Hvin和Ki-67蛋白在胆管癌组织中表达的意义

目的 探讨Livin和Ki-67蛋白在胆管癌组织中的表达及两者之间的关系和临床意义.方法 采用SP法检测2002年1月至2003年12月中国医科大学附属盛京医院手术切除的55例胆管癌组织和12例慢性胆管炎组织中Livin和Ki-67蛋白的表达,并分析这两种蛋白与胆管癌临床病理特征的关系.应用Spearman等级相关分析、χ2检验和t检验对结果进行分析.结果 Livin蛋白在胆管癌标本中的阳性表达率为71%(39/55),明显高于慢性胆管炎标本的0(0/12)(χ2=20.361,P<0.01);Livin蛋白的表达受胆管癌患者的分化程度和淋巴结转移影响(χ2=4.193,4.245,P<0.05).Ki-67蛋白在胆管癌标本中的阳性表达率为96%(53/55).临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者Ki-67标记指数分别为22%±16%、33%±12%、43%±15%、49%±10%,Ⅱ、Ⅲ、Ⅳ期与Ⅰ期比较差异有统计学意义(t=2.307,2.871,3.957,P<0.05);有无局部淋巴结转移的患者Ki-67标记指数分别为43%±13%、34%±16%,两者比较差异有统计学意义(t=2.334,P<0.05).胆管癌组织中Livin蛋白的表达与Ki-67标记指数呈正相关(r=0.502,P<0.01).结论 Livin蛋白在胆管癌的发生、发展中起重要作用,并且与胆管癌增殖活性相关,两者结合可作为胆管癌恶性程度和判断预后的标准.     

Hvin和Ki-67蛋白在胆管癌组织中表达的意义

Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.     

LivinmRNA在胰腺癌中的表达及与Bcl-2相关性的研究

目的:探讨凋亡抑制基因Livin mRNA在胰腺癌组织中的表达及其与Bcl-2蛋白表达的关系.方法:采用逆转录-多聚酶链反应(RT-PCR)法检测52例胰腺癌、10例慢性胰腺炎和12例正常胰腺组织中Livin mRNA的表达;用免疫组织化学法检测胰腺癌组织中Bcl-2蛋白的表达.结果:Livin mRNA在胰腺癌中的表达率为71.2%,明显高于慢性胰腺炎和正常胰腺组织(P<0.01).Livin基因表达与胰腺癌的分化程度和淋巴结转移有关(P<0.05).Livin基因表达与Bcl-2蛋白表达显著相关.结论:Livin基因在胰腺癌的发生发展中起重要作用;Livin与Bcl-2的异常表达可能在胰腺癌的发生中起协同作用.     

肿瘤转移抑制基因KiSS-1在胰腺癌组织中的表达及意义

目的:检测KiSS-1mRNA及KiSS-1蛋白metastin在胰腺癌组织中的表达,探讨其在胰腺癌浸润及转移中的作用.方法:采用逆转录多聚酶链反应(RT-PCR)法及免疫组织化学S-P法检测42例胰腺癌,10例慢性胰腺炎及12例正常胰腺组织中KiSS-1mRNA及KiSS-1蛋白metastin的表达情况及与各种临床病理参数的关系.结果:KiSS-1mRNA及Kiss-1蛋白metastin在胰腺癌组中的阳性表达显著低于慢性胰腺炎组及正常胰腺组(P＜0.01);KISS-1mRNA和KiSS-1蛋白metastin的表达均与胰腺癌临床分期及淋巴结转移有关(P＜0.05);二者在胰腺癌组织中的表达存在明显相关性.结论:肿瘤转移抑制基因KiSS-1在抑制胰腺癌的浸润和转移过程中可能起着重要的作用.     

Hvin和Ki-67蛋白在胆管癌组织中表达的意义

Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.     

Hvin和Ki-67蛋白在胆管癌组织中表达的意义

Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.