胰腺癌中磷酸酶和张力蛋白同源物基因及B7-H1蛋白的表达及其临床意义

Objective To investigate the probable correlation between the expressions of phosphatase and tensin homologue deleted on chromosometen (PTEN) and B7-H1 protein in pancreatic carcinoma and the biological behavior characteristics of tumors. Methods Forty-three patients were recruited who had undergone surgical resection for pancreatic carcinoma between 2002 and 2009. The PTEN and B7-H1 protein expressions in the tissue specimens of these 43 patients and 5 non-pancreatic carcinoma people' s pancreatic tissue specimens were evaluated by immunohistochemistry ELPS technique, and the clinical and pathological features of these specimens and the follow-up information were analyzed. Results PTEN expressions were significantly lower in pancreatic carcinoma tissues than in non-pancreatic carcinoma people' s pancreatic tissues but B7-H1 expressions were significantly higher ( P ＜ 0. 01 ). The expression of PTEN was negatively correlated to that of B7-H1 (r = -0.414 ,P ＜0. 01). PTEN and B7-H1 expressions correlated with the pathological grade and tumor-node-metastasis ( TNM ) stage, peripancreatic invasion, regional lymph node involvement,respectively (P＜0. 05). B7-H1 expressions also significantly correlated with the ages (P＜0. 01). Furthermore, PTEN and B7-H1 expressions showed significant prognostic effects (P＜0.01) and there are correlations existed between combined PTEN/B7-H1 expression and prognostic effects (P ＜0. 05). Conclusion The expression of PTEN and B7-H1 may be significantly correlated to the carcinogenesis,development and prognosis of pancreatic carcinoma.     

新生儿坏死性小肠结肠炎造瘘术后关瘘时机的选择

目的 多数具有手术指征的新生儿坏死性小肠结肠炎（NEC）患儿需要行坏死肠管切除+肠造瘘术。而对于术后多长时间关闭造瘘口较为合适,目前尚无共识。因此,本研究的目的是明确NEC造瘘术后关瘘的理想时机。方法 本研究回顾性分析了深圳市儿童医院新生儿外科2010年8月至2019年1月之间因NEC行坏死肠管切除+肠造瘘术并在术后一段时间后行关瘘术的患儿资料。为便于分析,我们将早期关瘘（EC）定义为造瘘术后8周内（含8周）,而晚期关瘘（LC）定义为造瘘术后8周后。结果 在58例患儿中,男35例,女23例。手术指征为气腹40例、保守治疗无法控制的感染18例,其中27例为早期关瘘（EC）,31例为晚期关瘘（LC）。关瘘术后EC组有18例患儿需要呼吸机支持（66.67%）,而LC组为10例（32.26%）（P<0.05）;EC组比LC组需要更长时间肠外营养支持;而且EC组的住院时间远高于LC组;共有13例患儿因粘连性肠梗阻的并发症接受了再次手术（其中EC组7例,LC组6例）;4例EC组患儿术后出现切口愈合不良,2例EC患儿因败血症死亡,1例EC患儿因短肠综合征和严重的营养不良死亡,而LC组患儿术后切口均恢复良好,无一例死亡。结论 本研究提示,NEC肠造瘘术后晚期关瘘比早期关瘘能为患儿带来更大的益处。     

胰腺癌中磷酸酶和张力蛋白同源物基因及B7-H1蛋白的表达及其临床意义

目的 观察胰腺癌磷酸酶和张力蛋白同源物基因(PTEN)蛋白和B7-H1蛋白的表达,探讨两者与胰腺癌肿瘤生物学特征的关系.方法 采用免疫组织化学ELPS法检测43例胰腺癌患者的组织标本和作为对照的5例非癌胰腺标本中PTEN和B7-H1蛋白的表达水平,分析其与临床和病理学特征的关系.结果 比较非癌胰腺组织,胰腺癌组织中PTEN蛋白表达显著降低,而B7-H1蛋白表达显著升高(P＜0.01),两者的表达还呈现显著负相关(r=-0.414,P＜0.01);两者的表达水平与肿瘤的分化程度、TNM分期、浆膜侵犯及淋巴结转移有关(P＜0.05),B7-H1表达水平还与年龄显著相关(P＜0.01);两者分别的表达水平与患者的预后均显著相关(P＜0.01),两者的联合表达水平与患者的预后相关(P＜0.05).结论 mN和B7-H1蛋白的表达水平与胰腺癌的发生、发展和预后密切相关.

Abstract：

Objective To investigate the probable correlation between the expressions of phosphatase and tensin homologue deleted on chromosometen (PTEN) and B7-H1 protein in pancreatic carcinoma and the biological behavior characteristics of tumors. Methods Forty-three patients were recruited who had undergone surgical resection for pancreatic carcinoma between 2002 and 2009. The PTEN and B7-H1 protein expressions in the tissue specimens of these 43 patients and 5 non-pancreatic carcinoma people' s pancreatic tissue specimens were evaluated by immunohistochemistry ELPS technique, and the clinical and pathological features of these specimens and the follow-up information were analyzed. Results PTEN expressions were significantly lower in pancreatic carcinoma tissues than in non-pancreatic carcinoma people' s pancreatic tissues but B7-H1 expressions were significantly higher ( P ＜ 0. 01 ). The expression of PTEN was negatively correlated to that of B7-H1 (r = -0.414 ,P ＜0. 01). PTEN and B7-H1 expressions correlated with the pathological grade and tumor-node-metastasis ( TNM ) stage, peripancreatic invasion, regional lymph node involvement,respectively (P＜0. 05). B7-H1 expressions also significantly correlated with the ages (P＜0. 01). Furthermore, PTEN and B7-H1 expressions showed significant prognostic effects (P＜0.01) and there are correlations existed between combined PTEN/B7-H1 expression and prognostic effects (P ＜0. 05). Conclusion The expression of PTEN and B7-H1 may be significantly correlated to the carcinogenesis,development and prognosis of pancreatic carcinoma.     

胰腺癌中磷酸酶和张力蛋白同源物基因及B7-H1蛋白的表达及其临床意义

Objective To investigate the probable correlation between the expressions of phosphatase and tensin homologue deleted on chromosometen (PTEN) and B7-H1 protein in pancreatic carcinoma and the biological behavior characteristics of tumors. Methods Forty-three patients were recruited who had undergone surgical resection for pancreatic carcinoma between 2002 and 2009. The PTEN and B7-H1 protein expressions in the tissue specimens of these 43 patients and 5 non-pancreatic carcinoma people' s pancreatic tissue specimens were evaluated by immunohistochemistry ELPS technique, and the clinical and pathological features of these specimens and the follow-up information were analyzed. Results PTEN expressions were significantly lower in pancreatic carcinoma tissues than in non-pancreatic carcinoma people' s pancreatic tissues but B7-H1 expressions were significantly higher ( P ＜ 0. 01 ). The expression of PTEN was negatively correlated to that of B7-H1 (r = -0.414 ,P ＜0. 01). PTEN and B7-H1 expressions correlated with the pathological grade and tumor-node-metastasis ( TNM ) stage, peripancreatic invasion, regional lymph node involvement,respectively (P＜0. 05). B7-H1 expressions also significantly correlated with the ages (P＜0. 01). Furthermore, PTEN and B7-H1 expressions showed significant prognostic effects (P＜0.01) and there are correlations existed between combined PTEN/B7-H1 expression and prognostic effects (P ＜0. 05). Conclusion The expression of PTEN and B7-H1 may be significantly correlated to the carcinogenesis,development and prognosis of pancreatic carcinoma.     

空气灌肠整复术治疗495例小儿急性肠套叠的临床研究

目的回顾性分析空气灌肠整复术治疗肠套叠的临床效果。方法将495名肠套叠患儿按年龄分为两组(A组和B组),A组≤2周岁,B组>2周岁;对两组患儿的空气灌肠成功率、复发率、手术治疗率、继发性肠套叠例数进行比较。结果两组患儿的空气灌肠成功率、复发率、手术治疗率无显著性差异(P>0.05);B组的继发性肠套叠例数较A组高,两组相比有显著性差异(P<0.05)。结论肠套叠患儿随着年龄增大发病率减少,但出现继发性肠套叠的几率增加。     

中西医结合非手术治疗儿童阑尾周围脓肿82例

目的：：总结中西医结合非手术治疗对阑尾周围脓肿的治疗效果。方法：回顾分析2011年5月至2015年4月,我科收治的儿童阑尾周围脓肿82例,其中42例为中西医结合治疗组,在静脉点滴抗生素的同时,结合中药治疗,内服大黄牡丹汤和意苡附子败酱散加减;40例为西医保守治疗组,以静脉点滴抗生素治疗。结果：中西医结合治疗组平均住院时间为(15±2.5)d ,治疗3d后即有明显疗效者30例(占71.4%)。西医保守治疗组平均住院时间为(21±3.5) d ,治疗3d后有明显疗效者15例(占35.7%),有8例因全身感染症状加重,腹膜炎不能局限,而行手术治疗。两组住院时间及疗效差异有非常显著性(P＜0.05),具有统计学意义。结论：中西医结合非手术治疗儿童阑尾周围脓肿疗效显著,可减轻患儿痛苦,缩短住院时间,适合临床推广。     

腹腔镜与传统手术治疗小儿美克尔憩室的对比研究

目的 回顾性分析腹腔镜手术与传统手术在治疗小儿美克尔憩室的手术效果。方法收集手术治疗的美克尔憩室伴出血28例,其中传统手术15例,腹腔镜辅助下手术13例。分析两组患儿手术时间、术后排气时间、住院时间、住院费用及并发症等差别。结果 腹腔镜辅助手术在手术时间、住院时间及术后肠功能恢复时间均较传统手术短,两者比较有统计学意义;腹腔镜手术的住院费用虽较传统术后稍高,但两者无统计学意义;传统手术术后并发症4例,腹腔镜手术术后并发症1例,两组无统计学意义。结论 腹腔镜手术由于创伤小,术后肠功能恢复快,住院时间短,切口美观等优点,是一种治疗小儿美克尔憩室的极好方法。     

联合门静脉-肠系膜上静脉切除的胰腺癌根治术:现状、争议与展望

由于胰头与门静脉系统解剖上的毗邻关系和胰腺癌侵袭性的生物学特性,胰腺癌极易侵犯门静脉系统.联合门静脉-肠系膜上静脉(PV/SMV)切除的胰腺癌根治术也许能为门脉受侵犯的胰腺癌患者带来潜在的益处,但这一手术的预后仍存在争议.目前尚无明确证据显示,联合PV/SMV切除的胰腺癌根治术能提高患者的生存率.为形成临床指导原则,仍...