42 Wistar rats were divided into three groups at random, liver cirrhosis (LC), portal vein stricture (PVS) and sham operation (SO) group. The changes of barrier capability of gastric mucosa in portal hypertensive rats were observed. The results demonstrated: the splanchnic blood flow of the portal hypertensive rats increased, as compared with the normal control group (Ｐ＜0.001), but actually gastric mucosa was under the condition of ischemia. Mucosa of gastric wall glycoprotein and PGE2 of gastric mucosa decreased, as compared with the normal control (Ｐ＜0.01); and more seriously decreased in cirrhotic portal hypertensive rats, there was no significant difference about amount of the basal acid secretion (BAS) among the three groups, but the amount of H＋ backdiffusion (H＋BD) was obviously increased, as compared with the normal control group (Ｐ＜0.001). The amount of H＋BD of cirrhotic portal hypertensive rats was the highest among this three groups. The results suggest that the barrier capability of gastric mucosa with portal hypertension is lower than that of the normal control group and much lower with cirrhotic portal hypertensive rats. The portal hypertensive gastropathy is associated with the lower capability of defense of gastric mucosa. The condition of liver function contributes to the change of barrier capability of gastric mucosa.
摘要:目的:總結十二指腸間質瘤的診斷及外科手術體會。方法:回顧分析1999年~2008年收治的25例十二指腸間質瘤患者的臨床資料。結果:臨床表現最多見為黑便(14/25)，其次為右上腹不適(11/25)，腹塊被(2/25)，無明顯癥狀者(2/25)。術前診斷采用上消化道鋇餐造影、CT、B超、胃鏡或十二指腸鏡、超聲內鏡檢查。25例均手術治療,其中胰十二指腸切除6例,局部切除18例,組織活檢術+胃腸吻合1例。術后隨訪5~96個月,1、3、5年生存率為95.4%、85.5%和67.3%。結論:綜合CT、胃腸道鋇餐造影、消化內鏡可使大部分十二指腸間質瘤術前得到確診。手術方式依據腫瘤部位、大小而定,局部切除應選擇正確重建方式。Abstract: Objective: To investigate the diagnosis and surgery treatment of duodenal gastrointestinal stromal tumors(GIST).Methods: The clinical data of 25 patients with GIST from 1999 to 2008 were analyzed retrospectively.Results: The most common symptoms of duodenal GIST were melena(14/25), as well as abdominal pain(11/25),abdominal mass, absence of symptoms(2/25). We performed the diagnosis by upper gastrointestinal radiography, gastroscopy, endoscopic ultrasonography and CT scan. All the 25 patients underwent surgical resection, of which 6 with pancreaticoduodenectomy, 18 with local resection, 1 with tissue biopsy and stomach intestinal anastomosis. With 5 to 96 months followup after operation, 1, 3 and 5year survival rates were 95.4%, 85.5% and 67.3%. Conclusion: Preoperative diagnosis of most of GIST was dependent on CT scan, upper gastrointestinal radiography and gastroscopy. The choices of surgical procedures are mainly determined by the location and size of the tumors, local excision should choose the correct way to rebulid alimentary tract.
Objective To evaluate the therapeutic effects of D1 and D2 operative methods for advanced gastric carcinoma. Methods 60 cases of the resectably distal gastric cancer were colleted prospectively and they were randomly divided into group D1 (30 cases) and group D2 (30 cases). They were operated respectively by the doctors with equivalent grade in two groups.Results No patients in the two groups died from the operation. The rate of recurrence and metastasis in group D1 and D2 was 40.0% and 3.3% (P＜0.01) respectively in a year, 53.3% and 10.0%(P＜0.01) in two years, 56.6% and 13.3% (P＜0.01) in three years, 60.0% and 16.7% (P＜0.01) in four years； The survival rates in group D1 and D2 were 73.3% and 96.7%(P＜0.05) in a year, 59.3% and 96.5% (P＜0.01) in two years, 53.6% and 83.3% (P＜0.05) in three years, 44.4% and 80.0% (P＞0.05) in four years, respectively. ConclusionIn reducing the recurrent rate of gastric cancer and increasing the postopertive survival rate, the D2 operative method is much better than the D1 operative method, and it can be the first choice for advanced gastric carcinoma.
The effects of pentagastrin (PG) on the viable cell count (Α value) and the synthesis of DNA (CPM value) of primary cultured large bowel carcinoma cells in 25 patients were evaluated in vitro by MTT assay,3H-TdR incorporation. The results showed that Α value and CPM value in well， moderately and poorly-differentiated carcinoma cells were higher than normal control (Ｐlt;0.01，Ｐ＜0.05). The proliferative effect was significant at a dose of 0.3907 μg/ml in well-differentiated carcinoma cells, and at a dose of 6.2500μg/ml in moderately and poorly-differentiated carcinoma cells. These indicat that PG has the proliferative effect on large bowel carcinoma cells. These results provide an experimental foundation for the endocrine therapy for patients with large intestine carcinoma, especially by using gastrin receptor antagonists for well-differentiated carcinoma.
Objective To introduce telomeres, telomerase and their expression in gastric carcinoma.MethodsThe related literatures were collected and reviewed.Rsults In summary, telomerase activity could be detected in 85%-90% of gastric cancer. Moreover, the patient with telomerase-positive tumors showed poorer prognosis than those with telomerase-negative tumours, indicating that telomerase-positive gastric cancer might have more malignant potential. ConclusionKnowledge of telomerase activity in gastric cancer may be useful in cancer diagnosis, as well as a prognostic indicator of clinical outcome. Future development of drugs aimed at telomerase inhibition may potentially provide a therapy with relatively less side effects.
CT texture analysis (CTTA) can objectively evaluate the heterogeneity of tissues and their lesions beyond the ability of subjective visual interpretation by extracting the texture features of CT images, then performing analysis and quantitative and objective evaluation, reflecting the tissue micro environmental information. This article reviews the recent studies on the applications of CTTA in gastric cancers, in the aspects of identification of gastric tumors, prediction of stage, correlation with Lauren classification, prediction of occult peritoneal carcinomatosis, evaluation of efficacy and prognosis, and prediction of biomarkers. It is regarded that CTTA has a good application prospect in gastric cancers.
【Abstract】ObjectiveTo study the effect of preoperative gastric arterial chemoembolization on apoptosis of lymph node metastasis of gastric cancer. MethodsForty patients with gastric cancer and lymph node metastasis underwent curative resection, among which there were 20 patients who received the preoperative gastric arterial chemoembolization, and they constituted the treatment group. The rest of the patients were included in the control group. The expressions of p53, CD95 and bcl-2 were examined by immunohistochemistry and apoptosis in the lymph node metastasis was examined by in situ terminal transferasemediated dUTP nick end labeling （TUNEL）. ResultsThe expression intensity of p53 and CD95 in lymph node metastasis of treatment group increased more significantly than that of control group, whereas the expression intensity of bcl-2 decreased in treatment group. There was a significantly positive correlation between the expressions of p53 and CD95 and the apoptosis.ConclusionPreoperative gastric arterial chemoembolization may affect the expressions of p53, CD95 and bcl-2 and may induce the apoptosis of lymph node metastasis. It may be helpful to improve the effect of curative resection of gastric cancer.
ObjectiveTo explore the effect of exogenous ghrelin on early recovery of rats after subtotal gastrectomy. MethodsTwelve rats undergoing subtotal gastrectomy (B-Ⅰtype) were randomly divided into two groups, and saline or ghrelin was intraperitoneally injected in two groups, respectively. The body weight and daily food intake were measured before operation and on 1-7 d after operation. Rats were killed on day 7 after operation and the expressions of ghrelin mRNA in the fundus of stomach and anastomotic stoma was determined by realtime fluorescent quantitative PCR assay. The anastomotic bursting pressure and hydroxyproline content of anastomotic stoma tissues were also detected. ResultsThere was no significant difference (P＞0.05) in pre and postoperative body weight between two groups. Gradual decrease in postoperative body weight among the rats of saline group was observed which was significantly lower than that before operation (Plt;0.01). Body weight reached it’s lowest on day 1 after operation (Plt;0.01), after which it gradually increased but was still lower than that before operation (Plt;0.01). The postoperative body weight of rats in ghrelin group gradually decreased too, and was also significantly lower than preoperative body weight (Plt;0.01), except for the day 1 after operation (P=0.693). It reached the lowest on day 4 after operation (Plt;0.01), then it gradually increased but was still lower than that before operation (Plt;0.05 or Plt;0.01). The cumulative food intake of rats in ghrelin group was （52.50±6.77） g, which was significantly higher than that in saline group 〔(45.67±7.47) g〕, Plt;0.05. On day 7 after operation, relative expression of ghrelin mRNA in the fundus of stomach of rats in ghrelin group was 0.08±0.04, which was significantly lower than that in saline group (0.22±0.07), Plt;0.01. Compared with saline group, ghrelin-treated rats displayed significantly higher bursting pressure 〔（155.83±6.62） mm Hg vs. （172.33±10.44） mm Hg, Plt;0.05〕 higher hydroxyproline content 〔 (0.43±0.05) μg/mg wet tissue vs. （0.50±0.29） μg/mg wet tissue, Plt;0.01〕 at the anastomotic stoma. ConclusionGhrelin may effectively promote the early recovery of rats after subtotal gastrectomy.
