目的 评价采用圆形吻合器治疗直肠黏膜脱垂的安全性和可行性. 方法 回顾性分析2002年10月至2006年1月我院手术治疗的42例直肠黏膜脱垂患者的临床资料,其中直肠内黏膜脱垂22例,直肠外黏膜脱垂20例,均经排粪造影诊断. 结果 42例均行经肛门直肠黏膜环切术(procedure for prolapse and haemorrhoids,PPH),术后随访2～40个月,2例术后半年少量便血,肠镜检查为吻合口丝线缝合处肉芽生长所致.总有效率为88.1%(37/42),其中直肠内黏膜脱垂有效率为81.8%(18/22),直肠外黏膜脱垂有效率达95.0%(19/20). 结论 PPH术治疗直肠外黏膜脱垂优于直肠内黏膜脱垂,手术简便.
【Abstract】ObjectiveTo investigate the role of apoptosis-related gene survivin, caspase-3 and cyclin-B1 in gastric carcinoma by detecting the expressions of survivin, caspase-3 and cyclin-B1 in gastric carcinoma. Methods The expressions of survivin mRNA, caspase-3 mRNA and cyclin-B1 mRNA were determined by reverse transcription-polymerase chain reaction (RT-PCR) method in 30 gastric carcinoma specimens and 10 normal gastric tissue specimens. ResultsThe positive expression rate of survivin mRNA in 30 gastric carcinoma specimens was 66.7%(20/30). While 10 normal gastric tissue specimens did not express survivin mRNA. Although all of 30 gastric carcinoma tissues and 10 normal gastric tissues expressed caspase-3 mRNA and cyclin-B1 mRNA, the expressions of caspase-3 and cyclin-B1 in 20 survivin-positive gastric carcinoma tissues were significantly lower than those of 10 survivin-negative gastric carcinoma tissues (P＜0.01) and 10 normal gastric tissues (P＜0.01). The expressions of caspase-3 mRNA and cyclinB1 mRNA in 10 survivin-negative gastric carcinoma tissues were significantly lower than those of 10 normal gastric tissues (P＜0.01). And in gastric carcinoma tissues the expression of survivin mRNA was negatively related with that of caspase-3 mRNA （r=-0.923,P＜0.01） and cyclin-B1 mRNA (r=-0.886,P＜0.01), the expression of caspase-3 mRNA was positively related with that of cyclin-B1 mRNA (r=0.892, P＜0.01). Conclusionsurvivin enhances gastric tumorigenesis, caspase-3 and cyclin-B1 inhibit gastric tumorigenesis.
Objective To investigate the effects of highly selective vagotomy plus mucosal antrectomy (HSVMA) and highly selective vagotomy (HSV) alone on the functions of the gastric antrum. MethodsEighteen dogs and 48 patients with chronic duodenal ulcer were tested. The time of gastric emptying, antral myoelectric activity, antral pressure were measured 4-6 months after operation in 18 dogs which were randomized into the control, HSV and HSVMA groups. The gastric evacuation, frequency and amplitude of electrogastrography (EGG) were observed 4-6 months after operation in 48 patients who were randomly divided into HSV (20 patients) and HSVMA (28 patients) group, their preoperative values were considered as control group. ResultsIt was found by barium meal examinations that the shape of the stomach and duodenum was normal and gastric peristalsis was clearly visible in all the animals and patients of two postoperative groups. The beginning and ending time of gastric emptying were (5.0±0.06) min and (4.0±0.4) h respectively in the dogs of HSVMA group, which were similar to those of the dogs of control and HSV group (Pgt;0.05). The frequency of the antral myoelectric action potential was (3.11±0.65 ) cycles/min in the dogs of HSVMA group, the frequency of EGG was (3.25±0.75) cycles/min in the patients of HSVMA group, which were significantly lower than that of the dogs or patients of control and HSV group (P＜0.05). Injection of pentagastrin in dogs or taking meal in patients significantly increased the antral pressure or amplitude of EGG. Conclusion The motor function of the reconstructed antrum in the HSVMA group approaches the normal level despite a lower antral myoelectric frequency. It is believed that HSVMA will be a choice for the treatment of duodenal ulcer.
To observe the changes of antral motor function and electrogastrography of 12 dogs and 30 patients with duodenal ulcer after highly selective vagotomy and mucosal antrectomy.Results: in an empty stomach, the preoperative and postoperative antral pressure value of dogs was similar, but the antral action potential frequency of dogs was slower after operation than that before operation. After injection of pentagastrin, whether before or after operation, the antral pressure value and action potential frequency of dogs were similar in the two groups. In an empty stomach, the electrogastrography frequency of patietns with duodenal ulcer was decreased after operation than that before operation, but their value of electrogastrography was similar, and after taking food, their preoperative and postoperative value and frequency of electrogastrography were significantly higher than that before taking food. But, whether before or after operation, there wasn’t significant diffence in them.Conclusions: there wasn’t changes of antral motor function and electrogastrography in dogs and patients with duodenal ulcer after highly selective vagotomy and mucosal antrectomy.
The effects of all-trans retinoic acid (ATRA) on primary gastric carcinoma models made by subcutaneous implanting gastric cancer to mice were observed. Thirty-two cancer bearing nude mice were randomly divided into 4 groups: control group (group Ⅰ)， ATRA low dose feeding group (100μg/day， group Ⅱ), moderate dose feeding group (300μg/day， group Ⅲ), and high dose feeding group (1 000 μg/day, group Ⅳ). The alteration of tumor growth, morphology, cytobiology, and immuno-histochemical assay were perfermed. The results showed significant inhibition of tumor growth and inducing differentiation in the group Ⅲ and group Ⅳ as compared with group Ⅰ (Ｐ＜0.01),and inhibited expression of p53, p21 protein in implanted tumor. The authors consider that ATRA has some effects of growth inhibition and differentiation on gastric cancer cells in vivo, and these is related to the inhibition of expression p53 and p21 onco-gene of cancer cells and accelerate apoptosis of carcinoma cells.
The antitumor activity of hyperthermia combined with mitomycin(MMC),5-fluorouracil(5-Fu)was observed in human gastric carinoma cell line MGC-803.The study was aimed at understanding the percentage of living carcinoma cell,plating efficiency and survival fraction.The results showed that hyperthermia combinedwith MMC had a synergistic antitumor activity which was enhanced with temperature increasing,but it was not the same as hyperthermia combined with 5-Fu.In comparison with simple hyperthermia,the antitumor activity of hyperthermia combined with 5-Fu was enhanced at lower temperture.This results raises a basis of clinical practice.