内镜技术的问世是医学史上的一次革命，是21世纪医学的重要进展之一。目前,内镜技术在肝胆胰外科领域得到了广泛的应用，有力地促进了肝胆胰外科的发展，肝胆胰内镜技术已成为微创外科重要的组成部分。。。。。。
Objective To summarize the progress of endoscopic diagnosis and therapy for pancreatic cancer. Methods Domestic and international publications online involving progress of diagnosis and therapy for pancreatic cancer by using endoscope in recent years were collected and reviewed. Results Recently, early diagnostic rate of pancreatic cancer increased with the development of endoscope and endoscopic technique such as endoscopic ultrasound, endoscopic ultrasound-guided fine needle aspiration, peroral pancreatoscopy, optical coherence tomography, ERCP, and cytology in pancreatic juice. Furthermore, varied therapies such as endoscopic ultrasound guided celiac plexus neurolysis, implantation of iodine 125-particles or pancreatic duct/bile duct stents were performed by endoscope for advanced pancreatic cancer. Conclusion Early diagnostic rate and novel therapeutic alternative of pancreatic cancer are supplied by digestive endoscopy.
【Abstract】ObjectiveTo study the effects of endothelin (ET) and Xuesaitong injection on hepatic, renal and myocardial tissues after bile duct ligation (BDL) in rabbits. MethodsSeventytwo rabbits were randomly divided into three groups: BDL group (24 rabbits), BDL+Xuesaitong injection group (24 rabbits), and sham operation group (24 rabbits). Each group was subdivided into four subgroups of postoperative 3, 6, 9 and 12 d (6 rabbits in each subgroup). Automatic biochemical analysis equipment was used to detect the levels of serum TBIL, ALT, BUN and Crea. The levels of ET in plasma, hepatic, renal and myocardial tissues were measured with radioimmunological method. ResultsThe levels of ET in plasma, hepatic, renal and myocardial tissues in both BDL group and BDL+Xuesaitong injection group were higher than those of sham operation group (P＜0.01). The levels of ET in plasma and tissues of BDL+Xuesaitong group were lower than those in BDL group (P＜0.05). ConclusionObstructive jaundice can lead to an increase of ET in plasma, hepatic, renal and myocardial tissues, the level of ET increases with the time of obstruction. Xuesaitong injection may play a protective role in the injury of hepatic, renal and myocardial tissues after obstruction by decreasing the level of ET in plasma and tissues.
Objective To investigate the structure characteristics， functions， and research progress of Notch signaling pathway in digestive tumors. Methods The related literatures about the molecular genetic mechanism of Notch signaling pathway were reviewed. Results The Notch signaling pathway plays an important role not only in normal cells’ growth， differentiation， proliferation， and apoptosis but also in a variety of tumors’ occurrence and development. Conclusion The reasonable regulation to Notch signaling pathway may open up new ways to the treatment of the tumor.
目的 比较开腹、腹腔镜和经皮肝穿刺引流3种方法治疗细菌性肝脓肿的优劣性，为细菌性肝脓肿治疗方法的选择提供参考依据。方法 回顾性分析笔者所在医院2010年9月至2011年7月期间收治的39例细菌性肝脓肿患者的临床资料，根据其治疗方式将患者分为开腹组、腹腔镜组和经皮经肝穿刺引流组（穿刺组）3组，对3组的首次治愈者比例、1个月治愈者比例、发生并发症者比例、住院时间及住院费用进行比较。结果 开腹组、腹腔镜组和穿刺组首次治愈者比例分别为10/12、8/9及12/18，3组间差异有统计学意义（P＜0.05）； 1个月治愈者比例分别为11/12、9/9及17/18，3组间差异无统计学意义（P＞0.05）；发生并发症者比例分别为2/12、1/9及2/18，腹腔镜组和穿刺组之间的差异无统计学意义（P＞0.05），2组与开腹组相比差异均有统计学意义（P＜0.05）；住院时间分别为（15.4±4.5） d、（9.7±2.3） d及 （16.7±5.8） d （P＜0.05）；住院费用分别为（1.9±0.5）万元、（1.3±0.3）万元及（0.8±0.2）万元（P＜0.05）。结论 开腹组、腹腔镜组和穿刺组3种治疗方法各有利弊，个体化选择治疗方式是肝脓肿的治疗策略。
ObjectivesThe aim of this meta-analysis was to evaluate the adjuvant efficacy of dendritic cell (DC) vaccines against advanced colorectal cancer.MethodsCNKI, CBM, WanFang Data, VIP, PubMed, Web of Science, The Cochrane Library and EMbase were searched to identify studies on dendritic cell vaccine for CRC up to August 13rd, 2017. After independently screening the literature and extracting data, two researchers evaluated the risk of bias in the studies, and used RevMan 5.3.5 software for meta-analysis.ResultsA total of 10 studies involving 2 050 patients were included. Meta-analysis showed that cellular immunotherapy based on DC vaccine treatment can improve the 2-year and 3-year overall survival rate of patients with advanced colorectal cancer (HR=0.33, 95%CI 0.17 to 0.27; 0.26, 95%CI 0.12 to 0.56, P<0.05), while there was no statistically significant difference in 1-year overall survival rate (HR=0.48, 95%CI 0.19 to 1.20, P=0.12); DC-CIK-based cellular immunotherapy could improve 2-year and 3-year overall survival rates (HR=0.27, 95%CI 0.10 to 0.75; HR=0.15, 95%CI 0.04 to 0.54, P<0.05), the difference of 1-year overall survival rate was not statistically significant (HR=0.39, 95%CI 0.13 to 1.13, P=0.08); DC combined with chemotherapy could improve 2-year and 3-year overall survival (HR=0.24, 95%CI 0.10 to 0.56; HR=0.22, 95%CI 0.04 to 0.54, P<0.05); the difference of 1-year overall survival rate was not statistically significant (HR=0.34, 95%CI 0.06 to 2.03, P=0.24); median overall survival in the DC vaccine group (MSR=1.25, 95%CI 1.16 to 1.34, P<0.05) and median progression-free survival (MSR=1.39, 95%CI 1.25 to 1.53, P<0.05) were superior to the control group. Fever was the most common adverse reaction and most patients could be relieved after treatment.ConclusionsDendritic cells vaccines-based immunotherapy can effectively improve the later overall survival rate and prolong median OS of patients with advanced colorectal cancer with mild adverse reactions, however the improvement of short term survival rate is not obvious.
Objective To construct the eukaryotic expressive vector of human tissue factor （TF），and to abserve the effect of TF on invasion and metastasis of gastric cancer cells line. Methods The human TF cDNA was obtained from human placenta by nest PCR, and the constructed eukaryotic expressive vector TF-pcDNA3 was transfected into SGC7901 cells by lipofectamine. Stable-transfected cells were screened by G418. The expressions of TF mRNA and protein on the cells were detected by RT-PCR and Western blot. Cell motility was assessed by using Transwell experiments and wound-healing assays. Results The eukaryotic expressive vector TF-pcDNA3 was successfully constructed and transfected into SGC7901. Compared with blank control group and negative control group, the expressions of TF mRNA and TF protein in transfection group were increased, the cell motility in vitro was enhanced. Conclusion TF can enhance the ability of invasion and metastasis of gastric cancer cells in vitro.
目的 探讨实施肠内营养的途径。方法 采用回顾性研究的方法，分析兰州大学第一医院2007年1月1日至2007年12月31日实施胆肠吻合术的15例患者的临床资料，包括复发性胆管结石4例，胆管癌3例，胆总管囊肿3例，壶腹癌（不能根治）5例； 平均年龄75.5岁； 在行胆肠Roux-en-Y吻合时，利用空肠盲襻实施空肠造瘘，术后第12 h开始肠内营养。统计肛门排气时间、住院时间及并发症。结果 15例患者平均肛门排气时间为54.6 h，平均住院时间为12 d，平均营养管拔除时间为20 d； 发生吻合口漏1例，肺部感染1例，切口感染1例，无一例因造瘘而发生机械性肠梗阻。结论 胆肠吻合利用空肠盲襻实施空肠造瘘肠内营养是肠内营养一种方便、可行的途径，它可以减少并发症的发生，缩短患者的住院时间，减轻患者的经济负担。与传统的方法比较，不会引起咽部不适及肺部感染，患者依从性好； 不会导致机械性肠梗阻，安全可行。