Barrett食管诊治研究中存在的问题及对策

在房殿春教授的积极倡导组织下“全国第二届Barrett食管学术会议”在重庆胜利召开。与会专家就Barrett食管相关领域最新研究成果进行了研讨，内容涉及Barrett食管分子机制研究进展，Barrett食管病理诊断中的问题，Barrett食管与腺癌的关系，Barrett食管流行病学以及Barrett食管的内镜诊断和治疗。本刊将分两期刊登相关内容，以飨读者。     

Barrett食管基因差异表达谱初步探讨

病变组织差异表达基因的分析有助于寻找与疾病发生、发展和临床治疗有关的关键分子。目的：应用寡核苷酸芯片对Barrett食管与正常食管黏膜组织的差异表达基因进行高通量分析．以期筛选与Barrett食管发生、发展相关的分子标记物。方法：取6例Barrett食管患者病变食管黏膜和相应正常食管黏膜组织。Trizol一步法抽提总RNA．纯化后合成cRNA探针；探针荧光标记和纯化后，将两种组织探针分别与Agilent全基因组寡核苷酸芯片（含30968个基因组探针）进行杂交；获取芯片扫描图谱，以特征提取软件行定量分析、处理。结果：Barrett食管与正常食管黏膜组织的2倍差异表达（Ratio值≥2或≤0．5）基因中，上调基因142个，下调基因284个，涉及细胞周期相关基因、信号转导相关基因、黏蛋白相关基因、癌基因和抑癌基因、骨形态蛋白基因、凋亡抑制基因、bcl-2家族相关基因等。结论：高通量的基因芯片技术可筛选出大量Barrett食管相关基因，对这些相关基因的功能进行验证将有助于找到Barrett食管发生、发展的关键基因或通路。     

纵观食管疾病

食管疾病包括食管器质性疾病、食管动力障碍疾病、功能性食管病以及系统性疾病等,这些疾病可以引起各种症状。这里将纵观食管疾病的诊断、Barrett食管和食管癌、胃食管反流病,并强调胃食管结合部的重要性。     

352例食管疾病的内镜治疗

食管静脉曲张破裂出血、食管狭窄以及贲门失弛缓症等均为临床上的常见的食管疾病.1983年以来作者对这些疾病进行了内镜下硬化治疗及扩张治疗.1 食管静脉曲张出血:共治疗了283例,将资料完整的231例报告如下:     

食管测压及24 h食管pH监测在食管源性胸痛诊断中的意义

食管源性胸痛(ECP)系指由食管自身疾患引起的胸痛。为了解食管测压及24h食管pH监测对ECP的诊断价值,将我院消化科胃肠动力室自2003-12～2005-02对排除心源性胸痛及食管器质性病变,以反复发作性胸痛的125例患者进行食管测压及24h食管pH监测,现将确诊的61例食管源性胸痛患者报道如下。1对象与方法1.1临床资料本组共125例,其中男61例、女64例,年龄18～75岁,平均年龄45.2岁。所有患者均无食管器质性病变,但有不同程度的胸痛,X线胸片、心电图、心脏动态心电图等有关心肺疾病常规检查均无异常发现。1.2仪器设备本研究采用MedtronicSynectics…     

食管心脏电生理技术与临床应用（3）--常用刺激方法与应用技巧

食管心房调搏是利用食管与心脏解剖关系密切的特点,将电极导管经鼻腔送入食管。除了在心律失常时记录食管导联心电图外,主要应用心脏刺激仪发放直流电脉冲,通过贴近心脏的食管电极对心房进行调搏。同步记录体表及食管内心电图以获得心脏各部位的电生理参数,揭示心律失常的发生机制,诊断和治疗某些心律失常。     

兰索拉唑联合莫沙必利对胃食管反流患者的胃食管动力学及胃电活动指标的影响

目的分析兰索拉唑联合莫沙必利对胃食管反流患者的胃食管动力学及胃电活动指标的影响。方法选取2010年1月-2012年1月收治的136例胃食管反流患者为研究对象,将患者随机分为对照组和观察组各68例,对照组给予兰索拉唑治疗,观察组在对照组基础上加用莫沙必利。将两组患者治疗前与治疗后2周、4周、12周的胃食管动力学指标及胃电参数进行比较。结果观察组治疗后2周、4周、12周的胃食管动力学指标及胃电参数均明显优于对照组,且观察组治疗后胃食管动力学指标及胃电参数呈进行性升高(P0.05)。结论兰索拉唑联合莫沙必利对胃食管反流患者的胃食管动力学及胃电活动指标的影响较大,治疗效果较好。     

应用改良的三腔二囊管防治昏迷患者食管反流

0引言昏迷患者尤其是高龄患者出现食管反流临床上非常常见,由于昏迷患者食管反流将会带来严重后果,我们将用于食管胃底静脉破裂出血止血的三腔二囊管进行改良来防治昏迷患者食管反流9例,取得了满意的临床疗效如下.     

食管镜检查术对食管疾患的诊断价值(附100例分析)

目前食管疾患的診断,多赖助于鋇剂食管造影及食管镜检查,尤以后者对食管疾患的診断具有重要参考价值。某些食管疾患如癌肿,多可由之做出确切診断。鉴于此因,将我院外科进行食管鏡检查术100例材料加以分析,并对操作方法,各种食管疾患之检查图象及診断符合率等問題略加討論,供作参考。     

内镜下Barrett食管恶变的风险因素与随访策略

Barrett食管是食管腺癌的癌前病变,食管腺癌预后差,因此对Barrett食管患者定期内镜监测非常必要。但是内镜监测的效果常受限于镜下早癌诊断较困难、活检取样不够、不同病理医生主观差异及相对较低的食管腺癌发生率的影响。可以通过内镜下特征及临床表现相结合的方法将Barrett食管分成低危到高危的类别来提高随访监测有效率。最近,国内外指南将Barrett食管化生的柱状上皮长度及是否伴有低度不典型增生纳入内镜监测时间间隔的参考依据中。在本综述中我们将讨论Barrett食管内镜下特征与癌变进展的关系,这些特征可运用于Barrett食管的内镜监测中。     

Public policy on aging in Korea

Korea has undergone the most dynamic social changes in the world during its modernization in the latter half of the 20th century. During the dynamic modernization period, the traditional rural society has been disorganized, and industrialization and urbanization has rapidly proceeded.
In this trend the traditional family system has changed, and the problem of the elderly has emerged as a social issue. However, public policy on aging has been laggedly developed, compared to the social change during the modernization.
In order to explain the public policy on aging in Korea, this paper examines the social changes and population aging, the family changes and the problem of the elderly, and then the development of the public policy on aging social care programs by stages. and this paper examines the reason why the development of the public policy on aging in Korea has been delayed.     

精神心理因素对功能性便秘的影响

功能性便秘（functional constipation，FC）是临床上较为常见的一种功能性消化道疾病，近年来已受到广泛关注。其发病机制尚未完全明确，目前认为其发生主要与结、直肠动力障碍、盆底功能失调、社会心理因素以及胃肠调节肽异常等有关。本文就有关精神心理因素对功能性便秘影响的研究进行总结，从排便反射、神经分泌物质及对FC患者的临床精神心理治疗成效等几个方面进行综述。     

Clinical progress and the future of HIV exceptionalism.

In the 18 years since the first cases of the acquired immunodeficiency syndrome (AIDS) were reported by the Centers for Disease Control and Prevention (CDC), the epidemic has undergone profound transformations, and so, too, has the sociomedical context within which public health policy is fashioned and implemented. The early years of neglect and panic were also characterized by relative therapeutic impotence and deep uncertainty about the epidemiological course the new threat would take. In the United States and in other economically advanced nations, the threat of contracting the human immunodeficiency virus (HIV) has abated. The incidence of infection has declined, and the prevalence of infection has stabilized and, in some instances, begun to fall. The pattern of HIV spread, where it has continued, has been dramatically circumscribed to marginalized populations. The panic of the mid-1980s has passed, and in many nations, AIDS has lost its salience as a public issue. A sense of therapeutic impotence no longer prevails, and a new mood of triumphalism has taken hold. How have these crucial changes affected AIDS policies in America?     

Implementation of a nurse practitioner policy for the requisition and administration of drugs in a haemophilia comprehensive care centre

Summary The evolution of comprehensive care centres for haemophilia has altered the work of those involved in the care of haemophilia patients. The role of the haemophilia sister has expanded and the concept of the haemophilia nurse specialist has emerged. We describe the implementation of a local policy which has enabled haemophilia nurse specialists to requisition and administer clotting factor concentrates, DDAVP, tranexamic acid and hepatitis vaccines independently, in hospital and community settings. Since the introduction of this policy on 2 August 1994, prescribing practice has not changed in the haemophilia centre, nor has the involvement of medical staff in the care of haemophilia patients. This approach is widely applicable in other centres and should be a logical progression of the haemophilia nurse specialist's role.     

Clinical applications of BSM

Body surface mapping (BSM) has now become a feasible clinical technique, providing useful information applicable to the diagnosis of cardiac arrhythmias and their treatment by surgical and endocardial catheter ablation. In WPW patients, validation of preexcitation patterns has been obtained by computer simulation and by direct epicardial mapping at surgery. BSM pacemapping has subsequently been developed to be used during radiofrequency catheter ablation. This method has been evaluated prospectively and its predictive accuracy assessed. The recognition of two distinct BSM patterns in idiopathic ventricular tachycardia, has led to the application of successful pacemapping for radiofrequency catheter ablation. The use of a realistic tridimensional heart-torso computer model has shown that specific sites of endocardial stimulation are related to distinct thoracic map patterns.     

乌苏图病毒及其人畜动物感染的研究进展

乌苏图病毒为上世纪在非洲蚊虫标本中分离的病毒,此后证明为黄病毒科黄病毒属病毒。近十余年,该病毒不仅在非洲许多国家的蚊虫中多次分离到该病毒,特别是在远离非洲上万公里的欧洲许多国家的蚊虫中分离到乌苏图病毒,并且不断发现由乌苏图病毒感染引起的大批鸟的死亡,甚至发生人类感染的病例。乌苏图病毒已经成为一种新发的,长距离传播的虫媒病毒,引起国际关注。我国尚未在蚊虫中发现乌苏图病毒,也未见该病毒感染人畜动物的报道。本文总结目前国际上有关乌苏图病毒的研究进展,以推动我国对该病的相关研究。     

A historical review of erectile dysfunction

Over the last three decades, there has been a significant increase in our understanding of the physiologic mechanisms responsible for erectile dysfunction. Erectile dysfunction has become a topic of considerable media and societal interest and acceptance. Paralleling the increase in knowledge has been an explosion in therapeutic options. This article will evaluate the therapeutic options, from a historical perspective of what has been available, and outline the progress that has been made.     

Identification of high risk relatives for coronary heart disease

The family at increased risk for future coronary heart disease is the family with a member who has 1) had one or more myocardial infarctions before age 55 years; 2) has levels of LDL cholesterol greater than 75th percentile for age; 3) has excessively low levels of HDL2 cholesterol; 4) has hypertension or has had a stroke, or both; 5) has excessive weight at any age and excessive weight gain during adulthood, or 6) smokes in the household.     

经内镜逆行胰胆管造影在小儿胰腺疾病中的应用

经内镜逆行胰胆管造影(ERCP)使成人胰腺疾病的治疗发生了革命性变化。经过多年的临床应用,目前成人治疗性ERCP技术已相当成熟。随着儿科内镜技术的发展,近年来,小儿治疗性ERCP技术已从研究阶段进入实际应用阶段,并逐渐成为小儿胰腺疾病的重要治疗手段。本文主要就ERCP在小儿胰腺疾病中的诊断、治疗及并发症等现状作一综述。     

Virus Eradication and Synthetic Biology: Changes with SARS-CoV-2?

The eradication of infectious diseases has been achieved only once in history, in 1980, with smallpox. Since 1988, significant effort has been made to eliminate poliomyelitis viruses, but eradication is still just out of reach. As the goal of viral disease eradication approaches, the ability to recreate historically eradicated viruses using synthetic biology has the potential to jeopardize the long-term sustainability of eradication. However, the emergence of the severe acute respiratory syndrome-coronavirus (SARS-CoV)-2 pandemic has highlighted our ability to swiftly and resolutely respond to a potential outbreak. This virus has been synthetized faster than any other in the past and is resulting in vaccines before most attenuated candidates reach clinical trials. Here, synthetic biology has the opportunity to demonstrate its truest potential to the public and solidify a footing in the world of vaccines.