ERCP联合ESWL治疗胰管结石12例报道

目的 评价ERCP联合ESWL治疗胰管结石的效果.方法 2008年1月-2009年12月在我院经影像学确诊的12例胰管结石患者接受了ERCP联合ESWL治疗.先行ERCP以了解胰管形态改变并放置胰管支架;续行ESWL,依结石形态及密度了解碎石效果,对碎石不满意者重复ESWL;6-8周后再行ERCP取石.结果 所有患者全部碎石成功（根据结石密度和体积变化）;其中,1例行ESWL后结石完全排净,5例ESWL后经内镜治疗结石被完全清除,1例结石部分清除,1例取石失败,2例碎石后失访.治疗期间未出现严重并发症.结论 ESWL对胰管结石碎石效果好,但单纯ESWL仅部分患者结石可自行排出;ESWL后结合内镜取石治疗,能提高胰管结石清除效果.     

下肢浅静脉曲张症的诊治

下肢浅静脉曲张症的诊治龚凯黄道景李冰范跃祖附属甘泉医院普外科（上海，２０００６５）关键词下肢；静脉曲张中图号Ｒ６５４．４下肢浅静脉曲张症是外科常见疾病。８０年代以后，由于对下肢静脉病变认识的提高，尤其是有关血流动力学、生理学和病因学的进展，其诊治方法...     

肿瘤抗侵袭转移研究与胆囊癌

胆囊癌是生物学毒性较强的消化道肿瘤 ,易于早期浸润转移 ,预后差[1,2 ] 。如何有效地对抗胆囊癌的浸润转移 ,是治疗胆囊癌复发和转移的关键。近年 ,有关肿瘤侵袭转移机制及抗侵袭转移的研究已取得不少进展。为此 ,本文就近年有关肿瘤侵袭转移机制及抗侵袭转移机制的研究现状以及与胆囊癌的关系 ,作一综述。1　血管生成与血管生成抑制　　血管生成或新生血管的产生对于原发肿瘤的增殖极为重要。业已发现 ,血管生成与肿瘤厚度和转移相关 ;新生成的肿瘤血管易通透肿瘤细胞以至于形成新的转移 ,故高程度的血管生成增加了肿瘤细胞进入循环系统及…     

急性下肢动脉栓塞症综合治疗

目的：观察急性下肢动脉栓塞各种治疗方法的疗效。方法：33例急性下肢动脉栓塞，采用Fogarty导管取栓 静脉溶栓、导管介入溶栓、静脉溶栓；将治疗结果进行回顾性分析。结果：Fogarty导管取栓 静脉溶拴后17例治愈，3例好转，3例肢体坏死，3例死亡，3例再次血栓栓塞；2例动脉导管介入溶栓者保存肢体出院；静脉溶栓中l例好转、2例肢体坏死，2例死亡。结论：急性下肢动脉栓塞应积极取栓，对于复发血栓栓塞建议采用动脉导管介入溶栓。     

金属蛋白酶-2及其组织抑制因子在原发性胆囊癌的表达及意义(英文)

目的　探讨MMP - 2、TIMP - 2蛋白在原发性胆囊癌的表达及意义。方法　应用免疫组化SABC法结合图像分析技术 ,定量检测 4 5例胆囊癌和 15例胆囊息肉样病变的MMP - 2和TIMP - 2蛋白表达。结果　胆囊癌MMP - 2表达量显著高于胆囊息肉样病变 (P =0 .0 0 2 ) ;MMP - 2表达与胆囊癌组织学类型、分化程度、浸润深度、淋巴结转移及肝脏浸润等均无相关性 ,但不同分期的MMP - 2表达量差异显著 ;胆囊癌TIMP - 2表达虽与胆囊息肉样病变无差异 (P =0 .2 95 ) ,但不同Nevin分期间、浸润深度不同、有无局部淋巴结转移及肝脏浸润的胆囊癌 ,TIMP - 2表达量有显著差异。结论　TIMP - 2表达能较准确地反映胆囊癌的生物学特点 ,有可能作为一个新的标志 ,在胆囊癌的早期诊断、浸润转移的判断和患者预后的估计有重要的意义。     

抗肿瘤血管生成与消化道肿瘤

该文综述了肿瘤血管生成及其调控因素如肿瘤血管生成因子和肿瘤血管生成抑制因子以及它们应用于消化道肿瘤抗血管生成治疗的研究进展，为治疗消化道肿瘤提供了新思路和新方法。     

局部植入化疗对结肠吻合口愈合的影响

目的探讨犬肠系膜植入缓释5-氟尿嘧啶(5-FU)对结肠吻合口愈合的影响。方法成年健康杂种犬28只,按随机数字法随机分为对照组(6只)和实验组(22只)。手术经腹正中切口行乙状结肠中段离断再吻合,将缓释5-FU200mg单点植入到距离肠吻合口1.0~1.5cm肠系膜处。对照组植入5-FU对照品。分别于植药后3、5、7、10及15d各处死4只动物,取肠系膜及吻合口组织行病理学检查,观察肠吻合口愈合的情况,并采用高效液相色谱法分别检测不同时相吻合口处及距植药点0、1、3、5、7、10及15cm处组织药物浓度。结果药物植入后3d,吻合口组织仅为炎症表现,未见明显的坏死、细胞变形等病理表现;植入后第10d,吻合口组织基本恢复正常。距植入点0~15cm范围内,各点组织药物浓度随距离及时间延长依次递减,但均高于抑瘤浓度(0.10μg/g)。结论结肠吻合口旁肠系膜植入缓释5-FU,对吻合口愈合无影响;局部植入缓释5-FU能在一定时间内维持较高的有效药物浓度。     

Study on Proteomics in Hepatic Metastasis of Colorectal neoplasms

Colorectal cancer is one of the most frequent cancers in the world. Hepatic metastasis is the most common site metastatic disease and dominant cause of death in colorectal cancer patients. In the large majority of cases, cell dysfunction in CRC results from multiple rather than single, gene interactions, so to be able to predict occurrence of disease and treatment outcome, more studies on comparative proteomics are needed both in sporadic and in hereditary colorectal cancer. This article is about the proteomic study on hepatic metastasis of colorectal cancer which helps to identify the specific proteins that play important roles in hepatic metastasis. The study of protein molecules with their expressions correlated to the metastatic process would help to understand the metastatic mechanisms and thus facilitate the development of strategies for the therapeutic interventions and clinical management of cancer.     

大肠癌中VEGF促淋巴生成作用的研究进展

淋巴道转移是结直肠癌最重要的转移途径,是其难以根治,影响外科治疗的重要因素.血管内皮生长因子（VEGF）家族是一类特异性地作用于内皮细胞的生长因子,其控制血管生成作用的研究较为透彻,但它们对淋巴道生发中的作用研究尚少.本文主要就VEGF对淋巴管生成的作用和结直肠微环境对该因子表达的影响,及以此为作用靶点的一些抗淋巴生成治疗方法作一综述.     

A new blood supply for human primary gallbladder carcinomas:vasculogenic mimicry,and its correlation with VEGF and significance

Objective To explore if vasculogenic mimicry (VM) exists in human primary gallbladder carcinomas and evaluate the correlation between the VM and expression of vascular epithelial growth factor (VEGF) in gallbladder carcinomas and its significance. MethodsSeventy-four carcinomas, 10 adenomas and 10 chronic inflammatory lesions of the gallbladder underwent operation and confirmed histopathologically were studied. Clinical-pathological data and survival of each patient with gallbladder carcinoma were recorded and followed-up. VM in human gallbladder carcinomas was observed under light microscope by HE staining, CD31 and PAS staining; the expression of VEGF proteins in each paraffin section of each patient in vivo was determined by Envision method of immunohistochemistry; the correlation among the VM, VEGF expression and their clinical significance in the patients with gallbladder carcinomas were analyzed and compared by Kaplan-Meier actuarial survival curves and Cox multiple factors. Results①13.5% (10/74) of human gallbladder carcinomas were found to contain VM, namely intratumoral, tumor cell-lined extracellular matrix (ECM)-rich, PAS-positive and vasculogenic-like network patterns. VM was associated with histological type (χ2=10.241,P=0.017), hepatic metastasis (χ2=4.238,P=0.042) and poor overall survival (χ2=5.722 1,P=0.016). ②Expression of VEGF was increased significantly in carcinomas with or without VM than adenomas and inflammatory lesions of the gallbladder (P<0.000 1) in vivo; VEGF expression in the gallbladder carcinomas without VM was increased significantly than that with VM (P=0.018 2). ③There is positive correlation between expression of VEGF and the gallbladder carcinomas without VM in the cases of Nevin stage (P=0.003 5), invasion depth (P=0.005 9), liver metastases (P=0.037 3) and lymph node metastases (P=0.000 1), the same correlation was only observed between expression of VEGF and the gallbladder carcinomas with VM in the cases of liver metastases (P=0.032 3). When being compared the