• 主题
高级搜索  >
历史搜索 清空历史
您现在的位置：首页> 中文期刊>外科学>医药卫生>中华消化外科杂志

中华消化外科杂志

中华消化外科杂志

北大核心

CSCD

CSTPCD

Chinese Journal of Digestive Surgery
中国科学技术协会主管，中华医学会主办。本刊是国内惟一涵盖消化外科各领域的高水平专业期刊。该刊为中国科技论文统计源期刊、中国自然科学类核心期刊；已被美国《化学文摘》(CA)、美国《乌利希国际期刊指南》(Ulrich IPD)、美国《剑桥科学文摘》(CSA)、波兰《哥白尼索引》(IC)、英国《国际农业与生物科学研究中心》(CABI)、世界卫生组织西太平洋地区医学索引(WPRIM)、中国科学引文数据库(CSCD)、RCCSE中国核心学术期刊、万方数字化期刊群等收录。办刊宗旨：传播国内外消化外科领域的新理论、新技术和新经验，立志成为联系国内外消化外科同道的纽带，推动我国消化外科学的发展。办刊方针：着重提高，兼顾普及。学术内容：涵盖消化外科各领域的基础与临床研究，包括食管、胃、肠、肝、胆、胰、脾及其相关的血管、内镜、介入治疗、外科营养支持等研究。
更多
  • 发文量：4076
  • 被引量：3784
  • H指数：3
  • 开始收录时间：1999(1)
  • CNKI综合因子：2.618
  • 维普期刊影响因子： 2.842
  • 万方期刊影响因子：3.58
  • 创刊时间：2002
  • 国内刊号/CN：11-5610/R
    国际刊号/ISSN：1673-9752
  • 发行周期：月刊
    邮发代号：78-117
  • 主管单位：中国科学技术协会
    主办单位：中华医学会
中华消化外科杂志-联系信息
  • 主编：-
  • 电话：010-51322060
  • 邮箱：digsurg@zhxhwk.com
  • 地址：北京市西城区东河沿街69号
  • 邮编：100052
中华消化外科杂志-获奖情况
  • • 第3届全国百强期刊;百种中国杰出学术期刊;第4届中国精品科技期刊;中国精品科技期刊顶尖学术论文(F5000)项目来源期刊;中国科技论文统计源期刊;中国自然科学类核心期刊;中华医学会优秀期刊;中国高校百佳科技期刊;中国高校科技期刊优秀团队;全军优秀医学期刊;2015、2016年度中华医学会系列杂志编辑出版质量评审一等奖;2012、2013、2015年度中国科协精品科技期刊工程项目3项课题资助
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

刊期浏览

相关中文期刊

相关中文会议

相关外文期刊

相关外文会议

最新期刊

热门期刊

中华消化外科杂志 >2021年第12期

学科

年度

全选（0）
排序：
共4384条结果
  • 摘要：目的 总结早期食管癌内镜及病理特点,探讨其对临床诊断的价值.方法 回顾性分析2003年1月至2007年12月西南医院收治的62例早期食管癌患者的临床资料,总结其内镜和病理特点.结果 食管上段癌8例,中段癌42例,下段癌12例.内镜分型依次为表面扩散生长型30例,双向生长型11例,腔内生长型9例,壁内生长型7例,混合生长型5例.多数肿瘤直径为1.0～2.9 cm.行外科手术治疗38例、内镜黏膜切除术治疗23例、内镜黏膜下层剥离术治疗1例.术后病理检查:原位癌13例,黏膜内癌22例,黏膜下癌27例,黏膜内癌和黏膜下癌的淋巴结转移率分别为5%(1/22)和15%(4/27).病理分型:鳞癌57例,腺癌2例,小细胞癌、肉瘤化癌、梭形细胞癌各1例.结论 早期食管癌好发于食管中段,以表面扩散生长型多见,以鳞癌为主,普通内镜联合卢戈液和美蓝检查是发现早期食管癌的重要方法.%Objective To analyze and investigate endoscopic and pathological characteristics in the diagnosis of early esophageal carcinoma. Methods The clinical data of 62 patients with early esophageal carcinoma who had been admitted to Southwest Hospital from January 2003 to December 2007 were retrospectively analyzed. Results Of all patients, 8 had upper esophageal carcinoma, 42 had middle esophageal carcinoma and 12 had lower esophageal carcinoma. The tumor growth patterns included surface diffusion growth (n = 30), bidirectional growth (n = 11), intracavitary growth (n = 9), intra-esophageal wall growth (n = 7) and mixed growth (n = 5). The diameter of lesions ranged from 1.0 cm to 2.9 cm in majority. Surgical resection was done in 38 patients, endoscopic mucosal resection in 23 patients and endoscopic submucosal dissection in 1 patient. Postoperative pathological examination showed that 13 patients had in situ carcinoma, 22 had intramucosal carcinoma and 27 had submucosal carcinoma. The lymph node metastatic rate of intramucosal carcinoma and submucosal carcinoma were 5% (1/22) and 15% (4/27), respectively. The numbers of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma carcinoma and spindle carcinoma were 57, 2, 1, 1, 1, respectively. ConelusionsEarly esophageal carcinoma tends to appear in the middle part of esophagus, and with surface diffusion growth type. Most of the early esophageal carcinoma are squamous cell carcinoma. Endoscopy combined with lugol's iodine and methyleneblue staining is effective in detecting early esophageal carcinoma.
  • 摘要：Objective To evaluate the influence of hepatic ischemia-repeffusion injury (HIRI) induced by Pringle maneuver on the prognosis of hepatoceUular carcinoma (HCC) patients after hepatectomy. Methods The chnical data of 315 HCC patients who had been admitted to Southwest Hospital from January 2004 to December 2008 were retrospectively analyzed. The 194 patients who received Pringle maneuver during hepatectomy were in the HIRI group. The control group was composed of 121 patients without portal triad clamping. The pre- and peri-operative characteristics and the prognosis of the patients were analyzed by t test, chi-square test, Kaplan-Meier survival curve, Log-rank test and Cox regression model analysis. Results Patients in the HIRI group were significantly younger than those in control group (median age, 49 vs 59) (X2 =4. 12, P < 0.05). There were 108 patients (55.7%) with large HCC (diameter > 5 cm) in the HIRI group, while the number of patients with large HCC in the control group was 83 (68.6%), with statistical difference between the 2 groups (X2=4. 12, P <0.05). The serum levels of aspartate aminotransferase on postoperative day 3 and day 7 were 255 U/L and 112 U/L, which were significantly higher than 128 U/L and 35 U/L in the control group (X2 =4.57, 5.89, P <0.05). The level of total bilirubin on postoperative day 3 was 56 U/L in the HIRI group, which was significantly higher than 39 U/L in the control group (X2=4.79, P <0.05). The disease-free survival rate and cumulative survival rate in the HIRI group were significantly lower than those in the control group (X2 = 5.93, 8. 32, P < 0. 05). Perioperative blood loss, diameter of tumor, portal triad clamping and portal vein invasion were independent factors influencing the diseasefree survival rate. Conclusions HIRI induced by Pringle maneuver significantly decreases the disease-free survival rate and cumulative survival rate of HCC patients after hepatectomy.%目的 探讨PrinCe法肝门阻断所致的肝脏缺血再灌注损伤是否影响肝癌肝切除患者的预后.方法 回顾性分析2004年1月至2008年12月西南医院收治的315例行肝癌肝切除患者的临床资料.将术中进行肝切除时采用Pringle法肝门阻断的分为缺血再灌注组(194例);肝切除时采用CUSA刀、Tissuelink电刀而没有进行肝门阻断的分为非缺血组(121例).采用:检验、X2检验、Kaplan-Meier生存曲线、Log-rank检验和Cox回归模型分析两组患者的术前、术中和预后情况.结果 缺血再灌注组中位年龄为49岁,较非缺血组中位年龄59岁明显年轻(X2=4.12,P<0.05).缺血再灌注组肿瘤直径5 cm者占55.7%(108/194),非缺血组5 cm者占68.6%(83/121),两组比较差异有统计学意义(X2=4.12,P<0.05).缺血再灌注组术后第3、7天AST分别为255 U/L和112 U/L,明显高于非缺血组的128 U/L和35 U/L(X2=4.57,5.89,P<0.05);缺血再灌注组术后第3天Tbil为56 U/L,高于非缺血组的39 U/L(X2=4.79,P<0.05);缺血再灌注组的无瘤生存率和累积生存率均显著低于非缺血组(X2=5.93,8.32,P<0.05).术中出血量、肿瘤直径、是否行肝门阻断和有无门静脉侵犯是无瘤生存率的独立影响因素.结论 采用Pringle法肝门阻断导致的肝脏缺血再灌注损伤可明显降低肝癌肝切除患者术后的无瘤生存率和累积生存率.
  • 摘要：恶性蝾螈瘤即恶性周围神经鞘瘤伴横纹肌分化，是一种罕见且恶性程度极高的肿瘤。迄今为止，全世界范围内有110例左右的报道，以头颈部、躯干和四肢多见，腹腔内仅见于腹膜后和直肠。我院收治1例累及腹腔多个部位且行手术切除的巨大恶性蝾螈瘤，极为罕见，现报道如下。
  • 摘要：Objective To investigate apoptosis of HepG2 ceils after transfecfion with LIGHT gene and interferon-γ. Methods LIGHT gene and interferon-γ were transfected into HepG2 cells by liposome mediated method. The HepG2 cells were divided into group A (transfected with LIGHT gene or interferon-γ), group B (transfeeted with LIGHT gene and interferon-γ) and group C (non-transfection group). The apoptosis rate of the HepG2 cells and the expression of Bcl-2 and Caspase-8 were detected 12, 24, 48 hours after transfeetion. Results (1) The apoptosis rates of HepG2 cells at hour 12, 24 and 48 after transfeetion were 18.8% ± 3.5%, 25.7%± 2.8% and 36.4% ±3.6% in group A, 23.8% ±2.4%, 31.1% ±2.1% and42.5% ±4.5% in group B, and 8.7% ± 2.1%, 9.3% ± 1.6% and 10.9% ± 1.2% in group C. There was a significant difference in apoptosis rate among the 3 groups (F = 15.69, 53.33, 48.28, P < 0.01). (2) The expression of Bcl-2 in HepG2 cells at hour 12, 24 and 48 after transfection was 16.4% ± 5.0%, 13.4% ± 3.5% and 8.6% ± 2.3% in group A, 14.7%±3.8%, 9.1% ±2.0% and 4.6% ±2.0% in group B, and 25.3% ±6. 3%, 19.8% ±4.4% and 10.1% ±3.8% in group C. There was a significant difference in the expression of Bcl-2 among the 3 groups (F = 6.19, 12.29, 5.81, P <0.05). (3) The expression of Caspase-8 at hour 12, 24 and48 after transfection were 19.3% ±2.4%, 27.2% ±1.9% and 33.7% ±3.0% in group A, 22.7% ±2.2%, 30.9% ±3.1% and 38.2% ±3.2% in group B, and 1.2% ±0.8%, 1.8% ±0.6% and 3.2% ±1.5% in group C. There was a significant difference in the expression of Caspase-8 among the 3 groups (F =71.54, 112. 78, I01.61, P < 0.01). Condusions LIGHT gene can signiticanfly promote cell apoptosis through regulating the expression of Bcl-2 and Caspase-8. Interferon-γ enhanced the effect of LIGHT gene on the apoptosis of HepG2 cells.%目的 探讨脂质体介导LIGHT基因和IFN-γ转染诱导肝癌HepG2细胞的促凋亡作用.方法 以脂质体介导LIGHT基因和IFN-γ转染肝癌HepG2细胞,设立转染组(单转、联合转染组)和对照组(未转染组).分别于转染后12、24、48 h检测肝癌HepG2细胞的凋亡率、Bcl-2及Caspase-8的表达量,并采用方差分析.结果 (1)细胞凋亡率:单转组转染后12、24、48 h为18.8%±3.5%、25.7%±2.8%、36.4%±3.6%;联合转染组为23.8%±2.4%、31.1%±2.1%、42.5%±4.5%;对照组为8.7%±2.1%、9.3%±1.6%、10.9%±1.2%.3组比较差异有统计学意义(F=15.69,53.33,48.28,P<0.01).(2)Bcl-2表达量:单转组在转染后12、24、48 h为16.4%±5.0%、13.4%±3.5%、8.6%±2.3%;联合转染组为14.7%±3.8%、9.1%±2.0%、4.6%±2.0%;对照组为25.3%±6.3%、19.8%±4.4%、10.1%±3.8%.3组比较差异有统计学意义(F=6.19.12.29,5.81,P<0.05).(3)Caspase-8表达量:单转组在转染后12、24、48 h为19.3%±2.4%、27.2%±1.9%、33.7%±3.0%;联合转染组为22.7%±2.2%、30.9%±3.1%、38.2%±3.2%;对照组为1.2%±0.8%、1.8%±0.6%、3.2%±1.5%.3组比较差异有统计学意义(F=71.54,112.78,101.61,P<0.01).结论 LIGHT基因转染肝癌HepG2细胞后通过调节Bcl-2及Caspase-8的表达来发挥促凋亡作用,IFN-γ能增强LIGHT基因诱导肝癌HepG2细胞的凋亡.
  • 摘要：Objective To investigate the number, distribution and metastatic rule of lymph nodes in the mesorectum of rectal cancer specimen after processing the recta] cancer specimen with modified fat clearance technique. Methods Sixty patients with mid-low rectal cancer who had been admitted to Peking University School of Ontology from 2003 to 2008 were assigned to test group. All the 60 patients who denied neo-adjuvant therapy were treated with total mesorectal excision, and the rectums resected were processed with the modified fat clearance technique. Rectums from another 50 patients with mid-low rectal cancer in control group were fixed in formalin solution for 24 hours. The mesorectum was divided into anterior, posterior, left and right quadrants, and each quadrant was further divided into upper, middle and lower parts. The numbers of lymph nodes harvested and metastatic rate of lymph nodes between the 2 groups were analyzed by t test and chi-square test. Results (1) The numbers of lymph nodes harvested in the test and control groups were 1436 and 525, with statistical difference between the 2 groups (t =- 12. 153, P <0.05). The number of small lymph nodes(diameter≤5 mm) harvested in test group was 985. (2) The numbers of lymph nodes harvested in the anterior, posterior and bilateral mesorectum were 125,696 and 615, respectively. The numbers of lymph nodes harvested in the upper, middle and lower part of the mesorectum were 395,534 and 507, respectively. The metastatic rate of lymph nodes in the upper part of the mesorectum was 18.5% (37/200), which was significantly lower than in the middle [43.5% (87/200)] and lower [38.0% (76/200)] part of the mesoreetum (X2= 9. 414, 6.406, P < 0.05). Two hundred metastatic lymph nodes in 33 patients were harvested, 48.0% (96/200) of which with a diameter of ≤ 5 mm. Twenty percent patients had their TNM stage changed after the retrieval of metastatic small lymph nodes. Conclusions Modified fat clearance technique significandy improves the retrieval of lymph nodes, and more small lymph nodes retrieved can increase the accuracy of staging. Rectal cancer cells have strong tendency to disseminate to the distal mesorectum. Adequate excision of the distal mesorectum is key in controlling the local recurrence.%目的 运用改良脂肪清除术处理直肠癌标本,并探讨直肠癌标本直肠系膜内淋巴结的数量、分布及转移规律.方法 选取2003年至2008年就诊于北京大学临床肿瘤学院的60例未经过新辅助治疗的中低位直肠癌患者设为研究组,行全直肠系膜切除术(TME)后,应用改良脂肪清除技术对标本进行处理.同期对照组50例患者于TME术后取直肠癌标本并采用福尔马林浸泡法固定24 h,常规手工检出系膜淋巴结.研究组直肠系膜被分割为前、后、左、右4个象限,每个象限被进一步分割为上、中、下3段.两组淋巴结检出率及淋巴结转移率比较采用t检验和X2检验.结果 (1)研究组共检出1436枚系膜淋巴结(平均23.9枚/例),对照组共检出525枚(平均10.5枚/例),两组比较差异有统计学意义(t=-12.153,P
  • 摘要：自1990年Jaeobs和Fowler先后在腹腔镜下行右半结肠切除术和乙状结肠切除术获得成功以来，腹腔镜结直肠癌手术的可行性和优点已经得到了广泛认可。我院2003年9月至2008年9月施行腹腔镜结直肠癌根治术共32例，取得了满意疗效。
  • 摘要：ERCP后胆胰肠结合部损伤的发生率为0．3％～1．3％，早期诊断困难，处理不当病死率在50％以上。2006年2月至2008年12月我院共行ERCP810例，所致胆胰肠结合部损伤2例，发生率为0．2％。本文总结我院对该病的诊断和治疗经验，现报道如下。
  • 摘要：无
  • 摘要：The causes of iatrogenic injury in choledo-cho-pancreatico-duodenai junction include iatrogenic factors, anatomic factors and pathological factors. T-tube, methylthionine chloride and fiber choledochoscopy are useful methods for early diagnosis. Accurate exploration of the injury site and reasonable choice of management were significant in dealing with the iatrogenie injury and can lead to a satisfactory result. Choledo-chojejunostomy and Oddi sphincteroplasty are not recommended unless the patients had distal bile duet stricture or the stones can not be removed. Accurate detection of the injury site, evaluation of the severity, and proper choice of the surgical method are important for the prognosis of the patients.
  • 摘要：Objective To investigate the diagnosis and treatment of injury in choledocho-pancreatico-duodenal junction. Methods The clinical data of 6 patients with injury in choledocho-pancreatico-duodenal junction who had been admitted to Beijing Hospital from January 2000 to January 2008 were retrospectively analyzed. Results Of the 6 patients, 4 were diagnosed according to the intraoperative findings, cholangiography and fiber cholangioscopy. The 4 patients were cured after suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage. Two patients developed severe abdominal and retroperitoneal infection and other complications after operation, and were diagnosed by cholangiography and fiber cholangioscopy. Of the 2 patients, 1 was cured and 1 died after multiple drainage procedures and debridement. Conclusions Diagnosis and treatment in the early stage are crucial for the curative purpose. Cholangingraphy and fiber cholangioscopy are effective in the diagnosis of injury in choledocho-pancreatico-duodenal junction. The suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage should be chosen for patients who are diagnosed during primary operation. For patients with abdominal and retroperitoneal abscess and cellulitis, drainage and debridement should be performed, and biliopancreatic diversion and duodenal diverticularizatian are applied to patients when necessary.%目的 探讨胆胰肠结合部损伤的诊断和治疗方法.方法 回顾性分析2000年1月至2008年1月卫生部北京医院收治的6例医源性胆胰肠结合部损伤患者的临床资料,总结诊断和治疗的经验.结果 4例患者在首次术中确诊,术中可疑胆胰肠结合部损伤,行胆道造影、纤维胆道镜检查确诊,施行损伤修补+胆总管T管引流+腹腔引流术,治愈出院.2例患者在术后出现了严重的腹腔、腹膜后感染及其他并发症,怀疑为胆胰肠结合部损伤,行胆道造影、纤维胆道镜检查后确诊,并多次行清创、引流手术,其中1例治愈,1例死亡.结论 早期诊断和及时、合理地治疗是取得良好疗效的关键.术中胆道造影、纤维胆道镜是确诊胆胰肠结合部损伤的有效方法.对于首次术中确诊者,可行损伤处修补+引流治疗.对于术后确诊并出现腹腔、腹膜后脓肿及蜂窝组织炎者,应充分清创、引流,必要时加行胆汁、胰液分流、十二指肠憩室化手术.
  • 摘要：患者女，19岁。因间断性腹痛、腹胀、嗳气2年，纳差、恶心、呕吐3个月，于2008年9月18日入院。体格检查：体温37℃，贫血貌，精神差，上腹稍隆起，全腹软，左上腹扪及一椭圆形包块，大小约7．0cm×8．0cm，可活动，质地坚硬，表面光滑，边界清楚，压痛。实验室检查：WBC9．30×10’9／L，小细胞低色素性中度贫血。B超检查：胃腔内一异常强回声区，纵径11．2cm，横径6．0cm，前后径3．6cm，后方有声影。
  • 摘要：患者女，22岁。于2007年7月体格检查发现HBsAg、抗-HBe、抗-HBc—IgM阳性，肝功能、AFP及CEA水平正常。上腹部CT检查发现肝左、右叶内病灶，考虑弥漫型肝癌，不排除肝转移癌或肝海绵状血管瘤。因实验室检查、临床表现无明显异常及患者经济原因，未进一步诊治。2008年12月患者复查AFP、肝功能及血常规正常，HBV DNA为2．039×103拷贝／ml。腹部超声及上腹部CT检查：肝内多发占位，考虑为肝转移癌。彩色多普勒超声检查：肝右叶多个减弱回声，范围4．5cm×2．6cm，边界欠清，周边可见环绕血流信号，内部可见点状血流信号；
  • 13.消息
    摘要：无
  • 摘要：目的 总结肝海绵状血管瘤外科治疗的经验.方法 回顾性分析1986年至2005年解放军总医院连续施行肝海绵状血管瘤切除术的345例患者的临床资料,探讨其外科治疗策略.结果 肝海绵状血管瘤患者男女之比为1:1.8.术前未发现或未明确诊断而因其他原因于术中或术后发现的肝海绵状血管瘤共18例(5.2%).肝海绵状血管瘤发病部位以右半肝居多,占16.2%(56/345).肿瘤直径<5.0 cm者占26.5%(91/344)、5.0～10.0 cm者占50.3%(173/344),>10.0 cm者占23.2%(80/344),平均直径为(8.0±5.0)cm(1例无直径记录).术前Child评分为A级者占99.7%(323/324).全组均采用右肋缘下斜切口施行肿瘤剜除术.术后并发症发生率为11.3%(39/345),病死率为0.3%(1/345).肝尾状叶海绵状血管瘤共切除11例,其中施行孤立性尾状叶切除9例.结论 部分肝海绵状血管瘤可误诊为肝实质性肿瘤.肝海绵状血管瘤切除术(包括尾状叶切除术)已成为较安全的手术,术中最主要的风险是切除肿瘤过程中的大量出血.%Objective To summarize the experience in surgical treatment of hepatic cavernous hemangioma (HCH). Methods The clinical data of 345 patients who received HCH resection in General Hospital of PLA from 1986 to 2005 were retrospectively analyzed. Results The ratio between male and female patients was 1/1.8. Eighteen patients (5.2%) were incidentally found with HCH during or after operation. Most of the HCH were located in the right lobe, with the proportion of 16.2% (56/345). Ninety-one patients (26.5%) had small HCH (diameter<5.0 cm), 173 (50.3%) had large HCH (diameter ranging from 5.0-10.0 cm), and 80 (23.2%) had giant HCH (diameter>10.0 cm). The mean diameter of the HCH was (8.0±5.0) cm. Three hundred and twenty-three (99.7%) patients were with Child pugh A. Right subcostal incision and enucleation were performed on all patients. The incidence of postoperative complications and mortality were 11.3% (39/345) and 0.3% (1/345), respectively. Caudate lobe resection was performed on 9 of 11 patients with the tumor located in caudate lobe. Conclusions Some HCHs may be easy to be misdiagnosed as hepatic solid tumor. HCH resection (inclu-ding hepatic caudate lobectomy) is safe for patients with HCH, and the most severe operative complication is massive bleeding during hepatectomy.
  • 摘要：The choledocho-pancreatico-duodenal junc-tion is located at the central part of choledocho-pancreatico-duodenal region. During early embryogenetic stage, the primary duodenum develops from the end of foregut and the beginning part of the midgut. The dorsal pancreas, hepatic diverticulum and the ventral pancreas which arises from the basic part of hepatic diverticulum are growing and rotating following the duodenum. During the course, the formations of the choledocho-pancreatico-duodenal region and the central part of choledocho-pancreatico-duodenal junction are complete. The injuries in cho-ledocho-pancreatico-duedenal junction may be caused by metal probe or lithotomy forceps for exploring, dilatating the distal bile duct or taking out the stones from the bile duct. Even if the injuries of choledocho-pancreatico-duodenal junction are deve-loped in a limited scope of several centimeters, several adjacent organs may be involved. Injuries in choledocho-pancreatico-duo-denal junction are hard to be identified during operation and may develop into serious pathological procedures.
  • 摘要：Objective To evaluate the long-term efficacy of modified loop choledochojejunostomy (MLC). Methods The clinical data of 259 patients who had underwent choledochojejunostomy in First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2006 were retrospectively analyzed. Of all the patients, 130 underwent MLC (MLC group) and 129 underwent Roux-en-Y choledochojejunostemy (RYC, RYC group). The changes in incidence of cholangitis and liver function between the 2 groups were compared. All the data were analyzed by t test, chi-square test or Fisher exact probability. Results The levels of alaninetransa-minase and alkaline phosphomonoesterase were (63±42) U/L and (147±147) U/L in MLC group, and (84±52)U/L and (256±201)U/L in RYC group, with statistical difference between the 2 groups (t=1.634, 1.655, P>0.05). The level of gamma-glutamyl transferase in MLC group was (116±91)U/L, which was signifieandy lower than (169±96)U/L in RYC group (t=2.461, P<0.05). Three patients (2.3%) in MLC group and 9 (7.0%) in RYC group suffered from acute cholangitis after operation, with no statistical difference in the incidence between the 2 groups (P>0.05). Of the 12 patients with acute cholangids, 1 in MLC group and 7 in RYC group were hospitalized, with statistical difference between the 2 groups (P<0.05). Conclusions The incidence of acute cholangitis in patients who underwent MLC is comparable to that of RYC. However, the procedure of MLC is simpler than RYC, and patients have milder symptom and lesser frequency of reflux cholangitis onset after MLC.%目的 探讨改良胆肠袢式吻合术的远期效果.方法 回顾性分析2000年1月至2006年12月中山大学附属第一医院收治的259例行胆肠吻合术患者的临床资料.其中行改良胆肠袢式吻合术130例(改良组),行Roux-en-Y吻合术129例(对照组).比较两组术后胆管炎发生率、肝功能的变化.采用t检验、χ2检验或Fisher确切概率法对结果进行分析.结果 术后改良组ALT、ALP分别为(63±42)U/L、(147±147)U/L,对照组分别为(84±52)U/L、(256±201)U/L,两组比较差异无统计学意义(t=1.634,1.655,P>0.05);改良组GGT为(116±91)U/L,低于对照组的(169±96)U/L(t=2.461,P<0.05).两组共有12例患者出现不同程度的急性胆管炎,其中改良组有3例(2.3%),对照组有9例(7.0%),改良组少于对照组,但差异无统计学意义(P>0.05).发生急性胆管炎的患者中,改良组有1例需住院治疗,对照组有7例,两组比较差异有统计学意义(P<0.05).结论 改良胆肠袢式吻合术与Roux-en-Y吻合术后急性胆管炎的发生率比较差异无统计学意义,但其术后急性胆管炎的发作频率更低、症状更轻,且操作简单,可作为常规胆肠吻合的方法.
  • 摘要：Objective To summarize the experience in prevention and management of delayed-diagnosed injury in choledocho-pancreatico-duodenal junction. Methods The clinical data of 5 patients with injury in chole-docho-pancreatico-duodenal junction who had received surgery from 2000 to 2007 in Peking Union Hospital was summarized and analyzed retrospectively. All the 5 patients were diagnosed 24 hours after the injury. The injury was caused after endoscopic retrograde cholangiopancreatography (or endoscopic sphincterotomy) +endovascular stent placement in 4 patients and by vehicle accident in 1 patient. Results All the patients were treated conserva-tively for 24-72 hours, and peritonitis was not alleviated, and were subsequently transferred to surgery. Three patients received gastrostomy +choledochostomy +jejunostomy. The abdominal pain was alleviated in 1 patient, and 2 died of multiple organ dysfunction syndrome 5-6 weeks later. Two patients received duodenal diverticulariza-tion + gastrostomy + jejunostomy + Roux-en-Y choledachojejunostomy + Roux-en-Y gastrojejunostomy, and had good prognosis. Conclusion Duodenal diverticularization is a proper choice for patients with perforation combined with severe intraabdominal infection.%目的 探讨延迟发现的胆胰肠结合部损伤的诊断和治疗方法.方法 回顾性分析2000年至2007年北京协和医院基本外科手术治疗5例胆胰肠结合部损伤患者的临床资料.5例均为延迟发现(损伤后24 h)的患者,其中4例为ERCP或EST+内支架植入术后造成胆胰肠结合部损伤,1例为车祸伤致十二指肠穿孔.结果 经保守治疗24～72 h,腹膜炎症状未减轻,急诊行手术.3例行胃、胆管和空肠三造瘘术,1例腹痛减轻,逐渐痊愈;2例因MODS于术后5～6周死亡.2例行十二指肠完全憩室化手术,术中结扎胆总管下段和幽门,修补十二指肠置T管和胃、空肠造瘘,腹膜后冲洗引流,6～7个月后再次重建消化道,行胆肠和胃空肠Roux-en-Y吻合,效果良好.结论 对于穿孔时间长、腹腔感染严重的患者,十二指肠完全憩室化是一种可考虑的选择.
  • 摘要：目的 探讨Livin和Ki-67蛋白在胆管癌组织中的表达及两者之间的关系和临床意义.方法 采用SP法检测2002年1月至2003年12月中国医科大学附属盛京医院手术切除的55例胆管癌组织和12例慢性胆管炎组织中Livin和Ki-67蛋白的表达,并分析这两种蛋白与胆管癌临床病理特征的关系.应用Spearman等级相关分析、χ2检验和t检验对结果进行分析.结果 Livin蛋白在胆管癌标本中的阳性表达率为71%(39/55),明显高于慢性胆管炎标本的0(0/12)(χ2=20.361,P<0.01);Livin蛋白的表达受胆管癌患者的分化程度和淋巴结转移影响(χ2=4.193,4.245,P<0.05).Ki-67蛋白在胆管癌标本中的阳性表达率为96%(53/55).临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者Ki-67标记指数分别为22%±16%、33%±12%、43%±15%、49%±10%,Ⅱ、Ⅲ、Ⅳ期与Ⅰ期比较差异有统计学意义(t=2.307,2.871,3.957,P<0.05);有无局部淋巴结转移的患者Ki-67标记指数分别为43%±13%、34%±16%,两者比较差异有统计学意义(t=2.334,P<0.05).胆管癌组织中Livin蛋白的表达与Ki-67标记指数呈正相关(r=0.502,P<0.01).结论 Livin蛋白在胆管癌的发生、发展中起重要作用,并且与胆管癌增殖活性相关,两者结合可作为胆管癌恶性程度和判断预后的标准.%Objective To investigate the relationship between Livin and Ki-67 proteins, and the expres-sion and clinical significance of Livin and Ki-67 proteins in cholangiocarcinoma. Methods Fifty-five samples of cholangiocarcinoma tissue were collected in Shengjing Hospital from January 2002 to December 2003. The expres-sion of Livin and Ki-67 proteins in the 55 samples of cholangiocarcinoma tissue and 12 samples of chronic cholan-gitis tissue were detected by immunohistochemical assay. The relationship between the expression of Livin and Ki-67 proteins and the clinicopathological parameters of cholangiocarcinoma was analyzed. The results were analyzed by Spearman rank correlation coefficient, chi-square test and t test. Results The positive expression rate of Livin protein in cholangiocarcinoma was 71% (39/55), which was significantly higher than 0 (0/12)in chronic cholan-girls tissue (χ2=20.361, P<0.01). The expression of Livin protein was influenced by the differentiation of cholangiocarcinoma and the lymph node metastasis (χ2=4.193, 4.245, P <0.05). The positive expression rate of Ki-67 protein was 96% (53/55) in cholangiocarcinoma. The label index of Ki-67 in patients in clinical stage Ⅰ,Ⅱ,Ⅲ,Ⅳ,were 22%±16%, 33%±12%, 43%±15%, and 49%±10%, respectively. There was signifi-cant difference in the label index of Ki-67 between patients in clinical stage Ⅰ and those in clinical stages Ⅱ, Ⅲ,Ⅳ(t=2.307, 2.871, 3.957, P<0.05). The label index of Ki-67 was 43%±13 % in patients with local lymph node metastasis, and 34%±16% in patients without local lymph node metastasis, with statistical difference between the 2 groups (t=2.334, P<0.05). The expression of Livin protein in cholangiocarcinoma was positively correlated with the label index of Ki-67 (r=0.502, P<0.01). Conclusions Livin protein plays an important role in the pathogenesis and development of eholangiocarcinoma, and it also has correlation with the proliferating activity of cholangiocarcinoma cells. Combined detection of the expression of Livin and Ki-67 proteins may be helpful in judging the malignancy of cholangiocarcinoma and determining the prognosis of patients.
  • 摘要：目的 检测大鼠肝卵圆细胞端粒酶活性,探讨端粒酶表达与卵圆细胞增殖分化的关系.方法 采用2-AAF/PH模型诱导大鼠卵圆细胞增殖,改良的胶原酶灌注结合密度梯度离心法分离,用细胞免疫荧光和电镜鉴定卵圆细胞.采用免疫组织化学、RT-PCR、荧光定量PCR等方法检测卵圆细胞端粒酶的表达,组间比较采用t检验分析其意义.结果 采用2-AAF/PH模型成功诱导大鼠卵圆细胞增殖.分离的卵圆细胞核大,卵圆形,胞质少,呈铺路石样生长.电镜发现细胞核质比大,胞质内细胞器少且发育不成熟.细胞免疫荧光结果表达OV-6、AFP、CK-19、albumin、c-kit.端粒酶逆转录酶(TERT)表达在门静脉周围增殖的卵圆细胞核内,随着卵圆细胞逐渐向肝细胞方向分化,TERT阳性细胞数逐渐减少.大鼠正常肝组织TERT mRNA表达水平最高,为LE-6卵圆细胞的2.27倍;分离的卵圆细胞TERT mRNA表达水平为LE.6卵圆细胞的1.26倍;采用2μg和4μg细胞提取物分析细胞的端粒酶活性,随着LE-6卵圆细胞传代次数的增加,由24代传至40代,端粒酶活性由△A=1.05、1.15降低到△A=0.25、0.45(t=17.74,12.38,P<0.05).结论 卵圆细胞具有端粒酶活性,端粒酶可能是卵圆细胞维持其增殖能力和多分化潜能的一个必要条件.%Objcctive To detect the telomerase activity in rat hepatic oval cells, and to explore the relationship between telomerase expression and the proliferation and differentiation of oval cells. Methods The 2-acetamidofluorene/partial bepatectomy (2-AAF/PH) rat model was used to induce the proliferation of oval cells. Oval cells were isolated by modified collagenase perfusion and gradient centrifugation. Electron microscope exami-nation and immunofluorescence were adopted to identify oval cells. Immunohistochemistry, RT-PCR and fluores-cence quantitative PCR were used to detect the expression of telomerase in oval cells. All the data collected were analyzed by t test. Results The proliferatiun of oval cells was successfully induced by 2-AAF/PH rat model. Freshly isolated oval cells showed a large and ovoid nuclei, a small proportion of cytomplasm and a cobblestone appearance. When viewed by electron microscopy, there were few and immature organelles, and the nucleus/ cytoplasm ratio was high. Immunofluorescence staining showed that oval cells expressed OV-6, alpha-fetoprotein, cytokeratin-19, albumin and c-kit. Telomerase reverse transcriptase (TERT) was located in the nuclei of oval cells which were around the portal areas. As oval cells differentiated into small hepatocytes, the number of TERT-positive cells decreased significantly. The expression level of TERT mRNA in normal rat liver tissue was 2.27 times higher than that in LE-6 oval cells; the expression level of TERT mRNA in the isolated oval cells was 1.26 times higher than that in LE-6 oval cells. The telomerase activity decreased gradually (from △A=1.05, 1.15 to △A=0.25, 0.45) as the increase of oval cells passage (from passage 24 to passage 40) (t=17.74, 12.38, P<0.05). Conclusions Oval cells have telomerase activity. Telomerase may be indispensable for maintaining the proliferative and multi-directional differentiation abilities of oval cells.
  • 摘要：Objective To investigate the effects of antisense recombinant euraryotic expression vector of HCCR-2 on the proliferation and apoptosis of HepG2. Methods The antisense recombinant eukaryotic expression vector of HCCR-2 was constructed. The vector was stably transfected to the HepG2 cells, and positive clones were selected by G418 (antiseuse vector group), pIRES2-EGFP vector was transfected into the HepG2 cells in the same way (pIRES2-EGFP group). The conditions of the nontransfected HepG2 cells were used as control (HepG2 group). Changes in cell growth curve, cell cycle, cell apoptosis and morphology of HepG2 cells after the transfec-tion were detected by MTT method, flow cytometry and transmission electron microscopy, respectively. All the data were analyzed by one-way ANOVA and chi-square test. Results The expression level of HCCR-2 mRNA was down-regulated to 0.39±0.04 in antisense vector group, and the expression level of HCCR-2 mRNA in pIRES2-EGFP group and HepG2 group were 0.62±0.06 and 0.72±0.03, respectively, with significant difference among the 3 groups (F=43.701, P<0.05). The apoptotic rate of HepG2 cells in antisense vector group, pIRES2-EGFP grop and HepG2 group were 13.30%, 2.51% and 2.07%, respectively, with significant difference among the 3 group (χ2=6.793, 8.721, P<0.05). The growth of HepG2 cells in antisense vector group was retarded, and was blocked in G0/G1 stage. Conclusions The HCCR-2 antisense recombinant eukaryotic expression vector can inhibit the mRNA expression of HCCR-2 and promote the apoptosis of cells. HCCR-2 may be involved in cell regulation and the proliferation of hepatocellular carcinoma cells.%目的 研究反义HCCR-2真核表达载体对肝癌HepG2细胞增殖及凋亡的影响.方法 构建反义HCCR-2真核表达载体(反义载体组),转染肝癌HepG2细胞,G418筛选阳性克隆,同样方法获得空载体pIRES2-EGFP稳定表达的细胞株(空载体组),取肝癌HepG2细胞为对照(肝癌HepG2组),用MTT法、流式细胞仪、透射电镜观察反义HCCR-2转染前后肝癌HepG2细胞生长曲线、细胞周期、细胞凋亡及细胞形态的变化.采用单因素方差分析和χ2检验比较各组差异.结果 反义载体组、空载体组、肝癌HepG2组HCCR-2 mRNA表达水平分别为0.39±0.04、0.62±0.06、0.72±0.03,3组比较差异有统计学意义(F=43.701,P<0.05);细胞凋亡率分别为13.30%、2.51%、2.07%,反义载体组与空载体组、肝癌HepG2组比较,差异有统计学意义(χ2=6.793,8.721,P<0.05);反义载体组细胞生长减慢,阻滞于G0/G1期.结论 HCCR-2反义核酸真核表达载体能抑制HCCR-2 mRNA的表达,促进细胞凋亡,HCCR-2蛋白可能参与肝癌细胞的周期调控,并与细胞的生长增殖有关.
  • 摘要：Objective To investigate the correlation between α1-adrenergic receptor and the pathological behavior of cholangiocarcinoma, and the effects of norepinephrine (NE) on the proliferation of cholangiocarcinoma cell line QBC939. Methods Thirty-six samples of cholangiocarcinoma were resected in Southwest Hospital from August 2002 to March 2008. The expression of α1-adrenergic receptor in the 36 samples of cholangiocarcinoma tissue and 4 samples of normal bile duct tissue were detected by SABC technique. The proliferation of cholangio-carcinoma cell line QBC939 was detected after processing the cells with NE, phentolamine and prazosin. All the data were analyzed by chi-square test. Results The high positive expression rate of α1-adrenergic receptor was 68% (17/25) in patients with lymph node metastasis, which was significantly higher than 9% (1/11) in patients without lymph node metastasis (χ2=10.604, P<0.05). The high positive expression rate of α1-adrenergic receptor was 85% (11/13) in patients with middle and low positioned cholangiocarcinoma, which was significantly higher than 30% (7/23) in patients with hilar cholangiocarcinoma (χ2=9.753, P<0.05). NE promoted the proliferation of cholangiocarcinoma cell line QBC939 by stimulating the expression of α1-adrenergic receptor, and in a concentration-dependent manner. The proliferative effect was weakened as time passed by, and it was eliminated by phentolamine and prazosin. Conclusions The expression of α1-adrenergic receptor is diverse due to lymph node metastasis and the location of the tumor, α1-adrenergic receptor with high expression may play an important role in the proliferation and metastasis of cholangiocarcinoma.%目的 探讨α1-肾上腺素受体对胆管癌细胞增殖的影响.方法 应用SABC免疫组织化学法检测2002年8月至2008年3月于西南医院行手术切除的36例人胆管癌组织和4例正常胆管组织中α1-肾上腺素受体的表达,并用去甲肾上腺素(NE)以及受体阻滞剂酚妥拉明、哌唑嗪处理胆管癌细胞,观察细胞的增殖变化.采用χ2检验分析结果.结果 发生胆管癌淋巴结转移的患者中α1-肾上腺素受体强阳性表达率为68%(17/25),明显高于未转移患者的9%(1/11),两者比较差异有统计学意义(χ2=10.604,P<0.05),且胆总管中、下段癌的α1-肾上腺素受体强阳性表达率为85%(11/13),高于肝门部胆管癌的30%(7/23),两者比较差异有统计学意义(χ2=9.753,P<0.05).NE促进胆管癌细胞的增殖,此作用呈浓度依赖性,随着时间的延长,促增殖作用逐渐减弱.该作用由α1-肾上腺素受体介导,在非选择性α-肾上腺素受体阻滞剂酚妥拉明及选择性α1-肾上腺素受体阻滞剂(哌唑嗪)存在的情况下可消除NE对胆管癌细胞的促增殖作用.结论 α1-肾上腺素受体的表达受淋巴结转移以及胆管癌部位影响,呈强阳性表达的α1-肾上腺素受体参与了胆管癌细胞增殖及转移过程.
  • 摘要：目的 探讨雌激素受体β(Erβ)基因多态性与肝细胞癌的关系.方法 选取2005年10月至2007年5月重庆医科大学附属第一医院收治的100例肝细胞癌患者为实验组,100例非肝病患者作为对照组.应用分子生物学的方法检测ERB基因Rsa Ⅰ及Alu Ⅰ限制性片段长度和5号内含子高变区核苷酸(CA)重复序列在两组中的分布.应用χ2检验、Fisher确切概率法、Logistic回归模型分析检测结果.结果 Rsa Ⅰ和Alu Ⅰ限制性片段长度多态性在两组中均呈多态性分布(χ2=11.375,6.162,P<0.05).R等位基因使人患肝细胞癌的风险是r等位基因的51.7%,A等位基因使人患肝细胞癌的风险是a等位基因的2.086倍.5号内含子高变区分离出9种CA重复序列等位基因CA16～24,两组等位基因的分布频率比较,差异无统计学意义(χ2=7.155,P>0.05).以n≤20作为SS型,n>20为LL型,实验组SS型等位基因为66%,对照组为51%,两组比较差异有统计学意义(χ2=4.634,P<0.05).结论 Erβ基因多态性与肝细胞癌发生有关,R等位基因可能是其保护因素,A等位基因和SS型等位基因可能是其危险因素.
  • 摘要：肝内胆管结石合并胆总管结石常用的治疗方法是胆道镜取石＋术中碎石冲洗。在基层医院，当术中胆道镜取石困难并且无碎石设备时，施行肝实质切开取石术可顺利完成手术。我院2003年3月至2008年3月共施行此种方法取石22例，效果良好。
  • 摘要：Isolated resection of bemangioma in the cau-date lobe is challenging due to the surgical anatomy of caudate lobe. The caudate lobe consists three portions: Spiegel's lobe, paracaval portion and caudate process. Most of the blood supply of caudate lobe is provided by the posterior segmental branches of the portal vein and left hepatic artery. The hepatic venous drainage encompasses a few sizable and several small branches that join the inferior vena cava. Selection of the ideal route for bepatectomy, adequate mobilization of the liver, preparatory placement of band for hepatic vascular occlusion are key factors during the operation.
  • 摘要：Iatrogenic injury in choledocho-pancreatico-duodenal junction is usually difficult to discover in the course of operation because of its unique anatomical position. The injury can lead to postoperative chilis, fever, pain and swelling of the waist, which would easily be misdiagnosed as acute necrotizing pancreatitis. Controlling operations, such as bile and pancreatic juice separation, duodenal diverticularization, jejunal fistulation for enteral nutrition and abdominal drainage should be performed in dealing with the injury in choledocho-pancreatico-duodenal junction. Combined application of pyloric suture with absorbable thread and ligatian, gastric fistulation, ligation of the distal common bile duct and T-tube drainage is minimally invasive, and can fulfill a fully separation of bile and pancreatic juice and duodenal diverticularization. It will improve the possibility of secondary radical operation by ameliorating pyemia and general nutritional condition.
  • 摘要：目的 探讨难治性胆石病的手术方式与技巧.方法 回顾性分析1990年1月至2007年12月湖南省人民医院肝胆外科收治的521例难治性胆石病患者的临床资料.结果 全组均行手术治疗,3例术后围手术期内并发肝肾功能衰竭死亡,其余518例无严重并发症发生,痊愈出院.经B超和CT复查有结石残留者78例,占15.1%.423例获随访,随访5个月至17年,平均随访时间7.5年,随访率81.7%.效果良好率达90.1%(381/423).结论 大部分难治性胆石病患者可以根治;根据患者的具体情况,采用相匹配的个体化手术方案、精细规范的手术操作是保证疗效的关键.%Objective To investigate the operative techniques for refractory cholelithiasis. Methods The clinical data of 521 patients with refractory cholelithiasis who had been admitted to People's Hospital of Hunan Province from January 1990 to December 2007 were retrospectively analyzed. Results All patients received surgery. After the operation, 3 patients died of liver and kidney failure, the remaining 518 patients were cured without severe complications. The results of B ultrasound and computed tomography showed residual stones in 78 patients (15.1%). Four hundred and twenty-three patients (81.7%) were followed up for 5 months to 17 years (mean, 7.5 years), and the rate of positive effect was 90.1% (381/423). Conclusions Most of the refractory cholelithiasis can be cured radically. Individualized surgical planning, fine and standard surgical procedure are key to the treatment effect.
  • 摘要：Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.%目的 总结成人肠旋转不良影像诊断和治疗方法.方法 回顾性分析2003年1月至2007年12月解放军总医院收治的11例成人肠旋转不良患者的临床资料.结合钡灌肠、消化道造影、B超、CT及肠系膜血管造影等检查对患者进行诊断.全组患者行Ladd手术治疗.结果 消化道造影结合B超检查确诊2例,消化道造影结合CT检查确诊4例,血管造影检查确诊1例,B超结合CT检查确诊1例,碘水造影结合CT检查确诊1例,术中探查确诊2例.术后1例患者因小肠广泛坏死导致短肠综合征,3个月后死亡,2例术后肾功能不全,1例术后肠瘘.结论 结合多种影像检查可提高成人肠旋转不良的诊断率,Ladd手术治疗成人肠旋转不良是必要和安全的.
  • 摘要：目的 探讨组织特异性胞嘧啶脱氨酶/5-氟胞嘧啶(CD/5-FC)系统热化疗对裸鼠结肠癌肝脏转移的影响.方法 将45只裸鼠按随机数字表法分为3组:对照组、非热疗组、热疗组,每组15只.门静脉注射法建立结肠癌肝脏转移动物模型,3组分别给予不同的治疗方法.采用χ2检验和单因素方差分析3组肝脏肿瘤转移率、转移数目;观察各组病理学变化、肿瘤细胞凋亡指数;荧光定量RT-PCR和Westernblot检测肿瘤组织中CD基因的表达情况.结果 对照组、非热疗组、热疗组肝脏平均转移癌结节数目和转移率分别为(4.6±1.3)、(2.2±1.0)、(0.5±0.8)个和100.0%、60.0%、13.3%,3组比较差异有统计学意义(F=25.898,χ2=5.208,19.548,5.168,P<0.05);肿瘤细胞凋亡指数平均为4.6%、9.9%和17.4%.热疗组可见大量细胞空泡变性、坏死、溶解现象,有较多的凋亡小体形成.3组均可以检测到CD基因的表达.结论 组织特异性CD/5-FC系统热化疗对转CD基因结肠癌LoVo细胞裸鼠肝脏转移有明显的抑制作用.%Objective To investigate the effects of tissue specific cytosine deaminase/5-fluorocytosine (CD/5-FC) thermotherapy on hepatic metastasis of colonic carcinoma in nude mice. Methods Forty-five nude mice were randomly divided into control group, 5-FC group and 5-FC thermotherapy group according to the random number table (15 mice in each group). Mice models of hepatic metastasis of colonic carcinoma were established by portal vein injection of LoVo/CEACD cells. The hepatic metastasis rate and number of metastatic nodules of the 3 groups were compared by ehi-square test and one-way ANOVA. The pathological changes in tumor tissues and apoptotic index of tumor cells were observed. The expression of the CD gene in tumor tissues was detected by fluorescent quantitative RT-PCR and Western blot. Results The number of metastatic nodules and liver metas-tasis rate were 4.6±1.3 and 100.0% in control group, 2.2±1.0 and 60.0% in 5-FC group, 0.5±0.8 and 13.3% in 5-FC thermotherapy group, with statistical difference among the 3 groups (F=25.898, χ2=5.208, 19.548, 5.168, P<0.05). The mean apoptotic indexes of tumor cells of the 3 groups were 4.6%, 9.9% and 17.4%, respectively. Vacuolar degeneration, cell necrosis, cytolysis and apoptotic bodies were mostly observed in the 5-FC thermotherapy group. The expression of CD gene in tumor tissue was detected in all the groups. Conclusion Tissue specific CD/5-FC thermotherapy has inhibitory effects on the hepatic metastasis of LoVo cells transfected with CD gene.
  • 摘要：随着医学的发展，医疗器械的改进，食管癌患者术后并发症及病死率已显著降低。为了进一步提高手术成功率，方便术中操作，手术视野暴露更清楚，减少肺损伤，通常选择双腔气管插管，术中单肺通气。术前用药常选择盐酸戊乙奎醚（长托宁）和东莨菪碱。本文回顾性分析2008年6月至2008年12月我院收治的30例老年食管癌患者的临床资料，探讨长托宁和东莨菪碱在食管癌根治术中的临床价值。
  • 摘要：@@ 1 临床资料rn患者女,26岁.因体格检查发现Caroli病半年于2008年5月5日入院.2007年12月1日,患者在当地医院行超声检查发现肝内胆管扩张,考虑Caroli病,无发热,皮肤、巩膜无黄染,无腹痛、腹胀等不适症状,未进行治疗.2007年12月12日,患者再次在当地医院行腹部CT及MRI检查发现肝内囊性占位病变,考虑Caroli病.为求进一步治疗入住我院.患者精神、睡眠、饮食良好,体质量无明显变化,大小便正常.

    中华消化外科杂志的期刊信息

    • 曾用名：消化外科
    • 创刊时间：2002
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会
    • 学科分类： 外科学;

    中华消化外科杂志的获奖情况

    • • 第3届全国百强期刊;百种中国杰出学术期刊;第4届中国精品科技期刊;中国精品科技期刊顶尖学术论文(F5000)项目来源期刊;中国科技论文统计源期刊;中国自然科学类核心期刊;中华医学会优秀期刊;中国高校百佳科技期刊;中国高校科技期刊优秀团队;全军优秀医学期刊;2015、2016年度中华医学会系列杂志编辑出版质量评审一等奖;2012、2013、2015年度中国科协精品科技期刊工程项目3项课题资助

    中华消化外科杂志的收录情况

    • • 北大核心期刊（2011版）
    • • 北大核心期刊（2014版）
    • • 北大核心期刊（2017版）
    • • 农业与生物科学研究中心文摘
    • • 化学文摘（网络版）
    • • 中国科学引文数据库（2011-2012）
    • • 中国科学引文数据库（2013-2014）
    • • 中国科学引文数据库（2015-2016）
    • • 中国科学引文数据库（2017-2018）
    • • 中国科学引文数据库（2019-2020）
    • • 哥白尼索引
    • • 日本科学技术振兴机构数据库
    • • 中国科技核心期刊

    中华消化外科杂志的投稿信息

    • 投稿方式：在线投稿
    • 投稿须知：点击查看
    • 期刊官方网站：点击前往
    • 通讯地址：北京市西城区东河沿街69号
    • 邮编：100052
    • 联系电话：010-51322060
    • 邮箱：digsurg@zhxhwk.com
    • 期刊栏目：院士论坛;述评;专家论坛;菁英论坛;专家点评;论著;论著·菁英荟研究报告;论著·外科天地;论著·影像集锦;指南与共识;短篇论著;经验交流;病例报道;大巡诊;综述;讲座;学术动态;新技术;读者来信等
    免费订阅本刊

    客服邮箱：kefu@zhangqiaokeyan.com

    京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有 出版物经营许可证

    • 客服微信

    • 服务号