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1.
The objective of this study was to investigate the endosonographic appearance of gastric linitis plastica(GLP) and to study the usefulness of endoscopic ultrasonography(EUS) for the T and N staging of GLP.EUS examinations of 55 patients with histologically proven GLP were retrospectively studied.In all patients,EUS showed that lesions involved at least one-third of the circumference of the stomach.Based on the findings of the EUS,the 55 patients were divided into two groups.There were 32(58.2%) patients in the first group.EUS of this group showed that the five sonographic layers had disappeared and had been replaced by a hypoechogenic thickening of the gastric wall.There were 23(41.8%) patients in the second group.EUS of this group showed that the first three sonographic layers were blurred and thickened,and the fourth layer was significantly thickened.The full thickness of the gastric wall was significantly thicker in first than in the second group of patients(P<0.01).The incidence of perigastric lesions was significantly higher in the first than in the second group of patients(P<0.01).Results for the 15 patients following preoperative EUS were compared postoperatively with histopathologic findings for T and N staging.The overall diagnostic accuracy of the T stage was 73.3% and of the N stage was 60.0%.In eight patients,we used EUS to assess a therapeutic response.No response was observed in five patients and a partial response in three.EUS images of GLP are characteristic.EUS is helpful in diagnosing GLP and for assessing the T and N stages.  相似文献   

2.
Objective: Malignant middle cerebral artery (MCA) infarction is characterized by mortality rate of up to 80%. The aim of this study was to determine the value of decompressive craniectomy in patients presenting malignant MCA infarction compared with those receiving medical treatment alone. Methods: Patients with malignant MCA infarction treated in our hospital between January 1996 and March 2004 were included in this retrospective analysis. The National Institute of Health Stroke Scale (NIHSS) was used to assess neurological status on admission and at one week after surgery. All patients were followed up for assessment of functional outcome by the Barthel index (BI) and modified Rankin Scale (RS) at 3 months after infarction. Results: Ten out of 24 patients underwent decompressive craniectomy. The mean interval between stroke onset and surgery was 62.10 h. The mortality was 10.0% compared with 64.2% in patients who received medical treatment alone (P<0.001). The mean NIHSS score before surgery was 26.0 and 15.4 after surgery (P<0.001). At follow up, patients who underwent surgery had significantly better outcome with mean BI of 53.3, RS of 3.3 as compared to only 16.0 and 4.60 in medically treated patients. Speech function also improved in patients with dominant hemispherical infarction. Conclusion: Decompressive craniectomy in patients with malignant MCA infarction improves both survival rates and functional outcomes compared with medical treatment alone. A randomized controlled trial is required to substantiate those findings.  相似文献   

3.
Objective:To investigate the relationship between the fatty acid-binding protein 4(FABP4)and colorectal cancer(CRC).Methods:Using an enzyme-linked immunosorbent assay(ELISA),we measured the expression of FABP4 in plasma of50 patients who underwent surgery for CRC from October 2017 to May 2018 and 50 healthy controls.The content of the visceral fat area(VFA)as seen with abdominal computed tomography(CT)scanning was measured by ImageJ software.The expression levels of FABP4,E-cadherin,and Snail proteins in CRC and adjacent tissues were determined by immunohistochemistry.Results:The mean concentration of plasma FABP4 of CRC patients was higher than that of the control group(22.46 vs.9.82 ng/m L;P<0.05).The concentration of plasma FABP4 was related to the tumor,node,metastatis(TNM)stage and lymph node metastasis and was independent of age,body mass index(BMI),tumor size and location,and the degree of differentiation of CRC.The concentration of plasma FABP4 was positively correlated with high VFA and lipoprotein-a(LPA)(P<0.05);but it was not correlated with total cholesterol(TG),total triglyceride(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL),or apolipoprotein AI(Apo-AI).The expression of FABP4 protein in CRC tissues was positively correlated with the degree of CRC differentiation,tumor stage,and lymph node metastasis.The level of FABP4 protein was negatively correlated with E-cadherin protein(r=-0.3292,P=0.0196)and positively correlated with Snail protein(r=0.5856,P<0.0001).Conclusions:High LPA and VFA were risk factors for increased plasma FABP4 in CRC patients.FABP4 protein was highly expressed in CRC tissues and associated with TNM stage,differentiation,and lymph node metastasis of CRC.The level of FABP4 in CRC tissue was correlated with E-cadherin and Snail expression,suggesting that FABP4 may promote CRC progression related to epithelial-mesenchymal transition(EMT).  相似文献   

4.
Objective:To estimate the impact of autologous transfusion on the status of perioperative immune activation inmalignant tumor patients.The Serum Neopterin and Interleukin-2(IL-2)were measured.Methods:Sixty patients undergoingelective radical resection for malignant stomach tumor were enrolled in the prospective study and assigned to the following groups:(Ⅰ)Group A received autologous transfusion;(2)Group H received allogeneic transfusion.The perioperative course(Beforeinduction of anesthesia,after operation and 5 d after operation)of Neopterin and IL-2 was compared.Results:In group A,SerumNeopterin was significantly lower than baseline alter operation and IL-2 had no significant changes.In group H,both SerumNeopterin and IL-2 were significantly lower than baseline alter operation and 5 d after operation.Compared with group A,SerumNeopterin was significantly lower than baseline alter operation and 5 d after operation and IL-2 was significantly lower thanbaseline 5 d alter operation.Conchision:Autologous  相似文献   

5.
Objective: To evaluate the predictive performance of ‘Diprifusor‘ TCI (target-controlled infusion) system for its better application in clinical anesthesia. Methods: The predictive performance of a ‘Diprifusor‘ TCI system was investigated in 27 Chinese patients (16 males and 11 females) during upper abdominal surgery under total intravenous anesthesia (TIVA) with propofol/fentanyl. Measured arterial propofol concentrations were compared with the values predicted by the TCI infusion system.Performance was determined by the median performance error (MDPE), the median absolute performance error (MDAPE), the divergence (the percentage change of the absolute PE with time), and the wobble (the median absolute deviation of each PE from the MDPE). Results: The median (range) values of 14.9% (-21.6%～42.9%) for MDPE, 23.3% (6.9%～62.5%) for MDAPE, -1.9% h^-1(-32.7%～23.0% h^-1) for divergence, and 18.9% (4.2%～59.6%) for wobble were obtained from 227 samples from all patients.For the studied population, the PE did not increase with time but with increasing target propofol concentration, particularly following induction. Conclusions: The control of depth of anaesthesia was good in all patients undergoing upper abdominal surgical operation and the predictive performance of the ‘Diprifusor‘ target controlled infusion system was considered acceptable for clinical purposes. But the relatively bigger wobble showed that the pharmacokinetic model is not so suitable and requires improvement.  相似文献   

6.
Objective： The aim of this retrospective investigation was to explore the influence of femoral osteoporosis on short-term curative effects ofcementless hip arthroplasty and to evaluate the femoral metaphyseal bone mineral density （BMD） for femoral osteoporosis in order to guide prosthesis choice and rehabilitation. Methods： We performed 127 total arthroplasty operations between June 1999 to February 2003 and investigated 49 cementless hip replacements with the Metalcancellous cementless Lubeck Ⅱ system being used in all hips. There were twenty men and twenty-nine women whose mean age at the time of the operation was 60 years （range, 52-81 years）. The patients were divided into osteoporosis or normal groups according to the femoral metaphyseal BMD measured preoperatively. The average duration of follow-up was 30 months （range, 8-52 months）. We evaluated all of the patients from a clinical standpoint with use of a standard-terminology questionnaire with respect to the short-term curative effects and patients＇ satisfaction. Hip pain status and functional ability were important indicators of treatment efficacy. Results： Harris hip score and patients＇ satisfaction in femoral osteoporosis patients who underwent noncemented hip arthroplasty were lower （P=0.004, P=0.03） while the incidence of thigh pain was higher （P=0.03） than the patients with non-osteoporosis. Conclusion： The higher incidence of pain, as well as the decrease in function experienced by the patients in osteoporosis group, supports the case that cementless arthroplasty is not a better choice for those patients and that we had better select prosthesis based on the femoral metaphyseal BMD.  相似文献   

7.
Objective:The aim of this study was to evaluate the association between the methylenetetrahydrofolate reductase(MTHFR) C677T excision repair cross-complementation group 1(ERCC1) genetic polymorphisms and the clinical efficacy of gemcitabine-based chemotherapy in advanced non-small cell lung cancer(NSCLC).Methods:A total of 135 chemonaive patients with unresectable advanced NSCLC were treated with gemcitabine/platinum regimens.The polymorphisms of MTHFR C677T,ERCC1 C8092A,and ERCC1 C118T were genotyped using the TaqMan methods.Results:The overall response rate was 28.9%.Patients with MTHFR CC genotype had a higher rate of objective response than patients with variant genotype(TT or CT)(41.2% versus 19.1%,P=0.01).Median time to progression(TTP) of patients with MTHFR CC genotype was longer than that of patients with variant genotype(7.6 months versus 5.0 months,P=0.003).No significant associations were obtained between ERCC1 C118T and C8092A polymorphisms and both response and survival.Conclusions:Our data suggest the value of MTHFR C677T polymorphism as a possible predictive marker of response and TTP in advanced NSCLC patients treated with gemcitabine/platinum.  相似文献   

8.
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9.
Objective: To evaluate the predictive performance of'Diprifusor' TCI (target-controlled infusion) system for its better application in clinical anesthesia. Methods: The predictive performance of a ‘Diprifusor’ TCI system was investigated in 27Chinese patients (16 males and 11 females) during upper abdominal surgery under total intravenous anesthesia (TIVA) with propofol/fentanyl. Measured arterial propofol concentrations were compared with the values predicted by the TCI infusion system.Performance was determined by the median performance error (MDPE), the median absolute performance error (MDAPE), the divergence (the percentage change of the absolute PE with time), and the wobble (the median absolute deviation of each PE from the MDPE). Results: The median (range) values of 14.9% (-21.6%～42.9%) for MDPE, 23.3% (6.9%～62.5%) for MDAPE, -1.9%h-1 (-32.7%～23.0% h-1) for divergence, and 18.9% (4.2%～59.6%) for wobble were obtained from 227 samples from all patients.For the studied population, the PE did not increase with time but with increasing target propofol concentration, particularly following induction. Conclusions: The control of depth of anaesthesia was good in all patients undergoing upper abdominal surgical operation and the predictive performance of the ‘Diprifusor’ target controlled infusion system was considered acceptable for clinical purposes. But the relatively bigger wobble showed that the pharmacokinetic model is not so suitable and requires improvement.  相似文献   

10.
Background: Allogeneic blood transfusion-induced immunomodulation (TRIM) and its adverse effect on the prognosis of patients treated surgically for cancer remain complex and controversial. However, the potential risk associated with allogeneic blood transfusion has heightened interest in the use of autologous blood transfusion. In the present study, the serum concentrations of neopterin, interferon-gamma (IFN-γ), T lymphocyte subsets (CD3 , CD4 , CD8 , CD4 /CD8 ) and a possible association between these variables were investigated. The purpose was to further evaluate the effect of autologous versus allogeneic blood transfusion on immunological status in patients undergoing surgery for gastric cancer. Methods: Sixty ASA I～II (American Society of Anesthesiologists) patients undergoing elective radical resection for stomach cancer were randomly allocated to receive either allogeneic blood transfusion (n=30) or autologous blood transfusion (n=30). Serum concentrations of the neopterin, IFN-γ and T lymphocyte subsets in the recipients were measured before induction of anesthesia, after operation, and on the 5th postoperative day. Results: Both two groups, serum neopterin, IFN-γ, percentages of T-cell subsets (CD3 , CD4 ), and CD4 /CD8 ratio had significantly decreased after operation, but decreased more significantly in group H (receiving allogeneic blood transfusion) than those in group A (receiving autologous whole blood transfusion) (P<0.05). On the 5th postoperative day, serum neopterin, IFN-γ, CD3 , CD4 T-cells, and CD4 /CD8 ratio returned to the baseline values in group A. In contrast, the above remain decreasing in group H, where there were no significant relations between serum neopterin and IFN-γ. Conclusion: Perioperative surgical trauma and stress have an immunosuppressive impact on gastric cancer patients. Allogeneic blood transfusion exacerbates the impaired immune response. Autologous blood transfusion might be significantly beneficial for immune-compromised patients in the perioperative period, clearly showing its superiority over allogeneic blood transfusion.  相似文献   

11.
对比分析腹腔镜与开腹胃癌根治术的临床疗效。回顾性分析355例进展期胃癌患者临床资料,其中行腹腔镜D2根治术160例,行开腹D2根治术195例,对比分析两组患者的疗效指标。结果显示,与开腹组比较,腹腔镜组患者手术时间较长,但出血量更少,清扫淋巴结数量更多,术后肠道恢复功能更快,进食半流质时间早,住院时间更短,差异均有统计学意义(P<0.05)。两组患者近、远端切缘长度及术后并发症发生率的比较,差异无统计学意义(P>0.05)。结果表明,腹腔镜胃癌根治术是治疗进展期胃癌安全、可行、有效方法。  相似文献   

12.
作者随访334例临床ⅠⅡ期乳癌,结果提示:临床ⅠⅡ期乳癌无论采用传统根治或改良根治术,其5、10年生存率无差别;但单纯改良根治术后5年复发率高于传统根治术;放疗加化疗确能提高手术后(特别是改良根治术后)5年生存率,降低5年内复发率;手术后早期放疗和/或化疗不能改善10年生存率,降低10年复发率。因此,作者认为术后无条件行化疗和放疗的乳癌患者,尽可能行传统乳癌根治术。并强调手术后特别是改良根治术后放疗加化疗的必要性。生存5年以上的患者应定期化疗,局部复发或有远处转移者应结合手术行再放疗以提高10年生存率,降低10年复发率。  相似文献   

13.
Objectives： To detect the serum proteomic patterns by using SELDI-TOF-MS （surface enhanced laser desorption/ ionization-time of flight-mass spectrometry） technology and CM10 ProteinChip in colorectal cancer （CRC） patients, and to evaluate the significance of the proteomic patterns in the tumour staging of colorectal cancer. Methods： SELDI-TOF-MS and CM10 ProteinChip were used to detect the serum proteomic patterns of 76 patients with colorectal cancer, among them, 10 Stage Ⅰ, 19 Stage Ⅱ, 16 Stage Ⅲ and 31 Stage Ⅳ samples. Different stage models were developed and validated by support vector machines, disctiminant analysis and time-sequence analysis. Results： The Model Ⅰ formed by 6 protein peaks （m/z： 2759.58, 2964.66, 2048.01, 4795.90, 4139.77 and 37761.60） could be used to distinguish local CRC patients （Stage Ⅰ and Stage Ⅱ） from regional CRC patients （Stage Ⅲ） with an accuracy of 86.67% （39/45）. The Model Ⅱ formed by 3 protein peaks （m/z： 6885.30, 2058.32 and 8567,75） could be used to distinguish locoregional CRC patients （Stage Ⅰ, Stage Ⅱ and Stage Ⅲ） from systematic CRC patients （Stage IV） With an accuracy of 75.00% （57/76）. The Model Ⅲ could distinguish Stage Ⅰ from Stage Ⅱ with an accuracy of 86.21% （25/29）. The Model Ⅳ could distinguish Stage Ⅰ from Stage Ⅲ with accuracy of 84.62% （22/26）. The Model Ⅴ could distinguish Stage Ⅱ from Stage Ⅲ with accuracy of 85.71% （30/35）. The Model Ⅵ could distinguish Stage Ⅱ from Stage Ⅳ with accuracy of 80.00% （40/50）. The Model Ⅶ could distinguish Stage Ⅲ from Stage Ⅳ with accuracy of 78.72% （37/47）. Different stage groups could be distinguished by the two-dimensional scattered spots figure obviously. Conclusion： This method showed great success in preoperatively determining the colorectal cancer stage of patients.  相似文献   

14.
目的探讨胃大部切除术后残胃功能性障碍的病因、发生机制、诊断及治疗。方法对1999~2006年33例胃大部切除术后胃排空障碍的病例进行回顾性分析。结果功能性排空障碍发生于术后3~12天。32例(96。9%)经非手术治疗于术后7~28天恢复胃动力,痊愈出院,一例(3。1%)因经济原因放弃治疗而死亡。结论胃手术后功能性排空障碍的原因是多因素的,消化道造影及胃镜检查是诊断本病的重要方法。采用非手术疗法一般均可治愈。  相似文献   

15.
Prognostic significance of bcl-2 and p53 expression in colorectal carcinoma   总被引：4，自引：0，他引：4  
INTRODUCTION Colorectal cancer is the most common cancer ofthe Western world and accounts for approx.Elevenpercent of all cancer deaths in the United States.Aswith other malignancies,colorectal adenocarcinomais thought to develop through the accumulation ofgenetic alterations that inhibit cell growth.Two of theoncogenes that have been implicated in this processare bcl-2and p53,the products of which are involvedin apoptosis,cell proliferation and tumor develop-ment(Garewal et al.,1996).S…  相似文献   

16.
目的：探讨进展期胃癌行腹腔镜辅助手术的安全性和可行性并评价临床近期疗效。方法：选择2011年1月至2013年6月30例进展期胃癌患者行腹腔镜辅助胃癌根治术患者（腹腔镜组）,与同期28例行传统开腹胃癌根治手术的患者（开腹组）比较两组患者的手术时间、出血量、清扫淋巴结数目、术后胃肠道功能恢复情况、并发症发生率、住院平均时间等情况。结果：腹腔镜组手术时间长于开腹组,两组间差异有统计学意义（t=4.635,P〈0.05）;腹腔镜组术中出血量、肛门首次排气时间、术后住院时间明显优于开腹组;腹腔镜组淋巴结清扫数量为（25.5±8.5）枚,开腹组为（20.6±7.8）枚,两组比较差异无统计学意义（P〉0.05）。腹腔镜组术后并发症发生率（6.7%）及死亡率（0）均低于开腹组,但差异无统计学意义。患者随访时间6个月,两组患者总体生存率差异无统计学意义（P〉0.05）。结论：腹腔镜辅助进展期胃癌根治术不仅创伤小,恢复快,具有安全性,而且能够达到与开腹手术相同的根治水平,其近期生存率与传统开腹手术无差别。  相似文献   

17.
Objectives: To explore the mechanism of development and aggressiveness in gastric carcinomas by investigating the expression and role of CD97 and its cellular ligand CD55 in gastric carcinomas. Methods: Tumor and corresponding normal mucosal tissue, collected from 39 gastric carcinoma patients, were examined by immunohistochemistry and RT-PCR for the expression of CD97 and CD55. Results: CD97stalk was strongly stained on scattered tumor cells or small tumor cell clusters at the invasion front of gastric carcinomas. The expression of CD97stalk was frequently observed in tumors of stage Ⅰ and T1 gastric carcinoma patients. The expression of CD97stalk between Stage Ⅰ and Stage Ⅱ, Ⅲ, Ⅳ specimens showed significant difference (P＜0.05), between T1 and T2, T3, T4 specimens also showed significant difference (P＜0.05). Specimens with tumor invasion depth limited in mucosa of T 1 specimens showed higher positive CD55 expression than specimens with the same tumor invasion depth in T2, T3, T4 specimens, the expression of CD55 between T1 and T2, T3, T4 specimens was significantly different (P＜0.05).There was strong correlation between the distribution patterns of CD97stalk and CD55 on tumor tissues (r=0.73, P＜0.05). Signet ring cell carcinomas frequently contained strong CD97stalk and CD55-staining. Conclusions: Our results suggest that CD97stalk is probably involved in the growth, invasion and aggressiveness of gastric carcinomas by binding its cellular ligand CD55. CD97stalk and CD55 could be useful as molecular markers for prognosis and therapy of gastric carcinoma patients.  相似文献   

18.
[目的]了解胃癌患者血清中抗核抗体谱的特点.[方法]以鸡卵核为抗原,应用免疫印迹法对18份胃癌术前患者以及22份正常对照组(年龄和性别分布均无差异)的血清进行分析.[结果]胃癌术前患者血清中特异识别5条抗原条带的抗核抗体的阳性率显著高于正常对照组,靶抗原的蛋白分子质量及胃癌术前组血清中特异识别这5条抗原条带的抗核抗体的阳性率分别为:69KD(44.4％,8/18),62KD(50％,9/18),58KD(33.9％,7/18),44KD(22.2％,4/18),37KD(38.9％,7/18).[结论] 胃癌患者体内存在抗核抗体,其相对的靶抗原有多种.  相似文献   

19.
Minimally invasive endoscopic resection has been rapidly adopted as a new technique for treating patients with gastric submucosal tumors (SMTs) originating in the muscularis propria (MP) layer. This study was conducted to evaluate the information obtained from endoscopic ultrasonography (EUS) to determine the appropriate endoscopic dissection method for treating SMTs originating in the MP layer. Between February 2014 and May 2016, a total of 50 patients with gastric SMTs originating in the MP layer were enrolled in this study. The clinical features of the patients and their endoscopic, EUS, and histopathologic findings, as well as their postoperative follow-up data, were analyzed in this retrospective study. The mean age of the patients was (55.0±10.2) years, and the male/female ratio was 17:33. Endoscopic submucosal dissection (ESD) was performed on 43 patients and an endoscopic full-thickness resection (EFR) was performed on seven patients. The most frequent location for an SMT was in the upper body region of the stomach (n=16), and the most common pathological diagnosis was a gastrointestinal stromal tumor (GIST) (n=32). The overall rates for complete resection were 95.3% (41/43) and 100.0% (7/7) when the SMTs were treated by ESD and EFR, respectively. The presence of a complete tumor capsule was significantly associated with a complete resection (P=0.001). Of the cases treated by ESD, nine patients developed perforation, one of whom required laparoscopic surgery. The remaining patients were closed with clips or purse-string sutures. The presence of an MP2-type tumor (P=0.018) and a wide connection with the MP layer (P=0.044) were significantly associated with perforation. A preoperative evaluation of the integrity and the location of a tumor capsule and the length of the tumor connection with the MP layer by EUS can improve the complete resection rate and reduce the occurrence of intraoperative complications. Tumors with a complete capsule originating from the superficial MP layer or with a narrow connection with the MP layer are appropriate candidates for treatment by ESD.  相似文献   

20.
目的：探讨总结8例直肠癌根治术后行结肠造瘘术艾滋病患者的手术前后心理干预及造口的处理方法。方法：通过术前艾滋病知识宣教,防护措施指导,以及术后造口的观察护理。结果：本组患者术后切口Ⅰ期愈合7例,Ⅱ期愈合1例,经积极换药后顺利愈合,患者及家属接受手术、接受造口,掌握造口护理技能。结论：耐心细致的造口护理指导可使患者掌握造口护理技能,家属掌握正确防护措施,接受艾滋病患者,提高艾滋病肿瘤患者的生活质量及生活信心,近期效果满意。  相似文献   

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