內鏡技術的問世是醫學史上的一次革命，是21世紀醫學的重要進展之一。目前,內鏡技術在肝膽胰外科領域得到了廣泛的應用，有力地促進了肝膽胰外科的發展，肝膽胰內鏡技術已成為微創外科重要的組成部分。。。。。。
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.
目的 比較開腹、腹腔鏡和經皮肝穿刺引流3種方法治療細菌性肝膿腫的優劣性，為細菌性肝膿腫治療方法的選擇提供參考依據。方法 回顧性分析筆者所在醫院2010年9月至2011年7月期間收治的39例細菌性肝膿腫患者的臨床資料，根據其治療方式將患者分為開腹組、腹腔鏡組和經皮經肝穿刺引流組（穿刺組）3組，對3組的首次治愈者比例、1個月治愈者比例、發生并發癥者比例、住院時間及住院費用進行比較。結果 開腹組、腹腔鏡組和穿刺組首次治愈者比例分別為10/12、8/9及12/18，3組間差異有統計學意義（P＜0.05）； 1個月治愈者比例分別為11/12、9/9及17/18，3組間差異無統計學意義（P＞0.05）；發生并發癥者比例分別為2/12、1/9及2/18，腹腔鏡組和穿刺組之間的差異無統計學意義（P＞0.05），2組與開腹組相比差異均有統計學意義（P＜0.05）；住院時間分別為（15.4±4.5） d、（9.7±2.3） d及 （16.7±5.8） d （P＜0.05）；住院費用分別為（1.9±0.5）萬元、（1.3±0.3）萬元及（0.8±0.2）萬元（P＜0.05）。結論 開腹組、腹腔鏡組和穿刺組3種治療方法各有利弊，個體化選擇治療方式是肝膿腫的治療策略。
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.
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.
目的 探討實施腸內營養的途徑。方法 采用回顧性研究的方法，分析蘭州大學第一醫院2007年1月1日至2007年12月31日實施膽腸吻合術的15例患者的臨床資料，包括復發性膽管結石4例，膽管癌3例，膽總管囊腫3例，壺腹癌（不能根治）5例； 平均年齡75.5歲； 在行膽腸Roux-en-Y吻合時，利用空腸盲襻實施空腸造瘺，術后第12 h開始腸內營養。統計肛門排氣時間、住院時間及并發癥。結果 15例患者平均肛門排氣時間為54.6 h，平均住院時間為12 d，平均營養管拔除時間為20 d； 發生吻合口漏1例，肺部感染1例，切口感染1例，無一例因造瘺而發生機械性腸梗阻。結論 膽腸吻合利用空腸盲襻實施空腸造瘺腸內營養是腸內營養一種方便、可行的途徑，它可以減少并發癥的發生，縮短患者的住院時間，減輕患者的經濟負擔。與傳統的方法比較，不會引起咽部不適及肺部感染，患者依從性好； 不會導致機械性腸梗阻，安全可行。
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.