简介：AIM:Toinvestigatetheefficacyofneoadjuvantchemoradiotherapy(NACRT)forresectabilityoflocallyadvancedgastriccancer(LAGC).METHODS:BetweenNovember2007andJanuary2014,29patientswithLAGC(clinicallyT3withdistalesophagusinvasion/T4orbulkyregionalnodemetastasis)thatweretreatedwithNACRTfollowedbyD2gastrectomywereincludedinthisstudy.ResectabilitywasevaluatedwithradiologicandendoscopicexamsbeforeandafterNACRT.Usingthreedimensionalconformalradiotherapy,patientsreceived45Gy,withadailydoseof1.8Gy.Theentiretumorextentandtheregionalmetastaticlymphnodeswereincludedinthegrosstumorvolume.PatientspresentingwitharesectabletumorafterNACRTreceivedatotalorsubtotalgastrectomywithD2dissection.ThepathologictumorresponsewasevaluatedusingJapaneseGastricCancerAssociationhistologicevaluationcriteria.PostoperativemorbiditywasevaluatedusingtheNationalCancerInstitute-CommonTerminologyCriteriaforAdverseEventsversion4.0.Overallsurvival(OS)andprogression-freesurvival(PFS)rateswereestimatedusingaKaplan-Meieranalysisandcomparedusingthelog-ranktest.RESULTS:Allpatientswereassessedasunresectablecases.Twenty-fourpatients(24/29;82.8%)showedLAGConpositronemissiontomography-computedtomography(CT)andcontrast-enhancedCT,whereasfourpatients(4/29;13.8%)withvagueinvasionorabutmenttoanadjacentorganunderwentdiagnosticlaparoscopy.Onepatient(1/29;3.4%),initiallyassessedasaresectablecase,underwentan'openandclosure'afterthetumorwasfoundtobeunresectable.Abutmenttoanadjacentorgan(34.5%)wasthemostcommonreasonforNACRT.TheclinicalresponserateonemonthafterNACRTwas44.8%.AfterNACRT,69%(20/29)ofpatientshadaresectabletumor.Ofthe20patientswitharesectabletumor,18patients(62.1%)underwentaD2gastrectomy.TheR0resectionratewas94.4%andtwopatients(2/18;11.1%)showedacompleteresponse.Themedianfollow-updurationwas13.5mo.Theone-yearOSandPFS

简介：AIM:ToinvestigatetheeffectofhepatitisBvirus(HBV)XgeneonapoptosisandexpressionsofapoptosisfactorsinXgene-transfectedHepG2cells.METHODS:TheHBVXgeneeukaryonexpressionvectorpcDNVA3-XwastransientlytransfectedintoHepG2cellsbylipid-mediatransfection.UntransfectedHepG2andHepG2transfectedwithpcDNA3wereusedascontrols.ExpressionofHBxinHepG2wasidentifiedbyPT-PCR.MTTandTUNELwereemployedtomeasureproliferationandapoptosisofcellsin.threegroups.Semi-quantifiedRT-PCRwasusedtoevaluatetheexpressionlevelsofFas/FasL,Bax/Bcl-xL,andc-mycineachgroup.RESULTS:HBVXgenewastransfectedintoHepG2cellssuccessfully.RT-PCRshowedthatHBxwasonlyexpressedinHepG2/pcDNA3-Xcells,butnotexpressedinHepG2andHepG2/pcDNA3cells.AnalyzedbyMTT,cellproliferationcapacitywasobviouslylowerinHepG2/pcDNA3-Xcells(0.08910±0.003164)thaninHepG2(0.14410±0.004927)andHepG2/pcDNA3cells(0.12150±0.007159)(P＜0.05andP＜0.01).AnalyzedbyTUNEL,cellapoptosiswasmuchmoreinHepG2/pcDNA3-Xcells(980/2000)thanHepG2(420/2000),HepG2/pcDNA3cells(520/2000)(P＜0.05andP＜0.01).Evaluatedbysemi-quantifiedRT-PCR,theexpressionlevelofFas/FasLwassignificantlyhigherinHepG2cellstransfectedwithHBxthaninHepG2andHepG2/pcDNA3cells(P＜0.05andP＜0.01).Bax/Bcl-xLexpressionlevelwasalsoelevatedinHepG2/pcDNA3-Xcells(P＜0.05andP＜0.01).Expressionofc-mycwasmarkedlyhigherinHepG2/pcDNA3-XcellsthaninHepG2andHepG2/pcDNA3cells(P＜0.05andP＜0.01).CONCLUSION:HBVXgenecanimpaircellproliferationcapacity,improvecellapoptosis,andupregulateexpressionofapoptosisfactors.TheinterventionofHBVXgeneontheexpressionofapoptosisfactorsmaybeapossiblemechanismresponsibleforthechangeincellapoptosisandproliferation.

简介：AIM:Toevaluatetheefficacyofthe14-dmoxifloxacinbasedtripletherapyforthesecond-lineeradicationofHelicobacterpylori(H.pylori)infection.METHODS:Between2011and2013,weconductedaretrospectivereviewofthemedicalrecordsof160patientswhohadexperiencedfailureoftheirfirst-lineprotonpumpinhibitor-basederadicationtherapyandsubsequentlyreceivedthemoxifloxacin-basedtripletherapyasasecond-lineeradicationtreatmentregimen.Thepatientswhoweretreatedwiththemoxifloxacinbasedtripletherapy(oral20mgrabeprazoleb.i.d.,1000mgamoxicillinb.i.d.,and400mgmoxifloxacinq.d.)for7dwereassignedtotheRAM-7group(n=79)whilethosewhotookthemfor14dayswereassignedtoRAM-14group(n=81).Theeradicationratesforbothgroupsweredeterminedbyintentionto-treat(ITT)andper-protocol(PP)analyses.ITTanalysiscomparedthetreatmentgroupsasoriginallyallocatedwhilethePPanalysisincludingonlythosepatientswhohadcompletedthetreatmentasoriginallyallocated.SuccessfuleradicationtherapyforH.pyloriinfectionwasdefinedasthedocumentationofanegative13C-ureabreathtest4wkaftertheendoftheeradicationtreatment.RESULTS:TheoverallITTeradicationratewas76.2%(122/160).ThefinalITTeradicationrateswere70.8%(56/79;95%CI:63.3%-77.1%)intheRAM-7groupand81.4%(66/81;95%CI:74.6%-88.3%)intheRAM-14group(P=0.034).TheoverallPPeradicationratewas84.1%(122/145),andthefinalPPeradicationrateswere77.7%(56/72;95%CI:70.2%-85.3%)intheRAM-7groupand90.4%(66/73;95%CI:82.8%-98.1%)intheRAM-14group(P=0.017).TheH.pylori-eradicationratesintheRAM-14groupweresignificantlyhighercomparedwiththatoftheRAM-7groupaccordingtoboththeITT(P=0.034)andthePPanalyses(P=0.017).Bothgroupsexhibitedgoodtreatmentcompliance(RAM-7/RAM-14group:100%/100%).Theadverseeventrateswere19.4%(14/72)and20.5%(15/73)intheRAM-7andRAM-14groups,respectively(P=0.441).Adverseeventsoccurredin14

简介：胃扭转自1866年Betti在尸检中发现以来，虽属少见病，但仍可占消化道疾病的0．4％。因其易于误/漏诊，因此提高对本病的X线诊断水平有十分重要的意义。为此，我们收集了1995-01／2005-04我院诊断的胃扭转病人50例，现结合有关资料，总结报告如下。

简介：例1男，17岁，因“右上腹疼痛伴发烧5天”入院。5天前无诱因右上腹疼痛，慢性钝痛持续性加剧、畏寒、发烧。查体：T39．0℃，皮肤粘膜无黄染；腹平、软，右上腹深压痛，无反跳痛，Murphy，S征(-)，肝区叩痛。B超：肝脏中部脏面探及-7×3cm大小囊性肿物，囊壁较厚，内有数块大小不等的强回声光团，正常胆囊位置未探及胆囊。输液、应用抗生素治疗两

简介：消化性溃疡病传统上一直认为仅发生于成人，儿童极为少见，但近年来有逐渐上升趋势。其症状多不典型，常易误诊或漏诊。为进一步提高对本病的认识，现将近年来我们所遇到的127例儿童十二指肠球部溃疡报告如下。

简介：柿石是最常见的植物性类石,多形成于胃内,并可进入十二指肠和空肠。而食管柿石症较少见,我院在胃镜检查中发现2例,并成功地经胃镜取出,现报告如下。例1:患者,女,78岁,因吞咽困难10天于1996年3月4日入院。入院前15天患者食柿子2个后逐渐出现吞咽困难,进食后呕吐,当地地区医院拟诊“食道癌”遂来我院。体检无阳性发现。纤维胃镜插入35cm见4.0cm×3.5cm×3.5cm大小褐

简介：肝性皮质盲又称肝脑眼综合症,是终末期肝病合并肝性脑病的一种特殊表现,临床较少见。我院在近期收治2例,现报告如下：病例摘要例1女性,32岁。

简介：我院放射科自使用数字化多功能X光机进行胃肠道检查以来，共检查1800例，现将初步体会总结报告如下。

简介：例1，女，58岁，发现右腹部包块3天入院。主要表现为腹胀、纳差。查体：腹部膨胀，右上腹触及一约15cm×15cm×15cm大的包块，质稍硬，活动度小，与周围边界不清，触之无压痛。腹部揉面感。实验室检查：血白细胞5．9×10^9/L，中性0．73，淋巴0．27；尿镜检正常；肝功、尿素氮均正常；B超示腹膜后肿瘤。初步诊断为腹膜后肿瘤。

简介：AIMTodeterminetheroleofcorticotropinreleasingfactorreceptor(CRF2)inepithelialpermeabilityandenterocytecelldifferentiation.METHODSForthispurpose,weusedratSpragueDawleyandvariouscoloncarcinomacelllines(SW620,HCT8R,HT-29andCaco-2celllines).ExpressionofCRF2proteinwasanalyzedbyfluorescentimmunolabelinginnormalratcolonandthenbywesternblotindissociatedcolonicepithelialcellsandinthelysatesofcoloncarcinomacelllinesorduringtheearlydifferentiationofHT-29cells(tenfirstdays).ToassesstheimpactofCRF2signalingoncoloniccelldifferentiation,HT-29andCaco-2cellswereexposedtoUrocortin3recombinantproteins(Ucn3,100nmol/L).Insomeexperiments,cellswerepre-exposedtotheastressin2b(A2b)aCRF2antagonistinordertoinhibittheactionofUcn3.Intestinalcelldifferentiationwasfirstanalyzedbyfunctionalassays:thetrans-cellularpermeabilityandthepara-cellularpermeabilityweredeterminedbyDextran-FITCintakeandmeasureofthetransepithelialelectricalresistancerespectively.Morphologicalmodificationsassociatedtoepithelialdysfunctionwereanalyzedbyconfocalmicroscopyafterfluorescentlabelingofactin(phaloidin-TRITC)andintercellularadhesionproteinssuchasE-cadherin,p120ctn,occludinandZO-1.Theestablishmentofmatureadherensjunctions(AJ)wasmonitoredbyfollowingthedistributionofAJproteinsinlipidraftfractions,afterseparationofcelllysatesonsucrosegradients.Finally,themRNAandtheproteinexpressionlevelsofcharacteristicmarkersofintestinalepithelialcell(IEC)differentiationsuchasthetranscriptionalfactorkrüppel-likefactor4(KLF4)orthedipeptidylpeptidaseIV(DPPIV)wereperformedbyRT-PCRandwesternblotrespectively.ThespecificactivitiesofDPPIVandalkalinephosphatase(AP)enzymesweredeterminedbyacolorimetricmethod.RESULTSCRF2proteinispreferentiallyexpressedinundifferentiatedepithelialcellsfromthecryptsofcolonandinhumancoloncarcinoma

简介：

简介：溃疡性结肠炎（UC）是一种发生于肠道的慢性复发性自身免疫性疾病,目前主要认为其病因与免疫因素、遗传、环境及饮食因素有关。病程长、易反复已成为其最突出的临床特征,严重影响了患者生活质量。国内外大量研究表明,维生素D及其受体在UC的病理生理过程中具有重要作用,且维生素D缺乏与疾病活动性相关。现就维生素D与溃疡性结肠炎相关性的研究进展进行一综述。

简介：十二指肠胃返流病如果引起胃粘膜充血、水肿、糜烂等损害，称为胆汁返流性胃炎，是胃镜直视下常见的一种疾病，目前X线对该病报道甚少，现将我们在胃肠透视中发现有价值的X线征象，经与胃镜检查及胆汁酸浓度测定对照分析，制定的十二指肠胃返流病X线诊断与分型的经验介绍如下。

简介：背景：维生素D受体（VDR）属于类固醇激素受体超家族，参与细胞增殖、分化、凋亡以及免疫应答等多种生物学过程，在多种恶性肿瘤中呈低表达。目的：探讨VDR在结直肠癌中的表达及其调控机制。方法：收集2010年2月-2012年12月上海交通大学医学院附属仁济医院收治的结直肠癌患者30例，以免疫组化法检测癌组织和相应癌旁非癌组织标本的VDR表达情况。从基因表达汇编（GEO）数据库中提取224例结直肠癌患者的临床资料，分析其癌组织VDR表达与患者临床病理特征和生存期的关系。采用组蛋白-赖氨酸N-甲基转移酶EZH2-siRNA或5-氮杂胞嘧啶核苷（5-AZA）处理人结肠癌细胞株HCT116和SW620，以实时PCR检测VDR表达水平，以甲基化特异性PCR（MSP）检测VDR启动子区甲基化水平。结果：结直肠癌患者癌组织VDR阳性表达率显著低于癌旁非癌组织（26.7%对70.0%，P〈0.001）。结直肠癌组织VDR表达与肿瘤组织学分期、远处转移、脉管转移、淋巴结转移呈负相关（P〈0.05）；VDR高表达者生存期显著长于低表达者（P=0.032）。与转染对照-siRNA相比，HCT116、SW620细胞转染EZH2-siRNA后，EZH2mRNA表达水平和VDR启动子区甲基化水平均显著降低（P〈0.05），VDRmRNA表达水平显著升高（P〈0.05）。5-AZA处理HCT116、SW620细胞后，VDR启动子区甲基化水平较阴性对照组显著降低（P〈0.05），VDRmRNA表达水平显著升高（P〈0.05）。结论：结直肠癌中VDR表达下调且与患者预后呈正相关。VDR在结直肠癌中的转录抑制受组蛋白甲基化和DNA甲基化共同调控。

简介：背景:Gankyrin是一个含锚蛋白重复序列的原癌蛋白,其高表达参与了多种恶性肿瘤的发生、发展进程。目的:探讨下调gankyrin表达对胃癌细胞增殖能力的影响及其可能机制。方法:以携带gankyrinsiRNA的慢病毒载体转染人胃癌细胞株MKN28,分别采用MTT实验、流式细胞术和蛋白质印迹法检测下调gankyrin表达对MKN28细胞增殖、细胞周期分布及其β-catenin/cyclinD1信号通路的影响。结果:慢病毒载体的转染效率在90%以上,转染gankyrinsiRNA后,MKN28细胞gankyrin蛋白表达显著受抑(P<0.01)。与未转染慢病毒和转染对照病毒的细胞相比,转染gankyrinsiRNA的MKN28细胞体外生长于第3天起显著受抑,细胞周期G1期细胞比率增高,S期细胞比率降低,细胞中的β-catenin和cyclinD1表达水平降低,差异均有统计学意义(P<0.01)。结论:下调胃癌细胞中的gankyrin表达可通过抑制β-catenin/cyclinD1信号通路引起细胞周期G1期阻滞和细胞增殖抑制,gankyrin有望成为胃癌靶向治疗的新靶点。

简介：Medicaltherapyfortype2diabetesmellitusisineffectiveinthelongtermduetotheprogressivenatureofthedisease,whichrequiresincreasingmedicationdosesandpolypharmacy.Conversely,bariatricsurgeryhasemergedasacost-effectivestrategyforobesediabeticindividuals;ithaslowcomplicationratesandresultsindurableweightloss,glycemiccontrolandimprovementsinthequalityoflife,obesity-relatedco-morbidityandoverallsurvival.Thefindingthatglucosehomeostasiscanbeachievedwithaweightloss-independentmechanismimmediatelyafterbariatricsurgery,especiallygastricbypass,hasledtotheparadigmofmetabolicsurgery.However,theprimaryfocusofmetabolicsurgeryisthealterationofthephysio-anatomyofthegastrointestinaltracttoachieveglycemiccontrol,metaboliccontrolandcardio-metabolicriskreduction.Todate,metabolicsurgeryisstillnotwelldefined,asitisusedmostfrequentlyforlessobesepatientswithpoorlycontrolleddiabetes.Themechanismofglycemiccontrolisstillincompletelyunderstood.Publishedresearchfindingsonmetabolicsurgeryarepromising,butmanyaspectsstillneedtobedefined.Thispaperexaminestheproposedmechanismofdiabetesremission,theefficacyofdifferenttypesofmetabolicprocedures,thedurabilityofglucosecontrol,andtherisksandcomplicationsassociatedwiththisprocedure.Weproposeatailoredapproachfortheselectionoftheidealmetabolicprocedurefordifferentgroupsofpatients,consideringtheindicationsandprognosticfactorsfordiabetesremission.

简介：目的探讨微小RNA-363(miR-363)靶向调控E2F转录因子3(E2F3)的表达对HepG2细胞增殖和凋亡的影响。方法体外培养HepG2细胞,采用Lipofectamine法将miR-363抑制剂或其阴性对照转染到HepG2细胞,继续培养48h,收获细胞,采用四噻唑蓝(MTT)法测定细胞增殖率,使用流式细胞术法检测细胞凋亡率,采用实时荧光RT-PCR法检测HepG2细胞miR-363mRNA水平,采用WesternBlot法检测HepG2细胞E2F3、BAX和Caspase-3蛋白表达水平。结果对照组HepG2细胞增殖率为(96.4±9.7)%,显著高于抑制剂处理组【(72.3±6.5)%,P<0.05】,凋亡率为(8.2±1.4)%,显著低于抑制剂处理组【(9.7±0.8)%,P<0.05】;对照组HepG2细胞miR-363mRNA相对水平为(1.0±0.1),显著高于抑制剂处理组【(0.6±0.2),P<0.05】,E2F3蛋白表达量为(1.0±0.1),显著高于抑制剂处理组【(0.6±0.1),P<0.05】,而对照组HepG2细胞Bax和Caspase-3蛋白表达量分别为(0.4±0.0)和(0.5±0.1),均显著低于抑制剂处理组【(0.6±0.1)和(0.7±0.0),P均<0.05】。结论miR-363可靶向调控E2F3的表达,抑制HepG2细胞增殖,诱导其凋亡。本研究结果为肝癌靶向治疗提供了一定的理论依据。

简介：病例1：患者女性,42岁,因＂间断腹泻18年,加重伴呕吐2个月＂于2010-09-16就诊于北京协和医院。18年前因进食生冷食物出现腹泻,为黄色水样便,量约300~500mL/次,每日5~6次,因夜间腹泻而影响睡眠,伴脐周胀痛,便后缓解,无黏液脓血便,无发热。外院曾考虑＂胃肠炎＂、＂肠易激综合征（IBS）＂,予止泻等对症治疗后好转。此后间断发作类似腹泻,每1~2周1次。

简介：免疫复合物(IC)的形成一般认为是清除抗原和终止免疫反应的过程。在某些病理情况下,IC激活补体并沉积于血管壁、肾小球基底膜以及其它血管外组织中,引起炎症反应和免疫病理损伤。抗原抗体结合形成IC并激活补体时,C1、C2、C4依次活化,C42将C3裂解成为C3a、C3b,I因子再将C3b裂解为C3c、C3f、