【Abstract】Objective To investigate the features of gallbladder carcinoma in two-phase spiral CT, and to analysis the values of two-phase spiral CT for the differential diagnosis between gallbladder carcinoma and chronic cholecystitis. Methods The two-phase spiral CT manifestations of 30 cases of gallbladder carcinoma, proved by surgery and pathology, and 30 cases of chronic cholecystitis were analyzed. Results According to the CT findings, the gallbladder carcinoma was categorized into 3 types: intraluminal mass of gallbladder in 6 out of 30 (20.0%）， thickening of the gallbladder wall in 11 (33.7%), and mass replacing the normal gallbladder in 13(43.4%). The most common enhancement patterns of the wall in gallbladder carcinoma were hyperattenuation during the arterial phase, while isoattenuation with the adjacent hepatic parenchyma during the venous phase; or hyperattenuation during both phases. The most common enhancement pattern of the wall in chronic cholecystitis was isoattenuation during both phases, with clear hypoattenuation linear shadow in the gallbladder fossa. Other ancillary features of gallbladder carcinomas included: infiltration of the adjacent parenchyma, local lymphadenopathy and intrahepatic metastasis. Conclusion Two-phase spiral CT scan can identify the features of the gallbladder carcinoma and is helpful for the differential diagnosis of these two different disease entities.
【摘要】 目的 观察利胆清微丸治疗慢性胆囊炎湿热蕴结兼血瘀证患者的疗效及安全性，进一步为临床研究提供依据。 方法 2001年4—7月，采用双盲、双模拟、随机平行对照临床试验，将40例患者随机分为试验组（20例）及对照组（20例）。试验组服用利胆清微丸3.5 g/次，3次/d，同时服用胆宁片模拟剂；对照组服用胆宁片3片/次，3次/d，同时服用利胆清微丸模拟剂。 结果 试验组痊愈1例，显效12例，有效5例，无效2例，显效率65%，有效率90%；对照组痊愈2例，显效10例，有效7例，无效1例，显效率60%，有效率95%，两组疗效比较差异无统计学意义（Pgt;0.05）。试验过程中未发现明显不良反应。 结论 利胆清微丸对于治疗慢性胆囊炎湿热蕴结兼血瘀证有良好效果，是一种安全有效的药物。【Abstract】 Objective To observe the safety and efficacy of Lidanqing pellet on chronic cholecystitis with damp and hot accumulate knot including blood stasis, and to provide a basis for further clinical trials. Methods A double-blind, double dummy, randomized, and controlled clinic trial was undertaken between April and July 2001. A total of 40 patients were randomly divided into trail group and control group. The trial group was given Lidanqin pellet 3.5 g per time, and three times per day; simultaneously taking Danning tablet simulation agent. The control group was given 3 tablets of Danning tablet per time and three times per day; simultaneously taking taking Lidanqing pellets simulation agent. Results In the trail group, one patient was cured, the therapeutic effect was obvious in 12, basically effective in five and invalid in two (with the rate of obvious effect of 65.00% and rate of basic effect of 90.00%). In the control group, two patients was cured, the therapeutic effect was obvious in 12, basically effective in 10, effective in seven and invalid in one (with the rate of basic effect of 60.00% and the rate of obvious effect of 95.00%). The difference between the two groups was significant (Pgt;0.05). Adverse reaction was not found in the trial group. Conclusion Lidanqing pellet, a safe medication, is effective on chronic cholecystitis with damp and hot accumulate knot including blood stasis.
目的:观察和探讨细胞角质素CK18慢性胆囊炎患者的胆囊组织和血清中的表达及其意义。方法:35例经腹腔镜胆囊切除的慢性结石性胆囊炎患者(27例女性患者,8例男性患者,年龄在55.65±13.48岁),将患者分为两个组,A组为患慢性非活动性结石性胆囊炎者(n=10),B组为患慢性活动性胆囊炎者(n=25),在细胞凋亡早期胱门蛋白酶分裂的CK18用M30细胞凋亡酶联免疫吸附测定,总细胞角蛋白18(从凋亡及坏死细胞中分离)用M65酶联免疫吸附测定。然后计算M30/M65结果:胱门蛋白酶分裂的CK18,特别是总CK18在胆汁中的表达远高于血清。在B组中,胱门蛋白酶分裂的CK18和总CK18的表达在胆囊组织和血清中表达差异相当大。在胆囊粘膜上皮细胞胱门蛋白酶分裂的CK18染色呈强阳性。结论:CK18在胆囊上皮细胞中表达。胱门蛋白酶分裂的CK18和总CK18在胆囊组织中的表达远高于血清中的表达。胱门蛋白酶分裂的CK18和总CK18的表达水平在活动性胆囊炎和非活动性胆囊炎中的表达并无明显差异。
To study the expressions of CA19-9 and CA125 and their clinicopathologic significancesin gallbladder adenocarcinoma , pericancerous tissues and chronic cholecystitis. Methods EnVisionTM immunohistochemist ry was used for assaying the expressive levels of CA1929 and CA125 in the routinely paraffin2embedded sections of specimens f rom gallbladder adenocarcinoma ( n = 108) , pericancerous tissues ( n = 46) , and chronic cholecystitis ( n = 35) . Results The positive rates of CA19-9 and CA125 were significantly higher in gallbladder adenocarcinoma ( 49. 1 % , 51. 9 %) than those in pericancerous tissues ( 26. 1 % , 15. 2 %) and chronic cholecystitis(14. 3 % , 5. 7 %) , respectively ( Plt; 0. 01) . The positive rates of CA19-9 and CA125 were significantly lower in thecases of adenomatous canceration , maximal diameter lt; 2 cm , no-metastasis of lymph node and no-invasion of regional tissues than those in the ones of low-differentiated adenocarcinoma , maximal diameter ≥2 cm , metastasis oflymph node and invasion of regional tissues ( Plt; 0. 05 , Plt; 0. 01 ) . The consistence of CA19-9 and CA125 expressivelevels was found in gallbladder adenocarcinoma (χ2 = 44. 69 , Plt; 0. 01) . Conclusion The expressions of CA19-9 andCA125 may be important tumor markers to reflect the carcinogenesis , progression , biological behaviors and prognosis of gallbladder adenocarcinoma.