目的：研究青蒿琥酯诱导人胃癌SGC-7901细胞凋亡作用及其可能机制.方法：应用流式细胞术（FCM）、透射电镜（TEM）等方法检测不同浓度下青蒿琥酯对人胃癌SGC-7901细胞生长的影响，并应用Western Blot法检测凋亡相关基因Bcl-2、Bax的表达水平。结果：经青蒿琥酯处理后，人胃癌SGC-7901细胞凋亡率升高，并具有时间浓度依赖性（Plt;0.05），癌细胞被阻滞于G0/G1期；电镜观察肿瘤组织中散在凋亡细胞及凋亡小体；Western Blot法检测到凋亡相关基因Bcl-2表达减弱，Bax表达增强（Plt;0.05）。结论：青蒿琥酯能有效抑制人胃癌SGC7901细胞增殖并诱导其凋亡，其机制可能与下调凋亡相关基因Bcl-2、上调Bax表达有关。
世界首例成功的全胃切除及消化道重建术（结肠前食管空肠端侧吻合术）1897年由德国人Schlatter完成； 随后Briigham对重建的术式做出了最早的探索，这一食管十二指肠吻合术也是最早的保留十二指肠食物通道功能的术式（Billroth Ⅰ）； 1903年Moynihan提出应加行空肠输入-输出袢之间的侧侧吻合（Braun吻合）； 1947年Orr提出的Roux-en-Y术式是最经典的不保留十二指肠食物通道功能的术式，以它为基础的术式（Billroth Ⅱ）在全胃切除术后的消化道重建中占有主要地位［1］。......
【Abstract】Objective To discuss the clinical significance of postoperative application of gastrointestinal decompression after anastomosis of lower digestive tract. Methods Three hundred and sixty-eight patients undergoing excision and anastomosis of lower digestive tract were divided into two groups: the group with postoperative gastrointestinal decompression and the group without it. The clinical therapeutic outcomes and incidences of complications were compared between the two groups. Results The volume of gastric juice in the decompression group was about 200 ml every day after operation. Both groups had a smaller abdomenal circumference before operation than after operation （P＜0.001）. No difference in the time of first passage of gas from anus and defecation after operation was found between the two groups. The incidence of complications in the decompression group was obviously higher than that of non-decompression group (28.0% vs. 8.2%, P＜0.001); the incidence of pharyngolaryngitis of the former was up to 23.1%. There was also no difference found between these two groups regarding the hospital stay after operation.Conclusion The present study shows that application of gastrointestinal decompression after excision and anastomosis of lower digestive tract cannot effectively reduce the gastrointestinal tract pressure and has no obvious effect on prevention from postoperative complications. On the contrary, it may increase the incidence of pharyngolaryngitis and other complications. Therefore, it is more beneficial for the recovery of patients without gastrointestinal decompression.
Objective To investigate the short term and long term effects of laparoscopic gastric bypass on obesity related type 2 diabetes. Methods Twenty obese patients with type 2 diabetes underwent laparoscopic gastric bypass between Nov. 2009 and Feb. 2012 were identified in the computer database of West China Hospital of Sichuan University. All patients had short term follow-up of less than 1 year and among them 11 were with long term follow-up of 1 year or more. Body weight， body mass index （BMI）， blood glucose， glycosylated hemoglobin （HbA1c）， homeostasis model assessment of insulin resistance-insulin resistance （HOMA-IR）， blood pressure， and blood lipids were examined. Short term （＜1 year） and long term （≥1 year） remission rates of diabetes were calculated and factors which might have effects on the remission of diabetes were analyzed. Results Of patients with short term follow-up，body weight， fasting plasma glucose （FPG）， 2h plasma glucose （2hPG）， HbA1c， and HOMA-IR were reduced significantly. Among them， 18 of 20 patients （90.0%） reached the glucose and medication standards of complete remission and partial remission， 9 patients were defined as completely remitted （9/20， 45.0%）. Those accompanied with hypertension and （or） hyperlipemia were all improved clinically. The duration of diabetes， fasting and 2 h C peptide were found to be related to short term diabetes remission. Patients with long term follow-up of 1 year or more were observed to have significant reductions in body weight， FPG， 2hPG， HbA1c， and HOMA-IR as well. Hypertension and hyperlipidemia were all well controlled. The remission rate of diabetes reached 9/11 （81.8%）and those who were defined as completely remitted took a proportion of 6/11 （54.5%）. In these patients， those who did not reach the standards of complete remission had longer duration of diabetes and higher FPG when compared with those who did. No severe adverse event was found during the follow-up in either group. Most patients investigated were satisfied with the surgery.Conclusion Laparoscopic gastric bypass is effective and safe on short term and long term treatment of obesity related type 2 diabetes.
Objective To determine whether lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU affects expressions of bcl-2, bax and caspase-3 in gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa. Methods Twenty-eight patients with gastric cancer in our department were divided into lymph node-targeted chemotherapy (LNTC) group and control group from October 2005 to August 2006. The patients were treated with carbon nanoparticles absorbing 5-FU before operation in LNTC group and those were operated directly in control group. The gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa were collected after operation. The expressions of bcl-2, bax and caspase-3 in those tissues were determined by immunohistochemical technique. Results In LNTC group, the positive expression rate of bcl-2 in gastric cancer tissues and metastatic lymph nodes was significantly lower than those in control group (28.6% vs . 78.6% , 25.0% vs . 70.0% , P ＜ 0.05), the positive expression rate of bax (85.7% vs . 28.6% , 80.0% vs . 30.0% ) and caspase-3 (57.1% vs . 14.3% , 55.0% vs . 15.0% ) in gastric cancer tissues and metastatic lymph nodes was significantly higher than those in control group ( P ＜ 0.05). The positive expression rate of bcl-2, bax and caspase-3 in normal gastric mucosa was not significantly different between two groups ( P ＞ 0.05). Conclusion The lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU can down-regulate the expression of bcl-2 and up-regulate the expression of bax and caspase-3 in gastric cancer tissues and metastatic lymph nodes, and therefore by affecting the expression levels of these apoptosis molecules may be one of the ways to induce tumor cell apoptosis.
Objective To compare the quality of life after laparoscopic and open surgery for gastric stromal tumor patients. Methods We collected the data of the patients undergoing the gastric stromal tumor surgery from May 2011 to August 2016 in West China Hospital of Sichuan University, and compared the basic data, complications, micturition time, hospital stay time, bleeding volume and hospitalization expenses. SF-36 scale was used to evaluate the quality of life. Then, SPSS 19.0 software was used for data analysis. Results Eighty nine patients involving 31 laparoscopic patients and 58 open surgery patients were included. There was no statistical significance in basic line between two groups. The laparoscopic group had shorter micturition time and hospital stay time, less intraoperative bleeding and lower hospitalization costs, the differences between two groups were statistically significant (P<0.05). But there were no significant differences between two groups in the operation time and postoperative complication rate. The SF-36 quality of life scale of laparoscopic group and open surgery group were 737.7±68.3 and 665.1±138.1, respectively. The laparoscopic surgery group had higher scores in validity (VT), social function (SF) and mental health (MH) than those in open surgery group with significant differences (P<0.05). Conclusion Laparoscopic surgery is safe and effective for the patients with stromal tumor. Patients in laparoscopic group have shorter recovery time and higher quality of life than open surgery group. Due to the limited of study design, more high quality studies are needed to verify above conclusion.