Objective: To investigate the expression and clinical significance of WD Repeat Domain 27(WDR27gene in gastric cancer tissues. Methods: The expression of WDR27 mRNA in 150 gastric cancer tissues and their paraneoplastic tissues was detected by qRT-PCR, and the relationship between WDR27 and the clinicopathological features of gastric cancer was analyzed. Results: The relative expression of WDR27 in gastric cancer tissues was significantly higher than that in paracancerous tissues（P ＜0.05）. WDR27 mRNA expression was associated with tumor T stage, TNM stage and lymph node metastasis（P ＜0.05）, but not with gender, age, differentiation, tumor size and tumor location（P ＞0.05）. Conclusion: High WDR27 expression was associated with gastric cancer progression, and WDR27expression could be used as a new molecular pathological marker to reflect the clinicopathological characteristics of gastric cancer.

Objective:To investigate the expression of microRNA (miR)-938, its effect on cell proliferation and its regulatory mechanism in hepatocellular carcinoma (HCC).Methods:HCC and paracancerous tissues were collected from 40 patients with HCC who underwent surgical resection in the Second Affiliated Hospital of Nantong University from January 2015 to June 2019, including 25 males and 15 females, with an average age of 61.4 years. HepG2 cells in the miR-938 overexpression group were transfected with miR-938 mimics, and the negative control group was transfected with the negative control sequence. Cell proliferation was detected by kit, the expression of miR-938 and the succinate dehydrogenase complex subunit D (SDHD) was detected by fluorescence quantitative polymerase chain reaction, and SDHD protein expression was detected by Western blot. The target genes of miR-938 were verified by dual luciferase reporting.Results:The relative expression of miR-938 in HCC tissues was (0.060±0.002), which was higher than that in adjacent tissues (0.030±0.002), and the difference was statistically significant ( P<0.05). The mRNA relative expression of SDHD in HCC tissues was (0.028±0.002), lower than that in adjacent tissues (0.062±0.002), and the protein expression of SDHD in HCC tissues was (0.963±0.008), lower than that in adjacent tissues (1.083±0.037), with statistical significance (both P<0.05). The proliferation activity of miR-938 overexpression group was significantly higher than that of negative control group, and the difference was statistically significant ( P<0.05). MiR-938 significantly inhibited the luciferase activity of SDHD wild-type 3’-untranslated regions. In the overexpression miR-938 cells, SDHD mRNA and protein levels were significantly lower than those in the negative control group ( P<0.05). Conclusion:MiR-938 was highly expressed in HCC tissues. MiR-938 promoted the proliferation of HCC cells by inhibiting the expression of SDHD.

目的 为探究JAK2/STAT3信号通路与炎性因子白细胞介素6、1β、10(interleukin-6、1β、10)的关系,IL-6、IL-1β、IL-10是否参与刀豆蛋白A(ConA)诱导的小鼠肝纤维化过程以及川芎嗪对其的影响.方法 BALB/C小鼠随机分为5组,正常对照组(A 组)10只;ConA 模型(B组)15只;川芎嗪低剂量(100 mg/kg)组(C组)15只;川芎嗪中剂量(200 mg/kg)组(D组)15只,川芎嗪高剂量(800 mg/kg)组(E组)15只.通过实时荧光定量 PCR 检测 IL-6mRNA、IL-1βmRNA和 IL-10mRNA 的表达水平;Western-blot检测 JAK2、STAT3和 p-JAK2、p-STAT3的表达情况.结果 与模型组相比,小鼠经不同剂量川芎嗪干预8周后,IL-6mRNA 和IL-1βmRNA 表达水平均降低,且与给药剂量呈相关性;IL-10mRNA表达水平升高,且与给药剂量呈相关性;p-JAK2、p-STAT3蛋白表达均降低,且下降程度与给药呈剂量相关性;JAK2和 STAT3蛋白表达变化不明显.结论 川芎嗪可能通过JAK2/STAT3信号通路及炎性因子 IL-6、IL-1β、IL-10对ConA诱导的小鼠肝纤维化产生保护作用.

目的:观察不同剂量川芎嗪对刀豆蛋白A诱导的小鼠肝纤维化TNF-α、IL-6、IL-10表达的影响.方法:BALB/C小鼠随机分为5组,正常对照组(A组)10只;ConA模型(B组)15只;川芎嗪低剂量(100 mg/kg)组(C组)15只;川芎嗪中剂量(200 mg/kg)组(D组)15只,川芎嗪高剂量(800 mg/kg)组(E组)15只.采血及留取肝组织,HE法检测肝组织病理变化,ELISA法检测血清中肿瘤坏死因子(TNF-α),IL-6的水平,RT-qPCR检测肝组织中IL-6、IL-10的表达.结果:刀豆蛋白A模型组小鼠肝纤维化明显,TNF-α、IL-6的表达明显增多,IL-10的表达明显减少,与其他组比较有差异显著(P<0.05);不同剂量的川芎嗪治疗干预后,肝纤维化减轻,伴TNF-α、IL-6表达下降,IL-10的表达增加,与刀豆蛋白A模型组比较差异明显(P<0.05),尤以高剂量组为著.结论:川芎嗪对刀豆蛋白A诱导的小鼠肝纤维化有保护作用,有剂量相关性,其机制可能与减少细胞凋亡的发生和通过抑制JAK-STATs信号通路的激活有关.

目的 分析和探究针对结直肠癌术前辅助检查系统中采用多学科协作诊治的模式进行干预的应用价值.方法 全面系统地回顾结直肠癌患者150例作为此次报告的研究对象,统计和探索结直肠癌患者的病程等一般临床指标,分析临床在治疗和护理结直肠癌术前需要准备的检查步骤,以及对于患者术后结肠癌治疗的效果.结果 结果显示,选取的100例结直肠癌患者,其中患者的术前检查项目为4~15个,平均术前项目为(10±2)个.应用相关性进行统计分析,肺功能检测与以下指标均呈现正相关,包括了(:1)血型:r=0.159,P=0.027.(2)肿瘤标记物:r=0.120,P=0.015.(3)胸部X线片:r=0.108,P=0.013.(4)常规心电图:r=0.187,P=0.004.其中有一些指标呈现负相关,包括了应激反应:r=-0.102,P=0.024.运用单因素进行讨论指出,结直肠癌患者的病灶区域和手术方式比较差异均无统计学意义.结论 临床在治疗结直肠癌患者的术前检查过程多包括了脏器功能检查、肿瘤标记物检查等,而应用多学科协作诊治模式有着较好的临床价值.并制定初步的辅助检查必需项目,一方面可以全面提高结直肠癌术前的评估准确性,另一方面可以提高医院的整体医疗质量,促进医院的发展.

目的 比较不同缝合方式在腹腔镜胆总管探查术一期缝合中应用的临床疗效.方法 我院2008年7月～ 2014年6月外科收治的胆囊结石合并胆总管结石患者105例.均实施腹腔镜胆囊切除+胆总管探查+胆总管一期缝合术,分为两组,可吸收线连续锁扣缝合组51例,Quill免打结缝合线组54例.结果 两组患者在术后胃肠功能恢复时间、术后住院时间比较差异有统计学意义(P＜0.05),手术中出血量、住院总费用、术后并发症发生率两组比较差异无统计学意义(P＞0.05).两组患者均随访6 ～ 24个月,随访期内均未发现胆管狭窄及胆管炎？残余结石等情况.结论 在具备丰富的腹腔镜操作技术的基础上,胆总管一期缝合是安全的,疗效确切.使用Quill免打结缝合线具有手术时间短,操作更加简便等优点.

目的：探讨损伤控制理论在复杂肝外伤的外科救治中的应用方法，分析其预后相关因素，并探讨降低复杂肝外伤患者病死率的外科救治理念。方法：回顾性分析2010年1月-2013年6月收治的22例严重肝脏外伤患者的资料，采用单因素分析22例AASTⅢ级及以上严重肝外伤患者临床资料。结果：22例严重肝外伤患者中，存活16例，死亡6例。单因素分析结果显示，休克时间、失血量，手术时间、手术方式等与患者顸后有关，差异有统计学意义(P<0.05)。分期损伤控制性手术组患者病死率为12.50%，早期确定性手术组患者病死率为35.71%，两组比较差异有统计学意义(P<0.05)。结论：复杂肝外伤的外科急诊救治采用损伤控制理论的分阶段处理原则，个体化治疗，快速的绿色通道，恰当的手术方式，尤其是损伤控制性手术的实施，能够提高肝外伤抢救的成功率。

objective: to study the central venous catheter drainage and chest cavity injection of cisplatin and the patient's clinical curative effect of 36 patients with lung cancer merger pleural effusion tredted by streptococcus. Selection methods: our hospital in January 2010 to December 2012 were analyzed in 40 patients with lung cancer merger pleural effusion, the observation group in the chest cavity injection of cisplatin and ShaPeiLin treatment, control group given cisplatin treatment. Results: the observation group efficiency (85.0%) were significantly greater than the control group (65.0%), P < 0.05; Two groups of adverse reactions are mild, the incidence of adverse reaction was no significant difference (P>0.05) Conclusion: the combined central venous catheter drainage of pleural effusion of lung cancer patients and chest cavity injection of cisplatin and ShaPeiLin treatment effect is remarkable, worth clinical promotion.

目的：研究骨桥蛋白(osteopontin，OPN)在胆固醇结石患者胆汁中的表达及其意义。方法：分别检测OPN及胆固醇在25例胆囊胆固醇结石患者(结石组)和10例非胆囊结石患者(非结石组)胆囊胆汁中的含量。结果：结石组患者胆汁中OPN含量明显低于非结石组(P<0.05)，胆固醇含量显著高于非结石组(P<0.05)。胆固醇结石患者胆汁中的OPN含量与胆固醇含量呈负相关。结论：胆固醇结石患者胆汁中OPN的低表达，且与胆汁中胆固醇含量成负相关，提示OPN可能与胆固醇结石的形成有关。

目的 探讨骨桥蛋白(OPN)在胆固醇结石患者胆囊黏膜上皮中的表达、分布及意义.方法 采用免疫组化Elivision二步法,检测骨桥蛋白在25例单纯胆囊胆固醇结石患者胆囊黏膜上皮(结石组)和10例非胆囊结石患者的胆囊黏膜上皮(非结石组)中的表达.结果 OPN集中表达于胆囊黏膜上皮细胞的管腔侧,OPN在结石组的表达显著高于非结石组(P＜0.05).结论 OPN在胆固醇结石患者胆囊黏膜上皮内高表达,原因可能与胆固醇结石的形成有关.

Objective: To investigate the protective effect and mechanism of S-ademetionine against hepatic ischemia-reperfusion injury in rats and its mechanism. Methods: Thirty-six SD female rats were randomly divided into 3 groups, SHAM:sham operation group, IR: ischemia-reperfusion group, SAMe: S-ademetionine treatment group. The model of 70% hepatic ischemia-reperfusion was established in the rats. Ischemia lasted for 1 h. The rats of SAMe group received SAM(100 mg/kg)intraperitoneally 1 d prior to operation and 1 h after operation. The other groups received saline solution at the same time.Rats were killed at 6,24 h after reperfusion respectively. Blood samples were collected and analyzed for the levels of serum,alanine aminotransferase(ALT), aspertate aminotransferase(AST), tumor necrosis factor α(TNF-α). The malonyldialdehyde(MDA) in liver tissues were measured and histologic changes were observed in HE staining. Results: Comparison to IR group,SAMe group was associated with lower serum transaminases ALT, AST, TNF-α. Besides, MDA expression in SAMe group was significantly lower than those in IR group. The injury of liver tissue in IR group was more obviously. Conclusion: S-ademetionine has a protective effect in hepatic ischemia-reperfusion injury in rat. The mechanism of protection appears to be dependent on its inhibitory effect on neutrophil infiltration and inflammatory cytokines.

Objective To explore serious liver trauma surgical emergency treatment methods and prognosis-related factors of severe hepatic trauma.Methods Single factor analysis was conducted to the clinical data of 18 AAST Ⅲ or above patients with severe liver trauma.Results Among 19 patients,12 survived and 6 died.The results of single factor analysis showed that shock time,blood loss,operating duration were related with the prognosis of the patients.Conclusion Severe liver trauma emergency surgical treatment must follow the principle of individualized treatment.Fast and easy access,the proper operation and interventional technique can greatly enhance the success rate of liver trauma rescue.

Objective To investigate the effect of splenectomy and somatostatin on rat with acute hepatic failure induced by 85%hepatectomy.Methods Fifty SD rats were randomly divided into five groups;85%hepatectomy group,splenectomy group,somatostatin group,splenectomy with somatostatin group and sham operation group.The rats in somatostatin group and splenectomy with somatostatin group were intraperitoneally injected with somatostatin[(84μg/(kg·d)]1 mL/100 g.After operation,we observed the change of ALT and AST level,portal venous pressure and pathological examined the liver of rats in the five groups.We also used the other 40 SD rats to construct the five groups as the above methods and observed the survival time of the rats.Results The ALT and AST level and portal venous pressure of rats in treatment groups were significantly lower than those in 85% hepatectomy group after 24 h and 48 h(P<0.05 ).But there was no significantly difference between the three treatment groups(P>0.05).Conclusion Splenectomy and somatostatin can decrease the acute hepatic failure induced by 85%hepatectomy on rat,it might be related to reducing portal vein perfusion and pressure and relieving the rat hepatic injury.

目的:分析胆肠吻合术后并发症再手术引流方式及手术处理的体会。方法:回顾性分析2002年8月～2008年2月29例胆肠吻合术后因并发症再手术患者手术引流方式及手术处理。结果:均再次手术,其中18例作局部切开T管引流,5例吻合口拆除重建,4例胆管十二指肠吻合改作胆管空肠Roux-en-Y吻合,2例肿瘤侵犯改作外引流,术后效果优良24例,优良率82.7%。结论:胆肠吻合术宜严格掌握手术适应证,再手术应遵循个体化原则。

Objective To determine the value and reasonable application of slowly coated vicryl plus and albumin gel in primary suture after common BD exploration. Methods The operation was successfully performed in all 45 patients. The incision of common bile duct was directly sewed up by slowly coated vicryl plus and spurted by albumin gel after the exploration. Results There were no complications such as bile leakage and bile duct stricture etc.The mean payment of hospitalization was low 10.5%. Conclusion This method was safe,feasible and effective.

目的:探讨胆总管探查一期缝合在临床上的应用价值。方法:选定胆总管结石33例患者作胆总管探查一期缝合。用4个"0"慢微乔线对胆道切开处作连续一期缝合,局部加用生物蛋白胶。结果:一期缝合22例均无胆瘘发生,术后第2天进食、第3天下床活动;术后第4～5天拔除负压引流管。平均住院天数8.5天,住院费用平均下降10%,随访1年无胆管狭窄发生。结论:胆总管探察一期缝合具有损伤小,恢复快,费用省的特点,掌握好适应证,胆道探查一期缝合是可行的。

目的分析因膀胱肿瘤行根治性膀胱全切后的尿流改道手术方式的选择标准及临床效果。方法选择2001年6月～2008年1月我院因膀胱肿瘤行根治性膀胱全切术后并尿流改道的病例共69例,其中回肠膀胱术37例,回肠新膀胱术32例。就两种尿流改道的术式的手术适应证和并发症进行分析。结果69例手术患者均无围手术期死亡。回肠膀胱术者出现酸中毒、电解质紊乱、肠梗阻近期并发症7例;回肠新膀胱出现近期并发症共6例。回肠新膀胱其中3例需压腹排尿或间断导尿,2例女性出现夜间尿失禁,其余术后能自行排尿。术后复查膀胱镜均未见尿道肿瘤复发。结论接受原位新膀胱患者的生活质量要优于接受非可控性尿流改道的患者,但应根据患者的具体情况来选择合适的尿流改道方式,以减少术后并发症的发生。

Objective To observe the clinical efficacy,adverse effects and quality of life in patients trrated with best supportive care(BSC),single gemcitabine(GEM) and gemcitabine plus carboplatin(CBP) for advanced non-small-cell lung cancer(NSCLC) in the aged.Methods Patients who refused chemotherapy joined the BSC group,and patients receiving chemotherapy were randomly divided into single-agent GEM group and gemcitabine plus carboplatin(GME+CBP) group.Those in single-agent group were given GEM 1 000 mg/m2 on the first day and eighth day,and those in combined group received GEM 1 000 mg/m2 on the first day and eighth day and CBP AUB=4 on the first day.All the drugs were given intravenously for 30 minutes.A cycle is 21 days and each case completed at least two cycles of treatment.Results In short-term effect,the response rate of BSC group was 0,GEM group was 30.3% and GEM+CBP group was 46.7%.The difference was significant(P0.05).The major toxic reaction was bone marrow depression and digestive tract reaction.Although Ⅲ+Ⅳ degree of adverse effects rate of GEM+CBP group was significantly higher than that the GEM group(P0.05),the two groups were well tolerant.The clinical benefit rate of BSC group was 13.2%,GEM group was 48.5% and GEM+CBP group was 50.0%.Two chemotherapy group was superior to BSC Group(P0.05),but the difference was insignificant between the two chemotherapy groups(P0.05).Conclusion Chemotherapy is superior to symptomatic supportive care for advanced non-small-cell lung cancer(NSCLC) in the aged.Gemcitabine plus carboplatin is superior to single gemcitabine,but increases adverse effects and clinical benefit response rate is insignificant.clinical practice,should pay attention to individual treatment.

目的:探讨腹腔镜胆囊切除术(LC)中开展选择性胆道造影技术的临床应用价值。方法:对术中胆道造影60例临床资料进行回顾性分析。结果:术中胆道造影60例,成功55例(91.6%)。术中发现胆管结石6例,胆道解剖异常1例。结论:选择性术中胆道造影显影清晰,可有效降低胆管结石的残余率和胆管损伤的发生率,避免不必要的胆道探查。

目的:观察胰、胆、十二指肠部位肿瘤采用捆绑式吻合术后疗效。方法:胰十二指肠切除26例采用捆绑式胰肠吻合方式。结果:无1例发生胰瘘,无临床死亡病例。结论:捆绑式胰肠吻合术是一种安全可靠的手术方法。