Objective To study the role of long non-coding RNA H19 in the chemosensitivity of colorectal cancer. Methods The colon cancer cell lines stably overexpressed and silenced with lncRNA H19 were constructed and cultured in 5-FU. The expression of H19 was detected by RT-qPCR. The cell proliferation rate was measured by MTT assay. The migration ability of each group was evaluated by scratch test. The protein expressions of MDR1, MRP1 and BCRP were detected by Western blot. Results Compared with normal cells, the expression of lncRNA H19 increased, and the proliferation rate of lncRNA H19 stable overexpression group was significantly higher than that of H19 silencing group. The migration distance in lncRNA H19 stable overexpression group was significantly longer than that in H19 silencing group and the overexpression of bcl-2 protein was down-regulated and bax、MDR1、MRP1 and BCRP was up-regulated in lncRNA H19 stable overexpression group. The expression of bcl-2 protein was up-regulated and the expression of bax、MDR1、MRP1 and BCRP was down-regulated in H19 silencing group. Conclusion Colorectal cancer with high expression of lncRNA H19 reduces the sensitivity of colorectal cancer to chemotherapeutic drugs, and down-regulation of lncRNA H19 expression can improve the curative effect of chemotherapy drugs. Key words: Colorectal neoplasms; lncRNA H19; Chemosensitivity; Long Noncoding RNA; Apoptosis

目的 分析腹腔镜与开腹手术应用于胃肠肿瘤治疗中的疗效.方法 选取我院2012年12月～2017年12月接收胃肠肿瘤患者80例资料予以分析,分成两组;对照组(35例)予以开腹手术,实验组(45例)予以腹腔镜治疗,对比两组效果.结果 实验组出血量(30.20±10.30) mL等术后指标较对照组优;实验组总并发症率4.44％均较对照组低,差异有统计学意义(P＜0.05).结论 将开腹手术用于胃肠肿瘤患者中,可有效改善临床指标以及降低总并发症率,值得临床推广.

Objective:To explore the expression and clinical pathological significances of ERKl, ERK 2 and p-ERK 1/2 by detecting expression of them in colorectal cancer tissues.Methods:120 ca-ses of human colorectal cancer tissues and adjacent tumor tissues were collected in our hospital from 2014-09 to 2016-09.The mRNA expression level was detected using reverse transcription PCR while protein level was detected by Western blotting and immunohistochemistry(IHC),respectively.The cor-relations between the protein level and clinical pathological significances were analyzed.Results:Com-pared with colorectal mucosa tissues,the mRNA expression of ERKl and ERK 2 in cancer tissues were significantly increased,respectively,and related to the level of tumor differentiation.The protein level of ERK 1,ERK 2 and p-ERK 1/2 showed by western blot were also significantly increased in cancer tis-sues.The positive rate of ERK 1,ERK 2 and p-ERK decided by IHC in cancer tissues were 85.0%、79.2%and 81.7%,significantly higher than adjacent tumor tissues,respectively.The high expression of these three proteins was significant correlation with the poor differentiation,high TNM staging,and lym-phatic metastasis.Conclusion:The significantly increased expression of ERKl,ERK 2 and p-ERK 1/2 in colonic and rectal cancer tissues are significantly related to differentiation of tumor cell,lymphatic metastasis and clinical stage.ERK 1/2 and p-ERK 2 may become potential therapeutic targets for the treatment of colorectal cancer.

Colorectal carcinoma is one of the most common gastrointestinal manlignant tumor,the differences of incidence in different areas is obvious,comparing with the more developed countries in the world,our country belong to the low hair area,but with the changing of the lifestyle,its incidence is increasing year by year. Colorectal carcinoma occur hiddenly in early stage and its development is relatively slow,most of the patients who appear the obvious symptoms and see a doctor are already in middle-late stage. The prognosis of colon cancer are relatively good,statistics showing,after the radical surgery,the total five-year survival rate can be more than 50%,and the five-year survival rate of the early diagnostic and postoperative patients can achieve 80% above,and the postoperative late 5 years of survival rate is only about 30%. So early diagnosis and early treatments on the prognosis of patients with colon cancer is particularly important. In this article the roles of cathepsin-D,MMP-9,CD44v6 in colorectal tumors' invasion and metastasis were investigated.

Objective This article aimed to review the diagnosis and management of obturator hernia (OH) patients at our hospital from October 2001 to September 2009 by describing the clinical symptoms,diagnostic modalities,and management. Methods A total of eight patients who underwent surgery for an OH within a 9-year period were included seven aged and thin females with multiple births and one married young female. Results The hospital stay lasted 2 to 24 days with a mean of 12. 5 days. Three cases with complications were observed. One of the patients died from serious postoperative complications. Conclusions Based on our experience,in case vomiting,abdominal or thigh pain,and intestinal obstruction were observed in an aged,thin female with multiple births,the differential diagnosis should include OH. Early diagnosis and timely initiation of treatment reduces the risk of surgical complications and increases the chance of survival.

目的探讨闭孔疝的诊断和治疗方法。方法回顾性分析了我院2001年10月至2009年8月期间收治并经手术证实的8例闭孔疝患者的临床资料。结果 8例均为女性,其中7例是老年、体弱的多产妇,1例是已婚年轻女性。平均年龄74.6岁(46～85岁),平均体重为39.1 kg(34～43 kg),平均生育5胎(1～10胎)。8例患者中5例术前经CT检查确诊而行手术治疗,3例由外院转入者在行急诊剖腹探查术中确诊。7例行坏死小肠切除吻合术,1例行嵌頓小肠复位术。术后4例出现并发症:1例肺炎、1例切口感染、1例低蛋白水肿、1例为酸中毒和低血钾(死亡)。7例痊愈出院,1例死亡。结论闭孔疝缺乏特异性表现,对年老体弱的经产妇出现腹痛、呕吐和股部疼痛应想到闭孔疝的可能;CT检查能提高闭孔疝的诊断率。准确的诊断和及时的手术干预是改善闭孔疝患者预后的关键。

[Objective]To discuss the value of laparoscope in clinical teaching of abdominal surgery.[Methods]Totally 63 five-year undergraduate program students doing clinical practice were divided into 2 groups of laparoscopic-assisted teaching group and traditional teaching group.The tests and questionnaires were adopted to evaluate the teaching effect.[Results]The teaching effect and the degree of satisfaction produced by the laparoscopic-assisted system(92±7)were much better than those of the traditional teaching system(85±16);the difference was significant(t=2.24,P0.05).[Conclusion]With the development of laparoscopic surgery,most operations of abdominal surgeries can be performed through laparoscope.Many video recording of visceral disease can be gathered by laparoscopic video recorder system.Making full use of laparoscopic video information in clinical teaching can provide real,lively,and comprehensive disease-related images for students.It can not only improves the interest of learning but also contributes to the well-understanding of what they have learned.

Objective To explore correlating factors of surgical treatment and prognosis of colorectal signet-ring cell carcinoma.Methods Clinical pathological data and follow-ups were analyzed retrospectively in 62 patients with colorectal signet-ring cell carcinoma hospitalized during January 1988~December 2006.Survival genetic data were evaluated by the Kaplan-Meier methods.Results All the 62 patients underwent rectum surgeries(33 underwent radical resection;19 underwent colostomy or exploratory surgery and 10 underwent palliative resection,diagnosed as signet-ring cell carcinoma,37 of whom underwent postoperatived adjunctive chemotherapy and 55 patients in the group were followed up).Median survival time was 28 months and the meta-survival time of radical incision,palliation incision and non surgical incision were 47,19,10 months respectively.The difference was of statistical significance(P<0.05).Regression analysis revealed that bowel obstruction,vessel tumor embolism,tumor infiltration,lymph node metastasis,operative modus and postoperative adjunctive therapy were independent prognostic factors.Conclusion Prognosis of colorectal signet-ring cell carcinoma tends to be unsatisfactory.Early diagnosis with radical resection and postoperative adjunctive therapy can improve prognosis.

微量元素在人体中起着多种重要的生理功能,许多肝脏疾病的发生,发展与微量元素在机体的变化及两者间的关系,逐渐受到人们的关注,而肝脏作为有许多重要生理功能的人体最大腺体,对微量元素的转运和分布起关键作用.

[Objective]To summarize the experience of diagnosis and surgical treatment of acute gallstone pancreatitis,so as to improve the diagnosis and treatment levels.[Methods]The clinical data of 86 gallstone pancreatitis cases in Inner Mongolia Medical College Affiliated People's Hospital of recent 8 years were retrospectively analyzed.[Results]Emergency surgery was performed on 17 cases of 86 gallstone pancreatitis patients,including cholecystectomy,choledochotomy,T-tube drainage,and pancreatitic capsule incision based on condition of pancreatitis,removaling of pancreatic necrosis lesions,and small omental drainage cavity lavage.For other 69 cases,firstly the conservative treatment was taken firstly,then operations were performed when the inflammation was subsided.[Conclusion]A clear diagnosis of gallstone pancreatitis should be made as soon as possible,the choice of emergency surgery or conservative treatment with following appropriate surgical approach at appropriate time after the subsided inflammation is based on whether there is obvious obstruction of biliary tract or not.The appropriate treatment can control disease development and reduce complications and improve cure rates of the disease.

在经济不发达地区,多数基层医院腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)开展情况并不理想[1],原因是LC的费用较高,而全麻是LC费用增高的原因之一.我院于2006年1月～2008年12月开展了连续硬膜外麻醉下LC 83例,占全部LC的15.9%(83/521).每例平均较气管插管全麻节省1000元以上,显著减少了患者住院治疗费用,取得了满意效果.目前,以腹腔镜为代表的微创外科已经逐渐成熟起来[2-7],现总结如下.

作者总结近年收治的184例老年胆系患者外科治疗情况,就其临床特点,手术时机的选择,手术方式的确定及并发症防治等方面进行了讨论。

<正>为探讨慢性结石性胆囊炎与肝脏损害程度的关系,对3年内因慢性结石性胆囊炎行择期胆囊切除术中60例<60岁患者术中取肝组织进行活检,现将结果分析报道如下。1临床资料1.1病例选择标准①60岁以下;②非急性发

总结了胆管空肠Roux—Y吻合术后再次手术23例资料,占同期此类手术7.5%。经手术证实再手术原因为肝胆管结石复发,前次手术病灶清除不彻底,吻合操作方法不当等。认为行胆管空肠Roux—Y吻合术必须要做到"取尽结石,清除病灶,纠正狭窄,通畅引流"。并对有关的具体问题进行了讨论。

OBJECTIVE:To analyze the results and the prognosis of local excision of lower rectal cancer, and investigate the proper indication of local excision for cure purpose.METHODS:The clinicopathological data of 76 patients with lower rectal cancer treated from February 1985 to October 2007 were analyzed.RESULTS:Sixty-nine patients received transanal excision, 6 cases received trans-sacral excision and 1 case received trans-vaginal excision. Among the cases, 48 cases were ranged as T1 phase, 25 cases as T2, 3 cases as T3. The operation complication rate was 7.9%, and the 30-day mortality rate post operation was 0. The local recurrence rate was 22.4% and the overall 5 year survival rate was 84.5%. The local recurrence was significantly related with T stage and resection margin status. The survival was significantly related with mucinous adenocarcinoma, resection margin status and lymphovascular invasion; and the resection margin and lymphovascular invasion was the independent factors affecting survival.CONCLUSION:Local excision was safe in early stage lower rectal cancer. Careful patient selection is the key of the operation. The proper indication of local excision is T1-2 without high risk factors (high histopathological grade, presence of lymphatic or vascular invasion, mucinous adenocarcinoma); and the cases with T2 phase tumor should undergo chemoradiotherapy after local excision.

[Objective] To explore the method of diagnosing and treating spleen rupture combined with multiple wounds. [Methods]Retrospective analysis was made on the diagnosis and treatment of spleen rupture combined with multiple wounds. [Results]53 cases of spleen rupture combined with multiple wounds were treated with operation, 49 were cured and 4 died. [Conclusion]Operative treatment is an effective method of curing spleen rupture combined with multiple wounds.

目的探讨治疗前列腺增生症(BPH)的有效手术方法。方法采用经尿道前列腺电切术治疗BPH36例。结果患者平均住院6d,留置导尿管平均5.5d,拔管后均排尿通畅。术后随访6~18个月,患者经国际前列腺症状评分(IPSS),平均为9.0分,未出现严重并发症。结论经尿道前列腺电切术是一种并发症少、安全性高、疗效确切的手术方法。

With a reference to the related articles,7cases of acute pancreatitis combined with pancreatic encephalopathy were reveiewed in order to discuss the causes,pathological physiology,clinical symptoms,diagnosis and treatment of pancreatic encephalopathy(PE).The main pathogenesis of PE was large quantity of enzymes,which were secreted by the pancreas,entering the blood and crossing the blood-brain barriers which resulted in cerebral hemorrhage,encephalomalacia,demyelination.That could give rise to neurasthenic syndrome.Pancreatic encephalopathy largely showed no signs of specificity and signs of localization which combined with intracranial hypertension and abnormal electroencephalogram.The author put forward the diagnosis criterion for refernce.The treatment principle was to perform an operation in early stage helping diminish inflammation which could block the subsequent damages associated with it.