目的 探讨在缺氧微环境下Pokemon对肝细胞癌血管形成的影响.方法 选取肝细胞癌细胞株HepG2和Huh7,采用短发夹RNA稳定转染并筛选稳定沉默Pokemon基因表达的肝细胞癌细胞株.通过RT-PCR验证沉默Pokemon之后血管形成相关基因的表达.在缺氧条件下通过Western blot法验证Pokemon基因沉默后缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)表达的影响.结果 成功构建Pokemon干扰质粒.HepG2和Huh7细胞在Pokemon基因沉默后,血管形成相关基因促血管生成素2(angiopoietin-2,ANG2)、血管内皮生长因子A(vascular endothelial growth factor A,VEGFA)以及血管内皮生长因子受体2(vascular endothelial growth factor receptor 2,VEGFR2)的mRNA表达均受到抑制(均P<0.05).在缺氧条件下,HepG2和Huh7细胞在Pokemon基因沉默后HIF-1α蛋白表达均下调(均P<0.05).将HIF-1α质粒瞬转至Hela细胞36 h后,通过Western blot检测发现HIF-1α的表达增加(P<0.05),而Pokemon的表达变化差异没有统计学意义(P>0.05).结论 在缺氧微环境下Pokemon上调HIF-1α表达促进肝细胞癌血管形成,促进肝细胞癌的发生及发展.

Objective To study the function and mechanism of tumor suppressor gene PTEN in colorectal cancer. Methods Colon canc-er cells HT-29 cells were transfected with plasmid of each group,and the concentration of cell suspension in each group was adjusted to 5 ×104 cells/ml. Five groups of experimental group and control group were set up,including overexpression of empty vector group(transfected NC-oe), overexpression group(transfected PTEN-oe),interference empty vector group(transfected NC-sh),interference expression group(transfected PTEN-sh),and control group. qPCR to detect the contents of PTEN gene in samples of colon cancer cell line. The effect of PTEN on the prolif-eration of colon cancer cells was detected by MTT assay. Flow cytometry detection of PTEN on cell cycle and cell apoptosis in colon cance;PTEN recombinants were implanted in the subcutaneous tumor of the axillary posterior part of nude mice. The body weight and tumor size of nude mice were measured regularly after tumor formation. Results Compared with empty vector control group and blank control group,the expression level of PTEN mRNA in the overexpression group was increased and significantly decreased in the interference group. The cell proliferation rate was slowed down in the overexpression group and increased in the overexpression group. The number of cells in S phase was decreased in the overex-pression group and increased significantly in the interfering group. The apoptotic rate of the overexpression group was increased and decreased in the interfering group. The tumor growth was rapid and the nude mice were dead ahead of time in the interference group,the tumor growth was slow in the expression group. Conclusion PTEN gene can inhibit the proliferation and the DNA synthesis of the colorectal cancer cells,promote the apoptosis of colorectal cancer cells. Enhancement of the PTEN gene can provid a new way for the drug therapy of clinical injections of PTEN gene in tumors.

Objective To study the subcellular localization of PEG10 gene in colorectal cancer cells,and explore the role of PEG10 in the invasion and growth of colorectal cancer.Methods Subcellular localization of PEG10 protein was detected by laser scanning confocal microscopy imaging.PEG10-siRNA expression vector was constructed and stably transfected into SW620 cells.The expression of PEG10 gene was detected by Western-blot.The effect of PEG10 on the invasion and growth of SW620 cells was investigate with Transwell assay.Observing The tumor growth was observed when the SW620 cells after PEG10-siRNA was injected in C57BL/6 mice.Results Laser scanning confocal microscopy imaging showed that PEG10 was mainly located in the cytoplasm.The interference plasmid PEG10 was successfully constructed.Transwell cell experiments indicated that siPEG10 inhibited colorectal cancer cell SW620 invasion ability.In vivo,siPEG10 SW620 cells were injected into subcutaneous tumor inhibited colorectal cancer cells growth compared with the control group.Conclusion PEG10 can promoted the invasion and growth of colorectal cancer cell lines in vitro and in vivo.

目的 探讨胶囊内镜对回肠末端溃疡患者的诊断价值.方法 对34例回肠末端溃疡患者行胶囊内镜检查,回顾性分析其镜下表现.结果 34例患者肠道准备条件均比较满意,胶囊内镜排出时间约24～72 h;33例患者顺利完成检查,1例患者电池耗尽未进入结肠,共检出慢性非特异性炎症20例,克罗恩病11例,白塞氏病、嗜酸细胞性胃肠炎各l例.患者在整个检查中无不适反应. 结论 胶囊内镜对回肠末端溃疡患者具有较高的诊断价值,安全性高,不良反应少,易被患者接受,值得推广.

Objective To investigate the expressions and clinical significance of ECHS1 and PKM2 proteins in cholangiocarcinoma.Methods The expressions of ECHS1 and PKM2 in cholangiocarcinoma tissues and paracancerous normal bile duct tissues were detected.The relationship of expressions of ECHS1 and PKM2 proteins with clinical pathology features and prognosis of cholangiocarcinoma were analyzed.Results The positive rates of ECHS1 and PKM2 proteins were significantly higher in cholangiocarcinoma than those in normal tissues (58.8% vs 17.9%, 64.7% vs 21.4%, P<0.05).The expressions of ECHS1 and PKM2 proteins in cholangiocarcinoma were not related with sex, age and tumor size (P>0.05).However, they were related with the differentiation grade, TNM stage and postoperative survival time (P<0.05).Conclusion Both ECHS1 and PKM2 poteins may play important roles in the occurrence and development of cholangiocarcinoma.

Objective To investigate the expression of the phosphatase and tensin homolog (PTEN), vascular endo-thelial growth factor-A (VEGF-A) and microvessel density (MVD) in colorectal cancer tissues, and analyze the associa-tion with clinical pathology. Method Immunohistochemical SP method was applied to detect the expression of PTEN and VEGF-A in 50 samples of colorectal cancer and normal intestinal mucosa, while the endothelial cells were deter-mined by CD31 staining, and then the association between the indexes and clinicopathological parameters was investigat-ed. Result PTEN and VEGF-A protein expression and MVD value in colorectal cancer tissues were significantly differ-ent with those in normal adjacent tissues (P<0.05);and the expression of PTEN and VEGF-A, as well as the MVD were closely related with patients’age, depth of invasion, clinical stage, lymph node metastasis, and distant metastasis (P<0.05). Conclusion The expression of PTEN, VEGF-A and MVD is associated with the occurrence, development, inva-sion, and distant metastasis of colorectal cancer. The combined detection of PTEN and VEGF-A and MVD facilitates a precise evaluation of the invasion and metastasis of colorectal cancer, and is a practical adjuvant diagnostic instrument in assessing the clinical pathology of colorectal cancer.

目的 比较经口内镜下肌切开术(peroral esophageal myotomy,POEM)与腹腔镜Heller手术治疗贲门失驰缓症的临床疗效.方法 收集中国人民解放军第1 74医院2004年1月-2013年2月收治的贲门失弛缓症患者,根据手术方式,分为POME组和腹腔镜Heller手术组(腹腔镜组),比较两组治疗后临床症状缓解率、食管最大宽度下降幅度、并发症发生率及复发率.结果 共纳入60例贲门失驰缓症患者,POME组27例,腹腔镜组33例,术后随访1个月,两组症状均明显缓解,食管最大宽度下降幅度分别为(2.5±1.2)cm、(2.2±1.3) cm,两组相比,差异无统计学意义(P＞0.05).POEM组出现2例(7.4％)并发症,腹腔镜Heller手术组出现2例(6.1％)并发症,两组相比,差异无统计学意义(P＞005).随访1个月后POEM组出现2例(7.4％)胃食管反流病患者,随访1年2例(7.4％)复发,腹腔镜组术后未出现明显不适,两组术后并发症发生率和复发率相比,差异均无统计学意义(P＞0.05).结论 腹腔镜Heller手术与POME治疗贲门失弛缓症有效性及安全性相当.

[目的]探讨内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗胃肠间质瘤(gastrointestinal stromal tumors,GIST)的疗效.[方法]回顾性分析运用ESD治疗的27例GIST患者的临床资料.[结果]27例均为单发肿瘤,直径为5～30(16±8)mm,其中位于胃底部13例,胃体8例,胃窦部3例,贲门部2例,直肠1例.27例均内镜下成功完成手术,手术时间为35～180(75±43.6)min,术中出血量较少,平均(10±8.2)ml,4例术中出现穿孔,其中1例主动穿孔行内镜下胃壁全层切除术,均予金属夹成功夹闭.术后病理提示26例为GIST,1例为平滑肌瘤.术后随访6～24个月,所有患者未见肿瘤复发及转移.[结论]ESD治疗GIST是安全、有效的.

【Objective】To investigate the procedure,efficacy and safety of endoscopic implantation with anti-tumor drug seeds for the treatment of advanced rectal carcinoma【.Methods】With informed consent, 54 patients of advanced rectal carcinoma were enrolled to be randomly divided into 4 groups to receive respective treatment, including symptomatic treatment, oral chemotherapy with capecitabine, endoscopic 5-fluorouracil (5-Fu) seed implantation, or combination therapy with oral capecitabine and 5-Fu seed implantation. The inhibition of tumor grow, incidence of intestinal obstruction, 1-year or 2-year survival rate, adverse effects and complications in the groups with different treatments were observed and analyzed. 【Results】Endoscopic 5-Fu seed implantation was tolerated by patients without apparent adverse effects and complications. The objective response rate was 54.5% in 5-Fu seeds implantation group, close to 58.8% in oral chemotherapy group. Moreover, incidences of intestinal obstruction (27.3%, 20.0%) were significantly decreased in 5-Fu seed implantation group and combination therapy group. Compared to the symptomatic treatment group, 2-year survival rates (35.3%, 36.4%, 40.0%) were not significantly improved in oral chemotherapy, 5-Fu seed implantation and combination treatment groups, but 1-year survival rates (64.7%, 63.6%, 80.0%) were significantly elevated. 【Conclusion】Endoscopic anti-tumor drug seed implantation is a convenient, better-tolerated, efficacious treatment for advanced rectal carcinoma patients with few adverse effects and complications.

AIM: To screen the differential expressed genes in colorectal cancer and polyp tissue samples.METHODS: Tissue specimens containing 16 cases of colorectal adenocarcinoma and colorectal polyp vs normal mucosae were collected and subjected to cDNA microarray and bioinformatical analyses. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to confirm some of the cDNA microarray data.RESULTS: The experimental data showed that eight genes were differentially expressed, most of which were upregulated in adenomatous polyp lesions. Forty-six genes expressions were altered in colorectal cancers, of which 29 were upregulated and 17 downregulated, as compared to the normal mucosae. In addition, 18 genes were similarly altered in both adenomatous polyps and colorectal cancer. qRT-PCR analyses confirmed the cDNA microarray data for four of those 18 genes: MTA1, PDCD4, TSC1 and PDGFRA.CONCLUSION: These differentially expressed genes likely represent biomarkers for early detection of colorectal cancer and may be potential therapeutic targets after confirmed by further studies. (C) 2012 Baishideng. All rights reserved.

<正>病例1,男,32岁。拟行纤维肠镜常规体检,遵医嘱口服20%甘露醇250 ml,之后饮矿泉水2 000 ml,0.5 h后突然出现腹胀、腹痛,伴肛门排气,解成形便1次,量约200 g,症状逐渐加重,无呕吐,遂行腹部立位片示小肠高位气液平。诊断:假性肠梗阻,予密切观察及补液(未行胃肠减

目的:总结食管裂孔疝的诊治体会.方法:回顾性分析16例食管裂孔疝患者的临床资料.结果:16例均痊愈,治愈率达100%.结论:X线钡餐造影检查是诊断食管裂孔疝的主要手段,结合胃镜检查可确定食管裂孔疝的类型,采用内科或手术治疗可治愈.

<正>病人,男,44岁。于4个月前吵架后情绪低落,企图自杀,吞服多根铁条,长短及大小不一,当时未出现特殊不适。3个月后出现中上腹部疼痛,呈阵发性针刺样,弯腰或蜷缩位可缓解,伴腹胀、心悸不适,无黑便、发热。就诊于多家医院,查腹部立位片示胃内多根长条形异物,均建议

The aim of the study was to screen the differentially expressed genes of Peutz-Jeghers syndrome (PJS) and colorectal carcinoma (CRC).

<正>1病例资料女,44岁。因右上腹痛伴发热15 d就诊。门诊肝脏CT平扫示:肝实质内多发性低密度灶,CT值10~50 Hu,以右肝顶病灶最大,7.0 cm×7.8 cm大小,中央可见大片状低密度坏死区,周围为厚壁影,边界较清楚,印象:多发性肝脓肿。收入院。查体:体温39.3℃,脉搏96/min,呼吸24/min,血压120/70 mmHg。发热面容,皮肤、巩膜无

<正>2008年11月—2010年10月我院内镜室分别采用皮圈套扎、氩气刀治疗直径10 mm以下消化道息肉186例,现将这两种方法的疗效报告如下。1资料与方法1.1一般资料186例(196枚息肉)中,男112例,女74例;年龄9～77岁;经内镜及病理诊断炎性息肉31例,腺瘤性息肉126例,幼年性息肉9例,其他20例;单发149例,多发37例;其中息肉直径<5 mm 71例(38.17%)、6～10mm 115例(61.83%);息肉位于食管19例、胃69例、十二指肠13例、结肠72例、直肠13例。分为两组,每组93例。

Objective To investigate the value of simeticone in gastroscopy examination. Methods Two hundred and forty patients in our hospital were randomly divided into group A and B,group A were taken by simeticone,group B was the control group.The level of gastrointestinal air bubbles,cleanness and satisfaction of endoscopists during inspection were observed. Results The air bubbles in group A was significantly lower than that in group B,the difference was statistically significant(χ2=4.36;P0.05);the cleanness in group A was higher than that in group B,the difference was statistically significant(χ2=6.11;P0.05);the satisfaction of endoscopists in group A was higher than that in group B,the difference was statistically significant(χ2=4.85;P0.05). Conclusion Simeticone obtained obviously value in the gastroscopy examination.

Objective To compare the efficacy of three different ways in treatment of the advanced colorectal carcinoma.Methods One hundred and twenty patients with advanced colorectal carcinoma were randomly divided into three groups.Group A were underwent intravenous chemotherapy;Group B were orally taken by the capecitabine;and the group C were done with 5-FU implantation.1,2-year survival rates,complication rate and efficacy were observed.Results 1,2-year survival rates of groups A,B and C were 77.50%,60.00%;70.00%,50.50%;75.00%,57.50%.Survival rates of groups A and C were higher than that of group B,the difference was statistically significant(χ2=6.11,P0.05).Complication rates of three groups were 72.50%,70.00%,15.00%,which group C was lower than groups A and B,the difference was statistically significant(χ2=6.83,P0.05).The efficacy of three groups were 85.00%,67.50%,92.50%,which group B was lower than groups A and C,the difference was statistically significant(χ2=6.29,P0.05).Conclusion 5-FU implantation is better than intravenous chemotherapy and oral chemotherapy in the treatment of advanced colorectal carcinoma.

目的试探性研究OMOM胶囊内镜适宜的肠道准备方法。方法将我院104例胶囊内镜检查者,随机分为6组,分别采用6种不同肠道准备方法,观察比较、分析其不良反应、通过时间及检查阳性率。结果口服恒康正清及肌注胃复安后不良反应少、通过时间短及检查阳性率明显提高(P<0.05),差异有统计学意义。结论口服恒康正清及肌注胃复安是OMOM胶囊内镜检查肠道准备适宜方法。