目的 观察过表达CDX2基因对人结肠癌细胞株增殖影响,并初步探讨其作用机制.方法 通过基因转染技术将CDX2基因转染入结肠癌HT-29细胞株,经G418筛选后获得稳定转染细胞株,RT-PCR和Western blot检测CDX2基因表达.采用四甲基偶氮唑盐(MTT)法、流式细胞仪分析转染细胞的生物学行为.Western blot检测CDX2过表达对HT-29细胞内Cyclin D1和NF-κB磷酸化水平的影响.结果 经脂质体转染和筛选,建立了稳定过表达CDX2人结肠癌HT-29细胞株.转染CDX2组与未转染组和空白质粒组相比,细胞的生长速度减慢(P<0.05),细胞周期中G1/G0期比例增加(P<0.05),而S期比例则减少(P<0.05);与未转染组和空白质粒组比较,转染CDX2基因组HT-29细胞的Cyclin D1和p-NF-κB活性明显降低.结论 CDX2基因可能通过抑制NF-κB通路抑制Cyclin D1活性,从而抑制人结肠癌HT-29细胞增殖.

目的:观察并研究克拉霉素、阿莫西林、兰索拉唑三联疗法联合瑞巴派特治疗老年消化性胃溃疡的临床效果,并观察胃黏膜形态学变化.方法:随机纳入105例老年消化性胃溃疡患者并分为三联组(53例)与瑞巴派特组(52例),两组均给予克拉霉素+阿莫西林+兰索拉唑联合治疗,瑞巴派特组在此基础上加用瑞巴派特,观察两组的临床疗效.结果:治疗前两组胃黏膜形态学指标无显著性差异(P＞0.05);治疗后8周时瑞巴派特组胃黏膜形态学指标有显著改善,治疗总有效率为98.1％,与三联组相比差异显著(P＜0.05).结论:在克拉霉素、阿莫西林、兰索拉唑三联用药基础上加用瑞巴派特治疗老年消化性胃溃疡效果确切,可有效改善胃黏膜形态学指标,值得推广应用.

门诊接诊了一名11岁男孩，自今年2月以来，出现不明原因的反酸、厌食、呕吐、食后胃部有轻微疼痛感，时轻时重，偶有腹胀、排便不畅感，起初家长不够重视，以为是常吃零食所致。3月6日，发现男孩精神不振，体重减轻3公斤，以为患上大病，这才来医院就诊。经检查，无任何器质性病变。追问病史，去年10月，在男孩10岁生日时，他姑姑送了一部手机给他，从此如获珍宝，每天与手机为伴，游戏水平档次不断升级，疑为因手机导致胃肠功能紊乱所引起的，嘱咐停玩手机一个月来院复查，服中药调理，4月8日来院检查，男孩一切恢复如前。

Objective To investigate the expression of tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in the patients with inflammatory bowel disease(IBD),and to analyze their correlation with endoscopic disease activity.Methods 63 cases of IBD were selected and divided into the group A[Crohn′s disease(CD),40 cases] and B[ulcerative colitis(UC),23 cases],other 30 healthy individuals were included as the group C.The enzyme-linked immunosorbent assay(ELISA) was adopted to detect the expression of plasma TNF-α and IL-8 in 3 groups,meanwhile the enteroscopic examination was performed.Results Compared with the group C,the expression of plasma TNF-α and IL-8 in the group A and B were significantly increased,the difference showing statistical significance(P<0.05),and which revealed the correlation with the endoscopic disease activity index(P<0.05).Conclusion The increased expression of plasma TNF-α and IL-8 in IBD has some relation with the disease activity reflected by endoscopy.

目的:研究非甾体类抗炎药（NSAID）塞来昔布对胃癌细胞MGC-803的抑制作用和对RECK、MMP-2、MMP-9基因表达的影响,以探讨塞来昔布的抗肿瘤机制.方法:培养胃癌MGC-803细胞,实验用不同浓度的塞来昔布（25、50、100μg/L）分别处理MGC-803细胞不同时间（12、24 h、48 h）,无血清培养基饥饿24 h达同步化后,MTT（噻唑蓝比色法）观察MGC-803细胞增殖;RT-PCR法检测细胞周期调控因子MMP-9、MMP-2、RECK mRNA的表达;Western blot法检测MMP-9、MMP-2、RECK mRNA蛋白的表达.结果:M T T法显示塞来昔布能抑制胃癌MGC-803细胞增殖,作用12 h时,随着塞来昔布处理浓度的增高,其抑制作用不明显,组间比较差异不显著（P＞0.05）,在作用24、48 h时呈浓度依赖性（25-100μg/L）,在25、50、100μg/L作用浓度呈时间依赖性（24-48 h）.塞来昔布在100μg/L浓度作用细胞48 h时抑制.RT-PCR法检测结果显示,在12 h的作用时间点,随着塞来昔布处理浓度的增高,RECK基因及MMP-2、MMP-9 mRNA变化不是很明显,组间比较无显著差异（P＞0.05）,在12 h后,塞来昔布能增加胃癌细胞RECK mRNA和蛋白表达,作用呈浓度（25-100μg/L）和时间依赖性（24-48h）,MMP-2、MMP-9表达则下降.Western blot法检测结果显示,作用12 h时,随着塞来昔布处理浓度的增高,其RECK蛋白及MMP-2,MMP-9蛋白改变不明显,组间比较差异不显著（P＞0.05）,在12 h以后,塞来昔布能增加RECKmRNA和蛋白表达并减少MMP-2、MMP-9表达,且作用呈浓度依赖性和时间依赖.结论:塞来昔布可抑制人胃癌MGC-803细胞增殖与转移;其可能是通过上调RECK基因,进而下调MMP-2、MMP-9来抑制胃癌细胞MGC-803的增殖与转移.

AIM: To explore the antitumor mechanisms of celecoxib by investigating the impact of non-steroidal anti-inflammatory drug (NSAID) celecoxib on the expression of RECK, MMP-2 and MMP-9 in human gastric cancer cell line MGC-803. METHODS: MGC-803 cells were starved in serum-free medium for 24 h and treated with different concentrations of celecoxib (25, 50, and 100 μg/L) for different durations (12, 24, and 48 h). Cell proliferation was determined by MTT assay. The expression of MMP-9, MMP-2 and RECK mRNAs and proteins was detected by RT-PCR and Western blot, respectively. RESULTS: Celecoxib inhibited MGC-803 cell proliferation in a concentration-dependent manner at 24 and 48 h but not at 12 h. The inhibitory effect was also time-dependent. Cell proliferation was mostly inhibited after treatment with celecoxib at a concentration of 100 μg/L for 48 h. The expression of RECK, MMP-2 and MMP-9 mRNAs showed no significant differences (all P > 0.05) among cells treated with different concentrations of celecoxib for 12 h. After 12 h, celecoxib increased RECK mRNA expression in a concentration- and time-dependent manner, but decreased the expression of MMP-2 and MMP-9. Similar results were also obtained for RECK, MMP-2 and MMP-9 protein expression. CONCLUSION: Celecoxib inhibits the proliferation and metastasis of MGC-803 cells possibly via mechanisms associated with up-regulation of RECK expression and down-regulation of MMP-2 and MMP-9 expression.

目的:探讨中老年缺铁性贫血(IDA)的病因及临床特点。方法:采用回顾性分析方法。结果:中老年组IDA患者以消化道恶性肿瘤为病因占26.9%,明显高于青年组2.7%(P<0.01)。中老年组重度贫血比例(48.72%)明显高于青年组(23.64%)(P<0.01)。结论:中老年IDA患者贫血程度较重,对中老年IDA患者应高度警惕消化道恶性肿瘤。

【Objective】To assess the efficacy,safety and gastric sensory function of tegaserod in the treatment of functional dyspepsia(FD) and to compare with those of oryzanol.【Methods】 One hundred and six patients who were in line with the Rome Ⅱcriteria for FD were randomly divided into two groups,each for 53 cases.The experimental group was given tegaserod 6 mg bid for two weeks,and the control group was given oryzanol 20 mg tid.Efficacy was assessed by patients' perception of overall symptoms of FD,and total effective rate and water load tests were studied before and after treatment.【Results】 After 2-week treatment,there were significant differences between experimental group and control group in the total symptom.There were significant differences in the total symptom scores between pre-and post-treatment in experimental group(P0.05).Both first satiety and full satiety evoked by drinking water were increased in experimental group after treatment(P0.05).The total effective rate was significant difference between two groups(P0.01).【Conclusion】 Tegaserod is an effective and safe drug in the treatment of functional dyspepsia.

非糜烂性反流病(NERD),也称作内镜阴性反流病(ENRD)或症状性胃食管反流病,占胃食管反流病(GERD)的50%～70%[1].我国北京、上海的一项调查报告显示,NERD约占GERD的67%[2],其发病机制与酸有明显的相关性.作者通过监测70例NERD患者24 h PH值并与RE患者、正常对照组比较,分析NERD患者酸暴露特点及其对临床诊治的意义.

[Objective] To observe the changes of serum endotoxin and TNF-α,interleukin-6 levels before and after treatment combined with beifeida and Lactulose in patients with liver cirrhosis and to observe the incidence of spontaneous bacterial peritonitis(SBP)and to find a method that can more efficient to reduce the incidence of SBP.[Methods]100 hundred patients were included in the study.Patients in controll Group A(n=50)were given conventional treatment such as protecting the liver,supplement human albumin and uragogue.Patients in treament Group B(n=50)were given both beifeida tid po and Lactulose bid po on the basis of conventional treatment for three months.[Results]Serum endotoxin,TNF-αand interleukin-6 levels in Group A were not significantly changed after treatment,but SBP incidence was higher than Group B.At Group B,serum endotoxin,TNF-α,interleukin-6 levels and SBP incidence significantly droped,the difference was significant at statistics as compared with Group A.[Conclusion] The treatment combined with beifeida and Lactulose can effectively reduce serum endotoxin,TNF-α and interleukin-6 levels,and also can significantly reduce the incidence of SBP.

目的探讨肿瘤科护士心理压力与心理健康状况、个性特征的相关性.方法整群抽取112名湖南省株洲市四所医院肿瘤科护士为研究对象,其它临床科护士120名为对照.采用心身压力测试量表、症状自评量表、艾森克个性问卷对两组进行评定分析.结果研究组58.93%心理压力程度高,对照组49.17%心理压力程度高;研究组心理压力积蓄高于对照组(P＜0.05).症状自评量表总分及阳性项目数研究组高于对照组,而两组又明显高于全国常模组(P＜0.01或P＜0.05);心身压力测试量表、症状自评量表总均分与艾森克个性问卷P、N量表分呈显著正相关,与E量表分呈显著负相关.结论肿瘤科护士心理压力程度与其个性特征及心理健康状况密切相关.在开展心理健康教育的同时,给予人文关怀是医院管理中不可忽视的内容.

目的:研究湘潭制槟榔与幽门螺旋杆菌感染相关关系.方法:首先随机对1 914例工矿、城市人口进行流行学调查,了解嚼槟榔与上消化道症状的分布情况.之后,从上述1914例中随机抽取105例无临床症状的人群分成食槟榔组55例,不食组50例,做血清抗H pylori-IgG检查;另外,在内镜室对1 814例有消化道症状的患者随机分成嚼湘潭制槟榔实验组956例和不嚼者的对照组858例.然后,通过胃镜对每位患者进行镜下胃窦部取2-3块标本做尿素酶检测,并进行实验室体外Hpylori抑菌试验.在临床上快速尿素酶、病理切片、涂片方法找Hpylori,其中上述三项中两项为阳性者为Hpylori阳性,共60例,分成治疗组及对照组各30例,治疗组用湘潭制槟榔每日8-50 g,对照组用传统三联(铋剂+氨苄青霉素+甲硝唑),治疗2 wk,停药后1 mo复查14C呼气试验.结果:流行学调查,1 914例中嚼槟榔1 236例,有上消化道症状的383例(占30.99%),且有上消化道症状的人中有嚼槟榔后缓解的153例(占39.34%),而不嚼槟榔者678例,有上消化道症状的215例(占31.7l%);血清学调查,嚼槟榔组55例中,抗Hpylori-IgG阴性者43例(占78.18%)、阳性12例(占21.82%),不嚼食50例抗Hpylori-IgG阴性者22例(占44%),阳性28例(占56%).另外,内镜调查,两组1 814例中,实验组Hpylori阳性率26.46%,对照组71.95%(P＜0.005).体外小剂量湘潭制槟榔对幽门螺旋杆菌有明显的杀灭作用.临床60例Hpylori感染患者中,治疗组30例,其中17例Hpylori阴性(占56.67%),对照组30例中Hpylori阴性21例(占70%),两组对此无明显差异(P＞0.05),证明体内试验湘潭制槟榔与传统三联疗效基本相近.结论:湘潭制槟榔对幽门螺旋杆菌有很强的抑菌作用.

Objective: To explore the effect of rifampicin on overnight 1.5 mg dexamethasone suppression test and its recovery after rifampicin with drawal. Methods: The test was performed before, at 0, 1, 2 and 3 weeks, respectively, after rifampicin treatment (450 mg/d, for 10 days) in 25 patients with pulmonary tuberculosis. Results: Rifampicin therapy rendered the tests abnormal (plasma cortisol (349±105) vs. (326±100) nmol/L, P0.05). In all patients with normal overnight 1.5 mg dexamethasone suppression test [(371±110) vs. (57±29) nmol/L, P0.001] before rifampicin treatment. After rifampicin with drawal, the tests were (356±105) vs. (243±88), at the 1st week (P0.05), (340±102) vs. (97±35), at the 2nd week (P0.01) and (352±107) vs. (64±33), at the 3rd week (P0.01), and the corresponding normal tests were 24.0%, 79.2% and 95.2%, respectively. Conclusion: The results show that overnight 1.5 mg dexamethasone suppression test has no clinical value in diagnosing cushing′s syndrome during treatment with rifampicin and it is prudent to discontinue rifampicin therapy for 3 weeks at least before performance of the test if necessary.

Objective:To investigate the effect of thyroidectomy on serum ionized calcium(Ca 2+ )and phosphorus(P).Methods:Serum Ca 2+ and P concentrations were measured before,at the first day,the first,second weeks after thyroidectomy in25patients with thyroid disease.Results:The levels of serum Ca 2+ and P at all time points after thyroidectomy were not significantly different from those before the operation respec-tively.In8patients with suspicious hypocalcemia after thyroidectomy,their serum Ca 2+ concentrations at the first day after the operation were significantly lower than those before throidectomy[(1.04±0.07)mmol/L vs.(1.13±0.12)mmol/L,P≈0.05],and after1week,rose to level before the operation.Serum P levels did not change markedly during this study.Conclusions:These results show that the effects of thyroidectomy on serum Ca 2+ are slight and temporary,and the operation takes no significant effect on serum P.

目的本文针对湘潭制槟榔与幽门螺杆菌(Hp)感染关系进行研究.方法我们首先随机将105例无临床症状的人群分成食槟榔组55例,不食者50例,做血清抗Hp-IgG检查;男外,在内镜室对1814例有消化道症状的城乡人群随机分成嚼湘潭制槟榔观察组956例和不嚼者的对照组858例.然后,通过内镜对每位患者进行镜下胃窦部取2～3块标本做尿素酶检测,并进行实验室体Hp抑菌试验.结果血清学调查,嚼槟榔组55例中,抗Hp-IgG阴性者43例(占78.18%)、阳性者12例(占21.82%),不嚼食50例抗Hp-IgG阴性者22例(占44%),阳性28例(占56%).另外,内镜调查,两组1814例中,观察组Hp阳性率26.46%,对照组71.95%(P<0.005).体外小剂量湘潭制槟榔对Hp有明显的杀灭作用.结论湘潭制槟榔对Hp有很强的抑菌作用.

缺铁性贫血(IDA)是一种常见的营养缺乏症,在我国发病率相当高.本病既往常用硫酸亚铁治疗,但因其消化道反应大而使一些病人不能坚持治疗.近几年来,作者使用右旋糖酐铁片口服治疗IDA,,获得满意疗效,且副作用少见,现报道如下.

幽门螺旋杆菌(Helicobacter Pylori,HP)与慢性胃炎(CG)、消化性溃疡(PU)复发,发展关系很明确,而且,HP也是胃癌的一个重要致病因素[1].目前,国内外学者都积极寻找根治HP的方法.