简介：例1男，17岁，因“右上腹疼痛伴发烧5天”入院。5天前无诱因右上腹疼痛，慢性钝痛持续性加剧、畏寒、发烧。查体：T39．0℃，皮肤粘膜无黄染；腹平、软，右上腹深压痛，无反跳痛，Murphy，S征(-)，肝区叩痛。B超：肝脏中部脏面探及-7×3cm大小囊性肿物，囊壁较厚，内有数块大小不等的强回声光团，正常胆囊位置未探及胆囊。输液、应用抗生素治疗两

简介：柿石是最常见的植物性类石,多形成于胃内,并可进入十二指肠和空肠。而食管柿石症较少见,我院在胃镜检查中发现2例,并成功地经胃镜取出,现报告如下。例1:患者,女,78岁,因吞咽困难10天于1996年3月4日入院。入院前15天患者食柿子2个后逐渐出现吞咽困难,进食后呕吐,当地地区医院拟诊“食道癌”遂来我院。体检无阳性发现。纤维胃镜插入35cm见4.0cm×3.5cm×3.5cm大小褐

简介：肝性皮质盲又称肝脑眼综合症,是终末期肝病合并肝性脑病的一种特殊表现,临床较少见。我院在近期收治2例,现报告如下：病例摘要例1女性,32岁。

简介：例1，女，58岁，发现右腹部包块3天入院。主要表现为腹胀、纳差。查体：腹部膨胀，右上腹触及一约15cm×15cm×15cm大的包块，质稍硬，活动度小，与周围边界不清，触之无压痛。腹部揉面感。实验室检查：血白细胞5．9×10^9/L，中性0．73，淋巴0．27；尿镜检正常；肝功、尿素氮均正常；B超示腹膜后肿瘤。初步诊断为腹膜后肿瘤。

简介：AIMTodeterminetheroleofcorticotropinreleasingfactorreceptor(CRF2)inepithelialpermeabilityandenterocytecelldifferentiation.METHODSForthispurpose,weusedratSpragueDawleyandvariouscoloncarcinomacelllines(SW620,HCT8R,HT-29andCaco-2celllines).ExpressionofCRF2proteinwasanalyzedbyfluorescentimmunolabelinginnormalratcolonandthenbywesternblotindissociatedcolonicepithelialcellsandinthelysatesofcoloncarcinomacelllinesorduringtheearlydifferentiationofHT-29cells(tenfirstdays).ToassesstheimpactofCRF2signalingoncoloniccelldifferentiation,HT-29andCaco-2cellswereexposedtoUrocortin3recombinantproteins(Ucn3,100nmol/L).Insomeexperiments,cellswerepre-exposedtotheastressin2b(A2b)aCRF2antagonistinordertoinhibittheactionofUcn3.Intestinalcelldifferentiationwasfirstanalyzedbyfunctionalassays:thetrans-cellularpermeabilityandthepara-cellularpermeabilityweredeterminedbyDextran-FITCintakeandmeasureofthetransepithelialelectricalresistancerespectively.Morphologicalmodificationsassociatedtoepithelialdysfunctionwereanalyzedbyconfocalmicroscopyafterfluorescentlabelingofactin(phaloidin-TRITC)andintercellularadhesionproteinssuchasE-cadherin,p120ctn,occludinandZO-1.Theestablishmentofmatureadherensjunctions(AJ)wasmonitoredbyfollowingthedistributionofAJproteinsinlipidraftfractions,afterseparationofcelllysatesonsucrosegradients.Finally,themRNAandtheproteinexpressionlevelsofcharacteristicmarkersofintestinalepithelialcell(IEC)differentiationsuchasthetranscriptionalfactorkrüppel-likefactor4(KLF4)orthedipeptidylpeptidaseIV(DPPIV)wereperformedbyRT-PCRandwesternblotrespectively.ThespecificactivitiesofDPPIVandalkalinephosphatase(AP)enzymesweredeterminedbyacolorimetricmethod.RESULTSCRF2proteinispreferentiallyexpressedinundifferentiatedepithelialcellsfromthecryptsofcolonandinhumancoloncarcinoma

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简介：Medicaltherapyfortype2diabetesmellitusisineffectiveinthelongtermduetotheprogressivenatureofthedisease,whichrequiresincreasingmedicationdosesandpolypharmacy.Conversely,bariatricsurgeryhasemergedasacost-effectivestrategyforobesediabeticindividuals;ithaslowcomplicationratesandresultsindurableweightloss,glycemiccontrolandimprovementsinthequalityoflife,obesity-relatedco-morbidityandoverallsurvival.Thefindingthatglucosehomeostasiscanbeachievedwithaweightloss-independentmechanismimmediatelyafterbariatricsurgery,especiallygastricbypass,hasledtotheparadigmofmetabolicsurgery.However,theprimaryfocusofmetabolicsurgeryisthealterationofthephysio-anatomyofthegastrointestinaltracttoachieveglycemiccontrol,metaboliccontrolandcardio-metabolicriskreduction.Todate,metabolicsurgeryisstillnotwelldefined,asitisusedmostfrequentlyforlessobesepatientswithpoorlycontrolleddiabetes.Themechanismofglycemiccontrolisstillincompletelyunderstood.Publishedresearchfindingsonmetabolicsurgeryarepromising,butmanyaspectsstillneedtobedefined.Thispaperexaminestheproposedmechanismofdiabetesremission,theefficacyofdifferenttypesofmetabolicprocedures,thedurabilityofglucosecontrol,andtherisksandcomplicationsassociatedwiththisprocedure.Weproposeatailoredapproachfortheselectionoftheidealmetabolicprocedurefordifferentgroupsofpatients,consideringtheindicationsandprognosticfactorsfordiabetesremission.

简介：目的探讨微小RNA-363(miR-363)靶向调控E2F转录因子3(E2F3)的表达对HepG2细胞增殖和凋亡的影响。方法体外培养HepG2细胞,采用Lipofectamine法将miR-363抑制剂或其阴性对照转染到HepG2细胞,继续培养48h,收获细胞,采用四噻唑蓝(MTT)法测定细胞增殖率,使用流式细胞术法检测细胞凋亡率,采用实时荧光RT-PCR法检测HepG2细胞miR-363mRNA水平,采用WesternBlot法检测HepG2细胞E2F3、BAX和Caspase-3蛋白表达水平。结果对照组HepG2细胞增殖率为(96.4±9.7)%,显著高于抑制剂处理组【(72.3±6.5)%,P<0.05】,凋亡率为(8.2±1.4)%,显著低于抑制剂处理组【(9.7±0.8)%,P<0.05】;对照组HepG2细胞miR-363mRNA相对水平为(1.0±0.1),显著高于抑制剂处理组【(0.6±0.2),P<0.05】,E2F3蛋白表达量为(1.0±0.1),显著高于抑制剂处理组【(0.6±0.1),P<0.05】,而对照组HepG2细胞Bax和Caspase-3蛋白表达量分别为(0.4±0.0)和(0.5±0.1),均显著低于抑制剂处理组【(0.6±0.1)和(0.7±0.0),P均<0.05】。结论miR-363可靶向调控E2F3的表达,抑制HepG2细胞增殖,诱导其凋亡。本研究结果为肝癌靶向治疗提供了一定的理论依据。

简介：病例1：患者女性,42岁,因＂间断腹泻18年,加重伴呕吐2个月＂于2010-09-16就诊于北京协和医院。18年前因进食生冷食物出现腹泻,为黄色水样便,量约300~500mL/次,每日5~6次,因夜间腹泻而影响睡眠,伴脐周胀痛,便后缓解,无黏液脓血便,无发热。外院曾考虑＂胃肠炎＂、＂肠易激综合征（IBS）＂,予止泻等对症治疗后好转。此后间断发作类似腹泻,每1~2周1次。

简介：瞄准：Disabled-2(DAB2)是在卵巢的癌症识别否定地影响生长因素和块地岬活动的致有丝分裂信号转导变异的候选人tumor-suppressor基因。在最近的研究，我们用cDNA在ESCC观察了DAB2抄本的下面规定微数组。在现在的学习，我们试图在食道的肿瘤发生决定DAB2蛋白质的损失的临床的意义，假设那个DAB2倡导者调停hypermethylation的基因silencing可以说明蛋白质的损失。方法：DAB2表示被免疫组织化学在50主要食道的有鳞的房间分析癌(ESCC)，30不同增生，15发育异常和10非恶意的食道的纸巾。决定倡导者hypermethylation是否在ESCC贡献DAB2表示的损失，DAB2倡导者的甲基化地位用methylation特定的PCR在DAB2免疫否定的肿瘤被分析。结果：DAB2蛋白质的损失在5/30(17%)被观察增生，10/15(67%)发育异常和34/50(68%)ESCC。DAB2蛋白质的重要损失从食道的正常粘膜被观察到增生，发育异常和侵略癌症(P(趋势)<0.001)。DAB2的倡导者hypermethylation在10中的2个被观察(20%)DAB2免疫否定的ESCC。结论：DAB2蛋白质表示的损失发生在食道的癌症的开发的早pre肿瘤的阶段并且在致瘤的小径下面被支撑。在ESCC的很少发生的DAB2倡导者甲基化建议渐成说基因silencing仅仅是在ESCC引起DAB2表示的损失的机制之一。

简介：肝脏的外分泌功能具有非常重要的作用,除了参与消化吸收以外,人体内大量化合物的代谢都需肝脏的处理并由胆汁排泄,这个外分泌过程就需要肝胆转运系统的参与,肝脏的转运系统中包含着许多的载体蛋白,这些载体蛋白与肝炎,肝内胆汁郁积,肿瘤化疗药物的耐受以及多种肝脏遗传性疾病有着密切的关系.本文所要综述的多药耐药相关蛋白2(themuhidrugresistanceprotein2,MRP2)就是这类载体中的一个.目前关于MRP2的研究主要集中在MRP2介导的肿瘤耐药以及MRP2缺乏所导致的高胆红素血症这两个方面.本文从MRP2的结构功能、与肿瘤化疗耐药之间的关系,MRP2缺乏与高胆红素血症之间的关系以及MRP2表达障碍时MRP3对其代偿作用等方面,对MRP2的研究进展作一简单介绍.

简介：瞄准：检验矩阵metalloproteinase-2(MMP-2)在胃的癌症纸巾并且到的表示与淋巴节点评估它的关系微转移。方法：作者从30学习了850淋巴结resected与淋巴腺切除术经历了胃切除术用的有胃的癌的病人颠倒抄写聚合酶链反应(RT-PCR)试金除了他染色。肿瘤纸巾的MMP-2表示被免疫检测组织化学的技术(EliVision加)。结果：MMP-2表示在21是积极的(70%)在9的盒子和negative(30%)盒子。没有重要关联在象年龄，性，肿瘤地点，肿瘤直径，Lauren分类和淋巴的侵略那样的MMP-2表示和另外的变量之间被发现。相反，MMP-2表示与肿瘤渗入的深度显著地相关(P=0.022)，淋巴节点转移(P=0.030)并且肿瘤区别(P=0.043)。淋巴节点微转移在77被检测(12.5%)14的淋巴节点(46.7%)胃的癌病人。MMP-2表示在12是积极的(85.7%)有淋巴节点的14个病人微转移，并且在9(56.3%)没有淋巴节点的16个病人微转移(P=0.118)。结论：我们的结果证明那MMP-2表情与肿瘤侵略，肿瘤区别和淋巴节点转移有重要关联。MMP-2表示可以是一个重要生物特征和胃的癌的重要预示的参数。我们也断定MMP-2可以参予淋巴节点的发展胃的癌的微转移。进一步的调查被需要得出一个结论。

简介：AIM:ToinvestigatetheeffectofhepatitisBvirus(HBV)XgeneonapoptosisandexpressionsofapoptosisfactorsinXgene-transfectedHepG2cells.METHODS:TheHBVXgeneeukaryonexpressionvectorpcDNVA3-XwastransientlytransfectedintoHepG2cellsbylipid-mediatransfection.UntransfectedHepG2andHepG2transfectedwithpcDNA3wereusedascontrols.ExpressionofHBxinHepG2wasidentifiedbyPT-PCR.MTTandTUNELwereemployedtomeasureproliferationandapoptosisofcellsin.threegroups.Semi-quantifiedRT-PCRwasusedtoevaluatetheexpressionlevelsofFas/FasL,Bax/Bcl-xL,andc-mycineachgroup.RESULTS:HBVXgenewastransfectedintoHepG2cellssuccessfully.RT-PCRshowedthatHBxwasonlyexpressedinHepG2/pcDNA3-Xcells,butnotexpressedinHepG2andHepG2/pcDNA3cells.AnalyzedbyMTT,cellproliferationcapacitywasobviouslylowerinHepG2/pcDNA3-Xcells(0.08910±0.003164)thaninHepG2(0.14410±0.004927)andHepG2/pcDNA3cells(0.12150±0.007159)(P＜0.05andP＜0.01).AnalyzedbyTUNEL,cellapoptosiswasmuchmoreinHepG2/pcDNA3-Xcells(980/2000)thanHepG2(420/2000),HepG2/pcDNA3cells(520/2000)(P＜0.05andP＜0.01).Evaluatedbysemi-quantifiedRT-PCR,theexpressionlevelofFas/FasLwassignificantlyhigherinHepG2cellstransfectedwithHBxthaninHepG2andHepG2/pcDNA3cells(P＜0.05andP＜0.01).Bax/Bcl-xLexpressionlevelwasalsoelevatedinHepG2/pcDNA3-Xcells(P＜0.05andP＜0.01).Expressionofc-mycwasmarkedlyhigherinHepG2/pcDNA3-XcellsthaninHepG2andHepG2/pcDNA3cells(P＜0.05andP＜0.01).CONCLUSION:HBVXgenecanimpaircellproliferationcapacity,improvecellapoptosis,andupregulateexpressionofapoptosisfactors.TheinterventionofHBVXgeneontheexpressionofapoptosisfactorsmaybeapossiblemechanismresponsibleforthechangeincellapoptosisandproliferation.

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简介：AIM:Toinvestigatetheefficacyofneoadjuvantchemoradiotherapy(NACRT)forresectabilityoflocallyadvancedgastriccancer(LAGC).METHODS:BetweenNovember2007andJanuary2014,29patientswithLAGC(clinicallyT3withdistalesophagusinvasion/T4orbulkyregionalnodemetastasis)thatweretreatedwithNACRTfollowedbyD2gastrectomywereincludedinthisstudy.ResectabilitywasevaluatedwithradiologicandendoscopicexamsbeforeandafterNACRT.Usingthreedimensionalconformalradiotherapy,patientsreceived45Gy,withadailydoseof1.8Gy.Theentiretumorextentandtheregionalmetastaticlymphnodeswereincludedinthegrosstumorvolume.PatientspresentingwitharesectabletumorafterNACRTreceivedatotalorsubtotalgastrectomywithD2dissection.ThepathologictumorresponsewasevaluatedusingJapaneseGastricCancerAssociationhistologicevaluationcriteria.PostoperativemorbiditywasevaluatedusingtheNationalCancerInstitute-CommonTerminologyCriteriaforAdverseEventsversion4.0.Overallsurvival(OS)andprogression-freesurvival(PFS)rateswereestimatedusingaKaplan-Meieranalysisandcomparedusingthelog-ranktest.RESULTS:Allpatientswereassessedasunresectablecases.Twenty-fourpatients(24/29;82.8%)showedLAGConpositronemissiontomography-computedtomography(CT)andcontrast-enhancedCT,whereasfourpatients(4/29;13.8%)withvagueinvasionorabutmenttoanadjacentorganunderwentdiagnosticlaparoscopy.Onepatient(1/29;3.4%),initiallyassessedasaresectablecase,underwentan'openandclosure'afterthetumorwasfoundtobeunresectable.Abutmenttoanadjacentorgan(34.5%)wasthemostcommonreasonforNACRT.TheclinicalresponserateonemonthafterNACRTwas44.8%.AfterNACRT,69%(20/29)ofpatientshadaresectabletumor.Ofthe20patientswitharesectabletumor,18patients(62.1%)underwentaD2gastrectomy.TheR0resectionratewas94.4%andtwopatients(2/18;11.1%)showedacompleteresponse.Themedianfollow-updurationwas13.5mo.Theone-yearOSandPFS

简介：AIM:Toinvestigateifanimmuneimbalancemayaccountforthedevelopmentandprogressionofchronicradiationenteritis.WeanalyzedtheTh1/Th2immuneresponseprofileearlyand6moafterfractionatedcolorectalirradiation.METHODS:Aratmodeloffractionatedcolorectalγ-irradiation(4-Gyfractions,3fractionsperweek)wasdesignedtoinvestigatetheeffectsofcumulativedoseoninflammatorymediators(cytokinesandchemo-kines)andimmuneresponse(Th1/Th2profileandim-munosuppressivemediatorIL-10)duringacute(early)responseand6moaftertheendoffractionatedirradia-tion(chronicresponse).Analyseswereperformed1dafterthecumulativedosesof16Gyand36Gyand1d,3d,and26wkafterthecumulativedoseof52Gy.RESULTS:Withoutcausinghistologicaldamage,fractionatedradiationinducedelevatedexpressionofIL-1β,TNFα,MCP-1,andiNOSindistalcolonicmucosaduringtheearlypost-irradiationphase.Atthattime,aTh2profilewasconfirmedbyexpressionofboththeTh2-specifictranscriptionfactorGATA-3andthechemokinereceptorCCR4andbysuppressionoftheTh1cytokineIFNγ/IP-10throughouttheirradiationprotocol.After6mo,despitethe2-foldreductionofiNOSandMCP-1levels,theTh2profilepersisted,asshownbya50%reductionintheexpressionoftheTh1transcriptionfactorT-bet,thechemokinereceptorCCXCR3,andtheIFNγ/STAT1pathway.Atthesametime-point,theimmuno-suppressiveIL-10/STAT3pathway,knowntoregulatetheTh1/Th2balance,wasexpressed,inirradiatedrats,atapproximatelyhalfitslevelascomparedtocontrols.ThissuppressionwasassociatedwithanoverexpressionofSOCS3,whichinhibitsthefeedbackoftheTh1polarizationandregulatesIL-10production.CONCLUSION:ColorectalirradiationinducesTh2polarization,defectiveIL-10/STAT3pathwayactivationandSOCS3overexpression.Thesechanges,inturn,maintainaimmunologicalimbalancethatpersistsinthelongterm.

简介：本文报道一家2例腹型肝豆状核变性病例,分别在4岁和6岁时发病,于发病后4周内死亡。例1,男性,4岁,因发热、乏力、纳差15天、尿黄5天、神志不清2天、肝功能异常于1992年6月8日住本院治疗,入院后查体神志恍惚,嗜睡状态,皮肤巩膜明显黄染,肝浊音界右侧锁骨中线第6肋间,肋下1.5cm,

简介：例1病人女，56岁，因眩晕、恶心、呕吐、吐出物为咖啡色，含食物，意识模糊1天入院，体格检查：神志尚清，精神萎靡，面色苍白，呼吸平稳，血压100／60mmHg，被动体位，查体合作，皮肤无出血点，体表淋巴结未触及，心肺未闻及异常、腹部软、肝脾肋下未触及，四肢肌力正常，腱反射存在，病理反射未引出，既往有高血压病2年，初诊上消化道出血，入院后给

简介：目的探讨对2型糖尿病病人胆结石与高胰岛素、脂代谢紊乱的关系。方法观察44例伴胆结石与64例不伴胆结石的2型糖尿病病人血清胰岛素、胰岛素敏感指数、血脂、血糖、糖化血红蛋白的变化。结果伴胆结石组病人的血清胰岛素、甘油三脂、胆固醇显著高于不伴胆结石组(P<0．05)，高密度脂蛋白、胰岛素敏感指数显著低于不伴胆结石组(P<0．05)。两组的病程、血糖、糖化血红蛋白、低密度脂蛋白无明显差异。结论高胰岛素血症，脂代谢异常是2型糖尿病病人胆结石形成的高危因素。

简介：缺氧诱导因子-2α（HIF-2α）是一种在缺氧条件下广泛存在于NSL动物和人体内的氧敏感性转录因子，通过调节缺氧诱导基因表达参与组织细胞对低氧的适应性应答，其表达是机体适应低氧的关键环节和起始步骤。近年研究发现HIF-2a可能与脂代谢过程有密切联系。本文就HIF-2α对脂肪酸代谢和胆固醇代谢的调节作用作一综述。