目的 探讨小儿结肠系膜淋巴管瘤的诊断与治疗方法。方法 回顾性分析我院2006年1月至2011年12月期间手术治疗的5例小儿结肠系膜淋巴管瘤的临床资料。结果 3例诊断为腹腔包块性质待查的患儿，术中发现腹腔肿块来源于乙状结肠系膜，其中1例肿块侵犯到降结肠系膜达结肠脾曲而行左半结肠切除＋肠吻合术，另外2例行乙状结肠系膜淋巴管瘤切除＋部分乙状结肠切除＋肠吻合术；1例患儿诊断为急性化脓性阑尾炎合并乙状结肠系膜淋巴管瘤，行阑尾切除＋乙状结肠系膜淋巴管瘤切除＋肠吻合术，1例患儿诊断为乙状结肠系膜淋巴管瘤破裂并弥漫性腹膜炎，行乙状结肠系膜淋巴管瘤切除＋乙状结肠造瘘术，术后6个月后再行二期手术。5例患儿手术后恢复良好，未发生吻合口漏等并发症。术后随访5个月～5年， （2.3±1.1）年，1例失访，余均存活，仍在随访中，所有病例均未复发。结论 日常行阑尾手术中，应常规探查小肠、结肠；未进行肠道准备的结肠一期吻合手术中结肠灌洗可减少吻合口漏等并发症的发生率；腹腔感染严重的患儿结肠一期吻合不可取，结肠造瘘安全；小儿结肠系膜淋巴管瘤术前确诊困难，反复出现腹痛、腹部包块的患儿应想到结肠系膜淋巴管瘤的可能性，行充分的肠道准备后择期手术，手术是肠系膜淋巴管瘤唯一的治疗方法。
Objective To investigate the mechanism and clinical significance of vincristine (VCR) inhibiting gastrinproliferation effects on human colon cell line SW480. Methods Effects of VCR on the viable cell count (A value), myoinositol triphosphate (IP3, CPM value), 〔Ca2+〕i and protein kinase C (PKC) activity of human colon cell line SW480 were evaluated in vitro by MTT assay,3Hmyoinositol incorporation, fluorescence measurements and γ-32P-ATP incorporation.Results A value of VCR+PG group was lower than that of PG or control group (Ｐ＜0.01 vs control, Ｐ＜0.01 vs PG). The concentration of IP3 or 〔Ca2+〕i in VCR+PG group was lower than that in PG group (Ｐ＜0.01 vs PG); and the PKC activity of membrane was lower than that in PG group (Ｐ＜0.05 vs PG, Ｐ＞0.05 vs control). Conclusion Effects of vincristine may be through the phosphoinositide signaling pathway on gastrinstimulating cell proliferation in human colon cell line SW480. It has provided an experimental evidence for antisignaling therapy for patients with colon cancer.
ObjectiveTo investigate the effects of specific farnesiod X receptor(FXR) agonist on growth of colon cancer cells in vitro. MethodsThe effects of specific FXR agonist(GW4064) on the growth of HCT116 cells of colon cancer were studied in vitro by using MTT and flow cytometry. The mRNA expressions of FXR and vascular endothelial grouth factor(VEGF), were determined by using RT-PCR. ResultsThe FXR specific agonist GW4064 could increase the FXR mRNA expression of HCT-116 cells of colon cancer, downregulation of VEGF mRNA expression, and had obvious inhibitory effect on growth of HCT-116 cells, and promoted the apoptosis of HCT116 cells in a dose and time dependence. ConclusionsGW4064 can significantly inhibit colon cancer cells in vitro. FXR may be a potential treatment arget of colon cancer.
Objective To explore the relationship between Epstein-Barr virus (EBV) infection with serum human kissin-1 (KISS-1) and matrix metalloproteinase 2 (MMP2) levels and prognosis in patients with colon cancer. Methods A total of 86 colon cancer patients who were hospitalized in our hospital from April 2015 to April 2016 were selected as the colon cancer group; in the same period, 84 cases of physical examination person in our hospital were selected as the control group. Real-time fluorescent quantitative PCR (qRT-PCR) was used to test colon cancer patients for EBV DNA, and divided the patients into EBV DNA negative group and EBV DNA positive group according to the test results. Enzyme-linked immunosorbent (ELISA) method was used to detect serum KISS-1 and MMP2 levels. Pearson method was used to analyze the correlation between serum KISS-1 and MMP2 levels in patients with colon cancer infected with EBV. The survival curve was drawn by Kaplan-Meier method, and the relationship between EBV infection and prognosis of colon cancer patients was analyzed by log-rank test. Multivariate Cox regression analysis were used to analyze the factors affecting the prognosis of colon cancer patients. Results Compared with the control group, the positive rate of EBV DNA in the colon cancer group was higher (χ2=21.854, P<0.001). The EBV DNA positive rate of patients with lymph node metastasis, TNM stage Ⅲ–Ⅳ, tumor low differentiation and tumor infiltration T3–T4 was higher than those without lymph node metastasis, TNM stage Ⅰ–Ⅱ, tumor high/medium differentiation and tumor infiltration T1–T2 (P<0.05). Compared with the EBV DNA negative group, the serum KISS-1 level of the EBV DNA positive group decreased, and the MMP2 level increased (P<0.001). There was a negative correlation between serum KISS-1 and MMP2 levels in colon cancer patients with EBV infection (r=–0.510, P<0.001). The 5-year survival rates of colon cancer patients in the EBV DNA-negative group and the EBV DNA-positive group were 52.94% (27/51) and 14.29% (5/35), respectively, the difference between the two groups was statistically significant (χ2=13.274, P<0.001). EBV infection, MMP2 high expression, and lymph node metastasis were independent risk factors affecting the prognosis of colon cancer patients (P<0.05), and KISS-1 low expression was a protective factor affecting the prognosis of colon cancer patients (P<0.05). Conclusions EBV infection is closely related to the progression and prognosis of colon cancer. The down-regulation of KISS-1 and the up-regulation of MMP2 may be related to EBV infection.
目的 探讨腹腔镜术中联合结肠镜治疗结直肠小占位病变的可行性和临床应用价值。方法对我院2006年12月至2009年5月期间23例行腹腔镜联合结肠镜手术的结直肠小占位病变患者的临床资料进行回顾性分析。结果 所有患者均在腹腔镜下完成手术，无中转开腹。 手术时间80～200 min，平均140 min; 出血80~120 ml，平均100 ml。 9例息肉病变行局灶切除，术中经快速冰冻切片病理证实4例早期癌及10例不典型增生均行相应肠段切除。 术后1例出现轻度肺炎，经积极抗炎对症治疗后痊愈，其余患者恢复良好。 所有患者术后第1天即离床活动，住院时间5～10 d，平均7 d。结论 腹腔镜术中联合结肠镜治疗结直肠占位是安全可行的，有助于结直肠病灶及切缘的准确定位，可缩短手术时间，值得临床进一步推广应用。
目的 为进一步探讨老年急性结肠癌性肠梗阻的诊断及外科治疗方法，总结经验教训。方法 对我院1993~2005年收治的38例老年急性结肠癌性肠梗阻患者的临床资料进行回顾性分析。结果 38例老年急性结肠癌性肠梗阻患者，手术行一期切除吻合23例，肿瘤姑息性切除4例，单纯结肠双腔造口2例，Hartmann手术9例。术后发生并发症6例，其中切口感染5例，经换药愈合； 发生吻合口漏1例，最终死于腹腔感染、多器官功能衰竭。其余32例术后恢复良好。结论 提高对老年急性结肠癌性肠梗阻的认识，选择合理术式，加强围手术期处理，是减少手术并发症的发生、降低死亡率的重要措施。
To analyze the causes of failure to reduce acute infantile intussusception with gas enema. 441 cases of acute infantile intussusception in our hospital who failed to be reduced with gas-enema, and underwent the operative therapy were analyzed. Result: 92 cases (20.9%) were intestinal necrosis, 184 cases (41.7%) double intussusception, 27 cases (6.1%) organic pathological changes and 8 cases (1.8%) intestinal perforation caused by gas-enema reduction. All the cases had a successful recovery after surgery. Conclusion: The main causes of failure to reduction with gas-enema were as follows: ①double intussusception, ②intestinal necrosis, ③late for visiting a doctor, ④organic pathological changes, ⑤perforation (in the process of gas-enema reduction). The importance of early diagnosis is emphasized.