肝硬化并发消化性溃疡的临床特征与发病机制研究

近年来随着人们生活水平的提高,生活速度的加快,更加看重效率等等,人们也长期的属于着一种亚健康的状态,加上平时又不注意养生护理,也不是经常性的做身体检查,所以到底很多人平时的时候没有事情突然之间身体就出现了病变,不得已而为之住进了医院,那么今天我们就来聊一聊与健康相关的问题,主要来探讨一下肝硬化并消化溃疡患者的临床状况以及发病的原因到底是为什么。

Clinicopathological features of early gastric cancer with duodenal invasion

The incidence of early gastric cancer （EGC） with duodenal invasion is extremely low, although advanced gastric cancer that arises in the antrum occasionally invades the duodenum. We investigated the clinicopathological features of EGC with duodenal invasion and provided strategies for clinical management.A Medline search was performed using the keyword early gastric cancer＂ and ＂duodenal invasion＇： Additional articles were obtained from references within the papers identified by the Medline search. We revealed that EGC with duodenal invasion was of the superficial spreading type of tumor. Tumors 〉 60 mm in size invaded the duodenum more extensively, and the distance of duodenal invasion from the pyloric ring was further in the elevated type than in the depressed type of tumor.There was no significant difference between the length of duodenal invasion and the histological type of the tumor. Gastric cancer located adjacent to the pyloric ring, even if cancer invasion was confined to the mucosa or submucosa, was more likely to invade the duodenum.The present study reveals that the elevated type of EGC is associated with more extensive duodenal invasion when the tumor size is 〉 60 ram, thus highlighting the importance of identification of duodenal invasion in these cases. We also reveal that sufficient duodenal resection with a cancer-free distal surgical margin should be performed in cases of duodenal invasion.

Multifocal stenosing ulceration of the small intestine

Several reports have described an apparently uncommon clinicopathological disorder that is characterized by multifocal stenosing small-intestinal ulceration.Compared to Crohn's disease,the ulcers are not transmural and typically remain shallow,and involve only the mucosa and submucosa.The disorder seems to be localized in the jejunum and proximal ileum only,and not the distal ileum or colon.Only nonspecif ic inflammatory changes are present without giant cells or other typical features of granulomatous inflammation.Most patients present clinically with recurrent obstructive events that usually respond to steroids,surgical resection,or both.With the development of newer imaging modalities to visualize the small-intestinal mucosa,such as double-balloon enteroscopy,improved understanding of the long-term natural history of this apparently distinctive disorder should emerge.

血清VEGF、TFF1、PG、EGF变化及其与胃溃疡病理过程的关系

本研究探讨血清中血管内皮生长因子(VEGF)、组织三叶因子(TFF1)、胃蛋白酶原(PG)、表皮生长因子(EGF)变化及其与胃溃疡临床特征及愈合的关系。应用ELISA法测定活动性胃溃疡(n=68)、浅表性胃炎(n=60)健康对照组(n=60)血清VEGF、TFF1、PG、EGF水平。胃溃疡组均给予雷贝拉唑三联方案治疗,治疗前后均行14C-尿素呼气试验,胃镜下观察胃溃疡患者病理特征。胃溃疡组血清PG水平高于浅表性胃炎组及对照组(p<0.05),而TFF1、VEGF、EGF水平低于浅表性胃炎组及对照组(p<0.05),浅表性胃炎组血清PG水平高于对照组(p<0.05)。胃溃疡患者治疗后愈合率为58.82%(40/68),HP根治率为76.47%(52/68)。治疗后胃溃疡组炎症活动性评分、粘膜炎症反应评分较治疗前明显下降,而溃疡直径较治疗前显著减少(p<0.05)。治疗后未愈合组血清PG水平高于愈合组(p<0.05),而TFF1、VEGF、EGF水平低于愈合组(p<0.05)。治疗后HP(+)组血清PG水平高于HP(-)组(p<0.05),而TFF1、VEGF、EGF水平低于HP(-)组(p<0.05)。经Pearson单因素分析显示,血清PG水平与炎症活动性评分、粘膜炎症反应评分及溃疡面积呈正相关(p<0.05),而TFF1、VEGF、EGF水平与炎症活动性评分、粘膜炎症反应评分及溃疡直径呈负相关(p<0.05)。血清VEGF、TFF1、PG、EGF变化及其与胃溃疡病理特征及愈合有密切的关系,可作为评价胃溃疡发生及预后的有效指标。