简介：Primarymalignanttumorsofthesmallintestinearerare,comprisinglessthan2%ofallgastrointestinaltumors.An85-year-oldwomanwasadmittedwithfeverof40℃andmarkedabdominaldistension.Hermedicalhistorywasunremarkable,butbloodexaminationshowedelevatedinflammatorymarkers.Abdominalcomputedtomographyshowedagianttumorwithcentralnecrosis,extendingfromtheepigastriumtothepelviccavity.Giantgastrointestinalstromaltumorofthesmallintestinecommunicatingwiththegastrointestinaltractorwithsuperimposedinfectionwassuspected.Becausenoimprovementoccurredinresponsetoantibiotics,surgerywasperformed.Laparotomyrevealedgianthemorrhagictumoradherenttothesmallintestineandoccupyingtheperitonealcavity.Thegianttumorwasasolidtumorweighing3490g,measuring24cm×17.5cm×18cmandshowingmarkednecrosis.Histologically,thetumorcomprisedspindle-shapedcellswithanaplasticlargenuclei.Immunohistochemicalstudiesshowedtumorcellspositiveforvimentin,CD31,andfactorⅧ-relatedantigen,butnegativeforc-kitandCD34.Angiosarcomawasdiagnosed.Althoughnopostoperativecomplicationsoccurred,thepatientexperiencedenlargementofmultiplemetastatictumorsintheabdominalcavityanddied42dpostoperatively.Theprognosisofsmallintestinalangiosarcomaisverypoor,evenaftervolume-reducingpalliativesurgery.

简介：Wepresentthreecasesofself-expandablemetallicstent（SEMS）placementusingaballoonenteroscope（BE）anditsovertube（OT）formalignantobstructionofsurgicallyreconstructedintestine.ABEiseffectivefortheinsertionofanendoscopeintothedeepbowel.However,SEMSplacementisimpossiblethroughtheworkingchannel,becausetheworkingchannelofBEistoosmallandtoolongforthestentdevice.Therefore,weusedatechniqueinwhichtheBEisinsertedasfarasthestenoticarea;thereafter,theBEisremoved,leavingonlytheOT,andthenthestentisplacedbyinsertingthestentdevicethroughtheOT.Inthepresentthreecases,amodificationofthistechniqueresultedinthesuccessfulplacementoftheSEMSforobstructionofsurgicallyreconstructedintestine,andtheprocedureswereperformedwithoutseriouscomplications.Weconsiderthatthepresentprocedureisextremelyeffectiveasapalliativetreatmentfordistalbowelstenosis,suchasinthesurgicallyreconstructedintestine.

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简介：AIM:Toclarifythecorrelationwithphenotypicexpression,clinicopathologicalfeatures,geneticalterationandmicrosatellite-instabilitystatusinsmallintestinaladenocarcinoma(SIA).METHODS:Thecasesof47patientsdiagnosedwithprimarySIAsthatweresurgicallyresectedatourinstitutionin1975-2005werestudied.Wereviewedclinicopathologicalfindings(age,gender,tumorsize,grossappearance,histologicalmorphologictype,invasiondepth,lymphaticpermeation,venousinvasion,andlymphnodemetastasis),andtheimmunohistochemicalexpressionofMUC5AC,MUC6,MUC2,CD10,andmismatch-repair(MMR)proteins(MLH1andMSH2).WeanalyzedKRASandBRAFgenemutations,andthemicrosatelliteinstability(MSI)status.TheimmunohistochemicalstainingofCD10,MUC2,MUC5ACandMUC6wasconsideredpositivewhendistinctstainingin>5%oftheadenocarcinomacellswasrecorded.ToevaluateofMMRproteinexpression,weusedadjacentnormaltissueincludinglymphoidfollicles,inflammatorycells,andstromalcellsasaninternalpositivecontrol.SectionswithoutnuclearstaininginthetumorcellswereconsideredtohavelosttheexpressionoftherespectiveMMRprotein.RESULTS:Therewere29malesand18femalespatients(meanage59.9years,range:23-87years).Tumorswerelocatedintheduodenumin14cases(30%),thejejunumin21cases(45%),andtheileumin12cases(25%).Aphenotypicexpressionanalysisrevealed20MUC2-positivetumors(42.6%),11MUC5AC-positive(23.4%),4MUC6-positive(8.5%),and7CD10-positive(14.9%).ThetumorsizesoftheMUC2(+)tumorsweresignificantlylargerthanthoseoftheMUC2(-)tumors(mean,5.7±1.4cmvs4.7±2.1cm,P<0.05).AllthreetumorswithadenomatouscomponentwerepositiveforMUC2(P<0.05).PolypoidappearancewasseensignificantlymorefrequentlyintheCD10(+)groupthanintheCD10(-)group(P<0.05).ThetumorsizewassignificantlylargerintheCD10(+)groupthanintheCD10(-)group(mean,5.9±1.4cmvs5.0±2.1cm,P<0.05).Of34SIAswithsuccessfullyobtainedMSIdata,4wereMSI-high.O

简介：Pomegranateleaf(PGL)hasadefiniteroleinregulatinglipidmetabolism.However,pharmacokineticresultsshowthemainactiveingredient,ellagicacid,inPGLhasloweroralbioavailability,suggestingthatthelipid-loweringeffectofPGLmayactthroughinhibitinglipidabsorptioninthesmallintestine.Ourresultsdemonstratedthatpomegranateleafanditsmainactiveingredients(i.e.,ellagicacid,gallicacid,pyrogallicacidandtannicacid)werecapableofinhibitingpancreaticlipaseactivityinvitro.Incomputationalmoleculardocking,thefouringredientshadgoodaffinityforpancreaticlipase.AcutelipidoverloadexperimentsshowedthatalargedosageofPGLsignificantlyreducedserumtotalcholesterol(TG)andtriglycerides(TC)levelsinadditiontoinhibitingintestinallipaseactivity,whichdemonstratedthatPGLcouldinhibitlipaseactivityandreducetheabsorptionoflipids.WealsofoundthatPGLcouldreversethereducedtight-junctionproteinexpressionduetointestinallipidoverload,promoteOccludinandClaudin4expressioninthesmallintestine,andenhancetheintestinalmucosalbarrier.Inconclusion,wedemonstratedthatPGLcaninhibitlipidabsorptionandreducebloodTGandTCbytargetingpancreaticlipase,promotingtight-junctionproteinexpressionandtherebypreventingintestinalmucosadamagefromanoverloadoflipidsintheintestine.

简介：在脾缺乏老鼠的空肠纸巾在肠的推进率，浆液D木糖的内容，腺苷triphosphate(ATP)的内容和腺苷triphosphatases(ATPase)的活动上观察艾灸的效果的目的，并且在ATP的生产和膜蛋白质的活动上探索艾灸的效果，为在增强脾胃分析艾灸的机制。四十只健康SpragueDawley老鼠随机被划分成四个组，也就是组织A(空白的控制组)，组织B(模型控制组)，组织C(艾灸组)并且组织D(植物组)的方法。脾缺乏的动物模型被intragastric管理与黄达(根值et根茎Rhei)一起建立注入。在组C的老鼠收到了艾灸在Zusanli(圣36)，Zhongwan(CV12)，Guanyuan(CV4)，Pishu(BL20)和Weishu(BL21)。在组D的老鼠与Si6月Zi煎收到了intragastric管理。肠的推进被墨粉方法测量，并且在浆液的D木糖的内容被phloroglucinol方法检测。比色法方法被用来在空肠纸巾检测ATP的内容和Na+-K+-ATPase和Ca2+-Mg2+-ATPase的活动。与组A相比结果，肠的推进率，在浆液的D木糖的内容，ATP的内容，在空肠纸巾的Na+-K+-ATPase和Ca2+-Mg2+-ATP的活动在组B显著地减少了(P<0.05或P<0.01)。与组B相比，肠的推进率，在浆液的D木糖的内容，ATP的内容，在空肠纸巾的Na+-K+-ATPase和Ca2+-Mg2+-ATPase的活动在组C和D显著地增加了(P<0.05或P<0.01)，当组C和组D之间没有重要差别时。结论艾灸能增加肠的推进率，在浆液的D木糖和在空肠纸巾的ATP的内容，以及Na+-K+-ATPase的活动和脾缺乏老鼠的Ca2+-Mg2+-ATPase，它建议那艾灸能由在肠的上皮的房间支持ATP的生产提高小肠的活动性和吸收功能，增加膜蛋白质的内容，并且改进transmembrane运输。