简介:目的探讨经胃镜植入放射性粒子行组织内放疗治疗晚期胃癌的可行性。方法在胃镜直视下对23例无法手术切除的晚期胃癌患者进行^125I放射性粒子植入术。首先用胃镜确定肿瘤的大小、生长部位,B超胃造影测出肿瘤区域胃壁的厚度。根据肿瘤的体积大小计算出需要植入粒子的数量。将^125I粒子源装入粒子枪内,进行高压灭菌,通过胃镜活检孔插入,^125I粒子专用注射针.直接刺入肿瘤组织内,将^125I粒子植入。术后进行胃镜、CT及彩超等的复查、随访。结果23例患者每例植入^125I粒子的数量8~15枚不等。接受手术1~3次。植入术均安全完成。^125I粒子植入1周后5例出现上腹部饥饿性痛伴呕血、黑便,12例感乏力,3个月后19例自觉症状消失,食欲增加,体重增加2~5kg。血液生化检查未见异常。CT、彩超复查7例腹膜后肿大淋巴结消失,6例肿大的胰头较前明显缩小,肝、肺转移无明显变化,生存时间最长已超过32个月。结论胃镜直视下植入放射性粒子进行组织内放疗治疗晚期胃癌效果可靠、并发症少,能够缓解症状,改善生活质量,延长生存期,是一种安全有效的新方法,值得进一步研究推广。
简介:AbstractImportance:Cadherin-11 (CDH11), a cell-to-cell adhesion molecule, is implicated in the fibrotic process of several organs. Biliary atresia (BA) is a common cholestatic liver disease featuring cholestasis and progressive liver fibrosis in children. Cholestatic liver fibrosis may progress to liver cirrhosis and lacks effective therapeutic strategies. Currently, the role of CDH11 in cholestatic liver fibrosis remains unclear.Objective:This study aimed to explore the functions of CDH11 in cholestatic liver fibrosis.Methods:The expression of CDH11 in BA livers was evaluated by database analysis and immunostaining. Seven BA liver samples were used for immunostaining. The wild type (Wt) and CDH11 knockout (CDH11-/-) mice were subjected to bile duct ligation (BDL) to induce cholestatic liver fibrosis. The serum biochemical analysis, liver histology, and western blotting were used to assess the extent of liver injury and fibrosis as well as activation of transforming growth factor-β (TGF-β)/Smad pathway. The effect of CDH11 on the activation of hepatic stellate cell line LX-2 cells was investigated.Results:Analysis of public RNA-seq datasets showed that CDH11 expression levels were significantly increased in livers of BA, and CDH11 was correlated with liver fibrosis in BA. BDL-induced liver injury and liver fibrosis were attenuated in CDH11-/- mice compared to Wt mice. The protein expression levels of phosphorylated Smad2/3 were decreased in livers of CDH11-/- BDL mice compared to Wt BDL mice. CDH11 knockdown inhibited the activation of LX-2 cells.Interpretation:CDH11 plays an important role in cholestatic liver fibrosis and may represent a potential therapeutic target for cholestatic liver disease, such as BA.
简介:摘要本文回顾性分析了2017年1月至2021年12月湖南省人民医院收治的11例胰管结石患儿的临床资料,其中男性4例,女性7例,中位年龄13岁,年龄范围8~17岁。所有患儿均经CT及MRI+磁共振胆胰管造影确诊,并行手术治疗。全组患儿无死亡病例,术后出现A级胰漏1例,经保守治疗后痊愈。随访时间3~60个月,随访期间无胰腺内外分泌功能不全表现;术后腹痛明显较前缓解。外科手术是治疗儿童胰管结石的重要手段,积极的手术治疗对于提高患儿生存质量具有重要意义。