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Formation and Postoperative Prevention of Peritoneal Adhesion

腹部手术后腹腔粘连是一种常见的临床现象，可导致严重的并发症，如肠梗阻、腹腔和盆腔疼痛、不孕和不育等。严重的腹腔粘连常给再次手术造成极大困难，由于粘连形成过程复杂，治疗效果又十分不理想，所以探索其形成机理及预防措施成为当今外科领域的重点内容之一，本文就此分述如下。

错构瘤致成人小肠双重套叠1例报告

Relationship Between Angiopoietin and Angiogenesis of Gastric Carcinoma

Objective　To study the relationship between angiopoietin and the angiogenesis of gastric carcinoma, and to investigate the inter-regulation effect between different vascular growth factors which exist in microenvironment of gastric carcinoma. Methods　Literatures about angiopoietin and angiogenesis of gastric carcinoma were collected and reviewed. Results　There is a relationship between the expression of angiopoietin in microcirculation and the angiogenesis of gastric carcinoma. Yet, it is still a disputable issue on the inter-regulation effect of different vascular growth factors. Conclusion　Angiopoietin may play an important role in the processes of sprouting, development and apoptosis of the microvessel of gastric carcinoma.

Lymph Node-Targeted Chemotherapy for Gastric Carcinoma　.

【Abstract】　Objective　 To introduce the recent studies about the lymph node-targeted chemotherapy for gastric carcinoma. Methods　The literatures on the lymph node-targeted chemotherapy for gastric carcinoma in recent years were collected and reviewed. Results　 The lymph node-targeted chemotherapy for gastric carcinoma was effective because it couled improve the drug concentrations in regional lymph node. Conclusion　As a part of multiple treatments for gastric carcinoma, lymph node-targeted chemotherapy will be further developed.

Current Status and Future of Comprehensive Therapy on Gastric Carcinoma

近年来,胃癌研究发展迅速,许多先进技术和治疗理念逐渐引入外科领域并为大家接受,以手术为主,辅以化疗、生物靶向治疗的综合治疗观念已经建立,成为主导趋势,现就这方面的问题予以讨论,并与同道商榷.……

胃癌的腹腔内种植性转移与热灌注化疗

ADVANCES IN CLINICAL APPLICATION OF LYMPH NODE DISSECTION FOR GASTRIC CANCER

Objective To provide a current language for clinical and pathological discription of gastric cancer. Methods The literature in recent years on the distribution of lymph nodes and staging of gastric cancer were reviewed. Results The lymph nodes of gastric cancer are distributed near the blood vessel and organs of gastric milieu. To ensure radical gastrectomy rational and scientific, the anatomic structure of gastric milieu should be familiarized. Conclusion The excellent outcome of surgery will be achieved by the effective dissection and removel of lymph nodes in gastric cancer.

十二指肠水平段间质瘤致反复上消化道出血1例报告

患者，女，44岁。因反复呕吐咖啡色样物及黑便2年，复发3天入院。2年前，无明显诱因出现呕吐咖啡色样物，解黑色稀便，伴乏力、头晕、心悸，无发热、腹痛、腹泻、返酸等，且反复多次发作，3天前上述症状再次出现，因诊断一直未明确而转入我院。查体： T 36.8℃，P 92次/分，R 20次/分，BP 13/7 kPa（1 mm Hg=0.133 kPa），重度贫血貌。皮肤巩膜无黄染，全身浅表淋巴结未扪及肿大，心肺（-）。腹软，未扪及包块，上腹部有深压痛，无反跳痛及肌紧张，肝脾肋下未扪及，移动性浊音阴性，肠鸣音正常。血常规： HGB 38 g/L, RBC 1.98×1012/L，WBC 4.9×109/L。多次胃镜检查示慢性浅表性胃炎，未发现出血灶。出血时急诊行肠系膜上、下动脉造影检查示： 上中腹部两侧均可见造影剂涂染团块，以右上、中腹部肿块尤明显，其内可见大量病理血管，分别由肠系膜上动脉近段分支供血，无静脉早显及明显造影剂外溢，以“空肠多发性肿瘤”行剖腹探查术。术中见： 十二指肠水平段有一直径为5 cm肿块，向肠腔外突出，肿块血运丰富，与后腹膜粘连； 小肠腔内有暗红色积血，未扪及明显肿块。行十二指肠肿瘤楔形切除术，剖视标本，见肿瘤占据肠周径一半，肠腔尚通畅，肿瘤中央有一脐样凹陷，肿块切面灰白，质软。病理检查： 十二指肠水平段间质瘤伴平滑肌分化，交界性。手术顺利，术后患者出血停止，痊愈出院。

腹膜后球血管肌瘤1例报告

患者，女，50岁，因健康检查发现右上腹包块1天收入院。查体： 一般情况好，皮肤、巩膜无黄染，体表淋巴结无肿大，心、肺无异常，上腹部稍膨隆，右中上腹扪及一约18 cm×10 cm大的包块，质中，界限欠清楚，稍活动，无压痛，移动性浊音（-），肠鸣音正常，双肾区无叩痛，双下肢无水肿。血常规正常。B超检查示： 右侧腹膜后有一稍强回声团块，大小约18 cm×10 cm，边界清楚，形态较规则，回声均匀，团块将右肾向内侧推挤至下腔静脉前方。腹部CT示： 右腹膜后有一10 cm×15 cm×16 cm大的肿块，其边缘光滑，中心有液化坏死区，余为较均匀软组织密度影，腹膜后肿块周围血管增多、增粗，右肾向内、前方推移。术中见： 腹腔内无腹水，肝脏、脾脏等脏器未见异常，未扪及肿大淋巴结。右中上腹腹膜后有一25 cm×18 cm× 22 cm大的肿块，其表面光滑，有包膜可见多支怒张血管，中等硬度，右肾被挤于中线，包块与右肾紧密粘连。手术完整切除包块，手术顺利。病理诊断： 右上腹腹膜后球血管肌瘤，为低度恶性肿瘤。免疫组化染色： SMA（+++），desmin(+++),vimentin(++)； Foot染色： 多数瘤细胞有网织纤维包绕，余CD31（-），FⅧ(-),Cytokeratin(-),EMA(-),CD117(-),SYN(-),CgA(-)。术后患者恢复良好。