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目的　总结 1例酒精性肝硬化并发食管胃静脉曲张出血 (EVB) 伴早期食管癌的治疗方法。方法　回顾 性分析1例酒精性肝硬化并发 EVB 伴早期食管癌患者的临床资料，总结其治疗方案。结果　患者中年男性，因“黑 便 2 d，腹痛、呕血5 h”入院，既往有“酒精性肝硬化，食管静脉曲张 (重度) ，门脉高压性胃病”病史 2 年余，“食管中上 段黏膜病变，早癌可能”病史 2 年余，“胃底静脉曲张组织胶注射”手术史4月余，“内镜下食管曲张静脉套扎术”手术 史9 d，饮酒史 30 余年，平均每日饮酒量折合乙醇约 200 g。入院后行急诊内镜检查提示急性上消化道出血，未见明 显活动性出血，给予药物止血、输血、保肝及营养支持等治疗。首次入院3个月后患者返院复查，明确诊断为肝硬化 失代偿期、门静脉高压、EVB、早期食管癌，既往有 EVB 史，符合经颈静脉肝内门体静脉分流术 (TIPSS) 手术适应证， 有内镜黏膜下剥离术 (ESD) 手术指征。排除禁忌证，于首次入院 3个月后行 TIPSS，术后随访 2月余，首次入院 4个 月胃镜检查显示曲张静脉直径较前缩小。排除禁忌证，于首次入院 6 个月行食管静脉曲张内镜下预防性套扎术，套 扎后接着进行早期食管癌 ESD，手术顺利，术后随访 10 个月，病情稳定。结论　对于肝硬化并发EVB伴早期食管癌 的患者，在对黏膜病变处采取内镜治疗等手术操作前可先行 TIPSS，TIPSS 可同时改善食管和胃底静脉的曲张程度， 能减少内镜手术中及术后再出血风险。 [ABSTRACT FROM AUTHOR]

Objective To observe the effect of curcumin on DNA methyltransferase (Dnmts) activity and tumor suppressor gene human H-cadherin (CDH13) in non-small-eell lung cancer i NSCLC A549 cells and to explore the mechanism of curcumin s demethylation. Methods A549 cells were divided into two groups: the observation group and the control group. Cells in the observation group were cultured with 40 μmol/ L curcumin and the culture medium, while cells in the control group only with the culture medium. MTT assay was used to detect the cell proliferation, and RT-PCR was used to detect the expression of CDH13 mRNA. CpG island methylation status of CDH13 promoter was detected by methylation-specific PCR (MSP) . and catalytic activity of Dnmts was detected by enzyme colorimetric determination kit. Results The OD of the observation group was 0. 638 ±0. 184. which was lower than that (0. 859 ±0. 040) of the control group (P < 0.05). The relative expression level of CDH13 mRNA in the observation group was 0.64 ±0.09. which was higher than that (0.43 ±0. 12) of the control group. There were methylation amplification bands, but no demethylation bands in the control group, and there were both methylation amplification bands and demethylation bands in the observation gmup. In the observation group and the control group, the activities of Dnmtl were separately (0. 153 ±0.016) and (0. 770 ± 0.014) μmol/min, and the activities of Dnmt3b were (0. 137 ±0.020) and (0. 179 ±0.013) μmol/min, respectively. The activities of Dnmtl and Dnmt3b in the observation group were lower than those in the control group (all P < 0. 05). Conclusion Curcumin inhibits the methylation status of CDH13 by decreasing the activity of Dnmts. and thereby inhibits A549 cell proliferation. [ABSTRACT FROM AUTHOR]

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Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)