Diabetic nephropathy diet principles

Diabetes diet should be controlled in order to alleviate the burden of islet β - cells, but can be complicated with nephropathy in patients with diabetes, diet control would also need to consider the patient urinary protein loss and renal function status.

 (1) if so intermittent or persistent proteinuria have hypoproteinemia, and no obvious nitrogen hyperlipidemia, divided by the supply of protein daily 1 g / kg body weight calculation, the need to further increase in the discharge of urine the protein quality, and at this time most patients have decreased renal function, it should not be too high protein content.

 (2) both edema or high blood pressure, no salt, or less sodium diet to prevent the development of edema and blood pressure increased.

 (3) the majority of kidney patients with hypertension and hyperlipidemia, due regard shall be used to reduce fat and unsaturated fatty acids, cholesterol is 300 mg should be limited following.

 (5) Some people think that poor diabetic control, the ability of red blood cells to release oxygen decreased, advocate the use of high-phosphorus diet, but should be strictly controlled diabetes mainly, if renal dysfunction, high-phosphorus diet on patients disadvantage.

 (6) If there anemia symptoms, in the diet should be more supply in the deployment of iron and vitamin C-rich foods, such as severe anemia drug must be supplemented by blood transfusion or even.

 (7) in patients with diabetic nephropathy, renal insufficiency, such as a kidney transplant or dialysis therapy, diet therapy may refer to the principle of acute and chronic renal failure, dialysis related to the rule of law, and other content. 

Surgical treatment of gastric cancer Introduction

Because endoscope technology development, and people’s growing awareness of early gastric cancer deepening found lesions smaller than 2 cm, mucosal invasion and the only significant increase in early gastric cancer, certain types of early gastric cancer in endoscopic treatment possible, there are two methods used, first, to make certain uplift lesions polyp resection, another method of using laser treatment, which tends to be used argon dyes and hematoporphyrin. So far the treatment of gastric cancer, the effect is still not satisfied. Because of this aspect of gastric cancer etiology is not clear, in its incidence can not be prevented before the other hand, the majority of patients diagnosed already in advanced patients, the natural effect of poor. Therefore improve early diagnosis of gastric cancer is still the key to the treatment effect.

A surgical treatment

Current treatment of gastric cancer as a major way, and it is only possible cure means of advanced gastric cancer. So the surgical treatment of gastric cancer should adopt a positive attitude, as long as patients systemic situation允可no clear when distant metastasis should be implemented laparotomy.

(1) the choice of surgery

1. Radical resection

Also known as curative resection. The upcoming primary gastric cancer lesions, together with the corresponding part of the organization and its regional lymph node resection together, no residues of any cancer. Also because of the scope of regional lymphadenectomy different, and is divided into four different radical operation: first stop will not completely remove the lymph nodes said R. Method: The first leg of lymph nodes completely removed R1 operation, the removal of all the same the second or third leg of lymphatic station, known as R2 or R3 operation, but also with the extent of lymph node metastasis according removal of the lymph nodes, distinction Radical absolutely and relative to two kinds of radical, radical means absolutely beyond metastatic lymph node dissection first leg of the above, such as the first leg of lymph node metastasis, the purposes of R2 or R3 radical, that is, that the absolute cure. If only for R1 surgery, although the clinical nor the remnants of metastatic lymph nodes, but can only think it is relatively radical.

General radical subtotal gastrectomy the scope should include the primary lesion, proximal or distal gastric the 2 / 3 to 3 / 4 full size omentum, gastric and duodenal first part of the regional lymph nodes. Sometimes in order to remove gastric cardia cancer beside the door spleen, lymph nodes around the splenic artery to the entire line of the stomach and pancreas, spleen and tail together with the expansion of radical operation. Involved transverse colon cancer or liver left lobe, and other neighboring organs, it can be used for organ together with the involvement of radical resection of the joint.

Because of the extended radical surgical mortality and the incidence of postoperative complications, it should be strictly surgical indications, if not all options will expand the implementation of gastric cancer are radical operation, and would not improve the survival rate of gastric cancer. Generally considered body of stomach cancer, cancer and diffuse infiltrative have the second leg of lymph node metastasis antrum should, in principle, to expand the radical operation.

Early gastric cancer surgery on the problem, in the past has advocated for R2 surgery. In recent years. Along with early gastric cancer cases has been increasing. Surgery increasingly rich experience accumulated more clinical data. Single found early gastric cancer lesions not only the survival rate significantly higher incidence into high and the relapse rate in all cases lower, only 2.8 percent, and the overwhelming majority of the cases were recurrent invasive submucosal lesions is associated with lymph node metastasis early gastric cancer. Besides its recurrence also in the form of more blood is transferred to the lung and liver. Another noteworthy regardless of whether the cancer has penetrated the single submucosal lesions, three different surgical approach - R0, R1, R2’s little difference in survival rates, so that the early gastric cancer surgery, mucosal carcinoma should be R1 operation, submucosal carcinoma for R2 surgery less than two centimeters of polypoid mucosa cancer, local resection for cancer or R0 operation has been fully adequate.

2. Palliative resection

Also on palliative resection of a different opinion. One view palliative resection can only lift pyloric obstruction, bleeding, pain to alleviate the symptoms and not prolong life. Therefore, Caesarean section that could not cure cancer, without the complications of surgery, that is, to give up. Most of that, many palliative surgery is the gastric cancer patients after resection survived more than five years, or even five-year survival rate up to around 11%. Domestic statistics palliative resection of gastric cancer survival rate of 11.7%. In various reasons for the palliative resection cases, a cut-best residual cancer, followed by stomach infiltration around again for residual metastatic lymph nodes and liver metastasis, and peritoneal cultivation for the worst. Therefore, the removal of the tumor should adopt a positive attitude, not easy to cure certain cases can make a simple palliative resection, some patients lose the opportunity to heal. Therefore, even radical resection has been beyond the scope of the transfer, as long as patients with systemic conditions permit, local tumor resection may be, should actively seek palliative resection of gastric part. As for the palliative total gastrectomy are generally not in favor because mortality and complication rates are higher.

3. Short-circuit such as cancer surgery and have unresectable for pyloric obstruction of the gastrojejunostomy, lifting obstruction, the patients can eat to improve the nutritional status and systemic create conditions for acceptance of other drug treatment.

Gastric cancer prevention and treatment errors

The prevention of gastric cancer is very important to diet, eat more fresh fruits and vegetables, eat more of vitamin A, B, E food, appropriately increase protein, dairy, milk intake, such as to protect gastric mucosa. Eat less, or do not eat pickles, leftovers. fried, moldy food, alcoholic drinks and tobacco bogey. In China, gastric cancer is a common cancer, the mortality rate is second only to lung cancer, liver cancer, colorectal cancer. However, because 80 percent of gastric cancer early non-specific symptoms to diagnosis difficult, therefore, can not miss any tangential clues, especially following some misconceptions people may lose their vigilance of gastric cancer.

A stomach illness in the elderly is wrong.

Wrong. Although the incidence of gastric cancer in the elderly group to a higher, but according to many hospitals in China reported that the 35-year-old youth following the incidence of stomach cancer has also been as high as 6% -11%, and a higher degree of malignancy. Because now young people learning work pressure, rest, diet does not rule, the incidence of gastric ulcer, and other stomach problems is not low, so when there’s the unknown causes abdominal discomfort, abdominal distension, secret anguish, anorexia, nausea , vomiting, poor appetite, sleepiness, easy fatigue, weight loss and sexual anemia, tar-like stool even hematemesis, it is necessary to check to the hospital in time.

Second, gastropathy is my years of old on their own can eat the medicine.

Wrong. Early gastric cancer patients with 80 percent no symptoms, there are a few symptoms of atypical symptoms are also more easily with a number of gastritis, gastric ulcer, and other stomach problems confusion. Therefore, please do not self-righteous and in accordance with past experience and symptoms of disease to determine their own medicines resolved, this is a very unscientific and most likely to interfere with the early diagnosis of gastric cancer.

Third, I have been suffering from gastric ulcer of the stomach resection more than half, it is impossible to a gastric cancer.

Wrong. In most of the stomach after resection of it is still possible for gastric cancer, gastric cancer medicine called residual. Residual stomach the incidence of gastric cancer in patients with healthy people 2-12 times than medication for stomach problems and higher 2-4 times. Residual stomach cancer because of the loss of function of Helicobacter pylori (pyloric sphincter function is twofold, first, to prevent stomach to digest good food has not yet entered the duodenum; Second is to prevent intestinal fluid, the protection of the stomach acidic Environment), duodenum and the bile can be dissolved pancreatin epithelial cells, accelerating cell division; bile, intestinal fluid mainly alkaline, which are easily damaged gastric mucosal barrier; remnant stomach bacteria increased production of nitrite, makes carcinogenic nitroso compounds concentration increased gastric resection and anastomosis of the excitement and tension at the high ligation, may also become a carcinogenic factor. Not because of gastric resection of gastric cancer lightly on healthy patients after stomach trouble, after five years should be done annually for a gastroscopy, will not reject them biopsy pathologic examination.

Gastric cancer is commonly used to check for:

1, fiber endoscopy (commonly known as gastroscopy); 2, X-ray barium meal examination; 3, ultrasonography; 4, immunological tests: If CEA; 5, CT.

Early gastric cancer difficult to conventional CT scan revealed that rely mainly on gas double contrast barium and fiber endoscope.

X-ray barium meal examination gastrointestinal cancer is the main method, especially gastric low-double contrast examination can show that the small 0.5 cm below the small gastric cancer, or gastric cancer tiny. Check 1-2 days stopped serving impenetrable X-ray or drug affected gastrointestinal function, as follows bismuth carbonate, calcium gluconate, etc.; stomach retention of patients check the night before gastric lavage; entire gastrointestinal barium meal examination, 2:00 clothes barium sulfate powder 100 g, with warm water 200-300 ml transfer service; relaxed mood, because swallowed barium no harmful effects on the body, will be absorbed, will be discharged with the feces in vitro, which after 1-2 days of the inspection of the white stool, but pregnant three months can not do the inspection.

Gastroscopy and biopsy is the gold standard for diagnosis of gastric cancer, doctors determined no correlation can be a contraindication for the inspection, examination subjects before fasting eight hours, it is estimated that delayed gastric emptying, the need fasting more long, pyloric obstruction, should first check again gastric lavage. Admission postoperative gastric tissue biopsy were not immediately Rough eating food and hot drinks. Gastroscopy that many patients are reluctant to accept too painful. In fact, under the conditions of modern technology, an endoscopic examination 10 minutes can be completed, the inspection service can reduce the suffering of some tranquilizers, many hospitals now launched a painless gastroscopy.

As early gastric cancer surgery 5-year survival rate of 80%, so that attention be paid to patients with early gastric cancer follow-up. These diseases include: ① chronic atrophic gastritis: cancer rate was 8.6% -13.8%; ② gastric polyps, especially multiple adenomatous polyps, cancer rates as high as 14% -59%; ③ cancerous ulcer rate of 1% -15%; ④ remnant stomach; ⑤ gastric dysplasia, moderate or severe dysplasia with early gastric cancer is very close, it was regarded as the most severe hyperplasia early gastric cancer.

The prevention of gastric cancer is very important to diet, eat more fresh fruits and vegetables, eat more of vitamin A, B, E food, appropriately increase protein, dairy, milk intake, such as to protect gastric mucosa. Eat less, or do not eat pickles, leftovers. fried, moldy food, alcoholic drinks and tobacco bogey.

The standard treatment in patients with gastric cancer program

Lu Hong Given the standard treatment program of chemotherapy and radiation therapy in the six weeks after the surgery began. For patients it is very inappropriate. About 20% to 30% of patients in the post-operative rehabilitation will not fully accept the postoperative treatment. Q & A: the gastric cancer treatment before surgery

Preoperative and postoperative gastric cancer patients when chemotherapy and radiation therapy is the best time?

On this issue we visited Ho. M.D., he or Doctor of Philosophy, gastric cancer and colorectal cancer Anderson School of Medicine assistant professor of oncology.

What is the standard treatment programs?

A few years ago a large social groups in the United States research shows that the standard treatment of gastric cancer program is receiving chemotherapy after surgery and radiation therapy.

Gastric cancer Knowledge Base

Anderson M.D. treatment recommendations?

We think that chemotherapy before surgery and radiation therapy for treatment of patients will be still better.

Generally speaking, why you choose to receive treatment before surgery?

Given the standard treatment program of chemotherapy and radiation therapy in the six weeks after the surgery began. For patients it is very inappropriate. About 20% to 30% of patients in the post-operative rehabilitation will not fully accept the postoperative treatment.

If patients receive treatment before surgery, when their physical conditions were relatively good, and more able to endure the pain arising from the treatment.

Its observation of the response to treatment programs help?

Yes. If a tumor to continue to grow, then we can consider using different chemical therapy.

If a patient’s tumor cells to chemotherapy and radiotherapy have resistance, and cancer continues, it is likely that those patients will not be recovered after surgery. In some cases, if the tumor spread to other organs, we may abandon the surgery. We might be from those of the patients will benefit surgery to save them.

Other treatment programs that may affect the order of factors?

Receiving treatment before surgery Another reason is that the chemotherapy drugs before surgery can better convey. Stomach surgery in connection with the need to intercept the vessel and therefore theoretically transfer after surgery without drugs before surgery when all is intact, the less effective transfer.

In addition to surgery, why should receive treatment?

Surgery is the main treatment of gastric cancer, but surgery alone is not enough. If a patient’s cancer had spread to lymph nodes, the cure on the probability dropped to 50 percent or less, additional treatment is necessary.

Gastric cancer surgery is involved?

In surgery, some or all of the stomach needs to be removed. Several centimeters of nearby organizations also need to be removed. Surgery needs of the surrounding clean gaps in the organization and will be conducted to ensure that no cancer recurrence, and pathology will tell them when the need to undergo screening.

(When the stomach was cut off after the organ through the bottom of the esophagus and small intestine connected. Which makes patients after intestinal digestion of food, but they must the meal.)

Before surgery results of patients treated?

Many of the survivors are too good. Zhou Gang, I saw this one in 2004 for treatment of patients with gastric cancer, he is now living a very good hygiene had no disease symptoms.

Before surgery you will study?

We are conducting the third before surgery clinical study, which involves different chemical treatment methods. The results still unknown, because it will take a few years time to observe the patient’s symptoms later.

In our present study, we are using drugs to effect (medication), which has been the United States Food and Drug Oversight Committee on Cancer accreditation. The extra drug is better able to make the results we had hoped for. Test is still underway, we are recruiting patients.

Self-metal stent is effective in treatment of esophageal gastric cancer complications

Netherlands Siersema and other reports, self-metal stent palliative treatment of esophageal, stomach cancer caused by stenosis, fewer complications, relatively safe and effective. Also metal stent for the treatment of esophageal cancer, stomach complications and (or) tumor recurrence.

Siersema will take membrane metals such as stent placement 57 cases of patients in vivo. Cases. (GastrointestEndosc2001, 54:579)

The results showed that 57 patients, 55 cases (96%) stent placement success. Dysphagia average score from 3.6 points to 1.6 points (P <0.001). There are 13 cases (23%) occurred in patients with more serious complications. All were esophageal fistula closure. Five cases of esophageal - tracheal fistula patients, 28 cases of gastric cancer patients after gastric tube insertion, three cases of stomach after patients, two cases of tumors located in the vicinity of the distal esophageal sphincter on patients with tumor recurrence. The median survival time was 61 days. Past radiotherapy, chemotherapy or radiotherapy and chemotherapy increased esophageal stent-related complication rate [were 38% (6 / 16 patients) and 10% (4 / 41 cases), the ratio ratio 5.5,95% CI 1.3 to 24, P = 0.018].

Researchers believe that when esophagus, stomach cancer patients due to fistula formation, tumor recurrence after tumor located in or near the esophageal sphincter on the cause dysphagia, consideration should be given at the earlier-metal stent.

Japan developed a new cancer therapy

The Osaka prefecture legislature Institute of Adult Disease Center recently developed a new cancer therapy, this new therapy is processed through the part of the bacteria or virus injected into the body to improve patients with immunity.

This new therapy is first decomposed bacteria or virus, and then injected into a part of the animals suffering from cancer, immune cells present in the surface proteins from the perception of TLR will mistakenly think that this is invasive pathogens, thus contributing to the immune cells become active again. Then again injected extract from the sick animals and processed some cancer cells, these cells will become targets of immune cells, the resulting strong immunity to the eradication of other cancer cells.

Researchers conducted experiments with mice that only into the past and some of the treated cells compared with immune therapy, a new therapy control tumor cells and increases the effect of the transfer better.

Elderly gastrointestinal cancer treatment status

American Dana-Farber Cancer Institute’s Dr. Enzinger PC and his colleagues pointed out that more than 2 / 3 of gastrointestinal cancer at the age of 65 more patients, and younger patients with symptoms similar. Despite progress in recent years mainly in the treatment of younger patients, but the treatment of elderly patients with the same safe and effective.

Most of gastrointestinal cancer in the colon and rectum, their means of prevention in constant development, has confirmed that elderly patients with long-term use of aspirin and estrogen have a preventive role. In addition, elderly patients with colorectal cancer paragraph near the high incidence of colonoscopy for screening also susceptible patients, which has greatly improved the elderly patients with early diagnosis of tumors rate.

Although compared with younger patients, older patients with the same adjuvant therapy to improve the survival and the role of side effects, but the adjuvant treatment of elderly patients with application rates remain relatively low. Currently, the elderly other gastrointestinal malignancies related study also rarely.

Diagnosis and treatment of early gastric cancer Status

The incidence of gastric cancer mortality in the world and ranked second in malignant tumors in China accounted for the first, the impact on human health is an important cancer, gastric cancer in recent years on the early detection and early treatment also has made great progress. Currently, the Japanese definition of the early gastric cancer has been accepted by my colleagues in the world, that is, cancer invasion to the submucosa, regardless of size and without lymph node metastasis. Western counterparts also have accepted early gastric cancer with advanced gastric cancer for the same disease in different stages of view, from early development to advanced gastric cancer will take about two to seven years, an average of about three years.

Early gastric cancer in Japan found that the rate is still the highest, with an average 45 percent more, some results of the census, the proportion of early cancer up to 79 percent. Early cancer proportion of the United States has not more than 20%, while different in various parts of China, in the census series of early cancer proportion accounted for 43% ~ 52% in specialty and major hospitals, the proportion of early cancer up to 18% ~ 20%, but in general hospitals, the proportion of early cancer low, mainly because in the early stages, 80% of the patients asymptomatic or only non-specific symptoms, these symptoms after drug application acid inhibitors can be an effective way to ease, thereby bringing misleading. Endoscopic examination early cancer lesions as small and difficult to detect, for the census should promote gastric cancer, at least in the out-patient clinical census to be met, that is, who should do epigastric discomfort endoscopy. Positive extensively carry out endoscopy and biopsy, which would effectively improve the early detection rate. Cheung Po-ling, and other reports 61 cases of early cancer, endoscopic naked eye initial diagnosis rate 44%, after the biopsy diagnosis rate of 95%, while endoscopic ulcer patients misdiagnosed as accounting for 41 percent, gastritis of 15%.

Between East and West, on the early gastric cancer Histopathological diagnosis of the different standard is also different rates of early diagnosis of one of the reasons. Western pathologists more emphasis infiltration performance of different types of cells, while with Japanese scholars and the nucleus of the main indicators of different types.

Endoscopic examination should be done carefully observed mucosal lesions, but not all rules are shallow ulcers or erosion, rough grievance mucosal biopsy should be done. Application pigment found endoscopic lesions can be effectively guided biopsy and, if necessary, the use of soluble enzyme protein can be further enhanced clarity and found lesions more easily, thus enhancing the rate of endoscopic early diagnosis. The number of endoscopic biopsy diagnosis can greatly enhance the positive rate. According to statistics in suspicious lesions, take a biopsy, the sensitivity was 70%, but for six biopsy of 100%. Endoscopic gastric cancer early stage of the judgment, the error rate was as high as 18.6 percent. A group of 435 cases of early endoscopic cancer in 81 cases for the period of progress, and most of the larger than 4 cm, and more small bend in the stomach central side of the undifferentiated cell type, with vessel invasion or metastasis. With high-definition endoscopic like beam to the development and application of the gastric mucosa fine structure to show that benign and malignant lesions for the differential diagnosis with a powerful means to further enhance the level of diagnostic endoscopy. Through Large observation, according to the stomach small concave shape and arrangement, can be divided into A, B, C, D IV. The rules show that with benign lesions, and malignant lesions with the degree of increased performance for the micro-structure of irregularly arranged and structural disorder until completely destroyed.

Early gastric cancer patients after surgery, the 5-year survival rate as high as 95 percent, closely related to lymph node metastasis and prognosis. Mucosa layer cancer metastasis rate of <5%, submucosa cancer can be as high as 20 percent. Zhou Qin, and other reports, submucosal layer of early cancer metastasis rate of 3 percent, the muscularis mucosa was 4.7%, submucosa for 22.9 percent. Where shifted to 1 to 3 groups lymph nodes, the 5-year survival rate <90%, the three groups more than 5-year survival rate <80%, while Sml of cancer metastasis rate is still very low, with the same cancer mucosal layer. Also tumor size and lymph node metastasis, less than 1 cm without lymph node metastasis, 1 ~ 4 cm to 5% transfer> 4 cm with 46% transfer.

Early gastric cancer prognosis and the changes of molecular biology have more reports, poor prognosis, easy early recurrence of early gastric cancer p53 expression as high as 43 percent, and cyclin E and p53 expression, the five-year survival rate is only 61 percent, none of them were 5-year survival rate as high as 90 percent.

Endoscopic ultrasonography (EUS) Early inspections help determine the depth of invasion and lymph node metastasis. According to statistics, a group of 79 cases of gastric cancer in patients with preoperative and postoperative pathologic ultrasound contrast rate, T1 tumor rate of 85.7%, T2 rate of 31.2%, T3 to T4 rate of 91.1 percent. Lymph node metastasis, lymph node metastasis rate of 77.4 percent. EUS diagnosed as a separation without lymph node metastasis was 50%, in the application of EUS attention should be paid to the above characteristics.

Mucosal resection (EMR), as early gastric cancer treatment has been recognized, its indications for well-differentiated, uplift and Ⅱ a, less than 2 cm, or depression type II c, <1cm scope can be implemented EMR. Because this type of lymph node metastasis is very small, with the surgical resection of the same, especially for the elderly and frail, also advocated> 2 cm may also EMR. EMR can as a means of treatment is also important diagnostic tool. If the RMR after specimens found to have infiltrated deep or vessel invasion, they should further implement the surgery. Another example, a wedge-shaped laparoscopic resection, or shrinking local excision surgery early gastric cancer is the main method of treatment.

Gastric cancer clinical manifestations and treatment

(A) The clinical manifestations: Late in the performance, there will be the following:

Easy to eat flu, abdominal distension, hypopharyngeal difficulties and upper abdominal discomfort, or have severe upper abdominal pain drilling. May pyloric obstruction or total gastrectomy tired and vomiting, cancer rupture can cause hematemesis and melena, and the elderly, there will be the course of weakness, loss of appetite, weight loss, anemia, edema fever, dry skin and hair loss and other clinical manifestations.

(B) Treatment:

Surgical treatment: the treatment of gastric cancer is the primary means, as long as patients with physical conditions permit nor distant metastasis, surgical resection should be both.

Chemotherapy: mainly used for gastric cancer patients before, during and after operation of advanced gastric cancer surgery or other reasons not to.

Chinese medicine treatment to purge, Qi Huayu; Qi Huoxue, Tongluo Xiaoji, and other treatment. Prescriptions (abbreviated).

(C) Prevention and Health:

Cause unclear, it is therefore not specific methods. Food can only avoid the associated factors. If attention to food hygiene, avoid or reduce the intake of carcinogenic substances more food, more food containing vitamin C-rich vegetables, fruits, such as Chinese cabbage, apples, tomatoes, and so on the stomach polyps, inflammation, ulceration to timely treatment, regularly reexamination.

Clinical manifestations of gastric cancer treatment

[Clinical]

1, on the early and more abdominal pain or discomfort for the secret anguish and late can have severe pain. Pain no laws, and instead increased postprandial, but also some pain in patients with similar flooding, Tang disease, may ease of use acid-fast.

2, upper abdominal discomfort.

3, anorexia, anorexia greasy meat, but whose favorite diet, despite eating as usual, there was a late anorexia.

4, cardia cancer can be expressed as swallowing,剑突under obstruction flu.

5, illness, there will be the development of advanced anorexia, weight loss, anemia, pyloric obstruction, continued black soiled, ascites, abdominal mass, evil quality of the symptoms.

6, no early signs.

Advanced:

(1) Multi-abdominal mass in the abdomen, quality hard (sometimes resembles liver leaves, susceptible to liver cancer or cirrhosis error).

(2) transfer performance can be left supraclavicular lymph nodes touch of the hardware; cancer ascites; cancer metastasis to the liver, lung, ovarian, and other emerging corresponding symptoms and signs.

(3) Upper gastrointestinal barium meal examination positive rate of over 90 percent, common are:

① filling defect;

② cavity niche, ulcers usually greater than 2.5 cm in diameter, external and see crescent, not on the edge, near the mucosal folds rough chaos, interrupted or disappear;

③ stenosis and obstruction. X-ray examination in recent years because of improved methods, such as the use of double photographic method can be observed by the mucosal folds gap existing micro-lesions, which can be found that the majority of early gastric cancer.

(4) gastroscopy and gastric mucosa in vivo cytology both fiber endoscopy or electronic endoscopy are an important basis for the diagnosis of gastric cancer, a pathological examination in vivo diagnosis of gastric cancer is the single most direct indicators.

(5) cytology examination of stomach gastric cancer diagnosis also contributed.

(6) laboratory

① fecal occult blood repeatedly about half of patients were positive.

② erythrocyte sedimentation rate of about 2 / 3 of patients with growth.

③ gastric juice of about 20% acid-free, and the remaining acid or low pH was normal.

The above three more checks early, the positive rate, the lower and therefore could not be considered normal results of this disease can be ruled out.

④ variety of other laboratory tests such as immunization inspection carcinoembryonic antigen (CEA), alpha-fetoprotein (aFP), the specificity of the diagnosis of gastric cancer are not high. Gastric cancer monoclonal antibody to detect gastric juice or gastric cancer antigen in the serum of methodological research is still active, so far no breakthrough progress.

[Treatment]

1, surgical treatment

Surgical resection of gastric cancer is the most effective method of treatment, radical surgery early as possible, according to preoperative and intraoperative judgment tumor location, depth of invasion, the extent of lymph node metastasis decision surgery program. With stage III and IV can not be as radical surgery, they may consider palliative surgery, such as palliative or subtotal gastrectomy the gastrointestinal ostomy surgery, such as palliative short-circuit.

2, chemotherapy

(1) of the surgery and chemotherapy

Preoperative 3 days from the (including operation) and can be used after 2 days of chemotherapy (eg, 5 Fu daily 500 ~ 750 mg intravenous) to reduce surgery cancer metastasis. T3 over to gastric cancer after surgery plus intraperitoneal chemotherapy to reduce postoperative peritoneal metastasis rate.

(2) conventional chemotherapy

Advanced gastric cancer after surgery or in patients with advanced gastric cancer, chemotherapy drugs be required to extend survival time and improve three years that 5-year survival rates. Commonly used anti-cancer drugs to 5 Fu, mitomycin C (MMC), Adriamycin (ADR) or epirubicin (epirubicin), carboplatin or cisplatin. General application of combination chemotherapy, combined chemotherapy with a variety of programs to choose from, such as ① MFC programs: MMC4mg, plus saline 20 ml, intravenous 5 Fu250 ~ 500mg, and 25% glucose 20 ml, intravenous; cytarabine (Ara - C) 100 mg, and 10% glucose 500 ml, slow infusion; these three drug application the same day, every four dl times to 10 to 12 times for treatment; ② FAM program: 5 F u, 750mg, slow injection, lasted 10 hours more than a day, a total of 5 days; section on the 1st at the same time using ADR, 60 ~ 80mg, plus saline 20 ml injection, and the MMC, 6 ~ 10mg, plus saline 20 ml, intravenous, 21 ~ 28 days for treatment , going on for several months; ③ can also use a single agent alone: 5 Fu, 500 ~ 750mg / d for 5 d, monthly meeting, timely and micro infusion pump slow drip, better efficacy than the rapid injection; tegafur (Chu Nom fluoride, FT207) 200mg oral four times daily, or fluoride Furtulon 200 mg, orally four times daily.

Gastric cancer cells or progesterone receptors such as estrogen receptor positive, and each should be used megestrol acetate or tamoxifen (tamoxifen), extended remission period.

3, immune enhancement treatment

Lentinan, Coriolus versicolor polysaccharide, solubilization chain are non-specific immune enhancer, interleukin-2 for transmission on behalf of the cytokines may improve treatment of patients with symptoms, improve quality of life and prolong survival time.

4, Anticancer Treatment

Integrated treatment can be used as one of the measures that apply to some not suitable for surgery and radiotherapy and chemotherapy or relapse after surgery patients. Hebei Tumor Hospital Fu Shan Chinese high-tech achievements developed using the cellular and molecular regulation of tumor suppressor medicine, “Fu Shan God” series of agents ( capsules, oral liquid, etc.) and tumor suppressor injections, breaking the “poisonous cancer, killing cancer, anti - cancer, “” traditional set thinking, “There is no toxic drug itself, not the cancer have a direct positive stimulus, it is cell gene therapy in clinical application. Its principle is the grams of cancer: carcinoid tumor angiogenesis inhibiting the formation of networks, blocking nutrient supply to the cancer cells, cancer cells metabolic cut off channels, causing cancer are not sources of nutrients gradually withered, the waste can not be discharged gradually degeneration and necrosis, and do not harm normal cells. In enhancing the body’s own immune function, and promote the body’s anticancer immune monitoring system regeneration, the activation of various types of cancer cells kill At the same time, cell cycle regulation and cell molecular dynamic engine, lost control of the cancer cell cycle back to normal rhythm, so that cancer cells reversed. The drug with chemotherapy and radiotherapy, can significantly reduce the release of the toxic side effects of chemotherapy, raising the number of white blood cell. Even has lost surgery, radiotherapy and chemotherapy in patients with advanced opportunities, but also control the transfer, less cancer pain, improve Syndrome, improve quality of life and prolong survival time with cancer.

[Prevention]

No precise methods of prevention, it is important to state precancerous gastric cancer and precancerous lesions in high-risk targets should Files legislature cards, periodic review to improve the diagnosis rate of early gastric cancer. Mass of the Census and gastric cancer knowledge and education to sustain the current biggest problem is the lack of an effective screening tool to investigate the electronic answer questions Pattern Recognition Act or gastric occult blood tests were all beads and evaluation of the trial. Fresh vegetables, a variety of vitamins, such as HP both prevention and treatment of gastric cancer incidence rates may be lower. Fresh garlic can be reported against gastric cancer.