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1.
目的通过高通量测序分析,探讨幽门螺杆菌(Helicobacter pylori)感染在正常胃部菌群多样性和组成中的差异。方法选择2017年10月-2018年1月在本院就诊的胃镜体检受试者40例,其中H.pylori阳性20例,阴性20例,均无阳性体征,收集胃液样本行胃部菌群MiSeq高通量测序分析。结果 H.pylori感染组α-多样性指数Shannon(t=-6.690,P0.001)和Simpson(t=-3.673,P=0.002)显著改变,显示胃部菌群多样性降低;菌群丰富度指数如PD Whole tree(t=-2.282,P=0.008),Chao1(t=-2.173,P=0.036)和Observed species(t=-2.627,P=0.012)在H.pylori阳性受试者中显著降低;β-多样性指数PCA分析可显著区分两组,结果显示H.pylori感染胃部菌群显著改变。LEfSe组成差异分析发现,胃部菌群组成亦发生了显著改变,H.pylori感染阳性组中变形菌门细菌显著升高,而厚壁菌门、拟杆菌门、放线菌门等显著降低;在属水平上,螺杆菌属(Helicobacter)、盐单胞菌属(Halomonas)、希瓦内拉菌属(Shewanella)和葡萄球菌属(Staphylococcus)等显著富集,而普氏菌属(Prevotella)、假单胞菌属(Pseudomonas)、芽胞杆菌属(Bacillus)等显著降低(LDA2,P0.05)。PiCRUSt菌群功能预测分析发现,H.pylori阳性的胃部菌群细菌分泌系统、脂多糖合成蛋白、脂多糖合成、细菌毒素、癌症信号通路的表达显著升高,而氨基酸代谢通路显著降低,这与胃癌的发生发展具有密切的联系。结论 H.pylori感染是影响正常胃部菌群多样性和组成的重要因素,这些改变可能与胃癌发生发展及预后密切相关。  相似文献   

2.
目的 探讨慢性萎缩性胃炎患者和慢性浅表性胃炎患者胃内幽门螺杆菌(Helicobacter pylori,H.pylori)感染与舌苔菌群的关系。方法 根据61名患者内镜、病理和H.pylori检测结果,将其分成慢性萎缩性胃炎H.pylori阳性组(12名)、慢性萎缩性胃炎H.pylori阴性组(16名)、慢性浅表性胃炎H.pylori阳性组(8名)和慢性浅表性胃炎H.pylori阴性组(25名)。采集舌苔样本进行16S rRNA基因测序,分析各组患者舌苔菌群结构。结果 16S rRNA基因测序结果显示,此次测序样本数据量足够,样本所含物种的丰富程度和均匀程度合理。4组舌苔菌群样本中Observed species指数差异有统计学意义(H=10.023 3,P<0.05)。门水平上,舌苔菌群由拟杆菌门、厚壁菌门、变形菌门3大优势菌门组成。属水平上,4组间共有11种菌属的丰度差异有统计学意义(均P<0.05)。在慢性萎缩性胃炎患者中,H.pylori阳性的患者拟普雷沃菌属相对丰度显著低于H.pylori阴性患者,而罗氏菌属的相对丰度则显著升高。此外,61例舌苔菌群样本中,仅1例...  相似文献   

3.
目的体外评价甘草提取物对牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌和伴放线放线杆菌四种牙周常见致病菌的抑制效果。方法以牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌和伴放线放线杆菌四种牙周常见致病菌作为供试菌,采用液体稀释法,考察甘草提取物对这四种细菌的最小抑菌浓度(MIC)和最小杀菌浓度(MBC);并采用不同浓度的甘草提取物溶液,绘制甘草提取物对四种牙周致病菌的时间-杀菌曲线。结果甘草提取物对牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌和伴放线放线杆菌的MIC值分别为1.50、1.50、0.75和1.50mg/mL,MBC值分别为6、3、3和3mg/mL。当甘草提取物达到对四种细菌的MBC值时,对于牙龈卟啉单胞菌、中间普氏菌、伴放线放线杆菌可在2h后可达到杀菌效果,对于具核梭杆菌可在4h后达到杀菌效果。结论甘草提取物对以上四种牙周常见致病菌具有良好的抑菌及杀菌作用。  相似文献   

4.
目的比较甲流(IA)患儿鼻咽部及口咽部菌群与健康儿童的差异,分析甲型流感病毒(IAV)感染后可能对儿童鼻咽部及口咽部菌群的影响。方法选取我院120例甲流患儿作为病例组,120例年龄性别相近的健康儿童作为健康组,采用高通量测序技术,对采集的所有鼻咽部及口咽部标本行16S rDNA基因测序分析,比较两组儿童间的菌群多样性及在门、属水平上菌群结构的差异。结果病例组鼻咽部及口咽部的菌群多样性均高于对照组(Ps0.05)。在门水平上,两组儿童鼻咽部及口咽部的第一优势菌门均为厚壁菌门(Firmicutes)(Ps0.05),病例组鼻咽部的变形菌门(Proteobacteria)相对丰度显著高于健康组(Ps0.05);在鼻咽部菌属水平上,病例组中正常优势菌莫拉氏菌属(Moraxella)、棒状菌属(Corynebacterium)、狡诈菌属(Dolosigranulum)、普氏菌属(Prevotella)等的相对丰度显著减少(Ps0.05),而链球菌属(Streptococcus)、嗜血杆菌属(Haemophilus)、盐单胞菌属(Halomonas)、不动杆菌属(Acinetobacter)、罗尔斯通菌属(Ralstonia)等的相对丰度显著增加(Ps0.05),叶杆菌属(Phyllobacterium)仅见于病例组;在口咽部菌属水平上,病例组菌群相对减少的有奈瑟菌属(Neisseria)、乳杆菌属(Lactobacillus)等,而葡萄球菌属(Staphylococcus)、奇异菌属(Atopobium)、放线菌属(Actinomyces)等的相对丰度显著增加(Ps0.05)。结论通过对甲流患儿进行上呼吸道菌群分析,揭示了甲流患儿鼻咽部及口咽部菌群的失调,这提示我们可从微生态角度研究甲流,从而进一步了解甲流的发病机制,为减少甲流严重并发症及病死率提供可能的理论依据。  相似文献   

5.
目的为揭示健康人咀嚼槟榔前后的菌群结构及其多样性,分析咀嚼槟榔前、咀嚼5 min后和咀嚼30min后口腔内菌群结构变化以及多样性特征。方法通过收集8个人咀嚼槟榔前后唾液,用宏基因组DNA进行高通量测序。结果咀嚼槟榔5min后,链球菌属(Streptococcus)、普雷沃菌_7属(Prevotella_7)、韦荣球菌属(Veillonella)、纤毛菌属(Leptotrichia)、嗜血杆菌属(Haemophilus)、拟普雷沃菌属(Alloprevotella)、普雷沃菌属(Prevotella)、卟啉单胞菌属(Porphyromonas)、梅毒螺旋体_2(Treponema_2)、普雷沃菌_6属(Prevotella_6)和兼性双球菌属(Gemella)较咀嚼前相对丰度明显下降,分别下降了16.57%、12.94%、9.38%、23.08%、54.55%、52.63%、30.00%、42.86%、30.00%、16.67%和42.86%,纤毛菌属(Leptotrichia)降幅最大。而咀嚼30min后,纤毛菌属(Leptotrichia)、嗜血杆菌属(Haemophilus)、拟普雷沃菌属(Alloprevotella)、卟啉单胞菌属(Porphyromonas)、梅毒螺旋体_2(Treponema_2)和罗思菌属(Rothia)的相对丰度较咀嚼5 min后均增大。结论链球菌属(Streptococcus)、韦荣球菌属(Veillonella)作为主要变化的菌属,在咀嚼槟榔的过程中,对口腔产生一定的作用,可能是口腔龋齿等牙周疾病的直接或间接影响因子。  相似文献   

6.
摘要:目的 探讨不同浓度臭氧水对4种牙周致病菌的体外抑菌效果。方法 采用定量悬液法,分别用1.02 ppm、2.03 ppm和3.88 ppm三种浓度臭氧水,0 ppm无臭氧水溶液(阴性对照组)及3%双氧水(阳性对照组),对常见的4种牙周致病菌牙龈卟啉单胞菌(Porphyromonas gingivalis)、具核梭杆菌(Fusobacterium nucleatum)、中间普氏菌(Prevotella intermedia)和黏性放线菌(Actinomyces viscosus)分别作用30 s、60 s后,观察不同作用时间下3种不同浓度臭氧水的抑菌效果。结果 对P. gingivalis、F. nucleatum、P. intermedia和A. viscosus作用30 s和60 s,与阴性对照组比较,1.02 ppm、2.03 ppm和3.88 ppm三种浓度臭氧水均具有明显的抑菌效果,3.88 ppm臭氧水与3%双氧水对4种细菌作用60 s的抑菌效果相同。 结论 实验所用的3种不同浓度臭氧水对牙周致病菌P. gingivalis、F. nucleatum、P. intermedia和A. viscosus均有抑菌作用,浓度越高,抑菌效果越好,臭氧水应用于牙龈牙周疾病临床防治有一定的价值和可行性。  相似文献   

7.
【目的】本研究旨在探究拟除虫菊酯类杀虫剂对棉铃虫Helicoverpa armigera幼虫肠道菌群结构及代谢的影响,丰富对杀虫剂作用机理的认识。【方法】分别对棉铃虫2和3龄幼虫饲喂普通人工饲料(对照组, SS)、含2%七氟菊酯(Ⅰ型拟除虫菊酯)粉剂饲料(七氟菊酯处理组,Te)和含2.5%溴氰菊酯(Ⅱ型拟除虫菊酯)乳油饲料(溴氰菊酯处理组, DM),然后提取3龄幼虫肠道菌群基因组DNA;利用Illumina MiSeq二代高通量测序技术对肠道细菌的16S rDNA的V3-V4变异区进行测序,分析其肠道细菌的多样性和丰富度;利用qPCR验证16S rDNA测序分析结果。取2和3龄幼虫肠道,匀浆后进行Biolog-Eco实验,分析肠道细菌对Eco板上31种碳源的代谢情况。【结果】16S rDNA测序结果表明,棉铃虫3龄幼虫肠道细菌主要是厚壁菌门(Firmicutes)、变形菌门(Proteobacteria)、拟杆菌门(Bacteroidetes)和蓝藻菌门(Cyanobacteria)。与对照组相比,溴氰菊酯处理组和七氟菊酯处理组的棉铃虫幼虫肠道细菌的α多样性指数没有显著性改变,但是菌群结构发生了变化:在门水平,拟杆菌门的相对丰度减少,厚壁菌门和蓝藻菌门的相对丰度增加,qPCR验证结果亦支持16S rDNA测序分析的这个结果;在属水平,拟杆菌属Bacteroides、普氏菌属Prevotella和假单胞菌属Pseudomonas等的相对丰度降低,狭义梭菌属Clostridium sensu stricto 1、埃希菌属-志贺氏菌属Escherichia-Shigella和盐单胞菌属Halomonas等的相对丰度增加,其中盐单胞菌属Halomonas的相对丰度显著增加。Biolog-Eco结果表明,与对照组相比,溴氰菊酯处理组中2龄幼虫对羧酸类碳源的代谢能力下降;溴氰菊酯处理组和七氟菊酯处理组中3龄幼虫对DL-α-磷酸甘油、肝糖和L-苯丙氨酸等碳源的利用能力下降。【结论】结果显示,拟除虫菊酯类杀虫剂对棉铃虫肠道菌群的结构和代谢能力有明显影响,拟除虫菊酯类杀虫剂使棉铃虫肠道有益菌的相对丰度下降,而使致病菌的相对丰度增加。短时间拟除虫菊酯处理未造成抗药性菌群的丰度增加。qPCR检测结果与16S rDNA测序分析结果相似。Ⅰ型和Ⅱ型拟除虫菊酯类杀虫剂对棉铃虫肠道菌群结构和代谢功能的影响不同。  相似文献   

8.
目的通过低龄龋齿儿童与口腔健康儿童的微生物组检测,探讨低龄儿童龋病牙菌斑的菌群组成特征。方法在深圳地区招募轻度龋齿、重度龋齿及口腔健康儿童共100名,采集其牙菌斑或健康牙齿表面微生物样本,采用MiSeq测序平台进行16S V4-V5区域的高通量测序。同时,通过生物信息分析方法,对低龄龋齿儿童的牙菌斑的微生物组成的特征进行挖掘分析。结果相对口腔健康儿童,重度龋齿患儿的牙菌斑微生物多样性增加,轻度龋齿患儿则减少,但变化不显著。门水平的优势菌主要为放线菌门、变形菌门及拟杆菌门,虽有相对丰度变化但差异无统计学意义。前10位的优势菌属中,轻度及重度龋齿儿童的最高丰度优势菌属为棒状杆菌属,重度龋齿儿童与健康儿童中的棒状杆菌丰度差异有统计学意义(t=-2.195 5, P=0.028 1)。健康儿童口腔的优势菌属包含了卟啉单胞菌属,但在轻度及重度龋齿儿童的优势菌属则替换为月形单胞菌属。种水平的菌群结构分析显示,前10位的优势菌丰度变化差异无统计学意义,而低丰度的致病菌如变异链球菌(H=27.302 1, P<0.000 1)、Atopobium parvulum(H=17.418 2, P=0.000 2)、栖牙普氏菌(H=10.598 9, P=0.005 0)、唾液普氏菌(H=10.035 0, P=0.006 6)等则在重度龋齿儿童中显著富集。结论低龄龋齿儿童的牙菌斑微生物结构发生了改变,部分口腔有害菌的丰度显著增加与龋病严重程度密切相关。  相似文献   

9.
目的 探讨益生菌联合铋剂四联疗法对不同分型幽门螺杆菌(Helicobacter pylori,H. pylori)根除率以及患者肠道菌群的影响,为相关治疗提供参考。方法 收集2021年12月至2022年6月因上腹部不适就诊于湖北医药学院附属随州医院消化内科门诊,证实为H. pylori感染的91例患者作为研究对象。完善胃镜、血清抗体分型检测,采集患者治疗前及治疗后粪便标本进行肠杆菌、肠球菌、双歧杆菌及乳杆菌等优势菌群的培养。根据血清抗体分型结果将患者分为H. pylori Ⅰ型组(54例)和H. pylori Ⅱ型组(37例)。H. pylori Ⅰ型组患者随机分为试验组与对照组,各27例;H. pylori Ⅱ型组患者随机分为试验组(19例)与对照组(18例)。全部对照组患者给予泮托拉唑钠肠溶胶囊、克拉霉素胶囊、阿莫西林胶囊及枸橼酸铋钾胶囊口服,疗程14 d;全部试验组患者在对照组基础上联合服用双歧杆菌三联活菌肠溶胶囊,疗程14 d。治疗结束停药4周后行14C呼气试验,结果为阴性则判定为H. pylori根除成功。比较不同分型H. pylori根除率以及感染者肠道菌群的改变。结果 H. pylori Ⅰ型感染者中试验组患者根除率显著高于对照组(100.0%vs85.2%,P<0.05)。H. pylori Ⅱ型感染者中试验组与对照组根除率比较差异无统计学意义(84.2%vs 55.6%,P> 0.05)。治疗前,H. pylori Ⅰ型组患者肠道双歧杆菌、乳杆菌、肠杆菌及肠球菌的数量均显著高于H. pylori Ⅱ型组(均P<0.05)。治疗后,H. pylori Ⅰ型和H. pylori Ⅱ型试验组中上述菌群均高于治疗前(均P<0.05)。H. pylori Ⅰ型对照组患者治疗后肠道双歧杆菌、乳杆菌及肠球菌数量低于同组治疗前,大肠埃希菌数量高于同组治疗前(均P<0.05)。治疗后,H. pylori Ⅱ型对照组患者肠道双歧杆菌数量低于同组治疗前,乳杆菌、大肠埃希菌、肠球菌数量均高于同组治疗前(均P<0.05)。治疗后,试验组中H. pylori Ⅰ型感染者肠道双歧杆菌、乳杆菌、大肠埃希菌、肠球菌数量均高于H. pylori Ⅱ型感染者(均P<0.05);对照组中H. pylori Ⅰ型感染者肠道双歧杆菌、乳杆菌及大肠埃希菌数量均高于H. pylori Ⅱ型感染者,肠球菌数量低于H. pylori Ⅱ型感染者(均P<0.05)。治疗后,H. pylori Ⅰ型组和H. pylori Ⅱ型组中试验组患者上述菌群均高于对照组(均P<0.05)。结论 在治疗H. pylori Ⅰ型感染者时添加益生菌不仅能提高H. pylori的根除率,而且有利于患者肠道菌群的恢复。在无严重胃部疾病时,对于H. pylori Ⅱ型感染者,选择定期随访有利于患者康复,若合并严重胃部疾病时可添加益生菌,虽不能提高H. pylori根除率但有利于调节肠道菌群,促使肠道微生态恢复平衡。  相似文献   

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【背景】妊娠期妇女口腔微生物改变与口腔疾病及全身性疾病之间有显著相关性。【目的】比较不同妊娠状态下女性口腔微生物结构的差异,探讨该差异与不同妊娠状态间的关联性。【方法】选取18名孕妇和9名非孕妇为研究对象[(28.2±3)岁],分为妊娠期糖尿病组[gestational diabetes mellitus,GDM,年龄(28.9±3.6)岁,孕周(30.1±3.2)周]、妊娠期非糖尿病组[non-diabetic pregnant women,PW,年龄(27.9±3.0)岁,孕周(28.6±4.7)周]和非妊娠期非糖尿病组[non-pregnant women,NPW,年龄(27.7±2.1)岁],每组9名,收集口腔唾液(saliva,S)和龈上牙菌斑(supragingival dental plaque,D),采取Illumina Novaseq测序平台针对细菌16S rRNA基因的V3-V4可变区进行测序,以SILVA为参考数据库使用朴素贝叶斯分类器对特征序列进行分类学注释,利用QIIME软件对样本进行生物信息学分析。【结果】三组中唾液及牙菌斑微生物差异比较显示:D-GDM中二氧化碳嗜纤维菌属检出量高于D-PW,而月形单胞菌属检出量显著低于D-PW;S-GDM中产气单胞菌属、拟杆菌属等厌氧菌属检出量高于S-PW,韦荣氏菌属检出量低于S-PW;D-PW中纤毛菌属、普氏菌属和月形单胞菌属检出量显著高于D-NPW;D-NPW中产气单胞菌属、放线杆菌属、二氧化碳嗜纤维杆菌属、奈瑟菌属、链球菌属和劳特罗氏菌属等检出量高于D-PW;S-PW中韦荣菌属、普氏菌属、链球菌属和卟啉单胞菌属检出量低于S-NPW;D-GDM中福赛斯坦纳菌属、纤毛菌属检出量高于D-NPW,劳特罗氏菌属检出量低于D-NPW;S-GDM中密螺旋体属、弯曲杆菌属检出量高于S-NPW,链球菌属低于S-NPW。在种水平上,S-GDM菌群中具核梭杆菌检出量显著高于S-PW,S-GDM菌群中牙龈卟啉单胞菌及福赛斯坦纳菌检出量与S-PW差异无统计学意义,产黑普氏菌检出量低于S-PW;S-PW中牙龈卟啉单胞菌、产黑普氏菌和福赛斯坦纳菌检出量均显著高于S-NPW。【结论】孕妇妊娠期糖尿病将增加口腔微生物群厌氧菌检出率,GDM与牙龈卟啉单胞菌、福赛斯坦纳菌和产黑普氏菌等牙周炎致病菌相关性不能确定。  相似文献   

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The development and progression of gastric cancer (GC) is greatly influenced by gastric microbiota and their metabolites. Here, we characterized the gastric microbiome and metabolome profiles of 37 GC tumor tissues and matched non-tumor tissues using 16s rRNA gene sequencing and ultrahigh performance liquid chromatography tandem mass spectrometry, respectively. Microbial diversity and richness were higher in GC tumor tissues than in non-tumor tissues. The abundance of Helicobacter was increased in non-tumor tissues, while the abundance of Lactobacillus, Streptococcus, Bacteroides, Prevotella, and 6 additional genera was increased in the tumor tissues. The untargeted metabolome analysis revealed 150 discriminative metabolites, among which the relative abundance of the amino acids, carbohydrates and carbohydrate conjugates, glycerophospholipids, and nucleosides was higher in tumor tissues compared to non-tumor tissues. The targeted metabolome analysis further demonstrated that the combination of 1-methylnicotinamide and N-acetyl-D-glucosamine-6-phosphate could serve as a robust biomarker for distinction between GC tumors and non-tumor tissues. Correlation analysis revealed that Helicobacter and Lactobacillus were negatively and positively correlated with the majority of differential metabolites in the classes of amino acids, carbohydrates, nucleosides, nucleotides, and glycerophospholipids, respectively, suggesting that Helicobacter and Lactobacillus might play a role in degradation and synthesis of the majority of differential metabolites in these classes, respectively. Acinetobacter, Comamonas, Faecalibacterium, Sphingomonas, and Streptococcus were also significantly correlated with many differential amino acids, carbohydrates, nucleosides, nucleotides, and glycerophospholipids. In conclusion, the differences in metabolome profiles between GC tumor and matched non-tumor tissues may be partly due to the collective activities of Helicobacter, Lactobacillus, and other bacteria, which eventually affects GC carcinogenesis and progression.Subject terms: Cancer metabolism, Gastrointestinal cancer  相似文献   

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Apoptosis in gastric mucosa with stress-induced gastric ulcers.   总被引:15,自引:0,他引:15  
The maintenance of gastric mucosal integrity depends upon the interplay between epithelial cell proliferation and apoptosis (programmed cell death). The Bcl-2 family of proteins plays a central role in the regulation of apoptotic cell death by suppressing the apoptosis while some others such as Bax proteins promote this process. Stress-induced gastric ulcerations are accompanied by the fall in gastric mucosal cell proliferation but little is known about the influence of the stress on the apoptosis in gastric mucosa. In the present study, the gastric epithelial apoptosis was determined by means of expression of Bax and Bcl-2 mRNA in the gastric mucosa following acute stress. Wistar rats were exposed to mild water immersion and restraint stress (WRS) for 3.5 h and then sacrificed at 0, 2, 4, 6, 12 and 24 h after the termination of WRS. At each time interval after WRS, the gastric blood flow (GBF) and the proliferating cell nuclear antigen (PCNA) labeling were determined. The apoptosis rate in the gastric mucosa was determined by the terminal deoxynucleotidyl transferase (TDT) mediated 2-deoxyuridine 5-triphosphate (dUTP)-biotin nick end-labeling (TUNEL) staining method and the expression of Bax and Bcl-2 mRNA was analyzed by RT-PCR and southern blot hybridization. WRS produced multiple erosions accompanied by the fall in GBF and PCNA index and by a dramatic enhancement in gastric epithelial apoptosis rate reaching maximum at 4 h after exposure to WRS. Following 6 and 12 h after the end of WRS the apoptotis declined but even 24 h after WRS it failed to reach the value recorded in intact gastric mucosa. The PCNA index was still significantly inhibited at 2 h after WRS but then showed significant rise at 6 and 12 h to reach at 24 h after WRS, the level similar to that measured in intact gastric mucosa. The expression of Bax mRNA was detected in intact gastric mucosa and gradually increased in first 4 h after WRS to decline at 24 h to the level not significantly different from that observed in the intact mucosa. In contrast, the expression of Bcl-2 mRNA was almost undetectable during first 4 h but showed strong signal at 6 and 12 h to decline to the control level 24 h after WRS. We conclude that: 1. Healing of WRS lesions involves an increase in GBF and mucosal cell proliferation and 2. The enhancement in gastric epithelial apoptosis accompanies the mucosal damage induced by stress and this appears to be triggered by the shift from the cell death effector Bax to the cell death repressor Bcl-2 protein.  相似文献   

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BACKGROUND: Gastrointestinal stromal tumors (GIST) constitute a large majority of mesenchymal tumors of the gastrointestinal (GI) tract, which express the c-kit proto-oncogene protein, a cell membrane receptor with tyrosine kinase activity. GI stromal tumors of the stomach are usually associated with bleeding, abdominal pain or a palpable mass. CASE PRESENTATION: A 75-year-old male presented with upper abdominal pain and palpable mass. Computed tomographic (CT) scan of the abdomen showed a large mass arising in the posterior aspect of fundus, body, and greater curvature of the stomach. Second day after the admission, there was significant reduction in the size of the tumor, clinically as well as radiologically. Endoscopic biopsy showed large bulge in fundus and corpus of the stomach posteriorly with an opening in the posterior part of the corpus, and biopsy from the edge of the opening reveled GIST. Patient underwent curative resection. CONCLUSION: Spontaneous ruptured of giant gastric stromal tumor is very rare presentation of stomach GIST. Thorough clinical examination and timely investigation can diagnose rare complication.  相似文献   

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