Clinical application of self-made drainage tube with balloon for iatrogenic colonic perforation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of colonic bypass drainage by self-made drainage tube with balloon for iatrogenic colonic perforation.</p><p><b>METHODS</b>A retrospective analysis of 8 patients with iatrogenic colonic perforations from January 2009 to March 2011 was performed. Self-made drainage tubes with balloon were placed in the bowel lumen endoscopically after perforations were closed with endoclips or endoloops under endoscope. The inflatable balloon at the front-end of the tube was fixed at the mouth side of colonic perforation to achieve continuous drainage of stool and intestinal juice.</p><p><b>RESULTS</b>Endoscopic bypass continuous drainage by using self-made drainage tube with balloon was successfully carried out in all the 8 patients. All the perforations healed and no surgical intervention required. Bypass drainage continued for 3-10 days(mean 7.6 days). One patient received colonoscopy 3 days after the procedure, and displacement of the drainage tube was noticed requiring endoscopic adjustment. All the drainage tubes were removed uneventfully, and no ulceration or perforation occurred at balloon fixed site after removal. After follow up ranging from 12 to 36 months, no chronic fistula, adhesive obstruction, or abdominal infection occurred.</p><p><b>CONCLUSION</b>Colonic bypass drainage by self-made drainage tube with balloon for iatrogenic colonic perforation is simple, feasible, safe and reliable.</p>

The presence and the significance of CD4+CD25+ regulatory T cells in livers of patients with hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the presence and clinical significance of CD4+CD25+ regulatory T cells in liver tissues of hepatocellular carcinoma (HCC) patients.</p><p><b>METHODS</b>CD4+CD25+ regulatory T cells and CD8+ cells and their relative proportions in liver tissues and peripheral blood of HCC patients and of healthy volunteers were analyzed using flow cytometry. The distributions of CD4+CD25+ regulatory T cells in liver tissues were also analyzed.</p><p><b>RESULTS</b>Around the tumor tissues (peri-tumor), the percentage of CD4+CD25+ regulatory T cells was 10.8% +/- 2.3%, which was obviously higher than in the tissues away from the cancer tissues (P < 0.05). The percentage of CD4+CD25+ regulatory T cells in the peripheral blood of HCC patients was 9.4% +/- 1.0%, which was obviously lower than that of the healthy volunteers (12.9% +/- 1.3%) (P < 0.01). With increasing CD4+CD25+ regulatory T cells in the peri-tumor tissue, there was a trend of CD8+ cells decreasing.</p><p><b>CONCLUSION</b>CD4+CD25+ regulatory T cells played an anti-tumor immunity role in hepatocellular carcinoma by restraining the CD8+ cells.</p>

Changes of immunocytes in livers of chronic hepatitis C patients treated with IFN alpha-2b and ribavirin / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the immunocytodynamic changes in the livers of chronic hepatitis C patients treated with IFN alpha-2b and ribavirin and to find new bases for an effective immune regulation therapy.</p><p><b>METHODS</b>Forty-two chronic hepatitis C patients were treated with combined IFN alpha-2b and ribavirin and their peripheral blood and liver tissues were collected before the treatment for analyses. After the treatment, peripheral blood and liver tissue specimens were obtained from only 11 patients. All the specimens were exposed to three monoclonal antibody fluorescence dyes, and the CD45+ cells with triple colors were analyzed using flow cytometry.</p><p><b>RESULTS</b>Compared to the control groups, the positive rates of CD56+, CD57+, CD161+ cells in the livers of those with chronic hepatitis C sharply decreased (Probability value less than 0.01), and CD56+T cells had decreased mildly; CD28 from the CD56+T cells decreased mildly, but the expression of CD152 increased (P<0.05); the positive rates of CD83+CD1a+ cells had decreased mildly, and the positive rates of CD80+CD11c+ and the CD86+CD11c+ cells significantly decreased (P<0.01). After the treatment, the CD56+, CD161+, CD56+T, CD161+T, CD80+CD11c+, CD86+CD11c+ cells in the responding group increased.</p><p><b>CONCLUSION</b>Combined interferon alpha-2b and ribavirin treatment can improve the suppressed cell immunity function.</p>