ABSTRACT
Objective To observe the effects of endoscopic drug therap on hemostasis, re-bleeding and the risk of occurrence of complication in patients with acute esophageal and gastric variceal bleeding (EGVB). Methods A retrospective method was conducted, and 100 patients with EGVB who were admitted to the Affiliated Hospital of Yan'an University from June 2015 to June 2017 were enrolled. According to the difference in treatment methods, they were divided into an endoscopy Sclerotherapy and Ligation group and transjugular intrahepatic portosystemic shunt (TIPS) group, 50 cases in each group. The TIPS group was treated with TIPS; the endoscopy Sclerotherapy and Ligation group underwent endoscopic variceal sclerotherapy, endoscopic esophageal variceal ligation and postoperative non-selective β blockers oral administration. After 2 years of follow-up, the patients' hemostasis, re-bleeding at acute stage, survival situation and the incidences of complications were recorded. Before treatment and 2 weeks after treatment, the levels of serum albumin (Alb), total bilirubin (TBil) and platelet count (PLT) were measured by Hitachi automatic biochemical analyzer in the two groups. Results The success rate of hemostasis in the endoscopy Sclerotherapy and Ligation group was significantly higher than that in the TIPS group [98.0% (49/50) vs. 82.0% (41/50) ], and the recurrence rate of varices, during 1- and 2-year follow-up, the recurrence rate of bleeding and the incidences of complications were significantly lower than those in TIPS group [the recurrence rate of varicose veins: 6.0% (3/50) vs. 24.0 (12/50), 1-year re-bleeding rate: 12.0% (6/50) vs. 30.0% (15/50), 2-year re-bleeding rate: 42.0% (21/50) vs. 66.0% (33/50), esophageal ulcer: 2.0% (1/50) vs. 14.0% (7/50), upper abdominal discomfort: 2.0% (1/50) vs. 14.0% (7/50), hepatic encephalopathy:4.0% (2/50) vs. 16.0% (8/50), chest pain: 6.0% (3/50) vs. 20.0% (10/50), all P < 0.05]. After treatment, the levels of Alb and PLT in the endoscopy Sclerotherapy and Ligation group were higher than those in the TIPS group [Alb (g/L):43.84±4.34 vs. 40.83±3.21, PLT (×109/L): 26.33±3.37 vs. 21.12±3.89, both P < 0.05], and the TBil was lower than that in the TIPS group (μmol/L: 13.82±4.32 vs. 19.33±4.59). Conclusion Endoscopic Sclerotherapy and Ligation can significantly improve the effect of hemostasis of patients with acute EGVB, the rate of re-bleeding does not increase compared with that of western medicine group using TIPS, and the incidences of complications are significantly lower than those of applying TIPS.
ABSTRACT
Objective To examine characteristics of patients with blood urea nitrogen (BUN) levels higher and lower than the normal limit.Methods During January 2012 to January 2015,116 patients with upper gastrointestinal diseases were selected to study,according to the patient's blood urea nitrogen level,all the patients were divided into high BUN group and low BUN group,and there were 76 patients in the high BUN group,and 40 patients in low BUN group,compared the biochemical indices,gastrointestinal bleeding forrest grading and disease severity of the two groups,and univariate logistic regression analysis.Results The serum white blood cell count,blood urea nitrogen,creatinine and glycated hemoglobin levels in patients of high BUN group [(9 593±5 012)× 102/μl,368.1±162.3 mg/L,11.2±3.7 mg/L and 6.38±1.08％] were significantly higher than that of low BUN patients [(6 804 ± 2 087) × 102/μl,121.0 ± 39.3 mg/L,8.1 ± 3.2 mg/L and 5.51 ± 0.42 ％] (t =3.645～12.659,all P＜0.05),and the hemoglobin levels (87.3±35.1 g/L) of the patients in high BUN group was significantly lower than that of the low BUN patients (108.0 ± 31.2 g/L) (t=3.252,P=0.032).Logistic regression analysis showed the presence of hemoglobin and glycosylated hemoglobin levelst of wo groups of patients was significantly different (P＜0.05),and showed that showed the highest correlation with BUN.Gastrointestinal bleeding forrest hierarchical data of the two groups of patients showed no significant difference (P＞0.05).The proportion of patients with gastric ulcers of high BUN patients was significantly higher than that of the low BUN patients (x2 =39.655,P=0.000).Conclusion Patients with high expression of serum urea nitrogen had more severe upper gastrointestinal bleeding,and it is worthy of attention in the process of clinical diagnostic.
ABSTRACT
Objective To investigate the relationaship between liver cirrhosis patients comibined with infection or death and intestinal permeability (IP)test.Methods 48 patients with liver cirrhois and 16 healthy volunteers were enrolled in the Af-filiated Hospital of Yan’an University during 2 years from 2013 to 2014 in this prospective study.Clinical data of patients were analyzed.LMR (IP index)were caculated and dectected by HPLC differental method.Serum LBP,IL-6 and I-FABP were determined by ELISA.Patients were followed for 1 year and assessed fro survival and the occurrence of infections.Re-lated factors with IP index were analyzed by Spearman’s rho.ROC curve,kaplan-meiser curve,cox regression were used to analyze related factors with the infection-free survival.Results IP index were increased in 40 (83.3%)patients with liver cirrhosis,compared with 4 increased IP index in healthy controls (χ2=19.006,P=0.001).IP index were correlated with al-bumin,IL-6,INR,bilirubin and Child-Pugh (CTP)scores by Spearman’s rho anaylsis (rs=-0.339~0.485,all P9,acites,I-FABP>1 728 pg/ml were independent factors of infection-free survial in liver cirrhosis patients by COX regression (all P<0.05).Conclusion Although increased IP was higher in liver cirrhosis,and it failed to predict infection-free survial in liver cirrhosis patients.
ABSTRACT
BACKGROUND:Tumor stem cels have self-renewal, drug resistance and metastasis tumorigenicity, which play an important role in occurrence, development and metastasis of tumors. Currently, there are two methods to identify tumor stem cels, namely, in vitro tumor sphere culture experiments and in vivo mouse tumorigenic experiments. However, there ia a lack of reports regarding clinicaly enriched gastric cancer cels by chemotherapy. OBJECTIVE:To investigate the enrichment of rat gastric cancer stem cels by cisplatin, and to explore the screening methods for their surface marker proteins. METHODS: BCG-823 gastric cancer model was established in rats, and then rat models were randomized into two groups: rats in experimental groups were subjected to intravenous injection of 0.1, 0.2, 0.25, 0.3 g/L cisplatin via the tail vein; those in control group were injected with normal salinevia the tail vein. After three courses of chemotherapy, gastric stem cels-enriched tissues were colected. Tumor surface proteins were extracted using high-throughput protein microarray and identified by western blot assay. Effects of cisplatin on enrichment of rat gastric cancer stem cels and screening methods for surface marker proteins were compared. RESULTS AND CONCLUSION:Cisplatin at a dose of 0.3 g/L×200μL exhibited the best therapeutic effects, and moreover, with the dose increasing, the tolerance became worse and the incidence of adverse reaction became higher. Transplantation tumors were verified by hematoxylin-eosin staining. Western blot test results were similar to the findings of protein microarray method, that is, HLA-DQ, PMP22 and Claudin7 protein expressions increased in gastric tissues, but HLA-DR, CD14, CD16 and CD56 protein expression decreased. These findings suggest that cisplatin can be used to enrich gastric cancer stem cels in rats, and to successfuly screen the corresponding surface marker proteins.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical value of multi-slice spiral computed tomography portography (MSCTP) in assessing severity of liver cirrhosis and predicting episode risks of hepatic encephalopathy (HE).</p><p><b>METHODS</b>Eighty-six patients with liver cirrhosis who were hospitalized in the Department of Gastroenterology at the Affiliated Hospital of Yan'an University were included in the study.All patients underwent 64-slice MSCTP to grade the portal vein anatomy.The West Haven criteria were used for semi-quantitative assessment of each patient's mental state.The Child-Pugh grading system was used to assess the extent of cirrhosis.Comparison of measurement data between multiple groups was made by one-way ANOVA analysis, and comparison of such between two groups was made by the Mann-Whitney U test, Ranked data were compared with the rank-sum test, and count data were compared by the Chi-Square test.Correlation analysis was performed with Spearman's correlation test.</p><p><b>RESULTS</b>Comparison of the HE grade III group and the HE grade I group showed significant differences between the two in the diameters of left gastric vein, the splenic vein, the intrahepatic left portal vein and the intrahepatic right portal vein (P less than 0.05).Comparison of the Child-Pugh grade C group and the Child-Pugh grade A group showed significant differences between the two in diameters of the left gastric vein, the splenic vein, the intrahepatic left portal vein and the intrahepatic right portal vein (P less than 0.05).The diameters of the main portal vein were not significantly different between the ChildPugh grades and HE classifications (P more than 0.05).The results of MSCTP did show significant differences between different HE classifications in patients with liver cirrhosis and the rate of formation of portal vein thrombosis and fistulas of the hepatic artery-portal vein (P less than 0.05), .but no significant differences with the esophageal and gastric varices, varicose veins around the esophagus, and periumbilical varicose veins (P more than 0.05).HE classification was significantly correlated with formation of portal vein thrombosis and fistula of the hepatic artery-portal vein (r=0.687, P less than 0.05 and r=0.565, P less than 0.05, respectively).MSCTP grading (grade 1:n=35, grade 2:n=36, grade 3:n=15) was not correlated with the Child-Pugh grade (grade A:n=36, grade B:n=32, grade C:n=18) (Z=-0.135, P more than 0.05).Incidence of HE was significantly different among the different MSCTP grades (grade 1:0%(0), grade 2:33.3% (12/36), grade 3:66.7% (10/15); x2=26.468, P less than 0.05).The MSCTP grade was significantly correlated with the episode risks of HE (r=0.552, P less than 0.05).</p><p><b>CONCLUSION</b>MSCTP may be valuable for assessing severity of liver cirrhosis and for predicting episode risks of HE; however, future studies with larger sample numbers is required for validation of our findings.</p>
Subject(s)
Humans , Esophageal and Gastric Varices , Hepatic Encephalopathy , Hepatic Veins , Liver Cirrhosis , Diagnostic Imaging , Pathology , Portal Vein , Portography , Risk Factors , Tomography, Spiral ComputedABSTRACT
By taking advantage of gene engineering,recombinant calcitonin analogue can be successfully obtained.This method can greatly improve the biological activity of the analogue of calcitonin and lower its antigenicity.In this review we discuss the recent progress in the production of recombinant human calcitonin.
ABSTRACT
Objective:To investigate the influence of the granulocyte-macrophage colony-stimulating factor(GM-CSF) on rat thyroid parafollicular cells(C cells).Methods: A total of 48 healthy SD rats were randomly and equally divided into a control group,a low dose group(GM-CSF 10 ?g/kg?d-1) and a high dose group(GM-CSF 50 ?g/kg?d-1).The latter two groups were treated by intraperitoneal administration of GM-CSF at their respective doses for 7 days,and then the thyroid parafollicular cells were stained by immunohishtochemical streptavidin-peroxidase(S-P) technique and their number counted.Results: The number of C cells was(67.43 ? 13.73)in the high dose group,significantly smaller than that of the low dose group(85.97 ? 20.12)(P
ABSTRACT
Objective To investigate the effect of granulocyte-macrophage colony-stimulating factor(GM-CSF) on rat calcitonin(CT).Methods A total of 48 SD healthy rats were randomly divided into control group,low GM-CSF(10?g/kg?d) and high GM-CSF dosage(50?g/kg?d) groups.The rats in experimental groups were continuously treated by an intraperitoneal application of GM-CSF for over 7 days.The level of calcitonin was measured by radioimmunoassay(RIA),and the serum calcium(Ca),ALP and phosphorus(P) were examined by biochemical method.Results The level of the serum calcium in high-dosage GMCSF group was lower than that in the control group(P0.05).Conclusion The high dosage GM-CSF can decrease the serum calcium;the low-and high-dosage GM-CSF can decrease the serum calcitonin,but has no effect on the level of serum phosphorus and ALP.
ABSTRACT
Objective To observe the distribution of the calcitonin(CT) in the submandibular glands of rat. Methods The submandibular gland tissues of the 16 SD health rats were taken to examine by the immunohistochemical streptavidin-peroxidase(SP) technique. Results The results showed that the immunoreactive CT can be observed,they mainly distributed in serous alveoli,serous cells of mixed alveoli,and every duct were also positively immunoreactive to CT.Conclusion The submandibular glands of rat might secrete CT.This suggests that submandibular glands might be related with the regulation of calcium and phosphorus.