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Objective:To investigate the efficacy of endoscopic histoacryl injection in cirrhotic patients with newly-developed esophagogastric varices (EGV) who have previously undergone splenectomy combined with pericardial devascularization.Methods:From January 2015 to January 2020, 125 cirrhotic patients with EGV treated with endoscopic histoacryl injection at the Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, were included in the retrospective analysis. There were 45 patients in the group of splenectomy combined with pericardial devascularization (splenectomy group for short) and 80 patients in the non-splenectomy group. The efficacy of endoscopic treatment, postoperative variceal improvement, rebleeding rate, and complications were analyzed between the two groups.Results:Endoscopic histoacryl injection was successfully completed in all 125 patients, and the median volume of histoacryl was 4.5 mL. The overall effective rate in splenectomy and non-splenectomy group was 80.0% (36/45) and 57.5% (46/80), respectively. The difference in the number of significantly effective, effective, and ineffective cases between the two groups was statistically significant (16, 20, 9 cases, and 20, 26, 34 cases, respectively, χ 2=6.469, P=0.039). Two and 14 patients developed rebleeding in the splenectomy group and non-splenectomy group, respectively; and the difference in the rebleeding rate between the two groups was statistically significant (4.4% VS 17.5%, Log-rank P=0.039). No patient died within 1 year in either group, and no serious complications such as ectopic embolism occurred. Conclusion:After splenectomy combined with pericardial devascularization in cirrhotic patients with EGV and hypersplenism, the application of histoacryl has better short-term efficacy and can significantly reduce the rebleeding rate compared with the non-splenectomy group.
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Background:Nonalcoholic fatty liver disease(NAFLD)is the liver manifestation of metabolic syndrome,and may be related with the incidence of colorectal polyps. However,studies on the correlation between NAFLD and colorectal polyps are rare. Aims:To investigate the correlation between NAFLD and colorectal polyps. Methods:Clinical data of 130 asymptomatic patients accepted physical examination were retrospectively analyzed. Detection rates of NAFLD and colorectal polyps were evaluated,and the correlations with body mass index(BMI),hs-CRP,triglyceride,low density lipoprotein,total cholesterol,alanine aminotransferase(ALT),glutamyltranspeptidase(GGT)were analyzed. Results:Compared with non-NAFLD patients,the detection rate of colorectal polyps in NAFLD patients was significantly increased (66.3% vs. 40.0%,P=0.003 9),BMI,triglyceride and ALT were significantly increased(P<0.05). However,no significant differences in hs-CRP,low density lipoprotein,total cholesterol and GGT were found between NAFLD and non-NAFLD patients. Compared with non-colorectal polyps patients,the average age of patients with colorectal polyps was higher(P =0.013),and detection rate of NAFLD was significantly increased(72.6% vs. 47.4%,P =0.003 9). However,no significant differences in BMI,hs-CRP,triglyceride,low density lipoprotein,total cholesterol,ALT,GGT were found between colorectal polyps group and non-colorectal polyps group(P>0.05). Conclusions:NAFLD may be closely correlated with the incidence of colorectal polyps.
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Objective: Acute pancreatitis(AP) often impairs peripancreatic tissues and involves more distant organs,such as the liver,which would exacerbate the progression of the disease.This study aimed to explore the clinical characteristics of acute pancreatitis-associated liver injury.Methods: We randomly retrieved 156 cases of AP from the medical records retrieval system of Jinling Hospital,of which 102 were complicated by liver injury.The latter were divided into a severe AP(n=44) and a mild AP group(n=58) for comparative analysis of the severity of liver injury and time of recovery.Results: Liver injury occurred in 65.38% of the AP patients,and it was more serious,had a longer disease course and took more time to recover in the severe than in the mild AP group.Conclusion: The incidence and severity of acute pancreatitis-associated liver injury are positively correlated with the severity of acute pancreatitis.
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Somatostatin,a cyclopeptide hormone,is generally distributed in vivo.Some studies have indicated that somatostatin can reduce proinflammatory cytokine in hepatic stellate cells and extracellular matrix,and inhibit their proliferation and contraction,promote their apoptosis.It can also regulate the function of Kupffer cells,influence the homing of hepatic stem cells.Somatostain has therapeutic effect on liver fibrosis,especially on the liver fibrosis caused by schistosoma mansoni.
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Objective To investigate the role of ribosomal S6 kinase (RSK) in the pathogenesis of rat hepatic fibrosis. Methods Intra-abdominal injection of dimethylnitrosamine was carried out to (establish) the model of rat experimental hepatic fibrosis. Immunofluorescent double labeling laser scanning (confocal) microscope was performed to detect the location of RSK, ?-smooth muscle actin(?-SMA) and the collagen type Ⅰ. Immunohistochemistry was used to determine the correlation of the expression of RSK and collagen type Ⅰ, Ⅲ in the tissue of hepatic fibrosis. Results In the tissue of hepatic fibrosis, RSK was coexpressed with ?-SMA, and the collagen type Ⅰ located around RSK. The expression of RSK was also correlated with that of collagen type Ⅰ and Ⅲ( P
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Objective To evaluate the protective effect of Caspase-1 inhibitor on acute lung injury(ALI) induced by experimental severe acute pancreatitis(SAP).Methods Forty-two SD rats were randomly assigned into 3 groups: healthy controls group(HC,n=6),SAP+normal saline group(SAP-S,n=18) and SAP+ICE inhibitor group(SAP-ICE-I,n=18).SAP was reproduced by retrograde injection of 5% sodium taurocholate into the pancreaticobiliary duct in SD rats.In animals in HC group same surgical procedure and duct cannulation were performed but without introduction of sodium taurocholate.In SAP-S group,rats received the first intraperitoneal injection of isotonic saline 2h after induction of acute pancreatitis,and the injection of saline was repeated at the 12th hour after induction.In SAP-ICE-I group,rats were given ICE inhibitor intraperitoneally 2h after induction of pancreatitis.Surviving rats were sacrificed at designated time points,and blood and all organs were obtained for subsequent analysis.Serum IL-1? was measured by ELISA.Intrapulmonary expressions of Caspase-1,IL-1? and IL-18 mRNA were detected by semi-quantitative RT-PCR.The ratios of wet/dry weight and histopathological changes in lung were also evaluated.Results The serum IL-1? levels in SAP-S group were 276.77?44.92pg/ml at 6h,308.99?34.95pg/ml at 12h and 311.60?46.51pg/ml at 18h after induction of SAP,respectively,which were increased significantly compared with that in HC group(P0.05).The wet/dry weight ratio of lung in SAP-S group was increased significantly compared with that in HC group(P