ABSTRACT
Objective:To explore the medium-long term efficacy of transjugular intrahepatic portosystemic shunt (TIPS) for gastrointestinal hemorrhage in patients with idiopathic non-cirrhotic portal hypertension (INCPH).Methods:From March 2013 to July 2018, clinical data of 13 INCPH patients, including 5 males, 8 females,with gastrointestinal hemorrhage were retrospectively analyzed, who were diagnosed at the First Affiliated Hospital of Zhengzhou University, Anyang Fifth People′ s Hospital and Yuncheng Central Hospital. All patients received TIPS treatment. The general information, postoperative survival rate, the incidence of rebleeding, shunt dysfunction rate, and incidence of hepatic encephalopathy were analyzed.Results:All 13 patients with INCPH completed TIPS successfully with an average age of 45±8 (33 to 59) years. The hepatic venous pressure gradient (HVPG) decreased from 20.0-26.0 (22.6±1.9) mmHg before procedure to 8.0-14.0 (9.4±3.2) mmHg after. The median follow-up time was 44±7 (31 to 53) months. One patient died of liver failure 27 months after TIPS. Hepatic encephalopathy occurred cumulatively in 1 case (1/13), 1 case (1/13) and 1 case (1/13) in 12, 24 and 36 months after TIPS. Stent restenosis occurred cumulatively in 2 cases (2/13), 3 cases (3/13) and 3 cases (3/13) in 12, 24 and 36 months after TIPS. Portal vein thrombosis occurred cumulatively in 2 cases (2/13), and no primary liver cancer developed.Conclusions:TIPS is safe and effective in the treatment of INCPH with gastrointestinal bleeding with favorable medium-long term outcome.
ABSTRACT
Objective To establish a suitable and stable metastatic rabbit VX2 liver tumor model for the use in experimental study,to discuss the successful rate of different tumor transplanting methods,and to analyze the digital subtract angiography(DSA)imagining features of the transplanted liver tumor.Methods Sixty male New Zealand white rabbits were randomly and equally divided into 3 groups with 20 rabbits in each group.For the rabbits of two groups,receiving injection methods and used as control groups,VX2 carcinoma particle(containing about 5×107 carcinoma cells) was inoculated into the left hepatic lobe through injection via hepatic artery or through direct injection with a syringe needle.For the rabbits in the retrofit group tumor tissue particle(containing about 106-108 carcinoma cells)was directly transplanted into liver through puncturing of the Glisson's capsule.The observation included the following two respects. (1)The tumor's survival rate of the three groups was evaluated.(2)The DSA imaging feature of the transplanted tumor was observed.Results The survival rate of the transplanted tumor in three groups was 7/20,10/20 and 19/20 respectively,with the survival rate of the retrofit group being the highest in 3 groups(P＜0.05).On DSA the transplanted tumors were rich in blood supplying.Conclusion For the establishment of rabbit VX2 liver carcinoma model,the direct transplantation of the tumor tissue particle is obviously superior to the injection method(direct injection or through hepatic arterial injection)in obtaining higher successful rate.This technique provides clinical and fundamental liver cancer studies with a reliable,stable and mature tumor animal model.