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Objective:To investigate the effect of transorally inserted anvil (OrVil TM) in patients with relapsed or denovo carcinoma at the esophagogastric junction. Methods:The clinical data of 60 patients who underwent radical intent resection for locally relapsed or denovo esophagogastric junction adenocarcinoma at Zhengzhou University Cancer Hospital from Jan 2011 to Jun 2021 were retrospectively analyzed. The patients were divided into two groups according to whether transorally inserted anvil was used. Twenty-six patients who had used the system were assigned to the experimental group. Thirty-four patients without transorally inserted anvil were set to control group.Results:The incisor distance of the experimental group was shorter than that of the control group [36(34-40)cm vs. 39(36-41)cm, Z=-4.948, P<0.05]. Operation time in experimental group was 177 (145-260) min, compared to control group of 172 (140-225) min ( Z=-0.735, P=0.463). Intraoperative blood loss was 200 (100-900) ml in the experimental group and 300 (100-800) ml in the control group ( Z=-1.244, P=0.213). Postoperative upper margin distance of the experimental group was (3.6±1.7) cm compared to control group of (1.8±1.1) cm ( t=-0.735, P<0.01). The positive rate of margin in the experimental group was 4% vs. 15% in the control group ( χ2=1.931, P=0.165). The length of postoperative hospital stay in the experimental group was (18.6±5.2) d vs. (20.5±4.7) d ( t=-1.455, P=0.151). Surgery-related complications developed in 19% in the experimental group vs. 27% in the control group ( P>0.05). Conclusion:The application of the transorally inserted anvil in the operation of patients with locally relapsed or denovo esophagogastric junction cancer after initial operation reduces the difficulty of operation and decreases the positive rate of margin.
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Object:To explore surgical treatments for duodenal fistula with intra-abdominal infection.Methods:The data of 19 patients with duodenal fistula treated at the Affiliated Tumor Hospital of Zhenzhou University between Jan 2015 and Dec 2021 were analyzed retrospectively. Surgery is performed with duodenostomy or modified duodenal shunt procedures.Result:All patients were accompanied by intra-abdominal infection, including 9 duodenal stump fistulas. All patients successfully completed the operation,11cases underwent duodenostomy, 8 case underwent modified duodenal shunt procedures. operating time was 110(60-140)min, postoperative hospitalization time was 29(9-103)d. Two patients died postoperatively. Fistula heals in other patients.Conclusion:Surgical intervention for duodenal fistula should focus on controlling the source of infection, strengthening intestinal and abdominal drainage, and reducing postoperative complications.
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Object:To investigate the impact of carbon nanoparticle tracing on the number of lymph nodes harvested in obese patients during radical gastrectomy for gastric cancer.Methods:Clinical data of 127 patients undergoing D 2 radical gastrectomy in the Affiliated Tumor Hospital of Zhengzhou University from Jan 2015 to Dec 2019 were retrospectively analyzed. According to whether the patients were injected with carbon nano particles during operation, they were divided into two groups: 64 patients without carbon nano particles during operation served as control group; 63 patients with carbon nano particles were included into experimental group. Results:The operation time of the control group was (160±31) min and that of the experimental group was (168±28) min ( t=-1.521, P=0.445). Intraoperative blood lose in the control group was (234±82) ml and that in the experimental group was (238±84) ml ( t=-0.295, P=0.846). The number of lymph nodes harvested in the first station, in the second station, the number of total lymph nodes and the number of lymph nodes with diameter <5 mm in the control group were less than those in the experimental group(10.4±3.8 vs. 24.5±10.6, t=-10.054),(6.6±2.8 vs. 16.8±7.3, t=-10.381),(17.1±6.4 vs. 41.2±17.6, t=-10.293),(3.9±2.5 vs. 21.2±9.1, t=-14.662) (all P<0.05), while the number of positive lymph nodes was not statistically different between the two groups all (5.9±6.2 vs. 4.2±3.4, t=-1.963, P>0.05). Black staining of lymph nodes in nano carbon group: 1 542 black stained lymph nodes were detected in the experimental group, the black staining rate of lymph nodes was 59.44% (1 542/2 594). Conclusion:Intraoperative application of carbon nanoparticles can significantly increase the number of harvested lymph nodes in obese (BMI≥25 kg/m 2) gastric cancer patients after radical resection.
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Objective To investigate the association between thyroxine level and nonalcoholic fatty liver disease (NAFLD). Methods A retrospective analysis was performed for 3289 subjects who underwent physical examination in PLA Rocket Force Characteristic Medical Center from July 2015 to April 2019, and according to medical history and thyroid function, they were divided into subclinical hypothyroidism group with 210 subjects and normal thyroid function group with 3079 subjects. According to the results of abdominal color Doppler ultrasound, the normal thyroid function group was divided into NAFLD group with 516 subjects and non-NAFLD group with 2563 subjects; according to body mass index (BMI), the normal thyroid function group was divided into non-obese group (BMI 0.05); after stratification based on age and body type, in the obese-young and middle-aged subgroup, male sex, low free thyroxine, fasting blood glucose, and triglyceride were independent risk factors for NAFLD (odds ratio=4.729, 0.067, 1.814, and 1.717, P =0.003, 0.010, 0.011, and 0.014). The cut-off values of free thyroxine, fasting blood glucose, and triglyceride were 1.123 ng/dL, 5.15 mmol/L, and 1.02 mmol/L, respectively, in predicting NAFLD, and the area under the ROC curve was 0.832 for combined prediction. Conclusion There is a high prevalence rate of NAFLD in the population with subclinical hypothyroidism, and when thyroid function is within the normal range, low free thyroxine is associated with the onset of NAFLD in the young and middle-aged obese people.
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Objective To investigate the association between thyroxine level and nonalcoholic fatty liver disease (NAFLD). Methods A retrospective analysis was performed for 3289 subjects who underwent physical examination in PLA Rocket Force Characteristic Medical Center from July 2015 to April 2019, and according to medical history and thyroid function, they were divided into subclinical hypothyroidism group with 210 subjects and normal thyroid function group with 3079 subjects. According to the results of abdominal color Doppler ultrasound, the normal thyroid function group was divided into NAFLD group with 516 subjects and non-NAFLD group with 2563 subjects; according to body mass index (BMI), the normal thyroid function group was divided into non-obese group (BMI 0.05); after stratification based on age and body type, in the obese-young and middle-aged subgroup, male sex, low free thyroxine, fasting blood glucose, and triglyceride were independent risk factors for NAFLD (odds ratio=4.729, 0.067, 1.814, and 1.717, P =0.003, 0.010, 0.011, and 0.014). The cut-off values of free thyroxine, fasting blood glucose, and triglyceride were 1.123 ng/dL, 5.15 mmol/L, and 1.02 mmol/L, respectively, in predicting NAFLD, and the area under the ROC curve was 0.832 for combined prediction. Conclusion There is a high prevalence rate of NAFLD in the population with subclinical hypothyroidism, and when thyroid function is within the normal range, low free thyroxine is associated with the onset of NAFLD in the young and middle-aged obese people.
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OBJECTIVE@#To explore the mechanism of @*METHODS@#Healthy male DBA/1 mice were used for CIA modeling. Twenty-five CIA mice with successful modeling and similar arthritis index (AI) scores were randomized equally into model group (CIA), methotrexate (MTX) group, and low-, medium-, and high-dose XWGD groups (0.975, 1.95, and 3.9 g/mL, respectively), with another 5 normal mice as the normal control group. The mice in normal control and CIA groups were given saline once a day, those in MTX group were given 0.1 mg/mL MTX once a week, and those in XWGD groups were treated daily via garage of XWGD containing crude drugs of different doses for 28 consecutive days. The AI score and HE staining were used to evaluate the changes in the joints of the CIA mice. The effect of XWGD on Th1, Th17, MDSC, G-MDSC and M-MDSC cells were evaluated with flow cytometry.@*RESULTS@#Treatment with MTX and different doses of XWGD significantly decreased the AI score of the mice and relieved joint inflammation as compared with the model group (@*CONCLUSIONS@#XWGD can improve joint inflammation in CIA mice by increasing the percentages of G-MDSC cells and decreasing the percentages of M-MDSC, Th1 and Th17 cells, and a high dose of XWGD can produce an equivalent therapeutic effect to methotrexate but with better safety.
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Animals , Male , Mice , Arthritis, Experimental/drug therapy , Arthritis, Rheumatoid/drug therapy , Methotrexate , Mice, Inbred DBA , Th17 CellsABSTRACT
ObjectiveTo investigate the metabolic characteristics of nonalcoholic fatty liver disease (NAFLD) and related risk factors in non-obese population. MethodsA retrospective analysis were performed for 12 125 individuals who underwent physical examination in Physical Examination Center of PLA Rocket Force Characteristic Medical Center from July 2013 to April 2019. According to body mass index (BMI) ＜25 kg/m2, these individuals were divided into non-obese group with 8528 individuals and obese group with 3597 individuals; according to the results of abdominal ultrasound, the non-obese group was further divided into NAFLD group with 1025 individuals and non-NAFLD group with 7503 individuals. According to BMI ＜25 kg/m2, 3281 individuals with NAFLD were divided into non-obese NAFLD subgroup with 1025 individuals and obese NAFLD group with 2256 individuals. Related clinical data were collected, including sex, age, BMI, fasting blood glucose, uric acid, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, and hemoglobin. Non-normally distributed continuous data were expressed as M(P25-P75), and the Mann-Whitney U test was used for comparison between groups; the chi-square test was used for comparison of categorical data between groups. A multivariate logistic regression analysis was performed to investigate risk factors. ResultsAmong the 12 125 individuals who underwent the physical examination, the detection rate of NAFLD was 27.06%, and the detection rate of non-obese NAFLD was 8.45%, accounting for 12.02% of the non-obese population. The multivariate logistic regression analysis, based on the univariate analysis, had a diagnostic accordance rate of 89%, and the results showed that the increase in age, BMI, fasting blood glucose, uric acid, triglyceride, low-density lipoprotein, and hemoglobin were independent risk factors for non-obese NAFLD (odds ratio ［OR］=1.043, 1.716, 1.161, 1.004, 1.791, 2.587, and 1.011, P＜0.001, ＜0.001, =0.001, ＜0.001, ＜0.001, ＜0.001, and =0.011), suggesting that non-obese NAFLD had the strongest association with low-density lipoprotein and had no association with age, uric acid, and hemoglobin. Total cholesterol and high-density lipoprotein were non-susceptible factors for non-obese NAFLD (OR=0.521 and 0.523, P=0.007 and 0.024). ConclusionNon-obese NAFLD is closely associated with metabolic disorders, and further studies are needed to explore the association between serum cholesterol and non-obese NAFLD.
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Objective@#To investigate the prenatal ultrasonographic features and prognosis of vasa previa, to explore the application value of sector scanning in the intracervical mouth by antenatal ultrasound, then to increase vasa previa detection rate.@*Methods@#Prenatal ultrasound images, clinical characteristics and pregnancy outcome of 35 pregnant women with vasa previa confirmed by surgery and pathology were analyzed retrospectively, the diagnostic effectiveness of sector scanning in the intracervical mouth was evaluated.@*Results@#Thirty-three of the 35 vasa previa cases were detected by sector scanning in the intracervical mouth, with a detection rate of 94.3% (33/35). Of the 35 cases, 20 cases (60.6%) were first contacted in second trimester and 13 cases (39.4%) were first contacted in third trimester. Two cases were missed or misdiagnosed, which were all first contact in third trimester. Among the 35 cases, 25 were velamentous placenta and 4 were battledore placenta. Twenty cases were low-lying placenta or marginal placenta previa. All 35 women underwent cesarean section. No neonatal mortality, 11 term infants, 20 premature infants of more than 34 weeks and 4 premature infants of less than 34 weeks. All placentas underwent pathological examination after delivery, 4 cases placentas underwent vascular casting, and it was found that 2 cases were vasa previa of umbilical artery branch and 2 cases were vasa previa of allantoic veins branch.@*Conclusions@#Vasa previa can be effectively detected by prenatal ultrasonography through sector scanning in the intracervical mouth. Second trimester is the best period to detect vasa previa. Pathomorphological examination on placenta after delivery and vascular casting are helpful to the understanding of vasa previa.
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Objective To investigate the prenatal ultrasonographic features and prognosis of vasa previa,to explore the application value of sector scanning in the intracervical mouth by antenatal ultrasound,then to increase vasa previa detection rate.Methods Prenatal ultrasound images,clinical characteristics and pregnancy outcome of 35 pregnant women with vasa previa confirmed by surgery and pathology were analyzed retrospectively,the diagnostic effectiveness of sector scanning in the intracervical mouth was evaluated.Results Thirty-three of the 35 vasa previa cases were detected by sector scanning in the intracervical mouth,with a detection rate of 94.3 ％ (33/35).Of the 35 cases,20 cases (60.6 ％) were first contacted in second trimester and 13 cases (39.4％) were first contacted in third trimester.Two cases were missed or misdiagnosed,which were all first contact in third trimester.Among the 35 cases,25 were velamentous placenta and 4 were battledore placenta.Twenty cases were low-lying placenta or marginal placenta previa.All 35 women underwent cesarean section.No neonatal mortality,11 term infants,20 premature infants of more than 34 weeks and 4 premature infants of less than 34 weeks.All placentas underwent pathological examination after delivery,4 cases placentas underwent vascular casting,and it was found that 2 cases were vasa previa of umbilical artery branch and 2 cases were vasa previa of allantoic veins branch.Conclusions Vasa previa can be effectively detected by prenatal ultrasonography through sector scanning in the intracervical mouth.Second trimester is the best period to detect vasa previa.Pathomorphological examination on placenta after delivery and vascular casting are helpful to the understanding of vasa previa.
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OBJECTIVE:To study antibacterial activities of meropenem(MPN)combined with cefoperazone sulbactam(SCF) to 3 kinds of multidrug resistance (MDR) Gram-negative bacteria. METHODS:Each 50 strains of MDR-Escherichia coli (MDR-EC),MDR-Klebsiella pneumoniae (MDR-KPN) and MDR-Acinetobacter baumannii (MDR-AB) were isolated from spu-tum,blood,urine,ascites or drainage specimens of patients during Jan. to Dec. in 2016 from the affilidated hospital of Taishan medical university. The agar dilution method and board method were used to determine MIC50,MIC90 and MICG of MPN,SCF, MPN+SCF to MDR-EC,MDR-KPN,MDR-AB and calculate fractional inhibitory concentration (FIC). Drug sensitivity test was conducted by K-B disk method. RESULTS:In terms of the MICG to MDR-EC,MDR-KPN,MDR-AB,MPN alone were respec-tively 36.82,82.45,34.32 μg/mL;SCF alone were respectively 42.14,112.67,24.11 μg/mL;MPN combined with SCF were re-spectively 25.97,56.64,11.36 μg/mL. In terms of MICG to MDR-EC,MDR-KPN,MICG showed that MPN+SCF0-0.5 (78.00%),>0-0.5(72.00%),>0.5-1.0 (82.00%). CONCLUSIONS:MPN combined with SCF can effectively improve antibacterial activities to MDR Gram-negative bac-teria as MDR-EC,MDR-KPN,MDR-AB. MPN combined with SCF has synergistic effects.
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ObjectiveTo investigate the change in the serum level of complement C5a after obstruction removal and its correlation with the serum levels of liver fibrosis markers in patients with obstructive jaundice. MethodsA total of 164 patients with obstructive jaundice who underwent endoscopic retrograde cholangiopancreatography and obstruction removal in our hospital from June 2012 to June 2014 were enrolled, and 20 healthy adults were enrolled as the control group. The serum levels of complement C5a and four liver fibrosis markers, type Ⅳ collagen (ⅣP), pre-type Ⅲ collagen (PⅢP), laminin (LN), and hyaluronic acid (HA), were measured. The t-test was applied for comparison between groups, and linear correlation analysis was applied for correlation analysis. ResultsCompared with the healthy controls, the patients with obstructive jaundice had a significantly higher serum level of complement C5a (89.7±30.2 vs 62.2±21.1 ng/L; t=2.213, P=0.016), and the serum level of complement C5a was closely related to the course of obstruction (r=0.954, P=0003). The serum level of complement C5a decreased significantly after obstruction removal (66.2±26.3 ng/L; t=1.998, P=0.021). Before obstruction removal, the serum level of complement C5a increased synchronously with those of ⅣP (r=0.976, P＜0.001), PⅢP (r=0972, P＜0.001), LN (r=0.915, P=0.039), and HA (r=0.962, P=0.002); after obstruction removal, the serum level of complement C5a decreased synchronously with those of ⅣP (r=0.965, P=0.001), PⅢP (r=0.912, P=0.003), and HA (r=0.875, P=0023). ConclusionComplement C5a may be involved in the development of liver fibrosis induced by obstructive jaundice.
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<p><b>OBJECTIVE</b>To construct full-length human bladder cancer-specific antibody libraries for efficient display of full-length antibodies on the surface of mammalian cells.</p><p><b>METHODS</b>The total RNA was isolated from peripheral blood mononuclear cells from patients with bladder cancer. The repertoires of IgG1 heavy chain variable region (VH) and Kappa light chain were amplified by RT-PCR using specific primers. The antibody genes were inserted into the vector pDGB-HC-TM to construct the bladder-cancer-specific antibody libraries of heavy chains and light chains. Ten clones from each library were randomly picked for gene sequencing and transient transfection into FCHO cells to analyze antibody display on mammalian cell surface by flow cytometry after staining with corresponding fluorescent labeled antibodies.</p><p><b>RESULTS</b>The libraries of bladder-cancer-specific antibody heavy chain (IgG1) and light chain (LCk) were successfully constructed. Seven out of the 10 clones randomly selected from the heavy chain library and 9 out of the 10 clones from the light chain library showed correct open reading frame, coding for 7 unique VH and 9 unique LCk. The combinatory library size reached 3.32×10(11).</p><p><b>CONCLUSION</b>We have successfully constructed a full-length human bladder-cancer-specific antibody library with a combinatory diversity of 3.32×10(11) based on mammalian display technology, which can be used for screening monoclonal antibodies against bladder-cancer-associated antigens.</p>
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Animals , Humans , Amino Acid Sequence , Antibodies , Genetics , Cell Surface Display Techniques , Gene Library , Immunoglobulin Heavy Chains , Genetics , Immunoglobulin kappa-Chains , Genetics , Peptide Library , Urinary Bladder Neoplasms , Genetics , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To construct a personalized full-length fully human antibody mammalian display library for children with systemic lupus erythematosus (SLE).</p><p><b>METHODS</b>The total RNA was isolated from the PBMCs of SLE children. The heavy chain variable region and kappa light chain (VH and LCκ) of the antibody genes were amplified by RT-PCR and inserted into the pDGB-HC-TM vector separately to construct the heavy chain and light chain libraries. The library DNAs were transfected into 293T cells and the expression of full-length fully human antibody on the surface of 293T cells was analyzed by flow cytometry.</p><p><b>RESULTS</b>Using 0.8 µg total RNA as the template, the VH and LCκ were amplified and the full-length fully human antibody mammalian display library was constructed. The VH and LCκ gene libraries had a size of 9.4×10(4) and 8.4×10(4), respectively. Sequence analysis of 10 clones randomly selected from the VH and LCκ gene libraries each showed that 8 heavy chain clones and 7 light chain clones contained correct open reading frames, and flow cytometry demonstrated that all the 15 clones express full-length antibodies on 293T cell surfaces. 293T cells co-transfected with the VH and LCκ gene libraries expressed the full-length antibodies on the cell surface.</p><p><b>CONCLUSION</b>The personalized full-length fully human antibody library for SLE children constructed allows display of the full-length antibodies on mammalian cell surfaces, thus providing a valuable platform for analyzing the autoantibodies, their etiological role, and their clinical implications in SLE.</p>
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Child , Humans , Amino Acid Sequence , Gene Library , Genetic Vectors , Immunoglobulin Heavy Chains , Genetics , Immunoglobulin kappa-Chains , Genetics , Lupus Erythematosus, Systemic , Genetics , Allergy and Immunology , Membrane Proteins , GeneticsABSTRACT
AIM: To study the anti-cancer effects of octreotide on the proliferation of liver cancer cells. METHODS: The liver cancer cells SMMC-7721 were cultured in RPMI-1640 media with 10% fetal bovine serum, 100 U?ml -1 penicillin and streptomycin. 10 -5, 10 -4, 10 -3 and 10 -2 g?L -1 of octreotide were added and MTT colorimetric assay were used to detect the growth inhibition rate. DNA staining and cell cycle analysis were done at 0, 6, 12, 24 and 36 hours after medication when the concentration of octreotide was 10 -3 g?L -1. RESULTS: MTT colorimetric tests showed that octreotide suppressed the growth of liver cancer cells. 48 hours after medication, the cell growth inhibition rate was 9.33%, 12.70%, 19.70% and 20.93% when the octreotide concentration was 10 -5, 10 -4, 10 -3 and 10 -2 g?L -1 separately. Cell cycle analysis showed that the percentage of G 0-G 1 phase cells increased and the percentage of G 2-M phase cells decreased. CONCLUSION: Octreotide inhibits the cultured liver cancer cells proliferation in vitro, its mechanisms may be related to preventing the G 0-G 1 phase cells from going into G 2-M phase.
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<p><b>BACKGROUND</b>To evaluate the results of combined chemotherapy with paclitaxel (PTX, taxol) plus cisplatin (DDP) in the treatment of advanced non small cell lung cancer (NSCLC).</p><p><b>METHODS</b>From January 1997 to December 2002, forty-seven patients with advanced non-small cell lung cancer received PTX 135-180 mg/m² by intravenous infusion, on day 1, and DDP 40 mg/time by intravenous infusion,on days 1-3. The treatment was repeated every 3 weeks, up to 2 or 3 cycles.</p><p><b>RESULTS</b>Forty-six patients were evaluable for efficacy. One patient got complete response (2.2%), and 16 got partial response (34.8%), with an overall response rate of 37.0%. The main toxicities were myelosuppression, nausea and vomiting, and other side effects were mild.</p><p><b>CONCLUSIONS</b>A high response rate can be obtained in advanced NSCLC by PTX plus DDP. PTX is a promising antitumor agent with tolerable toxicity.</p>
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<p><b>OBJECTIVE</b>To evaluate the efficacy of endoscopic variceal sclerotherapy (EVS) for esophago gastric variceal bleeding.</p><p><b>METHODS</b>A retrospective analysis was made on 1010 patients with esophagogastric variceal bleeding who underwent sclerotherapy, among whom there were 834 patients with cirrhosis, 160 with hepatocarcinoma, 12 with Budd-Chiari syndrome and 4 with congenital liver fibrosis. Totally, 3203 sessions of sclerotherapy were performed, including 602 sessions of emergency sclerotherapy and 2601 of selective surgery. The average number of sessions of sclerotherapy for the initial treatment in 710 cirrhosis patients who received continuous sclerotherapy was 3.2 +/- 1.1 times. Follow-up was done in 579 cirrhosis patients for 3-157 months, with an average period of 42.5+/- 32.8 months.</p><p><b>RESULTS</b>The rate of emergency hemostasis in the whole group was 97.0%. The rate of complications was 13.4%, and the mortality rate was 1.8%. The rate of complete eradication and basically complete eradication of esophagogastric varices in cirrhosis patients was 84.1%. The late rebleeding rate was 23.7%, and the survival rates were 95.8% +/- 0.8%, 86.1% +/- 1.6%, 74.5% +/- 2.4%, 53.6% +/- 3.8% at 1, 3, 5 and 10 years, respectively, according to Kaplan-Meier analysis.</p><p><b>CONCLUSION</b>EVS is an important method for the treatment of esophagogastric variceal bleeding.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Esophageal and Gastric Varices , Therapeutics , Follow-Up Studies , Gastrointestinal Hemorrhage , Therapeutics , Retrospective Studies , SclerotherapyABSTRACT
Objective To investigate the rule of changes in endoscopic and endoscopic ultrsonic findings after endoscopic variceal sclerotherapy in the follow-up period. Methods Patients suffered from esophagogastric variceal bleeding and received endoscopic variceal sclerotherapy were investigated. Patients with liver cirrhosis after viral heptitis and their varices eliminated or reduced to grade Ⅰor Ⅱ after sclerotherapy entered this study for at least 5 years' follow - up. Endoscopic and endoscopic ultrsonic findings were recorded to find its course of transformation. Results Lumens of varices were occluded by thrombus and eventually replaced by white fibrous tissue after endoscopic sclerotherapy. Vessels reappeared within e-sophageal wall gradually after a lot of time in the form of formation of new venules (93. 8% ) or re-vascular-ization (6. 2% ) . Newly formed varices within gastric wall after sclerotherapy were seen in 5. 3% of the cases and some cases of duodenal varices were also found rarely in the follow-up. Endoscopic ultrasonic finding confirmed the revascularization and dilatation of vessles after sclerotherapy. Conclusion From the follow-up results it indicates that varices would reappear gradually after endoscopic sclerotherapy, regular re-examination and appropriate treatment in time are the most important measure to assure its long term effect.
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Objective To investigate the correlated factors concerning esophago-gastric variceal bleeding and sclerotherapy in liver cirrhosis. Methods Twenty-six factors were selected for 670 patients with liver cirrhosis and esophagogastric variceal bleeding and received sclerotherapy in our hospital. Spearman relationship analyses were performed on factors concerning esophagogastric variceal bleeding and sclerotherapy. Results Duration and number of episodes of bleeding were not related to grade of esophagogastric varices, diameter of portal vein and hepatic function but negatively related to ascites and hypersplenism.Severity of bleeding was not related to all of the above parameters. Esophageal varices related to gastric varices while neither of them related to diameter of portal vein. Result of sclerotherapy related to grade of esophageal varices, and negatively related to number of operations in first-period sclerotherpy, supplementary sclerotherpy and total number of operations as well as to amount of scleroant of first-period sclerotherpy and total amount of scleroant. Types of sclerosant had no relationship with result of sclerotherapy. Conclusion Esophagogastric variceal bleeding is affected by multiple factors. Diameter of portal vein is not the only factor. Result of sclerotherapy is affected by number of operations and amount of scleroant and has nothing to do with types of sclerosant.
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Objective To analyze the clinical manifestation, diagnosis and treatment of acute mesenteric vascular obliteration (AMVO). Methods 112 cases of AMVO were analyzed, including 20 cases admitted to our hospital from 1992 to 2004 and 92 cases reported by other hospitals. Results Abdominal pain, abdominal distension, nausea and vomiting, decrease or disappearance of bowel sound, elevation of white blood cell count were more frequent manifestations.Cardiovascular disease, portal vein stasis or hypercoagulation state were common findings in patients' history. The average misdiagnosis rate of AMVO in these 112 patients was 61.5%, with a misdiagnosis rate of 45.0% in 20 cases of our hospital. The average mortality rate of all these patients was 41.9%, with a mortality rate of 30.0% for 20 cases of our hospital. Conclusion The early clinical manifestation of AMVO lacks specificity, the misdiagnosis ratio and mortality rate are very high. Angiography should be done early to confirm the diagnosis and improve the therapeutic effect in the patients suspicions of having this ailment.
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Objective To observe the effect of photodynamic reaction and sclerosant on venous en dothelial cells and to evaluate the potential significance of photodynamic therapy on esophageal varicose. Methods Endothelial cells of human umbilical vein ( ECV304) were cultured in DMEM medium containing 10% fetal bovine serum; 2. 5, 5, 10 and 20 mg/L of hematoporphyrin monomethyl ether were added to the cell mediums then received 5 or 10 minutes of irradiation by copper vapor laser at power density 15 mW/ cm2. MTT colorimetric assay was used to detect the cell survival rate, then drew the cell growth curve and observed the morphological changes of venous endothelial cell induced by photodynamic and sclerosant. Results Cell survival rate decreased along with the increasing dosage of irradiation or hematoporphyrin monomethyl ether. When hematoporphyrin monomethyl ether was 10 mg/L and irradiation time was 10 minutes or hematoporphyrin monomethyl ether was 20 mg/L and irradiation time was 5 minutes, the cell survival rate was less than 50%. Normal endothelial cells entered exponential growth stage from the 2nd day of culture, showing an "S" shape growth curve. After photodynamic irradiation the endothelial cells grew slowly and decreased from the 2nd day of culture, showing a low flat growth curve without exponential growth stage. Number of cells in photodynamic group was significantly lower than those of control group at 2nd, 3rd, 4th, 5th and 6th day ( P = 0. 002 , P