Risk Factors of Post-polypectomy Delayed Hemorrhage / 中山大学学报(医学科学版)

@#【Objective】To analyze the risk factors of delayed hemorrhage after colon polyp resection.【Methods】We retrospectively analyzed the clinical data of patients who underwent endoscopic polypectomy between January 2010 and December 2018，in which 106 patients with delayed hemorrhage were hemorrhage group，while 3 856 patients who did not bleed were the controlled group，and Logistic regression model was applied to screen the risk factors of hemorrhage after polyp resection.【Results】Of the 3 962 patients included in the study，106 had delayed post polypectomy hemorrhage， the hemorrhage rate being 2.68%. 89.6% delayed hemorrhage occurred within 3 days after polypectomy. Logistic regression analysis showed that the difference of polyp size，complicated hypertension，combined with chronic nephropathy，aspirin drug history and warfarin drug history in hemorrhage group and control group was statistically significant（P values were 0.011，0.009，0.028，0.001，0.023，respectively）.【Conclusion】The size of polyps，comorbidity of hypertension，chronic renal disease ，application of aspirin and warfarin were considered to be independent risk factors for post-polypectomy delayed hemorrhage，most of hemorrhage occurred within 3 days. According to the risk factors of patients，we may predict the risk of delayed hemorrhage.

Shikonin down-regulates CXCR4 expression and inhibits CXCL12-induced migratory responses in colorectal carcinoma cell line SW480 / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of shikonin on the proliferation, expression of CXCR4 and the migratory responses to CXCL12 in colorectal carcinoma cell line SW480.</p><p><b>METHODS</b>The proliferation of SW480 cells was assessed by MTT assay. Cell surface expression of CXCR4 was determined by flow cytometry. The migratory ability was determined by Transwell.</p><p><b>RESULTS</b>Shikonin inhibited the proliferation of SW480 cells in time- and concentration-dependent manner. The expression rate of CXCR4 in SW480 cells was 99.1%. After application of shikonin 0.01 micromol/L, 0.1 micromol/L and 1.0 micromol/L for 24 h, the expression rate of CXCR4 decreased to 76.0%, 59.1% and 35.5% respectively (F=1098.041, P <0.001), and the CXCL12-induced SW480 cell migratory inhibition rate was 25.2%, 38.5% and 55.7% respectively (F=48.970, P <0.001).</p><p><b>CONCLUSION</b>Besides having inhibiting tumor cell proliferation effect, Shikonin may also play a role in anti-metastasis via down-regulating the expression of CXCR4 and reducing the CXCL12-induced migratory response in colorectal carcinoma cell.</p>

Changes of RANTES levels in livers of patients with chronic hepatitis B: the clinical significance and the possible mechanisms / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To study the relationship between intra-hepatic levels of regulated on activation, normal T-cell expressed and secreted (RANTES) and the disease severity and liver inflammatory degrees in patients with chronic hepatitis B and the possible mechanism of the changes of intra-hepatic levels of RANTES.</p><p><b>METHODS</b>The expression of RANTES of the livers was studied using immunohistochemical stainings and morphometric quantitative measurements in liver specimens from 10 normal subjects and 64 patients with chronic hepatitis B with different degrees of liver inflammation and different clinical severity. The expressions of RANTES protein and mRNA in cell line HepG2, HepG2.2.15 and HepG2 treated with 10 ng/ml TNFa at different times were quantified by ELISA and one-step RT-PCR.</p><p><b>RESULTS</b>The expression of RANTES of the livers in patients was significantly higher than that in the normal controls. Hepatic RANTES levels increased significantly and the increases were parallel to the increases of the severity of the hepatitis, from mild, moderate to severe hepatitis (the positive units were 3.7+/-1.5, 15.6+/-6.9, 24.0+/-4.0, 37.9+/-11.1, respectively) and from G0 degree to G4 degrees of liver inflammation (the positive units were 3.7+/-1.5, 15.0+/-5.7, 21.6+/-5.9, 30.3+/-8.2, 40.9+/-12.3, respectively). The expressions of RANTES protein and mRNA of HepG2.2.15 were higher than that of HepG2. RANTES protein and mRNA were induced in HepG2 by TNFa.</p><p><b>CONCLUSION</b>RANTES may have an important role in the pathogenesis of chronic hepatitis B. The elevation of hepatic RANTES may be caused by hepatitis B virus and TNFa.</p>

Changes of Toll-like receptor (TLR) 2 and TLR4 on the peripheral blood mononuclear cells in patients with chronic hepatitis B and chronic severe hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the changes of TLR2 and TLR4 on peripheral blood mononuclear cells (PBMCs) and their role in the pathogenesis of chronic hepatitis B and chronic severe hepatitis B.</p><p><b>METHODS</b>The expressions of TLR2 and TLR4 on 10000 CD14+ PBMCs were determined by flow cytometry in 30 healthy controls, in 31 patients with chronic hepatitis B and in 30 patients with chronic severe hepatitis B. The level of serum tumor necrosis factor alpha (TNF alpha) was determined by ELISA. The differences of expression of TLR2 and TLR4 on PBMCs and serum TNFalpha among the three groups of study subjects were determined by Student-t test. The correlations between TLR2, TLR4 and TNF alpha were determined by linear correlation test.</p><p><b>RESULTS</b>The values of mean fluorescence intensity (MFI) of TLR2 on PBMCs of the healthy controls, patients with chronic hepatitis B and patients with chronic severe hepatitis B groups were 21.5+/-2.7, 39.0+/-4.1, and 47.7+/-21.4; TLR4 of those groups was 2.3+/-1.1, 3.7+/-2.3, and 6.9+/-4.1. The serum TNF alpha(ng/L) of the respective groups was 53.8+/-38.1, 164.3+/-89.9, and 359.8+/-140.0. There was a gradual increase of these values from the group of healthy controls to the group of patients with chronic hepatitis B and patients with chronic severe hepatitis B. No significant positive correlations between TLR2, TLR4 and serum TNFalpha were found.</p><p><b>CONCLUSION</b>TLR2 and TLR4 may have a role in the pathogenesis of chronic hepatitis B and chronic severe hepatitis B.</p>

The practical value of endoscopic retrograde cholangiography in biliary complications after liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the practical value of endoscopic retrograde cholangiography (ERC) in biliary complications after liver transplantation.</p><p><b>METHODS</b>The data of 71 biliary complications after liver transplantation were analyzed retrospectively. All patients were diagnosed and treated by ERC in our center from October 2003 to March 2006. The biliary complications included 52 cases of biliary stricture, 6 biliary leakage and 13 biliary stone.</p><p><b>RESULTS</b>The diagnostic rate of ERC for biliary stricture, leakage and stone was 98.1% (51/52), 100% (6/6) and 100% (13/13), respectively. The cure rate of interventional therapy through therapeutic ERC for anastomotic, extrahepatic, hilar, intrahepatic and diffuse biliary stricture was 66.7% (4/6), 66.7% (10/15), 0 (0/7), 0 (0/2) and 0 (0/21), respectively. And that for biliary leakage, common bile duct and intrahepatic bile duct stone was 66.7% (4/6), 77.8% (7/9) and 0 (0/4), respectively.</p><p><b>CONCLUSIONS</b>ERC is effective for diagnosis of biliary complications after liver transplantation. The effect of interventional therapy through ERC varies with the type of biliary complications. Only part of biliary complications (anastomotic stricture, extrahepatic biliary stricture, gently and moderate biliary leakage, common bile duct stone) can be cured by interventional therapy through ERC.</p>

Interventional therapy for biliary stricture after orthotopic liver transplantation / 中国普通外科杂志

Objective To evaluate interventional therapy for biliary stricture (BS) after orthotopic liver transplantation (OLT). Methods The efficacy of interventional therapy for BS after OLT from Oct 2003 to Jan 2006 was analyzed retrospectively. Fifty-three patients received 107 times of interventional therapy through endoscopic retrograde cholangiography ( ERC) which included 68 nasobiliary catheter placements,26 biliary balloon dilatations and stent placements and 13 ERC. Nine patients received 11 times of interventional therapy through percutaneous transhepatic cholangiography ( PTC) including 2 PTC, 7 percutaneous drainages,3 biliary balloon dilatations and 1 biliary stent replacement. One patient received bile drainage through T tube. Results The success rate of ERC was 88. 8% (95/107) , that of nasobiliary catheter placement 94% (64/68) , biliary stent placement 88. 5% (23/26). The success rate of PTC was 81. 8% (9/11) , that of percutaneous drainage was 100% (7/7) , biliary stent replacement 100% (1/1). The curative rate of interventional therapy for 53 patients with BS was 28. 3% (15/53) ,the improvement rate was 41. 5% (22/53). The curative rate of interventional therapy for anastomotic, extrahepatic, intrahepatic hilar and diffuse BS was respectively 66. 7% (4/6)、66. 7% (10/15)、50% (1/2)、0 (0/7) and 0 (0/22). Conclusions The efficacy of interventional therapy for BS after OLT was not satisfactory. The result relates to the type of BS, for anastomotic, extrahepatic and solitary intrahepatic BS this therapy was effective, while that for hilar and diffuse BS the prognosis was poor.