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Objective:To compare the value of Liaoning scoring system, model for end-stage liver disease (MELD), model for end-stage liver disease-Na (MELD-Na) and Blatchford score in predicting high-risk esophageal varices (EVs), hemorrhage or re-hemorrhage within 1 year and blood transfusion treatment in cirrhotic patients.Methods:Clinical data of 170 patients with esophageal varices confirmed by endoscopy from January 2018 to September 2019 were recorded. Liaoning score, MELD, MELD-Na score and Blatchford score were calculated when the first endoscopy was performed. These patients were followed up, and hemorrhage or re-hemorrhage within 1 year was recorded. Receiver operating characteristic (ROC) curve was drawn and the area under curve (AUC) was used to evaluate the accuracy of 4 scoring systems in predicting high-risk EVs, hemorrhage or re-hemorrhage within 1 year after the first endoscopy and blood transfusion. Cut-off values were obtained, and groups divided by cut-off values were compared for the proportion of high-risk EVs and hemorrhage or re-hemorrhage.Results:The cut-off value of high-risk EVs in patients with cirrhosis predicted by Liaoning score was 0.45, and the AUC was 0.702 (95% CI:0.612-0.781, P<0.01), superior to MELD, MELD-Na and Blatchford score (AUC were 0.593, 0.648, 0.610, respectively). The proportion of high-risk EVs in Liaoning score ≥0.45 and <0.45 were 71.8% (89/124) and 34.8% (16/46) with significant differences ( χ2=19.442, P<0.01). The AUC of Liaoning score for predicting hemorrhage or re-hemorrhage within 1 year was 0.680 (95% CI: 0.595-0.765, P<0.01), superior to MELD, MELD-Na and Blatchford score (AUC were 0.605,0.615,0.598, respectively). AUC of Blatchford score for predicting blood transfusion was 0.775 (95% CI:0.687-0.863, P<0.01), superior to MELD, MELD-Na and Liaoning score (AUC were 0.653, 0.719, 0.631, respectively). Conclusion:Liaoning score can predict high-risk EVs, hemorrhage or re-hemorrhage within 1 year after the first endoscopy in patients with cirrhosis and is superior to MELD, MELD-Na and Blatchford score. Blatchford score can effectively predict whether cirrhosis patients with EVs need blood transfusion.
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Objective:To study the characteristics and management of peripancreatic effusion in chronic pancreatitis.Methods:Data of 32 patients with chronic pancreatitis and 141 acute pancreatitis admitted to the First Affiliated Hospital of Guangxi Medical University from January 2018 to December 2019 were collected. According to the Atlanta classification, the peripancreatic effusion was divided into four categories: acute peripancreatic fluid collection (APFC), acute necrotic collection(ANC), pancreatic pseudocyst (PPC) and walled-off necrosis (WON). The general information, clinical manifestations, medical history, laboratory examination indicators and treatment of the four types of patients were recorded and analyzed.Results:Among the 32 patients with chronic pancreatitis complicated with peripancreatic effusion, 27 patients (84.4%) were diagnosed as having PPC, 3 patients (9.4%) WON and 2 (6.2%) APFC. No chronic pancreatitis with ANC was found. The incidence of PPC was higher in patients with chronic pancreatitis than those with acute pancreatitis [84.4% (27/32) VS 31.2% (44/141), P<0.01], and the APFC was lower [6.2% (2/32) VS 24.8% (35/141), P=0.021]. The incidence of ANC was also lower [0.0% (0/32) VS 36.9% (52/141), P<0.01], and there was no significant difference in the incidence of WON [9.4% (3/32) VS 7.1% (10/141), P=0.944]. Compared with patients with peripancreatic effusion of chronic pancreatitis, acute pancreatitis showed a higher proportion of clinical manifestations: fever [19.1% (27/141) VS 3.1% (1/32)], nausea [59.6% (84/141) VS 21.9% (7/32)], vomit [56.7% (80/141) VS 21.9% (7/32)], tenderness [79.4% (112/141) VS 34.4% (11/32)], rebounding pain [42.6% (60/141) VS 0.0% (0/32)], increase of C reactive protein [95.7% (135/141) VS 40.6% (13/32)] ( P< 0.05), and the mean hospital stay was longer (13 days VS 11 days, P=0.048). Imaging examination showed that the proportion of lesions >5 cm in diameter in PPC patients with acute pancreatitis was higher than those with chronic pancreatitis [70.5% (31/44) VS 29.6% (8/27), P=0.001]. WON in chronic pancreatitis patients was limited to the pancreas [3/3 VS 1/10, P =0.014]. In terms of treatment strategies, 25 patients (78.1%) received conservative treatment in 32 chronic pancreatitis. There was no significant difference in treatment strategy between patients with acute pancreatitis and those with chronic pancreatitis. Conclusion:In the peripancreatic effusion of chronic pancreatitis, PPC is the most common. Peripancreatic effusion is mainly treated conservatively. There is no difference in treatment among different types of peripancreatic effusion in chronic pancreatitis. However, compared with chronic pancreatitis, peripancreatic effusion in acute pancreatitis may need more active intervention.
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Objective:To investigate the relationship between Helicobacter pylori(Hp)infection and carotid atherosclerosis(CAS)in the elderly, in order to provide an empirical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly.Methods:A total of 287 patients aged 60 years and over admitted to the First Affiliated Hospital of Guangxi Medical University, who underwent the 13C-urea breath test( 13C-UBT), carotid color and two-dimensional Doppler ultrasonography from October 2015 to January 2019, were retrospectively enrolled.Patients were divided into the Hp infection group(n=137)and the non-Hp infection group(n=150). Common high-risk pathogenic factors, blood biochemical indicators, carotid intima-media thickness(IMT)and detection rate of carotid plaque were compared between the two groups. Results:Common high-risk pathogenic factors including age, gender, hypertension, diabetes, obesity, smoking, alcohol consumption, dyslipidemia, and hyperuricemia showed no significant difference between the two groups( P>0.05). The level of high-density lipoprotein cholesterol(HDL-C)was lower in the Hp infection group than in the non-Hp infection group( P<0.05). There was no difference in levels of white blood cells, neutrophils, total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), homocysteine, fasting blood glucose, creatinine or uric acid between the two groups( P>0.05). The detection rates of increased carotid IMT and carotid plaques were higher in the Hp infection group than in the non-Hp infection group(65.0% or 89 cases vs.48.7% or 73 cases, 76.6% or 105 cases vs.64.7% or 97 cases, P<0.01 and 0.05). The detection rate of carotid plaques in the Hp-infected group was higher than that in the non-Hp-infected group( P<0.05). The combined detection rate of increased carotid IMT and plaques was higher in the Hp infection group than in the non-Hp infection group(56.2% or 77cases vs.32.7% or 49 cases, P<0.01). Conclusions:Hp infection may play a role in the occurrence and progression of carotid atherosclerosis through initiating abnormal lipid metabolism.Early intervention and treatment may reduce the incidence of carotid atherosclerosis in patients with Hp infection.
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Cholangiocarcinoma is the second common tumor in the hepatobiliary system,with clinical features of biliary stricture,difficult early diagnosis and poor prognosis.High-resolution endoscopic ultrasonography can observe closely the bile duct tree and adjacent organs.In this article,authors reviewed the application of endoscopic ultrasonography in the diagnosis of cholangiocarcinoma.
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Objective To study the diagnostic value of narrow-band imaging ( NBI) combined with endoscopic ultrasonography ( EUS) for ampullary tumors. Methods A total of 21 patients suspected with ampullary lesions by imaging or endoscopic examination from December 2015 to March 2017 were enrolled in this prospective study. All patients underwent NBI and EUS, and 20 patients underwent biopsy. The type of ampullary tumor was predicted by preoperative examination, and appropriate treatment methods were chosen. The final diagnosis was confirmed by biopsy, surgical pathology, and clinical follow-up for more than 6 months. The accuracy of NBI combined with EUS and biopsy in diagnosis of ampullary malignant tumors was calculated according to the gold standard. The Chi-square test was used to compare diagnostic accuracies. Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of NBI combined with EUS in diagnosis of ampullary malignancies were 94. 1％ (16/17), 100. 0％ (4/4), 95. 2％ (20/21), 100. 0％ (16/16), and 80. 0％ (4/5), respectively. The corresponding indicators of preoperative biopsy were 41. 2％ ( 7/17) , 100. 0％ ( 3/3) , 50. 0％ ( 10/20) , 100. 0％ ( 7/7) , and 23. 1％( 3/13) , respectively. The accuracy of NBI combined with EUS in diagnosing ampullary malignant tumor was significantly higher compared with preoperative biopsy ( P=0. 004) . Conclusion NBI combined with EUS can more accurately predict benign or malignant ampullary tumor, and better guide the choice of surgical methods compared with preoperative biopsy.
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Objective To evaluate the safety and efficacy of endoscopic ultrasound (EUS) guided ethanol ablation of benign insulinoma and compare its' advantages and disadvantages with surgical treatment. Methods From April 2011 to February 2016, clinical data of 38 patients with benign insulinoma treated by EUS-guided ethanol ablation or surgical treatment were retrospectively analyzed. Results 97.4% (37/38) patients had a typical clinical manifestation of Whipple's triad, and the I/G ratio of 82.9% patients (29/35) was more than 0.3 with their onset of hypoglycemia. The positive preoperative etiologic diagnosis rates of transabdominal ultrasonography, CT, MRI, PET/CT and EUS were 50.0%, 67.6%, 66.7%, 75.0%, 89.7% respectively. In the current study, 18 patients underwent EUS-guided ethanol ablation (EUS-FNI group) and 20 patients received surgicaltreatment (surgical group). Compared with the surgical group, the operation time, intraoperative hemorrhage volume, postoperative complications, length of stay and hospitalization costs were significantly reduced in the EUS-FNI group (P < 0.05). No treatment-related complications was observed in EUS-FNI group, while 40.0% (8/20) patients in surgical group had complications. During the follow-up period, all these patients maintained stable blood glucose without taking medication, and there's no recurrence of insulinoma in EUS-FNI group after the last treatment with alcohol injection; In surgical group, only 90.0% (18/20) patients had no recurrence, episode of hypoglycemia was less after the operation in 10.0% (2/20) patients. Conclusion EUS-guided ethanol ablation of benign insulinoma is safe and effective, compared with traditional surgical treatment, EUS-guided ethanol ablation is minimally invasive, costs less, recovers fast after treatment and has fewer complications.
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Objective To evaluate measurement of the submucosal thickness with endoscopic ultrasonography (EUS) for activity of Crohn disease (CD).Methods Ten patients with active stage of CD and 10 healthy controls (HC) underwent EUS.Simple endoscopic score for Crohn disease(SES-CD)and submucosal thickness at the most severe lesions were measured and recorded.Submucosal thickness of the same region in CD patients were measured at remissive stage.In order to analyze the relationship between submucosal thickness and the stage of CD, submucosal thickness were compared among patients at active stage of CD, remissive stage of CD and HC.And the cut-off value of submucosal thickness was calculated to diagnose the stage of CD.Results The mean submucosal thicknesses of active stage and remissive stage of CD were 6.48±1.95 mm and 2.47±1.08 mm,respectively (P<0.01).The correlation analysis showed that submucosal thickness had a positive correlation with Crohn disease activity index(CDAI)(r=0.708,P<0.01) and SES-CD(r=0.807,P<0.01).Receiver operating characteristic curve analysis was used for 10 cases of CD patients and the area under the curve was 0.985(P<0.01).The cut-off value of submucosal thickness to diagnose active stage of CD was 3.85 mm, and the sensitivity and specificity reached 100% and 90% respectively.The Youden index was 0.9.Conclusion Measurement of gastrointestinal submucosal thickness by EUS could contribute to evaluate the stage of CD and to guide clinical treatment.
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Objective To investigate the diagnostic value of contrast-enhanced ultrasound endoscopy(CE-EUS) for the upper gastrointestinal tract and adjacent lesions.Methods One hundred and eighty samples of upper gastrointestinal tract and adjacent lesions in the First Affiliated Hospital of Guangxi Medical University from June 2014 to March 2015 were collected and performed CE-EUS.The preliminary diagnosis was taken by observing the features of various kinds of solid mass,which was conducted the contrastive analysis with the results of fine needle aspiration cytology(EUS-FNA) and (or) histopathology, biliary brush cytology smear results,operative pathologic findings,and CT,MRI scans and follow-up results.Results In 180 cases of gastrointestinal tract and adjacent placeholder,169 cases of CE-EUS were in line with the final results,while 11 cases were not consistent,and the diagnostic consistency rate was 93.9%.Conclusion CE-EUS can guide EUS-FNA puncture for increasing its positive rate..
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Objective:To investigate the effects and mechanisms of interleukin-22(IL-22) on inhibiting liver fibrosis induced by HSC,and explore the role of Wnt/β-catenin pathway in the activation of hepatic stellate cells(HSC).Methods:Rat HSC was activated by TGF-β1,and the mRNA and protein levels of β-catenin and α-SMA were detected by q-PCR and Western blot,respectively.HSC was treated with different hours and concentration of recombinant rat protein IL-22.The cell proliferation rates were detected by CCK8,cell apoptosis rates were tested by flow cytometry.HSC were treated with optimal concentration of IL-22 after activated by TGF-β1,the cell proliferation rates,mRNA and protein levels of β-catenin and α-SMA were compared of before and after intervention.Results:The mRNA and the protein levels of β-catenin and α-SMA were significantly increased after activated by TGF-β1(P0.05).IL-22 significantly inhibited the activation of HSC induced by TGF-β1 and remarkably decreased the mRNA and the protein expression level of β-catenin and α-SMA(P<0.05).Conclusion:The Wnt/β-catenin pathway may participates in the process of HSC activation and α-SMA secretion,and IL-22 inhibits biological function of HSC in a dose-and time-dependent manner.This effect probably via inhibited the Wnt/β-catenin signal pathway.
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Objective:To explore the effects and mechanism of anti IL-9 antibody on malignant ascites ( MA) of hepatic carci-noma in mice.Methods:A mouse model of MA was established by mouse H 22 cell line.45 mice were divided randomly into experi-mental group,negative control group and blank control group at 24 hours after modeling,with 15 mice in each group.The experimental group was injected intraperitoneally with anti IL-9 antibody;the negative control group was injected with isotype IgG antibody;the blank control group was injected with normal saline .The weight and behavior of the mice were measured before each injection .Five mice of each group was sacrificed at 24 hours after the last injection to measure the volume of MA .The level of VEGF,MMP-2,IL-9 and IFN-γin MA were determined with ELISA assay;the survival time of rest mice were recorded and compared .Results:The mean volume of MA of experimental group,negative control group and blank control group were (6.70±1.52)ml,(10.28±1.75)ml,(10.36±2.30) ml,respectively,the MA volume of experimental group were lower as compared to negative control group and blank control group ( P0.05 ) .Conclusion:Intraper-itoneal injection anti IL-9 antibody on H22 ascites-bearing mice can effectively inhibit the generation of the MA .The mechanism may be related to the inhibition of the expression of the VEGF and IL-9.
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Objective To evaluate the therapeutic effect of endoscopic management of plastic stents of post-liver transplantation anastomotic biliary stricture. Methods From January 2010 to October 2015, clinical data of patients with post-liver transplantation anastomotic biliary stricture and received endoscopic retrograde cholangiopancreatog﹣raphy and plastic stents management was collected. The technical success rate, ERCP-related complications, clinical remission rate and long-term complications were main outcome measurements to compare the efficacy and safety of different number of stents in managing post-liver transplantation anastomotic biliary stricture. Results Among the 18 patients (0.5 ~ 60.0 months) with post-liver transplantation ABSs, seven patients received less plastic stents treat﹣ment (< 3 stents), nine patients with persistent anastomotic or recurrent stricture received multiple plastic stents treatment (≥ 3 stents), two patients received multiple plastic stents treatment once suffered with post-liver trans﹣plantation ABSs. The endoscopic technical success rate was seventy-six over eighty (95.0 %). Among the seven pa﹣tients received less plastic stents treatment, one loss to follow-up, two were still under treatment, one died of acute hepatic failure, one died of septic stock, one combined with biliary fistula resulted in treatment failure, one achieved clinical remission, the clinical remission rate was one third (33.3 %). Among the eleven patients received multiple plastic stents treatment, two loss to follow-up, one was still under treatment, two received surgery because of failed treatment, six achieved clinical remission, the clinical remission rate was 75.0 % (6/8). The average diameters and stent durations of management of 1 stent, 2 stents, 3 stents, 4 stents, 5 stents, 7 stents were 8.5 F, 17.0 F, 24.0 F, 28.0 F, 36.0 F, 50.0 F. Among the six early postoperative complications, five cases occurred in less stent manage﹣ment and one occurred in MPSs management, the early postoperative complication rate was 7.5 %(6/80). No severe ERCP-related complications and procedure-related deaths. Conclusions Endoscopic management of plastic stents is safe and effective for post-liver transplantation ABSs. Providing larger biliary support, the multiple plastic stents treatment was superior to less plastic stents treatment in view of clinical remission rate, especially for refractory one. Multiple plastic stents did not increase the incidence of complications, it could be used as the first-line treatment of post-liver transplantation duct-to-duct biliary anastomosis for its safety and effectivity.
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Objective To evaluate the safety and efficacy of endoscopic ultrasonography(EUS) guided ethanol ablation in patients with insulinoma. Methods The data of 10 patients with insulinoma trea-ted at the First Affiliated Hospital of Guangxi Medical University from December 2013 to January 2015 were prospectively analyzed. Results The patients were given EUS-guided ethanol ablation with dose of 0. 10 to 2. 00 ml(average 0. 70 ± 0. 62 ml)in pancreatic lesions for 15 times. No complications were observed dur-ing and after the procedure. The blood glucose improved after the procedure[4. 8(3. 9-5. 5)mmol/ L VS 2. 4 (1. 9-2. 5)mmol/ L,P < 0. 05]and the serum insulin level significantly decreased[83. 7(40. 1-143. 5) pmol/ L VS 177. 3(66. 5-200. 6)pmol/ L,P<0. 05]. The average hospital stay was(4. 3±1. 5)days. The patients were followed up for 6-12 months. EUS indicated that the echo of pancreatic lesions changed from high to low. CE-EUS revealed low enhancement and lack of blood supply. Conclusion EUS-guided ethanol ablation may become a promising minimally invasive treatment for insulinoma because of its safety,efficacy and low price. Trail registration Clinical Trial.gov,NCT02121366.
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Objective To explore the expressions and significance of Galectin‐3 and Bcl‐2 in colorectal tissues of patients with ulcerative colitis(UC) .Methods Immunohistochemical SP method was applied to detected the expression of Galectin‐3 and Bcl‐2 in colorectal tissues of 60 patients in UC group and 20 healthy adults in the control group ,and analyzed the relationship of the expres‐sions between Galectin‐3 and Bcl‐2 .It was regarded as positive cell when obvious dark brown granules appeared in cytoplasm or cyteblast .Semi‐quantitative analysis was used basing on the staining intensity and the amount of the staining intensity and positive cells .Results Galectin‐3 and Bcl‐2 proteins expressed in cytoplasm .Galectin‐3 showed strong expression in normal colorectal epi‐thelium but weak in UC inflammatory tissues ,and it was associated with different lesion degrees under endoscopy .The expressions of Bcl‐2 were weak in normal colorectal epithelium ,and it enhanced significantly in UC inflammatory tissues ,especially in inflamma‐tory cells of laminae propria ,and it was not associated with different lesion degrees under endoscopy .The expression of Galectin‐3 and Bcl‐2 was not associated with the age ,sex of patients and the course of UC .Pearson correlation analysis showed that the posi‐tive expressions of Galectin‐3 and Bcl‐2 had no relevance .Conclusion Galectin‐3 and Bcl‐2 involved in the pathogenesis of UC . They may be able to used as markers of early diagnosis and prognosis in UC and may play the role in the pathogenesis of UC inde‐pendently .
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Objective:To assess the role of Th9 and Th17 cells in malignant ascites (MA). Methods: MA from 30 hepatic carcinoma patients and benign ascites from 30 cirrhotic patients were collected. Corresponding peripheral blood samples from these hepatic carcinoma and cirrhotic patients as well as 30 healthy subjects were collected. The frequency of Th9 and Th17 cells was tested by flow cytometry. Serum levels of interleukin (IL)-9 and IL-17 were examined byELISA. Results: The observed frequency of Th9 and Th17 cells, and the IL-9 and IL-17 serum levels were significantly higher in MA patients than those in cirrhotic patients and healthy control samples (P Conclusions:The increased frequency of Th9 and Th17 cells in MA patients suggests that these two T cell subsets play a synergistic role in MA pathogenesis. This study also demonstrated that Th9 and Th17 cells may perform their biological functions in conjunction with IL-9 production.
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<p><b>OBJECTIVE</b>To explore the role of the Rho pathway in the hepatocyte growth factor (HGF) paracrine signal-mediated bone marrow-derived mesenchymal stem cell (BMSC) promotion of apoptosis of hepatic stellate cells (HSCs).</p><p><b>METHODS</b>A BMSC-HSC co-culture system was established using plates with transwell inserts. Dynamic changes in response to pretreatment with the c-met blocker PHA665752 and the Rho pathway inhibitor Y-27632 were observed under an inverted phase contrast microscope at 24, 48 and 72 h of culture. Optimal intervention concentrations of Y-27632 and PHA665752 were determined by MTT assay. Expression of alpha-smooth muscle actin in HSCs was evaluated by immunohistochemistry, and the apoptosis rate of HSCs was measured by Annexin-V-FITC/propidium iodide. RhoA protein and mRNA levels were measured by western blot and quantitative real-time PCR respectively. Concentrations of HGF and hepatocyte growth factor activator (HGFA) were quantified by enzyme-linked immunosorbent assay. Between-group differences were evaluated by one-way ANOVA with P less than 0.05 indicating significance.</p><p><b>RESULTS</b>The apoptosis rates of HSCs gradually and steadily increased in a time-dependent manner. The apoptosis rate of the PHA665752 pretreated group was lowest and that of the Y-27632 pretreated group was highest, with the most robust difference occurring at the 72 h time point (P less than 0.05). The mRNA and protein expression levels of RhoA decreased in a time-dependent manner in the Y-27632 pretreated group (all time points, P less than 0.05) but the expression levels increased in a time-dependent manner in the PHA665752 pretreated group (all time points, P less than 0.05). For both the PHA665752 and the Y-27632 pretreated groups, the concentration of HGF decreased in a time-dependent manner, but the concentrations in both remained significantly higher than that in the control group at all time points examined (P less than 0.05). The concentration of HGFA increased in a time-dependent manner, and the PHA665752 pretreated group showed significantly higher levels than any of the other groups at all time points examined (P less than 0.01).</p><p><b>CONCLUSION</b>BMSC promotes HSC apoptosis in a co-culture system by activating HGF and down-regulating the RhoA signaling pathway.</p>
Subject(s)
Animals , Male , Rats , Actins , Metabolism , Apoptosis , Bone Marrow Cells , Cell Biology , Cell Line , Cells, Cultured , Coculture Techniques , Hepatic Stellate Cells , Cell Biology , Hepatocyte Growth Factor , Bodily Secretions , Mesenchymal Stem Cells , Cell Biology , Rats, Sprague-Dawley , Signal TransductionABSTRACT
Objective To study the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) for bile duct stricture diseases.Methods The results of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography,intraductal uhrasonography,bile duct brushing cytology,the liquid-based cytology and the histopathological examination were analyzed retrospectively.The final diagnosis was made based on clinical data,histopathology and follow-up results(≥4 months).Results Twenty-one patients were diagnosed as having malignant biliary diseases,including 9 biliary tract carcinoma,4 duodenal papilla carcinoma,4 pancreatic cancer infiltrated common bile duct,4 cancer of the liver infiltrated common bile duct ; 15 were diagnosed as having benign biliary diseases,including 9 bile duct stones,4 liver fluke disease,lbile duct inflammatory stenosis,1 bile duct stricture caused by external compression.The accuracy rate of the EUS,ERCP,IDUS and ERCP + IDUS in the differential diagnosis of the bile duct stricture disease were 77.8％,88.9％,91.7％ and 94.4％,respectively.The accuracy rates of IDUS,ERCP,ERCP combined with IDUS were significantly higher than that of EUS (P ＜ 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ERCP combined with IDUS were 95.2％,93.3％,95.2％ and 93.3％ respectively which were higher than those of EUS,ERCP and IDUS.After the bile duct brushing cytology and the liquid-based cytology or histopathological examination,19 patients were diagnosed as having malignant biliary diseases,17 were benign biliary diseases.The sensitivity,specificity and accuracy of the procedures for malignant bile duct stricture disease were 90.5％,100.0％,94.4％ respectively.Conclusion ERCP combined with IDUS can improve the diagnostic accuracy.The diagnostic positive rate will be higher with the help of ERCP,IDUS and targeted brush.
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Objective To evaluate the diagnostic value of the cell block (CB) with immunostaining method by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy for pancreatic lesions.Methods A total of 72 patients with pancreatic lesions underwent EUS-FNA at the First Affiliated Hospital of Guangxi Medical University from March 2012 to June 2013.The EUS-FNA samples of all patients were processed by conventional smear cytology,liquid-based cytology (LBC) and the cell block with immunostaining.Results There were 61 pancreatic patients who were finally diagnosed as having pancreatic tumors,including 55 cases of pancreatic cancer,2 pancreatic solid pseudopapillary tumor,4 pancreatic endocrine tumors (PETs),and 11 benign lesions:4 chronic pancreatitis,2 pancreatic tuberculosis,4 pancreatitis and 1 pancreatic mucinous cystadenoma.The diagnostic sensitivity of conventional smear cytology,liquid-based cytology and cell block with immuno-staining method were 68.9％ (42/61),75.4％ (46/61) and 90.2％ (55/61),respectively.The diagnostic specificity of three methods were all 100.0％.The diagnostic accuracy rates were 73.6％ (53/72),79.2％ (57/72) and 91.7％ (66/72),respectively.The diagnostic accuracy rate of the cell block with immunostaining was higher than those of conventional smear cytology (P ＜ 0.05) and the liquid-based cytology (P ＜ 0.05).Conclusion Endoscopic ultrasound-guided fine-needle aspiration is a safe and effective method with high sensitivity and specificity in the diagnosis of pancreatic lesions.Cell block method combining immunohistochemistry helps to increase the diagnosis and histological diagnosis of pancreatic lesions.The cell block has a greater clinical value in the diagnosis of pancreatic lesions.
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Objective To investigate the expression of sphingosine kinase 1(SphK1)and NF-κB in colon carcinoma tissues and their correlation with clinicopathologic features.Methods Sixty-six paraffinembedded colon carcinoma samples and 66 fresh colon carcinoma samples were tested using immunohistochemistry,RT-PCR and Western blot,respectively.Results In 66 fresh colon carcinoma samples,the positive rate of SphK1 and NF-κB mRNA expression were 84.85％(56/66)and 74.24％(49/66),while the positive rate of SphK1 and NF-κB protein detected by Western blot were 78.79％(52/66)and 69.70％(46/66).The positive rates were higher than those in the adjacent tissues[mRNA:63.64％(42/66),48.49％(32/66);protein:57.58％(38/66),45.45％(30/66)]and the normal mucosa [mRNA:42.42％(28/66),25.76％(17/66); protein:36.36％(24/66),24.24％(16/66)],with statistical significances(all P values ＜ 0.05).The mean expressive levels of SphK1 and NF-kB mRNA and protein in colon carcinoma were both significantly higher than those in the adjacent tissues and the normal mucosa(mRNA:0.55±0.06 vs0.35 ±0.05 vs0.25±0.05,0.75 ±0.06 vs0.43±0.05 vs0.30±0.04 ; protein:0.77 ± 0.05 vs 0.38 ± 0.06 vs 0.12 ± 0.03,0.45 ± 0.08 vs 0.23 ± 0.05 vs 0.13 ± 0.03 ;all P values ＜ 0.05).There was a close correlation between SphK1 and NF-kB expression levels (r =0.459,P =0.036).The results of immunohistochemistry were similar to those of RT-PCR and Western blot.Overexpression of SphK1 and NF-κB in colon carcinoma was related with depth of invasion,distant and lymph node metastasis and Dukes'stages(all P values ＜0.05).The expression of SphK1 was also related with differentiation(P ＜ 0.05).Conclusions Overexpression of SphK1 and NF-κB may be involved in the pathogenesis and progression of colon carcinoma.Moreover,SphK1 and NF-κB may be correlated with the invasion and metastasis of colon carcinoma.
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BACKGROUND:The hepatic stellate cells(HSCs)plays a key role in the development of liver fibrosis.Studies have shown that bone marrow-derived mesenchymal stem cell(BMSCs)transplantation can be used to treat liver fibrosis,but the mechanism for reversal of liver fibrosis remains unknown.OBJECTIVE:To explore the mechanism of bone marrow mesenchymal stem cells to regulate the proliferation of HSCs under co-culture in vitro.METHODS:Rat BMSCs and HSCs in the experimental group were cultured in the plastic culture plate(6 holes)to establish the upper and lower double-cell co-culture system.Rat normal fibroblast cell lines were seeded as control group;HSCs were cultured alone as blank group.Cell proliferation was determined by WST8 and cell cycle was determined by flow cytometry.The Cyclin D1 and P27 mRNA expression in HSC was determined by reverse transcription-polymerase chain reaction(RT-PCR)and the level of Cyclin D1 and P27 protein by Western blot.RESULTS AND CONCLUSION:HSCs co-cultured with BMSCs significantly inhibited HSC proliferation compared with the blank and control groups at 24,48,and 72 hours(P ＜ 0.01);Flow cytometry showed that the percentage of G_0/G_1 phase cells of co-culture group was increased but the S phase cells reduced(P ＜ 0.01)compared with the other groups at 72 hours,and BMSCs blocked HSC to convert from G_0/G_1 period to S phase.After HSCs co-cultured with BMSCs for 24 hours,the expression of Cyclin D1 mRNA and protein was reduced,and significantly less than the blank and control groups at 72 hours(P ＜ 0.01);no differences were detected in P27 mRNA expression in each group during the co-culture(P ＞ 0.05).After co-culture of 24 hours,the p27 protein expression was significantly increased compared with the blank and control groups(P ＜ 0.01).BMSCs inhibited the proliferation of HSCs,possibly through inhibiting CydinDI expression,increasing the p27 protein expression to cause cell cyde arresting in G_0/G_1 phase.
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Objective To study the expression of basic fibroblast growth factor(bFGF),fibroblast growth factor receptor-2(FGFR-2)and heparanase(Hpa)in the tissues of gastric cancer and precancerous lesions,and to explore its significance in the carcinogenesis and malignant progression of stomach.Methods The expression of bFGF,FGFR-2 and Hpa were detected by immunohistochemistry in 145 cases of paraffin-embedded specimens from different gastric mucosa,including 30 cases of chronic superficial gastritis(CSG),29 of intestinal metaplasia(IM),31 of dysplasia(Dys)and 55 of gastric carcinoma(GC).Results The expression of bFGF and FGFR-2 in CSG group was significantly lower than that of the other three groups(P