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【Objective】 To evaluate the detection and distribution characteristics of anti-P1 in tumor patients, so as to aid in blood screening and transfusion safety. 【Methods】 The clinical data of 112 658 tumor patients who underwent blood preparation and transfusion in our hospital from January 2014 to December 2021 were retrospectively analyzed, and column agglutination technique was used to perform transfusion compatibility test. 【Results】 A total of 1 079 (0.96%, 1 079/112 658) cases were detected with unexpected antibodies, of which 71 (6.58%, 71/1 079) were identified as anti-P1. In anti-P1 cases, 59.15% (42/71) were males; 60.56% had no pregnancy history (P<0.01); 29.58% (21/71), 52.11%(37/71), 12.68%(9/71) and 5.63%(4/71) of anti-P1 patients were with type A, B, O and AB, respectively. 57 cases of anti-P1 patients (80.28%) had difficulty in ABO blood group identification. The incidence of interfering in patients with type B was higher than that of other blood types (P<0.05), as the frequency of w+ in reverse blood typing was higher than other reactive patterns (P<0.05). The incidence of gastric tumor and brain space-occupying lesion in patients with anti-P1 was higher than that in patients with other alloantibodies, while the incidence of gynecological tumors was lower (P<0.05). 【Conclusion】 Anti-P1 affects the ABO blood group identification of tumor patients, and most of them had difficulty in ABO blood group identification. Compared with patients with other alloantibodies, patients with anti-P1 are more likely to be male and suffer from gastric and brain tumors, but less likely from gynecological tumors.
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Objective To explore the feasibility of interventional therapy in rat models of Budd-Chiari syndrome (BCS).Methods A total of 50 male clean SD rats were divided into model group and control group using random number table method,with 25 rats in each group.In the model group,BCS rat model was constructed by adopting partial ligation of the inferior vena cava (IVC),and the control group only had separation of surrounding tissues of IVC.Liver function was studied 12 weeks after postoperative raising,and digital subtraction angiography (DSA) and interventional therapy were performed,coupled with liver histopathology staining.Results Twenty BCS rats survived till the 12th week of raising,with the survival rate reaching 80.0％,and 22 survived in the control group.Compared with the control group,ALT [(43.1±5.5) U/L vs.(62.6±4.6) U/L] and AST [(84.7±26.5) U/L vs.(161.7±25.8) U/L)] in serum of rats in the model group increased,the differences were statistically significant (P＜0.05).HE staining showed that obvious hepatocyte necrosis and inflammatory cell infiltration were observed in BCS rats,and liver fibrosis was spotted via Masson staining.DSA examination found IVC obstruction in the model group,among which 14 (70.0％,14/20) received interventional therapy after successful probing of IVC obstructed segment,and 7 had balloon dilatation with a diameter of 3.5 mm,with 6 (85.7％,6/7) successfully dilatatedand the other 1 (14.3％,1/7) failed;the remaining 7 had balloon dilatation with a diameter of 4.5 mm,with 2 (28.6％,2/7) successfully dilatated,and the other 5 (71.4％,5/7) died of IVC rupture.Conclusion The BCS rat models by partial ligation of IVC can well simulate the pathophysiological changes and angiopathy characteristics of IVC obstructive BCS patients,which provide a platform for the basic research of interventional therapy of BCS.
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Objective To investigate the expression and significance of malonaldehyde (MDA), superoxide dismutase (SOD) and endotoxin (ET) in liver injury model of Budd-Chiari syndrome (BCS) in rats. Methods The animal model of BCS was established by partially ligating the inferior vena cava of the posterior segment of liver in rats. The experimental animals were divided into three groups: control group (12 rats), model group (48 rats) and sham operation group (48 rats). The model group and sham operation group were divided into four subgroups (1, 3, 6, 12 weeks) of 12 rats each. After the success of modeling,being confirmed by digital subtraction angiography (DSA), nine rats in each group were sacrificed at random respectively, where their serums and liver tissues was collected. The levels of MDA, SOD and ET in both liver homogenate and serum were examined respectively. ANOVA was used to compare the total difference between groups and within group of each measurement data. The LSD method was used to do multiple comparison within group and between groups. Pearson method was used to do correlation analysis of hypoxia markers. Results The levels of MDA, SOD and ET in liver homogenate and serum at different time points in model group were significantly different from those in control group and sham operation group (MDA: liver homogenate (F=52.906, 219.016), serum (F=21.573, 43.878); SOD: liver homogenate (F=22.927, 19.317), serum (F=10.841, 31.643);ET: liver homogenate (F=33.588, 105.515), serum (F=40.832, 46.323);P＜0.05). The total difference of the MDA level in serum at each time point after the operation was not statistically significant in model group(F=1.965,P=0.139), but that of liver homogenate in the model group was statistically significant (F=7.716, P=0.001). The SOD and ET levels in both liver homogenate and serum of model group were compared within groups at different time points after operation respectively, and the overall difference was statistically significant (SOD: F=17.053, 7.903; ET: F=19.870, 39.372; P＜0.05). The time-varying curves of MDA and ET in liver homogenate and serum in model group were similar, which both increased from 1 week after operation,peaked at 6th week and slightly decreased at 12th week. The increase levels of MDA and ET in liver homogenate were significantly higher than those in serum. There was a negative correlation between MDA and SOD in liver homogenate and serum (r=－0.814,－0.591;P=0.001, 0.001), a positive correlation between MDA and ET (r=0.761, 0.422; P=0.004, 0.001), and a negative correlation between SOD and ET (r=－0.726,－0.490;P=0.001, 0.001). Conclusions The levels of hypoxia related markers, such as MDA, SOD and ET in liver and serum of BCS animal model, change to varying degrees in the early stage, and will be aggravated as the disease continues to advance. In the later stage, with the establishment of collateral circulation, hypoxia will be slightly eased, but is still significantly higher than normal, which indicates that congestion and hypoxia run through the whole process of BCS, and could be the key and initiating factors.
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Objective To assess the therapeutic effect and influencing factors of TACE for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).Methods Data of 685 patients with HCC and PVTT were retrospectively analyzed.There were 475 patients treated with TACE (TACE group) and 210 patients treated with supportive treatment (supportive treatment group).The survival time of two groups were observed and compared.The multivariate Cox regression analysis was used to analyze the prognostic factors.Results The median survival time of all 685 patients was 6.3 months.The median survival time of patients in TACE group and supportive treatment group was 7.1 months and 5.2 months,respectively (P=0.002).The 6-,12-and 24-month survival rates were 57.30％,27.30％ and 12.10％ in TACE group,and 37.90％,12.20％ and 3.10％ in supportive treatment group,respectively.Univariate analysis showed that the Child-Pugh classification,the diameter of lesion,gamma-glutamyl transferase level and type of PVTT might be significant prognostic factors for overall survival.Multivariate Cox proportional hazard model analysis showed the Child-Pugh classification and type of PVTT were independent prognostic factors for overall survival.Further analysis showed that the median survival time of patients with type Ⅰ or Ⅱ PVTT in TACE group was 7.8 months,and that in supportive treatment group was 5.5 months.There were statistical differences of 6-,12-and 24-month cumulative survival rate between the 2 groups (P =0.001).The median survival time of patients with type Ⅲ or Ⅳ PVTT in TACE group was 5.3 months,and that in supportive treatment group was 4.5 months.There was no statistical difference of the 6-,12-and 24-month cumulative survival rate between the 2 groups (P=0.662).Conclusion TACE is effective in the treatment of HCC with PVTT.The major influencing factors for survival time of patients with HCC and PVTT are Child-Pugh classification and type of PVTT.The effect of TACE for HCC patients with type Ⅲ or Ⅳ PVTT is unsatisfied.
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Objective To summarize the causes of abdominal pain in the early postoperative period after laparoscopic cholecystectomy(LC), so as to employ preventative measures. Methods The clinical data of 35 patients with early postoperative abdomial pain after LC were analyzed retrospectively and the literature was reviewed . Nine cases underwent reoperation, and conservative treatment was successfully performed in the other 26 cases. Results Traumatic factors were involved in 8 cases, including 6 cases of postoperative biliary fistula , and 2 cases with calculus retained in the trocar hole of the abdominal wall. 27 cases had no traumatic factor and included 2 cases of ascariasis of common bile duct, 5 cases with calculus of common bile duct, 1 case of acute pancreatitis, 17 cases of bile duct dysfunction, 1 case of duodenal ulcer and 1 case of stomach cancer. All were cured. Conclusions The key to decrease complications after LC is a complete examination before LC and pay attention to each aspect of perioperative management.