Résumé
Objective To investigate the occurrence factors of duodenobiliary reflux (DBR) after endoscopic sphincterotomy (EST ) .Methods A total of 198 patients with choledocholithiasis hospitalized in the digestive department of the hospital from Sep-tember 2012 to February 2016 were selected and given duodenal papilla EST .The DBR occurrence was judged and the occurrence factors were investigated ,meanwhile the Oddi sphincter function was measured and long term complications were followed up .Re-sults All patients successfully completed EST ,the average common bile duct diameter in 198 cases was (2 .24 ± 0 .24)cm ,the aver-age common bile duct stones number was 3 .63 ± 1 .12 ;the maximum diameter of common bile duct stones was (1 .02 ± 0 .19)cm . There were 12 cases of DBR after EST ,the occurrence rate was 6 .1% ,the average radioactivity was (3 .39 ± 0 .89)MBq .The post-operative Oddi sphincter systolic peak and contraction frequency were (31 .49 ± 4 .22)mm Hg and (3 .78 ± 0 .53) times /min ,which were significantly lower than those before operation (P<0 .05);and the postoperative Oddi sphincter basic pressure and common bile duct pressure were (8 .23 ± 1 .03)mm Hg and (3 .32 ± 0 .45)mm Hg respectively ,which had no statistical difference compared with preoperation (P>0 .05) .The Logistic regression analysis showed that complicating gallbladder stone ,diameter of common bile duct ,frequency difference of Oddi sphincter contraction before and after operation ,number of stones and maximum diameter of stone were the main risk factors for postoperative DBR occurrence (P<0 .05) .All cases were followed up for 6 months ,18 cases developed long term complications ,the incidence rate was 9 .1% ,including 4 cases of reflux cholangitis ,6 cases of bile duct stric-ture ,4 cases of papillary stenosis and 4 cases of recurrence .Conclusion DBR after duodenal papilla EST is common ,which can re-sult in the Oddi sphincter function decrease and increase of long-term complications ,and needs to actively strengthen prevention and management .
Résumé
Objective To study the effects of the HBV x gene (HBx) on the biological characteristics and the expression of DNA repair enzyme hMTH1 mRNA of the L02/HBx transgene cell model. Methods Light microscopy was used to observe the morphologic characteristics of gene-transfected cell strain Lff2/HBx that stably expressed the HBx protein and the control groups of L02 and L02/PcDNA3.1. The changes of L02/HBx on the proliferation, cell cycle and apoptosis were observed by MTT assays and flow cytometry analysis respectively. Moreover, the malignant transformation of L02/HBxwas assayed by colony formation in soft agar and the expression of DNA repair enzyme hMTH1 mRNA was assayed in each group by real-time qPCR. Results Inversion phase contrast microscope showed that the morphologic characteristics of L02/HBx had changed obviously compared with control groups. The MTT showed that L02/HBx proliferated more quickly and flow cytometry analysis indicated that HBx could accelerate the progression of cell cycle and inhibit apoptosis. Colony formation in soft agar demonstrated that the rate of colony formation of L02/HBx was remarkably higher than the L02 and the L02/peDNA3. 1 cells (P<0. 05). The real-time qPCR detection showed that the expression of hMTH1 mRNA in L02/HBx was significantly higher than that in the control groups ( P < 0. 05 ). Conclusion HBx could play an important role in the malignant transformation of L02/HBx and the over expression of hMTH1 mRNA.