Therapeutic value of endoscopic retrograde cholangiopancreatography for liver cirrhosis combined with biliopancreatic diseases / 中华消化内镜杂志

Objective:To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for patients with liver cirrhosis combined with biliopancreatic diseases.Methods:Data of 99 patients with liver cirrhosis combined with biliopancreatic diseases who received ERCP at Xijing Digestive Hospital from November 2008 to December 2017 for the first time were retrospectively studied. Success rate of ERCP and incidence of complications were analyzed.Results:The 99 cases of liver cirrhosis were mainly caused by hepatitis B virus infection (40.4%, 40/99) and unknown reasons (30.3%, 30/99), and the mean model for end-stage liver disease score was 15.4±5.3. The common bile duct stones and bile duct stricture were the most common biliopancreatic diseases, accounting for 49.5% (49/99) and 33.3% (33/99), respectively. The success rate of ERCP was 100.0%(99/99). The total postoperative complication incidence was 14.1% (14/99), among which liver cirrhosis-related complications was 3.0% (3/99); ERCP-related complications was 11.1% (11/99), including 9.1% (9/99) biliary tract infection, and 2.0% (2/99) delayed bleeding. No post-ERCP pancreatitis, perforation or death occurred.Conclusion:ERCP is safe and effective for liver cirrhosis combined with biliopancreatic diseases.

A retrospective analysis of azathioprine in the treatment of 24 patients with refractory ulcerative colitis / 中华内科杂志

Objective To evaluate the efficacy and safety of azathioprine (AZA) in the treatment of refractory ulcerative colitis (UC).Methods Retrospective analysis of the clinical improvement,endoscopic improvement and mucosal healing rate,inflammation marker improvement after AZA administration and its safety in 24 refractory UC patients were performed,who were recruited between January 2007 and December 2011 in West China Hospital,Sichuan University,China.Results Twenty-four patients were enrolled,with a median age of 36 years old and a median course of 4 years.Among them,14 cases were moderate UC and 10 cases were severe UC.The patients were treated with AZA in a dose of (1.23 ±0.34) mg· kg-1 · d-1 from 7 weeks to 42 months.Efficacy was judged by Mayo disease activity index.At 3 months,6 months and 1 year after treatment,the effective rates were 73.9％ ( 17/23),81.8％(18/22) and 14/16 respectively,and the remission rates were 17.4％ (4/23),54.5％ (12/22) and 12/16respectively.Both ESR and C reactive protein level after treatment for 6 months and 1 year were significantly lower than those before treatment [ (9.3 ±8.9) mrn/1h,(10.9 ±7.3) mm/1h vs (22.3 ± 10.7) mm/1h;2.5(1.0-22.3) mg/L,2.3(1.0-28.0) mg/L vs 18.4(3.6-137.0) mg/L; all P ＜0.05].Corticosteroid withdrawal rates at 3 months and 1 year after AZA treatment were 16/18 and 15/16,respectively.At 6 months and 1 year after AZA treatment,the endoscopic improvement rates were 85.7％ ( 18/21 ) and 13/15 respectively; the cndoscopic remission rates were 61.9％ ( 13/21 ) and 11/15 respectively; and the mucosal healing rates were 61.9％ ( 13/21 ) and 11/15 respectively.Adverse effects were occurred in 8 patients.Leukopenia was the most common adverse effect,followed by liver function injury,alopecia and epigastric discomfort.Conclusions AZA is effective in the treatment of refractory UC patients with a low dose of ( 1.23 ± 0.34) mg· kg - 1 · d - 1,especially in the steroid withdrawing,maintaining remission and mucosal healing without severe adverse effects.

Primary intestinal non-Hodgkin's lymphoma: a retrospective study of 85 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To review the clinical characteristics and treatment outcomes of primary intestinal non-Hodgkin's lymphomas (PINHL) and analyze the differences between T-cell and B-cell lymphomas.</p><p><b>METHODS</b>The characteristics of PINHL patients treated in our hospital between January 2003 and December 2010 were reviewed for their clinical manifestations, diagnosis, endoscopic findings, treatments and outcomes.</p><p><b>RESULTS</b>Eighty-five cases of PINHL meeting the Dawson's criteria were identified. The median age of the patients at the time of diagnosis was 52 years and the male: female ratio was 3.05:1; 58 cases (68.2%) had B-lineage and 27 cases (31.8%) had T-cell lineage lymphomas. Compared to those with B-cell lymphoma, patients with T-cell lymphomas showed a younger age of disease onset (32 vs 56 years, P<0.01) and presented with a greater incidence of such symptoms as fever, hematochezia, diarrhea and night sweats (P<0.05); T-cell lymphoma showed more multifocal and ulcerative/ulcero-infiltrative lesions under endoscope with a longer diagnosis time (4 vs 2 months, P<0.01) and a greater likeliness of misdiagnosis (16/27 vs 12/58, P<0.01) and poor prognosis. Extranodal NK/T-cell lymphoma was the most common type of T-cell lymphomas.</p><p><b>CONCLUSION</b>In our cases, T-cell lymphoma appeared to be more common than B-cell lymphoma with a younger onset age, more difficult diagnosis, a greater likeliness of misdiagnosis, poorer prognosis and more extranodal NK/T-cell lymphoma.</p>

Effects of ginsenoside Rg1 on expression of insulin-like growth factor-1 in brain of rats with brain contusion / 中西医结合学报

OBJECTIVE: To study the effects of ginsenoside Rg1 on the expression of insulin-like growth factor-1 (IGF-1) in the brain of rats after the experimental brain contusion. METHODS: A total of twenty-six Wistar rats were randomly divided into normal control group (n=2), untreated group (n=8) and ginsenoside Rg1 group (n=16). Brain injuries were induced in rats by a mechanical striking device. The brain tissues were extracted at different times after brain injury (6th hour, 12th hour, 2nd day, 6th day), then the expression of IGF-1 in brain tissue was examined by immunohistochemical method. RESULTS: In comparison with the normal control group, the expression of IGF-1 in the brain tissues was increased in the untreated group after the brain contusion (P<0.05). The expression of IGF-1 in brain tissues in ginsenoside Rg1 group was significantly increased as compared with the untreated group (P<0.05). CONCLUSION: Ginsenoside Rg1 enhances the recovery of the contused brain through increasing the expression of IGF-1.