RÉSUMÉ
Objective:To investigate the application value of peri-gastric devasculariza-tion without dissociation of esophagus for portal hypertension.Methods:The retrospective and descriptive study was conducted. The clinical data of 94 patients with portal hypertension who were admitted to three medical centers, including 75 cases in the People′s Hospital of Ningxia Hui Autonomous Region, 12 cases in the People′s Hospital of Wuhai and 7 cases in the People′s Hospital of Wuzhong, from July 2018 to December 2022 were collected. There were 68 males and 26 females, aged 46(range, 21-70)years. All 94 patients underwent peri-gastric devascularization without dissociation of esophagus. Observation indicators: (1) intraoperative condition; (2) postoperative complications; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measure-ment data with skewed distribution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Intraoperative condition. All 94 patients underwent surgery success-fully without operation death, including 82 cases receiving open surgery and 12 cases receiving laparoscopic surgery. The operation time and volume of intraoperative blood loss were (183±85)minutes and 289(range, 158-560)mL, respectively, for the 94 patients. (2) Postoperative complications. Of 94 patients, early portal vein thrombosis occurred in 24 cases, intra-abdominal infection occurred in 2 cases, hepatic encephalopathy occurred in 1 case, pulmonary embolism occurred in 1 case, intra-abdominal hemorrhage requiring operation to stop bleeding occurred in 1 case and pleural effusion requiring drainage occurred in 1 case. All patients with postoperative complications were cured after treatment. None of the 94 patient had postoperative esophageal complications such as odynophagia or dysphagia. (3) Follow-up. All 94 patients were followed up for 38(range, 6-60)months. Of the 45 patients with paraesophageal vein, there were 36 cases of thinner and 9 cases of occlusion of the distal subphrenic paraesophageal vein after surgery, respectively. Cases with esophageal varices disappearance, cases with mild and moderate residual of esophageal varices, cases with severe residual of esophageal varices, cases with recurrence of esophageal varices, cases with esophageal varices bleeding were 7, 70, 9, 4, 4 in the 94 patients after surgery. Cases with esophageal varices disappearance was 7 in the 45 patients with paraesophageal vein, versus 0 in the 49 patients without paraesophageal vein, showing a significant difference between them ( P<0.05). Of 94 patients, 17 cases developed postoperative late portal vein thrombosis and cavernous transformation, 7 cases developed liver cancer, 1 case had hepatic encephalopathy, and 6 cases died. Conclusion:Peri-gastric devascularization without dissociation of esophagus is safe and feasible for the treatment of portal hypertension.
RÉSUMÉ
Objective To investigate the effect of endocrine gland-derived vascular endothelial growth factor(EG-VEGF) on the proliferation and apoptosis of pancreatic cancer cells and on the regulation of PI3K/AKT signaling pathway.Methords The expression of EG-VEGF and its receptor-VEGFR-2 in pancreatic cancer tissues and adjacent normal tissues was detected by PCR.The effect of EG-VEGF on proliferation of human pancreatic cancer cells was detected by MTT assay.The effect of EG-VEGF on the apoptosis of human pancreatic cancer cells was detected by flow cytometry.Western lot was used to detect the changes of related proteins expression in PI3K/AKT signaling pathway after EG-VEGF treatment.Results The expression (3.08±0.30,2.17±0.16 respectively) of EG-VEGF and VEGFR-2 in pancreatic cancer tissues was significantly higher than those (1.55±0.73,0.54±0.34 respectively) in adjacent tissues (both P＜ 0.05).MTT and flow cytometry data showed that EG-VEGF could promote the proliferation of pancreatic cancer cells and inhibit cell apoptosis.Western blot showed that EG-VEGF promoted AKT phosphorylation and activated PI3K/AKT signaling pathway.Conclusion EG-VEGF is highly expressed in pancreatic cancer tissue,and can activate PI3K/AKT signaling pathway to promote cell proliferation and inhibit cell apoptosis.