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Objective To explore the value of endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis after Billroth Ⅱ gastrointestinal anastomosis.Methods A retrospective cohort study was conducted to retrospective review the data of 189 patients with choledocholithiasis treated by ERCP from December 2015 to November 2017 in Department of Hepatobiliary Surgery,Second Hospital of Hebei Medical University.According to the history of Billroth Ⅱ gastrointestinal anastomosis,the patients who have not undergone digestive surgery were divided into the normal group(n =167) and patients who have undergone digestive surgery were divided into reconstruction group (n =22).The operation time,the success rate of stone extraction,complications,the hospitalization time,total hospitalization expenses were compared between the two groups.Measurement data with normal distribution were represented as (Mean ± SD) and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Comparisons of count data were analyzed using the x2 test or Fisher exact probability.Results The operation time of the normal group was (40.18 ± 11.80) min,and the success rate of ERCP was 97.60％ (163/167),the operation time of reconstruction group was(61.81 ± 13.21) min,and the success rate of ERCP was 81.82％ (18/22),There were significant differences between the two groups (t =0.105,x2 =10.400,P ＜ 0.05).The complications,the hospitalization time and the total hospitalization expense of the normal group were 16.17％ (27/167),(3.47 ± 1.55) d,(20 620.69 ± 3 117.88) yuan,the reconstruction group were 18.18％ (4/22),(4.18 ± 2.08) d,(22 426.41 ±5 916.30) yuan,with no statistically significant difference (x2 =0.000,t =4.204),t =10.828,P ＞ 0.05).Conclusions ERCP is safe and feasible for patients with choledocholithiasis after Billroth Ⅱ gastrointestinal anastomosis.It also has a high success rate of stone removal and small trauma,which is worthy of promotion.
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Objective To evaluate the use of endoscopic papillary balloon dilation in treatment of choledocholithiasis associated with peripapillary duodenal diverticulum.Methods From January 2017 to July 2018,a retrospective study was conducted on 124 patients with choledocholithiasis associated with peripapillary duodenal diverticula at the Department of Hepatobiliary Surgery,Second Hospital of Hebei Medical University.These patients were divided into the small endoscopic sphincterotomy combined with balloon dilation group (sEST+EPBD,n =60) and the simple papillary balloon dilation group (EPBD n =64).The operation time,one-time success rate of stone removal,complication and hospitalization stay were compared between the two groups of patients.Results The hospitalization expenses of the EPBD group was significantly less than the sEST+EPBD group (P＜0.05).The operation time of the EPBD group was significantly shorten than the sEST+EPBD group (P＜0.05).There were no significant differences in the one-time success rate of stone removal,complication rates and hospitalization stay between the two groups (P＞0.05).Conclusions Compared with sEST+EPBD,treatment of choledocholithiasis in patients with peripapillary duodenal diverticula using simple balloon dilation shortened the operation time,did not increase the complication rates and hospitalization stay.The procedure was safe and effective,and resulted in almost the same one-time success rate of stone removal.
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Objective To investigate the possible role of X-box binding protein (XBP1) expression at mRNA level in the hepatocarcinogenesis. Methods The expression of XBP1 at mRNA level was determined with RT-PCR method in liver carcinoma (42 cases), liver tissue adjacent to carcinoma (15 cases) and normal liver tissue (15 cases). XBP1 mRNA relative expression level was obtained by comparing with GAPDH mRNA level. The correlation between XBP1 expression and clinicopathological features of liver carcinoma were respectively analyzed. Results RT-PCR results showed that the expression of XBP1 mRNA in liver carcinoma cases (0.4396 ±0.0241) was significantly higher that that of liver tissues adjacent to carcinoma (0.4152±0.0252) and normal liver tissue (0.4095 ±0.0149), (F =12.79,P =0.001). No significant differences in the expression of XBP1 were found among different age and sex of the patients, different location, histological types, grade and metastatic status in liver carcinoma (P >0.05). Conclusion Increased expression of XBP1 mRNA is found in liver carcinoma but no correlation could be seen between XBP1 expression and clinicopathological features, which XBP1 is involved in the hepatocarcinogenesis.
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Objective To detect the expression of lung resistance protein (LRP) and investigate its significance in pancreatic carcinoma cell lines (SW1990, PCT-2, PCT-3, PCT-4, Aspc-1, Capan-1, Mia-PaCa-2 and Panc-1). Methods Reverse transcription PCR (RT-PCR) and immunocytochemistry (ICC) were carried out to investigate the expression of LRP. Results LRP mRNA was absent in PCT-2 cell line by RT-PCR. Mild to moderate expression level was found in other pancreatic carcinoma cell lines. PCT-4, Aspc-1 and Panc-1 presented the highest LRP mRNA expression level, in contrast, SW1990, PCT-3, Capan-1 and Mia-PaCa-2 showed moderate LRP mRNA expression. The median value was 0.56?0.33. LRP was further validated by ICC. Absent to weak protein expression of LRP was found in PCT-2 and PCT-3. Overexpressed LRP was present in SW1990, Capan-1 and Aspc-1, furthermore, the highest expression of LRP was found in Panc-1, Mia-PaCa-2 and PCT-4 cell lines. Conclusion All these data showed that LRP might play an important role in multidrug resistance of pancreatic carcinoma.