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Objective: To observe stent patency after TIPS with color Doppler and contrast-enhanced ultrasound, and to analyze the hemodynamic characteristics of the stent. Methods: Postoperative ultrasonographic data of 32 patients underwent TIPS were retrospectively analyzed. The patency of stent was evaluated using color Doppler and contrast-enhanced ultrasound (defined into grade 0-3), and the flow velocities of the portal vein site, middle site and hepatic vein site of the stent were measured. Stent patency after TIPS was analyzed and compared between different ultrasound techniques, and the flow velocities in different sites of stent were compared in stents with excellent patency (grade 3). Results: There was significantly statistical difference of stent patency between color Doppler ultrasound and contrast-enhanced ultrasound (Z=-3.589, P<0.001). Contrast-enhanced ultrasound showed mild stenosis of stents (grade 2) in 8 times examination, severe stenosis (grade 1) in 6 times examination and stent occlusion in 2 times examination, while color Doppler ultrasound showed excellent patency (grade 3). There was significantly statistical difference of blood flow velocities among the portal vein site ([71.52±36.84]cm/s), middle site ([94.35±39.94]cm/s) and hepatic vein site([99.83±32.63]cm/s) of the stent (F=22.617, P<0.001). Besides, the flow velocitie of middle site (P=0.001) and the hepatic vein site (P<0.001) were respectively higher than that of portal vein site through pairwise comparison. Conclusion: Color Doppler combined with contrast-enhanced ultrasound can improve the accuracy of the evaluation of stent patency after TIPS. Significant difference of flow velocities exist in different sites of the stent.
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Objective To investigate the contrast-enhanced ultrasonography appearances characteristics of intrahepatic peripheral cholangiocarcinoma( ICC) and to improve the diagnosis level of ICC on contrast-enhanced ultrasonography . Methods Thirty cases with ICC confirmed by pathological examinations of surgeries were retrospectively analyzed for findings of ultrasonography , clinic and pathology ,to explore the typical contrast-enhanced ultrasonography appearances and the correlation with pathological differentiation . ResultsOn contrast-enhanced ultrasonography , 30 lesions showed enhancement on the arterial phase and appeared hypo-echoic enhancement on the portal phase ,which displayed fast-in and fast-out" enhancement pattern . During the hepatic arterial phase of contrast-enhanced ultrasonography ,10 lesions showed peripheral enhancement ,10 lesions showed relatively homogeneous hyper-enhancement ,6 lesions showed heterogeneous enhancement ,2 lesions showed iso-enhancement ,and 2 lesions showed hypo-enhancement . To the 30 lesions ,the average initial time of enhancement was ( 18 .81 ± 4 .66)s (12 －28 s) ,the average time of washing-out was (36 .00 ± 12 .30) s (18 －60 s) . There was no significant difference in time of washing-in and washing-out among different pathological differentiation groups ( P＞0 .05) . Conclusions ICC often shows fast-in and fast-out" enhancement pattern on contrast-enhanced ultrasonography ,and the time of washing-out is generally in late arterial phase or early portal phase ,but there is no significant difference in time of washing-in and washing-out among different pathological differentiation groups .
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Objective To study the effects of dichloroacetate (DCA) on cell colony-forming,cell invasion and cell migration of the bladder cancer cells and to study the underlying mechanism.Methods The bldder cancer cells T24 were randomly divided into two groups:the observation group and the control group.Cells in the observation groups were treated with 5 mmol/L,10 mmol/L and 20 mmol/L dichloroacetate,and the control group was treated with the same amount of dimethyl sulfoxide.Colony formation assays were detected with Giemsa staining.Cell wound scratch assay and Transwell assay were applied to evaluate the ability of the T24 cell invasion and migration.Realtime PCR and Western blot were applied to detect the expression of the epithelial-mesenchymal transition (EMT)-related marker,including E-cadherin,N-cadherin,vimentin,Snail and Slug.Results Compared with the control group,the colony formation assays of T24 cells constantly decreased along with the increased doses in the observation group(P ＜ 0.01).The cell wound scratch assay showed that the scratch width of the observation groups were significantly higher along with the increased doses and prolonged time than that in the control group (P ＜ 0.01).The transwell assay showed that the invasion ability of the observation groups were significantly discreased along with the increased doses than that in the the control group (P ＜ 0.01).The expression levels of E-cadherin mRNA and protein in combination the control group were higher than those in the the observation groups (P ＜ 0.05).However,the expression levels of N-cadherin,vimentin,Snail and Slug mRNAs and proteins in combination the control group were lower than those in the the observation groups (P ＜ 0.05).Conclusion Dichloroacetate can inhibit the colony-forming,invasion and migration of bladder cancer T24 cells,and its mechanism may inhibit the expression of epithelial mesenchymal transition in T24 cells by down-regulating the expression of nuclear transcription factor Snail and Slug.
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At present,transjugular intrahepatic portosystemic shunt (TIPS) is an effective procedure widely used in the clinical treatment of portal hypertension.The blood stream in the portal vein can be directly shunted into the hepatic vein through the inserted stent,which helps to reduce portal vein pressure.TIPS provides treatment opportunities for the patients with advanced portal hypertension complicated by intractable ascites and gastroesophageal variceal bleeding and those who are waiting for transplantation or cannot tolerate surgery.The key to success of TIPS is to maintain stent patency after placement,and therefore,post-TIPS monitoring is of vital importance.As a noninvasive,cheap,practical,and repeatable procedure,ultrasound has an important value in post-TIPS monitoring.This article summarizes the role of color Doppler and contrast-enhanced ultrasound in evaluating stent function after TIPS.
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@#Objective To identify the effects of parenteral nutrition (PN) on the gene expressions of rat intestinal inflammatory cytokincs and receptors and to explore the role of these changes in PN-related intestinal impairment. Methods Totally 12 male Sprague-Dawley rats were equally divided into the control group and the PN group. A silastic catheter was inserted into the right jugular vein of each rat. No food or water was administered to the PN group except for a continuous 24-hour PN infusion through the silastic catheter in the jugular vein. The control group, while being regularly fed, was administered with an infusion of normal saline through the silastic catheter in thc jugular vein. After 7 days, intestinal tissues were taken for electron microscopy and real-time PCR array to analyze thc microstructure change in rat intestine and thc gene expressions of inflammatory cytokines and their receptors. Results Electron microscopy revealed atrophy of microvillus, engorgement of mitochondria, cell-cell junction breakage, and several apoptotic bodies in the PN group and normal intestinal microstructure in the control group. Compared with the control group, the PN group showed an up-regulation in the gene expressions of interferon γ, interleukin-1 receptor type I , interlcukin-8 receptor type b and a down-regulation in the gene expressions of CC chemokine ligand 17 (CCL17) , CCL19, CCL21, CCL22, CCL9, CXC chemokine receptor 3, CC chemokine receptor 3 ( CCP3 ), CCR7, CCR5, C-reactive protein, and interleukin-10. Conclusions PN influences the gene expressions of rat intestinal inflammatory cytokincs and receptors. The expression of cytokine interferon γ increases and that of interleukin-10 declines, and the expressions of CCL19, CCL21, CXC chemokine receptor 3, CCR3,CCR7, and CCR5 decline. The alterations of these genes may be associated with the impairment of intestinal immune and mechanical functions.
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Objective To analyze the DSA manifestations of arteriovenous fistulae in hepatic cancer and to discuss the appropriate method for obstructing the fistulae in order to improve the therapeutic results for hepatic cancer associated with arteriovenous fistulae. Methods The imaging findings in 183 patients of hepatic cancer with urteriovenous fistulae, which were. selected from 637 patients with liver cancer, were retrospectively analyzed. For cases with mild arteriovenous fistulae (n = 89) the tumor-feeding arteries were embolized after iodized oil embolization procedure, while for cases with moderate and severe aneriovenous fistulae (n = 94) the abnormal shunts were obstructed before performing chemoembolization of the tumor in order to ensure that the effective infusion of the drug into the lesion and the sufficient deposit of iodized oil in the tumor could be obtained. Results The tumor-feeding arteries were successfully embolized in all 89 patients with mild arteriovenous fistulae. Of 94 cases with moderate and severe arteriovenous fistulae,excellent deposit of iodized oil was seen in 64 (68.1%), incomplete embolization in 13 (14.83%), poor oil deposit due to over-embolization in 11 (11.7%) and failure to block the fistulae as the fistulae were too large or too diffuse in 6 (6.4%). No serious complications occurred. Conclusion The arteriovenous fistulae accompanied with hepatic cancer can be effectively obstructed in most patients, with resultant clinical improvement of the patients' condition. This therapeutic technique is safe and reliable.
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Objective To investigate the mechanism of Acinetobacter baumannii resistant to carbapenems.Methods E test and microdilution were used to determine the minimum inhibitory concentrations(MIC) of 11 antibiotics against 30 isolates of imipenem-resistant Acinetobacter baumannii strains.The production of ?-lactamase was detected by improved three-dimensional test.Nine coding genes of?-lactamase were detected by PCR.Results The resistance rates of 11 antibiotics were over 90% except for polymyxin B(23.3%) and ciprofloxacin(87.7%).Among 30 isolates of Acinetobacter baumannii the positive rate of single ESBLs,single AmpC,ESBLs+AmpC,non-ESBLs non AmpC?-lactamase was 33.3%(10/30),3.3%(1/30),23.3%(7/30) and 26.7%(8/30) respectively by three-dimensional test.The coding genes:VIM-1,VIM-2,OXA-24,CTX-M-2,IMP-1 and VEB-1 were undetectable.Two or three of coding genes:OXA-23,PER-1 and AmpC were detectable in 27 isolates,and their homologies compared with corresponding sequences of GenBank were more than 98%.A nucleotide mutation(A→C) at 617 site of PER-1 gene was found in No.26 strain,so this sequence was registered in GenBank(Accession No.DQ341275).Conclusions Carbapenems resistance in Acinetobacter baumannii related with the production of OXA-23,PER-1 and AmpC.