[Study on the comparative analysis of the efficacy of transmesenteric vein extrahepatic portosystemic shunt and transjugular intrahepatic portosystemic shunt in the treatment of cavernous transformation of portal vein].

Objective: To compare the safety and efficacy of transmesenteric vein extrahepatic portosystemic shunt (TEPS) and transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of cavernous transformation of the portal vein (CTPV). Methods: The clinical data of CTPV patients with patency or partial patency of the superior mesenteric vein treated with TIPS or TEPS treatment in the Department of Vascular Surgery of Henan Provincial People's Hospital from January 2019 to December 2021 were selected. The differences in baseline data, surgical success rate, complication rate, incidence rate of hepatic encephalopathy, and other related indicators between TIPS and TEPS group were statistically analyzed by independent sample t-test, Mann-Whitney U test, and Chi-square test. Kaplan-Meier survival curve was used to calculate the cumulative patency rate of the shunt and the recurrence rate of postoperative portal hypertension symptoms in both groups. Results: The surgical success rate (100% vs. 65.52%), surgical complication rate (6.67% vs. 36.84%), cumulative shunt patency rate (100% vs. 70.70%), and cumulative symptom recurrence rate (0% vs. 25.71%) of the TEPS group and TIPS group were statistically significantly different (P < 0.05). The time of establishing the shunt [28 (2141) min vs. 82 (51206) min], the number of stents used [1 (12) vs. 2 (15)], and the length of the shunt [10 (912) cm vs. 16 (1220) cm] were statistically significant between the two groups (t = -3.764, -4.059, -1.765, P < 0.05). The incidence of postoperative hepatic encephalopathy in the TEPS group and TIPS group was 6.67% and 15.79% respectively, with no statistically significant difference (Fisher's exact probability method, P = 0.613). The pressure of superior mesenteric vein decreased from (29.33 ± 1.99) mmHg to (14.60 ± 2.80) mmHg in the TEPS group and from (29.68 ± 2.31) mmHg to (15.79 ± 3.01) mmHg in TIPS group after surgery, and the difference was statistically significant (t = 16.625, 15.959, P < 0.01). Conclusion: The best indication of TEPS is in CTPV patients with patency or partial patency of the superior mesenteric vein. TEPS improves the accuracy and success rate of surgery and reduces the incidence of complications.

[Analysis of the short-and medium-term curative effect of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis].

Objective: To evaluate the short- and medium-term clinical efficacy of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis. Methods: 63 cases with acute portal vein thrombosis treated in our center from May 2017 to July 2019 were studied retrospectively, including 49 males and 14 females, aged 35-61 (46 ± 5) years. TIPS approach (with/without) combined with Angiojet thrombus aspiration and gastroesophageal varices embolization was performed simultaneously according to the patient's condition. Regular follow-up for 3-33 (22 ± 3) months after surgery was used to observe the curative effect. Results: The technical success rate was 100%. Portal vein and superior mesenteric vein blood flow were returned to normal after the operation. Two cases of biliary tract injury were untreated. Simultaneously, two cases of intrahepatic arteriovenous fistula were treated with superselective arterial embolization. During the follow-up period, 47 cases (74.61%) had complete portal vein recanalization, 13 cases (20.63%) had partial recanalization, 3 cases (4.76%) had complete portal cavernoma, 7 cases (11.11%) had symptomatic hepatic encephalopathy, 1 case had received artificial liver treatment (1.59%), 1 case had peptic ulcer (11.11%), 6 cases (9.52%) had lost to follow-up, and there was no portal hypertension-related bleeding or death. Conclusion: TIPS approach combined with AngioJet thrombus aspiration technology is safe, effective and feasible in the treatment of acute portal vein thrombosis, and the short- and medium-term clinical effects are satisfactory.

Effect of miR-21 on rat thoracic aortic aneurysm model by regulating the expressions of MMP-2 and MMP-9.

OBJECTIVE: To explore the mechanism underlying micro ribonucleic acid (miR)-21 in the invasion of rat aortic aneurysm cells in vitro by regulating matrix metalloproteinase (MMP)-2 and MMP-9. MATERIALS AND METHODS: Rats were randomly divided into three groups: control group, model group, and miR-21 group. Real Time fluorescence quantitative Polymerase Chain Reaction (qRT-PCR) was adopted to detect the levels of miR-21 in each group of cells, transwell assay was performed to measure the effect of miR-21 on the invasion of aortic aneurysm cells. Western blotting was used to examine the expression of PTEN, which is the predicted target of miR-21 in aortic aneurysm cells, as well as the expressions of invasion-related proteases, MMP-2 and MMP-9. RESULTS: The expression level of miR-21 in thoracic aortic aneurysm cells in model group was significantly higher than that in normal group (p<0.05), and that in miR-21 group was remarkably higher than that in model group (p<0.05). MiR-21 group had evidently more aortic aneurysm cells and stronger cell invasion ability than normal group and model group (p<0.05). In addition, the expression level of PTEN in model group was significantly higher than that in normal group (p<0.05), while that in miR-21 group notably declined compared to model group, (p<0.05). Compared with normal group and model group, the expressions of MMP-2 and MMP-9 were markedly increased in miR-21 group (p<0.05). CONCLUSIONS: In aortic aneurysm cells of rats, miR-21 could suppress the expression of PTEN and activate MMP-2 and MMP-9 signals to promote the proliferation and migration of aortic aneurysm cells.

[23 hair trace elements measurement in patients with schizophrenia].

23 hair trace elements were determined with the method of Inductively Coupled plasma Quantometer (ICP-AEP) in 85 cases of schizophrenics and 65 cases of normal controls. The results indicated that: there were no significant differences between age and the samples of the two groups; Significant sex differences were observed in schizophrenics, 11 trace elements were higher in female (P less than 0.01), 5 trace elements were increased in male (P less than 0.01); As a whole, 17 trace elements were decreased in schizophrenics than normal controls, the differences were significant (P less than 0.01).