Risk Factors for Single and Multiple Recurrences for Endoscopic Retrograde Cholangiopancreatography and Open Choledochotomy in Treating Choledocholithiasis.

Background: There are few studies comparing recurrences between endoscopic retrograde cholangiopancreatography (ERCP) and open choledochotomy (OCT). Aims: To compare the effect of different surgical methods on single and multiple recurrences of choledocholithiasis. Methods: A total of 1255 patients with choledocholithiasis who underwent ERCP or OCT were retrospectively studied. The recurrence of choledocholithiasis was calculated by the Kaplan-Meier method with the log-rank test. Multivariate analyses of recurrent choledocholithiasis were performed by introducing variables with P < 0.20 in univariate analysis into the logistic regression model. Results: A total of 204 (16.7%, 204/1225) patients relapsed. Among the 204 patients, 74.5% relapsed within three years after surgery, of whom 39.7% (81/204) had multiple relapses (≥ 2). The recurrence rate of ERCP (17.2%, 119/692) was higher than that of OCT (15.1%, 85/563), but the difference was not statistically significant. The independent risk factors for a single recurrence of choledocholithiasis were diabetes, stone number ≥ 2, maximum stone diameter ≥ 15 mm, sedentary occupation, the approach of ERCP (EST or EPBD), periampullary diverticulum, primary suture, high-fat diet (postoperative), frequency of weekly vegetable intake (< 4, postoperative), and drinking (postoperative). However, the ERCP approach (EST or EPBD), OCT approach (LCBDE), primary suture, high-fat diet (postoperative), and frequency of weekly vegetable intake (< 4, postoperative) were independent risk factors for multiple recurrences of choledocholithiasis. Conclusion: Patients with choledocholithiasis should be followed up regularly for one to three years after treatment. Stone number ≥ 2, diabetes mellitus, periampullary diverticulum, surgical methods, and lifestyle are all risk factors for the recurrence of choledocholithiasis. ERCP is still the preferred surgical method based on the advantages of low risk of cholangitis recurrence, less hospital stay, minimally invasive surgery, fewer postoperative complications, and easier acceptance by elderly patients. In addition to optimizing the treatment plans, postoperative lifestyle management is also vital.

Propofol Inhibits Proliferation and Invasion of Stomach Cancer Cells by Regulating miR-205/YAP1 Axis.

BACKGROUND: Propofol is a common clinical intravenous anesthetic. In the last few years, studies have revealed that propofol not only has good anesthetic effect but also has certain anticancer effect. However, its role in stomach cancer (SC) and related mechanisms are still under investigation. OBJECTIVE: This study was designed to determine the effect of propofol on SC and its related mechanisms. METHODS: Purchased SC cells were treated with propofol at different concentrations (5, 10, and 20 µg/mL), miR-205 overexpression, and YAP1 inhibition. Then, the Cell Counting Kit-8 (CCK8), Transwell, and flow cytometry were carried out to determine the biological behavior changes of treated cells and the expression of miR-205 and YAP1 after treatment. RESULTS: Propofol (10 µg/mL and 20 µg/mL) inhibited the growth of SC cells and promoted their apoptosis, and overexpressing miR-205 or inhibiting YAP1 can exert the same effects. In addition, propofol (10µg/mL and 20µg/mL) up-regulated miR-205 in SC cells. The dual-luciferase reporter assay revealed that YAP1 could be targeted and regulated by miR-205, and the rescue assay revealed that inhibiting miR-205 or overexpressing YAP1 could weaken the effect of propofol on the biological behaviors of SC cells. CONCLUSION: Propofol can strongly suppress the proliferation and invasion of SC cells and induce their apoptosis via the miR-205/YAP1 axis.

Prominent effect of platelet on improvement of liver cirrhosis.

Thrombopoietin (TPO) can improve liver regeneration and fibrosis. We report on a patient with liver cirrhosis who received treatment with TPO to improve liver function. An 82-year-old male had liver cirrhosis with ascites due to hepatitis C virus infection. The Child-Pugh classification was Child B. The patient received human recombinant TPO for 12 months. The platelet counts increased and were maintained at 60-80×109/L. The liver function improved, the ascites resolved, and the liver volume increased. These results indicate that the novel treatment with recombinant human TPO (rhTPO) may be effective for improving liver function in patients with liver cirrhosis.

Glomus tumor of the stomach: a case treated by endoscopic submucosal dissection.

Glomus tumors, as a type of quite rare neoplasms, originate from modified smooth muscle cells of the glomus body whose function is to regulate blood flow within arteries according to the body temperature. Although these tumors most commonly occur in the peripheral soft tissues, especially in the distal parts of extremities, there have been rare reports of visceral involvement (Lorber et al., 2005) [1]. We report a case of gastric glomus tumor, which was preoperatively diagnosed by ultrasonic endoscopy as a gastric stromal tumor and treated by endoscopic submucosal dissection (ESD).

[Observation on curative effect of chronic ulcerative colitis treated by retention enema with combination of Chinese and Western drugs].

OBJECTIVE: To evaluate the effect of retention enema with combination of Chinese and Western drugs in treating chronic ulcerative colitis (CUC). METHODS: The therapeutic effects of retention enema with combination of Chinese and Western drugs (as tested group) and with Western drugs alone (as control group) were compared in a randomized controlled trial. RESULTS: The total effective rate of clinical curative in the tested group and the control group was 96.7% and 73.3% respectively, the difference between them was significant (chi2 = 4.71, P < 0.05). Statistical difference in comparing pre- and post-treatment condition and comparing between groups was shown in comparison of symptoms, scores of endoscopic picture (except that of polypus), and routine examination of stool (except pus cell number, all P < 0.05). The total recurrence rate of the tested group was 33.3% and the control group 60.0%, the difference between them was significant (chi2 = 4.286, P < 0.05). CONCLUSION: Retention enema with combination of Chinese and Western drugs has good curative effects in treating CUC.