1
|
Liu FQ, Yang ZR, Wu SS, Zhao HY, Zhan SY, Sun F. [Analysis methods and case analysis of effect modification (3): effect modification in individual patient data Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:447-454. [PMID: 38514323 DOI: 10.3760/cma.j.cn112338-20230824-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
This paper briefly introduces the unique advantages, overall analysis ideas and existing analysis methods of individual patient data Meta-analysis in terms of effect modification. In addition to Meta-regression and subgroup analysis, this paper also introduces the analysis methods based on part of individual patient data integrated with aggregated data and summarizes the current reporting of the above mentioned methods. In addition, the application and results interpretation of the above mentioned methods in individual patient data Meta-analysis are presented in this paper by taking "Effects of sodium-glucose cotransporter 2 inhibitors on SBP in patients with type 2 diabetes" as an example and by introducing their advantages and limitations.
Collapse
Affiliation(s)
- F Q Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- School of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S S Wu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| |
Collapse
|
2
|
Lv YF, Zhu B, Meng MM, Wu YF, Dong CB, Zhang Y, Liu BW, You SL, Lv S, Yang YP, Liu FQ. Development of a new Cox model for predicting long-term survival in hepatitis cirrhosis patients underwent transjugular intrahepatic portosystemic shunts. World J Gastrointest Surg 2024; 16:491-502. [PMID: 38463355 PMCID: PMC10921221 DOI: 10.4240/wjgs.v16.i2.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/23/2023] [Accepted: 01/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS) placement is a procedure that can effectively treat complications of portal hypertension, such as variceal bleeding and refractory ascites. However, there have been no specific studies on predicting long-term survival after TIPS placement. AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS. METHODS A retrospective analysis was conducted on a cohort of 224 patients who underwent TIPS implantation. Through univariate and multivariate Cox regression analyses, various factors were examined for their ability to predict survival at 6 years after TIPS. Consequently, a composite score was formulated, encompassing the indication, shunt reasonability, portal venous pressure gradient (PPG) after TIPS, percentage decrease in portal venous pressure (PVP), indocyanine green retention rate at 15 min (ICGR15) and total bilirubin (Tbil) level. Furthermore, the performance of the newly developed Cox (NDC) model was evaluated in an internal validation cohort and compared with that of a series of existing models. RESULTS The indication (variceal bleeding or ascites), shunt reasonability (reasonable or unreasonable), ICGR15, postoperative PPG, percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement. The NDC model incorporated these parameters and successfully identified patients at high risk, exhibiting a notably elevated mortality rate following the TIPS procedure, as observed in both the training and validation cohorts. Additionally, in terms of predicting the long-term survival rate, the performance of the NDC model was significantly better than that of the other four models [Child-Pugh, model for end-stage liver disease (MELD), MELD-sodium and the Freiburg index of post-TIPS survival]. CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis, help identify high-risk patients and guide follow-up management after TIPS implantation.
Collapse
Affiliation(s)
- Yi-Fan Lv
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Bing Zhu
- Liver Vascular Disease Diagnosis and Treatment Center, The Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Ming-Ming Meng
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Cheng-Bin Dong
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Zhang
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Bo-Wen Liu
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Shao-Li You
- Liver Vascular Disease Diagnosis and Treatment Center, The Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Sa Lv
- Liver Vascular Disease Diagnosis and Treatment Center, The Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Yong-Ping Yang
- Liver Vascular Disease Diagnosis and Treatment Center, The Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Fu-Quan Liu
- Liver Disease Minimally Invasive Diagnosis and Treatment Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
3
|
Liu FQ, Yang ZR, Wu SS, Zhao HY, Zhan SY, Sun F. [Analysis methods and case analysis of effect modification (2): effect modification in network Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:273-278. [PMID: 38413068 DOI: 10.3760/cma.j.cn112338-20230824-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This paper briefly introduces the characteristics, research significance, and global reporting status of effect modification in network Meta-analysis, demonstrates the heterogeneity caused by effect modification in network Meta-analysis, and emphasizes the importance of exploring effect modification in network Meta-analysis. This paper also summarizes the normalized description and analysis strategies of effect modification in network Meta-analysis. Finally, by the case of "comparison of efficacy of three new hypoglycemic drugs in reducing body weight in type 2 diabetes patients", this paper demonstrates the realization of subgroup analysis and network Meta-regression in exploring effect modification, summarizes the advantages and disadvantages of the two methods, to provide references for future researchers.
Collapse
Affiliation(s)
- F Q Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- School of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S S Wu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| |
Collapse
|
4
|
Liu FQ, Yang ZR, Wu SS, Zhao HY, Zhan SY, Sun F. [Analysis methods and case analysis of effect modification (1): effect modification in epidemiology and traditional Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:148-154. [PMID: 38228538 DOI: 10.3760/cma.j.cn112338-20230824-00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This paper briefly introduces the definition, classification and significance of effect modification in epidemiological studies, summarizes the difference between effect modifier and confounders, and analyze the influence as well as the role of effect modification in epidemiological studies and Meta-analysis. In this paper, the possible scenarios of effect modification and related analysis strategy in Meta-analysis are indicated by graphics, aiming to arouse researchers' attention to effect modification. This paper also demonstrates how to identify and deal with effect modification in Meta-analysis through a study case of "Efficacy of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes", and shows the analysis process and interpretation of results of subgroup analysis and Meta-regression methods respectively. The advantages and disadvantages of these two methods are summarized to provide reference for the method selection of future research.
Collapse
Affiliation(s)
- F Q Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- Faculty of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S S Wu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| |
Collapse
|
5
|
Zhang D, Wang T, Yue ZD, Wang L, Fan ZH, Wu YF, Liu FQ. Hepatic venous pressure gradient: Inaccurately estimates portal venous pressure gradient in alcoholic cirrhosis and portal hypertension. World J Gastrointest Surg 2023; 15:2490-2499. [PMID: 38111777 PMCID: PMC10725542 DOI: 10.4240/wjgs.v15.i11.2490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Portal hypertension (PHT) in patients with alcoholic cirrhosis causes a range of clinical symptoms, including gastroesophageal varices and ascites. The hepatic venous pressure gradient (HVPG), which is easier to measure, has replaced the portal venous pressure gradient (PPG) as the gold standard for diagnosing PHT in clinical practice. Therefore, attention should be paid to the correlation between HVPG and PPG. AIM To explore the correlation between HVPG and PPG in patients with alcoholic cirrhosis and PHT. METHODS Between January 2017 and June 2020, 134 patients with alcoholic cirrhosis and PHT who met the inclusion criteria underwent various pressure measurements during transjugular intrahepatic portosystemic shunt procedures. Correlations were assessed using Pearson's correlation coefficient to estimate the correlation coefficient (r) and determination coefficient (R2). Bland-Altman plots were constructed to further analyze the agreement between the measurements. Disagreements were analyzed using paired t tests, and P values < 0.05 were considered statistically significant. RESULTS In this study, the correlation coefficient (r) and determination coefficient (R2) between HVPG and PPG were 0.201 and 0.040, respectively (P = 0.020). In the 108 patients with no collateral branch, the average wedged hepatic venous pressure was lower than the average portal venous pressure (30.65 ± 8.17 vs. 33.25 ± 6.60 mmHg, P = 0.002). Hepatic collaterals were identified in 26 cases with balloon occlusion hepatic venography (19.4%), while the average PPG was significantly higher than the average HVPG (25.94 ± 7.42 mmHg vs 9.86 ± 7.44 mmHg; P < 0.001). The differences between HVPG and PPG < 5 mmHg in the collateral vs no collateral branch groups were three cases (11.54%) and 44 cases (40.74%), respectively. CONCLUSION In most patients, HVPG cannot accurately represent PPG. The formation of hepatic collaterals is a vital reason for the strong underestimation of HVPG.
Collapse
Affiliation(s)
- Dan Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Tao Wang
- Department of Interventional Therapy, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264099, Shandong Province, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
6
|
Liao Y, Zhang L, Wang JT, Yue ZD, Fan ZH, Wu YF, Zhang Y, Dong CB, Wang XQ, Cui T, Meng MM, Bao L, Chen SB, Liu FQ, Wang L. A novel nomogram predicting overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in portal hypertension patients. Sci Rep 2023; 13:15244. [PMID: 37709823 PMCID: PMC10502141 DOI: 10.1038/s41598-023-42061-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023] Open
Abstract
We aim to develop a nomogram to predict overt hepatic encephalopathy (OHE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension, according to demographic/clinical indicators such as age, creatinine, blood ammonia, indocyanine green retention rate at 15 min (ICG-R15) and percentage of Portal pressure gradient (PPG) decline. In this retrospective study, 296 patients with portal hypertension who received elective TIPS in Beijing Shijitan Hospital from June 2018 to June 2020 were included. These patients were randomly divided into a training cohort (n = 207) and a validation cohort (n = 89). According to the occurrence of OHE, patients were assigned to OHE group and non-OHE group. Both univariate and multivariate analyses were performed to determine independent variables for predicting OHE after TIPS. Accordingly, receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to compare the accuracy and superiority of a novel model with conventional Child-Pugh and MELD scoring model. Age (OR 1.036, 95% CI 1.002-1.070, p = 0.037), Creatinine (OR 1.011, 95% CI 1.003-1.019, p = 0.009), Blood ammonia (OR 1.025, 95% CI 1.006-1.044, p = 0.011), ICG-R15 (OR 1.030, 95% CI 1.009-1.052, p = 0.004) and Percentage decline in PPG (OR 1.068, 95% CI 1.029-1.109, p = 0.001) were independent risk factors for OHE after TIPS using multifactorial analysis. A nomogram was constructed using a well-fit calibration curve for each of these five covariates. When compared to Child-Pugh and MELD score, this new nomogram has a better predictive value (C-index = 0.828, 95% CI 0.761-0.896). Consistently, this finding was reproduceable in validation cohort and confirmed with DCA. A unique nomogram was developed to predict OHE after TIPS in patients with PHT, with a high prediction sensitivity and specificity performance than commonly applied scoring systems.
Collapse
Affiliation(s)
- Yong Liao
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
- Department of Hepatobiliary Interventional Therapy, Beijing Tsinghua Changgung Hospital, Beijing, China
- School of Clinical Medicine, Tsinghua University, Beijing, 100038, People's Republic of China
- Department of Hepatobiliary Surgery, Xingtai People's Hospital of Hebei Medical University, Xingtai, 054001, Hebei, People's Republic of China
| | - Lin Zhang
- Department of Hepatobiliary Interventional Therapy, Beijing Tsinghua Changgung Hospital, Beijing, China
- School of Clinical Medicine, Tsinghua University, Beijing, 100038, People's Republic of China
| | - Ji-Tao Wang
- Department of Hepatobiliary Surgery, Xingtai People's Hospital of Hebei Medical University, Xingtai, 054001, Hebei, People's Republic of China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Yu Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Cheng-Bin Dong
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Xiu-Qi Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Ting Cui
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China
| | - Ming-Ming Meng
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Li Bao
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Shu-Bo Chen
- Department of Hepatobiliary Surgery, Xingtai People's Hospital of Hebei Medical University, Xingtai, 054001, Hebei, People's Republic of China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China.
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing, 100038, China.
| |
Collapse
|
7
|
Wang L, Zhang Y, Wang XQ, Yue ZD, Fan ZH, Wu YF, Liu FQ, Dong J, Zhang K, Jiang L, Ding HG, Zhang YN. [Evaluation of the efficacy of TIPS in 27 patients with hepatic sinus obstruction syndrome in the near and medium term]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:842-846. [PMID: 37723066 DOI: 10.3760/cma.j.cn501113-20221012-00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Objective: intrahepatic portocaval shunt (TIPS) in the treatment of hepatic sinusoidal obstruction syndrome (HSOS). Methods: A retrospective analysis was performed on 27 patients with HSOS who were treated with TIPS in our center from July 2018 to July 2020. The changes of portal vein pressure (PVP), portal vein pressure gradient (PPG) and liver function were observed, so as to evaluate the efficacy. Paired t test was adopted to evaluate the quantitative parameters, while χ (2) test was used to analyze qualitative parameters, with P < 0.05 as statistical difference. Results: PVP decreased from (4.41 ± 0.18) kPa before shunt to (2.69 ± 0.11) kPa after shunt (t = 82.41, P < 0.001), PPG decreased from (3.23 ± 0.18) kPa before shunt to (1.46 ± 0.23) kPa after shunt (t = 32.41, P < 0.001). The liver function improved significantly after operation. After 24 months of follow-up, 3 patients developed stent restenosis and recanalized after balloon dilation. Three patients developed hepatic encephalopathy, which was improved after drug treatment. One patient underwent liver transplantation due to liver failure. Conclusion: TIPS is effective in the treatment of HSOS in the short and medium term, and can provide time for liver transplantation patients to wait for liver source.
Collapse
Affiliation(s)
- L Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - X Q Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z D Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z H Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y F Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - F Q Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - J Dong
- Department of Radiology Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - K Zhang
- Department of Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - L Jiang
- Department of Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - H G Ding
- Department of Gastroenterology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Y N Zhang
- Department of Gastroenterology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| |
Collapse
|
8
|
Zhang D, Liu BW, Liang XQ, Liu FQ. Immunological factors in cirrhosis diseases from a bibliometric point of view. World J Gastroenterol 2023; 29:3899-3921. [PMID: 37426317 PMCID: PMC10324529 DOI: 10.3748/wjg.v29.i24.3899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Cirrhosis results from persistent liver injury that leads to liver fibrosis. Immunological factors play important regulatory roles in the development and progression of cirrhosis. Bibliometrics is one of the most commonly used methods for systematic evaluation of a field of study. To date, there are no bibliometric studies on the role of immunological factors in cirrhosis.
AIM To provide a comprehensive overview of the knowledge structure and research hotspots of immunological factors in cirrhosis.
METHODS We retrieved publications related to immunological factors in cirrhosis between 2003 to 2022 from the Web of Science Core Collection database on December 7, 2022. The search strategy was TS = ((Liver Cirrhosis OR hepatic cirrhosis OR liver fibrosis) AND (Immunologic* Factor* OR Immune Factor* OR Immunomodulator* OR Biological Response Modifier* OR Biomodulator*)). Only original articles and reviews were included. A total of 2873 publications were analyzed using indicators of publication and citation metrics, countries, institutes, authors, journals, references, and keywords by CiteSpace and VOSviewer.
RESULTS A total of 5104 authors from 1173 institutions across 51 countries published 2873 papers on cirrhosis and immunological factors in 281 journals. In the past 20 years, the increasing number of related annual publications and citations indicates that research on immunological factors in cirrhosis has become the focus of attention and has entered a period of accelerated development. The United States (781/27.18%), China (538/18.73%), and Germany (300/10.44%) were the leading countries in this field. Most of the top 10 authors were from the United States (4) and Germany (3), with Gershwin ME contributing the most related articles (42). World Journal of Gastroenterology was the most productive journal, whereas Hepatology was the most co-cited journal. Current research hotspots regarding immunological factors in cirrhosis include fibrosis, cirrhosis, inflammation, liver fibrosis, expression, hepatocellular carcinoma, activation, primary biliary cirrhosis, disease, and hepatic stellate cells. Burst keywords (e.g., epidemiology, gut microbiota, and pathways) represent research frontiers that have attracted the interest of researchers in recent years.
CONCLUSION This bibliometric study comprehensively summarizes the research developments and directions of immunological factors in cirrhosis, providing new ideas for promoting scientific research and clinical applications.
Collapse
Affiliation(s)
- Dan Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Bo-Wen Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xiao-Qing Liang
- Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
9
|
Dong J, Zhang Y, Wu YF, Yue ZD, Fan ZH, Zhang CY, Liu FQ, Wang L. Computed tomography perfusion in differentiating portal hypertension: A correlation study with hepatic venous pressure gradient. World J Gastrointest Surg 2023; 15:664-673. [PMID: 37206083 PMCID: PMC10190718 DOI: 10.4240/wjgs.v15.i4.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/11/2023] [Accepted: 03/23/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Hepatic venous pressure gradient (HVPG) is the gold standard for diagnosis of portal hypertension (PH), invasiveness and potential risks in the process of measurement limited its widespread use.
AIM To investigate the correlation of computed tomography (CT) perfusion parameters with HVPG in PH, and quantitatively assess the blood supply changes in liver and spleen parenchyma before and after transjugular intrahepatic portosystemic shunt (TIPS).
METHODS Twenty-four PH related gastrointestinal bleeding patients were recruited in this study, and all patients were performed perfusion CT before and after TIPS surgery within 2 wk. Quantitative parameters of CT perfusion, including liver blood volume (LBV), liver blood flow (LBF), hepatic arterial fraction (HAF), spleen blood volume (SBV) and spleen blood flow (SBF), were measured and compared before and after TIPS, and the quantitative parameters between clinically significant PH (CSPH) and non-CSPH (NCSPH) group were also compared. Then the correlation of CT perfusion parameters with HVPG were analyzed, with statistical significance as P < 0.05.
RESULTS For all 24 PH patients after TIPS, CT perfusion parameters demonstrated decreased LBV, increased HAF, SBV and SBF, with no statistical difference in LBF. Compared with NCSPH, CSPH showed higher HAF, with no difference in other CT perfusion parameters. HAF before TIPS showed positive correlation with HVPG (r = 0.530, P = 0.008), while no correlation was found in other CT perfusion parameters with HVPG and Child-Pugh scores.
CONCLUSION HAF, an index of CT perfusion, was positive correlation with HVPG, and higher in CSPH than NCSPH before TIPS. While increased HAF, SBF and SBV, and decreased LBV, were found after TIPS, which accommodates a potential non-invasive imaging tool for evaluation of PH.
Collapse
Affiliation(s)
- Jian Dong
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Zhang
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Chun-Yan Zhang
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
10
|
Wang L, Huang K, Zhang Y, Wu YF, Yue ZD, Fan ZH, Liu FQ, Li YW, Dong J. Short-term efficacy assessment of transarterial chemoembolization combined with radioactive iodine therapy in primary hepatocellular carcinoma. World J Gastrointest Surg 2023; 15:105-113. [PMID: 36741065 PMCID: PMC9896495 DOI: 10.4240/wjgs.v15.i1.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Transarterial chemoembolization (TACE) is an effective treatment for primary hepatocellular carcinoma (PHC). Radioactive iodine therapy has been used in the treatment of advanced PHC, especially in patients with portal vein tumor thrombosis. However, data on the therapeutic effect of TACE combined with radioactive iodine therapy in PHC are scarce.
AIM To investigate the clinical efficacy of TACE combined with radioactive iodine implantation therapy in advanced PHC via perfusion computed tomography (CT).
METHODS For this study, 98 advanced PHC patients were recruited and divided randomly into the study and control groups. Patients in the study group were treated with TACE combined radioactive iodine implantation therapy. Patients in the control group were treated with only TACE. The tumor lesion length, clinical effect, serum alpha-fetoprotein (AFP) and CT perfusion parameters were compared before and after therapy, and statistical analysis was performed.
RESULTS There was no significant difference in tumor length and serum AFP between the study and control groups (P > 0.05) before treatment. However, the tumor length and serum AFP in the study group were lower than those in the control group 1 mo and 3 mo after therapy. After 3 mo of treatment, the complete and partial remission rate of the study group was 93.88%, which was significantly higher than the control group (77.55%) (P < 0.05). Before treatment, there were no significant differences between the two groups on the perfusion CT variables, including the lesion blood volume, permeability surface, blood flow, hepatic artery flow and mean transit time (P > 0.05). After 3 mo of treatment, all perfusion CT variables were lower in the study group compared to the control group (P < 0.05). The survival time of patients in the study group was 22 mo compared to 18 mo in the control group, which was significantly different [log rank (Mantel-Cox) = 4.318, P = 0.038].
CONCLUSION TACE combined with radioactive iodine implantation in the treatment of advanced PHC can inhibit the formation of blood vessels in tumor tissue and reduce the perfusion level of tumor lesions, thereby improving the clinical efficacy and prolonging the survival time of patients.
Collapse
Affiliation(s)
- Lei Wang
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Kun Huang
- Department of Radiology, Chinese Medical University Affiliated First Hospital, Shenyang 110001, Liaoning Province, China
| | - Yu Zhang
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yong-Wu Li
- Department of Nuclear Medicine, The Fifth Center of People’s Liberation Army General Hospital, Beijing 100071, China
| | - Jian Dong
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
11
|
Wang L, Zhang Y, Wu YF, Yue ZD, Fan ZH, Zhang CY, Liu FQ, Dong J. Computed tomography perfusion in liver and spleen for hepatitis B virus-related portal hypertension: A correlation study with hepatic venous pressure gradient. World J Gastroenterol 2022; 28:6068-6077. [PMID: 36405387 PMCID: PMC9669822 DOI: 10.3748/wjg.v28.i42.6068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatic venous pressure gradient (HVPG) is the gold standard for diagnosis of portal hypertension (PH). However, its use can be limited because it is an invasive procedure. Therefore, it is necessary to explore a non-invasive method to assess PH.
AIM To investigate the correlation of computed tomography (CT) perfusion of the liver with HVPG and Child-Pugh score in hepatitis B virus (HBV)-related PH.
METHODS Twenty-eight patients (4 female, 24 male) with gastroesophageal variceal bleeding induced by HBV-related PH were recruited in our study. All patients received CT perfusion of the liver before transjugular intrahepatic portosystemic stent-shunt (TIPS) therapy. Quantitative parameters of CT perfusion of the liver, including liver blood flow (LBF), liver blood volume (LBV), hepatic artery fraction, splenic blood flow and splenic blood volume were measured. HVPG was recorded during TIPS therapy. Correlation of liver perfusion with Child-Pugh score and HVPG were analyzed, and the receiver operating characteristic curve was analyzed. Based on HVPG (> 12 mmHg vs ≤ 12 mmHg), patients were divided into moderate and severe groups, and all parameters were compared.
RESULTS Based on HVPG, 18 patients were classified into the moderate group and 10 patients were classified into the severe group. The Child-Pugh score, HVPG, LBF and LBV were significantly higher in the moderate group compared to the severe group (all P < 0.05). LBF and LBV were negatively associated with HVPG (r = -0.473, P < 0.05 and r = -0.503, P < 0.01, respectively), whereas splenic blood flow was positively associated with hepatic artery fraction (r = 0.434, P < 0.05). LBV was negatively correlated with Child-Pugh score. Child-Pugh score was not related to HVPG. Using a cutoff value of 17.85 mL/min/100 g for LBV, the sensitivity and specificity of HVPG ≥ 12 mmHg for diagnosis were 80% and 89%, respectively.
CONCLUSION LBV and LBF were negatively correlated with HVPG and Child-Pugh scores. CT perfusion imaging is a potential non-invasive quantitative predictor for PH in HBV-related liver cirrhosis.
Collapse
Affiliation(s)
- Lei Wang
- Department of Intervention Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Zhang
- Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Chun-Yan Zhang
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Jian Dong
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
12
|
Xu HF, Wang Y, He FL, Fan ZH, Liu H, Yang YP, Jia JD, Liu FQ, Ding HG. [Noninvasive assessment of the risk of esophageal variceal bleeding from noncirrhotic portal hypertension]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:1092-1099. [PMID: 36727234 DOI: 10.3760/cma.j.cn501113-20210126-00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: To verify Baveno VI criteria, Expanded-Baveno VI criteria, liver stiffness×spleen diameter-to-platelet ratio risk score (LSPS), and platelet count/spleen diameter ratio (PSR) in evaluating the severity value of esophageal varices (EV) in patients with non-cirrhotic portal hypertension (NCPH). Methods: 111 cases of NCPH and 204 cases of hepatitis B cirrhosis who met the diagnostic criteria were included in the study. NCPH included 70 cases of idiopathic non-cirrhotic portal hypertension (INCPH) and 41 cases of nontumoral portal vein thrombosis (PVT). According to the severity of EV on endoscopy, they were divided into the low-bleeding-risk group (no/mild EV) and the high-bleeding-risk group (moderate/severe EV). The diagnostic value of Baveno VI and Expanded-Baveno VI criteria was verified to evaluate the value of LSPS and PSR for EV bleeding risk severity in NCPH patients. The t-test or Mann-Whitney U test was used to compare the measurement data between groups. Comparisons between counting data groups were performed using either the χ2 test or the Fisher exact probability method. Results: Considering endoscopy was the gold standard for diagnosis, the missed diagnosis rates of low/high bleeding risk EVs in INCPH/PVT patients with Baveno VI and Expanded-Baveno VI criteria were 50.0%/30.0% and 53.8%/50.0%, respectively. There were no statistically significant differences in platelet count (PLT), spleen diameter, liver stiffness (LSM), LSPS, and PSR between low-bleeding-risk and high-bleeding-risk groups in INCPH patients, and the area under the receiver operating characteristic curve (AUC) of LSPS and PSR was 0.564 and 0.592, respectively (P=0.372 and 0.202, respectively). There were statistically significant differences in PLT, spleen diameter, LSPS, and PSR between the low and high-bleeding risk groups in PVT patients, and the AUCs of LSPS and PSR were 0.796 and 0.833 (P=0.003 and 0.001, respectively). In patients with hepatitis B cirrhosis, the Baveno VI and Expanded-Baveno VI criteria were used to verify the low bleeding risk EV, and the missed diagnosis rates were 0 and 5.4%, respectively. There were statistically significant differences in PLT, spleen diameter, LSM, LSPS and PSR between the low-bleeding-risk and high-bleeding-risk groups (P<0.001). LSPS and PSR AUC were 0.867 and 0.789, respectively (P<0.05). Conclusion: Baveno VI and Expanded-Baveno VI criteria have a high missed diagnosis rate for EVs with low bleeding risk in patients with INPCH and PVT, while LSPS and PSR have certain value in evaluating EV bleeding risk in PVT patients, which requires further clinical research.
Collapse
Affiliation(s)
- H F Xu
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Y Wang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - F L He
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z H Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - H Liu
- Department of Pathology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Y P Yang
- Comprehensive Liver Cancer Department, the Fifth Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - J D Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - F Q Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - H G Ding
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| |
Collapse
|
13
|
Wang L, Song QK, Yue ZD, Zhao HW, Fan ZH, Wu YF, Liu FQ, Meng K, Zhang L, Jiang HG, Ding YN, Zhang Y. [Study on the correlation between PPG and HVPG in patients with portal hypertension]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:722-727. [PMID: 36038341 DOI: 10.3760/cma.j.cn501113-20200603-00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the correlation between portal vein pressure gradient (PPG) and hepatic vein pressure gradient (HVPG) in patients with portal hypertension (PHT). Methods: 752 cases with portal hypertension (PHT) who underwent transjugular intrahepatic portosystemic shunt (TIPS) and met the enrollment criteria between January 2016 to December 2019 were analyzed for hepatic vein, inferior vena cava and portal vein pressure. Paired t-test was used for analysis. Pearson correlation test was used to estimate correlation coefficient and coefficient of determination. P<0.05 were considered statistically significant. Results: Wedged hepatic vein pressure (WHVP), portal vein pressure (PVP), correlation coefficient, and coefficient of determination were 27.98±8.95 mmHg, 33.85±7.33 mmHg, 0.329 (P<0.001), and 0.108, respectively. HVPG, PPG,correlation coefficient, and coefficient of determination were 16.84±7.97 mmHg, 25.11±6.95 mmHg (P<0.001), 0.145, and 0.021 (P<0.001), respectively. The difference between HVPG and PPG was greater than 5 mmHg in 524 cases, accounting for 69.7%. The difference between HVPG and PPG was within 5 mmHg or basically equal in 228 cases, accounting for 30.3%. The correlation coefficient between free hepatic venous pressure (FHVP) and inferior vena cava pressure (IVCP) was 0.568 (P<0.001), and the coefficient of determination was 0.323. According to the presence or absence of hepatic venous collaterals after balloon occluded hepatic angiography, they were divided into two groups: 157 (20.9%) cases in the group with hepatic venous collaterals, and 595 (79.1%) cases in the group without hepatic venous collaterals. The parameters of the two groups were compared: WHVP (15.73±3.63) mmHg vs. (31.22±6.90) mmHg, P<0.001; PVP (31.69±8.70) mmHg vs. (34.42±6.81) mmHg, P<0.001; HVPG (7.18±4.40) mmHg vs. (19.40±6.62) mmHg, P<0.001; PPG (24.24±8.11) mmHg vs. (25.34±6.60) mmHg, P<0.001; free hepatic venous pressure (FHVP) (8.58±3.37) mmHg vs. (11.82±5.07) mmHg , P<0.001; inferior vena cava pressure (IVCP) (7.45±3.29) mmHg vs. (9.09±4.14) mmHg, P<0.001. Conclusion: The overall correlation is poor between HVPG and PPG. HVPG of most patients is not an accurate representation of PPG, and the former is lower than the latter. Hepatic venous collateral formation is one of the important reasons for the serious underestimation of HVPG values.
Collapse
Affiliation(s)
- L Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Q K Song
- Science and Technology Division Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z D Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - H W Zhao
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z H Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y F Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - F Q Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - K Meng
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - L Zhang
- Department of Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - H G Jiang
- Department of Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Y N Ding
- Department of Gastroenterology, Beijing You 'an Hospital, Capital Medical University, Beijing 100069, China
| | - Yuening Zhang
- Department of Gastroenterology, Beijing You 'an Hospital, Capital Medical University, Beijing 100069, China
| |
Collapse
|
14
|
Yan XH, Yue ZD, Zhao HW, Wang L, Fan ZH, Wu YF, Meng MM, Zhang K, Jiang L, Ding HG, Zhang YN, Yang YP, Liu FQ. Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension. World J Gastrointest Surg 2022; 14:567-579. [PMID: 35979417 PMCID: PMC9258232 DOI: 10.4240/wjgs.v14.i6.567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with hepatocellular carcinoma complicated with main portal vein tumor thrombosis (mPVTT) and cirrhotic portal hypertension (CPH) have an extremely poor prognosis, and there is a lack of a clinically effective treatment paradigm.
AIM To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with radioactive seed strand for the treatment of mPVTT patients with CPH.
METHODS The clinical data of 83 consecutive patients who underwent TIPS combined with 125I seed strand placement for mPVTT and CPH from January 2015 to December 2018 were retrospectively reviewed. Procedure-related data (success rate, relief of portal vein pressure and CPH symptoms, and adverse events), PVTT response, and patient survival were assessed through a 2-year follow-up.
RESULTS The success rate was 100.0% without perioperative death or procedure-related severe adverse events. The mean portal vein pressure was significantly decreased after the procedure (22.25 ± 7.33 mmHg vs 35.12 ± 7.94 mmHg, t = 20.61, P < 0.001). The symptoms of CPH were all effectively relieved within 1 mo. The objective response rate of PVTT was 67.5%. During a mean follow-up of 14.5 ± 9.4 mo (range 1-37 mo), the cumulative survival rates at 6, 12 and 24 mo were 83.1%, 49.7%, and 21.8%, respectively. The median survival time was 12.0 ± 1.3 mo (95% confidence interval: 9.5-14.5). In multivariate Cox regression analysis, body mass index, Child-Pugh grade, cTNM stage, and PVTT response were independent prognostic factors (P < 0.05).
CONCLUSION TIPS combined with radioactive seed strand might be effective and safe in treating mPVTT patients with CPH.
Collapse
Affiliation(s)
- Xuan-Hui Yan
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Ming-Ming Meng
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Ke Zhang
- Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - Li Jiang
- Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - Hui-Guo Ding
- Department of Gastroenterology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Yue-Ning Zhang
- Department of Liver Disease Digestion Center, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Yong-Ping Yang
- Department of Liver Disease, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing 100038, China
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
15
|
Zhang W, Liu FQ, Zhang LP, Ding HG, Zhuge YZ, Wang JT, Li L, Wang GC, Wu H, Li H, Cao GH, Lu XF, Kong DR, Sun L, Wu W, Sun JH, Liu JT, Zhu H, Li DL, Guo WH, Xue H, Wang Y, Gengzang CJC, Zhao T, Yuan M, Liu SR, Huan H, Niu M, Li X, Ma J, Zhu QL, Guo WW, Zhang KP, Zhu XL, Huang BR, Li JN, Wang WD, Yi HF, Zhang Q, Gao L, Zhang G, Zhao ZW, Xiong K, Wang ZX, Shan H, Li MS, Zhang XQ, Shi HB, Hu XG, Zhu KS, Zhang ZG, Jiang H, Zhao JB, Huang MS, Shen WY, Zhang L, Xie F, Li ZW, Hou CL, Hu SJ, Lu JW, Cui XD, Lu T, Yang SS, Liu W, Shi JP, Lei YM, Bao JL, Wang T, Ren WX, Zhu XL, Wang Y, Yu L, Yu Q, Xiang HL, Luo WW, Qi XL. [Status of HVPG clinical application in China in 2021]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:637-643. [PMID: 36038326 DOI: 10.3760/cma.j.cn501113-20220302-00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.
Collapse
Affiliation(s)
- W Zhang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - F Q Liu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - L P Zhang
- Department of Radiology,Third Hospital of Taiyuan, Taiyuan 030012, China
| | - H G Ding
- Liver Disease Digestive Center,Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Y Z Zhuge
- Digestive Department,Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - J T Wang
- Department of Hepatobiliary Surgery, Xingtai People's Hospital, Xingtai 054001, China
| | - L Li
- Department of Interventional Radiology, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - G C Wang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - H Wu
- Digestive Department, West China Hospital, Sichuan University, Chengdu 610044, China
| | - H Li
- Institute of Hepatology and Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - G H Cao
- Department of Radiology, Shulan Hospital, Hangzhou 310022, China
| | - X F Lu
- Digestive Department, West China Hospital, Sichuan University, Chengdu 610044, China
| | - D R Kong
- Digestive Department, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - L Sun
- Department of Gastroenterology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325001, China
| | - W Wu
- Department of Gastroenterology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325001, China
| | - J H Sun
- Hepatobiliary and Pancreatic Intervention Center , the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - J T Liu
- Digestive Department,Hainan Hospital of Chinese PLA General Hospital, Sanya 572013, China
| | - H Zhu
- The 1 st Department of Interventional Radiology, the Sixth People's Hospital of Shenyang, Shenyang 110006, China
| | - D L Li
- No. 900 Hospital of the Joint Logistic Support Force, Fuzhou 350025, China
| | - W H Guo
- Department of Interventional Radiology, Meng Chao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, China
| | - H Xue
- Digestive Department, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y Wang
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - C J C Gengzang
- Department of Interventional Radiology, the Fourth People's Hospital of Qinghai Province, Xining 810007, China
| | - T Zhao
- Department of Radiology,Sir Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China
| | - M Yuan
- Department of Interventional Radiology Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - S R Liu
- Department of Infectious Disease,Qufu People's Hospital, Qufu 273199, China
| | - H Huan
- Digestive Department, Chengdu Office Hospital of Tibet Autonomous Region People's Government, Chengdu 610041, China
| | - M Niu
- Department of Interventional Radiology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - X Li
- Department of Radiology,Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Ma
- Department of Interventional Vascular Surgerg, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
| | - Q L Zhu
- Digestive Department,the Affiliated Hospital of Southwest Medical University, Luzhou 646099, China
| | - W W Guo
- Department of Interventional Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - K P Zhang
- Department of Hepatobiliary Surgery, Xingtai People's Hospital, Xingtai 054001, China
| | - X L Zhu
- Department of Surgery, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - B R Huang
- Department of Interventional Vascular Surgery,Jingzhou First People's Hospital, Jingzhou, China
| | - J N Li
- Liver Diseases Department,Jiamusi Infectious Disease Hospital, Jiamusi 154015, China
| | - W D Wang
- Hepatobiliary, Pancreatic and Spleen Surgery Department,Shunde Hospital, Southern Medical University, Foshan 528427, China
| | - H F Yi
- Digestive Department,Wuhan First Hospital, Wuhan 430030, China
| | - Q Zhang
- Interventional Vascular Surgery Department, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009, China
| | - L Gao
- Oncology and Vascular Interventional Department, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - G Zhang
- Digestive Department, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530016, China
| | - Z W Zhao
- Department of Interventional Radiology, Lishui Municipal Central Hospital, Zhejiang University School of Medicine, Lishui 323030, China
| | - K Xiong
- Digestive Department, the Second Affiliated Hospital of Nanchang University, Nanchang 330008, China
| | - Z X Wang
- Inner Mongolia Medical University Affiliated Hospital, Hohhot 010050, China
| | - H Shan
- Interventional Medicine Center, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - M S Li
- Department of Endovascular Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - X Q Zhang
- Digestive Department, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - H B Shi
- Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X G Hu
- Interventional Radiology Department,Jinhua Municipal Central Hospital, Jinhua 321099, China
| | - K S Zhu
- Interventional Radiology Department, the Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510260, China
| | - Z G Zhang
- Department of Liver Surgery,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - H Jiang
- Infectious Disease Department,Second Affiliated Hospital, Military Medical University of the Air Force, Xi'an 710038, China
| | - J B Zhao
- Department of Vascular and Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - M S Huang
- Interventional Radiology Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China
| | - W Y Shen
- Digestive Department,Fuling Hospital Affiliated to Chongqing University, Chongqing 400030, China
| | - L Zhang
- Hepatobiliary Pancreatic Center,Tsinghua Changgung Hospital, Beijing 102200, China
| | - F Xie
- Function Department,Lanzhou Second People's Hospital, Lanzhou 730030, China
| | - Z W Li
- Hepatobiliary Surgery Department,Shenzhen Third People's Hospital, Shenzhen518112, China
| | - C L Hou
- Department of Interventional Radiology, the First Affiliated Hospital of USTC, Hefei 230001, China
| | - S J Hu
- Digestive Department,People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
| | - J W Lu
- Department of Interventional Radiology, Qufu People's Hospital, Qufu 273199, China
| | - X D Cui
- Department of Interventional Radiology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530016, China
| | - T Lu
- Department of Gastroenterology, Yangquan Third People's Hospital, Yangquan 045099,China
| | - S S Yang
- Department of Gastroenterology, General Hospital of Ningxia Medical University , Yinchuan 750003, China
| | - W Liu
- Department of Interventional Radiology, Lishui People's Hospital, Zhejiang Province, Lishui 323050, China
| | - J P Shi
- Department of Liver Diseases, Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - Y M Lei
- Interventional Radiology Department, People's Hospital of Tibet Autonomous Region, Lhasa 850001, China
| | - J L Bao
- Department of Gastroenterology, Shannan people's Hospital,Shannan 856004, China
| | - T Wang
- Department of Interventional Radiology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264099,China
| | - W X Ren
- Interventional Treatment Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011,China
| | - X L Zhu
- Interventional Radiology Department, the First Affiliated Hospital of Suzhou University, Suzhou 215006, China
| | - Y Wang
- Department of Interventional Vascular Surgery, the Second Affiliated Hospital of Hainan Medical College, Haikou 570216, China
| | - L Yu
- Department of Interventional Radiology, Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365001,China
| | - Q Yu
- Interventional Radiology Department, Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - H L Xiang
- Department of Gastroenterology, Tianjin Third Central Hospital, Tianjin 300170, China
| | - W W Luo
- Deparment of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - X L Qi
- Center of Portal Hypertension Department of Radiology, Zhongda Hospital of Southeast University, Nanjing 210009, China
| |
Collapse
|
16
|
Wang HY, Song QK, Yue ZD, Wang L, Fan ZH, Wu YF, Dong CB, Zhang Y, Meng MM, Zhang K, Jiang L, Ding HG, Zhang YN, Yang YP, Liu FQ. Correlation of pressure gradient in three hepatic veins with portal pressure gradient. World J Clin Cases 2022; 10:4460-4469. [PMID: 35663094 PMCID: PMC9125293 DOI: 10.12998/wjcc.v10.i14.4460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/25/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The liver is one of the most important organs in the human body, with functions such as detoxification, digestion, and blood coagulation. In terms of vascular anatomy, the liver is divided into the left and the right liver by the main portal vein, and there are three hepatic efferent veins (right, middle, and left) and two portal branches. Patients with impaired liver function have increased intrahepatic vascular resistance and splanchnic vasodilation, which may lead to an increase in the portal pressure gradient (PPG) and cause portal hypertension (PHT). In order to measure the increased pressure gradient of portal vein, the hepatic venous pressure gradient (HVPG) can be measured to reflect it in clinical practice. The accuracy of PPG measurements is directly related to patient prognosis. AIM To analyze the correlation between HVPG of three hepatic veins and PPG in patients with PHT. METHODS From January 2017 to December 2019, 102 patients with PHT who met the inclusion criteria were evaluated during the transjugular intrahepatic portosystemic shunt procedure and analyzed. RESULTS The mean HVPG of the middle hepatic vein was 17.47 ± 10.25 mmHg, and the mean HVPG of the right and left hepatic veins was 16.34 ± 7.60 and 16.52 ± 8.15 mmHg, respectively. The average PPG was 26.03 ± 9.24 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.15 and 0.02 (P = 0.164); 0.25 and 0.05 (P = 0.013); and 0.14 and 0.02 (P = 0.013), respectively. The mean wedged hepatic vein/venous pressure (WHVP) of the middle and left hepatic veins was similar at 29.71 ± 12.48 and 29.1 ± 10.91 mmHg, respectively, and the mean WHVP of the right hepatic vein was slightly lower at 28.01 ± 8.95 mmHg. The mean portal vein pressure was 34.11 ± 8.56 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.26 and 0.07 (P = 0.009); 0.38 and 0.15 (P < 0.001); and 0.26 and 0.07 (P = 0.008), respectively. The average free hepatic venous pressure (FHVP) of the right hepatic vein was lowest at 11.67 ± 5.34 mmHg, and the average FHVP of the middle and left hepatic veins was slightly higher at 12.19 ± 4.88 and 11.67 ± 5.34 mmHg, respectively. The average inferior vena cava pressure was 8.27 ± 4.04 mmHg. The correlation coefficient and coefficient of determination of the right hepatic vein, middle hepatic vein, and left hepatic vein were 0.30 and 0.09 (P = 0.002); 0.18 and 0.03 (P = 0.078); and 0.16 and 0.03 (P = 0.111), respectively. CONCLUSION Measurement of the middle hepatic vein HVPG could better represent PPG. Considering the high success rate of clinical measurement of the right hepatic vein, it can be the second choice.
Collapse
Affiliation(s)
- Hao-Yu Wang
- Department of Oncology, The 9th Clinical Medical College & Beijing Shijitan Hospital, Peking University, Beijing 100038, China
| | - Qing-Kun Song
- Division of Clinical Epidemiology and Evidence-Based Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Cheng-Bin Dong
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Ming-Ming Meng
- Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Ke Zhang
- Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - Li Jiang
- Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - Hui-Guo Ding
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Yue-Ning Zhang
- Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
| | - Yong-Ping Yang
- Department of Therapeutic Research for Liver Cancer, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Fu-Quan Liu
- Department of Oncology, The 9th Clinical Medical College & Beijing Shijitan Hospital, Peking University, Beijing 100038, China
| |
Collapse
|
17
|
Wang L, Yue ZD, Zhao HW, Fan ZH, Wu YF, Zhang Y, Qi RZ, Zhang K, Jiang L, Ding HG, Zhang YN, Liu FQ. [Analysis of 53 cases of transjugular liver biopsy]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:220-223. [PMID: 35359075 DOI: 10.3760/cma.j.cn501113-20201019-00561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the practicability and safety of transjugular liver biopsy (TJLB). Methods: Data of 53 cases with transjugular liver biopsy from June 2015 to June 2020 were collected. LABS-100 was used in all patients who underwent transjugular liver biopsy. Among them, 45 cases and eight were biopsied via hepatic vein and intrahepatic segment of the inferior vena cava. The surgical indications, related complications, and postoperative pathological diagnosis were analyzed and summarized. Results: TJLB was successful in all patients, with an average of 2.8 punctures per case. Satisfactory liver tissue and histopathological diagnosis was obtained in all patients. Two cases developed a cervical hematoma that was improved spontaneously, and one patient developed an intrahepatic hematoma that was improved after conservative treatment. Conclusion: TJLB is a practical and safe method for patients with contraindications to percutaneous liver biopsy.
Collapse
Affiliation(s)
- L Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z D Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - H W Zhao
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Z H Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y F Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - R Z Qi
- Department of Surgery, the Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - K Zhang
- Department of Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - L Jiang
- Department of Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - H G Ding
- Department of Gastroenterology, Beijing You 'an Hospital, Capital Medical University, Beijing 100069, China
| | - Y N Zhang
- Department of Gastroenterology, Beijing You 'an Hospital, Capital Medical University, Beijing 100069, China
| | - F Q Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
18
|
Zhao HY, Zeng XY, Liu FQ, Chen SY, Zhan SY. [Methods for controlling time-varying confounding in pharmaco-epidemiological studies: a systematic reveiw]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:2179-2187. [PMID: 34954984 DOI: 10.3760/cma.j.cn112338-20201016-01240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To systematically review the application of methods for controlling time-varying confounding in pharmaco-epidemiological studies. Methods: PubMed, Embase, CNKI, and Wanfang were searched for pharmaco-epidemiological studies involving time-varying confounding on June 15th, 2020. The basic characteristics, drug exposure and outcome, time-varying confounders and the application of methods to control these confounders were analyzed. Results: A total of 298 articles were included. An increasing trend was observed in numbers of studies dealing with time-varying confounding in pharmaco-epidemiological studies in recent years. A total of 106 (35.6%) studies involved the safety or effectiveness of medication use in HIV/AIDS patients and 92 of them involved antiretroviral drugs. The most common outcome was mortality, while the most commonly concerned time-dependent confounders were laboratory examination results (179, 60.1%), comorbidities (136, 45.6%), and co-used medications (108, 36.2%). Marginal structure model (MSM) and inverse probability of treatment weighting (IPTW) were the most commonly used methods to control time-varying confounding factors (244, 81.9%). Compared with the results after properly controlling time-varying confounding, traditional methods adjusting only baseline confounders resulted in substantial bias (median 18.2%, interquartile range, 7.4%-40.8%). As for basic assumptions needed for causal methods controlling time-varying confounding, 28.9% and 64.8% of the included studies examined or discussed the assumptions of positivity and no unmeasured confounders, respectively. Conclusions: At present, most of the fields of drug therapy for chronic diseases still pay insufficient attention to time-varying confoundings. Information collected in routine medical practice, such as laboratory tests, comorbidities, and co-used drugs, was the most commonly concerned time-varying confounder. MSM and IPTW were the most commonly applied methods for dealing with time-varying confounding.
Collapse
Affiliation(s)
- H Y Zhao
- Department of Epidemiology and Biostatistics/China Center for Health Development Studies, School of Public Health Peking University, Beijing 100191, China
| | - X Y Zeng
- Department of Epidemiology and Biostatistics/China Center for Health Development Studies, School of Public Health Peking University, Beijing 100191, China
| | - F Q Liu
- Department of Epidemiology and Biostatistics/China Center for Health Development Studies, School of Public Health Peking University, Beijing 100191, China
| | - S Y Chen
- Department of Epidemiology and Biostatistics/China Center for Health Development Studies, School of Public Health Peking University, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics/China Center for Health Development Studies, School of Public Health Peking University, Beijing 100191, China Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100871, China;Coressponding author: Zhan Siyan,
| |
Collapse
|
19
|
Yu FT, Long DH, Shi GX, Wang LQ, Tu JF, Gang LL, Liu FQ, Wang Y, Cui X, Bao S, Yu Y, Wei W, Yan SY, Yang JW, Liu CZ. Evaluating the efficacy and safety of electro-acupuncture in patients with antipsychotic-related constipation: protocol for a randomized controlled trial. Trials 2021; 22:771. [PMID: 34736504 PMCID: PMC8567121 DOI: 10.1186/s13063-021-05732-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background Constipation is known as a common adverse effect of antipsychotics. Advice for its management remains inadequate. This study is designed to investigate the efficacy and safety of electro-acupuncture (EA) for antipsychotic-related constipation. Methods This is a single-centric, parallel-group, randomized controlled trial with blinded participants, outcome assessor, and statistician. One hundred twelve participants will be randomly assigned into the EA group or sham acupuncture (SA) group in a 1:1 ratio. The study will last for 22 weeks for each participant, including a 2-week baseline assessment period, an 8-week treatment period, and a follow-up for 12 weeks. The primary outcome is the change of mean weekly complete spontaneous bowel movements (CSBMs) during weeks 1 to 8 from baseline. Secondary outcomes include the change from baseline of mean weekly CSBMs during the follow-up period, mean weekly spontaneous bowel movements (SBMs), overall CSBM response rate, scores on Bristol Stool Form Scale (BSFS), straining level, Patient Assessment of Constipation Symptoms (PAC-SYM), Patient Assessment of Constipation Quality of life questionnaire (PAC-QOL), and Brief Psychiatric Rating Scale (BPRS). Adverse events and medicine use will be recorded as well. Discussion The study is designed based on a rigorous methodology to evaluate the efficacy and safety of EA for antipsychotic-related constipation. The finding will be published in peer-reviewed journals as reliable evidence. Trial registration ClinicalTrials.gov ChiCTR2000032582. Registered May 3, 2020, with the Chinese Clinical Trial Registry. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05732-5.
Collapse
Affiliation(s)
- Fang-Ting Yu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Di-He Long
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Jian-Feng Tu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Li-Li Gang
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Fu-Quan Liu
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Yang Wang
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Xiao Cui
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Si Bao
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Yu Yu
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Wei Wei
- Beijing Changping Hospital of Integrated Chinese and Western Medicine, Beijing, 102208, China
| | - Shi-Yan Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| |
Collapse
|
20
|
Zhang L, Feng ZP, Liu FQ, Yan R, Yin LY, Shen H, Liang XH. ASCL1 can bind to miR-135a-2 promoter elements to promote miR-135a-2 transcription and stem phenotypes in Huh7 cells. J BIOL REG HOMEOS AG 2021; 35:337-342. [PMID: 33601879 DOI: 10.23812/20-312-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Zhang
- Department of Endoscopy, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Z P Feng
- Department of Gastroenterology, Zengcheng District people's Hospital of Guangzhou, Guangzhou, China
| | - F Q Liu
- Department of Gastroenterology, Zengcheng District people's Hospital of Guangzhou, Guangzhou, China
| | - R Yan
- Department of Gastroenterology, Zengcheng District people's Hospital of Guangzhou, Guangzhou, China
| | - L Y Yin
- Department of Gastroenterology, Zengcheng District people's Hospital of Guangzhou, Guangzhou, China
| | - H Shen
- Department of Gastroenterology, Zengcheng District people's Hospital of Guangzhou, Guangzhou, China
| | - X H Liang
- Department of Gastroenterology, Zengcheng District people's Hospital of Guangzhou, Guangzhou, China
| |
Collapse
|
21
|
Wang Z, Wu YF, Yue ZD, Zhao HW, Wang L, Fan ZH, Zhang Y, Liu FQ. Comparative study of indocyanine green-R15, Child-Pugh score, and model for end-stage liver disease score for prediction of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt. World J Gastroenterol 2021; 27:416-427. [PMID: 33584073 PMCID: PMC7856842 DOI: 10.3748/wjg.v27.i5.416] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/25/2020] [Accepted: 01/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatic encephalopathy (HE) remains an enormous challenge in patients who undergo transjugular intrahepatic portosystemic shunt (TIPS) implantation. The preoperative indocyanine green retention rate at 15 min (ICG-R15), as one of the liver function assessment tools, has been developed as a prognostic indicator in patients undergoing surgery, but there are limited data on its role in TIPS.
AIM To determine whether the ICG-R15 can be used for prediction of post-TIPS HE in decompensated cirrhosis patients with portal hypertension (PHT) and compare the clinical value of ICG-R15, Child-Pugh score (CPS), and model for end-stage liver disease (MELD) score in predicting post-TIPS HE with PHT.
METHODS This retrospective study included 195 patients with PHT who underwent elective TIPS at Beijing Shijitan Hospital from January 2018 to June 2019. All patients underwent the ICG-R15 test, CPS evaluation, and MELD scoring 1 wk before TIPS. According to whether they developed HE or not, the patients were divided into two groups: HE group and non-HE group. The prediction of one-year post-TIPS HE by ICG-R15, CPS and MELD score was evaluated by the areas under the receiver operating characteristic curves (AUCs).
RESULTS A total of 195 patients with portal hypertension were included and 23% (45/195) of the patients developed post-TIPS HE. The ICG-R15 was identified as an independent predictor of post-TIPS HE. The AUCs for the ICG-R15, CPS, and MELD score for predicting post-TIPS HE were 0.664 (95% confidence interval [CI]: 0.557-0.743, P = 0.0046), 0.596 (95%CI: 0.508-0.679, P = 0.087), and 0.641 (95%CI: 0.554-0.721, P = 0.021), respectively. The non-parametric approach (Delong-Delong & Clarke-Pearson) showed that there was statistical significance in pairwise comparison between AUCs of ICG-R15 and MELD score (P = 0.0229).
CONCLUSION The ICG-R15 has appreciated clinical value for predicting the occurrence of post-TIPS HE and is a choice for evaluating the prognosis of patients undergoing TIPS.
Collapse
Affiliation(s)
- Zhong Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Zhang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
22
|
Cai L, Zhang HJ, He FL, Feng YY, Hu SX, Wang J, Liu FQ, Jiang YL, Tan XL, Pan HM, Tang BB, Yang H, Long HY, Zhan ZF, Gao LD. [Epidemiological and virus molecular characterization of dengue fever outbreak in Hunan province, 2018]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:2119-2124. [PMID: 33378826 DOI: 10.3760/cma.j.cn112338-20200107-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the epidemiological and etiological characteristics of a dengue fever outbreak in Hunan province in 2018. Methods: Real-time PCR assay was performed for the laboratory diagnosis of 8 suspected dengue fever cases. Etiological surveillance was performed in 186 suspected dengue fever cases and fever cases who had close contacts with dengue fever patients. C6/36 cells was used for the virus isolation from acute phase serum. By sequencing the full length of E genes of 15 dengue virus strains, phylogenetic analysis was performed based on the sequences obtained, including reference sequences from the NCBI GenBank database, the serotypes and gene subtypes of the virus were analyzed to trace the possible source of transmission. An emergency monitoring of vector density and a retrospective survey of sero-epidemiology in healthy population were conducted in the epidemic area. Results: In the serum samples of 8 suspected patients, 6 were dengue virus RNA positive, and 4 were NS1 antigen positive. In 186 suspected patients, 96 were dengue virus nucleic acid, NS1 antigen or antibody positive in etiological test. A total of 64 dengue virus strains were isolated. The phylogenetic analysis showed that all the dengue virus strains belonged to type 2, which might be from Guangdong or Zhejiang provinces. The Bretub index was up to 65, indicating an extremely high risk of transmission. The positive rate of the dengue virus IgG antibody was 0.53%(2/377) in retrospective survey of 377 healthy people. Conclusion: The field epidemiologic and the molecular genetics analyses showed the outbreak of dengue fever in Hunan in 2018 was caused by imported cases and dengue virus 2.
Collapse
Affiliation(s)
- L Cai
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - H J Zhang
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - F L He
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - Y Y Feng
- Qiyang Country Center for Disease Control and Prevention of Yongzhou, Qiyang 426100, China
| | - S X Hu
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - J Wang
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - F Q Liu
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - Y L Jiang
- Yongzhou Prefectural Center for Disease Control and Prevention, Yongzhou 425000, China
| | - X L Tan
- Yongzhou Prefectural Center for Disease Control and Prevention, Yongzhou 425000, China
| | - H M Pan
- Qiyang Country Center for Disease Control and Prevention of Yongzhou, Qiyang 426100, China
| | - B B Tang
- Qiyang Country Center for Disease Control and Prevention of Yongzhou, Qiyang 426100, China
| | - H Yang
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - H Y Long
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - Z F Zhan
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| | - L D Gao
- Hunan Provincial Center for Disease Control and Prevention, Key Laboratory of Microbial Molecular Biology of Hunan Province, Changsha 410005, China
| |
Collapse
|
23
|
Hu HQ, Qiao JT, Liu FQ, Wang JB, Sha S, He Q, Cui C, Song J, Zang N, Wang LS, Sun Z, Chen L, Hou XG. The STING-IRF3 pathway is involved in lipotoxic injury of pancreatic β cells in type 2 diabetes. Mol Cell Endocrinol 2020; 518:110890. [PMID: 32781250 DOI: 10.1016/j.mce.2020.110890] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023]
Abstract
Lipotoxic injury of pancreatic β cells is an important pathological feature in type 2 diabetes mellitus (T2DM). Stimulator of interferon genes (STING) can recognize its own DNA leaked into the cytoplasm from damaged mitochondria or nuclei of the host cell, thus activating its downstream factor interferon regulatory factor 3 (IRF3), causing inflammation and apoptosis. The STING-IRF3 signaling pathway is closely related to glycolipid metabolism, but its relationship with the lipotoxicity of pancreatic β cells has rarely been reported. Here, we investigated the role of the STING-IRF3 signaling pathway in lipotoxicity-induced inflammation, apoptosis, and dysfunction of pancreatic β cells. We examined the activation of STING and IRF3 in islets of db/db mice and identified the role of the STING-IRF3 signaling pathway in palmitic acid (PA)-induced lipotoxic injury of INS-1, a rat insulinoma cell line. STING and phosphorylated IRF3 including downstream interferon-β were upregulated in islets of db/db mice and PA-induced INS-1 cells. Gene silencing of STING or IRF3 ameliorated PA-induced INS-1 cell inflammation and apoptosis, and reversed impaired insulin synthesis. Additionally, PA induced downregulation of the phosphoinositide 3-kinase-AKT signaling pathway, and impaired high glucose-stimulated insulin secretion was reversed after knockdown of STING or IRF3. Our results suggest that activation of the STING-IRF3 pathway triggers inflammation and apoptosis of pancreatic β cells, leading to β-cell damage and dysfunction. Hence, inhibition of this signaling pathway may represent a novel approach for β-cell protection in T2DM.
Collapse
MESH Headings
- Animals
- Apoptosis/drug effects
- Cells, Cultured
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Insulin-Secreting Cells/drug effects
- Insulin-Secreting Cells/physiology
- Interferon Regulatory Factor-3/physiology
- Male
- Membrane Proteins/physiology
- Mice
- Mice, Transgenic
- Palmitic Acid/pharmacology
- Palmitic Acid/toxicity
- Phosphatidylinositol 3-Kinases/metabolism
- Signal Transduction/drug effects
Collapse
Affiliation(s)
- H Q Hu
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - J T Qiao
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - F Q Liu
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China; Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
| | - J B Wang
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - S Sha
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - Q He
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - C Cui
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - J Song
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - N Zang
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - L S Wang
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - Z Sun
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - L Chen
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China; Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China.
| | - X G Hou
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China; Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China.
| |
Collapse
|
24
|
Liu FQ, Liu CP, Xu MH, Zhu J, Yu W, Wang LL. Effects of sevoflurane postconditioning on the expression of AKT/mTOR and apoptosis of myocardial cells in myocardial ischemia-reperfusion rats. J BIOL REG HOMEOS AG 2020; 34:1909-1913. [PMID: 33147940 DOI: 10.23812/20-429-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- F Q Liu
- Operation Room, The People's Hospital of Zhangqiu area, Jinan, Shandong Province, China
| | - C P Liu
- Department of Cardiology, Jiyang People's Hospital, Jinan, Shandong Province, China
| | - M H Xu
- Department of Clinical Laboratory, Yantai Central Blood Station, Yantai, Shandong Province, China
| | - J Zhu
- Respiratory Department, The People's Hospital of Zhangqiu Area, Jinan, Shandong Province, China
| | - W Yu
- Department of Cardiology, The People's Hospital of Zhangqiu Area, Jinan, Shandong Province, China
| | - L L Wang
- Department of Anesthesiology, Jining No.1 People's Hospital, Affiliated Jining No.1 People's Hospital of Jining Medical University, Jining Medical University, Jining, Shandong Province, China
| |
Collapse
|
25
|
Zhang Y, Wang Z, Yue ZD, Zhao HW, Wang L, Fan ZH, Wu YF, He FL, Liu FQ. Accurate ultrasonography-based portal pressure assessment in patients with hepatocellular carcinoma. World J Gastrointest Oncol 2020; 12:931-941. [PMID: 32879669 PMCID: PMC7443839 DOI: 10.4251/wjgo.v12.i8.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Portal pressure is of great significance in the treatment of hepatocellular carcinoma (HCC), but direct measurement is complicated and costly; thus, non-invasive measurement methods are urgently needed.
AIM To investigate whether ultrasonography (US)-based portal pressure assessment could replace invasive transjugular measurement.
METHODS A cohort of 102 patients with HCC was selected (mean age: 54 ± 13 years, male/female: 65/37). Pre-operative US parameters were assessed by two independent investigators, and multivariate logistic analysis and linear regression analysis were conducted to develop a predictive formula for the portal pressure gradient (PPG). The estimated PPG predictors were compared with the transjugular PPG measurements. Validation was conducted on another cohort of 20 non-surgical patients.
RESULTS The mean PPG was 17.32 ± 1.97 mmHg. Univariate analysis identified the association of the following four parameters with PPG: Spleen volume, portal vein diameter, portal vein velocity (PVV), and portal blood flow (PBF). Multiple linear regression analysis was performed, and the predictive formula using the PVV and PBF was as follows: PPG score = 19.336 - 0.312 × PVV (cm/s) + 0.001 × PBF (mL/min). The PPG score was confirmed to have good accuracy with an area under the curve (AUC) of 0.75 (0.68-0.81) in training patients. The formula was also accurate in the validation patients with an AUC of 0.820 (0.53-0.83).
CONCLUSION The formula based on ultrasonographic Doppler flow parameters shows a significant correlation with invasive PPG and, if further confirmed by prospective validation, may replace the invasive transjugular assessment.
Collapse
Affiliation(s)
- Yu Zhang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Zhong Wang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Fu-Liang He
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| |
Collapse
|
26
|
Chen Q, Zhang Y, Yue ZD, Zhao HW, Wang L, Fan ZH, Liu FQ. High-mobility group protein B1: A predictive biomarker for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt. J Hepatobiliary Pancreat Sci 2020; 27:522-530. [PMID: 32463549 DOI: 10.1002/jhbp.770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/28/2020] [Accepted: 03/25/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The aim of the present study was to investigate whether portal level of high-mobility group protein B1 (HMGB1) is associated with hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS). METHODS We enrolled 127 consecutive patients who underwent TIPS and collected portal and peripheral blood samples in our department from December 2017 to May 2019. HMGB1 levels were determined using enzyme-linked immunosorbent assay kits. HMGB1 and other HE related parameters were estimated by competing risk analysis, receiver operating characteristic (ROC) analysis and Kaplan-Meier analysis. RESULTS Patients with HE after TIPS were older (P = .019) and had higher portal HMGB1 level (P = .038) than those without. Univariate competing risk analysis: age (sHR 1.025, P = .026), hepatorenal syndrome (sHR 3.149, P = .010), model for end-of-stage liver disease (MELD) score (sHR 1.055, P = .024), prior HE (sHR 4.029, P = .0005), portal HMGB1 before TIPS (sHR 1.177, P = .001) reached statistical significance. Multivariate analysis: age (sHR 1.025, P = .037), MELD score (sHR 1.062, P = .011), prior HE (sHR 2.492, P = .030) and portal HMGB1 level before TIPS (sHR 1.217, P = .0002) were significantly different. ROC analyses and Kaplan-Meier curve showed portal HMGB1 level changes before and after TIPS (ΔHMGB1) had good predictive value in the cut-off 0.012 ng/mL (AUC = 0.748, P < .001, Sensitivity = 0.743, Specificity = 0.655). CONCLUSIONS Portal HMGB1 may be a therapeutic target for post-TIPS HE.
Collapse
Affiliation(s)
- Quan Chen
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Yu Zhang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Lei Wang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, Beijing, China
| |
Collapse
|
27
|
He FL, Qi RZ, Zhang YN, Zhang K, Zhu-Ge YZ, Wang M, Wang Y, Jia JD, Liu FQ. Transjugular intrahepatic portosystemic shunt and splenectomy are more effective than endoscopic therapy for recurrent variceal bleeding in patients with idiopathic noncirrhotic portal hypertension. World J Clin Cases 2020; 8:1871-1877. [PMID: 32518776 PMCID: PMC7262696 DOI: 10.12998/wjcc.v8.i10.1871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/28/2020] [Accepted: 04/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS), splenectomy plus esophagogastric devascularization (SED) and endoscopic therapy + non-selective β-blockers (ET + NSBB) are widely applied in secondary prevention of recurrent gastroesophageal variceal bleeding in patients with liver cirrhosis. These different treatments, however, have not been compared in patients with idiopathic non-cirrhotic portal hypertension (INCPH).
AIM To compare the outcomes of TIPS, SED and ET + NSBB in the control of variceal rebleeding in patients with INCPH.
METHODS This retrospective study recruited patients from six centers across China. Demographic characteristics, baseline profiles and follow-up clinical outcomes were collected. Post-procedural clinical outcomes, including incidence of rebleeding, hepatic encephalopathy (HE), portal vein thrombosis (PVT) and mortality rates, were compared in the different groups.
RESULTS In total, 81 patients were recruited, with 28 receiving TIPS, 26 SED, and 27 ET + NSBB. No significant differences in demographic and baseline characteristics were found among these three groups before the procedures. After treatment, blood ammonia was significantly higher in the TIPS group; hemoglobin level and platelet count were significantly higher in the SED group (P < 0.01). Rebleeding rate was significantly higher in the ET + NSBB group (P < 0.01). Mortality was 3.6%, 3.8% and 14.8% in the TIPS, SED and ET + NSBB groups, respectively, with no significant differences (P = 0.082). Logistic regression analysis showed that mortality was significantly correlated with rebleeding, HE, portal thrombosis and superior mesenteric vein thrombosis (P < 0.05).
CONCLUSION In patients with INCPH, TIPS and SED were more effective in controlling rebleeding than ET + NSBB, but survival rates were not significantly different among the three groups. Mortality was significantly correlated with rebleeding, HE and PVT.
Collapse
Affiliation(s)
- Fu-Liang He
- Department of Hepatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Rui-Zhao Qi
- Department of General Surgery, Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - Yue-Ning Zhang
- Department of Gastroenterology, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China
| | - Ke Zhang
- Department of General Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - Yu-Zheng Zhu-Ge
- Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
| | - Min Wang
- Department of Hepatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yu Wang
- Department of Hepatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Ji-Dong Jia
- Department of Hepatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
28
|
Li TT, Wu YF, Liu FQ, He FL. Hepatic amyloidosis leading to hepatic venular occlusive disease and Budd-Chiari syndrome: A case report. World J Clin Cases 2019; 7:3282-3288. [PMID: 31667180 PMCID: PMC6819297 DOI: 10.12998/wjcc.v7.i20.3282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/30/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Systemic amyloidosis in which multiple systems can be involved has become a common clinical disease. When the liver is affected, symptoms such as abdominal distension, fatigue, edema, liver, and jaundice could appear. To date, hepatic amyloidosis combined with hepatic venular occlusive disease and Budd-Chiari syndrome has not been reported.
CASE SUMMARY A 54-year-old female patient was admitted to the Beijing Shijitan Hospital with hepatic amyloidosis leading to hepatic venular occlusion and Budd-Chiari syndrome in 2018. The patient underwent surgery 1 mo previously for liver rupture and hemorrhage after Budd-Chiari syndrome was diagnosed. She was diagnosed with hepatic venular occlusion, liver amyloidosis, and Budd-Chiari syndrome (i.e. extensive hepatic vein occlusion). Transjugular intrahepatic portosystem shunt was performed. After the treatment, the clinical symptoms improved markedly with increase in urine volume.
CONCLUSION Hepatic amyloidosis with hepatic venous occlusion and Budd-Chiari syndrome is relatively rare clinically, and transjugular intrahepatic portosystem shunt is an effective treatment for this disease.
Collapse
Affiliation(s)
- Ting-Ting Li
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China
| | - Fu-Liang He
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China
| |
Collapse
|
29
|
Chen Q, Lin LS, Chen L, Lin J, Ding Y, Bao XD, Wu JF, Lin LK, Yan LJ, Wang R, Shi B, Qiu Y, Zheng XY, Pan LZ, Chen F, Wang J, Cai L, He BC, Liu FQ. [Relationship between selenium and the risk for oral cancer: a case-control study]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:810-814. [PMID: 31357804 DOI: 10.3760/cma.j.issn.0254-6450.2019.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the relationship between selenium and the risk for oral cancer. Methods: We performed a case-control study in 325 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 650 controls from the same hospital and community. Unconditional logistic regression and stratification analyses were used to explore the association between selenium and oral cancer. Adjusted OR and corresponding 95%CI were calculated. The analyses on multiple interactions between selenium and smoking or drinking status, and fruit or fish intake frequencies were conducted. Results: The level of serum selenium was 112.42 (80.98-145.06) μg/L in the case group, which was lower than 164.85 (144.44-188.53) μg/L in control group, the difference was statistical significant (P<0.01). There was a negative correlation between serum selenium level and the risk for oral cancer regardless of smoking and drinking status, and fruits and fish intake frequencies (P<0.05). There were multiple interactions between serum selenium level and smoking or drinking status, and fruit and fish intakes. Conclusions: The high level of serum selenium is a protective factor for the incidence of oral cancer, and serum selenium has multiple interactions with smoking or drinking status, and fruit and fish intakes. Therefore, reducing tobacco use and alcohol consumption and increasing the intakes of fruit and fish can reduce the risk for oral cancer to some extent.
Collapse
Affiliation(s)
- Q Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - L S Lin
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - L Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - J Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Y Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - X D Bao
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - J F Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - L K Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - L J Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - R Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - B Shi
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Y Qiu
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - X Y Zheng
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - L Z Pan
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - F Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - J Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - L Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - B C He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - F Q Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| |
Collapse
|
30
|
Zhang Y, Liu FQ, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL. Safety and efficacy of transfemoral intrahepatic portosystemic shunt for portal hypertension: A single-center retrospective study. World J Clin Cases 2019; 7:1410-1420. [PMID: 31363469 PMCID: PMC6656674 DOI: 10.12998/wjcc.v7.i12.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/28/2019] [Accepted: 05/11/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Transfemoral intrahepatic portosystemic shunt (TFIPS) can be performed to treat portal hypertension. However, few studies have evaluated the safety and efficacy of this technique.
AIM To retrospectively evaluate the safety and clinical outcomes of TFIPS and compare them with those of typical transjugular intrahepatic portosystemic shunt (TIPS).
METHODS This retrospective study was approved by our hospital ethics committee. From November 2012 to November 2015, 19 patients who underwent successful TFIPS placement were included. In addition, 21 patients treated with TIPS during the same period were selected as controls. Data collected included the success rate and complications of TIPS and TFIPS. Continuous data were expressed as the mean ± SD and were compared using the Student’s t test. All categorical data were expressed as count (percentage) and were compared using the χ2 test or Fisher’s exact test. The Kaplan–Meier method was used to calculate cumulative survival rate and survival curves.
RESULTS Baseline characteristics were comparable between the two groups. The success rate of TFIPS and TIPS was 95% (19/20) and 100% (21/21), respectively. Effective portal decompression and free antegrade shunt flow was completed in all patients. The portal pressure gradient prior to TIPS and TFIPS placement was 23.91 ± 4.64 mmHg and 22.61 ± 5.39 mmHg, respectively, and it was significantly decreased to 10.85 ± 3.33 mmHg and 10.84 ± 3.33 mmHg after stent placement, respectively. Time–to-event calculated rates of shunt patency at one and two years in the TFIPS and TIPS groups were not statistically different (94.7% vs 95.2% and 94.7% vs 90.5%, respectively). De nova hepatic encephalopathy was 27.5% (11/40) with five patients in the TFIPS group (26.3%) and six patients (28.6%) in the TIPS group experiencing it (P = 0.873). The cumulative survival rates were similar between the two groups: 94.7% and 94.7% at 1 and 2 years, respectively, in the TFIPS group vs 100% and 95.2% at 1 and 2 years, respectively, in the TIPS group (P = 0.942).
CONCLUSION TFIPS may be a valuable adjunct to traditional approaches in patients with portal hypertension.
Collapse
Affiliation(s)
- Yu Zhang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| | - Lei Wang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| | - Fu-Liang He
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100010, China
| |
Collapse
|
31
|
Abstract
Colorectal cancer is one of the most common malignant tumors in the world, threatening human health. The treatment strategy of stage II and stage III colorectal cancer has changed from surgery alone to multidisciplinary mode emphasizing perioperative treatment. The indication of adjuvant chemotherapy for stage II colon cancer is still defined by high-risk factors, but only microsatellite status and BRAF gene mutation can help predict efficacy of chemotherapy. Combined chemotherapy is the main adjuvant therapy for stage III colon cancer. The recommended course of adjuvant chemotherapy is 6 months. Based on the results of the IDEA study, the three-month CapeOX regimen (oxaliplatin and capecitabine) is recommended for the treatment of patients with T1-3 and N1 tumors. Neoadjuvant chemotherapy for locally advanced colon cancer is still in the exploratory stage of clinical trials. The difference between the treatment of rectal cancer and colon cancer lies in the application of radiotherapy. Chemoradiotherapy combined with TME (total mesorectal excision) surgery and adjuvant chemotherapy has become the standard treatment for locally advanced rectal cancer. Nowadays, the research hotspots in neoadjuvant therapy of rectal cancer include neoadjuvant chemotherapy and total neoadjuvant therapy (TNT). This article will review the progress of perioperative treatment for colorectal cancer.
Collapse
Affiliation(s)
- F Q Liu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | | |
Collapse
|
32
|
Bao XD, Lin LS, Chen F, Liu FQ, Wang J, Shi B, Yan LJ, Wu JF, Lin LK, Wang R, Pan LZ, Zheng XY, Qiu Y, Cao RK, Hu ZJ, Cai L, He BC. [Association of single nucleotide polymorphisms of TBX5 gene and environmental exposure index with susceptibility to oral cancer]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:480-485. [PMID: 31091605 DOI: 10.3760/cma.j.issn.0253-9624.2019.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the association of TBX5 polymorphisms and environmental exposure index with susceptibility to oral cancer. Methods: A case-control study was conducted to collect 300 oral cancer patients hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University from September 2010 to December 2016. A total of 445 non-tumor patients were selected as the control group. Questionnaires were used to collect the information of all subjects and 5 ml peripheral blood was collected to detect single nucleotide polymorphisms (SNPs) of the rs10492336 locus of TBX5 gene. According to the environmental exposure index score, subjects were divided into two groups, low risk group (0-2.31) and high risk group (2.32-11.76). To analyze the association of TBX5 gene rs10492336 SNPs, environmental exposure index and oral cancer and its interactions. Results: The age of all subjects in the case group and control group were (56.19±13.10) years and (54.56±12.48) years old. Compared with CC genotype, the OR (95%CI) values of the co-dominant genetic model AC genotype and the dominant genetic model AC+AA genotype were 0.69 (0.49-0.98) and 0.70 (0.51-0.97), respectively. Compared with the low risk group, the OR (95%CI) risk of oral cancer in the high risk group was 3.72 (2.55-5.43). The results of gene-environment interaction analysis showed that compared with the group with CC genotype and high risk of environmental exposure index, the OR (95%CI) value of oral cancer in the group with AC+AA genotype and low risk of environmental exposure index was 0.18(0.10-0.31). Furthermore there was a multiplicative interaction between rs10492336 SNPs and environmental exposure index (β=-0.405, P<0.001). Conclusion: This study suggests that the TBX5 gene rs10492336 SNPs and environmental exposure index were associated with oral cancer. And there was a multiplication interaction between rs10492336 SNPs and environmental exposure index.
Collapse
Affiliation(s)
- X D Bao
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - L S Lin
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - F Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F Q Liu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - J Wang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - B Shi
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - L J Yan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - J F Wu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - L K Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - R Wang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - L Z Pan
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - X Y Zheng
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - Y Qiu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - R K Cao
- Tongji University School of Stomatology, Shanghai 200072, China
| | - Z J Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - L Cai
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - B C He
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| |
Collapse
|
33
|
Zhang Y, Wu YF, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL, Wang T, Liu FQ. Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus. World J Gastrointest Oncol 2019; 11:310-321. [PMID: 31040896 PMCID: PMC6475673 DOI: 10.4251/wjgo.v11.i4.310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/11/2019] [Accepted: 03/12/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Main portal vein tumor thrombus (MPVTT), which has a high incidence, is the major complication of terminal liver cancer. The occurrence of MPVTT is always a negative prognostic factor for patients with hepatocellular carcinoma (HCC). Therefore, attention should be paid to the treatment of MPVTT and its complications.
AIM To evaluate the efficacy of transarterial chemoembolization/transarterial embolization (TACE/TAE)+125I seeds implantation with transjugular intrahepatic portosystemic shunt (TIPS) in treating MPVTT and its complications.
METHODS From January 2007 to March 2015, 85 consecutive patients with MPVTT were nonrandomly assigned to undergo treatment with TACE/TAE + TIPS and 125I implantation (TIPS-125I group) or TACE/TAE + TIPS only (TIPS only group) in Beijing Shijitan Hospital, and all clinical data were collected. During 24 mo follow-up, the incidence of overall survival, stent stenosis and symptom recurrence was analyzed to evaluate the efficacy of TIPS-125I.
RESULTS During 24 mo follow-up of all patients, we collected data at 6, 12 and 24 mo. The rates of survival were 80%, 45%, and 20%, respectively, in the TIPS-125I group, whereas those in the TIPS only group were 64.4%, 24.4%, and 4.4%, respectively (P < 0.05). The rates of symptom recurrence were 7.5%, 22.5%, and 35%, respectively, in the TIPS-125I group, whereas those in the TIPS only group were 31.1%, 62.2%, and 82.2% (P < 0.05). The rates of stent restenosis were 12.5%, 27.5%, and 42.5%, respectively, in the TIPS-125I group, and 42.2%, 68.9%, and 84.4%, respectively, in the TIPS only group (P < 0.05). TIPS-125I was found to be significantly favorable in treating MPVTT and its complications in patients with HCC.
CONCLUSION TACE/TAE+125I combined with TIPS is effective in treating MPVTT and its complications, improving quality of life of patients and reducing mortality.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Fu-Liang He
- Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| | - Tao Wang
- Department of Interventional Therapy, The affiliated Yantai Yuhuangding Hospital of Qingdao University, No.20 Yuhuangding East Road, Yantai 264000, Shandong Province, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
| |
Collapse
|
34
|
He FL, Li C, Liu FQ, Qi XS. Correlation analysis of collagen proportionate area in Budd-Chiari syndrome: A preliminary clinicopathological study. World J Clin Cases 2019; 7:130-136. [PMID: 30705890 PMCID: PMC6354089 DOI: 10.12998/wjcc.v7.i2.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/01/2018] [Accepted: 12/12/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Collagen proportionate area (CPA) is an important index for assessing the severity of liver fibrosis. Budd-Chiari syndrome can frequently progress to liver fibrosis and cirrhosis. CPA might play an important role in the pathological progress of Budd-Chiari syndrome.
AIM To explore the role of CPA in predicting the outcomes of patients with Budd-Chiari syndrome.
METHODS Nine patients with Budd-Chiari syndrome undergoing transjugular intrahepatic portosystemic shunt (TIPS) were included. The median CPA level and correlation of CPA and prognosis of TIPS were determined.
RESULTS Median CPA was 23.07% (range: 0%-40.20%). Pearson’s χ2 test demonstrated a significant correlation of CPA with history of gastrointestinal bleeding (Pearson’s coefficient: 0.832, P = 0.005), alanine aminotransferase (Pearson’s coefficient: -0.694, P = 0.038), and prothrombin time (Pearson’s coefficient: 0.68, P = 0.044). Although CPA was not significantly correlated with shunt dysfunction or hepatic encephalopathy after TIPS, the absolute CPA was relatively larger in patients who developed shunt dysfunction or hepatic encephalopathy after TIPS.
CONCLUSION This preliminary clinicopathological study found a marginal effect of CPA on the outcomes of Budd-Chiari syndrome patients treated with TIPS.
Collapse
Affiliation(s)
- Fu-Liang He
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Chuan Li
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110016, Liaoning Province, China
- Section of Medical Services, General Hospital of Shenyang Military Area, Shenyang 110016, Liaoning Province, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xing-Shun Qi
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110016, Liaoning Province, China
| |
Collapse
|
35
|
Wu YF, Wang T, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL, Liu FQ. Stents combined with iodine-125 implantation to treat main portal vein tumor thrombus. World J Gastrointest Oncol 2018; 10:496-504. [PMID: 30595803 PMCID: PMC6304304 DOI: 10.4251/wjgo.v10.i12.496] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/19/2018] [Accepted: 11/24/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the efficacy of main portal vein stents combined with iodine-125 (125I) to treat main portal vein tumor thrombus.
METHODS From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization (TACE)/transarterial embolization (TAE) + portal vein stents combined with 125I implantation (Group A) and TACE/TAE + portal vein stents only (Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses.
RESULTS From January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P < 0.05, hazard ratio (HR): 0.37, 95%CI: 0.24-0.56]. The rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant (log rank P < 0.05, HR: 0.42, 95%CI: 0.27-0.63). Cox regression identified that treatment was the only factor affecting survival rate in this study.
CONCLUSION Main portal vein stents combined with 125I can significantly improve survival rate and reduce the rate of stent restenosis.
Collapse
Affiliation(s)
- Yi-Fan Wu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Tao Wang
- Department of Interventional Therapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
| | - Zhen-Dong Yue
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Hong-Wei Zhao
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Liang He
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
36
|
Abstract
Objective: To evaluate the effect of stereotactic iodine-125 brachytherapy in the management of adult thalamic high grade gliomas. Methods: Five cases of adult thalamic high grade gliomas (WHO Ⅲ-Ⅳ) were treated with stereotactic iodine-125 brachytherapy and temozolomide chemotherapy at the Second Affiliated Hospital of Zhejiang University School of Medicine between December 2016 and February 2018, assisted with stereotactic plan and radiation therapy planning system. Results: Pathology revealed anaplastic astrocytoma (WHO Ⅲ, 2 cases) and glioblastoma (WHO Ⅳ, 3 cases). The average amount of iodine-125 implanted was 10.6 seeds. After surgery, the Karnofsky Performance Scale (KPS) was the same as preoperative KPS, and there was no severe surgery related neurological deficits. The follow-up time was from 2 months to 16 months, with an average of 7.8 months. One patient (WHO Ⅲ) without chemotherapy presented with tumor progression 6.5 months later. The other four cases showed tumor stable on MRI. Conclusions: Stereotactic iodine-125 brachytherapy in the management of adult thalamic high grade gliomas showed satisfactory recent curative effect. Large case studies and long follow-up are needed for further evaluation.
Collapse
Affiliation(s)
- J Zheng
- Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | | |
Collapse
|
37
|
Qiao JT, Cui C, Qing L, Wang LS, He TY, Yan F, Liu FQ, Shen YH, Hou XG, Chen L. Activation of the STING-IRF3 pathway promotes hepatocyte inflammation, apoptosis and induces metabolic disorders in nonalcoholic fatty liver disease. Metabolism 2018; 81:13-24. [PMID: 29106945 DOI: 10.1016/j.metabol.2017.09.010] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/12/2017] [Accepted: 09/19/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a common result of obesity and metabolic syndrome. Hepatocyte injury and metabolic disorders are hallmarks of NAFLD. Stimulator of interferon genes (STING) and its downstream factor interferon regulatory factor 3 (IRF3) trigger inflammatory reaction in response to the presence of cytosolic DNA. STING has recently been shown to play an important role in early alcoholic liver disease. However, little is known about the role of STING-IRF3 pathway in hepatocyte injury. Here, we aimed to examine the effect of STING-IRF3 pathway on hepatocyte metabolism, inflammation and apoptosis. METHODS We examined the activation of the STING-IRF3 pathway, a high-fat diet (HFD)-induced obese mouse model, and determined the role of this pathway in a free fatty acid (FFA)-induced hepatocyte inflammatory response, injury, and dysfunction in L-O2 human liver cells. RESULTS STING and IRF3 were upregulated in livers of HFD-fed mice and in FFA-induced L-O2 cells. Knocking down either STING or IRF3 led to a significant reduction in FFA-induced hepatic inflammation and apoptosis, as evidenced by modulation of the nuclear factor κB (NF-κB) signaling pathway, inflammatory cytokines, and apoptotic signaling. Additionally, STING/IRF3 knockdown enhanced glycogen storage and alleviated lipid accumulation, which were found to be associated with increased expression of hepatic enzymes in glycolysis and lipid catabolism, and attenuated expression of hepatic enzymes in gluconeogenesis and lipid synthesis. CONCLUSIONS Our results suggest that the STING-IRF3 pathway promotes hepatocyte injury and dysfunction by inducing inflammation and apoptosis and by disturbing glucose and lipid metabolism. This pathway may be a novel therapeutic target for preventing NAFLD development and progression.
Collapse
Affiliation(s)
- J T Qiao
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - C Cui
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - L Qing
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - L S Wang
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - T Y He
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - F Yan
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - F Q Liu
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China
| | - Y H Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States; Texas Heart Institute, Houston, TX, United States.
| | - X G Hou
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China.
| | - L Chen
- Department of Endocrine and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong, China.
| |
Collapse
|
38
|
Lin L, Liu FQ, Yan F. [Cyclical Cushing syndrome due to pulmonary neuroendocrine tumor: a case report]. Zhonghua Nei Ke Za Zhi 2017; 56:945-947. [PMID: 29202538 DOI: 10.3760/cma.j.issn.0578-1426.2017.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
|
39
|
Yan LJ, Chen F, Liu DM, Huang JF, Liu FP, Wu JF, Liu FQ, Ye JZ, Qiu Y, Lin LS, He BC. [Tea, coffee intakes and risk of oral squamous cell carcinoma: a case-control study]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 37:1531-1535. [PMID: 28057147 DOI: 10.3760/cma.j.issn.0254-6450.2016.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effects of tea and coffee intakes on oral squamous cell carcinoma (OSCC) stratified by milk intake. Methods: A case-control study involving 593 OSCC patients confirmed by pathological diagnoses and 1 128 gender-age frequency matched controls was conducted in Fujian province during September 2010-March 2016. Unconditional logistic regression was used to calculate adjusted odds ratios (aORs) and corresponding 95% confidence intervals (CIs) to assess the effects of coffee, tea intakes and related variables on OSCC. Additive interaction was estimated by relative excess risk interaction (RERI), attributable proportions interaction (API) and synergy index (SI). Results: Tea intake was significantly associated with decreased risk of OSCC: the adjusted ORs were 0.54 for all subjects (95%CI: 0.41-0.71), 0.47 for milk consumers (95%CI: 0.31-0.71) and 0.57 for non-milk consumers (95%CI: 0.40-0.81). Moreover, starting tea drinking at age ≥25 years, moderate tea concentration and water temperature, drinking green tea and oolong tea showed effects to decrease the risk for OSCC in three groups. Additionally, there was a tendency of a reduced risk with increased daily tea drinking and longer tea-drinking period (all trend P<0.05). No significant association was observed between coffee intake and OSCC. A multiplicative but not additive interactions was found between tea drinking and milk intake. Additionally, we did not observe multiplicative and additive interaction between coffee drinking and milk intake. Conclusion: Tea drinking is a protective factor for OSCC, and there is a multiplicative interaction between tea drinking and milk intake. Therefore, tea drinking and increasing intake of milk can reduce the risk of OSCC at certain extent.
Collapse
Affiliation(s)
- L J Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - D M Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - J F Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F P Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - J F Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F Q Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - J Z Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - Y Qiu
- Department of Stomatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - L S Lin
- Department of Stomatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - B C He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, China
| |
Collapse
|
40
|
Huang JF, Qiu Y, Cai L, Liu FP, Chen F, Yan LJ, Wu JF, Bao XD, Liu FQ, Zheng XY, Lin LS, He BC. [Pickled food, fish, seafood intakes and oral squamous cell carcinoma: a case-control study]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:680-685. [PMID: 28763915 DOI: 10.3760/cma.j.issn.0253-9624.2017.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects between fish, seafood and pickled food intakes on oral squamous cell carcinoma (OSCC). Methods: A case-control study was carried out in Fujian area during September 2010 to December 2016, in which 604 newly diagnosed primary OSCC cases confirmed by pathological diagnosis were collected from hospital and 1 343 control subjects were enrolled from community and healthy hospital population. Demographic data, history of smoking drinking and tea drinking, oral hygiene status and dietary behaviors (fish, seafood and pickled food intakes) were collected by in-person interviews using a standard questionnaire.Using unconditional logistic regression to estimate adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) to assess the effects of fish, seafood and pickled food intakes on OSCC. Analysis stratified by smoking, alcohol drinking and bad prosthesis to explore the possible difference in association between subgroups. Multiplicative interactions and additive interactions between fish and bad prosthesis, seafood and alcohol drinking, pickled food and bad prosthesis were assessed by unconditional logistic regression, relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results: The average age of case group and control group were separately (58.69±13.92) years old and (59.27±11.37) years old (χ(2)=4.75, P=0.191). The people whose fish and seafood intakes ≥3 times/week had the lower risk of OSCC, the adjusted OR (95%CI) values were 0.63 (0.52-0.77) and 0.51 (0.41-0.64); The stratified analysis indicated that the people having bad prosthesis had the lower risk of OSCC if they eating fish ≥3 times/week, and the adjusted OR (95%CI) values was 0.53 (0.39-0.71); the people having bad prosthesis had the higher risk of OSCC if they eating pickled food ≥3 times/week, the adjusted OR (95%CI) values was 1.37 (1.02-1.88). Regularly eating seafood can decrease the risk of OSCC for non-smokers, smokers, non-drinkers, drinkers, people without bad prosthesis and had bad prosthesis, the adjusted OR (95%CI) values were 0.49 (0.36-0.68), 0.52 (0.37-0.73), 0.41 (0.31-0.55), 0.77 (0.51-0.96), 0.49 (0.36-0.67), 0.59 (0.42-0.83). Crossover analysis showed fish and bad prosthesis exist multiplication interaction relationship (adjusted OR=0.66, 95%CI: 0.44-0.97) and additional interaction relationship (RERI=-0.81, 95%CI:-1.43--0.19; AP=-0.76, 95%CI:-1.35--0.17; S=0.08, 95%CI: 0.01-0.98); pickled food and bad prosthesis exist multiplication interaction relationship (adjusted OR=1.63, 95%CI: 1.06-2.51) and addition interaction relationship (RERI=0.65, 95%CI:0.08-1.22; AP=0.36, 95%CI:0.10-0.62; S=5.19, 95%CI:1.32-54.49). Conclusion: Reducing the consumption of pickled food, quitting smoking and limiting alcohol consumption, and regularly eating fish and seafood can prevent the occurrence of OSCC.
Collapse
Affiliation(s)
- J F Huang
- The First Affiliated Hospital of Xiamen University, Xiamen 361000, China
| | - Y Qiu
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou 350108, China
| | - L Cai
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F P Liu
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F Chen
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - L J Yan
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - J F Wu
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - X D Bao
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - F Q Liu
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| | - X Y Zheng
- Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou 350108, China
| | - L S Lin
- Department of Epidemiology and Health Statistics, Fuzhou 350108, China
| | - B C He
- School of Public Health, Fujian Medical University, Fuzhou 350108, China
| |
Collapse
|
41
|
Qiu B, Li K, Dong X, Liu FQ. Transjugular Intrahepatic Portosystemic Shunt for Portal Hypertension in Hepatocellular Carcinoma with Portal Vein Tumor Thrombus. Cardiovasc Intervent Radiol 2017; 40:1372-1382. [PMID: 28488102 DOI: 10.1007/s00270-017-1655-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 04/18/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE In patients with hepatocellular carcinoma (HCC), limited therapeutic options are available for portal hypertension resulted from portal vein tumor thrombus (PVTT). We aimed to determine safety and efficacy of TIPS for treatment of symptomatic portal hypertension in HCC with PVTT. METHODS We evaluated clinical characteristics of 95 patients with HCC and PVTT out of 992 patients who underwent TIPS. The primary endpoints included success rate, procedural mortality, serious complications, decrease in portosystemic pressure gradient, and symptom relief. The secondary endpoints included recurrence of portal hypertension, overall survival, adverse events related to treatments for HCC, and quality of life measured by Karnofsky Performance Status Scale (KPS). RESULTS Success rate of TIPS was 95.8% (91/95), with procedural mortality of 1.1%. Serious complications related to TIPS procedure occurred in 2.1% (2/95) of patients. The symptoms of portal hypertension were well relieved. Variceal bleeding was successfully controlled and terminated in 100% of patients, with a recurrence rate of 39.2% in 12 months. Refractory ascites/hydrothorax was controlled partially or completely in 92.9% of patients during 1 month after TIPS, with a recurrence rate of 17.9% in 12 months. Survival rate at 6, 12, 24, and 36 months was 75.8, 52.7, 26.4, and 3.3%, respectively. No unexpected adverse event related to treatments for HCC was observed. The KPS score was 49 ± 4.5 and 63 ± 4.7 before and 1 month after TIPS, respectively (p < 0.001). CONCLUSIONS TIPS is a safe and efficacious treatment for symptomatic portal hypertension in HCC with PVTT.
Collapse
Affiliation(s)
- Bin Qiu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Rd., Yangfangdian, Haidian District, Beijing, 100038, China.,Department of Interventional Therapy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Kai Li
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Xiaoqun Dong
- Section of Gastroenterology, Section of Hematology/Oncology, Stephenson Cancer Center, Department of Internal Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Fu-Quan Liu
- Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Rd., Yangfangdian, Haidian District, Beijing, 100038, China.
| |
Collapse
|
42
|
Ismail MLB, Liu FQ, Yim WL, Ganguly R, Li Y, So CW. Reactivity of a Base-Stabilized Germanium(I) Dimer toward Group 9 Metal(I) Chloride and Dimanganese Decacarbonyl. Inorg Chem 2017; 56:5402-5410. [PMID: 28425294 DOI: 10.1021/acs.inorgchem.7b00503] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The reactivity of the 2-imino-5,6-methylenedioxylphenylgermanium(I) dimer toward group 9 metal(I) chloride and dimanganese decacarbonyl is described. [LGe:]2 (1, L = 2-imino-5,6-methylenedioxylphenyl) underwent a disproportionation reaction with 1.5 equiv of group 9 metal(I) chloride [MCl(cod)]2 (M = Rh, Ir) in toluene to afford a mixture of the group 9 metallogermylene-chlorometal(I) complexes [LGeμ-{M(cod)}2Cl] (M = Rh (2), Ir (4)) and chlorogermylene-chlorometal(I) complexes [L(Cl)GeM(cod)Cl] (M = Rh (3), Ir (5)), respectively. The disproportionation property of 1 is further evidenced by its reaction with 0.5 equiv of Mn2(CO)10 in refluxing toluene to form a mixture of the manganogermylene dimer [(LGe)μ-{Mn(CO)4}]2 (7) and free ligand [LH] (8). Compounds 2-5, 7, and 8 were elucidated by NMR spectroscopy, X-ray crystallography, and DFT calculations, respectively.
Collapse
Affiliation(s)
- Muhammad Luthfi Bin Ismail
- Division of Chemistry and Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University , Singapore 637371
| | - Fu-Quan Liu
- Division of Chemistry and Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University , Singapore 637371
| | - Wai-Leung Yim
- Institute of High Performance Computing, Agency for Science, Technology, and Research , 1 Fusionopolis Way, No. 16-16 Connexis, Singapore 138632
| | - Rakesh Ganguly
- Division of Chemistry and Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University , Singapore 637371
| | - Yongxin Li
- Division of Chemistry and Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University , Singapore 637371
| | - Cheuk-Wai So
- Division of Chemistry and Biological Chemistry, School of Physical and Mathematical Sciences, Nanyang Technological University , Singapore 637371
| |
Collapse
|
43
|
Qiu B, Zhao MF, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL, Dai S, Yao JN, Liu FQ. Combined transjugular intrahepatic portosystemic shunt and other interventions for hepatocellular carcinoma with portal hypertension. World J Gastroenterol 2015; 21:12439-12447. [PMID: 26604651 PMCID: PMC4649127 DOI: 10.3748/wjg.v21.i43.12439] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/05/2015] [Accepted: 09/15/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate combination transjugular intrahepatic portosystemic shunt (TIPS) and other interventions for hepatocellular carcinoma (HCC) and portal hypertension.
METHODS: Two hundred and sixty-one patients with HCC and portal hypertension underwent TIPS combined with other interventional treatments (transarterial chemoembolization/transarterial embolization, radiofrequency ablation, hepatic arterio-portal fistulas embolization, and splenic artery embolization) from January 1997 to January 2010 at Beijing Shijitan Hospital. Two hundred and nine patients (121 male and 88 female, aged 25-69 years, mean 48.3 ± 12.5 years) with complete clinical data were recruited. We evaluated the safety of the procedure (procedure-related death and serious complications), change of portal vein pressure before and after TIPS, symptom relief [e.g., ascites, hydrothorax, esophageal gastric-fundus variceal bleeding (EGVB)], cumulative rates of survival, and distributary channel restenosis. The characteristics of the patients surviving ≥ 5 and < 5 years were also analyzed.
RESULTS: The portosystemic pressure was decreased from 29.0 ± 4.1 mmHg before TIPS to 18.1 ± 2.9 mmHg after TIPS (t = 69.32, P < 0.05). Portosystemic pressure was decreased and portal hypertension symptoms were ameliorated. During the 5 year follow-up, the total recurrence rate of resistant ascites or hydrothorax was 7.2% (15/209); 36.8% (77/209) for EGVB; and 39.2% (82/209) for hepatic encephalopathy. The cumulative rates of distributary channel restenosis at 1, 2, 3, 4, and 5 years were 17.2% (36/209), 29.7% (62/209), 36.8% (77/209), 45.5% (95/209) and 58.4% (122/209), respectively. No procedure-related deaths and serious complications (e.g., abdominal bleeding, hepatic failure, and distant metastasis) occurred. Moreover, Child-Pugh score, portal vein tumor thrombosis, lesion diameter, hepatic arterio-portal fistulas, HCC diagnosed before or after TIPS, stent type, hepatic encephalopathy, and type of other interventional treatments were related to 5 year survival after comparing patient characteristics.
CONCLUSION: TIPS combined with other interventional treatments seems to be safe and efficacious in patients with HCC and portal hypertension.
Collapse
MESH Headings
- Adult
- Aged
- Carcinoma, Hepatocellular/etiology
- Carcinoma, Hepatocellular/mortality
- Carcinoma, Hepatocellular/surgery
- Carcinoma, Hepatocellular/therapy
- China
- Cholangiopancreatography, Magnetic Resonance
- Humans
- Hypertension, Portal/etiology
- Hypertension, Portal/mortality
- Hypertension, Portal/physiopathology
- Hypertension, Portal/surgery
- Kaplan-Meier Estimate
- Liver Cirrhosis/complications
- Liver Cirrhosis/diagnosis
- Liver Neoplasms/etiology
- Liver Neoplasms/mortality
- Liver Neoplasms/surgery
- Liver Neoplasms/therapy
- Male
- Middle Aged
- Portal Pressure
- Portasystemic Shunt, Transjugular Intrahepatic/adverse effects
- Portasystemic Shunt, Transjugular Intrahepatic/mortality
- Risk Factors
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
Collapse
|
44
|
Wang L, He FL, Liu FQ, Yue ZD, Zhao HW. Establishment of a hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol. World J Gastroenterol 2015; 21:9544-9553. [PMID: 26327762 PMCID: PMC4548115 DOI: 10.3748/wjg.v21.i32.9544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 04/27/2015] [Accepted: 07/03/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the feasibility and safety of establishing a porcine hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol.
METHODS: Twenty-one healthy Guizhou miniature pigs were randomly divided into three experimental groups and three control groups. The pigs in the three experimental groups were subjected to hepatic arterial perfusion with 7, 12 and 17 mL of 80% alcohol, respectively, while those in the three control groups underwent hepatic arterial perfusion with 7, 12 and 17 mL of saline, respectively. Hepatic arteriography and direct portal phlebography were performed on all animals before and after perfusion, and the portal venous pressure and diameter were measured before perfusion, immediately after perfusion, and at 2, 4 and 6 wk after perfusion. The following procedures were performed at different time points: routine blood sampling, blood biochemistry, blood coagulation and blood ammonia tests before surgery, and at 2, 4 and 6 wk after surgery; hepatic biopsy before surgery, within 6 h after surgery, and at 1, 2, 3, 4 and 5 wk after surgery; abdominal enhanced computed tomography examination before surgery and at 6 wk after surgery; autopsy and multi-point sampling of various liver lobes for histological examination at 6 wk after surgery.
RESULTS: In experimental group 1, different degrees of hepatic fibrosis were observed, and one pig developed hepatic cirrhosis. In experimental group 2, there were cases of hepatic cirrhosis, different degrees of increased portal venous pressure, and intrahepatic portal venous bypass, but neither extrahepatic portal-systemic bypass circulation nor death occurred. In experimental group 3, two animals died and three animals developed hepatic cirrhosis, and different degrees of increased portal venous pressure and intrahepatic portal venous bypass were also observed, but there was no extrahepatic portal-systemic bypass circulation.
CONCLUSION: It is feasible to establish an animal model of hepatic cirrhosis and portal hypertension by hepatic arterial perfusion with 80% alcohol, however, the safety of this model depends on a suitable perfusion dose.
Collapse
MESH Headings
- Animals
- Biomarkers/blood
- Biopsy
- Blood Coagulation
- Ethanol
- Feasibility Studies
- Female
- Hepatic Artery/diagnostic imaging
- Hypertension, Portal/blood
- Hypertension, Portal/chemically induced
- Hypertension, Portal/diagnostic imaging
- Hypertension, Portal/physiopathology
- Liver Circulation
- Liver Cirrhosis, Alcoholic/blood
- Liver Cirrhosis, Alcoholic/diagnostic imaging
- Liver Cirrhosis, Alcoholic/etiology
- Liver Cirrhosis, Alcoholic/physiopathology
- Liver Cirrhosis, Experimental/blood
- Liver Cirrhosis, Experimental/chemically induced
- Liver Cirrhosis, Experimental/diagnostic imaging
- Liver Cirrhosis, Experimental/physiopathology
- Male
- Perfusion/methods
- Phlebography
- Portal Pressure
- Portal Vein/diagnostic imaging
- Portal Vein/physiopathology
- Swine
- Swine, Miniature
- Time Factors
- Tomography, X-Ray Computed
Collapse
|
45
|
He FL, Wang L, Zhao HW, Fan ZH, Zhao MF, Dai S, Yue ZD, Liu FQ. Transjugular intrahepatic portosystemic shunt for severe jaundice in patients with acute Budd-Chiari syndrome. World J Gastroenterol 2015; 21:2413-2418. [PMID: 25741149 PMCID: PMC4342918 DOI: 10.3748/wjg.v21.i8.2413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 11/24/2014] [Accepted: 01/08/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the feasibility of transjugular intrahepatic portosystemic shunt (TIPS) for severe jaundice secondary to acute Budd-Chiari syndrome (BCS).
METHODS: From February 2009 to March 2013, 37 patients with severe jaundice secondary to acute BCS were treated. Sixteen patients without hepatic venule, hepatic veins (HV) obstruction underwent percutaneous angioplasty of the inferior vena cava (IVC) and/or HVs. Twenty-one patients with HV occlusion underwent TIPS. Serum bilirubin, liver function, demographic data and operative data of the two groups of patients were analyzed.
RESULTS: Twenty-one patients underwent TIPS and the technical success rate was 100%, with no technical complications. Sixteen patients underwent recanalization of the IVC and/or HVs and the technical success rate was 100%. The mean procedure time for TIPS was 84.0 ± 12.11 min and angioplasty was 44.11 ± 5.12 min (P < 0.01). The mean portosystemic pressure in the TIPS group decreased significantly from 40.50 ± 4.32 to 16.05 ± 3.50 mmHg (P < 0.01). The mean portosystemic pressure gradient decreased significantly from 33.60 ± 2.62 to 7.30 ± 2.21 mmHg (P < 0.01). At 8 wk after the procedures, in the TIPS group, total bilirubin (TBIL) decreased significantly from 266.24 ± 122.03 before surgery to 40.11 ± 3.52 μmol/L (P < 0.01) and direct bilirubin (DBIL) decreased significantly from 194.22 ± 69.82 μmol/L to 29.82 ± 3.10 μmol/L (P < 0.01). In the angioplasty group, bilirubin returned to the normal range, with TBIL decreased significantly from 258.22 ± 72.71 μmol/L to 13.33 ± 3.54 μmol/L (P < 0.01) and DBIL from 175.08 ± 39.27 to 4.03 ± 1.74 μmol/L (P < 0.01). Liver function improved faster than TBIL. After 2 wk, in the TIPS group, alanine aminotransferase (ALT) decreased significantly from 50.33 ± 40.61 U/L to 28.67 ± 7.02 U/L (P < 0.01) and aspartate aminotransferase (AST) from 49.46 ± 34.33 U/L to 26.89 ± 8.68 U/L (P < 0.01). In the angioplasty group, ALT decreased significantly from 51.56 ± 27.90 to 14.22 ± 2.59 μmol/L (P < 0.01) and AST from 60.66 ± 39.89 μmol/L to 8.18 ± 1.89 μmol/L (P < 0.01). After mean follow-up of 12.6 mo, there was no recurrence of jaundice in either group.
CONCLUSION: Severe jaundice is not a contraindication for TIPS in patients with acute BCS and TIPS is appropriate for severe jaundice due to BCS.
Collapse
|
46
|
Wang Y, Mu JJ, Geng LK, Wang D, Ren KY, Guo TS, Chu C, Xie BQ, Liu FQ, Yuan ZY. Effect of salt intake and potassium supplementation on brachial-ankle pulse wave velocity in Chinese subjects: an interventional study. ACTA ACUST UNITED AC 2014; 48:83-90. [PMID: 25493387 PMCID: PMC4288497 DOI: 10.1590/1414-431x20144213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/22/2014] [Indexed: 01/11/2023]
Abstract
Accumulating evidence has suggested that high salt and potassium might be associated
with vascular function. The aim of this study was to investigate the effect of salt
intake and potassium supplementation on brachial-ankle pulse wave velocity (PWV) in
Chinese subjects. Forty-nine subjects (28-65 years of age) were selected from a rural
community of northern China. All subjects were sequentially maintained on a low-salt
diet for 7 days (3.0 g/day NaCl), a high-salt diet for an additional 7 days (18.0
g/day NaCl), and a high-salt diet with potassium supplementation for a final 7 days
(18.0 g/day NaCl+4.5 g/day KCl). Brachial-ankle PWV was measured at baseline and on
the last day of each intervention. Blood pressure levels were significantly increased
from the low-salt to high-salt diet, and decreased from the high-salt diet to
high-salt plus potassium supplementation. Baseline brachial-ankle PWV in
salt-sensitive subjects was significantly higher than in salt-resistant subjects.
There was no significant change in brachial-ankle PWV among the 3 intervention
periods in salt-sensitive, salt-resistant, or total subjects. No significant
correlations were found between brachial-ankle PWV and 24-h sodium and potassium
excretions. Our study indicates that dietary salt intake and potassium
supplementation, at least in the short term, had no significant effect on
brachial-ankle PWV in Chinese subjects.
Collapse
Affiliation(s)
- Y Wang
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - J J Mu
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - L K Geng
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - D Wang
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - K Y Ren
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - T S Guo
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - C Chu
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - B Q Xie
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - F Q Liu
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| | - Z Y Yuan
- Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P. R., China
| |
Collapse
|
47
|
He FL, Wang L, Yue ZD, Zhao HW, Liu FQ. Parallel transjugular intrahepatic portosystemic shunt for controlling portal hypertension complications in cirrhotic patients. World J Gastroenterol 2014; 20:11835-11839. [PMID: 25206289 PMCID: PMC4155375 DOI: 10.3748/wjg.v20.i33.11835] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/19/2014] [Accepted: 06/13/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the feasibility of a second parallel transjugular intrahepatic portosystemic shunt (TIPS) to reduce portal venous pressure and control complications of portal hypertension.
METHODS: From January 2011 to December 2012, 10 cirrhotic patients were treated for complications of portal hypertension. The demographic data, operative data, postoperative recovery data, hemodynamic data, and complications were analyzed.
RESULTS: Ten patients underwent a primary and parallel TIPS. Technical success rate was 100% with no technical complications. The mean duration of the first operation was 89.20 ± 29.46 min and the second operation was 57.0 ± 12.99 min. The mean portal system pressure decreased from 54.80 ± 4.16 mmHg to 39.0 ± 3.20 mmHg after the primary TIPS and from 44.40 ± 3.95 mmHg to 26.10 ± 4.07 mmHg after the parallel TIPS creation. The mean portosystemic pressure gradient decreased from 43.80 ± 6.18 mmHg to 31.90 ± 2.85 mmHg after the primary TIPS and from 35.60 ± 2.72 mmHg to 15.30 ± 3.27 mmHg after the parallel TIPS creation. Clinical improvement was seen in all patients after the parallel TIPS creation. One patient suffered from transient grade I hepatic encephalopathy (HE) after the primary TIPS and four patients experienced transient grade I-II after the parallel TIPS procedure. Mean hospital stay after the first and second operations were 15.0 ± 3.71 d and 16.90 ± 5.11 d (P = 0.014), respectively. After a mean 14.0 ± 3.13 mo follow-up, ascites and bleeding were well controlled and no stenosis of the stents was found.
CONCLUSION: Parallel TIPS is an effective approach for controlling portal hypertension complications.
Collapse
|
48
|
Wang Y, Mu JJ, Liu FQ, Ren KY, Xiao HY, Yang Z, Yuan ZY. Salt-induced epithelial-to-mesenchymal transition in Dahl salt-sensitive rats is dependent on elevated blood pressure. ACTA ACUST UNITED AC 2014. [PMID: 24676494 PMCID: PMC3982943 DOI: 10.1590/1414-431x20133554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dietary salt intake has been linked to hypertension and cardiovascular disease. Accumulating evidence has indicated that salt-sensitive individuals on high salt intake are more likely to develop renal fibrosis. Epithelial-to-mesenchymal transition (EMT) participates in the development and progression of renal fibrosis in humans and animals. The objective of this study was to investigate the impact of a high-salt diet on EMT in Dahl salt-sensitive (SS) rats. Twenty-four male SS and consomic SS-13BN rats were randomized to a normal diet or a high-salt diet. After 4 weeks, systolic blood pressure (SBP) and albuminuria were analyzed, and renal fibrosis was histopathologically evaluated. Tubular EMT was evaluated using immunohistochemistry and real-time PCR with E-cadherin and alpha smooth muscle actin (α-SMA). After 4 weeks, SBP and albuminuria were significantly increased in the SS high-salt group compared with the normal diet group. Dietary salt intake induced renal fibrosis and tubular EMT as identified by reduced expression of E-cadherin and enhanced expression of α-SMA in SS rats. Both blood pressure and renal interstitial fibrosis were negatively correlated with E-cadherin but positively correlated with α-SMA. Salt intake induced tubular EMT and renal injury in SS rats, and this relationship might depend on the increase in blood pressure.
Collapse
Affiliation(s)
- Y Wang
- Cardiovascular Department, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| | - J J Mu
- Cardiovascular Department, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| | - F Q Liu
- Cardiovascular Department, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| | - K Y Ren
- Cardiovascular Department, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| | - H Y Xiao
- Cardiovascular Department, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Z Yang
- Department of Pathology, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Z Y Yuan
- Cardiovascular Department, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
49
|
Tian YL, Zhao YQ, Hu BS, Liu FQ. First Report of Seedling Blight of Watermelon Caused by Acidovorax citrulli Transmitted from Rootstock of Pumpkin in China. Plant Dis 2013; 97:420. [PMID: 30722381 DOI: 10.1094/pdis-10-12-0931-pdn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Bacterial fruit blotch (BFB) is a devastating disease caused by Acidovorax citrulli, which was first observed in the United States in 1988 (3). A. citrulli can cause severe infection on a wide range of cucurbits, including watermelon, cantaloupe, and pumpkin. Cotyledon symptoms are brown, angular, necrotic spots or large necrotic lesions. The disease is seedborne, so seeds usually serve as the primary inoculum source for BFB outbreaks (2). In July 2012, seedling blight was observed by local farmers from Anhui province in China on watermelon seedlings grafted to pumpkin rootstocks; lesions were morphologically similar to those caused by A. citrulli. Presence of A. citrulli was detected in symptomatic samples by using species-specific primers BX-L1/BX-S-R2 (1). The seed company claimed seeds of watermelon (cv. Changfeng) were certified free of bacterial fruit blotch, but pumpkin seeds (cv. Kangkuxianfeng-1) had not been tested for A. citrulli. For investigating the inoculum source, the remaining seeds of watermelon (cv. Changfeng) and pumpkin (cv. Kangkuxianfeng-1) for seedling production were collected from the farmer and processed for pathogen extraction as described by Walcott and Gitaitis (2). Two microliters of seed wash was used as template for PCR using primers BX-L1/BX-S-R2 (1). The experiment was conducted three times. A 279-bp DNA fragment was consistently amplified by PCR from seed wash of pumpkin seeds, but not from the seed wash of watermelon seeds. Three Acidovorax-like strains (A1, A2, and A3) were isolated from pumpkin seed wash using TWZ semi-selective medium (0.5% peptone, 0.025% CaCl2, 1% Tween-80, 50 mg/liter berberine, 50 mg/liter cycloheximide, 50 mg/liter 2,3,5-triphenyltetrazolium chloride). PCR was performed on the 16S rDNA gene from isolate strain A1, A2, and A3 (1,492 bp; GenBank Accession Nos. JX875533, JX875534, and JX875535) with primers rp1/fd2 (4), and PCR products were sequenced. Results of sequence analysis showed the sequences of strains A1, A2, and A3 were 99% identical to that of the type strain of A. citrulli AAC00-1 (NC_008752). Pathogencity was confirmed by injection of pumpkin cotyledons with bacterial suspensions of each isolate. Collected pumpkin seeds (n = 100 seeds) and watermelon seeds (n = 100 seeds) were planted in plastic pots containing sterilized field soil at room temperature to detect A. citrulli by a wet chamber growing out test. Eight days later, brown, angular, necrotic spots or wilt developed in pumpkin seedlings, but no symptoms were noted on the watermelon seedlings. To our knowledge, this is the first report of A. citrulli causing watermelon seedling blight transmitted from pumpkin seeds by grafting in China. References: (1) O. Bahar et al. Plant Pathol. 57:754, 2008. (2) R. R. Walcott and R. D. Gitaitis. Plant Dis. 84:470, 2000. (3) G. C. Wall et al. Phytopathology 78:1605, 1988. (4) W. G. Weisburg et al. J. Bacteriol. 173:697, 1991.
Collapse
Affiliation(s)
- Y L Tian
- College of Plant Protection and Key Laboratory of Integrated Management of Crop Diseases and Pests, Ministry of Education, Nanjing Agricultural University, Nanjing 210095, China
| | - Y Q Zhao
- Shanghai Agricultural Technology Extension and Service Center; Shanghai 201103, China
| | - B S Hu
- College of Plant Protection and Key Laboratory of Integrated Management of Crop Diseases and Pests, Ministry of Education, Nanjing Agricultural University, Nanjing 210095, China and National Engineering Research Center For Cucurbits, Changji 831100, China
| | - F Q Liu
- College of Plant Protection and Key Laboratory of Integrated Management of Crop Diseases and Pests, Ministry of Education, Nanjing Agricultural University, Nanjing 210095, China and National Engineering Research Center For Cucurbits, Changji 831100, China
| |
Collapse
|
50
|
Abstract
The spin current, orbit angular momentum current and total angular momentum current in a tensor form have been universally defined according to the quantum electrodynamics. Their conservation quantities and the continuity equations have been discussed in different cases. Non-relativistic approximation forms are deduced in order to explain their physical meanings, and to analyze some experimental results. The spin current of helical edge states in HgTe/CdTe quantum wells is calculated to demonstrate the properties of the spin current of the two dimensional quantum spin-Hall system. A generalized spin-orbit coupling term in the semiconducting media is deduced based on the theory of the electrodynamics in the moving media. It is recommended to use the effective total angular momentum current instead of the pure spin current to describe the distribution of polarization and the transport properties in spintronics.
Collapse
Affiliation(s)
- Z An
- Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education, and School of Physics and Technology, Wuhan University , Wuhan 430072, China
| | | | | | | |
Collapse
|