AIM: To investigate the effect of vascular endothelial growth factor (VEGF) transfection on hepatic sinusoidal capillarization. METHODS: Enhanced green fluorescent protein (EGFP)/ VEGF transfection was confirmed by im...AIM: To investigate the effect of vascular endothelial growth factor (VEGF) transfection on hepatic sinusoidal capillarization. METHODS: Enhanced green fluorescent protein (EGFP)/ VEGF transfection was confirmed by immunofluorescence microscopy and immunohistoche-mistry both in primary hepatocytes and in normal liver. Cirrhotic rats were generated by thioacetamide (TAA) administration and then divided into a treatment group, which received injections of 400 μg of plasmid DNA encoding an EGFP- VEGF fusion protein, and a blank group, which received an equal amount of normal saline through the portal vein. The portal vein pressure was measured in the normal and cirrhotic state, in treated and blank groups. The average number of fenestrae per hepatic sinusoid was determined using transmission electron microscopy (TEM), while the relative abundance of VEGF transcripts was examined by Gene array. RESULTS: Green fluorescent protein was observed in the cytoplasms of liver cells under immunofluorescence microscopy 24 h after transfection with EGFP/VEGF plasmid in vitro. Staining with polyclonal antibodies against VEGF illustrated that hepatocytes expressedimmunodetectable VEGF both in vitro and in vitro. There were significant differences in the number of fenestrae and portal vein pressures between normal and cirrhotic rats (7.40 ± 1.71 vs 2.30 ± 1.16 and 9.32 ± 0.85 cmH2O vs 17.92 ± 0.90 cmH2O, P < 0.01), between cirrhotic and treated rats (2.30 ± 1.16 cmH2O vs 4.60 ± 1.65 and 17.92 ± 0.90 cmH2O vs 15.52 ± 0.93 cmH2O, P < 0.05) and between the treatment group and the blank group (4.60 ± 1.65 cmH2O vs 2.10 ± 1.10 cmH2O and 15.52 ± 0.93 cmH2O vs 17.26 ± 1.80 cmH2O, P < 0.05). Gene- array analysis revealed that the relative abundance of transcripts of VEGF family members decreased in the cirrhotic state and increased after transfection. CONCLUSION: Injection of a plasmid encoding VEGF through the portal vein is an effective method to induce the formation of fenestrae and decrease portal vein pressure in cirrhotic rats. Therefore, it may be a good choice for treating hepatic cirrhosis and portal hypertension.展开更多
BACKGROUND The incidence of acute kidney injury(AKI)in patients with sepsis is high,and the prognosis of patients with septic AKI is poor.The early diagnosis and treatment of septic AKI is of great significance in imp...BACKGROUND The incidence of acute kidney injury(AKI)in patients with sepsis is high,and the prognosis of patients with septic AKI is poor.The early diagnosis and treatment of septic AKI is of great significance in improving the prognosis of patients with sepsis.AIM To explore the value of contrast-enhanced ultrasound(CEUS),serum creatinine(Scr),and other indicators in the early diagnosis of septic AKI.METHODS Ninety patients with sepsis during hospitalization at Tongji Hospital of Tongji University were recruited as subjects.Each patient was recorded with relevant basic data,clinical indicators,and CEUS results.The patients were divided into AKI group and non-AKI group according to the results of renal function diagnosis after 48 h.On the 7th day,the renal function of the non-AKI group was re-evaluated and the patients were further divided into AKI subgroup and non-AKI subgroup.The differences of the indicators in different groups were compared,and the diagnostic value of each indicator and their combination for septic AKI was analyzed.RESULTS Systemic inflammatory response score(2.58±0.75),blood lactic acid(3.01±1.33 mmol/L),Scr(141.82±27.19μmol/L),blood urea nitrogen(4.41±0.81mmol/L),and rise time(10.23±2.63 s)in the AKI group were higher than those in the non-AKI group.Peak intensity(PI)(10.78±3.98 dB)and wash in slope(WIS)(1.07±0.53 dB/s)were lower than those in the non-AKI group.The differences were statistically significant(P<0.05).The PI(12.83±3.77 dB)and WIS(1.22±0.68 dB/s)in the AKI subgroup were lower than those in the non-AKI subgroup,and the differences were statistically significant(P<0.05).The area under curve(AUC)of Scr for the diagnosis of septic AKI was 0.825 with a sensitivity of 56.76% and a specificity of 100%.The AUCs of WIS and PI(0.928 and 0.912)were higher than those of Scr.Their sensitivities were 100%,but the specificities were 71.70% and 75.47%.The AUC of the combination of three indicators for the diagnosis of septic AKI was 0.943,which was significantly higher than the AUC diagnosed by each single indicator.The sensitivity was 94.59%,and the specificity was 81.13%.CONCLUSION The combination of Scr,PI,and WIS can improve the diagnostic accuracy of septic AKI.PI and WIS are expected to predict the occurrence of early septic AKI.展开更多
AIM To analyze the incidence of hepatocellular carcinoma (HCC) in a population that underwent health checkups and had high serum miR-106b levels. METHODS A total of 335 subjects who underwent checkups in the Digestive...AIM To analyze the incidence of hepatocellular carcinoma (HCC) in a population that underwent health checkups and had high serum miR-106b levels. METHODS A total of 335 subjects who underwent checkups in the Digestive and Liver Disease Department of our hospital were randomly selected. RT-PCR was used to detect the level of miR-106b in serum samples. Laboratory and imaging examinations were carried out to confirm the HCC diagnosis in patients who had a > 2-fold change in miR-106b levels. Ultrasound-guided biopsy was also used for HCC diagnosis when necessary. On this basis, the clinical data of these subjects, including history of hepatitis virus infection, obesity, long-term history of alcohol use and stage of HCC, were collected. Then, the impact of these factors on the level of miR1-06b in serum was analyzed. Furthermore, receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of miR-106b for HCC. RESULTS A total of 35 subjects had abnormal serum miR-106b levels, of which 20 subjects were diagnosed with HCC. t-test revealed that the difference in serum miR-106b level in terms of sex, age, history of hepatitis virus infection, obesity and long-term history of alcohol use was not statistically significant. However, serum miR-106b levels in patients with advanced HCC (stage. /.) was higher than in patients with early HCC (stage./.), and the difference was statistically significant (P = 0.000). Moreover, the ROC curve revealed that the area under the curve value for miR-106b was 0.885, which shows that serum miR-106b level has a certain clinical value for HCC diagnosis. CONCLUSION The random sampling survey shows that serum miR-106b level is a valuable diagnostic marker for HCC. However, the diagnostic threshold value needs to be further researched.展开更多
AIM: To determine the correlation between portal hemodynamics and spleen function among different grades of cirrhosis and verify its significance in cirrhosis staging.METHODS: The portal and splenic vein hemodynamics ...AIM: To determine the correlation between portal hemodynamics and spleen function among different grades of cirrhosis and verify its significance in cirrhosis staging.METHODS: The portal and splenic vein hemodynamics and spleen size were investigated by ultrasonography in consecutive 38 cirrhotic patients with cirrhosis (Child's grades A to C) and 20 normal controls. The differences were compared in portal vein diameter and flow velocity between patients with and without ascites and between patients with mild and severe esophageal varices. The correlation between peripheral blood cell counts and Child's grades was also determined.RESULTS: The portal flow velocity and volume were significantly lower in patients with Child's C (12.25±1.67 cm/s vs 788.59±234 mm/min, respectively) cirrhosis compared to controls (19.55±3.28 cm/s vs 1254.03±410 mm/min,respectively) and those with Child's A (18.5±3.02 cm/s vs1358.48±384 mm/min, respectively) and Child's B (16.0±3.89cm/s vs 1142.23±390 mm/min, respectively)cirrhosis.Patients with ascites had much lower portal flow velocity and volume (13.0±1.72 cm/s vs 1078±533 mm/min) than those without ascites (18.6±2.60 cm/s vs 1394±354 mm/min).There was no statistical difference between patients with mild and severe esophageal varices. The portal vein diameter was not significantly different among the above groups.There were significant differences in splenic vein diameter,flow velocity and white blood cell count, but not in spleen size, red blood cell and platelet counts among the various grades of cirrhosis. The spleen size was negatively correlated with red blood cell and platelet counts (r= -0.620and r = -0.8.34, respectively).CONCLUSION: An optimal system that includes parameters representing the portal hemodynamics and spleen function should be proposed for cirrhosis staging.展开更多
BACKGROUND Gastric adenomyoma(GA)is a rare submucosal benign neoplasm that occurs mostly in the gastric antrum and is often misdiagnosed.No standard treatment has been established for this disease in cases of malignan...BACKGROUND Gastric adenomyoma(GA)is a rare submucosal benign neoplasm that occurs mostly in the gastric antrum and is often misdiagnosed.No standard treatment has been established for this disease in cases of malignancy.CASE SUMMARY A 75-year-old woman with a 10-year history of hypertension was admitted to the Emergency Department of our hospital complaining of paroxysmal exacerbation of acute abdominal pain for 1 d with no apparent cause.Enhanced computed tomography and magnetic resonance imaging indicated a mass in the caudal pancreas,cholecystitis,and cholecystic polypus.Gastrointestinal endoscopy showed a mass arising from the gastric antrum.Due to the imaging findings,pancreatic cancer(PC),gastric lesion,cholecystitis,and cholecystic polypus were our primary consideration.Radical pancreatectomy,splenectomy,and cholecystectomy were performed successfully,and the gastric tumor was locally resected.Postoperative paraffin specimens confirmed the diagnosis of caudal PC,GA,and heterotopic pancreas(HP).Unfortunately,the patient died 13 mo later due to PC metastases to the liver,lung,and adrenal glands.CONCLUSION GA is a rare benign disease,especially when occurring with HP.It may stem from the same origin as HP.This is the first case report to date of a patient suffering from the simultaneous occurrence of GA,HP,and PC.GA is a lesion that can mimic other benign or malignant gastrointestinal diseases;thus,a definitive diagnosis depends on postoperative pathological biopsy.Although GA and HP are both benign lesions,they should be resected because there is a chance of malignancy.Additional research should be conducted to better understand these submucosal lesions.展开更多
Objective: To investigate the significance of vascular endothelial growth factor (VEGF) in the pathogene- sis of liver cirrhosis and the correlation between VEGF and proto-oncogene c-fos and c-myc in cir- rhotic liver...Objective: To investigate the significance of vascular endothelial growth factor (VEGF) in the pathogene- sis of liver cirrhosis and the correlation between VEGF and proto-oncogene c-fos and c-myc in cir- rhotic liver. Methods: The proteins of VEGF, c-fos, and c-myc were identified immunohistochemically in each tissue section of 53 cases of liver cirrhosis. The correlations between VEGF, c-fos and c-myc were analyzed. The levels of VEGF protein in different Child gradings were also compared. Results: The proteins of VEGF were more highly ex- pressed in Child A and B patients than in Child C patients and controls. The expressions of both c-fos and c-myc were not statistically significant between VEGF positive and negative patients. Conclusions: The protein level of VEGF can reflect the compensation status of cirrhosis patients and may act as an anti-cirrhotic factor. The proto-oncogene c- fos, c-myc and VEGF may have different mecha- nisms in the course of cirrhosis or hepatic tumorigen- esis.展开更多
基金The National Natural Science Fundation of China, No. 30300341The Natural Science Fundation of Shandong Province, No. Y2004Z12
文摘AIM: To investigate the effect of vascular endothelial growth factor (VEGF) transfection on hepatic sinusoidal capillarization. METHODS: Enhanced green fluorescent protein (EGFP)/ VEGF transfection was confirmed by immunofluorescence microscopy and immunohistoche-mistry both in primary hepatocytes and in normal liver. Cirrhotic rats were generated by thioacetamide (TAA) administration and then divided into a treatment group, which received injections of 400 μg of plasmid DNA encoding an EGFP- VEGF fusion protein, and a blank group, which received an equal amount of normal saline through the portal vein. The portal vein pressure was measured in the normal and cirrhotic state, in treated and blank groups. The average number of fenestrae per hepatic sinusoid was determined using transmission electron microscopy (TEM), while the relative abundance of VEGF transcripts was examined by Gene array. RESULTS: Green fluorescent protein was observed in the cytoplasms of liver cells under immunofluorescence microscopy 24 h after transfection with EGFP/VEGF plasmid in vitro. Staining with polyclonal antibodies against VEGF illustrated that hepatocytes expressedimmunodetectable VEGF both in vitro and in vitro. There were significant differences in the number of fenestrae and portal vein pressures between normal and cirrhotic rats (7.40 ± 1.71 vs 2.30 ± 1.16 and 9.32 ± 0.85 cmH2O vs 17.92 ± 0.90 cmH2O, P < 0.01), between cirrhotic and treated rats (2.30 ± 1.16 cmH2O vs 4.60 ± 1.65 and 17.92 ± 0.90 cmH2O vs 15.52 ± 0.93 cmH2O, P < 0.05) and between the treatment group and the blank group (4.60 ± 1.65 cmH2O vs 2.10 ± 1.10 cmH2O and 15.52 ± 0.93 cmH2O vs 17.26 ± 1.80 cmH2O, P < 0.05). Gene- array analysis revealed that the relative abundance of transcripts of VEGF family members decreased in the cirrhotic state and increased after transfection. CONCLUSION: Injection of a plasmid encoding VEGF through the portal vein is an effective method to induce the formation of fenestrae and decrease portal vein pressure in cirrhotic rats. Therefore, it may be a good choice for treating hepatic cirrhosis and portal hypertension.
基金National Natural Science Foundation of China,No.81873609
文摘BACKGROUND The incidence of acute kidney injury(AKI)in patients with sepsis is high,and the prognosis of patients with septic AKI is poor.The early diagnosis and treatment of septic AKI is of great significance in improving the prognosis of patients with sepsis.AIM To explore the value of contrast-enhanced ultrasound(CEUS),serum creatinine(Scr),and other indicators in the early diagnosis of septic AKI.METHODS Ninety patients with sepsis during hospitalization at Tongji Hospital of Tongji University were recruited as subjects.Each patient was recorded with relevant basic data,clinical indicators,and CEUS results.The patients were divided into AKI group and non-AKI group according to the results of renal function diagnosis after 48 h.On the 7th day,the renal function of the non-AKI group was re-evaluated and the patients were further divided into AKI subgroup and non-AKI subgroup.The differences of the indicators in different groups were compared,and the diagnostic value of each indicator and their combination for septic AKI was analyzed.RESULTS Systemic inflammatory response score(2.58±0.75),blood lactic acid(3.01±1.33 mmol/L),Scr(141.82±27.19μmol/L),blood urea nitrogen(4.41±0.81mmol/L),and rise time(10.23±2.63 s)in the AKI group were higher than those in the non-AKI group.Peak intensity(PI)(10.78±3.98 dB)and wash in slope(WIS)(1.07±0.53 dB/s)were lower than those in the non-AKI group.The differences were statistically significant(P<0.05).The PI(12.83±3.77 dB)and WIS(1.22±0.68 dB/s)in the AKI subgroup were lower than those in the non-AKI subgroup,and the differences were statistically significant(P<0.05).The area under curve(AUC)of Scr for the diagnosis of septic AKI was 0.825 with a sensitivity of 56.76% and a specificity of 100%.The AUCs of WIS and PI(0.928 and 0.912)were higher than those of Scr.Their sensitivities were 100%,but the specificities were 71.70% and 75.47%.The AUC of the combination of three indicators for the diagnosis of septic AKI was 0.943,which was significantly higher than the AUC diagnosed by each single indicator.The sensitivity was 94.59%,and the specificity was 81.13%.CONCLUSION The combination of Scr,PI,and WIS can improve the diagnostic accuracy of septic AKI.PI and WIS are expected to predict the occurrence of early septic AKI.
文摘AIM To analyze the incidence of hepatocellular carcinoma (HCC) in a population that underwent health checkups and had high serum miR-106b levels. METHODS A total of 335 subjects who underwent checkups in the Digestive and Liver Disease Department of our hospital were randomly selected. RT-PCR was used to detect the level of miR-106b in serum samples. Laboratory and imaging examinations were carried out to confirm the HCC diagnosis in patients who had a > 2-fold change in miR-106b levels. Ultrasound-guided biopsy was also used for HCC diagnosis when necessary. On this basis, the clinical data of these subjects, including history of hepatitis virus infection, obesity, long-term history of alcohol use and stage of HCC, were collected. Then, the impact of these factors on the level of miR1-06b in serum was analyzed. Furthermore, receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of miR-106b for HCC. RESULTS A total of 35 subjects had abnormal serum miR-106b levels, of which 20 subjects were diagnosed with HCC. t-test revealed that the difference in serum miR-106b level in terms of sex, age, history of hepatitis virus infection, obesity and long-term history of alcohol use was not statistically significant. However, serum miR-106b levels in patients with advanced HCC (stage. /.) was higher than in patients with early HCC (stage./.), and the difference was statistically significant (P = 0.000). Moreover, the ROC curve revealed that the area under the curve value for miR-106b was 0.885, which shows that serum miR-106b level has a certain clinical value for HCC diagnosis. CONCLUSION The random sampling survey shows that serum miR-106b level is a valuable diagnostic marker for HCC. However, the diagnostic threshold value needs to be further researched.
基金Supported by the National Science Fund or Foundation for Postdoctoral Fellows in China,No.2001.6the Medical Science Found of Shandong Province,No.1999CA2BJBA1.
文摘AIM: To determine the correlation between portal hemodynamics and spleen function among different grades of cirrhosis and verify its significance in cirrhosis staging.METHODS: The portal and splenic vein hemodynamics and spleen size were investigated by ultrasonography in consecutive 38 cirrhotic patients with cirrhosis (Child's grades A to C) and 20 normal controls. The differences were compared in portal vein diameter and flow velocity between patients with and without ascites and between patients with mild and severe esophageal varices. The correlation between peripheral blood cell counts and Child's grades was also determined.RESULTS: The portal flow velocity and volume were significantly lower in patients with Child's C (12.25±1.67 cm/s vs 788.59±234 mm/min, respectively) cirrhosis compared to controls (19.55±3.28 cm/s vs 1254.03±410 mm/min,respectively) and those with Child's A (18.5±3.02 cm/s vs1358.48±384 mm/min, respectively) and Child's B (16.0±3.89cm/s vs 1142.23±390 mm/min, respectively)cirrhosis.Patients with ascites had much lower portal flow velocity and volume (13.0±1.72 cm/s vs 1078±533 mm/min) than those without ascites (18.6±2.60 cm/s vs 1394±354 mm/min).There was no statistical difference between patients with mild and severe esophageal varices. The portal vein diameter was not significantly different among the above groups.There were significant differences in splenic vein diameter,flow velocity and white blood cell count, but not in spleen size, red blood cell and platelet counts among the various grades of cirrhosis. The spleen size was negatively correlated with red blood cell and platelet counts (r= -0.620and r = -0.8.34, respectively).CONCLUSION: An optimal system that includes parameters representing the portal hemodynamics and spleen function should be proposed for cirrhosis staging.
文摘BACKGROUND Gastric adenomyoma(GA)is a rare submucosal benign neoplasm that occurs mostly in the gastric antrum and is often misdiagnosed.No standard treatment has been established for this disease in cases of malignancy.CASE SUMMARY A 75-year-old woman with a 10-year history of hypertension was admitted to the Emergency Department of our hospital complaining of paroxysmal exacerbation of acute abdominal pain for 1 d with no apparent cause.Enhanced computed tomography and magnetic resonance imaging indicated a mass in the caudal pancreas,cholecystitis,and cholecystic polypus.Gastrointestinal endoscopy showed a mass arising from the gastric antrum.Due to the imaging findings,pancreatic cancer(PC),gastric lesion,cholecystitis,and cholecystic polypus were our primary consideration.Radical pancreatectomy,splenectomy,and cholecystectomy were performed successfully,and the gastric tumor was locally resected.Postoperative paraffin specimens confirmed the diagnosis of caudal PC,GA,and heterotopic pancreas(HP).Unfortunately,the patient died 13 mo later due to PC metastases to the liver,lung,and adrenal glands.CONCLUSION GA is a rare benign disease,especially when occurring with HP.It may stem from the same origin as HP.This is the first case report to date of a patient suffering from the simultaneous occurrence of GA,HP,and PC.GA is a lesion that can mimic other benign or malignant gastrointestinal diseases;thus,a definitive diagnosis depends on postoperative pathological biopsy.Although GA and HP are both benign lesions,they should be resected because there is a chance of malignancy.Additional research should be conducted to better understand these submucosal lesions.
文摘Objective: To investigate the significance of vascular endothelial growth factor (VEGF) in the pathogene- sis of liver cirrhosis and the correlation between VEGF and proto-oncogene c-fos and c-myc in cir- rhotic liver. Methods: The proteins of VEGF, c-fos, and c-myc were identified immunohistochemically in each tissue section of 53 cases of liver cirrhosis. The correlations between VEGF, c-fos and c-myc were analyzed. The levels of VEGF protein in different Child gradings were also compared. Results: The proteins of VEGF were more highly ex- pressed in Child A and B patients than in Child C patients and controls. The expressions of both c-fos and c-myc were not statistically significant between VEGF positive and negative patients. Conclusions: The protein level of VEGF can reflect the compensation status of cirrhosis patients and may act as an anti-cirrhotic factor. The proto-oncogene c- fos, c-myc and VEGF may have different mecha- nisms in the course of cirrhosis or hepatic tumorigen- esis.
