目的:探討內鏡下氬離子凝固術(APC)聯合抑酸治療對Barrett食管的臨床療效。方法:選擇經內鏡及病理確診的Barrett食管患者40例,隨機分為兩組,治療組21例,對照組19例,治療組經內鏡下APC治療后聯合埃索美拉唑20mg 2次/日連續3月,對照組單用埃索美拉唑20mg 2次/日連續3月,分別于3月、6月、12月對兩組進行臨床癥狀積分和內鏡及病理隨訪。結果:兩組治療后3、6、12月臨床癥狀積分緩解無明顯差異性(Plt;0.05),但從內鏡、病理隨訪的有效率來看,治療組與對照組相比有顯著差異性(Plt;0.05)。結論:BE內鏡下APC聯合抑酸治療能有效逆轉Barrett上皮,是一種安全、有效的治療方法。
Objective To investigate the effects of DNA methyltransferase inhibitor (DNMTi) and histone deacetylase inhibitor (HDCAi) on expression of E-cadherin gene and invasiveness of cholangiocarcinoma cell. Methods According to different treatment, the QBC939 cells were divided into four groups: blank control group, hydralazine group, valproic acid group and hydralazine and valproic acid combined group. After 48 h, the expression of E-cadherin was evaluated by reverse transcription-PCR (RT-PCR), mehtylation specific PCR (MSP) and Western blot, the invasiveness of QBC939 cells was evaluated by Transwell method. Results There was no expression of E-cadherin mRNA and protien in blank control group and valproic acid group. The expressions of E-cadherin mRNA and protien in hydralazine and valproic acid combined group were higher than those in hydralazine group ( P ＜ 0.01), while the invasiveness of QBC939 cells of hydralazine and valproic acid combined group was much lower than that of blank control group, hydralazine group and valproic acid group ( P ＜ 0.01). Conclusion DNMTi and HDACi can synergistically re-express E-cadherin gene and weaken the invasiveness of QBC939 cell, which plays an important part in treatment of cholangiocarcinoma.
Helicobacter pylori (HP) infection is common worldwide, and the first-line eradication regimen recommended by domestic and foreign guidelines faces many challenges in practical application. In order to further improve the HP eradication rate and patient compliance, problems such as increased antibiotic resistance, a wide variety of drugs, and obvious drug side effects need to be solved urgently. In recent years, high-dose dual therapy of amoxicillin combined with proton pump inhibitor have achieved good eradication effect in the treatment of HP infection. This article reviews the action mechanism, safety and therapeutic effect of high-dose dual therapy, aiming to provide a reference for clinical diagnosis and treatment.
ObjectiveTo investigate the trend of serum bilirubin in patients with liver cirrhosis before and after transjugular intrahepatic portosystemic shunt (TIPS).MethodsThe data of patients with cirrhotic portal hypertension who underwent TIPS between October 2016 and June 2018 were collected retrospectively, including liver function before and after surgery (1 week, 1 month, 3 months, and 6 months after surgery), preoperative and postoperative portal vein pressure, and the Child-Pugh scores, model for end-stage liver disease (MELD) scores, and albumin-bilirubin (ALBI) scores. Paired t-test was used for the statistical measurement data. The total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) levels at five time points were analyzed by analysis of variance of repeated measurement data with its own before and after comparison, and Wilcoxon signed ranks test was used for the ordered data.ResultsA total of 60 patients were included.The portal vein pressure was (27.86±2.53) mm Hg (1 mm Hg=0.133 kPa) before TIPS and (17.22±2.33) mm Hg after TIPS, and the difference was statistically significant (P<0.05). The common logarithm of the serum TBIL level [lg(TBIL)] before surgery and 1 week, 1 month, 3 months, and 6 months after surgery were (1.27±0.23), (1.44±0.21), (1.51±0.20), (1.56±0.22), (1.48±0.19) lg(μmol/L), respectively, and the difference was statistically significant (P<0.001). The common logarithm of the serum DBIL level [lg(DBIL)] at the five time periods were (0.90±0.26), (1.14±0.24), (1.18±0.25), (1.21±0.28), (1.08±0.21) lg(μmol/L), respectively, and the difference was statistically significant (P<0.001). The common logarithm of the serum IBIL level [lg(IBIL)] at the five time periods were (1.00±0.23), (1.13±0.22), (1.20±0.23), (1.26±0.21), (1.22±0.23) lg(μmol/L), respectively, and the difference was statistically significant (P<0.001). There were no statistically significant differences in the three liver reserve function scores (Child-Pugh, MELD, and ALBI, respectively) before and six months after operation (P>0.05). The differences in the composition of Child-Pugh and ALBI before and after surgery were not statistically significant (P>0.05).ConclusionsTIPS has a significant effect on reducing portal hypertension. Serum bilirubin levels continue to increase during a period after TIPS, but begin to decrease within 6 months.
【摘要】 目的 探討膠囊內鏡對小腸疾病的診斷價值及順應性和安全性。 方法 分析2009年4月-2010年3月對35例疑有小腸疾病者行膠囊內鏡檢查的臨床資料。 結果 35例中發現小腸病變26例 （74.3%），包括血管畸形9例，間質瘤1例，息肉2例，小潰瘍 1例，非特異性炎癥 11例，寄生蟲2例，其中 4例患者同時存在兩種病變。所獲取的圖像質量良好。膠囊胃內運行平均時間為 62 min（5～460 min），小腸運行時間為 347 min（103～538 min），平均到達盲腸時間為384 min （120～540 min），平均記錄時間為547 min（299～605 min），平均獲取照片數為54 766張，膠囊排出體外時間平均為33 h（10～120 h）。受檢者順應性良好，無任何并發癥發生。 結論 膠囊內鏡是一種對小腸疾病具有較高的檢出能力；其安全性高、順應性好 。【Abstract】 Objective To investigate the diagnostic value of capsule endoscope for small intestine diseases, and to evaluate the compliance and security of capsule endoscopy. Methods The clinical data of 35 patients who underwent capsule endoscopy due to small bowel diseases between April 2009 and March 2010 were retrospectively analyzed. Results In the 35 patients, 26 (74.3%) had intestine diseases including vascular malformation in nine, interstitialoma in one, polyp in two, aphtha in one, non-specific inflammation in 11 and parasite in two; 4 patients had two lesions simultaneously. The quality of the obtained images was good. The average running time of the capsules in the stomach ranged from five to 460 minutes with an average time of 62 minutes. The running time of the capsules in the small intestine ranged from 103 to 538 minutes with an average of 347 minutes. The running time of the capsules arriving at the cecum ranged from 103 to 538 minutes with an average of 347 minutes. The time of the capsules egested out ranged from 10 to 120 hours with an average of 33 hours. The recording time ranged from 299 to 605 minuets with an average of 547 minutes. The mean acquired images were 54 766 pieces, The patients had good compliance, and none had any complications. Conclusion The capsule endoscopy had high security and good compliance. It has high detectivity in diagnosing small intestine diseases.
Objective To evaluate the efficacy and safety of high-dose dual therapy (HDDT) in the treatment of Helicobacter pylori (HP) infection. Methods The clinical data of patients with HP infection who were treated in Suining Central Hospital between June 2020 and August 2021 were retrospectively collected. They were divided into HDDT group and bismuth-containing quadruple therapy (BQT) group according to the treatment regimen. The efficacy and adverse reactions of the two treatment regimens were observed. Results A total of 520 patients were included. Among them, there were 284 cases in the HDDT group and 236 cases in the BQT group. By propensity score matching, 223 pairs of patients were successfully matched. The eradication rates of HDDT and BQT were 74.4% and 77.1%, respectively (χ2=0.440, P=0.507), and the incidence of adverse reactions were 9.9% and 16.6%, respectively (χ2=4.395, P=0.036). Conclusion The efficacy of HDDT and BQT in the treatment of HP infection is comparable, but the former has fewer adverse reactions.
Objective To investigate the gastrin level in patients with type 2 diabetes mellitus (T2DM) with gastroesophageal reflux disease (GERD), and analyze the possible mechanism of gastrin in the pathogenesis of T2DM combined with GERD. Methods Thirty-eight patients with T2DM combined with GERD treated between January 2013 and January 2015 were designated as group A; 40 patients with T2DM only were regarded as group B; 36 patients with GERD only were regarded as group C; and another 40 healthy volunteers who underwent physical examination at the same period were regarded as group D. The fasting serum levels of gastrin were measured and compared among the above four groups. Results The fasting serum level of gastrin was significantly higher in group A [(116.53±22.02) pg/mL] than group B [(101.89±20.76) pg/mL], group C [(90.04±21.16) pg/mL], and group D [(92.48±19.69) pg/mL] (P<0.01). The fasting serum level of gastrin in group B was significantly higher than group C and D (P<0.05). There was no significant difference between group C and D in terms of fasting serum level of gastrin (P>0.05). Conclusions There is a high level of gastrin in patients with GERD combined with T2DM. Abnormal secretion of gastrin may be closely related with the occurrence and development of T2DM and GERD.
Objective To investigate the technique and feasibility of hepatic pedicle vascular control in laparoscopic hepatectomy. Methods From May 2005 to June 2011, 95 cases of hepatectomies were performed by laparoscopy in the Department of Minimally Invasive Surgery, The First Affiliated Hospital, Guangxi Medical University.The characteristics of these cases were analyzed. Results Left lateral segmentectomy were required in 21 patients, left hepatectomy in 13 patients, right hepatectomy in 4 patients, segmentectomy in 17 patients, tumor resection in 24 patients,hemangioma resection in 5 patients, and conversions to laparotomy in 11 patients. The intermittent Pringle maneuver were performed in 39 patients. The mean vascular clamping time in Pringle maneuver was （30.84±9.51） min. The selective vascular control of inflow were performed in 56 patients， the technique included intrahepatic Glisson approach in 14 patients and controlling hepatic artery and portal vein separately in 42 patients. Pre-parenchymal transection control of hepatic outflow were performed in 12 patients, included the left hepatic vein were controlled by suturing or separating in 11 patients and right hepatic vein was controlled by separating in 1 patient. Others were controlled intraparenchymally during transection. The mean operative time was （236.80±95.97） min，mean operative blood loss was（ 551.55±497.41） ml， concentrate red blood cells transfusion volume was（ 2.60±2.23） U， and plasma transfusion volume was （211.90±179.29） ml. The postoperative complications included bleeding in 4 patients, pleural effusion in 4 patients, pneumonia in 3 patients, ascites in 7 patients, and biliary fistula in 2 patients, and dead in 1 patient. The mean hospitalization time was（ 12.47±4.18） days. At the deadline（ February 2012）, 72 cases with liver cancer were followup. The follow-up time ranged from 5 to 81 months and the mean time was（ 24.14±16.62） months， where survival rate was 68.4%（ 54/79） of 1-year and 21.5%（ 17/79） of 3-year. Conclusions The application of hepatic pedicle vascular control in laparoscopic hepatectomy is feasible.