Partial splenic embolization using Bletilla striata particles for hypersplenism in cirrhosis: a prospective study.

The article evaluates the long-term follow-up results of PSE using Bletilla striata (BS) particles for hypersplenism in cirrhosis, as compared to PSE using gelfoam particles. Fifty-nine patients with cirrhosis-induced hypersplenism were treated with PSE. The patients were randomly assigned into two groups: gelfoam group, which includes 32 patients using gelfoam particles as the embolic material, and BS group, which includes 27 patients using BS particles. The peripheral blood cell counts and parameters for complications associated with PSE were measured during the follow-up. The mean values of leukocyte and thrombocyte, but not hemoglobin, were significantly increased after PSE (p < 0.01) in both groups. The values of leukocyte and thrombocyte during the long-term follow-up were significantly improved in BS group than that in gelfoam group (both p < 0.01). The frequency of bleeding episodes from esophageal varices in both groups was significantly reduced after PSE (both p < 0.01), but the post-PSE bleeding episodes showed no remarkable differences between the two groups (p = 0.084). Post-embolization syndrome consisted mainly of fever, nausea and vomiting, and abdominal pain in the two groups. The incidence of grade II to III abdominal pain in BS group (82.8%, 27/33) was significantly higher than in gelfoam group (57.9%, 33/57) (p = 0.020). The mean survival time was 61.5 ± 9.1 (median 60, 1-157) months in gelfoam group and 63.4 ± 9.9 (median 52, 0-161) months in BS group, which showed no significant difference (p = 0.930). In conclusion, BS particles could be used as the embolic material in PSE. Compared to gelfoam used in PSE, BS can achieve even better efficacy in alleviating hypersplenism. It provides a long-term effect on the hematological parameters, bleeding from esophageal varices and good palliation, and improved clinical status contributing to symptomatic control.

[Correlation of preoperative plasma levels of big endothelin-1 to prognosis of gastric carcinoma].

BACKGROUND & OBJECTIVE: Endothelin, a potent vasoconstrictor peptide, is involved in mitogenesis modulation, apoptosis, angiogenesis, tumor invasion and metastases. Big endothelin-1 (Big ET-1), the stable precursor of endothelin-1, is regarded as a marker of tumor progression and prognosis. This study was to detect the expression of Big ET-1 in gastric cancer patients, and explore its correlations to progression and prognosis of gastric cancer. METHODS: The plasma levels of Big ET-1 in 118 gastric cancer patients and 20 healthy subjects were detected by enzyme-linked immunosorbent assay (ELISA). The expression of Big ET-1 in primary tumor and para-cancerous gastric tissues of the 118 patients was detected by immunohistochemistry. RESULTS: The plasma level of Big ET-1 was significantly higher in patients with advanced gastric cancer than in patients with early stage gastric cancer and healthy subjects [(5.78+/-1.85) ng/L vs. (3.13+/-1.72) ng/L and (2.46+/-0.59) ng/L, P=0.026, P=0.008]. The plasma level of Big ET-1 was significantly higher in patients with lymph node metastases than in those without [(6.13+/-2.34) ng/L vs. (4.25+/-1.65) ng/L, P=0.006], and significantly higher in stage II, III, IV patients than in stage I patients. During follow-up, patients with high plasma levels of Big ET-1 had higher recurrence rate and lower 2-year survival rate as compared with those with low plasma levels of Big ET-1 (84.6% vs. 60.9%, P=0.034; 38.5% vs. 56.5%,P=0.017). The positive rate of Big ET-1 was significantly higher in stage II,III and IV patients than in stage I patients. CONCLUSION: The plasma level of Big ET-1 may play a vital role in the development, invasion and metastasis of gastric cancer, and may be a predictor of tumor disease severity and prognosis.

Pre- and post-operative plasma big endothelin-1 levels in patients with gastric carcinoma undergoing radical gastrectomy.

BACKGROUND: Big Endothelin-1 levels increase significantly in patients with various tumors, and raised plasma concentrations are associated with worse outcome. The aim of this study was to investigate plasma Big Endothelin-1 levels in patients with gastric carcinoma before and after radical gastrectomy and to explore its clinical significance. MATERIALS AND METHODS: One hundred and six patients with gastric carcinoma and 20 controls were studied. Big Endothelin-1 plasma levels in patients with advanced gastric cancer were examined by enzyme-linked immunosorbent assay before and on days 1, 3 and 10 after curative surgery and were then tested every 3 months. RESULTS: All patients, except those with stage I gastric cancer, had significantly higher mean plasma Big Endothelin-1 levels compared with the normal controls (p = 0.000). The plasma Big Endothelin-1 levels were markedly increased on the first post-operative day (1st POD) in all patients but decreased on the 3rd POD with no significant difference compared to the pre-operative levels. On the 10th POD, patients with stages I and II gastric cancer showed a marked reduction in the plasma Big Endothelin-1 levels (p=0.010 and p=0.000, respectively), whereas no significant difference was observed in stage III and IVpatients. During the follow-up, plasma Big Endothelin-1 levels immediately before recurrences occurred in stage II patients were significantly higher compared with the levels on the 10th POD (p=0.011). CONCLUSION: Plasma Big Endothelin-1 levels might be a reliable marker to determine the severity of gastric carcinoma. Monitoring plasma Big Endothelin-I levels after curative resection in stage II gastric cancer patients was valuable in predicting recurrences.

[Peripheral plasma Big endothelin 1 levels in patients with gastric carcinoma undergoing radical gastrectomy and its relationship with tumor recurrence].

OBJECTIVE: To investigate the plasma Big endothelin-1 levels in patients with gastric carcinoma before and after radical gastrectomy, and explore its clinical significance. METHODS: One hundred and six patients with gastric carcinoma and 20 controls were enrolled. The Big ET-1 plasma levels were examined by enzyme-linked immuno absorbent assay before and on the 1st, 3rd, and 10th day after curative surgery, and then were tested every 3 months in the patients with advanced gastric cancer. RESULTS: All patients, except those with stage I gastric cancer, had significantly higher mean plasma Big ET-1 levels compared with normal controls (P=0.000). Higher plasma Big ET-1 levels were associated with lymph node metastasis (P=0.020) and serosal infiltration (P=0.035). The plasma Big Endothelin-1 levels were markedly increased on the first post-operative day (1st POD) in all patients,but decreased on the 3rd POD with no significant difference compared to the preoperative levels. On the 10th POD, the patients with stage I and II gastric cancer showed marked reduction in plasma Big ET-1 levels (P=0.010 and P=0.000, respectively), whereas no significant difference was observed in stage III and IV patients. During the follow-up, the plasma Big ET-1 levels just before recurrence in stage II patients were significantly higher compared with the levels on the 10th POD (P=0.011). CONCLUSIONS: Plasma Big ET-1 might be a reliable marker to determine the severity of gastric carcinoma. Monitoring plasma Big ET-1 levels after curative resection in stage II gastric cancer patients is valuable to predict recurrence.

Effects of Ginkgo biloba extract on inflammatory mediators (SOD, MDA, TNF-alpha, NF-kappaBp65, IL-6) in TNBS-induced colitis in rats.

Inflammatory mediators play a critical role in ulcerative colitis immune and inflammatory processes. The aim of the study was to investigate the effects of Ginkgo biloba extract on inflammatory mediators (SOD, MDA, TNF-alpha, NF-kappaBp65, IL-6) in TNBS-induced colitis in rats. Colitis in rats was induced by colonic administration with 2,4,6-trinitrobenzene sulfonic acid (TNBS, 150 mg/kg). EGB in doses of (50, 100, 200 mg/kg) was administered for 4 weeks to protect colitis. The results showed that EGB could significantly ameliorate macroscopic and histological damage, evidently elevate the activities of SOD and reduce the contents of MDA, inhibit the protein and mRNA expressions of TNF-alpha, NF-kappaBp65, and IL-6 in the colon tissues of experimental colitis in a dose-dependent manner compared with the model group. We concluded that the probable mechanisms of EGB ameliorated inflammatory injury in TNBS-induced colitis in rats by its modulation of inflammatory mediators and antioxidation.