An improved method of nasojejunal feeding tube placement for patients requiring endoscopic nasobiliary drainage.

OBJECTIVE: To avoid a second endoscopy for nasojejunal feeding tube placement (NFTP) in patients undergoing endoscopic nasobiliary drainage (ENBD), we studied improved NFTP method and compared it to endoscopic method. METHODS: Patients with ENBD were divided into two groups. One group (18 patients) received endoscopic NFTP and the other group (26 patients) received improved NFTP. Placement time, physical condition of the patients and complications were recorded. RESULTS: In 18 patients who underwent endoscopic NFTP, NFT was successfully placed on the first attempt in 14 patients with a first placement success rate of 77.8%. NFT was wrongly intubated into the trachea in one patient inducing coughing, and after it was removed, the second placement was successful. The total success rate of endoscopic NFTP was 83.3% with an average placement time of 17.0 minutes. In 26 patients undergoing improved NFTP, all were successfully placed on the first attempt with a success rate of 100%, and an average placement time of 2.55 minutes. In patients with ENBD, the success rate of improved NFTP was significantly higher than endoscopic NFTP (χ²=36.4, p<0.05) with a significantly shorter placement time (t=18.5, p<0.05). CONCLUSION: For patients with ENBD, improved NFTP method is superior to the endoscopic method as it is more effective, convenient, faster, and cheaper. Additionally it avoids a second endoscopy and has fewer complications, better security and a higher success rate. The improved method is a safer, easier, more effective and practical method of EN and deserves general adoption in clinical work.

[Effects of neurotrophin 3 on interdigestive migrating motor complex in rats with acute liver injury.].

OBJECTIVE: To observe the effects of neurotrophin 3(NT-3)on interdigestive migrating motor complex (MMC) in rats with D-galactosamine induced acute liver injury. METHODS: Twenty-four specific pathogen-free purebred rats were equally randomized into control and acute liver injury groups. The control group was injected with equal volume of normal saline via tail vein. Acute liver injury model of the rats was induced by D-galactosamine injection via the tail vein in the acute liver injury group. And the indexes of interdigestive MMC before and after NT-3 injection were recorded by a polygraph and analyzed in model group. The serum NT-3 concentration was assayed in the two groups. RESULTS: There were no significant changes of gastrointestinal MMC cycle and jejunal phase I MMC after NT-3 injection. Compared with the acute liver injury rats before NT-3 injection , the antral phases I, III and IV MMC were significantly prolonged [(577.44 ± 248.60)s vs (343.58 ± 227.30) s, (80.94 ± 21.15) s vs (24.76 ± 7.41) s, (405.69 ± 131.34) s vs (191.67 ± 128.15) s, P < 0.05] and the phase II MMC was shortened [ (883.94 ± 488.50) s vs (1519.00 ± 831.14) s, P < 0.05] in the acute liver injury group. The duodenal phases I, III and IV MMC were significantly prolonged [ (557.63 ± 335.14) s vs (309.46 ± 220.22) s,(75.91 ± 15.75) s vs (31.15 ± 13.67) s, (423.38 ± 135.22) s vs (209.77 ± 123.83) s, P < 0.05] and MMC II phase was shortened [ (748.81 ± 579.69) s vs (1535.86 ± 930.50) s, P < 0.05] in the acute liver injury rats. In addition, the jejunal MMC III and MMC IV phase was significantly prolonged [ (86.58 ± 23.40) s vs (31.41 ± 16.09) s,(385.18 ± 110.02) s vs (220.59 ± 159.30) s, P < 0.05] and phase II MMC was shortened [ (876.89 ± 652.01) s vs (1870.89 ± 1010.35) s, P < 0.05 ] in the acute liver injury rats. The serum NT-3 level was significantly higher in model group than in control group. CONCLUSION: NT-3 could enhance the gastrointestinal motility in acute liver injury rats.

beta-catenin siRNA regulation of apoptosis- and angiogenesis-related gene expression in hepatocellular carcinoma cells: potential uses for gene therapy.

The molecular mechanism responsible for hepatocellular carcinoma (HCC) development remains to be defined although a number of gene pathways have been shown to play an active role, such as Wnt/beta-catenin signaling. In this study, beta-catenin small interfering RNA (siRNA) was designed, synthesized, and transfected into HCC HepG2 cells. RT-PCR and western blot assays were performed to detect expression of altered genes and proteins, and the MTT assay was used to detect cell viability. Our data showed that beta-catenin mRNA and protein expression levels were effectively knocked down by beta-catenin siRNA and subsequently, tumor cell proliferation was significantly suppressed. Flow cytometry assay showed that tumor cells were arrested at the G0/G1 phase of the cell cycles. Molecularly, expression of Smad3, p-caspase-3, and Grp78 protein were upregulated after 72 h of beta-catenin siRNA transfection, whereas expression of TERT, caspase-3, XIAP, MMP-2, MMP-9, VEGF-A, VEGF-c, and bFGF protein were reduced. However, there was no change between the expression of STAT3 and the HSP27 protein following transfection. The results from the current study demonstrated the importance of the Wnt/beta-catenin signaling pathway in regulation of gene expression in HCC. Further studies are required to investigate the role of this pathway in HCC development and targeting of this pathway to control HCC.