ABSTRACT
Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed. Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.
ABSTRACT
Objective To summarize the diagnosis and treatment experience of portal vein aneurysm after liver transplantation. Methods Clinical data of two recipients with portal vein aneurysm after liver transplantation were retrospectively analyzed. Clinical features, diagnosis, treatment and prognosis were summarized based on literature review. Results Both two cases were diagnosed with intrahepatic portal vein aneurysm complicated with portal vein thrombosis and portal hypertension after liver transplantation. Case 1 was given with targeted conservative treatment and he refused to undergo liver retransplantation. Physical condition was worsened after discharge, and the patient eventually died from liver graft failure, kidney failure, lung infection, and septic shock. Case 2 received high-dose glucocorticoid pulse therapy, whereas liver function was not improved, and the patient was recovered successfully after secondary liver transplantation. Conclusions Long-term complication of portal vein aneurysm (especially intrahepatic type) after liver transplantation probably indicates poor prognosis. Correct understanding, intimate follow-up and active treatment should be conducted. Liver retransplantation may be a potential treatment regimen.
ABSTRACT
Immune checkpoint inhibitors (ICIs) have ushered in a new era of tumor treatment; however, immunotherapy-related adverse events are critical issues that restrict the clinical application of ICIs and have attracted wide attention. The liver is one of the target organs that is easily affected. With the progress in research, scholars have found that besides hepatocytes, intrahepatic and extrahepatic bile ducts can also be attacked by the immune system, leading to the disease known as immune-related cholangitis. This article reviews the research advances in ICI-related cholangitis by summarizing related articles, in order to preliminarily reveal its clinical, pathological, and imaging features and provide clues for early identification, standard treatment, and subsequent research.
ABSTRACT
Ischemia-reperfusion injury is one of the main causes of complications related to liver transplantation, hepatectomy, trauma and hemorrhagic shock. The cells of ischemia and hypoxic injury release of injury-related molecular patterns, lead to the activation of immune cells and cytokine, which further aggravates the inflammatory response and enlarges the injury. It’s indicated that injury-related molecular patterns, liver resident immune cells and cytokines play a key role in promoting inflammation and liver ischemia-reperfusion injury. However, recent studies suggested that the ischemia cells and cytokines played acomplex role in this process. Relevant progresses were reviewed in this article.
ABSTRACT
Ischemia-reperfusion injury is one of the main causes of complications related to liver transplantation, hepatectomy, trauma and hemorrhagic shock. The cells of ischemia and hypoxic injury release of injury-related molecular patterns, lead to the activation of immune cells and cytokine, which further aggravates the inflammatory response and enlarges the injury. It ' s indicated that injury-related molecular patterns, liver resident immune cells and cytokines play a key role in promoting inflammation and liver ischemia-reperfusion injury. However, recent studies suggested that the ischemia cells and cytokines played acomplex role in this process. Relevant progresses were reviewed in this article.
ABSTRACT
Objective To investigate effects of interleukin-35 (IL-35) on proliferation,invasion and migration of a HepG2 cell line in vitro.Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine peripheral blood expression levels of IL-35 in hepatocellular carcinoma patients and in normal healthy subjects.The effects of exogenous IL-35 on cell proliferation activity of HepG2 in vitro were measured using CCK-8 assay.The transwell invasion and scratch test were used to study the invasive and migration abilities.Results The content of IL-35 protein in hepatocellular carcinoma patients (HCC) was significantly higher than in healthy individuals [(118.45 ±28.66) ng/L vs (39.56 ± 11.15) ng/L,P ＜0.05].Exogenous IL-35 significantly promoted proliferation,invasion and migration abilities of HepG2 cells in vitro (P ＜ 0.05).Conclusions The level of IL-35 was elevated significantly in hepatocellular carcinoma patients.IL-35 had biological characteristics of promoting HCC cell proliferation,invasion and migration.
ABSTRACT
Objective To study and correlate serum bilirubin and regulatory T cell (Treg) levels in patients with bile duct stone.Methods Flow-cytometry and Enzyme-linked immunosorbent assay (Elisa) were used to study the peripheral blood expression level of Tregs and the bilirubin level in 27 patients with bile duct stones and jaundice.The changes in the expression level of Tregs and the bilirubin level were studied and correlated before and after treatment.Results After treatment,both the peripheral blood bilirubin level,the Tregs expression level and the cell cytokines decreased significantly.The total bilirubin level decreased from (102.8 ± 33.1) mmol/L to (15.3 ± 5.7) mmol/L (P ＜ 0.05),the direct bilirubin level decreased from (38.1 ± 12.8) mmol/L to (5.0 ± 1.6) mmol/L (P ＜0.05);the percentages of CD4+ CD25 +Foxp3 + T cells in CD4+ T decreased from (4.2 ± 2.0) ％ to (2.4 ± 1.0) ％ (P ＜ 0.05).Before treatment,the levels of IL-10 and TGF-β were 171.4 ± 13.7 and 2016 ±657 pg/ml but after treatment,the two cytokines decreased to 92.1 ± 7.4 and 1 686 ± 168 pg/ml,respectively (P ＜ 0.05).Conclusions Patients with bile duct stones and jaundice presented with high expressions of bilirubin and Tregs level.These expressions returned to normal after effective treatment.The Tregs expression level was positively correlated with the bilirubin level.
ABSTRACT
Objective To investigate the expressions of regulatory T cell (Treg) and interleukin-35 (IL-35) in patients with cholangiocarcinoma and to explore their clinical significance.Methods Flow-cytometry,PCR,Enzyme-linked immunosorbent assay (Elisa) and immunohistochemistry were used to detect the levels of Treg and IL-35 in peripheral blood and cholangiocarcinoma tissues in 42 patients with cholangiocarcinoma.Healthy volunteers were used as a control group.Result The percentage of Treg cells to CD4 + T cells in patients with cholangiocarcinoma was (5.6 ± 1.7) ％,while that in the normal control group was (2.9 ± 0.8) ％.There was a significant difference between the two groups (P ＜ 0.05).The plasma levels of IL-35 in patients with cholangiocarcinoma was (198.4 ± 81.4) pg/ml,while that in the normal control group was (33.7 ± 18.0) pg/ml.Again,a significant difference was observed between the two groups (P ＜ 0.05).In peripheral blood mononuclear cell,the IL-35 mRNA level was positively correlated with the plasma IL-35 level (p35,R =0.795,P ＜0.05;EBI3,R =0.812,P ＜ 0.05).Immunohistochemical studies showed that FOXP3 + tumor cells and Treg cells increased significantly in tumor tissues.Conclusion Overexpressions of Treg and IL-35 in peripheral blood and tumor tissues of patients with cholangiocarcinoma suggested that they may play important roles in the development of cholangiocarcinoma.
ABSTRACT
Objective To investigate the effects and safety of needle?knife precut papillotomy in diffi?cult common bile duct cannulation of endoscopic retrograde pancreatic duct radiography ( ERCP ) . Methods The data of 104 cases treated with needle?knife precut papillotomy were retrospectively analyzed. The effect of pre incision and short?term complications were observed,and compared with 1326 cases( conventional group) of con?ventional selective intubation in the same period of ERCP. Results Successful cannulation of the bile duct was achieved in 97 of 104 patients who underwent needle?knife precut papillotomy, the total success rate was a?chieved in 93. 3%. The complications of needle?knife precut papillotomy occurred in 8 patients(7. 7%),inclu?ding mild bleeding in 4 cases,mild pancreatitis in 2 cases and billiary infection in 2 cases. There were 1326 ca?ses conventional selective intubation in the same period of ERCP,and 98 cases(7. 4%) with complication. There was no significant difference in the incidence of complications between the needle knife cut group and the con?ventional selective intubation group(χ2=0. 055,P>0. 05 ) . Conclusion In case of difficult common bile duct cannulation of ERCP,needle?knife precut sphincterotomy surgery can be safely and effectively catch the high ?ERCP the success of treatment,is worthy of wider application.
ABSTRACT
Objective To investigate causes and treatment approaches for postoperative complications after laparoscopic adjustable gastric banding(LAGB).Methods Clinical and follow-up data of 302 cases were reviewed.The body mass index (BMI),percent excess weight loss (％ EWL),operation time,intraoperative blood loss,the incidence of complications and management were analyzed and summarized.Results There were no conversion to open surgery.The overall complication rate was 6.29％ including 2 cases of gastric wall injury,5 cases of gastric banding slippage (recovered by reoperation).There was no gastric parietal banding corrosion,tube bursting leakage,pulmonary embolism,micronutrient deficiencies,nor mortality.Conclusions The majority of patients were satisfied with the operation effect,still,there were substantial postoperative complications including gastric wall injury,gastric banding slippage.