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Autoimmune hepatitis (AIH) is an immune-mediated inflammatory disease of the liver parenchyma, which is characterized by hypergammaglobulinemia, the presence of autoantibodies, and typical abnormalities in liver histology; however, the diverse clinical manifestations of AIH and the lack of specific serological markers have brought difficulties and challenges in the diagnosis of AIH. Although portal lymphoplasmacytic infiltration, interface hepatitis, lymphocyte emperipolesis, and hepatocyte rosettes are the typical histological features of AIH, many other histological features can also be observed in AIH, including centrilobular necrosis and Kupffer cell hyaline globules. Therefore, no single histological feature can be used for the diagnosis of AIH, and a confirmed diagnosis should be made with reference to clinical and laboratory examinations, with the exclusion of liver diseases due to other causes. This article summarizes the histological features of AIH, different histopathological spectrum, common clinical issues, differential diagnosis, and recent advances.
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Non-small cell lung cancer (NSCLC) is the most important histological type of lung cancer. This disease affects a large number of patients, and the prognosis of advanced patients is poor. Although great progress has been achieved for existing treatment methods, challenges still exist. Cancer is a genetic disease, and its occurrence is accompanied by substantial genomic-sequence instability. (GT/CA)n repeat sequence is a common microsatellite sequence serving as transcriptional function-related regions, DNA-methylation modification sites, and other functional sites. Its polymorphism is closely related to the expression of EGFR, HO-1, and HIF-1α in NSCLC patients. (GT/CA)n repeat sequence is the breakthrough point to explore the molecular mechanism of NSCLC occurrence and development, develop molecular markers for diagnosis and prognosis and epigenetics research. This paper summarizes the studies on (GT/CA)n repeat polymorphisms in NSCLC with the aim of providing references for relevant NSCLC research.
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BACKGROUND:A previous study by our group found that protein phosphatase 2Cm(PP2Cm)null mice developed significantly fewer symptoms of renal failure relative to wild-type mice,and thus it was speculated that PP2Cm may play an important protective role in the development of renal fibrosis,however,the molecular mechanisms remain undefined. OBJECTIVE:To investigate the effect of the PP2Cm gene on the transcriptome of human renal tubular epithelial cells. METHODS:Cultured human renal tubular epithelial cells were transfected with the PP2Cm gene into human renal tubular epithelial cells using plasmids.The expression of PP2Cm in the cells was detected by fluorescence quantitative PCR assay and western blot assay,and subsequently,cell RNA was separately extracted for transcriptome sequencing to look for differentially expressed genes between transfected and control groups.The resulting differential genes were further subjected to GO analysis and KEGG analysis using bioinformatics methods. RESULTS AND CONCLUSION:There were 796 differentially expressed genes,553 of which were downregulated genes and 243 upregulated genes,in human renal tubular epithelial cells transfected with the PP2Cm gene compared with untransfected blank cells by sequencing analysis.GO analysis results showed that the upregulated genes were significantly enriched in cellular biosynthetic processes,protein translation,intrinsic apoptotic signaling pathways,and so on.The downregulated expressed genes were significantly enriched in endothelial cell proliferation,cell adhesion and other signaling pathways.KEGG analysis results showed that the significantly up-regulated genes were enriched in metabolism-related signaling pathways such as amino acid metabolism and biosynthesis.The downregulated expressed genes were significantly enriched in signaling pathways such as pantothenate and coenzyme A biosynthesis.Our results show that PP2Cm overexpression can affect a number of signaling pathways related to a range of biological processes in renal tubular epithelial cells,which may be important in metabolism-related signaling pathways such as amino acid metabolism and biosynthesis.
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Objective@#To understand the status of childcare center disinfection around the COVID-19 pandemic, the needs of professional technical support, so as to give advice for improvement measures.@*Methods@#Using multi stage stratified sampling method, one was selected from each area of northern and southern Anhui Province, with 3 counties/districts selected from each city. A total of 54, 58, 60 childcare institutions were selected. A questionnaire survey, as well as on site visits and data check were administered in these childcare centers in Anhui Province were implemented. Information regarding the three stage disinfection work from 2019 to 2022 and technical support needs were collected.@*Results@#A total of 54, 58, 60 childcare centers were investigated in 2019, 2020 and 2021-2022. Most of the childcare centers recorded disinfection work (96.3%, 96.6%, 98.3%), while few of them ( 26.4% , 26.3%, 58.3%) monitored disinfection factor intensity. The implementing rate of disinfection effect evaluation was 68.3% at the stage of normal prevention and control, the highest demand rate for professional technical support was guidance and training ( 95.0% ), and the highest demand rate for training content was disinfectant preparation method (81.7%). There were significant differences in the rate of disinfection tableware room allocation (A: 93.3%, B: 70.0%), and the rate of disinfection effect evaluation among different cities (A: 53.3%, B: 83.3%)( χ 2=6.24, 5.46, P <0.05).@*Conclusions@#From 2019 to 2022, childcare center disinfection has significantly improved, however, disinfection factor intensity monitoring and disinfection effect evaluation are neglected during the stage of normal prevention and control. The demand for professional technical institutions to provide disinfectant preparation method guidance and training is high.It is suggested to strengthen the monitoring and evaluation of disinfection and related technical guidance.
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Objective:To advance the understanding of X-linked adrenal hypoplasia congenita(XL-AHC)through genetic analysis.Methods:Genomic DNA was extracted from peripheral blood of three patients with XL-AHC and their family members as well. Pathogenic genes were screened with whole exome sequencing followed by Sanger sequencing and pedigree verification.Results:All three probands were diagnosed as primary adrenal insufficiency at early age and developed hypogonadotropic hypogonadism in adolescence. The proband 1 was hemizygous for c. 420delG(p.R141Gfs*123)mutation in exon 1 of NR0B1 gene. His mother was a heterozygous mutation carrier while his brother did not carry the mutation, which was consistent with the X-linked recessive inheritance. A hemizygous mutation c. 212_213delAA(p.K71Rfs*41)of NR0B1 gene was detected in both proband 2 and proband 3. These two novel mutations were not reported in HGMD database.Conclusions:In this study, two novel NR0B1 mutations, c. 420delG and c. 212_213delAA were identified in 3 patients with XL-AHC. For men with early onset of adrenocortical hypofunction, XL-AHC should be considered. Early genetic screening of NR0B1 gene is helpful for early diagnosis.
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Oral cancer is a common head and neck malignant tumor. Its molecular mechanism of pathogenesis is complex and needs further exploration. Non-coding RNAs account for more than 95% of human transcripts and include microRNAs, lncRNAs, and circRNAs. They are an important entry point for research on molecular mechanism of oral cancer. Non-coding RNAs and protein-coding genes constitute a complex regulatory system involved in the regulation of physiological and pathological processes. This review summarizes articles about oral cancer-related non-coding RNAs and presents valuable information from the perspectives of microRNA, lncRNA, and circRNA.
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This article aims to review the clinical efficacy of existing non-pharmacological therapies for post-stroke depression (PSD), in order to provide references for the comprehensive treatment of PSD. As a common complication of stroke, PSD seriously affects patients' rehabilitation and daily life, and brings a heavy burden to patients and their families. Non-pharmacological therapy is an important intervention approach for PSD. Therefore, this article gives a review on the non-pharmacological therapies for PSD including psychotherapy and physical therapy.
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Background: Fucosyltransferase 2 (FUT2) and FUT3 specifically catalyze the biosynthesis of human histo-blood group antigens, and has been demonstrated to be closely related to inflammatory bowel disease (IBD). However, there are few clinical studies focusing on FUT2, FUT3 and IBD. Aims: To investigate the expressions of FUT2 and FUT3 in intestinal mucosa of IBD patients with various clinical characteristics and their clinical relevance. Methods: Patients initially diagnosed as active IBD in the Affiliated Hospital of Hangzhou Normal University from January 2019 to December 2020 were recruited consecutively. Endoscopic biopsy specimens prior to the initiation of treatment were collected to assess the expressions of FUT2 and FUT3 immunohistochemically. Correlations of FUT2, FUT3 with the clinical characteristics and inflammatory indicators were analyzed. Results: Seventy cases of ulcerative colitis (UC), 37 Crohn's disease (CD), and 66 healthy subjects were enrolled. The positivity rate and relative expression level of FUT2 were decreased, while those of FUT3 were increased in CD group than in control group (all P0.05). But moderate positive correlations were found between FUT3 expression and the serum C-reactive protein and fecal calprotectin (r=0.259, P=0.007; r=0.388, P=0.001). Conclusions: FUT2 and FUT3 might be used as indicators for the assistant diagnosis of IBD and assessment of drug therapy response.
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ObjectiveTo investigate the expression of phosphoinositide 3-kinase (PI3K), mammalian target of rapamycin (mTOR), 70-kDa ribosomal protein S6 kinase (p70S6K), and interferon-α (IFNα) in umbilical cord blood plasmacytoid dendritic cells (pDCs) in parturients in the immune tolerance stage of hepatitis B virus (HBV) infection versus normal parturients. MethodsA total of 20 parturients in the immune tolerance stage of HBV infection and 10 normal parturients who were hospitalized in Inpatient Department of Obstetrics in The First Affiliated Hospital of Hunan University of Chinese Medicine from October 2017 to January 2020 were enrolled as hepatitis B group and normal group, respectively. Umbilical cord blood pDCs were isolated and cultured, and CpG-A was added on day 7. The cells and the supernatant were collected after 24 hours; real-time PCR was used to measure the mRNA expression of PI3K, mTOR, and p70S6K, Western Blot was used to measure the protein expression of PI3K, mTOR, and p70S6K, and ELISA was used to measure the level of IFNα in the supernatant of pDCs. The two-independent-samples t-test was used for comparison of continuous data between the two groups. ResultsCompared with the normal group, the hepatitis B group had significantly lower mRNA and protein expression of PI3K, mTOR, and p70S6K in umbilical cord blood pDCs (mRNA expression: t=-81.04, -63.07, and -34.55, all P<0.001; protein expression: t=-8.13, -7.75, and -6.71, all P<0.001). The hepatitis B group had significantly lower expression of IFNα in the supernatant of umbilical cord blood pDCs than the normal group (t=-15.88, P<0.05). ConclusionParturients in the immune tolerance stage of HBV infection have reductions in the mRNA and protein expression of PI3K, mTOR, and p70S6K and the level of IFNα in umbilical cord blood pDCs, suggesting that pDC function is inhibited.
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Objective To assess the efficacy and safety of post operative adjuvant concurrent chemoradiotherapy for patients with high-risk salivary gland tumors (SGT).Methods Fifty-two patients with moderate or high malignant pathological stage complicated with locally advanced stage Ⅲ/ⅣA±positive margin/close margin admitted to Shanghai Ninth People's Hospital from 2016 to 2018 were enrolled in this study.Among them,35 patients were male and 17 female with a median age of 55.5 years old (range:21-73 years old).All 52 patients were treated with intensity-modulated radiotherapy and concurrent chemotherapy.Patients with adeno carcinoma of the salivary gland receives concurrent chemotherapy with TP regimen.Patients with lympho epithelial cancer and squamous cell carcinoma were treated with cisplatin regimen.Results Forty-seven patients (90%) completed two cycles of concurrent chemotherapy,and five patients (10%) completed one cycle of concurrent chemotherapy.The median follow-up time was 15.7 months (3.2-34.8 months).The 2-year disease-free survival (DFS) and overall survival (OS) rates were 74% and 98%.Three patients experienced regional lymph recurrence and 6 cases had distant metastasis.Grade Ⅲ oral mucositis was observed in 30 patients.Grade Ⅲ dermatitis occurred in 5 cases.Only one patient experienced Grade Ⅳ neutropenia,and 2 patients developed Grade Ⅲ neutropenia.DFS was positively correlated with the cycle of postoperative adjuvant concurrent chemotherapy (P=0.006).Conclusions Patients with high-risk SGT can obtain higher 2-year DFS and OS rates and tolerable adverse events after postoperative concurrent chemoradiotherapy.Nevertheless,the long-term outcomes remain to be validated by randomized controlled clinical trials.
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Objective@#To preliminary, explore the effect of small intestinal epithelial dendritic cells on the occurrence and development of nonalcoholic fatty liver disease in mice.@*Methods@#Thirty-two (half male and half female) 4-week-old C57BL/6 mice were randomly divided into two groups. The mice were fed with normal diet (SD group) and high-fat diet (HFD group). Eight mice (half male and half female) were randomly killed from each group over the 14 and 20-weeks feeding period to observe their body weight, liver and small-intestine wet weight. Alanine aminotransferase, aspartate aminotransferase, blood glucose, high-density lipoprotein, low-density lipoprotein, total cholesterol and triglyceride were determined by eyeball blood samples. Pathological diagnosis and alcoholic fatty liver disease activity score were collected. The number of mice small intestinal dendritic cells was observed under a microscope. Statistical analysis was performed to compare two groups of independent samples with homogeneity test of variance, t test, and covariance analysis.@*Results@#The body weight, liver wet weight, serum alanine aminotransferase and aspartate aminotransferase of mice in HFD group were significantly higher than those of control group at 20 weeks (P < 0.05), and the serum high density lipoprotein of mice in HFD group was significantly higher than that of SD group at 14 weeks (P < 0.05). At 14th weeks, the liver tissue of mice in HFD group had early pathological manifestations of hepatitis (fatty degeneration, punctate necrosis and balloon-like degeneration). Of which 87.5% (7/8) of them were diagnosed as non-alcoholic steatohepatitis or non-alcoholic fatty liver disease, while only a few mice in SD group had early pathological manifestations of hepatitis. At 20th weeks, all mice in HFD group were diagnosed with non-alcoholic steatohepatitis or non-alcoholic fatty liver disease, while none of the mice in SD group was diagnosed with non-alcoholic fatty liver disease. At both time points, the percentage of small intestinal dendritic cells in HFD group was significantly higher than that in SD group (14 weeks: 4.181 ± 4.314 vs. 15.099 ± 10.349; 20 weeks: 9.615 ± 8.267 vs. 32.839 ± 24.475, both P < 0.05). Statistical analysis combined with the alcoholic fatty liver disease activity score showed that there was no linear correlation between the two groups (regression coefficient was 20.196%).@*Conclusion@#The number and different staging of small intestinal dendritic cells in mice is associated with the occurrence and development of NAFLD.
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Objective Conducting Metrology study on the literature of foreign "proprotein convertase subtilisin/Kexin type 9 (PCSK9)",combing the development process of the discipline,and predicting its future development trend,hope this research methodology could be generalized in research management.Methods PCSK9 related literature from 2003 to 2016 were searched and retrieved from Web of Science and PUBMED platform database.After data cleaning,the metrology tools are used to analyze the situation of the subject,the social network analysis of the authors,meanwhile,the scientific research management related information is also analyzed.Results After data cleaning,1 593 valid records were obtained;the calculation results generated 30 nodes of PCSK9 research and development citation map;the statistical searched literature had a total of 3,820 authors,and based on Price's theory,163 high-yield core authors were calculated.Conclusions The international research on PCSK9 is fast increasing currently,both its literature and patents are showing rapid growth,which is closely related to the management level of scientific research projects.United States,France and other countries are at the forefront of research,formed a global research cooperation.It is urging that good scientific research management and communication play an important role which we should learn and make references.
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Objective To systematically evaluate the effects of safflower yellow injection on the treatment of senile early diabetic nephropathy. Methods All databases from January 2000 to June 2017,including the Chinese biomedical literature database(CBM),Chinese Journal Full-text Database (CNKI),Chinese PSTP VIP(VIP)and Wanfang database(WFSD),were searched on the safflower yellow injection for treatment of senile early diabetic nephropathy in randomized controlled trail.Literatures were selected based on inclusion and exclusion standards defined in advance,and their quality was evaluated.The valid data were retrieved and a Meta analysis of the urinary albumin excretion rate and serum creatinine was undertaken using RevMan5.3 Software. Results 16 articles with 1 048 cases were internalized into the study.Among 1 048 cases,525 cases were treated with safflower yellow injection added to general comprehensive treatment(treatment group),and 523 cases with general comprehensive treatment(control group).The results of meta analysis showed that urinary protein excretion rate 〔WMD(weighted mean difference)= -0.74,95% CI:-0.85 to -0.63;Z=13.15,P=0.000〕 and serum creatinine level 〔W M D= -4.30,95% CI:-6.54 to -2.06,Z=3.77,P= 0.002〕 were significantly lower in safflower yellow injection added to conventional treatment than in conventional treatment. Conclusions Safflower yellow pigment injection is superior to conventional treatment for senile early diabetic nephropathy,but there are few high quality studies and the sample size is limited,therefore more studies are needed.
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Objective To investigate the accuracy of CT in the diagnosis of central lung cancer and the clinical significance of magnetic resonance imaging ( MRI) supplementary diagnosis ,in order to provide reference for clinical diagnosis.Methods From January 2015 to October 2017,30 patients with suspected central lung cancer treated in General Hospital of Lingchuan County Medical Group were selected in the research .All patients were examined by CT and MRI ,and the results of pathological examination were taken as the standard .The results of CT and MRI were observed and the value of MRI supplementary examination in CT diagnosis was analyzed .Results The sensitivity,specificity and accuracy of CT in the diagnosis of central lung cancer were 68.0%,20.0%and 60.0%, respectively .After MRI imaging supplementary diagnosis , the diagnostic sensitivity , specificity and accuracy of diagnosis of central lung cancer were 92.0%,80.0% and 90.0%, respectively.Conclusion The accuracy of diagnosis of central lung cancer by CT is low .In order to ensure the accuracy of diagnosis ,it is necessary to carry out MRI supplementary diagnosis to the patients .
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Objective To investigate the relationships between seven single nucleotide pdymorphisms(SNPs), including 6788895(SIAH2 gene), rs10941679(5p12), rs889312(MAP3K1), rs13387042(2q35), rs6504950(17q23), rs17530068(6q14) and rs2284378(20q11), and female breast cancer of Hui and Han nationalities.Methods A hospital-based case-control using age and nationallity as frequency matching conditions was conducted in Affiliated General Hospital of Ningxia Medical University.Results ①A total of 225 breast cancer patients and 225 controls were enrolled in this study.There was no significant differentce between case group and control group in age(48.27±9.27 vs 48.48±9.36, t=0.238,P=0.812) or nationallity (181 Han people and 44 Hui people vs 184 Han people and 41 Hui people, x2=0.131, P=0.718).②The subjects of study conformed to Hardy-Weinberg equilibrium principles.③The genotype and allele distribution of the above seven SNPs were not significantly different between cases group and control group of Hui and Han nationalities.Conclusion The seven SNPs mentioned above may not be related to breast cancer among people Hui and Han nationalities.
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Objective@#To investigate the role of neutrophil elastase inhibitor, sivelestat, in preventing and treating nonalcoholic steatohepatitis (NASH) and its underling mechanisms.@*Methods@#A total of forty 4-week-old male C57BL/6J ApoE-/-mice were equally divided into the following four groups: standard chow (SC)+isotonic saline; SC+sivelestat; high-fat, high-cholesterol (HFHC) diet+isotonic saline; and HFHC+sivelestat. These mice were treated with above methods for 12 weeks. Blood and liver tissue samples were collected to measure biochemical parameters, hepatic steatosis and non-alcoholic fatty liver disease (NAFLD) activity score (inflammation) were evaluated by oil red O staining and HE staining, respectively. The mRNA and protein expression levels of hepatic inflammatory cytokines, CD68, and F4/80 were determined by quantitative RT-PCR and immunohistochemistry, respectively. Comparison of means between the four groups was made by one-way analysis of variance, and comparison between any two groups was made by the LSD or SNK method (for data with homogeneity of variance) or the Tamhane or Dunnett method (for data with heterogeneity of variance).@*Results@#Mice fed with an HFHC diet for 12 weeks developed typical pathological features of NASH compared with those fed with SC. Compared with mice fed with HFHC diet without sivelestat, those treated with HFHC and sivelestat exhibited the following features: (1) significantly reduced fast blood glucose, blood cholesterol, and hepatic biochemical parameters, as well as increased insulin sensitivity; (2) significantly reduced NAFLD activity score (5.71±1.11 vs 3.16±1.16, P < 0.05); (3) reduced monocyte chemoattractant protein-1 and tumor necrosis factor -α; (4) significantly reduced mRNA levels of CD68 and F4/80; and (5) reduced expression of CD68 in the liver.@*Conclusion@#Sivelestat alleviates the hepatic steatosis and inflammation of NASH in mice by inhibiting the activation of Kupffer cells.
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Objective:Adenoid cystic carcinoma (ACC) is an uncommon malignant neoplasm, which mostly originates from the major and minor salivary glands of the head and neck region. This study aims to provide new information on head and neck ACC with cervical lymph node metastasis. Methods:Out of the 616 patients who underwent primary tumor resection from 1995 to 2008 in the authors' hospital, 62 cases with cervical lymph node metastasis were analyzed. Results:The general incidence rate of cervical lymph node me-tastasis in ACC was approximately 10%. The base of the tongue, mobile tongue, and mouth floor were the most frequent sites of lymph node metastasis with incidence rates of 19.2%, 17.6%, and 15.3%, respectively. Most cases exhibited the classictunnel-stylemetastatic pattern of occurrence, and the levelⅠb andⅡregions were the most frequently involved areas. Primary site and lympho-vascular invasions were significantly associated with lymph node metastasis. High patient mortality rate was also significantly correlat-ed with a high number of lymph node positive cases. Conclusion:Cervical lymph node metastasis has a high tendency of occurrence in the tongue-mouth floor complex, following the classictunnel-stylemetastatic pattern. Peritumoral lymphovascular invasion could be taken as a strong predictor for the occurrence of lymph node metastasis, which ultimately leads to poor prognosis of ACC patients. A selective neck dissection should be considered as a management in such patients.
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Objective To observe the MSCT features of invasive pulmonary tuberculosis,and to investigate its effect on the prognosis.Methods 60 patients with invasive pulmonary tuberculosis were selected as the study subjects.The gold standard was in sputum culture and histopathology.The clinical value of MSCT in the diagnosis of invasive pulmonary tuberculosis was evaluated.The distribution and morphological characteristics of the lesions in the invasive pulmonary tuberculosis were observed and analyzed.The patients were divided into the treatment group and the death group.The morphological changes of lung lesions were compared between the two groups.Results In 60 patients,a total of 45 patients with invasive pulmonary tuberculosis were diagnosed,MSCT of infiltrating pulmonary tuberculosis diagnostic sensitivity,specificity,positive predictive rate,negative predictive rate,correct rate,misdiagnosis rate,missed diagnosis rate,diagnostic accordance rate were 93.3%,80.0%,93.3%,80.0%,73.3%,20.0%, 6.7%,90.0%,respectively.On the lung multiple patchy shadow,real change shadow,multiple nodules,cavity shadow, on the unilateral lung syndrome,and branch sign and halo sign is the main sign of invasive pulmonary tuberculosis. Before treatment,MSCT signs of deterioration of chest between the treatment group and death group had no statistically significant difference(P>0.05).After 4 weeks of treatment,the proportion of effusion lesions in the treatment group was significantly decreased compared with before and during the same period of treatment(37.5%vs 76.9%;3.1%vs 92.3%),the differences were statistically significant(χ2 =5.750,16.541,all P<0.05).After 8 weeks of treat-ment,the proportions of effusion,nodules and cavity lesions in the treatment group were significantly lower than those in the deteriorated group(3.1% vs 92.3%;0.0% vs 15.4%;6.2% vs 38.5%),the differences were statistically significant (χ2 =16.541,5.152,7.302,all P<0.05).Conclusion Morphological changes of MSCT in invasive pulmonary tuberculosis have certain characteristics.In the diagnosis,differential diagnosis and therapeutic evaluation of invasive pulmonary tuberculosis,MSCT has high value.
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Objective To develop a clinical nomogram for predicting the probability of bladder outlet obstruction (BOO) in male LUTS/BPH using the most common and noninvasive parameters in clinical practice , with the hope of detecting BOO individually and precisely. Methods Retrospectively analyze the outpatients and inpatients of male LUTS/BPH from November 2003 to November 2015 in Guangzhou First People′s Hospital. Collect the Pressure-flow study parameters and other clinical parameters including Qmax , PV, TZV, TZI, PSA, and PVR. Find out the best independent predictors on the diagnosis of BOO and develop the nomogram for pre-dicting BOO. Results The data from 1 599 patients were analyzed. The areas under the ROC curve (AUCs)of PV, TZV, TZI, PSA, Qmax, and PVR were 0.803, 0.807, 0.698, 0.775, 0.742, and 0.641, respectively. Qmax, PV, and PSA were selected as the best clinical parameters to predict BOO. The Logistic regression equa-tion is Log(p)=0.332 4 - 0.201 8*Qmax + 0.026 6*PV + 1.135 1*PSA. Finally, a nomogram model was developed by R statistical software. This nomogram showed a concordance index of 0.854 according to the inter-nal validation of the model. Conclusions The clinical nomogram presented a high accuracy (85.4%) in de-tecting BOO, which would help predicting BOO in male LUTS/BPH noninvasively, individually, accurately, and providing valuable reference and guidance in clinical decision.
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Objective To evaluate the therapeutic effect of endoscopic management of plastic stents of post-liver transplantation anastomotic biliary stricture. Methods From January 2010 to October 2015, clinical data of patients with post-liver transplantation anastomotic biliary stricture and received endoscopic retrograde cholangiopancreatog﹣raphy and plastic stents management was collected. The technical success rate, ERCP-related complications, clinical remission rate and long-term complications were main outcome measurements to compare the efficacy and safety of different number of stents in managing post-liver transplantation anastomotic biliary stricture. Results Among the 18 patients (0.5 ~ 60.0 months) with post-liver transplantation ABSs, seven patients received less plastic stents treat﹣ment (< 3 stents), nine patients with persistent anastomotic or recurrent stricture received multiple plastic stents treatment (≥ 3 stents), two patients received multiple plastic stents treatment once suffered with post-liver trans﹣plantation ABSs. The endoscopic technical success rate was seventy-six over eighty (95.0 %). Among the seven pa﹣tients received less plastic stents treatment, one loss to follow-up, two were still under treatment, one died of acute hepatic failure, one died of septic stock, one combined with biliary fistula resulted in treatment failure, one achieved clinical remission, the clinical remission rate was one third (33.3 %). Among the eleven patients received multiple plastic stents treatment, two loss to follow-up, one was still under treatment, two received surgery because of failed treatment, six achieved clinical remission, the clinical remission rate was 75.0 % (6/8). The average diameters and stent durations of management of 1 stent, 2 stents, 3 stents, 4 stents, 5 stents, 7 stents were 8.5 F, 17.0 F, 24.0 F, 28.0 F, 36.0 F, 50.0 F. Among the six early postoperative complications, five cases occurred in less stent manage﹣ment and one occurred in MPSs management, the early postoperative complication rate was 7.5 %(6/80). No severe ERCP-related complications and procedure-related deaths. Conclusions Endoscopic management of plastic stents is safe and effective for post-liver transplantation ABSs. Providing larger biliary support, the multiple plastic stents treatment was superior to less plastic stents treatment in view of clinical remission rate, especially for refractory one. Multiple plastic stents did not increase the incidence of complications, it could be used as the first-line treatment of post-liver transplantation duct-to-duct biliary anastomosis for its safety and effectivity.