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Objective:To investigate the differences in clinical features and imaging findings of cirrhotic patients with fundic varices between gastroesophageal varices type 2 (GOV2) and isolated fundic varices type 1 (IGV1).Methods:Clinical and imaging data of cirrhotic patients with fundic varices treated in Union Hospital, Tonji Medical Colloge, of Huazhong University of Science and Technology from October 2013 to March 2021 were retrospectively analyzed.Results:A total of 210 patients were enrolled, including 139 patients of GOV2 (GOV2 group) and 71 patients of IGV1 (IGV1 group). Blood routine examination results showed that the median value of hemoglobin in GOV2 group was lower than that in IGV1 group(91.00 g/L VS 112.00 g/L, P<0.05). The incidence of portal hypertensive gastropathy (PHG) in GOV2 group was higher than that in IGV1 group [20.14% (28/139) VS 5.63% (4/71), P<0.05]. The incidence of peptic ulcer was lower in GOV2 group than that in IGV1 group [12.23% (17/139) VS 38.03% (27/71), P<0.05]. The median diameter of portal veins in GOV2 group was larger than that in IGV1 group (15.09 mm VS 12.85 mm, P<0.05), and the volume of gastric fundus varices in GOV2 group was smaller than that in IGV1 group (2.14 mL VS 10.00 mL, P<0.05). The proportion of afferent veins in left gastric vein in GOV2 group was higher than that in IGV1 group [98.43% (125/127) VS 77.78% (42/54), P<0.05], and the median diameter of left gastric vein in GOV2 group was larger than that in IGV1 group (5.58 mm VS 4.53 mm, P<0.05). The efferent vessels mainly included gastrorenal shunt and splenorenal shunt. The incidences of gastrorenal shunt [27.56% (35/127) VS 66.67% (36/54)] and splenirenal shunt [12.60% (16/127) VS 25.93% (14/54)] in GOV2 group were lower than those in IGV1 group ( both P<0.05). The incidences of venae parumbilicales vein [38.58% (49/127) VS 12.96% (7/54)] and retroperitoneal collateral shunt [30.71% (39/127) VS 11.11% (6/54)] in GOV2 group were higher than those in IGV1 group (both P<0.05). Conclusion:There is significant heterogeneity in clinical features and imaging findings between cirrhotic patients complicated with GOV2 and IGV1. Recognizing and understanding the differences between the two types of patients is beneficial to taking appropriate clinical measures and improving patient prognosis.
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Objective:To establish and evaluate acute hepatic sinusoidal obstruction syndrome (HSOS) mouse models induced by three pyrrolidine alkaloids (PAs) including monocrotaline (MCT), retrorsine (RTS) and senecionine (SEN).Methods:Forty-eight male C57 mice were divided into four groups, control group, MCT group, RTS group and SEN group, with 12 mice in each group, which were gavaged once with phosphate buffer saline (300 μL), MCT solution (800 mg/kg), RTS solution (100 mg/kg) and SEN solution (100 mg/kg), respectively. At 24 hours after gavage, the number of mortality and success modeling, liver function, and pathological changes of liver of four groups of mice were analyzed. One way analysis of variance, Bonferroni test and Chi-square test were used for statistical analysis.Results:At 24 hours after gavage, the number of dead mice of MCT group, RTS group and SEN group was zero, nine and zero, respectively; and the number of survival successfully modeled mice was nine, three and six, respectively; the difference of mortality among three groups was statistically significant ( χ2=21.734, P<0.05), and the difference of the number of success modeling was not statistically significant ( χ2=2.836, P>0.05). The alanine aminotransferase (ALT) levels of MCT group, RTS group and SEN group were (111.72±37.62), (562.97±242.42) and (3 891.40±1 009.44) U/L, respectively; aspartate transaminase (AST) levels were (156.96±64.95), (331.22±120.83) and (2 107.55±532.80) U/L, respectively; and total bilirubin (TBil) levels were (41.66±10.42), (79.43±18.45) and (120.80±17.44) μmol/L, respectively, which were all higher than those of the control group ((31.40±10.98) U/L, (34.66±13.00) U/L and (16.91±2.89) μmol/L, respectively); and the differences were statistically significant (Bonferroni test, all P<0.008 3). There were statistically significant differences in ALT and AST levels between MCT group and RTS group (Bonferroni test, both P<0.008 3), while there was no statistically significant difference in TBil level between two groups ( P>0.008 3). There was statistically significant difference in TBil level between MCT group and SEN group (Bonferroni test, P=0.002), however there were no statistically significant differences in ALT and AST levels between two groups (both P>0.008 3). There were statistically significant differences in ALT, AST and TBil levels between RTS group and SEN group (Bonferroni test, all P<0.008 3). The mouse liver tissues of all three groups showed coagulative necrosis of hepatocytes, subendothelial hemorrhage of central vein, the dilation of hepatic sinusoids, erythrocyte clogging in the space of disse, and destruction of normal lobular structure. In MCT and RTS groups, the main damages were hepatocyte necrosis, sinusoidal dilatation and congestion in zone 3 of the liver acinus, while in SEN group, which were hepatocyte necrosis and sinusoidal congestion in zone 1 and 2 of the liver acinus. The histological changes of mouse liver tissues of MCT group were moderate to severe, and those of RTS group and SEN group were all severe. Conclusions:Acute HSOS mouse models induced by three kinds of PA including MCT, RTS and SEN are successfully established, of which MCT is the most suifable choice.
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To construct the specific siRNA expression vectors and investigate their effect on leptin and collagen I in HSC, which provide a new approach to the prevent and treat hepatic fibrosis. The five siRNAs against leptin gene were transcript synthesized intracellularly by expression templates of plasmid vector psiRNA-hH1neo. The recombinant leptin siRNA plasmid vectors could express in eukaryocyte , and then to evaluate them by using enzyme cutting and sequencing. The recombinant plasmids were transfected into HSCs using Lipofectamine methods respectively. The cells were selected after growing in DMEM containing 300 μg/mL G418 for about 4 weeks. Gene expression of leptin and collagen I were showed by Western blot analysis and reverse transcription polymerase chain reaction (RT-PCR). Identification by enzyme cutting and sequencing showed that the leptin siRNA expression vectors were constructed successfully, and leptin siRNA could inhibit the leptin and collagen I gene expression effectively. It was concluded that RNA interference-mediated silencing of leptin gene diminished leptin and collagen I gene expression in HSCs. Furthermore, attenuated the extracellular matrix over-deposition at the same time. Leptin gene is ideal targets of gene therapy for liver fibrosis.
