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1.
Biomed Pharmacother ; 118: 109031, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31545219

RESUMO

BACKGROUND: This study was conducted to investigate the protective effect of Fms-like tyrosine kinase 3 (FLT3)/FLT3 ligand (FLT3L)-dependent CD103+ dendritic cells (DCs) on hepatic ischemia-reperfusion injury (IRI). METHODS: A mouse model of hepatic IRI and cellular model following hypoxia-reperfusion (H/R) treatment were established. Peripheral blood and liver tissues were obtained and analyzed by flow cytometer in terms of percentage of CD103+DCs and regulatory T (Treg) cells. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were determined to assess liver function. Moreover, pro-inflammatory cytokines levels including tumor necrosis factor (TNF)-α, interleukin (IL)-1ß and IL-6 were measured using enzyme-linked immunosorbent assay (ELISA). The histological morphology of liver tissues was examined with hematoxylin and eosin (HE) staining. The apoptosis was detected by terminal deoxynucleotidyl transferase (TdT) dUTP Nick End Labeling (TUNEL) assay. Treg-associated cytokines transforming growth factor (TGF)-ß and IL-10 expressions were measured using quantitative real time polymerase chain reaction (qRT-PCR). RESULTS: CD103+ DCs were significantly decreased in peripheral blood and liver tissues of mouse model of hepatic IRI. In vivo experiments indicated that CD103+ DCs infusion ameliorated IRI-induced liver damage and Treg inhibition. Further investigations demonstrated that FLT3/FLT3L-dependent CD103+ DCs suppressed hepatocyte apoptosis via activation of Treg cells in vitro. CONCLUSION: FLT3/FLT3L-induced CD103+ DCs alleviated hepatic IRI through activating Treg cells.


Assuntos
Antígenos CD/metabolismo , Células Dendríticas/transplante , Cadeias alfa de Integrinas/metabolismo , Fígado/irrigação sanguínea , Proteínas de Membrana/metabolismo , Traumatismo por Reperfusão/terapia , Linfócitos T Reguladores/imunologia , Tirosina Quinase 3 Semelhante a fms/metabolismo , Animais , Transplante de Células , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Fígado/imunologia , Testes de Função Hepática , Ativação Linfocitária , Camundongos Endogâmicos C57BL , Traumatismo por Reperfusão/imunologia
2.
Cardiovasc Intervent Radiol ; 42(9): 1311-1321, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31218407

RESUMO

OBJECTIVE: This retrospective study evaluated interventional treatments (recanalization, balloon dilation, and/or stent placement) for Budd-Chiari syndrome (BCS), caused by combined obstruction of the inferior vena cava (IVC) and hepatic veins (HVs). METHODS: Before and after interventional therapy, patients with BCS (n = 162; asymptomatic 105.2 ± 103.3 mo; follow-up 15 [6-24] mo) underwent imaging studies (color Doppler ultrasound, CT, or MRI), and inferior vena cavography and manometry. Venous lesions were characterized by occlusion features, and presence of thrombosis and peripheral collateral vessels. RESULTS: One, 2, and 3 main HV occlusions were observed, respectively, in 25 (15.4%), 61 (37.7%), and 76 (46.9%) patients. Eighty-three (51.2%), 98 (60.5%), and 104 (64.2%) patients had, respectively, large accessory HVs, venous collaterals formed between the HVs, or venous communicating branches between the HV and the peritoneal veins. The middle, left, and right HV was patent in 32 (19.8%), 35 (21.6%), and 44 (27.2%) patients. Recanalization of both hepatic and caval occlusions was successful in 96% (51/53) of those attempted; recanalization of IVC occlusion was successful in 97% (106/109). Among 157 patients successfully treated, 146 were cured and 11 showed clinical improvement. Clinical symptoms were relieved in 82.4% after the initial intervention, and 94.2% after the second intervention. CONCLUSION: Recanalization and balloon angioplasty was effective for the management of BCS with concurrent HV and IVC occlusions. The majority of patients required only IVC recanalization. The outcome of patients treated only by IVC intervention was similar to that of patients given combined HV and IVC intervention.


Assuntos
Síndrome de Budd-Chiari/cirurgia , Procedimentos Endovasculares/métodos , Veias Hepáticas/patologia , Veias Hepáticas/cirurgia , Veia Cava Inferior/patologia , Veia Cava Inferior/cirurgia , Adolescente , Adulto , Idoso , Angioplastia com Balão/métodos , China , Diagnóstico por Imagem/métodos , Feminino , Veias Hepáticas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents , Resultado do Tratamento , Veia Cava Inferior/diagnóstico por imagem , Adulto Jovem
3.
Exp Ther Med ; 16(6): 5227-5235, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30542478

RESUMO

Budd-Chiari syndrome (BCS) is a rare clinical syndrome caused by the obstruction of hepatic venous outflow. In theory, hepatic congestion and hypoxia induce pathological damage and changes in the liver. However, at present, laboratory evidence supporting this theory is lacking. The aim of the present study was to assess the expression and significance of the hypoxia-associated indicators malondialdehyde (MDA), superoxide dismutase (SOD) and endotoxin (ET) in the liver and serum of subjects with BCS. An animal model of BCS was established by partial ligation of the inferior vena cava (IVC) in rats. The levels of MDA, SOD and ET in the serum of BCS patients, as well as in the liver and serum of rats with BCS, were detected and analyzed. In human patients with BCS, the serum levels of MDA, ET and SOD were significantly different from those in healthy control subjects. In the animal model, similar trends were observed regarding the MDA, ET and SOD levels in liver homogenate and serum (P<0.05), the degree of which was more pronounced in the liver homogenate than in the serum. At 6 weeks after the surgery, these indicators reached peak/valley levels in the experimental group and were at least partially restored by week 12. A negative correlation between MDA and SOD, a positive correlation between MDA and ET, and a negative correlation between SOD and ET was identified. In conclusion, the levels of hypoxia-associated indicators significantly changed with BCS progression, suggesting that hypoxia is a major factor in the pathogenesis of BCS.

4.
Cancer Manag Res ; 10: 4719-4726, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30410405

RESUMO

Objectives: To explore the efficacy and influencing factors of transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT). Materials and methods: The clinical data of 3,126 consecutive patients who suffered from advanced HCC and underwent TACE were retrospectively analyzed. A total of 685 patients had a combination of HCC and PVTT. Of these patients, 475 were treated with TACE (Group A) and 210 were given a supportive care (Group B). The local response and overall survival of the two groups were observed and compared, and the influencing factors were examined through Cox regression analysis. Results: The median survival time and cumulative survival rate at 6, 12, and 24 months of Group A were higher than those of Group B (P=0.002). Multiple Cox regression analysis revealed that Child-Pugh classes and PVTT grades were the independent prognostic factors affecting a patient's survival. Stratified analysis demonstrated that the survival time of patients diagnosed with grades I/II PVTT and treated with TACE was superior to that of patients provided with supportive care (P=0.001), but the survival time of patients with grades III/IV PVTT with or without TACE did not significantly differ (P=0.662). Conclusion: TACE can significantly improve local response, increase cumulative survival rate, and prolong the survival duration of patients with HCC and grades I/II PVTT, whereas the efficacy of TACE for patients with grades III/IV PVTT should be further verified, although their local responses were improved. Child-Pugh classes and PVTT grades are essential factors influencing patient prognosis.

5.
Exp Ther Med ; 16(5): 4141-4149, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30402156

RESUMO

To date, interventional therapy for patients with Budd-Chiari syndrome (BCS) due to hepatic vein obstruction (HVO) has not been standardized in China. In Western countries, BCS primarily occurs due to thrombosis and the majority of patients receive thrombolysis. In China, BCS is mostly caused by the membranous occlusion of the HV or IVC. The present retrospective study evaluated the efficacy of recanalization techniques in patients with primary BCS due to HVO. The data of 69 patients with BCS due to HVO, who underwent endovascular therapy at 2 centers in China between December 2010 and December 2012, were analyzed. All of the patients underwent balloon angioplasty. In addition, 14, 6 and 5 patients received thrombolysis, endovascular stent and thrombolysis + endovascular stent, respectively. The overall technical success rate was 95.7% (66/69), and was comparable among the treatments. The HV pressure after the treatments was significantly lower compared with that prior to the procedures (23.3±6.9 vs. 46.5±8.6 cmH2O; P<0.001). The mean follow-up duration was 75 months (range, 60-84 months). During the 5-year follow-up, 10 patients (15.2%) had developed a recurrence of BCS-associated symptoms, of which 7 were successfully treated. The cumulative survival rates at 12, 36 and 60 months after endovascular interventional therapy (balloon angioplasty or combined treatment) were 98.5, 98.5 and 93.9%, respectively. After treatment by endovascular therapy, the patients with BCS caused by HVO had high survival rates and low recurrence rates in the short- and mid-term.

6.
Medicine (Baltimore) ; 96(52): e9535, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29384971

RESUMO

PURPOSE: The present study investigates the side effects and complications of computed tomography (CT)-guided percutaneous iodine-125 (I-125) seeds implantation for advanced pancreatic cancer. METHODS: The clinical data were retrospectively analyzed for patients treated with implantation of I-125 seeds under CT-guide in our hospital from May 2010 to April 2015. The side effects and complications were collected and their possible reasons were analyzed. RESULTS: A total of 78 patients were enrolled. The side effects were categorized as fever in 29 cases (37.18%), abdominal pain in 26 cases (33.33%), nausea and vomiting in 9 cases (11.54%), diarrhea in 5 cases (6.41%), and constipation in 4 cases (5.13%). Complications were composed of pancreatitis in 9 cases (11.54%), infection in 5 cases (6.41%), seed migration in 2 cases (2.56%), intestinal perforation in 1 case (1.28%), and intestinal obstruction in 1 case. The incidence of complication was 23.08% (18/78). The difference in incidence of complication was statistically significant between patients implanted with ≤27 seeds and those with >27 seeds (P = .032). CONCLUSION: The side effects and complications frequently occur in implantation of I-125 seeds for patients with advanced pancreatic cancer. More concern should be given to the patients treated by this technique.


Assuntos
Braquiterapia/efeitos adversos , Braquiterapia/métodos , Radioisótopos do Iodo/uso terapêutico , Neoplasias Pancreáticas/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Intervencionista , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
7.
Medicine (Baltimore) ; 95(17): e3503, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27124055

RESUMO

To investigate the clinical features, risk factors, and bacterial spectrum of liver abscess following transarterial chemoembolization (TACE) and evaluate the therapeutic effect of percutaneous catheter drainage (PCD) on the abscesses.A retrospective review of patient charts was performed in 3613 patients who suffered from liver malignancies (2832 patients with hepatocellular carcinoma and 781 with metastatic hepatic tumor) and had undergone 11,054 TACE procedures from January 2005 to October 2013. Liver abscesses were found in 21 patients. PCD was performed in all abscess patients. The clinical features, risk factors, and bacterial spectrum of liver abscess following TACE were investigated and the therapeutic effect of PCD was evaluated.The incidence of liver abscess was 0.58% per patient and 0.19% per procedure. Approximately 57.1% of the patients had a medical history of bilioenteric anastomosis or biliary stent implantation. On computed tomography scans, the abscesses appeared as low-attenuation lesions and high-density iodinate oil scattered in the abscesses. The ultrasound showed the well defined, heterogeneously hypoechoic lesions. Positive microbiological isolates were obtained in all pus cultures and in 47.6% of blood cultures. The most common bacterium was Escherichia coli (52.4%). Twenty patients (95.2%) were cured from abscesses by using PCD, and 1 died of sepsis.Patients with predisposing factors are prone to an increased risk of liver abscess following TACE. Bacterial culture and antibiotic sensitivity tests on pus and blood help on the antibiotics selection. PCD combined with aggressive antibiotics can be recommended as the first-line therapeutic regimen.


Assuntos
Infecções Bacterianas/microbiologia , Infecções Bacterianas/terapia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/terapia , Abscesso Hepático/microbiologia , Abscesso Hepático/terapia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Paracentese , Adulto , Idoso , Bacteriemia/microbiologia , Bacteriemia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
8.
Gastroenterol Res Pract ; 2015: 121060, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26451141

RESUMO

Objective. To investigate the serum level of CA-125 and its corresponding clinical significance in Chinese patients with primary BCS. Methods. Serum CA-125 was measured in 243 patients with primary BCS receiving interventional treatment in the participating hospitals and in 120 healthy volunteers. The correlation between serum CA-125 levels and ascites volume, liver function, and prognosis was analyzed. Results. Serum CA-125 was significantly elevated in BCS patients compared to healthy volunteers (P < 0.001). Higher levels of CA-125 were found in BCS patients with abnormal hepatic function and low serum albumin levels and in patients with high volume of ascites compared to patients without these abnormalities. Serum CA-125 levels significantly correlated with ascites volume, serum level of alanine aminotransferase, aspartate aminotransferase, albumin, and Rotterdam BCS scores. The follow-up study indicated that the survival rate and asymptomatic survival rate after interventional treatment were lower in BCS patients with serum CA-125 > 175 U/mL (P < 0.05). Conclusion. Serum CA-125 was significantly higher in patients with primary BCS and had a positive correlation with the volume of ascites, severity of liver damage, and poor prognosis. Thus the serum CA-125 levels may be used to estimate the severity and prognosis of BCS in Chinese patients.

9.
Oncol Lett ; 9(5): 2256-2260, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26137052

RESUMO

Primary hepatic leiomyosarcoma (PHL) is an extremely rare tumour. This tumour is difficult to diagnose by imaging examinations due to its rarity, and non-specific conventional imaging manifestations and clinical presentation. The present study reports the case of a 42-year-old male with PHL that was confirmed by histopathological and immunohistochemical examinations. Multimodal imaging examinations, including ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT and digital subtraction angiography, were performed. The imaging manifestations were analysed and the associated literature was reviewed. The results found that no characteristic imaging appearance was present on ultrasound or plain CT scan. However, on unenhanced MRI, the tumours presented with a heterogeneous low signal density on T1-weighted imaging (WI) and a high signal density on T2WI and diffusion-WI. On gadopentetate dimeglumine enhanced MRI, the lesions were not enhanced during the arterial and portal venous phases; by contrast, these lesions were evidently enhanced during the 5-min delayed phase. Therefore, the delayed imaging of enhanced MRI is likely to be used to differentiate PHL from other hepatic tumours.

10.
Korean J Radiol ; 16(4): 810-20, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26175580

RESUMO

OBJECTIVE: To prospectively evaluate the performance of computed tomography perfusion imaging (CTPI) in predicting the early response to transarterial chemo-lipiodol infusion (TACLI) and survival of patients with colorectal cancer liver metastases (CRLM). MATERIALS AND METHODS: Computed tomography perfusion imaging was performed before and 1 month after TACLI in 61 consecutive patients. Therapeutic response was evaluated on CT scans 1 month and 4 months after TACLI; the patients were classified as responders and non-responders based on 4-month CT scans after TACLI. The percentage change of CTPI parameters of target lesions were compared between responders and non-responders at 1 month after TACLI. The optimal parameter and cutoff value were determined. The patients were divided into 2 subgroups according to the cutoff value. The log-rank test was used to compare the survival rates of the 2 subgroups. RESULTS: Four-month images were obtained from 58 patients, of which 39.7% were responders and 60.3% were non-responders. The percentage change in hepatic arterial perfusion (HAP) 1 month after TACLI was the optimal predicting parameter (p = 0.003). The best cut-off value was -21.5% and patients who exhibited a ≥ 21.5% decrease in HAP had a significantly higher overall survival rate than those who exhibited a < 21.5% decrease (p < 0.001). CONCLUSION: Computed tomography perfusion imaging can predict the early response to TACLI and survival of patients with CRLM. The percentage change in HAP after TACLI with a cutoff value of -21.5% is the optimal predictor.


Assuntos
Neoplasias Colorretais/patologia , Óleo Etiodado/administração & dosagem , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Imagem de Perfusão/métodos , Adulto , Idoso , Neoplasias Colorretais/mortalidade , Meios de Contraste/administração & dosagem , Feminino , Artéria Hepática/diagnóstico por imagem , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Taxa de Sobrevida , Tomografia Computadorizada por Raios X/métodos
11.
Zhonghua Gan Zang Bing Za Zhi ; 21(11): 850-4, 2013 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-24331696

RESUMO

OBJECTIVE: To prospectively study clinical features and etiology in patients with incident Budd-Chiari syndrome (BCS) in China. METHODS: Taking consecutive case series of patients with incident BCS as who were diagnosed in our hospital, enrolled from September 2010 to January 2012 as the object of research, and the follow-up was lasting until June 2012. Taking records for all patients' symptoms, signs, laboratory findings, radiology findings, treatment, interventional treatment survival and symptom-free period. RESULTS: There are total 149 incident cases of BCS. In which, the median age was 46 years old (range 10 to 82); 61.7% of them were male patients, 38.3% were female patients; 85.9% of them were chronic, the other patients (14.1%) were diagnosed during acute or subacute periods; the median duration of symptoms before diagnosis was 96 months (range 1 day to 360 months). In terms of causes, 30.9% of the patients caused by hepatic venous block, 5.4% of them resulted from inferior vena cava block, and the rest 63.8% were suffered from combined hepatic venous and inferior vena cava block. 80.5% patients have at least one etiological factor, Furthermore, the most common cause was the web (61.1%), only 4.8% have myeloproliferative diseases (JAK2 V617F mutation), and none Factor V Leiden mutation cases was found. 144 patients were treated by percutaneous transluminal angioplasty, the technical success rate was 95.1%, and took oral anticoagulation therapy for 12 months. At 18 months, The survival rate and the symptom-free survival rate after percutaneous transluminal angioplasty were 97.8% and respectively. CONCLUSION: Web is the most prevalent etiological factor for BCS in China. It is different in western countries; the common reasons of BCS are risk factors related to thrombosis, such as myeloproliferative disease and Factor V Leiden mutation, etc., which are seldom found in Chinese BCS patients. In China, most chronic BCS patients were treated with percutaneous transluminal angioplasty and have excellent clinical outcome.


Assuntos
Síndrome de Budd-Chiari/diagnóstico , Síndrome de Budd-Chiari/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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