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Xue H.,Xi'an Jiaotong University | Zhang M.,Central Hospital of Nanyang City | Pang J.X.Q.,Xi'an Jiaotong University | Yan F.,Xi'an Jiaotong University | And 6 more authors.
World Journal of Gastroenterology | Year: 2012

AIM: To compare early use of transjugular intrahepatic portosystemic shunt (TIPS) with endoscopic treatment (ET) for the prophylaxis of recurrent variceal bleeding.METHODS: In-patient data were collected from 190 patients between January 2007 and June 2010 who suffured from variceal bleeding. Patients who were older than 75 years; previously received surgical treatment or endoscopic therapy for variceal bleeding; and complicated with hepatic encephalopathy or hepatic cancer, were excluded from this research. Thirty-five cases lost to follow-up were also excluded. Retrospective analysis was done in 126 eligible cases. Among them, 64 patients received TIPS (TIPS group) while 62 patients received endoscopic therapy (ET group). The relevant data were collected by patient review or telephone calls. The occurrence of rebleeding, hepatic encephalopathy or other complications, survival rate and cost of treatment were compared between the two groups. RESULTS: During the follow-up period (median, 20.7 and 18.7 mo in TIPS and ET groups, respectively), rebleeding from any source occurred in 11 patients in the TIPS group as compared with 31 patients in the ET group (Kaplan-Meier analysis and log-rank test, P = 0.000). Rebleeding rates at any time point (6 wk, 1 year and 2 year) in the TIPS group were lower than in the ET group (Bonferroni correction a' = a/3). Eight patients in the TIPS group and 16 in the ET group died with the cumulative survival rates of 80.6% and 64.9% (Kaplan-Meier analysis and log-rank test χ2 = 4.864, P = 0.02), respectively. There was no significant difference between the two groups with respect to 6-wk survival rates (Bonferroni correction a' = a/3). However, significant differences were observed between the two groups in the 1-year survival rates (92% and 79%) and the 2-year survival rates (89% and 64.9%) (Bonferroni correction a' = a/3). No significant differences were observed between the two treatment groups in the occurrence of hepatic encephalopathy (12 patients in TIPS group and 5 in ET group, KaplanMeier analysis and log-rank test, χ2 = 3.103, P = 0.08). The average total cost for the TIPS group was higher than for ET group (Wilcxon-Mann Whitney test, 52 678 RMB vs 38 844 RMB, P < 0.05), but hospitalization frequency and hospital stay during follow-up period were lower (Wilcxon-Mann Whitney test, 0.4 d vs 1.3 d, P = 0.01; 5 d vs 19 d, P < 0.05). CONCLUSION: Early use of TIPS is more effective than endoscopic treatment in preventing variceal rebleeding and improving survival rate, and does not increase occurrence of hepatic encephalopathy. © 2012 Baishideng. All rights reserved.


Yang Y.-B.,Central Hospital of Nanyang City | Xing W.-Y.,Zhengzhou University | Wang G.-Z.,Central Hospital of Nanyang City
World Chinese Journal of Digestology | Year: 2015

AIM: To investigate the risk factors for postoperative ileus following radical resection for colorectal cancer. METHODS: A total of 1686 patients with colorectal cancer who underwent radical resection from January 2010 to January 2014 were enrolled for the prospective cohort study and received follow-up after discharge. Postoperative ileus was the outcome of followup. Patients with postoperative ileus were classified into group A (n = 90), and others into group B (n = 1596). Clinical data were compared between the two groups. Kaplan- Meier method was used to calculate the median time to postoperative ileus, and Cox proportional hazard model was performed to determine the risk factors. RESULTS: The median follow-up time among the 1686 cases was 10.5 mo. Ninety cases developed postoperative ileus, and the median time to postoperative ileus was 2.46 wk. Stage Ⅲ disease, history of colorectal cancer resection, preoperative intestinal obstruction, hypoproteinemia, conversion to open surgery, right hemicolectomy, left hemicolectomy, operation time ≥ 3 h, and postoperative radiotherapy were independent risk factors of postoperative ileus following radical resection for elderly patients with colorectal cancer, and laparoscopic operation was an independent protective factor (P < 0.05). CONCLUSION: Stage III disease, history of colorectal cancer resection, preoperative intestinal obstruction, hypoproteinemia, conversion to open surgery, right hemicolectomy, left hemicolectomy, operation time ≥ 3 h, and postoperative radiotherapy could increase the risk of postoperative ileus following radical resection for colorectal cancer, and laparoscopic operation could decrease the risk. © 2015 Baishideng Publishing Group Inc. All rights reserved.


Ma H.-L.,Central Hospital of Nanyang City | Li M.-L.,Central Hospital of Nanyang City | Li C.-S.,Central Hospital of Nanyang City | Zhang J.-W.,Central Hospital of Nanyang City | Ren Z.-H.,Central Hospital of Nanyang City
World Chinese Journal of Digestology | Year: 2014

AIM: To detect the expression of Tiam1, C-met and vascular endothelial growth factor (VEGF)-D in colorectal carcinoma and to assess their clinical significance. METHODS: One hundred and two colorectal carcinoma specimens, 80 intraepithelial neoplasia specimens, and 80 normal colorectal tissues were included in this study. The expression of Tiam1, C-met and VEGF-D in the above specimens was detected by immunohistochemistry. RESULTS: The expressions of Tiam1, C-met and VEGF-D differed significantly among colorectal carcinoma, intraepithelial neoplasia and normal colorectal tissues. The expression of Tiam1, C-met and VEGF-D was associated with tumor invasion, differentiation, vascular invasion and Dukes stage. There were positive correlations between Tiam1, C-met and VEGF-D expression in primary tumors. CONCLUSION: Overexpression of Tiam1, C-met and VEGF-D might be related to the development of colorectal carcinoma. Tiam1 and C-met can promote the expression of VEGF-D, which can in turn induce lymphangiogenesis in colorectal carcinoma. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.


Zhang H.,Central Hospital of Nanyang City | Guo M.,Central Hospital of Nanyang City | Chen J.-H.,Fudan University | Wang Z.,Central Hospital of Nanyang City | And 3 more authors.
Cellular Physiology and Biochemistry | Year: 2014

Background: Osteopontin (OPN) is associated with tumor formation, progression and metastasis, and increased OPN levels have been associated with poor survival in breast cancer. We investigated the mechanisms responsible for OPN activity, and the relationships between OPN expression and clinical parameters in breast cancer. Methods: OPN mRNA and protein levels were compared in malignant and benign breast tumors by polymerase chain reaction (PCR) and immunohistochemistry, respectively, and levels in breast cancer cells were determined by PCR and western blotting. The effects of lentiviral-mediated knockdown of OPN on OPN and αv,β3 integrin expression, cell invasion and migration, autophagy and apoptosis were analyzed in MDA-MB-231 cells. Results: OPN expression increased with aggressiveness of breast cancer phenotype. OPN knockdown inhibited αv, β3 integrin expression in MDA-MB-231 cells, with subsequent inhibition of cell migration and invasion. Knockdown also inhibited the PI3K/Akt/mTOR pathway, promoted expression of the autophagy-related gene products LC3 and Beclin 1, and increased apoptosis. OPN expression was positively associated with tumor grade and lymph node metastasis. Conclusion: These results suggest that knockdown of OPN may inhibit breast cancer metastasis by regulating αv,β3 integrin expression and inducing autophagy and subsequent inhibition of PI3K/Akt/mTOR signaling, thus providing further insights into the complex mechanisms regulating tumor growth and metastasis. © 2014 S. Karger AG, Basel.

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