Wu X.J.,Nanjing Jin Ling Hospital
Zhonghua wai ke za zhi [Chinese journal of surgery] | Year: 2010
To retrospectively compare the clinical outcome in patients with portal hypertension treated with transjugular intrahepatic portosystemic shunt (TIPS) using Fluency stent-graft (PTFE-covered stents) or bare stents. Approval of study and treatment protocol and waiver of informed consent for the retrospective study were obtained from institutional review board. Informed consent was obtained from each patient before procedure. Sixty consecutive patients with portal hypertension treated with TIPS from April 2007 to April 2009 were included. TIPS creation was performed with Fluency stent-graft in 30 patients (group A) and with bare stents in 30 patients (group B). Liver function, TIPS patency and clinical outcome were evaluated every 3 months. During hospitalization, there was no hepatic encephalopathy and recurrency of variceal bleeding.Acute shunt occlusion was observed in one patient with group A and another patient with group B.Follow-up was performed with average time of (6.2 +/- 3.9) months in group A and (8.3 +/- 4.4) months in group B. The rates of recurrent bleeding, acute shunt occlusion, hepatic encephalopathy and death were 3.3% and 20.0%, 0 and 30.0%, 16.7% and 20.0%, 0 and 13.3% in group A and B. The rates of recurrent bleeding, acute shunt occlusion and death in group A was lower than those in group B. There was no difference of hepatic encephalopathy between group A and B. The decrease of portal pressure and portosystemic pressure gradient, and the increase of portal flow and shunt flow in group A were higher than those in group B. There were no difference of liver function, ammonia and MELD between group A and B. Fluency stent-graft is safe and effective in TIPS creation, with high patency rate. Covered-stent can improve the clinical outcome of portal hypertension.
Rong J.-M.,No454 Hospital Of Pla |
Ji H.-Z.,Nanjing Jin Ling Hospital |
Wu X.-W.,Nanjing Jin Ling Hospital |
Sun Q.,Nanjing Jin Ling Hospital |
And 3 more authors.
Experimental and Therapeutic Medicine | Year: 2014
Chymase, a chymotrypsin-like protease, is a non-angiotensin-converting enzyme (ACE) angiotensin II (Ang II)-generating enzyme. The aim of the present study was to investigate whether chymase activity was increased in inflammatory polyps of elderly patients with functional bowel disorder (FBD). This study enrolled 45 elderly patients with FBD and 44 healthy control individuals. Expression of chymase in intestinal mucosa was assessed using fluorescence quantitative polymerase chain reaction and immunohistochemistry (IHC). IHC showed an increased number of chymase-positive mast cells in inflammatory polyps than in healthy intestinal mucosa (P<0.05). Compared with healthy mucosa, expression of chymase at the mRNA and protein level was significantly higher in inflammatory polyps. The frequencies of the chymase GG genotype and the G allele type were higher in the intestinal mucosa of patients with FBD compared with healthy controls (66.67 versus 40.91%, 81.11 versus 63.63%, both P<0.05). The frequency of the G allele type in the intestinal mucosa of the C4 subgroup of FBD was higher than that in the control group. However, in other FBD subgroups, there was no difference between patients and controls. Based on the fact that enhanced chymase expression was observed in inflammatory polyps of elderly patients with FBD relative to those in healthy controls, it was concluded that chymase has a significant role in the pathogenesis of inflammatory polyps in elderly patients with FBD.