BACKGROUND The efficacy of endoscopic ultrasonography for the follow-up of gastric varices treated with endoscopic variceal ligation(EVL)has not been established.AIM To evaluate the diagnostic correlation of esophagog...BACKGROUND The efficacy of endoscopic ultrasonography for the follow-up of gastric varices treated with endoscopic variceal ligation(EVL)has not been established.AIM To evaluate the diagnostic correlation of esophagogastroduodenoscopy(EGD)and high-frequency intraluminal ultrasound(HFIUS)for type 1 gastric varices(GOV1)after EVL and to identify the predictability for rebleeding of EGD and HFIUS.METHODS In liver cirrhosis patients with GOV1,we performed endoscopic follow-up using EGD and HFIUS synchronously after EVL for hemorrhage from GOV1.Endoscopic grading and red color signs were analyzed using EGD,and the largest variceal cross-sectional areas were measured using HFIUS.In addition,1-year follow-up was performed.Variceal rebleeding was defined as the presence of hematemesis,hematochezia,or melena without other evidence of bleeding on endoscopic follow-up.RESULTS In 26 patients with GOV1,variceal cross-sectional areas on HFIUS of GOV1 was poorly correlated with EGD grading of GOV1(r=0.36).In 17 patients who completed the 1-year follow-up,variceal cross-sectional areas on HFIUS was a good predictor of subsequent rebleeding,whereas EGD grading was not a predictor of subsequent rebleeding.CONCLUSION HFIUS measurement is more predictive of GOV1 rebleeding than EGD grading,so HFIUS measurement may be necessary for endoscopic follow-up after EVL in patients with GOV1.展开更多
High-frequency spinal cord stimulation(HF-SCS) has been established as an effective therapy for neuropathic pain. However, the analgesic mechanisms involved in HF-SCS remain to be clarified. In our study, adult rat ne...High-frequency spinal cord stimulation(HF-SCS) has been established as an effective therapy for neuropathic pain. However, the analgesic mechanisms involved in HF-SCS remain to be clarified. In our study, adult rat neuropathic pain was induced by spinal nerve ligation. Two days after modeling, the rats were subjected to 4 hours of HF-SCS(motor threshold 50%, frequency 10,000 Hz, and pulse width 0.024 ms) in the dorsal horn of the spinal cord. The results revealed that the tactile allodynia of spinal nerve-injured rats was markedly alleviated by HFSCS, and the effects were sustained for 3 hours after the stimulation had ceased. HF-SCS restored lysosomal function, increased the levels of lysosome-associated membrane protein 2(LAMP2) and the mature form of cathepsin D(matu-CTSD), and alleviated the abnormally elevated levels of microtubule-associated protein 1 A/B-light chain 3(LC3)-II and sequestosome 1(P62) in spinal nerve-injured rats. HF-SCS also mostly restored the immunoreactivity of LAMP2, which was localized in neurons in the superficial layers of the spinal dorsal horn in spinal nerve-injured rats. In addition, intraperitoneal administration of 15 mg/kg chloroquine for 60 minutes reversed the expression of the aforementioned proteins and shortened the timing of the analgesic effects of HF-SCS. These findings suggest that HF-SCS may exhibit longlasting analgesic effects on neuropathic pain in rats through improving lysosomal dysfunction and alleviating autophagic flux. This study was approved by the Laboratory Animal Ethics Committee of China Medical University, Shenyang, China(approval No. 2017 PS196 K) on March 1, 2017.展开更多
目的利用血清学、影像学及病理学评价3种术式大鼠肝外型胆汁淤积模型造模方式的优缺点。方法将15只雌性SD大鼠随机分为传统组、改良组及电刀组,分别采用胆总管结扎法(n=5)、肝门区肝总管缝扎法(n=5)及胆总管高频电刀电凝法(n=5)进行胆...目的利用血清学、影像学及病理学评价3种术式大鼠肝外型胆汁淤积模型造模方式的优缺点。方法将15只雌性SD大鼠随机分为传统组、改良组及电刀组,分别采用胆总管结扎法(n=5)、肝门区肝总管缝扎法(n=5)及胆总管高频电刀电凝法(n=5)进行胆汁淤积手术造模,术前及术后进行CT平扫及体重测量,比较肝密度、胆管直径;术后7 d 3组大鼠进行采血,测量谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL);采血结束后麻醉过量法处死大鼠,取部分肝组织使用4.2%~5.2%福尔马林溶液固定,石蜡切片HE染色观察病理学变化。结果3组大鼠造模后7 d均出现不同程度的肝损伤及胆汁淤积。传统组较电刀组AST、TBIL、DBIL高(P<0.05),传统组较改良组AST、ALT、TBIL、DBIL高(P<0.05);传统组及电刀组ALT、改良组及电刀组AST、ALT、TBIL、DBIL之间比较均无统计学差异(P>0.05);病理学可见传统组在三组中胆管增生、胆管壁增厚程度最严重,改良组程度最轻,电刀组居于两者之间;CT扫描传统组扩张肝外胆管内径大于改良组和电刀组(P<0.05),改良组及电刀组两组之间胆管直径无统计学差异(P>0.05);传统组肝CT值与术前比较明显减低(P<0.01),改良组和电刀组肝CT值较术前均无统计学差异(P>0.05)。结论电刀法及改良法均较有效的延长大鼠胆汁淤积的病程,可以更好的模拟人部分肝外胆汁淤积类疾病,为动态观察胆汁淤积病理过程提供了可能。展开更多
基金Konkuk University Medical Center Research Grant 2018.
文摘BACKGROUND The efficacy of endoscopic ultrasonography for the follow-up of gastric varices treated with endoscopic variceal ligation(EVL)has not been established.AIM To evaluate the diagnostic correlation of esophagogastroduodenoscopy(EGD)and high-frequency intraluminal ultrasound(HFIUS)for type 1 gastric varices(GOV1)after EVL and to identify the predictability for rebleeding of EGD and HFIUS.METHODS In liver cirrhosis patients with GOV1,we performed endoscopic follow-up using EGD and HFIUS synchronously after EVL for hemorrhage from GOV1.Endoscopic grading and red color signs were analyzed using EGD,and the largest variceal cross-sectional areas were measured using HFIUS.In addition,1-year follow-up was performed.Variceal rebleeding was defined as the presence of hematemesis,hematochezia,or melena without other evidence of bleeding on endoscopic follow-up.RESULTS In 26 patients with GOV1,variceal cross-sectional areas on HFIUS of GOV1 was poorly correlated with EGD grading of GOV1(r=0.36).In 17 patients who completed the 1-year follow-up,variceal cross-sectional areas on HFIUS was a good predictor of subsequent rebleeding,whereas EGD grading was not a predictor of subsequent rebleeding.CONCLUSION HFIUS measurement is more predictive of GOV1 rebleeding than EGD grading,so HFIUS measurement may be necessary for endoscopic follow-up after EVL in patients with GOV1.
基金supported by the National Nature Science Foundation of China,No.81870838Liaoning Province Distinguished Professor Support Program of China,No.XLYC1802096+1 种基金Shenyang Clinical Medicine Research Center of Anesthesiology of China,Nos.19-110-4-24,20-204-4-44the Outstanding Scientific Foundation of Shengjing Hospital of China,No.201708(all to PZ)。
文摘High-frequency spinal cord stimulation(HF-SCS) has been established as an effective therapy for neuropathic pain. However, the analgesic mechanisms involved in HF-SCS remain to be clarified. In our study, adult rat neuropathic pain was induced by spinal nerve ligation. Two days after modeling, the rats were subjected to 4 hours of HF-SCS(motor threshold 50%, frequency 10,000 Hz, and pulse width 0.024 ms) in the dorsal horn of the spinal cord. The results revealed that the tactile allodynia of spinal nerve-injured rats was markedly alleviated by HFSCS, and the effects were sustained for 3 hours after the stimulation had ceased. HF-SCS restored lysosomal function, increased the levels of lysosome-associated membrane protein 2(LAMP2) and the mature form of cathepsin D(matu-CTSD), and alleviated the abnormally elevated levels of microtubule-associated protein 1 A/B-light chain 3(LC3)-II and sequestosome 1(P62) in spinal nerve-injured rats. HF-SCS also mostly restored the immunoreactivity of LAMP2, which was localized in neurons in the superficial layers of the spinal dorsal horn in spinal nerve-injured rats. In addition, intraperitoneal administration of 15 mg/kg chloroquine for 60 minutes reversed the expression of the aforementioned proteins and shortened the timing of the analgesic effects of HF-SCS. These findings suggest that HF-SCS may exhibit longlasting analgesic effects on neuropathic pain in rats through improving lysosomal dysfunction and alleviating autophagic flux. This study was approved by the Laboratory Animal Ethics Committee of China Medical University, Shenyang, China(approval No. 2017 PS196 K) on March 1, 2017.
文摘目的利用血清学、影像学及病理学评价3种术式大鼠肝外型胆汁淤积模型造模方式的优缺点。方法将15只雌性SD大鼠随机分为传统组、改良组及电刀组,分别采用胆总管结扎法(n=5)、肝门区肝总管缝扎法(n=5)及胆总管高频电刀电凝法(n=5)进行胆汁淤积手术造模,术前及术后进行CT平扫及体重测量,比较肝密度、胆管直径;术后7 d 3组大鼠进行采血,测量谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL);采血结束后麻醉过量法处死大鼠,取部分肝组织使用4.2%~5.2%福尔马林溶液固定,石蜡切片HE染色观察病理学变化。结果3组大鼠造模后7 d均出现不同程度的肝损伤及胆汁淤积。传统组较电刀组AST、TBIL、DBIL高(P<0.05),传统组较改良组AST、ALT、TBIL、DBIL高(P<0.05);传统组及电刀组ALT、改良组及电刀组AST、ALT、TBIL、DBIL之间比较均无统计学差异(P>0.05);病理学可见传统组在三组中胆管增生、胆管壁增厚程度最严重,改良组程度最轻,电刀组居于两者之间;CT扫描传统组扩张肝外胆管内径大于改良组和电刀组(P<0.05),改良组及电刀组两组之间胆管直径无统计学差异(P>0.05);传统组肝CT值与术前比较明显减低(P<0.01),改良组和电刀组肝CT值较术前均无统计学差异(P>0.05)。结论电刀法及改良法均较有效的延长大鼠胆汁淤积的病程,可以更好的模拟人部分肝外胆汁淤积类疾病,为动态观察胆汁淤积病理过程提供了可能。
