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World Journal of Gastroenterology 2022年第31期28卷 4467-4470页

作者： Xin Yao Sheng He Meng Wei jian-ping qin Department of Gastroenterology General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina

This letter is regarding the study titled‘Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt(TIPS)to reduce hepatic encephalopathy’.Prior to the approval of TIPS dedicated stents(Viatorr stents)in China in October 2015,Fluency covered stents were typically *** Fluency covered stents have a strong support force and axial elastic tension,a‘cap’may form if the stent is located too low at the end of the hepatic vein or too short at the end of the portal vein during surgery,leading to stent *** the blood shunted by the stent is from the main trunk of the portal vein,the correlation between the incidence of postoperative hepatic encephalopathy and the location of the puncture target(left or right portal vein branch)is worth ***,no studies in China or foreign countries have proven the occurrence of left and right blood stratification after the accumulation of splenic vein and mesenteric blood flow in the main trunk of the portal vein in patients with cirrhotic portal hypertension.

关键词： Viatorr stent Portosystemic shunt Transjugular intrahepatic Hypertension portal Left and right portal vein branches

Effects of transjugular intrahepatic portosystemic shunt using the Viatorr stent on hepatic reserve function in patients with cirrhosis

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World Journal of Clinical Cases 2021年第7期9卷 1532-1542页

作者： Xin Yao Hao Zhou Shan Huang Shan-Hong Tang jian-ping qin Department of Gastroenterology General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina Department of Gastroenterology Fengjie County People's HospitalChongqing 404600China Department of Digestive Medicine General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina Department of Digestion General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina

BACKGROUND As transjugular intrahepatic portosystemic shunt(TIPS)creation alters the hemodynamic status of the portal system,whether reduced portal blood supply affects the synthetic reserve function of the liver has been the focus of clinical *** the Viatorr stent entered the Chinese market in 2015,it has not yet been widely used in clinical ***,unlike other countries,the main cause of liver cirrhosis in China is viral ***,use of the Viatorr stent to establish a TIPS channel in patients with liver cirrhosis with differing etiologies is of great clinical *** To investigate factors affecting changes in liver reserve function after TIPS Viatorr stent *** Clinical data from 200 patients with cirrhotic portal hypertension who received TIPS treatment from March 2016 to March 2020 were analyzed *** patients were divided into three groups(A-C),according to their disease etiology,with post-hepatitis,autoimmune,and alcoholic cirrhosis,*** and postoperative liver and renal function and coagulation data,Child-Pugh grade,and model for end-stage liver disease(MELD)scores were *** analyses were performed using the t-test or chi-square *** incidence and of hepatic encephalopathy and patient survival were calculated using Kaplan-Meier *** The surgical success rate was 100%,with mean portal pressure gradient(mmHg)decreasing from 25.5±5.22 to 10.04±2.76(t=45.80;P<0.001).After 24 mo,the cumulative incidence of hepatic encephalopathy in group A was significantly lower than that in group B/C,while the cumulative survival rate was significantly higher in group A than in group B/C(P<0.05 for both).The Child-Pugh score for group A was 6.96±1.21,which was significantly better than those of groups B(7.42±0.99;t=-2.44;P=0.016)and C(7.52±1.12;t=-2.67;P=0.009).Further,the MELD score for group A(9.62±2.19)was significantly better than those for groups B(10.64

关键词： Portal shunt,transjugular intrahepatic Hypertension Viatorr stent Liver reserve function

Clinical efficacy of antiviral therapy in patients with hepatitis Brelated cirrhosis after transjugular intrahepatic portosystemic shunt

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World Journal of Gastroenterology 2021年第30期27卷 5088-5099页

作者： Xin Yao Shan Huang Hao Zhou Shan-Hong Tang jian-ping qin Department of Gastroenterology General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina Department of Gastroenterology Fengjie County People's HospitalChongqing 404600China

BACKGROUND As a country with a high burden of hepatitis B,China has about 86 million cases of hepatitis B virus infection,ranking the first in the ***,there are about 390000 deaths due to hepatitis B-related complications such as liver cirrhosis and liver cancer every ***,how to control portal hypertension,improve liver functional reserve,and reduce the incidence of hepatic failure and liver cancer in such patients is the focus of current clinical *** clinical study in our center suggested that at 24 mo after transjugular intrahepatic portosystemic shunt(TIPS),the liver functional reserve of patients with hepatitis B cirrhosis was better than that of patients with alcoholinduced and immune cirrhosis,which may be related to the effective etiological *** To investigate the clinical efficacy of three first-line antiviral drugs recommended by the guidelines of prevention and treatment for chronic hepatitis B in China(2019)in the treatment of patients with hepatitis B-related cirrhosis who had received a *** The clinical data of 137 patients with hepatitis B-related cirrhosis with portal hypertension after receiving TIPS at our centre between March 2016 and December 2020 were analysed *** to different anti-viral drugs,the patients were divided into entecavir(ETV)(n=70),tenofovir alafenamide fumarate(TAF)(n=32),and tenofovir disoproxil fumarate(TDF)(n=35)*** cumulative incidence of hepatic encephalopathy and hepatocellular carcinoma,survival,and changes in hepatic reserve function and glomerular filtration rate in patients treated with different antiviral drugs within 24 mo after surgery were *** At 24 mo after surgery,the Child-Pugh score in the TAF group(6.97±0.86)was lower than that in the TDF(7.49±0.82;t=-2.52,P=0.014)and ETV groups(7.64±1.17;t=-2.92,P=0.004).The model for end-stage liver disease score in the TAF group at 24 mo after surgery was 9.72±1.5,which was

关键词： Transjugular intrahepatic portosystemic shunt Hypertension Antiviral Hepatitis B-related cirrhosis Liver reserve function

Prevention and treatment of hepatic encephalopathy during the perioperative period of transjugular intrahepatic portosystemic shunt

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World Journal of Gastrointestinal Surgery 2023年第8期15卷 1564-1573页

作者： Lan-Jing Wang Xin Yao Qi Qi jian-ping qin Department of Gastroenterology The General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina

Transjugular intrahepatic portosystemic shunt(TIPS)is an established procedure for treating the complications of portal hypertension in liver *** the pathogenesis of postoperative TIPS-related hepatic encephalopathy(HE)has yet to be fully understood,intraoperative portosystemic shunts may provide a pathological basis for the occurrence of postope-rative HE in patients with liver *** at home and abroad have expressed mixed opinions about TIPSrelated *** study presents a literature review on the risk factors for and prevention and treatment of perioperative TIPS-related HE in patients with liver cirrhosis,aiming to optimize the procedure and reduce the incidence of postoperative HE.

关键词： Portosystemic shunt Transjugular intrahepatic Hepatic encephalopathy Liver cirrhosis Hypertension Portal Therapeutics

Temporary pacemaker protected transjugular intrahepatic portosystemic shunt in a patient with acute variceal bleeding and bradyarrhythmia:A case report

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World Journal of Clinical Cases 2021年第30期9卷 9192-9197页

作者： Xin Yao Shi-Hui Li Li-Rong Fu Shan-Hong Tang jian-ping qin Department of Gastroenterology General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina

BACKGROUND Esophagogastric varices are a common complication of cirrhosis with portal hypertension and endoscopic treatment has been recognized as a primary preventive and therapeutic option for such patients;however,it should be noted that bradyarrhythmia is regarded as one of the contraindications to endoscopic ***,acute variceal bleeding may result in a high mortality rate in cirrhotic patients with portal hypertension accompanied by *** present,there is an absence of reports concerning the treatment of such group of patients who underwent transjugular intrahepatic portosystemic shunt(TIPS).The present report details the case of a cirrhotic patient with acute variceal bleeding accompanied by bradyarrhythmia who underwent TIPS under temporary pacemaker *** SUMMARY We report the case of a 64-year-old male patient who was confirmed with bradyarrhythmia by ambulatory electrocardiogram 24 h before the *** patient was successfully treated by TIPS under temporary pacemaker *** In terms of cirrhotic patients with abnormal cardiac electrophysiological conduction,TIPS may be effective in reducing the complications of portal hypertension following the exclusion of severe pulmonary hypertension and heart failure,showing moderate feasibility in clinical applications.

关键词： Transjugular intrahepatic portosystemic shunt Hypertension Cirrhotic Temporary pacemaker Bradyarrhythmia

contrast enhanced computed tomography and reconstruction of hepatic vascular system for transjugular intrahepatic portal systemic shunt puncture path planning

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World Journal of Gastroenterology 2015年第32期21卷 9623-9629页

作者： jian-ping qin Shan-Hong Tang Ming-De jiang Qian-Wen He Hong-Bin Chen Xin Yao Wei-Zheng Zeng Ming Gu Department of Digestion General Hospital of Chengdu Military Command Disease Preventive and Control Center Chengdu Military Command Department of Radiology General Hospital of Chengdu Military Command

AIM: To describe a method for the transjugular intrahepatic portal systemic shunt(TIPS) placement performed with the aid of contrast-enhanced computed tomography(CECT) and three-dimensional reconstructed vascular images(3D RVIs), and to assess its safety and effectiveness. METHODS: Four hundred and ninety patients were treated with TIPS between January 2005 and December 2012. All patients underwent liver CECT and reconstruction of 3D RVIs of the right hepatic vein to portal vein(PV) prior to the operation. The 3D RVIs were carefully reviewed to plan the puncture path fromthe start to target points for needle pass through the PV in the TIPS procedure. R E S U LTS :The improved TIPS procedure was successful in 483(98.6%) of the 490 patients. The number of punctures attempted was one in 294(60%) patients, 2 to 3 in 147(30%) patients, 4 to 6 in 25(5.1%) patients and more than 6 in 17(3.5%) patients. Seven patients failed. Of the 490 patients, 12 had punctures into the artery, 15 into the bile duct, eight into the gallbladder, and 18 through the liver capsule. Analysis of the portograms from the 483 successful cases indicated that the puncture points were all located distally to the PV bifurcation on anteroposterior images, while the points were located proximally to the bifurcation in the three cases with intraabdominal bleeding. The complications included three cases of bleeding, of whom one died and two needed surgery. CONCLUSION: Use of CECT and 3D RVIs to plan the puncture path for TIPS procedure is safe, simple and effective for clinical use.

关键词： Transjugular intrahepatic portal systemic shunt Co

Clinical effects and complications of TIPS for portal hypertension due to cirrhosis:A single center

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World Journal of Gastroenterology 2013年第44期19卷 8085-8092页

作者： jian-ping qin Ming-De jiang Wen Tang Xiao-Ling Wu Xin Yao Wei-Zheng Zeng Hui Xu Qian-Wen He Ming Gu Department of Digestion Chengdu Military General Hospital Department of Radiology Chengdu Military General Hospital

AIM:To determine the clinical effects and complications of transjugular intrahepatic portosystemic shunt(TIPS)for portal hypertension due to ***:Two hundred and eighty patients with portal hypertension due to cirrhosis who underwent TIPS were retrospectively *** trunk pressure was measured before and after *** changes in hemodynamics and the condition of the stent were assessed by ultrasound and the esophageal and fundic veins observed ***:The success rate of TIPS was 99.3%.The portal trunk pressure was 26.8±3.6 cmH2O after surgery and 46.5±3.4 cmH2O before surgery(P<0.01).The velocity of blood flow in the portal vein *** internal diameters of the portal and splenic veins were *** short-term hemostasis rate was100%.Esophageal varices disappeared completely in68%of patients and were obviously reduced in 32%.Varices of the stomach fundus disappeared completely in 80%and were obviously reduced in 20%of *** disappeared in 62%,were markedly reduced in 24%,but were still apparent in 14%of *** total effective rate of ascites reduction was 86%.Hydrothorax completely disappeared in 100%of *** incidence of post-operative stent stenosis was 24%at 12 mo and 34%at 24 *** incidence of post-operative hepatic encephalopathy was 12%at3 mo,17%at 6 mo and 19%at 12 *** incidence of post-operative recurrent hemorrhage was 9%at 12mo,19%at 24 mo and 35%at 36 *** cumulative survival rate was 86%at 12 mo,81%at 24 mo,75%at 36 mo,57%at 48 mo and 45%at 60 ***:TIPS can effectively lower portal hypertension due to *** is significantly effective for hemorrhage of the digestive tract due to rupture of esophageal and fundic veins and for ascites and hydrothorax caused by portal hypertension.

关键词： Transjugular intrahepatic portosystemic shunt Cirrhosis Portal hypertension Therapeutic effect Complication

Correlation of the antiseptic resistance in Acinetobacter baumannii and the antiseptic resistance gene qacEΔ1 located in classⅠintegron

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Journal of Microbiology and Immunology 2006年第3期4卷 194-199页

作者： WEI FENG SHI jian ping qin NING XU Department of Clinical Laboratory the Third Affiliated Hospital Suzhou University Changzhou P.R. China Department of Clinical Laboratory Changzhou Traditional Medicine Hospital Changzhou P. R.China Department of Clinical Chemistry University Hospital of Lund Lund Sweden

In the past decade, uses of antiseptics and disinfectants in hospitals and other health care centers are rather common, but the chance to develop resistance to antiseptics and disinfectants is also increased. Acinetobacter baumannii is one of the opportunistic bacteria involving in the nosocomial infection. In the present study, the correlation of the antiseptic resistance in A. baumannii and the antiseptic resistance gene qacEΔ 1 was investigated by means of determination of MICs. Meanwhile, the MICs of glutaraldehyde, chlorhexidine, benzalkonium bromide, iodophor and trichloroisocyanurate to 80 clinical isolates of A. baumannii were detected by tube dilution assay and the resistance genes intll and qacE Δ 1 in these isolates were amplified by PCR and verified by DNA sequencer. It was found that the MIC50 for these 5 antiseptics tested were 32, 8, 8, 4 and 1 μg/ml respectively, and the detection rates of intll and qacEΔ1 gene were 60.0% and 77.6% respectively. In addition, 55% of the 80 isolates simultaneously possessed both intll and qacEΔ1 gene, and the percentage of antiseptic resistance of A. baumannii carring both genes to benzalkonium bromide were higher than that without these two genes, however, there was no significant difference between intll and qacEΔ1 gene. The result in bactericidal efficiency assay indicated that chlorhexidine could still produce rapid and strong bactericidal effect at concentration of 1 MIC after 10 rain exposure. These results suggest that the antiseptic resistance of A. baumannil to various antiseptics is correlated with the presence of the antiseptic resistance genes qacEΔ 1 in bacteria, thus warning that the increase of the antiseptic resistance should not be ignored and the relative high concentration or prolonged application time is required to achieve a sufficient bactericidal effect.

关键词： Acinetobacter baumannii Antiseptic Resistance Integron qacEΔ 1

Effect of Oxymatrine on the TGFbeta-Smad signaling pathway in rats with CCl_4-induced hepatic fibrosis

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World Journal of Gastroenterology 2008年第13期14卷 2100-2105页

作者： Xiao-Ling Wu Wei-Zheng Zeng Ming-De jiang jian-ping qin Hui Xu Department of Digestion General Hospital of Chengdu Military Command Chengdu 610083 Sichuan Province China

AIM： To explore the anti-fibrotic effect of Oxymatrine on CCl4-induced liver fibrosis in rats and its modulation on the TGFbeta-Smad signaling pathway. METHODS： One hundred healthy male SD rats were randomly divided into three groups： normal group （n = 20）, treatment group of Oxymatrine （n = 40） and CCh-induced fibrosis group （n = 40）. Experimental hepatic fibrosis was induced by subcutaneous injection of carbon tetrachloride （CCh soluted in liquid paraffin with the concentration of 300 g/L, the dosage of injection was 3 mL/kg, twice per week for 8 wk）. The treated rats received Oxymatrine via celiac injection at a dosage of 10 mg/kg twice a week at the same time. The deposition of collagen was observed with H＆E and Masson staining. The concentration of serum TGF-β1 was assayed with ELISA. The gene expression of Smads and CBP （CREB binding protein） was detected with in situ hybridization （ISH） and immunohistochemistry （IH）, respectively. All the experimental figures were scanned and analyzed with special figure-analysis software. RESULTS： A significant reduction of collagen deposition and rearrangement of the parenchyma was noted in the liver tissue of Oxymatrine-treated rats. The semi- quantitative histological scores （2.43 ± 0.47 μm^2 vs 3.76 ±0.68, P 〈 0.05） and average area of collagen/in those rats were significantly decreased when compared with hepatic cirrhosis model rats （94.41 ± 37.26 μm^2 vs 290.86 ± 89.37 μm^2, P 〈 0.05）. The gene expression of Smad 3 mRNA was considerably decreased in the treated animals. The A value of Smad 3 mRNA was lower in the treated rats than the model rats （0.034 ± 0.090 vs 0.167 ± 0.092, P 〈 0.05）. Contrarily, the A value of Smad 7 mRNA was increased considerably in the treated animals （0.175 ± 0.065 vs 0.074 vs 0.012, P 〈 0.05）. There was an obvious decrease in the expression of CBP mRNA in treated rats as illuminated by a reduction of its A value when compared with model rats （0.065±0.049 vs 0.235 ± 0.025, P 〈 0.001）. CONCLUSI

关键词： Oxymatrine Hepatic Fibrosis TGF-Smad signaling

Rare portal hypertension caused by Abernethy malformation(Type IIC):A case report

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World Journal of Radiology 2023年第8期15卷 250-255页

作者： Xin Yao Yang Liu Li-Dan Yu jian-ping qin Department of Gastroenterology General Hospital of Western Theater CommandChengdu 610083Sichuan ProvinceChina

BACKGROUND Abernethy malformation is a rare congenital vascular malformation with a portosystemic shunt that may clinically manifest as cholestasis,dyspnea,or hepatic encephalopathy,among other *** diagnosis and classification are very important to further guide ***,patients with congenital portosystemic shunts have no characteristics of portal ***,we report an 18-year-old female with prominent portal hypertension that manifested mainly as rupture and bleeding of esophageal *** showed a thin main portal vein,no portal vein branches in the liver,and bleeding of the esophageal and gastric varices caused by the collateral circulation upwards from the proximal main portal *** with Abernethy malformation type I are usually treated with liver transplantation,and patients with type II are treated with shunt occlusion,surgery,or transcatheter *** patient was treated with endoscopic surgery combined with drug therapy and had no portal hypertension and good hepatic function for 24 mo of *** SUMMARY This case report describes our experience in the diagnosis and treatment of an 18-year-old female with Abernethy malformation type IIC and portal *** condition was initially diagnosed as cirrhosis combined with portal *** patient was ultimately diagnosed using liver histology and subsequent imaging,and the treatment was highly *** publish this case report,written informed consent was obtained from the patient,including the attached imaging *** Abernethy malformation type IIC may develop portal hypertension,and traditional nonselective beta-blockers combined with endoscopic treatment can achieve high efficacy.

关键词： Abernethy malformation congenital absence of portal vein portal hypertension