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Transparent cap adjusted the stent placed for stenosis after endoscopic injection of esophageal varices:A case report

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World Journal of Clinical Cases 2024年第15期12卷 2614-2620页

作者： Fu-Long Zhang Jing Xu Yuan-Dong Zhu Qian-Neng Wu Yan Shi Lei Fang Dan Zhou Hai Wang Chao-JunHuang Chun-Hua Zhou Qun Zhu department of Gastroenterology Hangzhou Xixi hospitalHangzhou 310023Zhejiang ProvinceChina department of hepatopathy Hangzhou Xixi hospitalHangzhou 310023Zhejiang ProvinceChina

BACKGROUND The stent embedded in the esophageal mucosa is one of the complications after stenting for esophageal stricture.We present a case of stent adjustment with the aid of a transparent cap after endoscopic injection of an esophageal varices stent.CASE SUMMARY A 61-year-old male patient came to the hospital with discomfort of the chest after the stent implanted for the stenosis because of endoscopic injection of esophageal varices.The gastroscopy was performed,and the stent embedded into the esophageal mucosa.At first,we pulled the recycling line for shrinking the stent,however,the mucosa could not be removed from the stent.Then a forceps was performed to remove the mucosa in the stent,nevertheless,the bleeding form the mucosa was obvious.And then,we used a transparent cap to scrape the mucosa along the stent,and the mucosa were removed successfully without bleeding.CONCLUSION A transparent cap helps gastroscopy to remove the mucosa embedded in the stent after endoscopic injection of the esophageal varices stent.

关键词： Stent Transparent cap Stenosis Endoscopic injection Esophageal varices Case report

Liver abscess and tracheal fistula induced by transcatheter arterial chemoembolization for hepatocellular carcinoma:A case report

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World Journal of Clinical Cases 2024年第16期12卷 2911-2916页

作者： Fu-Long Zhang Jing Xu Yu-Hong Jiang Yuan-Dong Zhu Qian-Neng Wu Yan Shi Fang-Yuan Zhu Jing-Wen Chen Liang-Xiao Wu department of Gastroenterology Hangzhou Xixi HospitalHangzhou 310023Zhejiang ProvinceChina department of hepatopathy Hangzhou Xixi HospitalHangzhou 310023Zhejiang ProvinceChina

BACKGROUND Transarterial chemoembolization(TACE)is a standard treatment for intermediate-stage hepatocellular carcinoma(HCC).The complications of TACE include biliary tract infection,liver dysfunction,tumor lysis syndrome,biloma,partial intestinal obstruction,cerebral lipiodol embolism,etc.There are few reports about tracheal fistula induced by TACE.CASE SUMMARY A 42-year-old man came to our hospital with cough and expectoration for 1 month after TACE for HCC.Laboratory test results showed abnormalities of albumin,hemoglobin,prothrombin time,C-reactive protein,D-dimer,and prothrombin.Culture of both phlegm and liver pus revealed growth of Citrobacter flavescens.Computed tomography showed infection in the inferior lobe of the right lung and a low-density lesion with gas in the right liver.Liver ultrasound showed that there was a big hypoechoic liquid lesion without blood flow signal.Drainage for liver abscess by needle puncture under ultrasonic guidance was performed.After 1 month of drainage and anti-infection therapy,the abscess in the liver and the infection in the lung were reduced obviously,and the symptom of expectoration was relieved.CONCLUSION Clinicians should be alert to the possibility of complications of liver abscess and tracheal fistula after TACE for HCC.Drainage for liver abscess by needle puncture under ultrasonic guidance could relieve the liver abscess and tracheal fistula.

关键词： Tracheal fistula Liver abscess Transcatheter arterial chemoembolization Hepatocellular carcinoma Drainage Case report

Deficiency of betaine-homocysteine methyltransferase activates glucose-6-phosphate dehydrogenase(G6PD) by decreasing arginine methylation of G6PD in hepatocellular carcinogenesis

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Science China Life Sciences 2024年第8期 1648-1665页

作者： Jie Gao Xiaoyi Shi Yaohui Sun Xudong Liu Feng Zhang Chengcheng Shi Xiao Yu Zhiping Yan Long Liu Shizhe Yu Jiacheng Zhang Xiaodan Zhang Shuijun Zhang Wenzhi Guo department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital of Zhengzhou University Henan Diagnosis & Treatment League for hepatopathy The First Affiliated Hospital of Zhengzhou University Henan Innovative Research Group for Hepatobiliary & Pancreatic Surgery and Digestive Organ Transplantation Henan Organ Transplantation Quality Control Centre Henan Engineering Technology Research Center for Organ Transplantation department of Pharmacy The First Affiliated Hospital of Zhengzhou University department of General Surgery Huashan HospitalFudan University Cancer Metastasis Institute Fudan University

Betaine-homocysteine methyltransferase（BHMT） regulates protein methylation and is correlated with tumorigenesis;however,the effects and regulation of BHMT in hepatocarcinogenesis remain largely unexplored.Here,we determined the clinical significance of BHMT in the occurrence and progression of hepatocellular carcinoma（HCC） using tissue samples from 198 patients.BHMT was to be frequently found（86.6%） expressed at relatively low levels in HCC tissues and was positively correlated with the overall survival of patients with HCC.Bhmt overexpression effectively suppressed several malignant phenotypes in hepatoma cells in vitro and in vivo,whereas complete knockout of Bhmt(Bhmt-/-) produced the opposite effect.We combined proteomics,metabolomics,and molecular biological strategies and detected that Bhmt-/-promoted hepatocarcinogenesis and tumor progression by enhancing the activity of glucose-6-phosphate dehydrogenase（G6PD）and PPP metabolism in DEN-induced HCC mouse and subcutaneous tumor-bearing models.In contrast,restoration of Bhmt with an AAV8-Bhmt injection or pharmacological inhibition of G6PD attenuated hepatocarcinogenesis.Additionally,coimmunoprecipitation identified monomethylated modifications of the G6PD,and BHMT regulated the methylation of G6PD.Protein sequence analysis,generation and application of specific antibodies,and site-directed mutagenesis indicated G6PD methylation at the arginine residue 246.Furthermore,we established bidirectionally regulated BHMT cellular models combined with methylation-deficient G6PD mutants to demonstrate that BHMT potentiated arginine methylation of G6PD,thereby inhibiting G6PD activity,which in turn suppressed hepatocarcinogenesis.Taken together,this study reveals a new methylation-regulatory mechanism in hepatocarcinogenesis owing to BHMT deficiency,suggesting a potential therapeutic strategy for HCC treatment.

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Effect of Chinese Medicine Therapy for Strengthening-Pi and Nourishing-Shen in Preventing Lamivudine Induced YMDD Mutation and Its Immunologic Mechanism

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Chinese Journal of Integrative Medicine 2010年第1期16卷 19-22页

作者：冯慧张永华 department of hepatopathy Zhejiang Provincial Hospital of Integrative Medicine

Objective： To observe the effect of Chinese medicine therapy for strengthening-Pi （脾） and nourishing-Shen （肾, SPNS） in preventing lamivudine induced YMDD mutation and its immunological mechanism. Methods： One hundred and sixty chronic hepatitis B （CHB） patients with positive HBeAg were equally assigned to two groups at random： the observation group and the control group. Patients in the observation group were treated with lamivudine combined with SPNS, and those in the control group were treated with lamivudine only, with the treatment lasting for 52 weeks in total. Changes in indexes, including liver function, HbeAg, HBV-DNA, YMDD variation, CD4, CD4/CD8 ratio, interferon- γ, （IFN-γ）, interleukin-4 （IL-4）, blood routine, renal function, as well as any adverse reactions that occurred in patients, were observed at different time points. Results： The ALT, AST recovery rate and HBV-DNA negatively inversing rate at the 24th week, the 36th week and the 52nd week were all higher （P〈0.05）; meanwhile, the YMDD mutation rate at the 36th week and the 52nd week was lower （P〈0.05） in the observation group than in the control group. The post- treatment levels of CD4, CD4/CD8 ratio, IFN- γ, and IL-4 as well as the pre-post treatment difference of these indexes in the observation group were significantly different from those in the control group （n=〈0.05）. Conclusion： Chinese medicine SPNS therapy can significantly reduce the YMDD variation of HBV, and the mechanism may be related to its regulation of the CD4 level, CD4/CD8 ratio and Th1/Th2 balance. KEYWORDS Chinese medicine therapy for strengthening-Pi and nourishing-Shen, lamivudine, YMDD mutation, mechanism

关键词： Chinese medicine therapy for strengthening-Pi and nourishing-Shen lamivudine YMDDmutation mechanism

Evaluation on Quality of Life and Analysis on Its Correlation with TCM Syndromes in Patients of Chronic Hepatitis B

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Chinese Journal of Integrative Medicine 2009年第1期15卷 30-33页

作者：张玮王俐琼刘一博 department of hepatopathy Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Objective:To evaluate the quality of life(QOL) in patients with chronic hepatitis B(CHB) and analyze its correlation with traditional Chinese medicine(TCM) syndrome types.Methods:With cross-sectional investigation adopted,the QOL of 335 CHB patients was studied by the World Health Organization Quality of Life BREF Questionnaire(WHOQOL-BREF) and the chronic liver disease questionnaire(CLDQ).The results was compared with that of 30 healthy persons.Results:The QOL of the patients with chronic hepatitis B was l...

关键词： chronic hepatitis B quality of life traditional Chinese medicine syndrome type

A cyclodextrin-based nanoformulation achieves co-delivery of ginsenoside Rg3 and quercetin for chemo-immunotherapy in colorectal cancer

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Acta Pharmaceutica Sinica B 2022年第1期12卷 378-393页

作者： Dandan Sun Yifang Zou Liu Song Shulan Han Hao Yang Di Chu Yun Dai Jie Ma Caitriona M.O’Driscoll Zhuo Yu Jianfeng Guo School of Pharmaceutical Sciences Jilin UniversityChangchun 130021China Laboratory of Cancer Precision Medicine The First Hospital of Jilin UniversityChangchun 130021China Pharmacodelivery Group School of PharmacyUniversity College CorkCork T12 YT20Ireland department of hepatopathy Shuguang HospitalAffiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China

The immune checkpoint blockade therapy has profoundly revolutionized the field of cancer immunotherapy. However, despite great promise for a variety of cancers, the efficacy of immune checkpoint inhibitors is still low in colorectal cancer(CRC). This is mainly due to the immunosuppressive feature of the tumor microenvironment(TME). Emerging evidence reveals that certain chemotherapeutic drugs induce immunogenic cell death(ICD), demonstrating great potential for remodeling the immunosuppressive TME. In this study, the potential of ginsenoside Rg3(Rg3) as an ICD inducer against CRC cells was confirmed using in vitro and in vivo experimental approaches. The ICD efficacy of Rg3 could be significantly enhanced by quercetin(QTN) that elicited reactive oxygen species(ROS). To amelioratein vivo delivery barriers associated with chemotherapeutic drugs, a folate(FA)-targeted polyethylene glycol(PEG)-modified amphiphilic cyclodextrin nanoparticle(NP) was developed for co-encapsulation of Rg3 and QTN. The resultant nanoformulation(CD-PEG-FA.Rg3.QTN) significantly prolonged blood circulation and enhanced tumor targeting in an orthotopic CRC mouse model, resulting in the conversion of immunosuppressive TME. Furthermore, the CD-PEG-FA.Rg3.QTN achieved significantly longer survival of animals in combination with Anti-PD-L1. The study provides a promising strategy for the treatment of CRC.

关键词： Nano drug delivery system Chemotherapy Immunotherapy Combination therapy Immunogenic cell death Reactive oxygen species Tumor microenvironment Colorectal cancer

Inhibition of methicillin-resistant Staphylococcus aureus by the compound Qingre granules

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Chinese Medical Journal 2010年第8期123卷 1017-1020页

作者： YU Yi-yun WANG Hong ZHANG Shu-wen WANG Bao-en department of Infectious Diseases Beijing Friendship Hospital Capital Medical University Beijing 100050 China department of hepatopathy Beijing Friendship Hospital Capital Medical University Beijing 100050 China

Background The infection rate of methicillin-resistant Staphylococcus aureus （MRSA） is increasing yearly due to the overprescription of antibiotics. Traditional Chinese compound medicines are less inclined to induce bacterial resistance in the clinical setting because of their multi-acting mechanisms. However, most current research is limited to bacteriostasis in vitro using single extracts or formulations. Plasma pharmacology is an in vitro method, using what is called ＂medicine serum＂. The aim of this study was to investigate whether the medicine serum of compound Qingre granules （QRKL） alone or in combination with antibiotics may treat MRSA infection in the clinic. Methods An animal model of MRSA resistance was created by injecting rabbits with the standard strain of MRSA ATCC43300. Infected rabbits were treated with QRKL by intragastric administration. Sixty minutes after the last intragastric administration, serum was obtained from the rabbits by heart puncture to obtain what is termed ＂medicine serum＂. The minimum inhibitory concentration （MIC） of QRKL, medicine serum alone, or serum combined with antibiotics was assessed by agar dilution. Results were compared with the growth of sixteen isolates of MRSA. Results The MIC of QRKL to the standard strain ATCC43300 was 10.00 mg/ml. The MICgo of vancomycin was 1.00 pg/ml, which, when combined with QRKL, dropped to 0.50 lJg/ml. The MICg0 of cefuroxime alone was 512.00 pg/ml. This level also decreased to 256.00 tJg/ml when combined with QRKL. The addition of QRKL thus significantly reduced the MIC of both cefuroxime and vancomycin compared with antibiotics alone （P 〈0.01）. The MICgo of vancomycin with medicine serum decreased to 0.50 pg/ml, and the MIC of vancomycin with medicine serum also descended compared with using vancomycin alone （P 〈0.01）. Conclusions The growth of MRSA can be inhibited by QRKL or medicine serum of QRKL in vitro. The addition of QRKL results in increased sensitivity of MRSA to vancomycin and this may provide a novel treatment for patients

关键词： Compound Qingre Granules methicillin-resistant Staphylococcus aureus microbial sensitivity tests

Heme oxygenase-1 prevents liver fibrosis in rats by regulating the expression of PPAR_γ and NF-_κB

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World Journal of Gastroenterology 2012年第14期18卷 1680-1688页

作者： Hui Yang Long-Feng Zhao Zhong-Fu Zhao Yan Wang Jing-Jing Zhao Li Zhang department of Infectious Diseases the First AffiliatedHospital of Shanxi Medical University Taiyuan 030001 ShanxiProvince China Institute of hepatopathy Changzhi MedicalCollege Changzhi 046000 Shanxi Province China

AIM:To investigate the effects of heme oxygenase(HO)-1 on liver fibrosis and the expression of peroxisome proliferator-activated receptor gamma(PPARγ) and nuclear factor-kappa B(NF-κB) in rats.METHODS:Sixty Wistar rats were used to construct liver fibrosis models and were randomly divided into 5 groups:group A(normal,untreated),group B(model for 4 wk,untreated),group C(model for 6 wk,untreated),group D [model for 6 wk,treated with zinc protoporphyrin Ⅸ(ZnPP-Ⅸ) from week 4 to week 6],group E(model for 6 wk,treated with hemin from week 4 to week 6).Next,liver injury was assessed by measuring serum alanine aminotransferase(ALT),aspartate aminotransferase(AST) and albumin levels.The degree of hepatic fibrosis was evaluated by measuring serum hyaluronate acid(HA),type Ⅳ collagen(Ⅳ-C) and by histological examination.Hydroxyproline(Hyp) content in the liver homogenate was determined.The expres-sion levels of alpha-smooth muscle actin(α-SMA) in liver tissue were measured by real-time quantitative polymerase chain reaction(RT-PCR).The expression levels of PPARγ and NF-κB were determined by RT-PCR and Western blotting.RESULTS:The expression of HO-1 increased with the development of fibrosis.Induction of HO-1 by hemin significantly attenuated the severity of liver injury and the levels of liver fibrosis as compared with inhibition of HO-1 by ZnPP-Ⅸ.The concentrations of serum ALT,AST,HA and Ⅳ-C in group E decreased compared with group C and group D(P < 0.01).Amount of Hyp and α-SMA in the liver tissues in group E decreased compared with group C(0.62 ± 0.14 vs 0.84 ± 0.07,1.42 ± 0.17 vs 1.84 ± 0.17,respectively,P < 0.01) and group D(0.62 ± 0.14 vs 1.11 ± 0.16,1.42 ± 0.17 vs 2.56 ± 0.37,respectively,P < 0.01).The expression of PPARγ at levels of transcription and translation decreased with the development of fibrosis especially in group D;and it increased in group E compared with groups C and D(0.88 ± 0.15 vs 0.56 ± 0.19,0.88 ± 0.15 vs 0.41 ± 0.11,respectively,P < 0.01).The expression of NF-κB increased with the development o

关键词：血红素氧合酶-1 Wistar大鼠肝纤维化过氧化物酶体增殖物激活受体 α-平滑肌肌动蛋白 Western印迹核因子-κB RT-PCR

The Combined Use of Tonification and Purgation in Treatment of Fatty Liver

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Journal of Traditional Chinese Medicine 2003年第1期23卷 7-9页

作者：吴沛田王新中 hepatopathy department Sanya Municipal Hospital of Traditional Chinese MedicineSanya 572000Hainan Province

Fatty liver is a disease caused by excessive accumulation of fat in the liver due to long-term ort repeated affection of various causative factors'When the pathogenic factor prevails,the qi is sure to be deficient',Therefore,deficiency of the vital-qicontributes greatly to the occurrence of fatty liver.For many years,the author has concentrated ont the treatment of fatty liver with the tonificatioin method,or tonification followed by purgation,or the combination of tonificaytioin with purgation,so as to effectively prevent the liver from being injured by harmful substances ,and to benefit the recovery of fatty liver.The following is a report of his experience in treatment of fatty liver with the combined use of tonification and purgation.

关键词：脂肪肝催泻补益联合应用治疗中医药疗法