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Table of Content

    25 May 2021, Volume 26 Issue 03 Previous Issue    Next Issue
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    Editorial
    Experts forum
    Liver transplantation in treatment of cirrhotic portal hypertension
    LI Tao, CHEN Hao
    2021, 26 (03):  189-194.  DOI: 10.16139/j.1007-9610.2021.03.002
    Abstract ( 270 )   HTML ( 1 )   PDF (579KB) ( 326 )  
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    Study on pathogenesis of cirrhotic portal hypertension: current status
    LUO Meng, LI Hongjie, ZHENG Lei
    2021, 26 (03):  195-198.  DOI: 10.16139/j.1007-9610.2021.03.003
    Abstract ( 438 )   HTML ( 6 )   PDF (378KB) ( 166 )  
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    Drug therapy for esophageal and gastric fundus varices in liver cirrhosis
    HU Mingli, WANG Qixia, MA Xiong
    2021, 26 (03):  203-207.  DOI: 10.16139/j.1007-9610.2021.03.005
    Abstract ( 319 )   HTML ( 2 )   PDF (507KB) ( 196 )  
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    Clinical value of TIPS in treatment of portal hypertension with esophageal and gastric fundus variceal hemorrhage
    FAN Xinxin, WU Xingjiang, HE Changsheng
    2021, 26 (03):  208-211.  DOI: 10.16139/j.1007-9610.2021.03.006
    Abstract ( 196 )   HTML ( 1 )   PDF (368KB) ( 133 )  
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    Evaluation of liver function in portal hypertension during perioperative stage
    CHEN Wei, BU Junfeng
    2021, 26 (03):  212-216.  DOI: 10.16139/j.1007-9610.2021.03.007
    Abstract ( 254 )   HTML ( 0 )   PDF (543KB) ( 215 )  
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    Prospect of laparoscopic surgery in treatment of portal hypertension
    YANG Tao, YIN Jikai, LU Jianguo
    2021, 26 (03):  217-220.  DOI: 10.16139/j.1007-9610.2021.03.008
    Abstract ( 268 )   HTML ( 0 )   PDF (441KB) ( 128 )  
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    Original article
    Short-term clinical outcome of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension in liver cirrhosis
    CUI Ran, YE Lunhe, WANG Xujing, WANG Yongkun, ZHANG Qiqi, WANG Kaijing, WANG Ming, DAI Chenxin, YANG Ludi, DONG Chunxiu, CHEN Bo
    2021, 26 (03):  221-225.  DOI: 10.16139/j.1007-9610.2021.03.009
    Abstract ( 375 )   HTML ( 2 )   PDF (835KB) ( 128 )  

    Objective To investigate the short-term outcome and safety of laparoscopic splenectomy combined with peripheral cardia disconnection in treatment of portal hypertension. Methods A retrospective analysis was done with clinical data of 23 patients who underwent laparoscopic splenectomy combined with peripheral cardia disconnection in our hospital from September 2018 to December 2020. Comparison was performed using the clinical data of 13 cases with the method of open surgery, which were comparable to the clinical pathological baseline. Results Less blood loss, longer operative time, and earlier both exhaust time and feeding time were found in the patients of laparoscopic group compared with those in open group. There were no statistically significant differences in postoperative hospital stay and postoperative complications including bleeding, pleural effusion, deep vein thrombosis, gastroparesis, and incision infection between two groups(P>0.05). Conclusions Laparoscopic splenectomy combined with peripheral cardia disconnection can treat portal hypertension which is safe, less blood loss, early postoperative feeding and the short-term outcome similar to open surgery.

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    Surgical treatment of esophagogastric varices from cavernous transformation of portal vein: one case report
    SUN Longci, ZHANG Bin
    2021, 26 (03):  226-230.  DOI: 10.16139/j.1007-9610.2021.03.010
    Abstract ( 438 )   HTML ( 0 )   PDF (770KB) ( 407 )  

    Objective To discuss the treatment of esophagogastric varices fom cavernous transformation of portal vein(CTPV). Methods A 2l-year-old male patient with CTPV from Department of Gastrointestinal Surgery Renji Hospital im2020 was analyzed retrospectively. Results The patient was admitted with lower WBC count 1.38×109/L and lower plateletcount 37×109/L and abdominal enhanced CT scan showedl main portal vein obliteration and collateral vessels proximal tothe obstruction.The examination revealed negative hepatitis markers and Child-Pugh A stage.He was diagnosed as CTPvassociated with large esophagogastric varices, massive splenomegaly and hypersplenism. He underwent splenectomy,splenorenal shunting and pericardial devascularization and the postoperative recovery was uneventful without hepaticencephalopathy. Postoperative abdominal CTA was suggestive of splenorenal shunt patent. Conclusion lt was suggested that preventive shunting and devascularization were suitable for CTPV associated with large esopha gogastric varices, massive splenomegaly and hypersplenism.

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    Retrospective analysis of immunosuppression drug withdrawal after liver transplantation
    QI Debin, CHEN Peng, TONG Hui, PENG Chenghong, LI Tao
    2021, 26 (03):  231-235.  DOI: 10.16139/j.1007-9610.2021.03.011
    Abstract ( 324 )   HTML ( 1 )   PDF (450KB) ( 92 )  

    Objective To analyze the clinical data of patients with immunosuppression drug withdrawal after liver transplantation. Methods The clinical data of 15 patients with immunosuppression drug withdrawal after liver transplantation in our center from January 2013 to June 2020 were analyzed retrospectively. Results Eleven patients had immunosuppression withdrawal passively with time(10.4±6.2) months because of severe adverse effects. Two cases had acute rejection and success rate was 81.8%. The withdrawal time of 4 patients with active immunosuppression withdrawal was (28.8±30.3) months, and withdrawal was all successful(100%). One case had complete immunosuppression withdrawn for 74 months. There were no statistically significant differences in terms of sex, age, body mass index, induction of monoclo-nal antibody, time after liver transplantation, complications(diabetes, hyperlipidemia, hypertension), withdrawal time and success rate between active withdrawal group and passive withdrawal group (P>0.05). Duration after liver transplantation in successful withdrawal group was significantly longer than that in failed withdrawal group(P<0.05). Conclusions The patients after liver transplantation with long-term survival can safely and completely withdraw immunosuppression under guidance by doctors, but should be followed up closely.

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    Clinical effect of endoscopic full thickness resection in treatment of small gastric submucosal tumors
    LIU Jingzheng, REN Zhong, HU Jianwei, QIN Wenzheng, ZHONG Yunshi, ZHOU Pinghong
    2021, 26 (03):  236-239.  DOI: 10.16139/j.1007-9610.2021.03.012
    Abstract ( 348 )   HTML ( 2 )   PDF (690KB) ( 117 )  

    Objective To evaluate the clinical efficacy of endoscopic full thickness resection in treatment of small gastric submucosal tumors (diameter≤1 cm). Methods A total of 102 patients with small gastric submucosal tumors treated using endoscopic full thickness resection in Zhongshan Hospital, Fudan University between January 2015 and December 2015 were analyzed retrospectively. Tumor resection rate, procedure time, interoperative bleeding and postoperative complications were observed in the procedures. Patients had follow-up endoscopy for evaluation of efficacy and safety. Results Endoscopic treatment was successful and resection of tumor was complete for all 102 patients. The average procedure time was (34.8±7.5) (11-126) min, Tumor diameter was (0.50±0.36) (0.3-1.0) cm and located all at gastric fundus. Pathological diagnose showed that 51 cases were with stromal tumor(50%), 45 cases with leiomyoma(44.1%), 2 cases with fibroma (2.0%), 2 cases with neuroendocrine tumors(2.0%), 1 case with hamartoma(1.0%), and 1 case with lymphoma(1.0%). Bleeding and perforation were not found and lesion surface of stomach was repaired well shown by follow-up. Conclusions Endoscopic full thickness resection in treatment of gastric submucosal tumors is effective and safe.

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    Analysis of efficacy of dexmedetomidine combined with sufentanil anesthesia in ERCP
    DU Chonglin, LI Xiaojing, FAN Qiuwei, XIA Yimeng
    2021, 26 (03):  240-243.  DOI: 10.16139/j.1007-9610.2021.03.013
    Abstract ( 307 )   HTML ( 1 )   PDF (459KB) ( 93 )  

    Objective To study the effect of anesthesia with a dexmedetomidine-sufentanil combination in patients undergoing endoscopic retrograde cholangiopancreatography(ERCP), we observe the hemodynamic variation and the incidence of adverse reactions. Methods Fifty-two patients with ERCP were randomized and divided into two groups each 26 cases: study group using anesthesia with a dexmedetomidine-sufentanil combination and control group using local anesthetics with lidocaine aerosol. Clinical results were compared. Characteristic and demography in two groups were evalua-ted. Mean arterial pressure, heart rate and pulse oxygen saturation value were recorded with examination of a total 11 times including before anesthesia, and 5 min, 10 min after intravenous anesthetics, and at the time of entering the endoscopy, and the time of 1 min, 3 min, 5 min, 10 min, 15 min during ERCP, and at the end of ERCP endoscopic operation. The adverse effect during ERCP was observed including cough, nausea and vomiting, dysphoria, restlessness and respiratory depression. The degree of comfort and acceptance of patients were recorded on the first day after ERCP. Results Hemodynamic variation and the incidence of adverse reactions were significantly lower in study group than those in control group respectively(P<0.05). There was no significant difference in pulse oxygen saturation between two groups. The accep-tability to receive ERCP was 100% in study group and 65% only in control group. The operative time was significantly shorter in study group than that in control group(P<0.05). Conclusions Anesthesia with dexmedetomidine-sufentanil combination under monitored care for ERCP could have an advantage of more safe and more comfort on patients and acceptance.

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    Effects and safety of continuous infusion of cisatracurium in laparoscopic abdominal surgery
    ZHU Qianlin, LI Kai, ZI Yuqiang, JIN Weifang
    2021, 26 (03):  244-248.  DOI: 10.16139/j.1007-9610.2021.03.014
    Abstract ( 282 )   HTML ( 1 )   PDF (498KB) ( 83 )  

    Objective To explore the effects and safety of continuous infusion of cisatracurium in laparoscopic abdominal surgery. Methods Ninety patients undergoing elective laparoscopic abdominal surgery in Gubei Branch of Ruijin Hospital from January 2019 to January 2020 were randomly divided into continuous infusion group (n=45) and intermittent infusion group (n=45). Parameters including dosage of cisatracurium, onset time, lack of muscle relaxant occurrences, extubation time, recovery index, which was stimulation with train of four(TOF) and T1 recovery from 25% to 75%, TOF 70% (recovery time for 70% from drug withdrawal to TOF), TOF 90%(recovery time for 90% from drug withdrawal to TOF), both mean arterial pressure and heart rate during anesthesia and during induction, and adverse reactions were compared between two groups. Results There was no significant difference in onset time of cisatracurium between two groups(P=0.102). Lack of muscle relaxant occurrences(P=0.003) and dosage of cisatracurium (P<0.001) in continuous infusion group was significantly lower than those in intermittent infusion group. There was no significant difference in extubation time between two groups (P=0.095). Recovery index, TOF 70% and TOF 90% in continuous infusion group were significantly lower than those in intermittent infusion group (P<0.001). There was no significant difference in both mean arterial pressure and heart rate during anesthesia and during induction(P>0.05) and in the incidence of adverse reactions(P>0.05) between two groups. Conclusions Compared with intermittent infusion, continuous infusion of cisatracurium in laparoscopic abdominal surgery could have more effect of muscle relaxation, reduce the dosage of cisatracurium, shorten recovery index and reduce adverse reactions.

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    Expression of microRNA-324-5p in hepatocellular carcinoma based on the Cancer Genome Atlas (TCGA) database and analysis of prognosis risk factor
    WU Chengxiao, FANG Jie, ZHOU Jichuan, XIAO Yongsheng, ZHANG Xiaoguang
    2021, 26 (03):  249-253.  DOI: 10.16139/j.1007-9610.2021.03.015
    Abstract ( 366 )   HTML ( 3 )   PDF (562KB) ( 89 )  

    Objective To study the expression of microRNA-324-5p (miR-324-5p) in hepatocellular carcinoma (HCC) and the prognosis risk factor in patients with HCC. Methods MiRNA expression database in tissue of both tumor and normal liver combined with clinical data of HCC patients were collected from The Cancer Genome Atlas (TCGA) database. Relationship between miR-324-5p expression and pathological features was analyzed. Relation of miR-324-5p expression to prognosis of the patients was analyzed through survival curve. Univariate and multivariate Cox regression models were used to analyze the risk factors related to HCC. Results The expressions of miR-324-5p in HCC were higher than those in normal tissues(P<0.001) and were associated with poor prognosis. Multivariate Cox analysis showed that miR-324-5p was an independent risk factor for HCC (P<0.05). Conclusions MiR-324-5p is upregulated in HCC, which play a role as risk factor in the HCC patients with shorten suvival and may be a possible biomarker of HCC prognosis prediction.

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    Clinical effect and prognosis analysis of laparoscopic cholecystectomy combined with cholangioscopy and duodenoscopy in treatment of gallbladder stones associated with choledocholithiasis
    ZHANG Bo, HUANG Xia
    2021, 26 (03):  254-258.  DOI: 10.16139/j.1007-9610.2021.03.016
    Abstract ( 451 )   HTML ( 0 )   PDF (643KB) ( 120 )  

    Objective To compare the clinical effects on elderly patients suffered from gallbladder stones associated with choledocholithiasis between the group of laparoscopic cholecystectomy(LC) with common bile duct exploration (LCBDE) using three scopys including laparoscopy, cholangioscopy and duodenoscopy and the group of endoscopic sphincterotomy(EST) with LC. Methods Sixty elderly patients more than 65 years with stones in gallbladder and common bile duct had common bile duct diameter 10 mm and more in our hospital between March 2018 and June 2019 and were analyzed retrospectively. Thirty-five cases had LC and LCBDE with primary duct closure combined with biliary stent. Twenty-five cases were treated EST with LC. Clinical effects were compared between two groups. Results There was no significant difference in postoperative hospital stay, pancreatitis, biliary bleeding, pulmonary infection and stone recurrence, biliary tract infection between two groups. However, the differences were significant in operative time, hospital cost and postoperative hyperamylasemia between two groups. Conclusions The stones in gallbladder and common bile duct in elderly patients could be treated by LC, LCBDE and primary duct closure combined with biliary stent, which had better clinical effects when compared to EST and LC.

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    Estrogen: risk factor for Xinjiang female patients with gallstone
    Azatijiang Ainiwaer, Abuduwaili Aierken, YU Sufu, YU Wenqing, Kelimu
    2021, 26 (03):  259-261.  DOI: 10.16139/j.1007-9610.2021.03.017
    Abstract ( 306 )   HTML ( 1 )   PDF (363KB) ( 172 )  

    Objective To investigate estrogen as one of risk factors in women with gallstone in Xinjiang. Methods Estradiol, luteinizing hormone(LH), follicle-stimulating hormone(FSH), testosterone, progesterone, and prolactin in 204 women with gallstone were compared with those in 204 control patients without gallstone. Results There were no statistically significant differences in LH, FSH, testosterone, progesterone and prolactin levels between Xinjiang female patients with gallstone and the patients in control group and between female patients with single stone and those with multiple stones. Estradiol level increased statistically significant both premenopausal women and postmenopausal women when compared with controls women. Higher estradiol level was found in female patients of multiple gallstones compared with that in female patients of single gallstone with statistically significant difference. Conclusions There was increase in serum estrogen of premenopausal and postmenopausal women combined with the higher estrogen level in women with multiple gallstones than those with single gallstone, which indicated the increasing in serum estrogen may be risk factor for gallstone disease and the pathogenesis of gallstone disease.

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    Proteomics analysis of exosome in mice with Candida albicans infection for biomarker
    WANG Zetian, WU Chunrong, QI Yue, XU Dan, SUN Keyuan, TANG Jianguo
    2021, 26 (03):  262-268.  DOI: 10.16139/j.1007-9610.2021.03.018
    Abstract ( 378 )   HTML ( 4 )   PDF (1146KB) ( 238 )  

    Objective To analyze serum exosome using proteomic in mice with Candida albicans infection and to find out marker. Methods Mice model of Candida albicans infection was established by injection of Candida albicans liquid through tail vein. Exosome in serum were extracted and analyzed by liquid chromatography-mass spectrometry/mass spectrometry. Mice models of both Staphylococcus aureus infection and Escherichia coli infection were established to compare the protein expression in exosome among three groups of infection. Results A total of 4 055 peptides and 418 proteins were identified. With the ratio <0.5 or >2.0 times between Candida albicans infection group and normal control group and with P<0.05, 10 of different proteins were screened out. Both Cathepsin B and Pentraxin 3 which were related with Candida albicans infection were identified by ELISA. Receiver operating characteristic curves were used to evaluate proteins and the different proteins in exosome were found to have high sensitivity and specificity. In 3 groups of Candida albicans infection, Staphylococcus aureus infection and Escherichia coli infection, it was found that exosome proteins expressed more in Candida albicans infection group and less in the other two infection group. Conclusions Proteins including Cathepsin B and Pentraxin 3 were related to Candida albicans infection, which could be used as molecular markers of Candida albicans infection.

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    Clinial research
    Comparative analysis of laparoscopic appendectomy and open appendectomy in treatment of acute appendicitis
    ZHANG Yong, ZHAO Su, CUI Weidong, LI Xiaoyong, YANG Yanjun, WANG Junqing
    2021, 26 (03):  269-270.  DOI: 10.16139/j.1007-9610.2021.03.019
    Abstract ( 328 )   HTML ( 3 )   PDF (270KB) ( 149 )  
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    Review
    Diagnosis and treatment of xanthogranulomatous cholecystitis
    WU Wenta, LI Wei, CAO Yijun
    2021, 26 (03):  271-274.  DOI: 10.16139/j.1007-9610.2021.03.020
    Abstract ( 254 )   HTML ( 2 )   PDF (437KB) ( 227 )  
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