To research the risk factors of portal vein thrombosis( PVT) in liver cirrhosis patients. 110 cirrhotic pa-tients with ( n =39 ) or without ( n =71 ) PVT diagnosed were enrolled. 12 common ultrasonographic and serum markers were analyzed. SPSS software was used for statistic analysis. Single factor analysis and Logistic regression model analysis showed that fibrinogen was the independent risk factor of portal vein thrombosis( PVT) in liver cir-rhosis patients. Fibrinogen should be monitored in patients with cirrhosis to prevent and find the occurrence of portal vein thrombosis.

Objective To develop a digital video system for esophageal variceal manometry and to evaluate its reliability. Methods The system consists of esophageal variceal manometer, pressure transducer, video capture card and special computer programs. An artificial esophagus containing water-filled latex tube was designed, in which the pressure had been measured by this system in vitro. The pressures of esophageal varices had been measured by using the method in five patients. Results In vitro study, a good correlation was showed between the actual pressure and measured pressure in the artificial varices with different diameter (3,6,9 mm)(r=0.975, P

Objective To prospectively study the main risk factors of variceal bleeding in cirrhotic patients. Methods Fifty-seven patients with liver cirrhosis and esophageal varices who had never experienced variceal bleeding were followed up for 12 months. The patients underwent measurements of esophageal variceal pressure by non-invasive endoscopic balloon technique. The endpoint of the study was the presence of a variceal hemorrhage. The relationship between variceal hemorrhage and endoscopic findings including varices, variceal pressure, Child-Pugh status, ascites, and etiology of cirrhosis was studied. Results Thirty-four patients (59.6% ) developed a variceal hemorrhage. In univariate analysis, the level of variceal pressure (P= 0. 001), the size of varices (P=0. 006), and the endoscopic red color sign on the variceal wall (P=0. 012) predicted higher risks of variceal hemorrhage. The multiple logistic regression revealed that variceal pressure was a major predictor of the risk for a first variceal bleeding (OR=2. 817, P=0. 003). The area under the receiver operating characteristic (ROC) of variceal pressure for predicting variceal bleeding was 0. 98, and the variceal pressure cutoff value was 25.3 mm Hg (1 mm Hg=0. 133 kPa) with both specificity and sensitivity of 91 %. Conclusion The level of variceal pressure is a major predictor for variceal bleeding in cirrhotic patients.

Objective To evaluate the clinical efficacy of transjugular intrahepatic portosystemic shunt(TIPS)combined with stomach and esophageal variceal embolization(SEVE)for gastric variceal haem-orrhage,and the efficacy with or without a gastrorenal shunt. Methods A total of 52 patients with gastric variceal bleeding history and portal hypertension treated with TIPS combined with SEVE were included from October 2013 to March 2015.Patients were divided into two groups according to preoperateive CT angiogra-phy,27 cases with gastric variceal haemorrhage associated with a gastrorenal shunt in group A,and 25 gastric varices bleeding cases without gastrorenal shunt in group B. During the follow-up,the incidence of the total rates of rebleeding,TIPS primary patency and hepatic encephalopathy,and the survival rates were compared between group A and group B. Results In all patients,the average portal vein pressure decreased from 36. 50±7. 00 cmH2 O(1 cmH2 O= 0. 098 kPa)before operation to 28. 15±6. 27 cmH2 O after TIPS combined with SEVE,with significant difference(t= 10. 357,P= 0. 001). Fifty two patients were followed up for 1 to 18 months(1-18 months in group A;1-15 months in group B).The total rates of rebleeding,TIPS primary patency,hepatic encephalopathy and survival were 11. 54%(6/ 52),86. 54%(45/ 52),11. 54%(6/ 52) and 92. 31%(48/ 52),respectively. There were no significant differences between the two groups in the total rates of rebleeding[11. 11%(3/ 27)VS 12. 00%(3/ 25),P = 1. 000],TIPS primary patency[88. 89%(24/ 27)VS 84. 00%(21/ 25),P= 1. 000],hepatic encephalopathy[14. 81%(4/ 27)VS 8. 00%(2/ 25), P= 0. 738]or total survival rate[92. 59%(25/ 27)VS 92. 00%(23/ 25),P = 1. 000]after TIPS combined with SEVE. Conclusion TIPS combined with SEVE is effective for gastric varices,and equally effective in the treatment of both gastric variceal haemorrhage associated with a gastrorenal shunt and gastric varices bleeding without gastrorenal shunt.

Objective To explore an accurate,objective and simple method for barrel distortion correction and lesion area measurement by assistance of computer.Methods The software of Panaroma tool was employed to correct barrel distortion of endoscopy and Image J to measure lesion size and manage the relative measurement error.Computed measurement in vitro of lesion area was established,firstly,by identification of correction factor of Panorama tool to minimize measurement error; then by determination of influence of object distance change between the lens and the image.This measurement was used on patients with gastric ulcer for focal area.Results were compared with those of traditional method.Results Number of 0.1was determined to be the correction factor for barrel distortion of endoscopy.Prior to the correction of the barrel distortion,the relative error of measurement gradually increased with the increasing distance between endoscopy and the image.However,different object distances did not exert influence on the relative measurement error when barrel distortion was corrected by Panaroma tool ( P =0.141 ).A total of 50 foci of gastric ulcer were measured,results from combinational treatment of Panorama tool and Image J showed the areas (35.0 ± 5.0) mm2 were significantly larger than those determined by traditional method [ ( 29.1 ± 4.1 ) mm2,P =0.000 ],with a correlation coefficient of 0.988.Conclusion Computed endoscopic lesion measurement is a relatively accurate,objective and simple method to determine the area of gastric lesions.

Objective To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with gastroesophageal variceal embolization (SEVE) in the treatment of patients with gastroesophageal varices accompanied by a gastrorenal shunt with a diameter over 5 mm .Methods From October 2013 to December 2014 ,the clinical data of 18 patients with portal hypertension caused gastroesophageal variceal bleeding and treated by TIPS combined with SEVE were collected . The difference of portosystemic pressure gradient between before and after operation was observed ,and Child‐Pugh score before and after operation was also evaluated .The hemostasis in 24 hours ,TIPS patency ,the occurrence of hepatic encephalopathy(HE) ,rebleeding ,hepatic failure ,mortality and the change of liver function and thrombocytopenia were recorded after operation .Student′s t‐test or analysis of variance was performed for statistical analysis of measurement data .Results In the 18 patients ,the average portal vein pressure decreased from (34 .23 ± 6 .35) cmH2O (1 cmH2O= 0 .098 kPa) before operation to (25 .69 ± 6 .89) cmH2O after TIPS combined with SEVE ,and the difference was statistically significant (t=7 .572 , P<0 .01) .The difference of portal vein pressure before and after operation was (8 .54 ± 4 .79) cmH2O . No hepatic failure was observed in all 18 patients .Among 10 patients with emergency operation ,nine patients obtained successful hemostasis in 24 hours .No operation related complications were observed in all the patients .During the follow‐up period of 18 patients ,two patients had variceal rebleeding confirmed by endoscopy ;one patient had stent stenosis;three patients got HE and one patient died .At different follow‐up time point of patients ,there was no significant difference in Child‐Pugh score ,blood ammonia level ,albumin level ,bilirubin level ,white blood cell count and blood platelets count compared with those before operation (all P>0 .05) .Conclusion TIPS combined with SEVE in the treatment of patients with gastroesophageal varices accompanied by a gastrorenal shunt with a diameter over 5 mm could effectively control bleeding ,and no ectopic embolism happened .

Objective To explore the risk factors of esophageal gastric varices in patients with primary biliary cirrhosis (PBC ) .Methods From January 2008 to November 2014 ,112 PBC patients underwent gastroscopy examination and among them 24 received liver biopsy .The correlation between esophageal gastric varices and histological stage ,age ,gender ,anti‐centromere antibodies (ACA) ,platelet (PLT ) , albumin (Alb ) , total bilirubin (TBil ) , alkaline phosphatase (ALP ) , γ‐glutamyl‐transferase (GGT ) ,aspartate‐aminotransferase (AST ) ,alanine‐aminotransferase (ALT ) ,prothrombin time (PT ) and Mayo score was analyzed .Logistic regression analysis was used to identify independent risk factors predicting esophageal gastric varices in PBC patients .Results Among 112 patients with PBC ,varices was found in 62 patients (51 pure esophageal varices ,nine esophageal gastric varices and two pure gastric varices) .Among 24 patients with liver biopsy ,15 had varices (two at early histological stage Ⅰ and Ⅱ , 13 at later histological stage Ⅲ and Ⅳ ) .The ACA positive rate ,PT ,TBil and Mayo score of patients with varices were higher than those of patients without varices ;while Alb ,GGT and PLT were lower than those of patients without varices , and the differences were statistically significant (all P < 0 .01) . Multivariate Logistic regression analysis revealed that positive ACA (odds ratio (OR) = 8 .759 ,95%cofidence interval (CI) :1 .308 to 58 .637) ,Mayo score over 4 .52 (OR = 8 .941 ,95% CI :1 .145 to 69 .809) ,PLT count less than 96 .5 × 109 /L (OR = 10 .410 ,95% CI :2 .344 to 46 .224) ,TBil level over 26 .62 μmol/L(OR = 14 .348 ,95% CI :2 .945 to 69 .913) were independent risk factors predicting varices . Conclusion ACA positive ,PLT count less than 96 .5 × 109 /L ,TBil level over 26 .62 μmol/L and Mayo score over 4 .52 can help to predict esophageal gastric varices in patients with PBC .

BACKGROUND:In recent years, monitoring the pressure in the human body, especial y esophageal variceal pressure, becomes a hot spot. A lot of progress has been achieved regarding fiber optical sensors for measurement of the pressure in the human body.
OBJECTIVE:To briefly review the fiber optical sensor applications in the human body.
METHODS:A computer-based online retrieval was performed to search papers in CNKI periodical ful-text database and PubMed database (from January 1983 to March 2013) using the key words of“fiber optical sensor, pressure, measurement”in Chinese and English, respectively. After excluding objective-independent and repetitive papers, 40 papers were included for further analysis.
RESULTS AND CONCLUSION:Compared with traditional sensors, fiber optical sensors, which have advantages in high sensitivity, large dynamic range, fast response, tolerance to electronic interference, explosion proofing, fireproofing and corrosion protection, have been used to measure esophageal variceal pressure, intracranial pressure, pharyngeal pressure, pediatric airway pressure, cardiovascular&blood pressure, intervertebral disc pressure, intrauterin pressure in childbirth, pressure in the colon, plantar pressure and shear force as wel as other pressures in the human body. Fiber optical sensors have been used more widely in pressure monitoring. With the development of production technology and device performance, fiber optical sensors wil further promote the rapid development of medical science in the near future.

Objective To evaluate the clinical reliability and feasibility of computerized endoscopic balloon manometry in vitro and in vivo, in measurement of pressure of esophageal varices. Methods Computerized endoscopic balloon manometry was used to measure the pressure of variceal model with different diameter (3 mm, 6 mm and 8 mm) and intraluminal pressures (ranging from 8 to 36 mm Hg), and the findings were compared with actual pressures. The technique was also applied in 23 patients with liver cirrhosis and esophageal varices, and its correlation with hepatic venous pressure gradient and other factors related with varices bleeding. Results The study in vitro showed that the measured intraluminal pressure was correlated significantly with the actual value ( r ≥ 0. 993, P ＜ 0. 001 ) without obvious measurement bias(95% CI = -0.13 cm H2O to 0. 33 cm H2O). The measurement in 23 patients were success with little variation coefficient (r≥0. 998) between repeated procedures. Regression analysis showed a good correlation between variceal pressure and hepatic venous pressure gradient (r=0. 858, P ＜ 0. 001 ). A higher variceal pressure was strongly associated with presence of previous bleeding episodes, vascular diameter and presence of red color signs, but did not correlate with the parameter of Child-Pugh classification ( t = 0. 31, P =0. 76). Conclusion Computerized endoscopic balloon manometry is reliable and feasible to examine esophageal variceal pressure, and is very likely to be a valuable clinical index for variceal bleeding.

Objective: To investigate whether combined diabetes affects rebleeding after endoscopic treatment in cirrhosis patients with esophageal varices. Methods: A total of 207 liver cirrhosis cases with esophageal varices bleeding who underwent initial treatment of endoscopic variced ligation or endoscopic injection sclerotherapy in the First Affiliated Hospital of Anhui Medical University from June 2015 to March 2018 were included in the retrospective study. The cases were divided into bleeding group (n=54) and non-bleeding group (n=153) according to the presence or absence of rebleeding within 6 months after treatment. The influencing factors on postoperative bleeding were analyzed by univariate analysis and logistic regession analysis. Results: Univariate analysis showed that gender composition, age, presence or absence of portal vein thrombosis, smoking history, drinking history (P=0.05), hypertension, platelet count, total bilirubin level, albumin level, alanine aminotransferase level, prothrombin time, degree of esophageal varices, and surgical methods were not significantly different (all P≥0.05) between the bleeding group and the non-bleeding group. There were significant differences in diabetes, hemoglobin level, blood glucose level, ascites composition, and liver function grade composition between the two groups (all P<0.05). Combined diabetes (yes/no), hemoglobin levels, blood glucose levels, ascites (none-mild/medium-severe), liver function Child-Pugh classification (Grade A/B-C), and history of drinking (yes/no) were included in multivariate analysis, and results showed that diabetes was an independent risk factor for rebleeding after endoscopic treatment of esophageal varices (P=0.008, OR=2.973, 95%CI: 1.322-6.689). Conclusion After endoscopic treatment of liver cirrhosis patients with esophageal varices, rebleeding is more likely to occur in patients complicated with diabetes.