Objective To investigate the timing of endoscopic treatment for acute cholangitis of severe type(ACST) accompanying multiple organ dysfunction syndrome(MODS).Methods On the basis of routine medical measures,such as oxygen inhalation and antishock treatment,9 patients with ACST accompanying MODS were given endoscopic retrograde cholangiopancreatography(ERCP) with endoscopic sphincterotomy(EST),or endoscopic nasobiliary drainage(ENBD) after needle electrode fenestration and stone removal with basket,or endoscopic retrograde biliary drainage(ERBD) with internal stent.Results The endoscopic treatment was successfully accomplished within 35 min in all the 9 patients.Seven patients at stage 1~2 of MODS rehabilitated at 1~2 weeks after treatment,while 2 patients at stage 3 of MODS died in 2 weeks.Conclusions Endoscopic treatment should be applied to patients with ACST at stage 1~2 of MODS as early as possible.For patients with ACST at stage 3~4 of MODS,however,emphasis should be laid on the prevention of organ failure and the reversion of organ functions.

Adenine ; analogs & derivatives ; Hepatitis B, Chronic ; Humans ; Organophosphonates ; Tenofovir ; Treatment Failure

[Objective] To investigate the therapeutic status of laparoscopic management for gallbladder stones and common bile duct stones. [Methods] A Retropective study were adopted to analysize the therapeutic scheme,effect for patients with gallbladder stones and common bile duct stones who were treated from January 1996 to September 2004. [Results] 68 cases were diagnosed, and most of them underwent single stage laparoscopic cholecystectomy (LC) and common bile duct exploration (LC BDE). A few of them were treated through endoscopic procedure in combination with LC, or open surgery when the minimal invasive surgery failed. [Conclusions] Both them indicated that patients by LC+LCBDE have shorter hospital stay, easier recovery and less complications. LC+LCBDE has obvious advantage over the other methods with appropriate operative time and high success rate. For choledochlithiasis patients, the single laparoscopic management should be a better, major option.

OBJECTIVETo investigate the effects of treatment with ursodeoxycholic acid (UDCA) on intrahepatic cholestasis in rats, and to explore its mechanism.

METHODRats suffering from intrahepatic cholestasis were treated with UDCA. Their serum alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), gamma-glutamyl transpeptidase (gamma-GT), total cholesterol (TCH), bile flow, total bile acid excretion, total Na(+) and TCH of bile were measured before and after treatment. In addition, the changes of liver tissue under microscrope were observed and recorded.

RESULTSCompared with the control group, serum ALT, ALP, TBIL, DBIL, gamma-GT and TCH of rats in the treatment group decreased, while bile flow, total bile acid excretion, total Na(+) and TCH decreased significantly. Degeneration of hepatocytes, infiltration of inflamed cells and proliferation of small bile ducts in the treatment group were improved under microscope.

CONCLUSIONUDCA may have therapeutic effects on cholestatic hepatitis. The mechanism may involve in its hydrophilicity, choleretic effect and immune modulation.

Animals ; Cholestasis, Intrahepatic ; drug therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Ursodeoxycholic Acid ; therapeutic use

Objective To investigate the expression of Nodal and its receptors in different tissues and organs of different development stages of mice.Methods Ten pairs(male and female each for a pair) of mice were divided into the four groups:3 pairs served as adult mice group,the rest 7 pairs were allowed to mate,among them 3 pregnant mice served as the fetal group,and 3 pregnant mice served as the neonatal group and 1 pregnant mouse served as filial group.The multiple tissues and organs such as brain,liver,kidney,heart,lung were selected from fetal,neonatal,filial and adult mice for preparing the protein samples.Western blot was performed to detect the expression of Nodal and its type Ⅰ receptors of ALK7 and ALK4 as well as auxiliary receptor Cripto-1.Results Only cerebrum,cerebellum,liver and kidney had Nodal express in the four different mouse ontogenetic stages,in which only liver and kidney simultaneously expressed Nodal and its receptor protein in the whole four ontogenetic stages.Besides,most tissues and organs of adult mice expressed Nodal and its receptor protein,which was significantly different from the fetal,neonatal and filial mice.Conclusion Nodal signaling might have a certain effect on the growth and development of mouse liver and kidney during the late development stage.

To investigate the expression of zinc finger protein 207 (ZNF207) in hepatocellular carcinoma (HCC) tissues, and analyze the correlation of ZNF207 with clinicopathological factors and HCC patients' survival.
 Methods: Real-time PCR was used to detect ZNF207 mRNA expression in 10 paired fresh HCC and adjacent non-tumor liver tissue samples. Immunohistochemical (IHC) analysis was used to detect ZNF207 protein expression in 135 cases of randomly selected paraffin-embedded HCC tissues. The correlation of ZNF207 expression with clinicopathological factors and survival of HCC was analyzed.
 Results: The ZNF207 mRNA expression level in HCC was significantly higher than that in the adjacent non-tumor liver tissue (P<0.01). IHC results showed that ZNF207 protein level was elevated in HCC tissues and ZNF207 expression was correlated with cirrhosis, nodule number, tumor capsule, vascular invasion, and TNM stage (P<0.05). Survival analysis showed that patients with high ZNF207 expression had poorer overall survival (OS) and disease-free survival (DFS) than those with the low ZNF207 expression (P<0.01), and ZNF207 was an independent risk factor for OS and DFS of HCC (P<0.05).
 Conclusion: ZNF207 expression is elevated in HCC and associated with adverse clinicopathological factors, indicating poor prognosis for HCC.
Biomarkers, Tumor ; Carcinoma, Hepatocellular ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms ; Microtubule-Associated Proteins ; Prognosis

OBJECTIVE: To measure retinol binding protein 4 (RBP4) levels in serum and bile and to analyze their relationship with insulin resistance, dyslipidemia or cholesterol saturation index (CSI).
 METHODS: A total of 60 patients with gallstone were divided into a diabetes group (n=30) and a control group (n=30). The concentrations of RBP4 in serum and bile were detected by enzyme-linked immunosorbent assay (ELISA). Enzyme colorimetric method was used to measure the concentration of biliary cholesterol, bile acid and phospholipid. Biliary CSI was calculated by Carey table. Partial correlation and multiple linear regression analysis were used to evaluate the correlation between the RBP4 levels in serum or bile and the above indexes.
 RESULTS: The RBP4 concentrations in serum and bile in the diabetes group were significantly elevated compared with those in the control group (both P<0.01). There was no significant difference in the serum total bile acid (TBA), serum triglyceride (TG), serum high-density lipoprotein (HDL), bile TBA, bile total cholesterol (TC) , bile phospholipids and bile CSI between the 2 groups (all P>0.05); but the serum TC, low density lipoprotein (LDL), fasting blood glucose (FBG), fasting insulin (FINS), and homeostasis model assessment for insulin resistance (HOMA-IR) in the diabetes group were significantly increased compared to those in the control group (all P<0.05). The partial correlation analysis, which was adjusted by age, showed that the bile RBP4 was positively correlated with body mass index (BMI), waist circumference (WC), FINS, FBG, TC, LDL and HOMA-IR (r=0.283, 0.405, 0.685, 0.667, 0.553, 0.424 and 0.735, respectively), and the serum RBP4 was also positively correlated with the WC, FINS, FBG, TC, LDL and HOMA-IR (r=0.317, 0.734, 0.609, 0.528, 0.386 and 0.751, respectively). Stepwise multivariate linear regression analysis suggested that the HOMA-IR, BMI and WC were independently correlated with the level of bile RBP4 (multiple regression equation: Ybile RBP4=2.372XHOMA-IR+0.420XBMI+0.178XWC-26.813), and the serum RBP4 level was correlated with the HOMA-IR and WC independently (multiple regression equation: Yserum RBP4=2.832XHOMA-IR +0.235XWC-20.128). Multiple regression equations showed that HOMA-IR was the strongest correlation factor with RBP4.
 CONCLUSION RBP4 concentrations in serum and bile in the diabetes group are significantly higher than those in the control group. HOMA-IR, BMI and WC are independently correlated with the level of bile RBP4. HOMA-IR and WC are independently correlated with the serum RBP4 level. HOMA-IR is the strongest correlation factor with RBP4. RBP4 might play an important role in the course of gallstone formation in Type 2 diabetes mellitus.
Bile ; chemistry ; Bile Acids and Salts ; blood ; Blood Glucose ; chemistry ; Body Mass Index ; Cholesterol ; chemistry ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Gallstones ; complications ; Humans ; Insulin ; blood ; Insulin Resistance ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Phospholipids ; chemistry ; Retinol-Binding Proteins, Plasma ; metabolism ; Triglycerides ; blood ; Waist Circumference