目的探讨超声内镜(EUS)引导下聚桂醇注射治疗胰岛素瘤的可行性及安全性。方法 72岁胰岛素瘤患者1例,经实验室、影像学和超声内镜细针穿刺(EUS-FNA)确诊,患者存在反复低血糖发作症状,给予经超声内镜向瘤体内注射10 m L∶100 mg聚桂醇0.9 m L进行干预。动态观察低血糖症状、血糖等实验室指标及影像学变化。结果患者术后低血糖发作症状消失,血糖渐升高至正常,实验室及影像学检查证实其获得完全缓解,术后第5天出院。结论聚桂醇可作为新的硬化剂安全地用于超声内镜引导注射治疗胰岛素瘤,值得扩大病例进一步研究。
Objective:To investigate the role of T helper 9(Th9) cells in liver cirrhosis(LC) patients and whether chemokine receptor type 6(CCR6)/chemokine ligand 20(CCL20) axis is involving in the recruitment of Th9 cells into liver.Methods:Peripheral blood and liver tissue from 30 LC patients and 18 normal controls were recruited.The frequency of Th9 cells and CCR4,CCR6 in the peripheral blood was tested by flow cytometry.Serum interleukin(IL)-9 and CCL20 levels were tested by enzyme-linked immunosorbent assay.Immunohistochemical staining was used to detect a-smooth muscle actin,CCR6 and CCL20 expression in liver tissue.Results:The frequency of Th9 cells in LC patients was significantly increased compared with controls(P < 0.05).The serum IL-9 level and CCL20 level increased markedly in LC patients compared with controls(P < 0.05),and IL-9 was positively correlated to Th9 cells and CCL20.Furthermore,the frequency of Th9 cells was correlated to prothrombin time,total bilirubin level,hyaluronic acid and type IV collagen in LC patients.We also found that Th9 cells in LC patients expressed higher frequency of CCR4+,CCR6+(P < 0.05).Compared with normal controls,the expression of CCR6 and CCL20 in LC tissue were significantly elevated(P < 0.05).The expression of a-smooth muscle actin was correlated to the CCR6 and CCL20 in liver tissue of LC patients.Conclusions:This study suggests that Th9 cells may participate in the pathogenesis of LC,and the recruitment of Th9 cells into liver tissue might be through CCL20/CCR6 axis.
