This study based on two serial animal experiments: ①caerulein-induced edematous pancreatitis with gut motility inhibited by administration of lopemin (an opium antidiarrheal agent) and ②deoxycholate intraductal-injection induced pancreatitis with gut motility improved by administration of rhubarb solution. The results of these experiments indicated that inhibition of gut motility will increase the incidence of bacterial translocation and endotoxemia during acute pancreatitis; and acceleration of gut motility will significantly decrease the incidence of bacterial translocation and endotoxemia during severe type of acute pancreatitis. The authors conclude that promotion of gut motility may protect the inflammatory pancreas from infection and prevent the multiple organ failure during acute pancreatitis, and eventualy improve the prognosis of pancreatitis.
bjectiveTo observe the effecacy of immunosuppressive agents on modulation of the disorders of inflammatory and antiinflammatory cytokines in acute pancreatitis, and to investigate the mechanism of treatment of acute pancreatitis with immunosuppressive agents. MethodsSD male rats were divided into 6 groups: group 1, the normal control group (n=6); group 2, acute pancreatitis induced by ductual injection of 5%sodium cholate sulfur at the volume of 1.0 ml/kg without treatment (n=8). After the pancreatitis were induced, the rest rats were injected intravenously with 5Fu 40 mg/kg (group 3, n=6); or methylprednisolone 30 mg/kg (group 4, n=6); or cyclophosphamide 20 mg/kg (group 5, n=6); or methotrexate 1.2 mg/kg (group 6, n=6). Twentyfour hours afteroperation, the animals were killed, the blood samples were taken for measurement of TNFα, IL1, IL6 (by bioassay), and IL10, TGFβ (by ELISA) as well as amylase. ResultsThe inflammatory cytokines (TNFα,IL1,IL6 ) and the antiinflammatory cytokines (IL10 and TGFβ), in blood of acute pancreatitis were increased significantly. After treated with immunosuppressive agents, both the inflammatory and antiinflammatory cytokines were decreased in different degrees. Some indexes of the severity of acute pancreatitis, such as amylase and pancreatic weight were improved obviously.ConclusionImmunosuppressive agents can regulate inflammatoryassociated cytokines increased remarkably in the acute pancreatitis. Therefore, improvement of acute pancreatitis can be achieved through rectifying the abnormal immunity and relieving the pathophysiological disorders of the acute pancreatitis by immunosuppressive agents.
Objective To investigate the impact of immunonutrition in organ transplantation.Methods The literatures of recent years on the studies of immunonutrition in organ transplantation were reviewed. Results Immunonutrition including ω-3 fatty acid and special amino acids etc could reduce inflamation and supress immunal response following organ transplantation markably. Conclusion Application of immunonutrition associated with immunosupress could take the place of traditional steroids completely in the treatment following organ transplantation, even shorten clinical course of immunosupress.
【Abstract】ObjectiveTo investigate the anatomic feature and special clinical manifestations of variant right intrahepatic bile duct draining into left hepatic bile duct near the umbilical portion. MethodsVariant right intrahepatic bile ducts joining into left hepatic bile ducts near the umbilical portions were identified through cholangiograms in 52 patients, who were included in this study. Their history, clinical process and operations were reviewed. ResultsThere were total 38 cases of intrahepatic gallstone in this group. High incidence of intrahepatic calculi was found in variant right intrahepatic bile ducts （23/38 cases, 60.52%） and left hepatic ducts （33/38 cases, 86.84%）. Most of these cases were accompanied with dilatation and stricture of bile ducts in these area. The gallstones in the variant right intrahepatic bile ducts were not detected in 8 cases (8/23) and the rate of residual gallstone was as high as 86.95%(20/23). Injury of variant right intrahepatic bile duct took place when left hepatectomy was performed in one case. ConclusionGallstone is very likely to be formed in the variant right intrahepatic bile duct due to derangement of bile hydrokinetics and compression of blood vessel. Special attention should be paid to the diagnosis and operation of this abnormity.
ObjectiveTo establish a mouse model of acute necrotizing pancreatitis.MethodsThirty-six male ICR mice were randomly divided into control group (n=6) and experimental group (n=30). Each of the animals in the experimental group received 7 intraperitoneal injections of caerulein (50 μg/kg body weight) in 0.9% NaCl at hourly intervals over 6 hours. The animals in the experimental group were killed at 9,18,24,48 and 72 hours respectively after the first caerulein injection. The control animals received the same volume of 0.9% NaCl without caerulein. The animals in the control group were killed at the 18th hour after the first intraperitoneal injection. The severity of acute necrotizing pancreatitis was evaluated in terms of amylase level, pancreatic weight/body weight and the histological changes. Variance analysis was employed in the processing of these data. ResultsBoth amylase level and pancreatic weight elevated 9 hours after the first caerulein injection, and correlated with the course of pancreatitis. The maximums of both alterations were observed at the same time point (18 hours after the first injection of caerulein). Prominent interstitial inflammation and acinar cell necrosis occurred at the 18th hour, and the histological score for pancreatitis reached a maximum （P＜0.05）. Conclusion Intraperitoneal injection of a large dosage of caerulein can induce acute necrotizing pancreatitis in ICR mice. This method is simple and noninvasive, and the model established thus is stable and reproducible.