Objective To investgate the expression of p38 mitogen-activated protein kinase （p38MAPK） in lung tissue of rats with severe acute pancreatitis （SAP）， and to explore the relationship between p38MAPK and pulmonary capillary barrier injury. Methods Forty male and healthy Sprague-Dawley （SD） rats were randomly （random number method） divided into sham operation （SO） group and SAP group， then rats of SAP group were sub-divided into 3， 6， 12， and 24 h group， each group enrolled 8 rats， respectively. SAP model rats were established by injecting 5% sodium taurocholate solution retrograde into the biliopancreatic duct. ELISA method was used to test the serum tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）， and pathological changes in lung and pancreas tissues were observed by HE staining. Immunohischemistry method was used to detect phosphorylated p38 （p-p38） protein and aquaporin 1 （AQP1） protein of lung tissues. The expression level of AQP1 mRNA was measured by quantitative real-time PCR. Results Hyperemia， edema， and inflammatory cell infiltration were observed in lung tissues， abundance of necrosis， part gland structure fuzzy or even disappear were observed in pancreas tissues of all 4 time point groups. Compared with SO group， levels of serum TNF-α and IL-1β were significantly higher in 4 time point groups （P＜0.05）. Lower expression level of p-p38 protein was detected in lung tissues of SO group， while in the early stage of SAP （SAP 3 h group）， the expression level of p-p38 protein significantly increased， which peaked in 6 h group and was still higher than SO group in 24 h group （P＜0.05）. Compared with SO group， the expression levels of AQP1 mRNA and protein were significantly lower in all 4 time point groups （P＜0.05）， which had negative correlation with the levels of serum TNF-α，IL-1β， and the expression level of p-p38 protein （r=-0.87， P＜0.05；r=-0.88， P＜0.05；r=-0.78， P＜0.05）. Conclusion The decrease of AQP1 protein in lung tissue is one of the vital causes for pulmonary capillary barrier injury in SAP， which probably works by the activation of p38MAPK and the excessive release of inflammatory cytokines.
Objective To investigate the influence of colectomy on the expressions of 5-hydroxy tryptamine (5-HT) and chromogranin A (CgA) in colon mucosa of Chinchilla rabbits. Methods Colon (7-8 cm) upon colon-rectum junction (control group) of 15 Chinchilla rabbits was cut out. After two weeks, these rabbits were executed and the samples of colon at anastomotic stoma (study group) were taken. 5-HT positive cells and CgA positive cells in two groups were detected by immunohistochemical method. Results The number of 5-HT positive cells was 10.40±2.22 in control group， and 26.27±2.35 in study group; the number of CgA positive cells was 20.60±5.34 in control group, and 51.51±6.13 in study group. There were significant differences between two groups respectively (P＜0.01). Conclusion The increase of 5-HT positive cells and CgA positive cells can be caused by colectomy.
ObjectiveTo explore the relationship between blood glucose variability index and persistent organ failure (POF) in acute pancreatitis (AP). MethodsWe prospectively included those patients who were diagnosed with AP with hyperglycemia and were hospitalized in the West China Center of Excellence for Pancreatitis of West China Hospital of Sichuan University from July 2019 to November 2021. The patients were given blood glucose monitoring at least 4 times a day for at least 3 consecutive days. The predictive value of blood glucose variability index for POF in patients with AP was analyzed. ResultsA total of 559 patients with AP were included, including 95 cases of POF. Comparing with those without POF, patients with AP complicated by POF had higher levels of admission glucose (11.0 mmol/L vs. 9.6 mmol/L), minimum blood glucose (6.8 mmol/L vs. 5.8 mmol/L), mean blood glucose (9.6 mmol/L vs. 8.7 mmol/L), and lower level of coefficient of variation of blood glucose (16.6 % vs. 19.0 %), P<0.05. Logistic regression analyses after adjustment for confounding factors showed that the risk of POF increased with the increase of admission glucose [OR=1.11, 95%CI (1.04, 1.19), P=0.002], minimum blood glucose [OR=1.28, 95%CI (1.10, 1.48), P=0.001] and mean blood glucose [OR=1.18, 95%CI (1.04, 1.33), P=0.010]; with the higher level of coefficient of variation of blood glucose [OR=0.95, 95%CI (0.92, 0.99), P=0.021], the risk of POF decreased. The results of area under the curve (AUC) of the receiver operator curves showed that AG [AUC=0.787, 95%CI (0.735, 0.840)] had the highest accuracy in predicting POF, with sensitivities of 60.0% and specificities of 84.7%. ConclusionHigh admission glucose, minimum blood glucose, mean blood glucose, and low coefficient of variation of blood glucose were risk factors for the development of POF in patients with hyperglycemic AP on admission.