Objective To explore the early prevention measures of severe acute pancreatitis （SAP） complicated with infection. Methods The foreign and native related literatures of SAP complicated with infection in recent 10 yearswere retrieved， and the effect of sooner measures for SAP complicated with infection were discussed. Results It was beneficial to reduce the incidence of infection and improve the outcome in SAP by using antibiotics of apt through the blood-pancreatic barrier， using proton pump inhibitor properly， and using enteral nutrition， hemofiltration， and hyperbaric oxygen as soon as possible， and then combined with traditional Chinese medicine. Conclusions SAP complicated with infection is the one of the main reasons of death. It is a must to take effective and comprehensive measures in the early stage in order to reduce the rate of infection. However， there are several unclear problems to probe in the future on this issue.
Objective To assess the efficacy and safety of fat emulsion (FE) for acute pancreatitis (AP).Methods We searched the electronic biological databases: Cochrane Controlled Trials Register (Issue 2, 2007), Medline(1996 to April 2007), EMBASE (1984 to April 2007), Chinese biological medical database (1978 to April 2007). We alsodid handsearching to identify other published and unpublished data. Data collection and undertaken by two reviewersaccording to the Cochrane Handbook for Reviews of Intervention. Randomized controlled trials (RCTs) or quasi-RCTscomparing FE versus glucose in the treatment of AP were collected. Pooled estimates of overall treatment effect werecalculated using the RevMan 4.2.10 according to available data from included studies. Otherwise, qualitative descriptiveanalysis was performed. Results In total, 10 clinic control trials finally (include 314 participant) met the eligible criteria. ① To long chain triglyceride (LCT), the comparison of overall mortality (relative risk, 0.73; 95%CI, 0.34 to 1.58; P=0.26) and complications (Pgt;0.05) showed no significant difference. One study reported LCT cannot reduce hospital stay (Pgt;0.1). The effects of LCT on cholesterol and triglyceride were inconsistent with respect to the course of treatment. ② However, there were no changes of the cholesterol and triglyceride levels secondary to the medium chain triglyceride and long chain triglyceride (MCT/LCT) (Pgt;0.05, respectively) according to one study. ③ No severe adverse events were reported.Conclusions The evidence currently available cannot conclude that FE is safe and effective, though LCT may decreasethe mortality of AP. Therefore, more high-quality trails are needed.
Objective To explore the secretion law of high mobility group box 1（HMGB1）in rat pancreatic acinar cells induced by trypsin activation peptide（TAP）and release of HMGB1 affected by ethyl pyruvate（EP）. Methods The experiment was performed in 12 SD rats. The pancreatic acinar cells of rats were taken out and then separated into three groups：control group， TAP group， and EP group. TAP was added into TAP group and EP group（keep TAP at a final concentration of 3 nmol/L）， respectively， but EP was added into EP group only （keep EP at a final concentration of 28 mmol/L）. The expressions of HMGB1 mRNA and protein were detected by using real-time quantitative reverse transcription polymerase chain reaction（RT-PCR）or Western blot at 3 h， 6 h， 12 h， and 24 h time point， respectively. The relationship between HMGB1 and TAP action time was explored by rank correlation. Results Compared with control group， the expressions of HMGB1 mRNA and protein were increased with prolongation of the TAP action in TAP group and EP group（P＜0.05）. Compared with TAP group， the expressions of HMGB1 mRNA and protein were decreased in EP group（P＜0.05）. The expressions of HMGB1 mRNA and protein were increased with prolongation of the TAP action（P＜0.05）， and were highest at 12 h time point（P＜0.01）in TAP group. There were positive correlation between the expressions of HMGB1 mRNA and protein and TAP action time（rs=0.971， P＜0.01；rs=0.966， P＜0.01）.Conclusions TAP can induce the release of HMGB1 in pancreatic acinar cells. There is positive relationship between TAP in early stage and HMGB1 in later period of acute pancreatitis. EP can inhibit the release of HMGB1.