Objective To investigate the relationship between gene expression of endothelin-3 (ET-3） and inflammation of acute pancreatitis （AP） in rats. Methods Fifty-four rats were divided randomly into 4 groups: sham operation group, AP group, arterial injection group and vein injection group. AP was induced by reverse intra-bile duct infusion 4.5% sodium taurocholate, treated with low dose dopamine 〔5 μg/（kg·min）〕 by injecting arterial or tail vein. Rats were sacrificed at 1， 6 and 24 h after the induction of AP. The mRNA expression of ET-3 was evaluated by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and pathological changes was observed in rats. Results Expression of ET-3 mRNA could be detected from 1 up to 24 h after the induction of pancreatitis. Expression of ET-3 mRNA of sham operation group was decreased significantly compared with other three groups. Expression of ET-3 mRNA showed a significant decrease by arterial injection dopamine than that by tail vein (P＜0.05， P＜0.01). The pathologic score in AP group was the highest, vein injection group was the next one, and score in sham operation group was the lowest. Conclusion There are significant relationship between inflammation of AP and expression of ET-3 mRNA. Dopamine administration by arterial injection is more effective than that by tail vein injection.
Objective To investigate the CT imaging features of autoimmune pancreatitis (AIP) with report of 4 cases and literature review. Methods The CT imaging data of 4 AIP patients proved on the basis of clinical findings, laboratory tests, response to steroids therapy and follow-up observation were retrospectively collected. Plain CT and contrast-enhanced dual phase CT scan at arterial and portal venous phases were performed for all 4 patients. All imaging data were reviewed, focusing on the shape, size, parenchyma density and enhancement patterns of the pancreas, as well as the biliary and pancreatic ducts, peripancreatic fat, blood vessels, retroperitoneal spaces, lymph nodes, and other positive findings. Results Three patients showed diffuse swelling of the pancreas on CT and 1 had focal enlargement of pancreatic head. Swelled pancreas was hypodense on plain CT images, showed decreased enhancement on artery phase and moderate enhancement on portal venous phase images of contrast-enhanced CT. Capsule-like enhanced rim was found around swelled pancreas in 2 patients. Stricture of distal common bile duct was present in 2 patients, and ERCP showed irregular narrowing of the main pancreatic duct in 1 cases. After steroid therapy, all patients showed significant morphological improvement of the pancreas at follow-up CT examination. Conclusion CT scan reveals certain characteristic imaging findings of AIP, thus it is helpful for the diagnosis of AIP.
Objective To investigate a new way for the treatment of severe acute pancreatitis (SAP). Methods The clinical data of 59 cases of SAP were analyzed, and they were divided into two groups: LAI group and control group. In LAI group, 30 cases were treated mainly by local arterial infusion (LAI). In control group, 29 cases were treated by intravenous infusion. Results Compared with control group, the results of LAI group were much better in abdominal pain relief, recovery of intestinal function, reducing the complications, shorter antibiotictime, decreasing the incidence of secondary systemic infection. The mortality of SAP class Ⅱ in LAI group and control group were 35.71% and 66.67% respectively. Conclusion LAI is a new way for the treatment of SAP.
【Abstract】Objective To study the liver injury and effects of aescin on liver in rats with acute pancreatitis. Methods The rats were divided into 3 groups (control group, AP group and aescin group). The serum alanine aminotransferase （ALT）, serum lactate dehydrogenase (LDH), hepatic cellular energy charge (EC) and adenosine triphosphate (ATP) were detected. The pathologic changes in pancreas and liver were also observed. Results The serum levels of ALT and LDH in aescin group were significantly lower than those of the AP group. The EC and ATP levels were significantly higher in aescin group than that of the AP group. Conclusion Introvenous injection of aescin can alleviate the liver injury in rats with acute pancreatitis.
Objective To assess the possible causes of acute pancreatitis (AP) in long term peritoneal dialysis (PD) and hemodialysis (HD) patients, and to discuss the diagnosis and treatment of AP in this kind of patients. Methods The clinical data of 9 cases of AP in PD and HD patients who were admitted in the hospital during January 1993 and January 2000 were analysed retrospectively. Results The serum levels of amylase of all the 9 cases were over three and a half times of upper limit value of healthy subjects. B mode ultrasound and CT scan examinations were useful for diagnosis of AP. Eight patients recovered very well with conservative treatment, while one patient who was diagnosed as acute severe pancreatitis and complicated with shock died. Conclusion Long term PD and HD patients are predisposing to develop AP. Diagnosis of AP in these patients primarily depends on the detection of serum amylase. Dialysis treatment is indispensable for cure of AP.
In order to choose the appropriate antibiotics for treating secondary pancreatic infection, permeability of antibiotics to pancreatic tissue was investigated on experimental dogs with acute hemorrhagic necrotizing pancreatitis. The concentrations of 8 different antibiotics were determined in the blood and the pancreatic tissue using highperformance liquid chromatography. Pancreatic tissue permeability of Cefotaxime, Ofloxacin, Amikacin, Piperacllin, Cefoperazone, Ampicillin, Metronidazole and Ciprofloxacin was 12%, 19%, 20%, 46%, 55%, 63%, 71% and 132% respectively. The study shows that this eight antibiotics have different permeability to the pancreatic tissue. Such observations support the existence of a bloodpancreas barrier, which acts to restrict the permeation of antibiotics into the pancreas. The results suggest that antibiotics with high permeability rate be used to treat the patient with secondary pancreatic infection.
To observe the changes of intestinal bacteriology in acute necrotizing pancreatitis (ANP). Dog ANP model was induced by injection of sodium taurocholate with trypin into the pancreatic duct. All dogs were sacrificed on the seventh postoperative day, mucosal and luminal microflora of intestine were analyzed quantitatively. The blood and organs were collected for culture. The results showed that population levels of E.coli in the intestinal mucosa and the content in cecum of the ANP dogs showed much higher level than those of the controls (Ｐ＜0.01 or Ｐ＜0.05), while bifidobacterium and lactobacillus were decreased significantly (Ｐ＜0.01), resulting in reversal of bifidobacterium/E.coli ratio. Blood levels of endotoxin were 1-2 times higher in ANP group as compare with the controls. The positive rate of blood and organs were 100% in ANP dogs. E.coli were the major bacteria cultured. The results indicated that microecological disturbance could take place after the onset of ANP, which may take an important role on pancreatic infection complicating ANP.
The aim of this study was to investigate the role of tumor necrosis factor (TNF), interleukin-6(IL-6), C-reactive protein (CRP) in pancreatitis and its systemic complications. Thirty six patients with acute pancreatitis were studied, 12 with mild disease, and 24 severe disease, of whom 9 developed systemic complications. TNF, IL-6, CRP in these patients with pancreatitis was assessed during the first, 4th, 8th days of admission. The serum concentration of TNF, IL-6, CRP were significantly increased, and significantly higher in complicated group than in mild group and severe group. These findings suggest that proinflammatory cytokines play a central role in the pathophysiology of the disease, the host systemic response to pancreatic inflammation and the level of the response did relate to the development of organ dysfunction.
This study aimed to assess the therapeutic effect of mannital administration on acute hemorrhagic necrotizing pancreatitis (AHNP), 28 Wistar rats were randomily divided into therapeutic group and control group after induction of AHNP by retrograde intraductal injection of 5 percent sodium taurocholate. The rats of therapeutic group received intravenous 20% mannital (1g/kg) through tail vein, once in 12 hours, until the end of experiment; control group received saline (5.0 ml/kg) with the same way. Blood of all the rats were collected from heart and the rats were killed after 96 hours. Results: lipid peroxide (LPO) in pancreatic tissue, LPO in serum, lactate dehydrogenase (LDH), alpha-1-antitrypsin (α1-AT), glutamicoxalacetic transaminase (GOT), necrotizing square of pancreatic tissue in the therapeutic group were significantly less than those in control group (Ｐ＜0.05 or Ｐ＜0.01). The damage to pancrease, heart, liver, kidney in the therapeutic group were lighter than those of the control group and the mortality was lower (Ｐ＜0.05).Conclusions: Mannital can scavenge the oxygenderived free radicals and play a therapeutic role in AHNP.
Eighty two cases of acute gallstone pancreatitis on early operation are reported and the significance of the clinical picture and pathology are analysed. The data showed that gallstone was found in 85.5%, among the cases of them mulliple gallstone was 71.1%, dilated cystic duct was 26.4%, common bile duct stone 36.8%, distal bile ductal stricture was found in 9.3%, and anomalous conjunction of biliary and pancreatic duct was 20.1%. Sixteen cases with serious pancreatitis were determined on operation, but death rate was 3.7% only. The authors claim that early operation may be of value in patients of acute gallstone pancreatitis with or without jaundice espesially in bile duct obstruction.