ObjectiveTo investigate the relationship between the changes of nerve cells in sphincter of Oddi and acute pancreatitis. MethodsThe rabbit models of acute pancreatitis were prepared by using sodium taurocholate perfusion. Immunohistochemical method was used to detect the expressions of nitric oxide synthase (NOS) and vasoactive intestinal peptide (VIP) in neurons of the sphincter of Oddi. ResultsIn the control group, (45.83±2.17)% of myenteric neurons were NOS-positive, (52.46±2.47)% of myenteric neurons were VIP positive, and (22.73±1.95)% of myenteric neurons were NOS and VIP double positive. In contrast, (11.26±0.93)% of myenteric neurons were NOS-positive and (28.62±2.83)% of myenteric neurons were VIP positive in SAP group, which were significantly less than those of control group (P < 0.01). ConclusionsThe sphincter of Oddi of normal rabbits is rich in VIP and NOS positive neurons. The significant reduction of NOS-positive and VIP-positive neurons when SAP, which may be the reason of decreased the activities of the sphincter of Oddi.
Objective To investigate the alternatives of different endoscopic drainages for acute cholangitis of severe type (ACST) in elderly patients with chronic respiratory disease. Methods The clinical data of 74 cases of ACST in elderly patients with chronic respiratory disease undergoing 3 kinds of drainages, endoscopic retrograde double biliary stent drainage (D-ERBD), endoscopic retrograde single biliary stent drainage (S-ERBD), or endoscopic nasobiliary drainage (ENBD) in the First Hospital of Lanzhou University from October 2005 to October 2015 were collected to analyze prospectively. Results Compared with preoperative, the white blood cell (WBC), direct bilirubin (DBIL), temperature, and abdominal pain NRS evaluation in 48 h after operation in 3 groups all decreased, the difference was statistically significant (P＜0.05). Compared among 3 groups, there were no significant difference among the incidences of postoperative hyperamylasemia, pancreatitis and gastrointestinal hemorrhage (P＞0.05). The group of ENBD was more likely to develop pulmonary infection and achieve a secondary treatment than other 2 groups (P＜0.05). Totally 5 patients died in 3 groups, with a mortality of 6.76%, but the mortality rates were similar among the 3 groups (P＞0.05). The deaths were predominantly caused by multiple organ failure (MOF), 4 cases of which were caused by respiratory failure related to respiratory infection. Conclusion The alternative of endoscopic retrograde double biliary stent drainage (D-ERBD) can not only alleviate cholangitis rapidly, but it can reduce the incidence of aspiration pneumonia.