Objective To study the effects of endothelin (ET) on acute pancreatitis in rats. Methods The acute edematous pancreatitis (AEP) and hemorrhagic necrotizing pancreatitis (AHNP) model of rats were induced by cerulein and dextran-110 and endothelin-1 was administered on AEP rats via intravenous injection. Serum amylase, plasma ET and 6-Keto-PGF1α, pancreas hostologic observation were determined. Results The serum concentration of amylase increased markedly in AHNP rats, and there was a significant difference between AHNP and AEP (Ｐ＜0.01). A dose of extrinsic ET-1 may induce the conversion of AEP to AHNP in rats. The degree of pancreatic damage correlates positively with the level of the plasma ET. Conclusion Endothelin might take part in the development of acute pancreatitis, and play a key role in the conversion of AEP to AHNP.
【Abstract】ObjectiveTo study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients’ survival rate.MethodsFrom Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Logrank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4－131 months.ResultsSingle factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.ConclusionIndependent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.
Objective To establish the model of pancreatoduodenal allotransplantation in pigs with enteric drainage (ED) and portal venous drainage (PVD). Methods Forty-six hybrid landraces were divided into two groups (donor and recipient groups) randomly, for pancreatoduodenal allotransplantation. Donors were perfused via abdomial aorta without clamping the portal venous outflow with UW solution after heparinization. Whole pancreatoduodenal graft was arvested with segments of abdomial aorta and portal vein and shaped under cold UW solution. Then, the end-to-end nastomosis was performed with the donor iliac artery bifurcation “Y” graft to the recipient superior mesenteric arteries and celiac artery. Furthermore, type Ⅰdiabete model was made by removal of the recipient pancreas. The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesenteric vein. Meanwhile, the end-to-side anastomosis was performed with the donor common iliac artery bifurcation “Y” graft to the recipient abdomial aorta and the side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. External jugular vein was intubated for transfusion. The levels of blood glucose， insulin and glucagon in blood were measured before and during the operation and 1， 3， 5， 7 d after operation. Results Twenty-three cases of pancreatoduodenal allotranplantations were performed on pigs. One died from complication of anesthesia. Success rate of operation was 95.7％.Complications of operation happened in 2 cases in which one was phlebothrombosis, incidence 4.5％and the other was duodenojejunal anastomotic leak, incidence 4.5％. The level of blood glucose increased within 30 min and recovered on the 2nd day after removal of pancreas. The levels of insulin and glucagon decreased within 30 min and recovered on the 2nd day after removal of pancreas. Rejection curred at the 1st day and reached the worst level on the 9th day after transplantation without the change of insulin and glucagon in blood and clinical symptoms of rejection. Conclusion Pancreatoduodenal transplantation in pigs can treat type Ⅰ diabete. ED and PVD can keep the function of endocrine in normal. The technique of duodenal transplantation with ED and PVD may pave the way for the further development of pancreas transplantation in clinic.
Objective To investigate the inhibitory effects of RNA interference (RNAi) expression vector on the expression of survivin in pancreatic cancer cell PANC-1. Methods The protein and mRNA expressions of survivin were examined with immunofluorescence and RT-PCR. The survivin gene was cloned into the T-vector and sequenced. The RNAi expression vectors targeting survivin, named si-svv-1 and si-svv-2 respectively according to whether they harbored a mutation or no mutation, were constructed and transfected into PANC-1 cells with liposome. The expression of survivin mRNA was detected with RT-PCR. Apoptosis of PANC-1 cells was analyzed with DNA ladder and FACS. Results There was a high degree expression of survivin in PANC-1 cells. The expression of survivin was not inhibited by RNAi expression vectors si-svv-1, but inhibited about (72.43±8.04)% by si-svv-2 and the apoptosis rate of PANC-1 cells increased to （12.36±1.44）% after 72 h. Conclusion The RNAi expression vector can effectively inhibit the expression of survivin in pancreatic cancer cell PANC-1 cells and induce the apoptosis in PANC-1 cells.
Objective To explore treatment strategy of pancreatic pseudocyst induced left-sided portal hypertension (LSPH) complicated with hypersplenism. Methods The clinical data of 49 cases of pancreatic pseudocyst induced LSPH complicated with hypersplenism from January 2010 to June 2015 in this hospital were retrospectively analyzed. Among them, 36 patients who were not complicated with upper gastrointestinal bleeding were designed to splenectomy group and non-splenectomy group based on splenectomy or not. The epidemiological and clinical features, intraoperative and postoperative results of these two groups were compared. Results There were 38 males and 11 females with age ranging from 22 to 67 years old. As for 13 patients suffering LSPH complicated with hypersplenism caused by pancreatic pseudocyst with upper gastrointestinal bleeding, one patient didn’t accept splenectomy, then the upper gastrointestinal bleeding recurred and the hypersplenism was not alleviated after operation; Whereas, the hypersplenisms were relieved in the others patients after operation. In the 36 patients without upper gastrointestinal bleeding who were complicated with hypersplenism, 23 patients were performed splenectomy (splenectomy group) and 13 patients were not (non-splenectomy group). In the splenectomy group, the blood loss, operation time, and intraoperative blood transfusion were significantly more than those of the non-splenectomy group (P<0.05). The hospital stay and the discharged laboratory examinations had no significant differences between the splenectomy group and the non-splenectomy group (P>0.05) except for the platelet count. Furthermore, the incidence of the postoperative upper gastrointestinal bleeding was lower (P<0.05) and the relief rate of hypersplenism was higher (P<0.05) in the splenectomy group as compared with the non-splenectomy group. Conclusions For pancreatic pseudocyst induced LSPH with hypersplenism, we should be vigilant and early intervent. Usually, primary focus can be treated only. However, splenectomy can effectively relieve hypersplenism and prevent recurrent bleeding for patients with upper gastrointestinal bleeding or patients with close adhesion of pancreas tail and spleen inflammatory lesions and constricting splenic hilus.