ObjectiveTo investigate the differential diagnosis of chronic pancreatitis with mass of pancreatic head and pancreatic carcinoma, and choose the effective treatment of chronic pancreatitis with mass of pancreatic head. MethodsEighty cases of chronic pancreatitis with mass of pancreatic head from January 2008 to January 2014 in this hospital were retrospectively analyzed.The preoperative blood tumor markers, hepatobiliary and pancreatic color Doppler ultrasound, CT strengthen, MRI, MRCP, or other imaging studies were tested for all the patients. ResultsThere were 4 cases of long-term drinking or excessive drinking history in 8 cases of chronic pancreatitis with mass of pancreatic head.The past medical history included 5 patients with acute pancreatitis, 3 patients with chronic cholecystitis, 2 patients with cholecystolithiasis.Six patients had varying degree of jaundice and 5 patients had left upper abdominal pain.There were 4 patients with high blood sugar, 6 patients with serum hyperbilirubin, 5 patients with elevated CA19-9 and 2 patients with elevated CEA by serum assay.The imaging revealed that a mass was in the head of the pancreas.The standard pancreaticoduodenectomy was performed in 6 cases, duodenum-preserving pancreatic head resection was performed in 2 cases.These 8 patients underwent the intraoperative fine needle aspiration cytological examination revealed the changes of chronic pancreatitis by postoperative pathology.The levels of CA19-9 and CEA on 1 week after operation were reduced to normal levels in patients with elevated CA19-9 and CEA alone or together.There was no case of serious complications such as postoperative pancreatic leakage and bile leakage.The intermittent vomiting appeared in 3 months after duodenum-preserving pancreatic head resection, the upper gastrointestinal radiography showed the stenosis of duodenum, the contrac-tures of the duodenum, especial the descending duodenum, was found through reoperation, the symptom was relief after gastrojejunal anastomosis.The recurrence was not seen in all these 8 patients with follow-up of 1-6 years. ConclusionsThe jaundice and abdominal for the patients with pancreatic head mass of chronic pancreatitis and pancreatic cancer pain are the main symptoms, but their characteristics are different, the former is minor, volatility, and intermittent; the latter is sustained and progressively aggravated.Understanding of past medical history for the identification of both is some significances.CA19-9 and CEA as the identification of the pancreatic head mass in chronic pancreatitis and pancreatic cancer is not meaningful.Patients with chronic pancreatitis of pancreatic mass are finished by multi-needle biopsy for pancreatic head mass, duodenum-preserving pancreatic head resection is preferred.Patients with invasive pancreatic mass and peripheral vascular adhesion must undergo standard pancreaticoduodenectomy.
ObjectiveTo discuss the changes of myelin basic protein (MBP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in serum and cerebrospinal fluid of experimental pancreatic encephalopathy rat model, analyze the relationship between each factor and the occurrence and development of pancreatic encephalopathy, and to provide the experimental basis for clinical diagnosis and treatment of pancreatic encephalopathy. MethodsSelecting 40 SD rats were randomly divided into sham operation group (SO group, n=10) and pancreatic encephalopathy group (PE group, n=30), respectively by the duodenal papilla retrograde pancreatic puncture injection of saline solution or 5% sodium taurocholic acid induced rat pancreatic encephalopathy model were set up. The rats in SO group were sacrificed on 1 d, and the PE group were sacrificed ten rats on 1 d, 3 d, and 7 d, respectively after surgery. The brain and pancreatic tissues of rats in each group were taken to observe the pathological changes of the rats and the brain white blood cells within microvessels gathered and coanda phenomenon. The water content of brain tissues, and the contents of MBP, TNF-α and TL-6 in serum and cerebrospinal fluid were detected. ResultsThe changes of brain nerve cell edema and nerve fiber demyelination were obvious in PE group rats after surgery with the extension of time. The contents of MBP, TNF-α and TL-6 in serum and cerebrospinal fluid on 1 d, 3 d, and 7 d after surgery in PE group were significantly higher than that SO group (P<0.05), and gradually increased with the extension of time. But by two two compared, the change trend of the above three indicators were different. ConclusionsMBP, TNF, and IL-6 on the occurrence and development of brain damage of pancreatic encephalopathy play a synergistic effect. To detecte the MBP, TNF-a, and IL-6 content in blood and cerebrospinal fluid could be diagnosed and evaluated the pancreatic encephalopathy.
ObjectiveTo observe the effects of Shenlingcao oral liquid on HIV-RNA load, CD4+ T cells of HIV carriers. MethodsWe included asymptomatic HIV-infection people from February to April 2012, gave them Shenlingcao oral liquid for oral intake (1 bottle/d, 200 mL/bottle) during 6 months, and observed the changes of HIV-RNA load and CD4+ T cell at different time points (before intake, 2 months, 4 months, and 6 months). ResultsA total of 25 cases were included. The results showed that a tendency existed that CD4+ T cells counts gradually increased along with time; HIV-RNA load did not change regularly; and the total effective rate was steady; and the cases in steady status tended to increase. ConclusionShenlingcao oral liquid is beneficial to the improvement of the immunity of asymptomatic HIV-infected people. Because of limited sample size and study design, the above conclusion should be verified by further conducting large-scale high quality randomized controlled trials.
ObjectiveTo observe intervention effect of Shenlingcao oral liquid on asymptomatic chronic hepatitis B virus carriers (AsC). MethodsA self control before-after trial was conducted in the First Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine and the Ninth People's Hospital of Nanchang City from November 2011 to May 2012. A total of 64 AsCs were treated by Shenlingcao oral liquid (1 bottle/d, 200 mL, once daily for 6 months). Serum HBV viral load, six specific serum markers of HBV and 11 liver function index were tested and recorded before and at the 1th, 3th, 6th months of the treatment. Analysis of variance of repeated data was conducted. ResultsAfter one month of the treatment, 35/57 (61.40%) AsCs' serum HBV-DNA loads decreased, 1 log decrease was observed in 15 cases, 2 log decrease was observed in 4 cases, and decrease under the detection limit was observed in 12 cases. 41/57 (71.93%) AsCs' serum HBV-DNA loads decreased after 3 months of treatment, 1 log decrease was observed in 21 cases, 2 log decrease was observed in 5 cases, and decrease under the detection limit was observed in 15 cases. 31/49 (63.26%) AsCs' serum HBV-DNA loads decreased after 6 months of the treatment, 1 log decrease was observed in 19 cases, decrease more than 2 log was observed in 7 cases, and decrease under the detection limit was observed in 12 cases. The serum HBV viral loads at different time points of the treatment were significantly different (P<0.001). As medication time went, AsCs' serum HBV viral loads presented a decrease trend after taking Shenlingcao oral liquid, especially obvious at the 3th month. ConclusionShenlingcao oral liquid could help promote AsCs' ability of clearing virus and controlling serum HBVDNA loads.