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| 1 | Effects of early enteral nutrition on immune function of severe acute pancreatitis patients显示文摘AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN).Enteral nutrition was started within 48 h after admission in EEN group,whereas from the 8 th day in DEN group.All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1,3,7 and 14 after admission.The clinical outcome variables were also recorded.RESULTS:Sixty SAP patients were enrolled to this study.The CD4+ T-lymphocyte percentage,CD4+/CD8+ ratio,and the CRP levels in EEN group became significantly lower than in DEN group from the 7 th day after admission.In contrast,the immunoglobulin G(IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7 th day after admission.No difference of CD8+ T-lymphocyte percentage,IgM and IgA levels was found between the two groups.The incidences of multiple organ dysfunction syndrome,systemic inflammatory response syndrome,and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group.However,there was no difference of hospital mortality between the two groups.CONCLUSION:EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression.EEN can improve the clinical outcome,but not decrease the hospital mortality of SAP patients. | Jia-Kui Sun Xin-Wei Mu Wei-Qin Li Zhi-Hui Tong Jing Li Shu-Yun Zheng | 2013 | World Journal of Gastroenterology2013，19，6： | 106 |
| 2 | Sequential blood purification therapy for critical patients with hyperlipidemic severe acute pancreatitis显示文摘AIM: To evaluate the efficacy of sequential blood purification therapy in the treatment of critical patients with hyperlipidemic severe acute pancreatitis.METHODS: Thirty-one intensive care unit(ICU) patients with hyperlipidemic severe acute pancreatitis treated at the Second Affiliated Hospital of Harbin Medical University were divided into either a study group(n = 15; July 1, 2012 to June 30, 2014) or a control group(n = 16; July 1, 2010 to June 30, 2012) based on the implementation of sequential blood purification therapy. The control group received continuous venous-venous hemofiltration(CVVH) on the basis of conventional treatments, and the therapeutic dose of CVVH was 30 m L/kg per hour. The study group received sequential plasma exchange and CVVH on the basis of conventional treatments. The anticoagulation regimen of CVVH is the regional citrate anticoagulation. Mortality rate on day 28, rates of systemic and local complications, duration of ICU, and time to target serum lipid level, as well as physiologic and laboratory indices were compared between the two groups.RESULTS: The mortality rate on day 28 was significantly lower in the study group than in the control group(13.33% vs 37.50%; P < 0.05). The duration of ICU stay was significantly shorter in the study group than in the control group(7.4 ± 1.35 d vs 9.19 ± 2.99 d, P < 0.05). The time to target serum lipid level was significantly shorter in the study group than in the control group(3.47 ± 0.52 d vs 7.90 ± 1.14 d, P < 0.01). There were no significant differences in the rates of systemic complications and local complications between the two groups(60% vs 50% and 80% vs 81%, respectively). In the comparisons of physiologic and laboratory indices, serum albumin and C-reactive protein were significantly better in the study group than in the control group after treatment(37.8 ± 4.6 g/L vs 38.9 ± 5.7 g/L, and 20.5 ± 6.4 mg/L vs 28.5 ± 7.1 mg/L, respectively, both P < 0.05). With the exception of plateletcrit, no other indices showed significant differences between the two groups.CONCLUSION: Sequential blood purification therapy is effective in the treatment of ICU patients with hyperlipidemic severe acute pancreatitis and can improve patient prognosis. | Hong-Liang Wang Kai-Jiang Yu | 2015 | World Journal of Gastroenterology2015，21，20： | 57 |
| 3 | 早发型重度子癎前期严重并发症的监测与防范显示文摘 | 杨孜 | 2006 | 中国实用妇科与产科杂志2006，22，7： | 49 |
| 4 | Prognostic value of red blood cell distribution width for severe acute pancreatitis显示文摘BACKGROUND Severe acute pancreatitis(SAP)is a common condition in the intensive care unit(ICU)and has a high mortality.Early evaluation of the severity and prognosis is very important for SAP therapy.Recently,red blood cell distribution(RDW)was associated with mortality of sepsis patients and could be used as a predictor of prognosis.Similarly,RDW may be associated with the prognosis of SAP patients and be used as a prognostic indicator for SAP patients.AIM To investigate the prognostic value of RDW for SAP patients.METHODS We retrospectively enrolled SAP patients admitted to the ICU of the First Affiliated Hospital of China Medical University from June 2015 to June 2017.According to the prognosis at 90 d,SAP patients were divided into a survival group and a non-survival group.RDW was extracted from a routine blood test.Demographic parameters and RDW were recorded and compared between the two groups.The receiver operator characteristic(ROC)curve was constructed and Cox regression analysis was performed to investigate the prognostic value of RDW for SAP patients.RESULTS In this retrospective cohort study,42 SAP patients were enrolled,of whom 22 survived(survival group)and 20 died(non-survival group).The baseline parameters were comparable between the two groups.The coefficient of variation of RDW(RDW-CV),standard deviation of RDW(RDW-SD),Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment(SOFA)score were significantly higher in the non-survival group than in the survival group(P<0.05).The RDW-CV and RDW-SD were significantly correlated with the APACHE II score and SOFA score,respectively.The areas under the ROC curves(AUCs)of RDW-CV and RDW-SD were all greater than those of the APACHE II score and SOFA score,among which,the AUC of RDW-SD was the greatest.The results demonstrated that RDW had better prognostic value for predicting the mortality of SAP patients.When the RDW-SD was greater than 45.5,the sensitivity for predicting prognosis was 77.8%and the specificity was 70.8%.Both RDW-CV and RDW-SD could be used as independent risk factors to predict the mortality of SAP patients in multivariate logistic regression analysis and univariate Cox proportional hazards regression analysis,similar to the APACHE II and SOFA scores.CONCLUSION The RDW is greater in the non-surviving SAP patients than in the surviving patients.RDW is significantly correlated with the APACHE II and SOFA scores.RDW has better prognostic value for SAP patients than the APACHE II and SOFA scores and could easily be used by clinicians for the treatment of SAP patients. | Fang-Xiao Zhang Zhi-Liang Li Zhi-Dan Zhang Xiao-Chun Ma | 2019 | World Journal of Gastroenterology2019，25，32： | 50 |
| 5 | Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes显示文摘Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN)with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patientswith severe traumatic brain injury (STBI).Methods A prospective randomized control trial was carried out from January 2009 to May 2012 inNeurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow ComaScale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were administratedEN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function,complications and clinical outcomes were examined and compared statistically. | Ming-chao Fan Qiao-ling Wang Wei Fang Yun-xia Jiang Lian-di Li Peng Sun Zhi-hong Wang | 2016 | Chinese Medical Sciences Journal2016，31，4： | 37 |
| 6 | Pathological changes at early stage of multiple organ injury in a rat model of severe acute pancreatitis显示文摘BACKGROUND:Severe acute pancreatitis (SAP) is a commonly seen acute abdominal syndrome characterized by sudden onset,rapid progression and high mortality rate.The damage in peripheral organs may be more severe than that in the pancreas,and can even lead to multiple organ dysfunction.It is critical to recognize early pathological changes in multiple organs.This study aimed to assess the early pathological features of damaged organs in a rat model of SAP.METHODS:Thirty clean grade healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into a model control group (n=15) and a sham-operated group (n=15).The SAP rat model was induced by sodium taurocholate.Samples of blood and from multiple organs were collected 3 hours after operation.We assessed the levels of IL-6,TNF-α,PLA2,NO,ET-1,MDA,amylases and endotoxin in blood and observed the early pathological changes in multiple damaged organs.RESULTS:Levels of IL-6,TNF-α,PLA2,NO,ET-1 and MDA in serum and of amylase and endotoxin in plasma of the model control group rats were significantly higher than those of the sham-operated group (P<0.01).Different degrees of pathological change were observed in multiple damaged organs.CONCLUSION:Multiple organ injury may occur at the early stage of SAP in rats. | Zhang, Xi-Ping Zhang, Jie Ma, Mei-Li Cai, Yang Xu, Ru-Jun Xie, Qi Jiang, Xin-Ge Ye, Qian | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，1： | 33 |
| 7 | Short-term entecavir therapy of chronic severe hepatitis B显示文摘BACKGROUND:Chronic severe hepatitis B patients often have limited survival.This investigation aimed to evaluate the short-term effects of nucleoside analog therapy on chronic severe hepatitis B. METHODS:We retrospectively,randomly collected the data of 129 chronic severe hepatitis B patients:55 were treated with entecavir,and the remaining 74 were not treated with nucleoside analogues. RESULTS:No significant difference in short-term survival rate was found between the group treated with entecavir and that treated without nucleoside analogues.Although entecavir greatly reduced HBV replication in different periods of therapy(P<0.001),the model for end-stage liver disease(MELD)score and liver function(alanine aminotransferase,albumin,bilirubin,prothrombin time) showed no significant change.No significant differences were found in MELD scores and liver function in patients with different HBV DNA levels(≤104copies/ml,>10 4 to<10 6 copies/ml,≥10 6 copies/ml).Nor correlation was observed between HBV DNA levels and MELD scores in different periods of therapy(P>0.05).The HBV DNA levels of patients who survived for over 3 months or less than 3 months were not significantly different either.However, the MELD score and parameters of liver function(albumin, bilirubin,prothrombin time)were different between the two groups(P<0.05).CONCLUSION:These results suggest that short-term suppression of HBV replication may not slow down the progression of liver failure in patients with chronic severe hepatitis B. | Chen, Jun Han, Jian-Hua Liu, Chun Yu, Ren-He Li, Fa-Zhao Li, Qun-Fang Gong, Guo-Zhong | 2009 | Hepatobiliary & Pancreatic Diseases International2009，8，3： | 31 |
| 8 | Pathogenesis of pancreatic encephalopathy in severe acute pancreatitis显示文摘BACKGROUND: Pancreatic encephalopathy (PE) is a serious complication of severe acute pancreatitis (SAP). In recent years, more and more PE cases have been reported worldwide, and the onset PE in the early stage was regarded as a poor prognosis sign of SAP, but the pathogenesis of PE in SAP still has not been clarified in the past decade. The purpose of this review is to elucidate the possible pathogenesis of PE in SAP. DATA SOURCES: The English-language literature concern- ing PE in this review came from the Database of MEDLINE (period of 1991-2005), and the keywords of severe acute pancreatitis and pancreatic encephalopathy were used in the searching. RESULTS: Many factors were involved in the pathogenesis of PE in SAP. Pancreatin activation, excessive release of cytokines and oxygen free radicals, microcirculation abnormalities of hemodynamic disturbance, ET-1/NO ratio, hypoxemia, bacterial infection, water and electrolyte imbalance, and vitamin B1 deficiency participated in the development of PE in SAP. CONCLUSIONS: The pathogenesis of PE in SAP has not yet been fully understood. The development of PE in SAP may be a multi-factor process. To find out the possible inducing factor is essential to the clinical management of PE in SAP. | Zhang, Xi-Ping Tian, Hua | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，2： | 24 |
| 9 | Criteria for the diagnosis and severity stratification of acute pancreatitis显示文摘Recent diagnostic and therapeutic progress for severe acute pancreatitis(SAP)remarkably decreased the casemortality rate.To further decrease the mortality rate of SAP,it is important to precisely evaluate the severity at an early stage,and initiate appropriate treatment as early as possible.Research Committee of Intractable Diseases of the Pancreas in Japan developed simpler criteria combining routinely available data with clinical signs.Severity can be evaluated by laboratory examinations or by clinical signs,reducing the defect values of the severity factors.Moreover,the severity criteria considered laboratory/clinical severity scores and contrastenhanced computed tomography(CE-CT)findings as independent risk factors.Thus,CE-CT scans are not necessarily required to evaluate the severity of acute pancreatitis.There was no fatal case in mild AP diagnosed by the CE-CT severity score,whereas case-mortality rate in those with SAP was 14.8%.Case-mortality of SAP that fulfilled both the laboratory/clinical and the CE-CT severity criteria was 30.8%.It is recommended,therefore,to perform CE-CT examination to clarify the prognosis in those patients who were diagnosed as SAP by laboratory/clinical severity criteria.Because the mortality rate of these patients with SAP is high,such patients should be transferred to advanced medical units. | Makoto Otsuki Kazunori Takeda Seiki Matsuno Yasuyuki Kihara Masaru Koizumi Masahiko Hirota Tetsuhide Ito Keisho Kataoka Motoji Kitagawa Kazuo Inui Yoshifumi Takeyama | 2013 | World Journal of Gastroenterology2013，19，35： | 24 |
| 10 | Modified Da-chai-hu Decoction regulates the expression of occludin and NF-κB to alleviate organ injury in severe acute pancreatitis rats显示文摘Modified Da-chai-hu Decoction(MDD), a traditional Chinese medicinal formulation, which was empirically generated from Da-chai-hu decoction, has been utilized to treat severe acute pancreatitis(SAP) for decades. The aim of the present study was to explore its potential organprotective mechanism in SAP. In the present study, rat SAP model was induced by retrograde injection of 3.5% sodium taurocholate into the biliopancreatic duct, MDD(23.35 g/kg body weight, twelve times the clinical dose) were orally given at 2 h before and 10 h after injection. At 12 h after model induction, blood was taken from vena cava for analysis of amylase, diamine oxidase(DAO), pulmonary surfactant protein-A(SP-A), and C-reactive protein(CRP). Histopathological change of pancreas, ileum and lung was assayed by H&E staining, myeloperoxidase(MPO) activity were determinated using colorimetric assay, and the expressions of occludin and nuclear factor-κB(NF-κB) were detected by real-time RT-PCR and western blot, respectively. In addition, the tissue concentrations of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), and monocyte chemoattractant protein-1(MCP-1) were measured by enzyme-linked immunosorbent assay(ELISA). The results showed that in SAP rats, MDD significantly alleviated histopathological damage, depressed the MPO activity and the concentrations of TNF-α, IL-1β, and MCP-1 of pancreas, ileum and lung, and reduced the serum levels of amylase [(3283.4±585.5) U·L^(-1) vs(5626.4±795.1) U·L^(-1)], DAO[(1100.1±334.3) U·L^(-1) vs(1666.4±525.3) U·L^(-1)] and CRP [(7.6±1.2) μg·mL^(-1) vs(17.8±3.8) μg·mL^(-1)]. However, the serum SP-A concentration [(106.1±16.6) pg·mL^(-1) vs(90.1±14.9) pg·mL^(-1)] was elevated when treated SAP rats with MDD. Furthermore, MDD increased the occludin expression and reduced the NF-κB expression in pancreas, ileum and lung of SAP rats. Our findings suggested that MDD administration was an effective therapeutic approach for SAP treatment. It could up-regulate occludin expression to protect intercellular tight junction and down-regulate NF-κB expression to inhibit inflammatory reaction of pancreas, ileum and lung. | ZHAO Guang ZHUO Yu-Zhen CUI Li-Hua LI Cai-Xia CHEN Sha-Yan LI Dan LIU Jun-Hong LI Di-Hua CUI Nai-Qiang ZHANG Shu-Kun | 2019 | Chinese Journal of Natural Medicines2019，17，5： | 23 |
| 11 | Endoscopic Surgery versus External Ventricular Drainage Surgery for Severe Intraventricular Hemorrhage显示文摘The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventficular hemorrhage (IVH) were explored and compared.From Jan.2015 to Dec.2016,the clinical data of 42 cases of IVH were retrospectively analyzed,including 18 patients undergoing endoscopic hematoma evacuation (group A),and 24patients receiving EVD (group B).The hematoma clearance rate was calculated by 3D Slicer software,and complications and outcomes were compared between the two groups.There were no significant differences in age,sex and Graeb score between groups A and B (P>0.05).The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (P<0.05).The operative time in groups A and B was 72.45±25.26 min and 28.54±15.27min,respectively (P<0.05).The Glasgow Coma Scale (GCS) score increased from 9.28±2.72 at baseline to 11.83±2.91 at 1 week postoperatively in group A,and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05).The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05).The GOS scores at 6 months after surgery were 3.83±1.12 in group A,and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate,fewer complications and better outcomes in the treatment of severe IVH,indicating it is a safe,effective and promising approach for severe IVH. | Ping SONG Fa-liang DUAN Qiang CAI Jing-lei WU Xiao-bin CHEN Yuan WANG Cong-gang HUANG Ji-qiang LI Zhu-qiang HE Qiao-chun HUANG Mei LIU Yan-gao ZHANG Ming LUO | 2018 | Current Medical Science2018，38，5： | 21 |
| 12 | Epidural anesthesia improves pancreatic perfusion and decreases the severity of acute pancreatitis显示文摘AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein > 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP. | Samira M Sadowski Axel Andres Philippe Morel Eduardo Schiffer Jean-Louis Frossard Alexandra Platon Pierre-Alexandre Poletti Leo Bühler | 2015 | World Journal of Gastroenterology2015，21，43： | 21 |
| 13 | Protective effects of MCP-1 inhibitor on a rat model of severe acute pancreatitis显示文摘BACKGROUND:Chemokines and their receptors play key roles in the pathogenesis of acute pancreatitis.This study aimed to establish a rat model of severe acute pancreatitis(SAP) for investigating monocyte chemotactic protein-1(MCP-1) expression in the pathogenesis of the disease.We assessed the effects of the inhibitor of MCP-1,Bindarit,on SAP and explored the mechanisms underlying SAP. METHODS:Seventy-two Sprague-Dawley rats were randomly divided into a saline control group(group S),an SAP group (group P),and a Bindarit group(group T).The SAP model was induced by retrograde infusion of 4%sodium taurocholate into the bilio-pancreatic duct.Based on the SAP model,Bindarit was injected intraperitoneally in group T,and 0.5% methyl cellulose was injected intraperitoneally in groups S and P.In group S,saline was retrogradely infused into the bili- pancreatic duct.Serum amylase levels and the histological changes in the pancreas were assessed at different time- points in each group.Expression of MCP-1 in serum was measured by enzyme-linked immunoadsorbent assay(ELISA). MCP-1 protein and mRNA expression levels were detected by immunohistochemistry,Western blotting,and semi- quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS:Serum amylase levels in groups P and T were higher than those in group S.Serum amylase levels were significantly lower in group T than in group P at 6 and 12 hours after operation.The levels of MCP-1 in serum at 6 and 12 hours after operation in group P were significantly higher than in group S,and significantly lower in group T than in group P at 6 and 12 hours after operation.The pathological damage in the pancreas was milder in group T than in group P.MCP-1 protein and mRNA expression levels in the pancreas were higher in groups P and T than in group S.These expression levels were positively correlated with the pathological damage of pancreatic tissues.The activity of MCP-1 in group T was significantly lower than in group P.CONCLUSION:MCP-1 may play important roles in the pathogenesis of SAP.The data suggest that Bindarit ameliorates SAP by inhibiting the activity of MCP-1 in vivo. | Zhou, Guo-Xiong Zhu, Xue-Juan Ding, Xiao-Ling Zhang, Hong Chen, Jian-Ping Qiang, Hui Zhang, Hai-Feng Wei, Qun | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，2： | 20 |
| 14 | Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis显示文摘AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis(PSMVT) in the early stage of severe acute pancreatitis(SAP).METHODS Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography(CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic(ROC) curve was generated for the qualifying independent risk factors.RESULTS Twenty-five of the one hundred and forty(17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis(AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar's CT severity index(CTSI) scores [odds ratio(OR): 2.742; 95% confidence interval(CI): 1.664-4.519; P = 0.000], hypoalbuminemia(serum albumin level < 25 g/L)(OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening(OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar's CTSI scores was 0.777(P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5.CONCLUSION High Balthazar's CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP. | Ling Ding Feng Deng Chen Yu Wen-Hua He Liang Xia Mi Zhou Xin Huang Yu-Peng Lei Xiao-Jiang Zhou Yin Zhu Nong-Hua Lu | 2018 | World Journal of Gastroenterology2018，24，35： | 20 |
| 15 | Abdominal paracentesis drainage ameliorates severe acute pancreatitis in rats by regulating the polarization of peritoneal macrophages显示文摘AIM To investigate the role of peritoneal macrophage(PM) polarization in the therapeutic effect of abdominal paracentesis drainage(APD) on severe acute pancreatitis(SAP).METHODS SAP was induced by 5% Na-taurocholate retrograde injection in Sprague-Dawley rats. APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after the induction of SAP. To verify the effect of APD on macrophages, PMs were isolated and cultured in an environment, with the peritoneal inflammatory environment simulated by the addition of peritoneal lavage in complete RPMI 1640 medium. Hematoxylin and eosin staining was performed. The levels of pancreatitis biomarkers amylase and lipase as well as the levels of inflammatory mediators in the blood and peritoneal lavage were determined. The polarization phenotypes of the PMs were identified by detecting the marker expression of M1/M2 macrophages via flow cytometry, qPCR and immunohistochemical staining. The protein expression in macrophages that had infiltrated the pancreas was determined by Western blot.RESULTS APD treatment significantly reduced the histopathological scores and levels of amylase, lipase, tumor necrosis factor-α and interleukin(IL)-1β, indicating that APD ameliorates the severity of SAP. Importantly, we found that APD treatment polarized PMs towards the M2 phenotype, as evidenced by the reduced number of M1 macrophages and the reduced levels of proinflammatory mediators, such as IL-1β and L-selectin, as well as the increased number of M2 macrophages and increased levels of anti-inflammatory mediators, such as IL-4 and IL-10. Furthermore, in an in vitro study wherein peritoneal lavage from the APD group was added to the cultured PMs to simulate the peritoneal inflammatory environment, PMs also exhibited a dominant M2 phenotype, resulting in a significantly lower level of inflammation. Finally, APD treatment increased the proportion of M2 macrophages and upregulated the expression of the anti-inflammatory protein Arg-1 in the pancreas of SAP model rats.CONCLUSION These findings suggest that APD treatment exerts antiinflammatory effects by regulating the M2 polarization of PMs, providing novel insights into the mechanism underlying its therapeutic effect. | Ruo-Hong Liu Yi Wen Hong-Yu Sun Chun-Yu Liu Yu-Fan Zhang Yi Yang Qi-Lin Huang Jia-Jia Tang Can-Chen Huang Li-Jun Tang | 2018 | World Journal of Gastroenterology2018，24，45： | 20 |
| 16 | Gene heterogeneity of hepatitis B virus isolates from patients with severe hepatitis B显示文摘BACKGROUND: The pathogenesis of severe hepatitis B remains unknown. Reports have indicated that hepatitis B virus (HBV) mutations are important factors in the pathogenesis of this disease. This study was to investigate the genetic heterogeneity of HBV strains from serum samples of patients with fulminant hepatitis B. METHODS: Full-length HBV genomes from 4 patients with severe hepatitis B were cloned and sequenced to observe mutations in every open reading-frame ( ORF). Serum samples of another 25 patients with severe hepatitis B, 30 patients with chronic hepatitis B, and 25 HBV carriers were collected for sequencing and comparison of mutations in preS2, preC and core promoter regions. RESULTS: Of 4 HBV full-length genome sequences, 3 had a G to A mutation at nucleotide A1896 in the preC region and 1 had double mutations of T1762-A1764 in the core promoter region. The 4 sequences showed mutations in the known B or T cell epitopes of the preS2 and C regions. For the other 3 groups, more mutations were seen in the preS2 region in the HBV isolates from the patients with severe hepatitis B than those from the patients with chronic hepatitis B and HBV carriers (P <0.01). There was a significant difference of mutations in the T cell epitope region of preS2 between the patients with severe hepatitis B and those with chronic hepatitis B or HBV carriers (P <0.01). In the preC and core promoter regions, the mutation frequencies of T1653 and C1753 were 48.0% and 24.0% respectively in the patients with severe hepatitis B, but none of these mutations were observed in the patients with chronic hepatitis B group or HBV carriers (P <0.01). The mutation frequency of T1762-A1764 was 76.0% in the patients with severe hepatitis B, 40.0% in the patients with chronic hepatitis B (P <0. 01) , and 16. 0% in the HBV carriers ( P < 0. 01). There was a significant difference in A1896 mutation between the patients with severe hepatitis B and the patients with chronic hepatitis B (P < 0. 05 ) or the HBV carriers (P<0.05). CONCLUSION: Our observations suggest that the accumulation and persistence of high frequency mutations or complex mutations may be associated with the development and deterioration of HBV infection. | Wei Wu, Yu Chen, Bing Ruan and Lan-Juan Li Hangzhou, China Department of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Infectious Diseases of Health Ministry of China, Hangzhou 310003, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，4： | 20 |
| 17 | Early intrajejunal nutrition: bacterial translocation and gut barrier function of severe acute pancreatitis in dogs显示文摘Objective: To evaluate the effect of early intrajejunalnutrition in attenuating bacterial and/or endotoxintranslocation and improving gut barrier function ofsevere acute pancreatitis (SAP) in dogs.Methods: 15 dogs were divided into parenteral nutrition(PN) group(7 dogs)and early intrajejunal nutrition(EIN) group(8). EIN was delivered nutrients via a nee-dle jejunostomy catheter feeding at 48h after operation.SAP model was induced by injecting 1 ml/kg of com-bined solution of 5% sodium taurocholate and 8000-10000 BAEE units trypsin/ml into the pancreas via thepancreatic duct. Systemic blood samples were ob-tained before and 1, 3, 5, 7 d following SAP, and culturedby aerobic as well as anaerobic bacterial growth. Systemicplasma and portal vein endotoxin levels were quantifiedby the chromogenic limulus amebocyte lysate (LAL)technique. Portal vein blood and specimens of tissuefrom the mesenteriolum and mesocolon lymph nodes,lung, pulmonary portal lymph nodes, pancreatitis tissueand periopancreas tissue were adopted before the experi-ment was finished. Aliquots of the homogenata were cul-tured as blood mentioned above to determine the magnitudeof the bacteria DNA, protein and the villi, the thickness ofmucosa, and the whole bowel wall of the ileum and trans-verse colon were measured.Results: The study showed that the levels of systemicplasma endotoxin and the magnitude of bacterialtranslocation to the portal and systemic blood and dis-tant organ were reduced significantly in the EINgroup as compared with the TPN group. The contentsof protein and DNA, the height of villi, the thicknessof mucosa and whole bowel wall of the ileum andtransverse colon in the EIN group were higher thanthose in the PN group.Conclusion: Our results suggested that EIN is safe andeffective to be adopted by intrajejunal delivery of nu-trients in SAP, decreases the occurrence of gut bacterialtranslocation, and improves the gut barrier function. | Huan-Long Qin Zhen-Dong Su Qi Gao Qing-Tian Lin From the Department of Surgery, Shanghai Sixth People’s Hospital, Shanghai, 200233, China | 2002 | Hepatobiliary & Pancreatic Diseases International2002，1，1： | 20 |
| 18 | Arpin contributes to bacterial translocation and development of severe acute pancreatitis显示文摘AIM: To assess the impact of Arpin protein and tight junction(TJ) proteins in the intestinal mucosa onbacterial translocation in patients with severe acute pancreatitis(SAP).METHODS: Fifty SAP patients were identified as study objects and then classified into two groups according to the presence of bacterial translocation(BT) in the blood [i.e., BT(+) and BT(-)].Twenty healthy individuals were included in the control group.BT was analyzed by polymerase chain reaction, colonic mucosal tissue was obtained by endoscopy and the expression of TJ proteins and Arpin protein was determined using immunofluorescence and western blotting.RESULTS: Bacterial DNA was detected in the peripheral blood of 62.0% of patients(31/50) with SAP.The expression of TJ proteins in SAP patients was lower than that in healthy controls.In contrast, Arpin protein expression in SAP patients was higher than in healthy controls(0.38 ± 0.19 vs 0.28 ± 0.16, P < 0.05).Among SAP patients, those positive for BT showed a higher level of claudin-2 expression(0.64 ± 0.27 vs 0.32 ± 0.21, P < 0.05) and a lower level of occludin(OC)(0.61 ± 0.28 vs 0.73 ± 0.32, P < 0.05) and zonula occludens-1(0.42 ± 0.26 vs 0.58 ± 0.17, P = 0.038) expression in comparison with BT(-) patients.Moreover, the level of Arpin expression in BT(+) patients was higher than in BT(-) patients(0.61 ± 0.28 vs 0.31 ± 0.24, P < 0.05).CONCLUSION: Arpin protein affects the expression of tight junction proteins and may have an impact on BT.These results contribute to a better understanding of the factors involved in bacterial translocation during acute pancreatitis. | Wen-Sheng Deng Jian Zhang Hui Ju Hong-Mei Zheng Jiang Wang Su Wang Dian-Liang Zhang | 2015 | World Journal of Gastroenterology2015，21，14： | 20 |
| 19 | Overexpressed miRNA-155 dysregulates intestinal epithelial apical junctional complex in severe acute pancreatitis显示文摘AIM:To investigate whether miRNA-155(miR-155)dysregulates apical junctional complex(AJC)protein expression in experimental severe acute pancreatitis(SAP).METHODS:Twenty-four male BALB/c mice were randomly assigned to two groups:the SAP group(n=12)receiving sequential intraperitoneal injection of 50μg/kg caerulein and 10 mg/kg lipopolysaccharide over 6h,and the control group(n=12)receiving intraperitoneal injection of normal saline.Animals were sacrificed3 h following the last injection for collection of blood samples and pancreas and distal ileal segment specimens.Routine pancreas and intestine histology was used to assess SAP pathology and intestinal epithelial barrier damage.Levels of serum amylase,diamine oxidase(DAO),and tumor necrosis factor(TNF)-αwere determined using commercial kits.Total RNA samples were isolated from intestinal epithelial specimens and reversely transcribed into cDNA.miR-155 and RhoA mRNA expression profiles were determined using quantitative real-time polymerase chain reaction.Target genes for miR-155 were predicted using the miRTarBase database,RNA22 and PicTar computational methods.Western blotting was performed to quantitate the protein expression levels of the target gene RhoA,as well as zonula occludens(ZO)-1 and E-cadherin,two AJC component proteins.RESULTS:Intraperitoneal injection of caerulein and lipopolysaccharide successfully induced experimental acute pancreatic damage(SAP vs control,10.0±2.0vs 3.2±1.2,P<0.01)and intestinal epithelial barrier damage(3.2±0.7 vs 1.4±0.7,P<0.01).Levels of serum amylase(21.6±5.1 U/mL vs 14.3±4.2 U/mL,P<0.01),DAO(21.4±4.1 mg/mL vs 2.6±0.8 mg/mL,P<0.01),and TNF-α(61.0±15.1 ng/mL vs 42.9±13.9 ng/mL,P<0.01)increased significantly in SAP mice compared to those in control mice.miR-155 was significantly overexpressed in SAP intestinal epithelia(1.94±0.50 fold vs 1.03±0.23 fold,P<0.01),and RhoA gene containing three miR-155-specific binding sites in the three prime untranslated regions was one of the target genes for miR-155.RhoA(22.7±5.8 folds vs 59.6±11.6 folds,P<0.01),ZO-1(46±18 folds vs68±19 folds,P<0.01),and E-cadherin proteins(48±15 folds vs 77±18 folds,P<0.01)were underexpressed in SAP intestinal epithelia although RhoA mRNA expression was not significantly changed in SAP(0.97±0.18 folds vs 1.01±0.17 folds,P>0.05).CONCLUSION:TNF-α-regulated miR-155 overexpression inhibits AJC component protein syntheses of ZO-1,and E-cadherin by downregulating post-transcriptional RhoA expression,and disrupts intestinal epithelial barrier in experimental SAP. | Rui Tian Rui-Lan Wang Hui Xie Wei Jin Kang-Long Yu | 2013 | World Journal of Gastroenterology2013，19，45： | 19 |
| 20 | Pathogenesis of acute lung injury in rats with severe acute pancreatitis显示文摘BACKGROUND: Acute lung injury (ALI) is the most common and severe complication of severe acute pancreatitis (SAP). The elucidation of the mechanism of ALI contributes to the diagnosis and treatment of the illness. In this study, we studied the pathogenesis of ALI in rats with severe acute pancreatitis. METHODS: The rats were sacrificed at 1, 3, 5, 6, 9 and 12 hours after the establishment of the model of SAP. Pancreas and lung tissues were obtained for pathological study, and examination of microvascular permeability and myeloperoxidase (MPO) examination. The gene expressions of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule-1 (ICAM-1) in the pancreas and lung tissues were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: After the establishment of the SAP model, the degree of pancreatic and lung injury increased gradually along with the gradual increase of MPO activity and micro-vascular permeability. Gene expressions of TNF-α and ICAM-1 in the pancreas rose at 1 hour and peaked at 7 hours. In contrast, their gene expression in the lungs rose slightly at 1 hour and peaked at 9-12 hours. CONCLUSION: An obvious time window existed between SAP and lung injury, which is beneficial to the early prevention of the development of ALI. | Xue-Min Liu, Jun Xu and Zi-Fa Wang Department of Hepatobiliary Surgery, First Hospital, Xi’an Jiaotong University, Xi’an 710061 , China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，4： | 18 |
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