To evaluate the effects of different pressure and duration of autologous bile perfusion into dog’s pancreatic duct on the severity of induced acute pancreatitis. Thirty mongrel dogs were divided into five groups, with each group consisting of six dogs. Histological changes of pancreas were observed. Results: Histological changes of pancreas were correlated with the pressure and duration of autologous bile perfusion into pancreatic duct. It was easier to produce acute hemorrhagic necrotizing pancreatitis in the groups with a higher pressure and a longer duration of perfusion than in the groups with a lower pressure and a shorter duration. The results indicated that there was a significant effect of higher pressure and longer duration bile perfusion into pancreatic duct on the severity of induced acute pancreatitis.
Objective To evaluate the activity of the pancreatic tissue phospholipase A2 (PLA2) in acute pancreatitis (AP) and the therapeutic effects of verapamil in rats. MethodsThe model of rat AP induced by a closed duodenal loop technique was established to observe the changes of PLA2 activity in AP group and treated group. The pancreatic histology was examined by light and electron microscopy. Results At 16 and 24 hours after induction of AP in rats, significant inhibition of the pancreatic tissue PLA2 activity was shown in the treated group as compared with AP group, with 32.34±3.87u, 35.26±4.52u and 44.83±5.31u, 47.77±5.86u respectively. The treated animals also showed a decrease in the severity of pancreatic hemorrhage, necrosis and damage to the cellular ultrastructures. Conclusion There exists high activity of PLA2 in rats AP. Calcium channel blocker, verapamil might take therapeutic effects on AP by inhibiting activity of PLA2.
Objective To investigate the effect of chaiqin chengqi decoction (CQCQD) on serum lipid metabolism in experimental acute pancreatitis. Methods A total of 27 C57BL/6 mice were randomly divided into three groups (n=9 for each group). The mice in the acute pancreatitis model group (AP group) and the acute pancreatitis model + CQCQD treatment group (APQ group) received seven intraperitoneal injections of cerulein (50 μg/kg) at hourly intervals, while the mice in the control group (CON group) received phosphate-buffered saline injections at the same regimen of cerulein. Oral gavage of CQCQD (5.5 g/kg) or same volume of distilled water was commenced 1 h after the first cerulein injection for three times at intervals of 4 h for the APQ group and AP group, respectively. Animals were sacrificed 12 h after the first cerulein / phosphate-buffered saline injection for collecting serum and tissue samples. The levels of serum lipase and amylase, pancreatic histopathology assessment, as well as pancreatic myeloperoxidase activity, were used to assess the severity of acute pancreatitis and the efficacy of CQCQD. Additionally, serum lipid metabolites were analyzed in all groups. Results In comparison to the CON group, the mice in the AP group exhibited significant edema, inflammatory cell infiltration, necrosis of pancreatic tissues, as well as elevated levels of serum amylase, lipase, and pancreatic myeloperoxidase activity (P<0.05); in comparison to the AP group, inflammatory cell infiltration and necrosis of pancreatic tissue, as well as elevated level of serum amylase significantly reduced in the APQ group (P<0.05). A total of 319 lipid molecules were identified in serum, and 13 lipid metabolites were significantly increased in the AP group and successfully decreased in the APQ group, of which 9 were lyso-phosphatidylethanolamine (LPE) molecules involved in the glycerol phospholipid metabolic pathway. Further statistical analysis revealed that six of these LPE molecules could serve as potential biomarkers. Conclusions CQCQD ameliorated pancreatic injury and serum lipid metabolism disorder of acute pancreatitis model induced by cerulein and significantly improved the abnormal increase of serum LPE level. However, the role of LPE in acute pancreatitis and the underlying mechanisms of CQCQD on LPE metabolic pathways still need further study.
Objective To summarize the role of inflammatory cytokines in the pathogenesis of acute pancreatitis (AP) and gut barrier dysfunction in recent years. Methods Literatures on cytokines and experimental pancreatitis as well as clinical pancreatitis were collected and reviewed. Results Tumor necrosis factor-α and other inflammatory cytokines were elevated significantly during pancreatitis in many tissues, especially in pancreas and alimentary tract, in a fashion independent of the animal model used. Anti-cytokine therapy could decrease the concentration of the cytokines in experimental animal. Conclusion Inflammatory cytokines are believed to be primarily responsible for the pathogenesis of acute pancreatitis and its associated distant organ dysfunction. Further study of the nature of these cytokines may provide a new approach to treating this disease.
ObjectiveTo investigate the value of plasma microRNA-216 (miR-216) in patients with acute pancreatitis as a clinical biomarker to early identify severe acute pancreatitis (SAP).MethodsPatients with acute pancreatitis who admitted to the hospital within 48 hours after the onset of disease between September and November 2014 were enrolled in this study. Plasam and clinical data of all the patients were collected. MiR-216 in the plasma was detected using quantitative real time-polymerase chain reaction.ResultsA total of 25 patients were enrolled. The Ct value of plasma miR-216 in SAP patients (32.40±1.43) was significantly upregulated than mild acute pancreatitis (MAP) (35.85±1.91, P<0.05) and moderately severe acute pancreatitis (MSAP) patients (35.90±2.44,P<0.05), respectively. The area under receiver operating characteristic curve for plasmamiR-216 in predicting SAP was 0.792 (P<0.05), which did not differ much from other conventional parameters such as C-reactive protein, urinary nitrogen, and cytokines (P>0.05).ConclusionPlasma miR-216 is significantly upregulated in SAP patients compared with MAP and MSAP, but it shows no inferior efficiency than the investigated conventional predictors in predicting SAP.
Objective To observe the alteration of anti-inflammatory cytokines (IL-10 and TGF-β) in acute pancreatitis. MethodsSD male rats were divided into 2 groups: group 1, the normal rats as a control (n＝6); group 2, the acute pancreatitis induced by intraductal injection of 5% sodium cholate sulfur with the volume of 1.0 ml/kg。 The animals were killed at 2(n＝6), 6(n＝6) and 24 hours (n＝8) after operation, the blood samples were taken for measurement of IL-10, TGF-β (by ELISA). The weight of pancreatic tissue and amylase were also observed. Results Serum IL-10 and TGF-β in control group were 32.05±14.87 pg/ml and 66.40±13.20 pg/ml, respectively. Serum IL-10 in group 2 was 36.52±9.76 pg/ml (2 hour), 37.75±6.54 pg/ml (6 hour), and 68.13±19.90 pg/ml (24 hour), respectively. Serum TGF-β in group 2 was 64.58±10.56 pg/ml (2 hour), 72.87±18.34 pg/ml (6 hour), 103.77±28.95 pg/ml (24 hour), respectively. Compared to that of normal rats, the serum level of IL-10 and TGF-β in 24 hours of acute pancreatitis increased significantly (Ｐ＜0.05). Conclusion Anti-inflammatory cytokines, both IL-10 and TGF-β were increased remarkablly in acute pancreatitis. This result indicates that there is a potential tendency of compensatory anti-inflammatory response sydrome in acute pancreatitis.
ObjectiveTo investigate the change of blood glucose and its clinical significance in patients with acute pancreatitis (AP). MethodsThe regularity of blood glucose change and the relation between the regularity and the prognosis were analyzed in 115 patients with AP and hyperglycemia.ResultsBlood glucose was increased with a median (M) of 8.7 mmol/L，18.45 mmol/L and 27.22 mmol/L, which gradually decreased to normal value within 3-17 days, 7-26 days and 24-46 days after treatment,respectively in patients with mild AP, type Ⅰ of severe acute pancreatitis (SAP) and type Ⅱ of SAP. There was marked statistical difference among the three groups. A smaller dose of regular insulin was used for 36 patients with mild AP; however, a larger dose of regular insulin was used for all 30 patients with SAP.ConclusionThe level of blood glucose, the dose of regular insulin and the duration of hyperglycemia increase with the severity of AP.
ObjectiveTo find out the diagnostic power and correlation between platelet-related parameters and inflammatory indicators in acute pancreatitis patients with different severity.MethodsA total of 88 patients with acute pancreatitis diagnosed in West China Hospital of Sichuan University from January 2019 to August 2019 were enrolled in the retrospective study, including 58 mild acute pancreatitis patients and 30 severe acute pancreatitis patients. The patients’ platelet-related parameters and inflammatory indicators were collected. The platelet parameters and inflammatory indicators in different severity acute pancreatitis groups were compared and the diagnostic power and correlation were analyzed.ResultsThe platelet count and plateletcrit of the severe group were lower than those of the mild group, the difference was statistically significant (Z=–5.502, –3.673; P<0.001). The immature platelet fraction, platelet distribution width, mean platelet volume and platelet-large cell ratio levels of the severe group were higher than those of the mild group (Z=–4.217, –2.998, –3.754, –3.816; P<0.05). Platelet-related parameters platelet count, immature platelet fraction, platelet distribution width, mean platelet volume, platelet-large cell ratio, plateletcrit and inflammatory indicators procalcitonin, interleukin-6 showed good diagnostic power with areas under under receiver operating characteristic curves greater than 0.75 in differentiating the severity of acute pancreatitis. Correlation analysis showed that immature platelet fraction was positively correlated with procalcitonin and interleukin-6 levels in patients with acute pancreatitis (rs=0.457, 0.385; P<0.05).ConclusionsImmature platelet fraction is correlated with the severity of acute pancreatitis, and positively correlated with the levels of inflammatory indicators procalcitonin and interleukin-6.
ObjectiveTo investigate the effect of multidrug resistant (MDR) bacterial infection in clinical course of acute pancreatitis.
MethodsThe medical records of 134 patients with a diagnosis of infected pancreatic necrosis in West China Hospital from Jan. 2003 to Jun. 2010 were reviewed.
ResultsMDR microorganisms were found in 78 of the 134 patients. MDR group had higher rate of transferred patients than non-MDR group (38.5% vs. 10.7%, P=0.002). The intensive care unit admission rate was significantly higher in patients with MDR bacterial infections (48.7% vs. 26.8%, P=0.01). The mean intensive care unit stay was significantly longer in patients with MDR bacterial infections (20 days vs. 3 days, P<0.001). Mortality and total hospital stay was not significantly different in the patients with MDR infections vs. those without it (20.5% vs. 14.3%, P>0.05; 78 d vs. 55 d, P>0.05).
ConclusionClinicians should be aware of the high incidence and impact of MDR infections in patients with acute necrotizing pancreatitis, especially in transferred patients.
Objective To study the variety and the action of inflammatory cytokines and the relevant anti-inflammatory factors in acute pancreatitis (AP). Methods The authors observed the change of peripheral blood IL-6 and sTNFR in 41 patients with mild and severe AP in two groups on 1, 5, 14d after acute attack by ELISA. Results All cases recovered gradually in mild group (n＝22) after five days. Twelve patients improved gradually in severe group (n＝19) after 5-7 days. The level of sTNFR increased markedly in 2 groups at 1, 5, 14d(Ｐ＜0.001), and that of the severe group was markedly higher decreased gradually (Ｐ＜0.01). The level of IL-6 increased apparently only in severe group on 1d, 40.38 pg/ml∶12.4 pg/ml, (Ｐ＜0.001). The levels of IL-6 and sTNFR correlated respectively with severity of AP. Conclusion These results show that peripheral blood IL-6 and TNFα are useful index to supervise the severity and conversion and final results of AP.
