Objective To research the changes in plasma endothelin, LPS, TNF-α, IL-6 and IL-8 in the patients with obstructive jaundice (OJ) and non-obstructive jaundice (NOJ) after surgery. Methods The plasma ET, LPS, TNF-α, IL-6 and IL-8 were measured in 15 patients without jaundice as controls. Results As compared with NOJ, the postoperative changes of ET, LPS, TNF-α, IL-6 and IL-8 in OJ group increased significantly at multiple time points (P＜0.05). Conclusion There is interaction between ET,LPS, TNF-α, IL-6 and IL-8 and damage to multiple organ function in patients with OJ after surgery.
Objective To investigate the changes and significance of intercellular adhesion molecule-1 (ICAM-1) and tumor necrosis factor-α (TNF-α) in intestinal mucosa in rats with obstructive jaundice. MethodsTwenty-four SD rats were randomly divided into sham operation (SO) group and bile duct ligation (BDL) group, and each group were randomly divided into the day 7 and day 14 subgroup. The expression of ICAM-1 was assayed by immunohistochemistry. The level of TNF-α was determined by ELISA. The activity of myeloperoxidase (MPO) and diamine oxidase (DAO) was determined as well.ResultsOn the day 7 and 14, in the bile duct ligation group, the ICAM-1 protein was mainly expressed in the intestinal epithelia and increased with the time on (P＜0.05); the level of TNFα increased from （14.25±1.01） ng/g to （23.83±1.43） ng/g （P＜0.01）； the intestinal DAO activity decreased from （1.70±0.36） U/mg to （1.22±0.41） U/mg （P＜0.01），and plasma DAO activity increased from （6.44±1.74）U/ml to （8.93±1.29） U/ml （P＜0.01）; the MPO activity increased from （2.85±1.22 ） U/mg to （4.93±1.37） U/mg （P＜0.01）. ConclusionThe ICAM-1 expression is significantly upregulated and the level of TNFα significantly increases after bile duct ligation, which may be involved in the PMNmediated injury to intestinal mucosa.
【Abstract】Objective To explore the relation between the expression of telomerase and DNA ploidy with biliarypancreatic system cancer, so as to find a better way to diagnose and distinguish jaundice between malignance and benign disease.Methods Endoscopic retrograde cholangiopancreatography (ERCP) were performed before operation in patients with obstructive jaundice. The bile and pancreatice juice were collected before ERCP. Biopsy specimens from part of patients were obtained during ERCP. All cancer specimens were possessed once again during operation and were assessed by the activity of telomerase and DNA ploidy. Results ① Telomerase positive rate 〔87.50%(56/64)〕 of tissue specimens in malignant obstructive jaundice were higher than that in benign obstructive jaundice 〔3.33%(2/60)〕，P=0.000. ② Telomerase positive rate〔71.88%(46/64)〕of Bile and pancreatice juice in malignant obstructive jaundice were higher than that in benign obstructive jaundice 〔3.33%(2/60)〕， P=0.000, tissue specimens obtained by endoscopy with malignant obstructive jaundice had detectable telomerase activity, positive rate was 83.33%（20/24）. ③ The rate of DNA heteroploid with malignant obstructive jaundice was 62.50%（40/64）, that of diploid can be seen in all patients with benign obstructive jaundice, the difference was statistically significant (P=0.000). ④ The rate of telomerase positive and DNA heteroploid in high differentiation tumor were significantly lower than in middlelow differentiation tumor （P=0.028，P=0.001）.Conclusion Applying the duodenoscope we collected the bile and pancreatic fluid before operation and obtain biopsy specimens whose telomerase activity and DNA ploid were detected. This is simple, safe, quick method which can identify the malignant and benign obstructive jaundice.
【Abstract】Objective To investigate the expressions of TNF-α and superoxide dismutase (SOD) mRNA in myocardium of rats with obstructive jaundice (OJ). Methods The expressions of TNF-α and SOD mRNA were semi-quantitatively analyzed after amplification of cDNA in myocardium of the rats with OJ by RTPCR. Results The expression of TNF-α mRNA increased and that of SOD mRNA decreased in the myocardium of rats with OJ. The level of plasm TNF-α increased and SOD synthesis in myocardium decreased. Conclusion The injury of myocardium in OJ is correlated with increasing expression of TNF-α mRNA and decreasing expression of SOD mRNA.
This experimental study was aimed at observing the influence of bile salt and lactulose on intestinal mucosa of obstructive jaundiced rat. Twenty adult Wistar rate were divided into four groups (five rats for each group): sham operation, common bile duct ligation (CBDL), CBDL plus sodium deoxycholate feeding and CBDL plus lactulose feeding. The results showed that the intestinal mucosa of rats with obstructive jaundice took on marked edema, markedly decreased activities of adenosine triphosphatase, alkaline phosphatase and succinic dehydrogenase and intensified acid phosphatase activity. However, the intestinal mucosa of the rats, treated with bile salt or lactulose as compared with that of the obstructive jaundiced rats showed both pathological and histochemical improvement.
【Abstract】ObjectiveTo investigate the protective effect of melatonin on renal injury induced by bile duct ligation in rats. MethodsSixtyfour rats were randomly divided into four experimental groups (n=16 rats per group): the control group (CN), sham operative group (SO), bile duct ligation group (BDL) and bile duct ligation melatonin treatment group (BDL+Mel). Obstructive jaundice was induced by common bile duct ligation. Plasma level of nitric oxide (NO), total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN) and creatinine (Cr) were measured 4 d and 8 d after operation. NO and inducible nitric oxide synthase (iNOS) in renal tissue were detected at the same time point, too. Histopathological changes of kidneys were examined by HE staining. ResultsIn BDL group, the plasma levels of NO, TB, DB, ALT, AST, BUN and Cr were higher than those of SO group (P＜0.01）, and the level of NO and activities of iNOS in renal tissue were significantly increased (P＜0.01）. However, in BDL+Mel group, the plasma levels of NO, ALT, AST, BUN and Cr were lower than those of the BDL group (P＜0.01）, and the level of NO and activities of iNOS in renal tissue were significantly suppressed (P＜0.01）; histopathological changes of kidneys were improved.ConclusionAugmentation of iNOS activities and increasing of NO production in local tissue contributed to renal injury induced by bile duct ligation, and the mode of melatonin’s protective actions, at least in part, relates to interference with no pathways.
Objective To investigate the effect of renal cell apoptosis induced by obstructive jaundice on the expression of bcl-2 in rats, and to explore the mechanism of renal impairment induced by obstructive jaundice. Methods Thirty-two male SD rats were randomly divided into 2 groups: SO group and BDL group. The rats in SO group received sham operation. Bile ducts of rats in BDL group were ligated. Pathology of kidneys was observed under the microscope. The levels of D-Bil, TBA, GOT, GPT, Cr and BUN in serum and β2-MG in urine were measured. The apoptotic rate of renal cells was calculated by flow cytometry and the forms of DNA fragmentation in renal cells were detected by agarose gel electrophoresis. The expression of inhibitory gene bcl-2 in the renal tissues was detected by immunohistochemistry. Results The color of urine in BDL group became dark yellow in day 2 after operation; The ears, tails and the muscle of abdominal wall and splanchnic organs, such as liver and kidney, also became yellow and swollen in day 7. The D-Bil, TBA, GOT, GPT, BUN of serum and β2 -MG of urine in BDL group were higher than those in SO group (P＜0.05, P＜0.01), and each value (except β2 -MG) in BDL group of 14 d was higher than that in BDL group of 7 d (P＜0.05, P＜0.01), respectively. The result of flow cytometry showed that the apoptotic rate of SO group and BDL (7 d and 14 d) group were (2.10±0.75)%， (18.17±0.86)% and (36.39±2.23)% respectively, there were significantly difference among them (P＜0.05). The expression rate of bcl-2 of renal cell in BDL group of 7 d was higher than that in BDL group of 14 d. Conclusion Obstructive jaundice could induce apoptosis of the renal cells, and activate the expression of bcl-2 of the renal tubular epithelial cells in feedback, which may regulate the process of apoptosis.
Thirty patients with obstructive jaundice were investigated for serum complement-3 (C3) and plasma fibronectin (FN).The levels of C3 and FN of the juandiced patients were higher than that of thirty patients without obstructive jaundice (Ｐ＜0.01). As compared to pre-operation, the level of C3 of the jaundiced patients decreased obviously within two weeks after operation(Ｐ＜0.01), and recovered in the third week after operation. The level of FN of the juandice patients decreased evidently within one week(Ｐ＜0.01), and recovered in the second week after operation. However, the levels of C3 and FN of the patients without obstructive jaundice changed slightly after operation (Ｐ＜0.05). The high levels of C3 and FN of jaundiced patients may be relative to the latent infection. Consumption and immune imparing may be the reasons of C3 and FN to decrease.
We have measured the serum levels of total cholic acid (TCA) in 103 samples of obstructive jaundiced patients (OB group) and 83 samples of gallbladder stone patients without jaundice (control group) by enzymeconjugated colorimetric analysis method. The results revealed that TCA level was higher in OB group than in control group (Plt;0. 001) and had postive correlation with total bilirubin, direct bilirubin and alanine aminotransferase in OB group (Plt;0.01 in all). The clinical value of TCA in obstructive jaundice in comparison with alkaline phosphatase is discussed.
Twenty-eight cases of hepatocellular carcinoma(HCC)involving bile duct and causing obstructive jaudice in this hospital between 1987-1994 were studied.In this series cancerous cast formation in bile duct was found in 13 cases and cancerous thrombus in 15 cases which accounts for 5.7% of 487 HCC patients admitted to this hospital in the same period.According to the operative and pathological findings,characteristics of cancerous cast type are:①direct connection of cancerous cast with the primary tumor as a dumb bell-shped,②no adhesion between the cast and the thin wall of bile duct,③central location of the primary tumor in liver near the larger bile duct and ④HCC tissues seen in pathologic section of the cast.Characteristics of cancerous thrombus type are:①no connection between intraductal thrombus and the primary tumor,②segmental stenosis or obstruction of the bile duct,③adherence of cancerous thrombus to the thick ductal wall,④peripheral location of the primary tumor and⑤HCC cells scattered in the thrombus.
