Objective To study the regulative effect of angelica sinensis on cellular immune function in perioperative patients with obstructive jaundice. Methods Fourteen patients with obstructive jaundice were injected with angelica before and after operation for 14 days. The activity of IL-2 and the expression of IL-2R in lymphocytes in peripheral blood were measured, respectively. Results The activity of IL-2 and the expression of IL-2R decreased significantly in patients with obstructive jaundice (P＜0.01). The activity of IL-2 and the expression of IL-2R in peripheral blood lymphocyte increased significantly before and after operations (after treatment using angelica) (P＜0.01), though there was a little decrease after operation but they were still higher than that befor using angelica.Conclusion It maybe useful to use angelica to improve the cellular immune function in patients with obstructive jaundice.
The comparison made between two experimental models with obstructive jaundice, which were newly established reversible model and traditional bile duct ligation and internal drainage model, showed that the new model was superior to the traditional one. This study suggests that the new model would be an ideal model, which could replace the traditional one for studying obstructive jaundice.
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.
ObjectiveTo investigate the clinical value of preoperative biliary drainage in patients with malignant obstructive jaundice and its influence on postoperative complications.MethodsThis study retrospectively analyzed patients from June 2006 to June 2018 at Department of Hepatobiliary Surgery of Gaozhou People’s Hospital, Guangdong Medical University, who had underwent pancreaticoduodenal surgery. In this study, bilirubin was divided into bilirubin normal group and bilirubin abnormal group according to the level of bilirubin, then the bilirubin abnormal group was divided into non-drainage group and drainage group. The main observation indexes were the incidence of complications and their severity.ResultsThere was no difference in intraoperative blood loss, operative time, and postoperative hospitalization among the three groups (P>0.05), but there was significant difference among the three groups on incidence of bile leakage, pulmonary infection, and the comprehensive complication index (CCI) value (P<0.05). The trend of clotting time, serum albumin, and hemoglobin in the bilirubin normal group, non-drainage group, and drainage group after operation were basically the same. The transaminase was recovered after operation in the bilirubin normal group and the drainage group, which were better than that of the non-drainage group within 7 days .ConclusionsThe preoperative biliary drainage in patients with malignant obstructive jaundice complicated with hyperbilirubinemia, cholangitis, and hepatic dysfunction do not significantly improve the incidence of complications, but could significantly improve the severity of the overall complication.
ObjectiveTo investigate the effects of different levels of resveratrol on oxidative stress injury in central nervous system of rats with obstructive jaundice and its protective effect and mechanism of oxidative stress injury.
MethodsThirty two female SD rats of 6 weeks old were used as experimental object. The animals were randomly divided into four groups, 8 rats in each group. Sham operation group (SO group), the common bile duct were seperated without ligation; while the models of obstructive jaundice of obstructive jaundice group (OJ group), obstructive jaundice+low dose resvera-trol (L-Res)treatment group (OJ+L-Res group), and obstructive jaundice+high dose resveratrol (H-Res) treatment group (OJ+H-Res group) were established by operation. After the operation, the rats in OJ+L-Res group and OJ+H-Res group were treated with different doses of resveratrol, the rats in SO group and OJ group were given the same dose of normal saline. On the 14th day after operation, blood were tested for total bilirubin (TBIL), direct bilirubin (DBIL), ALT, and AST. And cerebral cortex specimen were collected, then malondialdehyde (MDA), total superoxidedismutase (T-SOD) activity, and HO-1 protein expression in the rats brain of the four groups were measured.
ResultsThe levels rise of TBIL and DBIL after modeling suggested that obstructive jaundice model were estabilshed successfully, but there was no significant difference among the OJ group, OJ+L-Res group, and OJ+H-Res group. In the OJ group, OJ+L-Res group, and OJ+H-Res group, the levels of ALT, AST, and MDA were increased while levels of T-SOD and HO-1 protein expression were decreased when compared with SO group(P < 0.05). Among the OJ group, OJ+L-Res group, and OJ+H-Res group, levels of ALT, AST and MDA were lower in the treatment groups than in the OJ group(P < 0.05), while levels of T-SOD and HO-1 protein expression which reflects the oxidative stress were higher in the treatment group(P < 0.05). Different doses of resveratrol had different effects on T-SOD and HO-1 protein expression with statisticl significance (P < 0.05).
ConclusionsResveratrol have little effect on TBIL and DBIL of obstrctive jaundice rats, but it can protect the liver function, and it has antioxidant properties of decreasing MDA and incresing SOD and HO-1 protein expression levels in the cerebral cortex cells of obstructive jaundiced rats.
Objective To compare the therapeutic effect of percutaneous transhepatic cholangial drainage (PTCD) and operation drainage for the patients with inoperable malignant obstructive jaundice. Methods A total of 131 patients with inoperable malignant obstructive jaundice were treated in this hospital, in which 102 patients had PTCD by placement of metallic stent and (or) plastic tubes to remove obstruction of bile duct (interventional treatment group). Simultaneously 29 patients were selected for operation by intraexternal drainage (operation drainage group). The patients were followed up for comparison of the serum level of total bilirubin, postoperative complications, average length of hospitalization and average cost between the two groups. Results PTCD was successfully performed in all the patients of the interventional treatment group. There were no significant differences of 50% decrease period of average total bilirubin level or postoperative complications between the two groups (Pgt;0.05). The average length of hospitalization and average cost of interventional treatment group were less than those of operation drainage group (Plt;0.05). Conclusions Compare with operation drainage, interventional treatment can reduce average length of hospitalization and average cost, without increase of postoperative complications, which is a main chance of treatment for malignant obstructive jaundice.
Kupffer cell phagocytic function and plasma endotoxin level in 36 patients with obstructive jaundice were observed. The results indicated that kupffer cell phagocytic function was inhibited and the plasma endotoxemia level was markedly increased as compared with those in the control group Ｐ＜0.05 and Ｐ＜0.01 respectively. Kupffer cell phagocytic function were recoverd and plasma endotoxemia alleviated while the biliary obstruction was released by surgery.
Sixteen cases unresectable carcinoma of the head of the pancreas complicated with jaundice were treated by one stage cholecysto-jejunal and gastro-jejunal loop double anastomosis, the same result of jaundice drainage and prevention of bile reflux were obtained when compared with simple cholecysto-jejunal loop anastomosis, on the other hand, the obstructive symptoms resulting from postoperative cancerous comppression of duodenum and pylorus were avoided as well. The operation is simple with less physiologic disturbance and the patient can lead better postoperative live.
Objective To investigate the effects of cimetidine on the red cell immune function and interleukin-2(IL-2) in rats with obstructive jaundice. Methods Sixty SD rats were divided into bile duct ligation(BDL) group, cimetidine therapy (BDLC) group and sham operation(SO) group respectively. The red cell immue function and serum IL-2 level were determined with the red cell yeast-rosttes test and radioimmunoassay respectively. Results The red blood cell C3b receptor rosette rate(RBC-C3bRR), the red blood cell immune complex rosette rate(RICR), the red blood cell C3b receptor rosette-forming excited rate(RFER) and serum IL-2 level were significantly lower in BDL group as compared with SO group, the red blood cell C3b receptor rosette-forming inhibitory rate(RFIR) in BDL group was higher than that of SO group. After 7 days’ cimetidine therapy RBCC3bRR, RICR, RFER and IL-2 became higher than those of BDL group, but RFIR was lower than that of BDL group. Conclusion Supplemental cimetidine can significantly enhance the impaired red cell immune function and IL-2 production in rats with obstructive jaundice.
Platelet aggregation test (PAgT), platelet adhesion test (PAdT), thromboplastic activity of factor Ⅷ (FⅧ∶c), antithrombin Ⅲ activity (AT-Ⅲ∶a), antithrombin Ⅲ antigen (AT-Ⅲ∶Ag), von willebrand factor (vWF) and fibrinogen (Fg) were measured in 33 patients with biliary tract diseases and 24 normal individuals. The results showed that there was no significant difference in PAgT, PAdT, AT-Ⅲ∶a and AT-Ⅲ∶Ag between the two groups (Ｐ＞0.05). Fg increased more significantly in biliary tract disease than in the controls (Ｐ＜0.01). FⅧ∶c increased more significantly in patients with obstructive jaundice than in that of nonjaundiced and the controls (Ｐ＜0.01). The levels of vWF increased higher and higher in the sequence of patients with no jaundice, obstructive jaundice due to benign diseases and obstructive jaundice due to malignancy(Ｐ＜0.01). In conclusion, Fg, FⅧ∶c and vWF increased in patients with biliary tract disease.
