ObjectiveTo study the changes of lipopolysaccharide binding protein (LBP) in the serum of Wistar rats with obstructive jaundice and to investigate its potential mechanism.MethodsEighty male Wistar rats were randomly divided into obstructive jaundice group (OJ group, n=40） and sham operation group (SO group, n=40）. Before operation and the 5th, 10th, 15th, 20th day after common bile duct ligation, the levels of LBP, endotoxin, tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in plasma were detected in all the rats. ResultsLBP levels in serum increased significantly in OJ group on the 10th day after operation compared with those of SO group. Moreover, LBP levels gradually increased in OJ group with the prolongation of obstructive time. A positive correlation existed between serum LBP and plasma endotoxin, TNF-α and IL-6.ConclusionThe study demonstrates that LBP in serum is high and plays an important role in the pathogenesis of multiple organ injury secondary to obstructive jaundice. It may be an appropriate way to treat patients with obstructive jaundice by decreasing LBP levels in serum.
Objective To observe therapeutical effect of recombinant human growth hormone (rhGH) on postoperative obstructive jaundice. Methods Fourtyeight patients were divided into two groups randomly: control group with 30 patients and rhGH group with 18 patients. After operation, subcutaneous injection of rhGH was administered 8 U/d for a week. At the same time, parenteral nutrition was given to both groups until the patients could eat and drink. Biochemistry examination, endotoxin, tumor necrosis factor, sIL-2R and nutritional status were all measured at following states: before operation 1, 7 and 14 days after operation. Results Body weights of rhGH group on the fourth day after operation and that of control group on the seventh day after operation increased, but the increasing tendency of rhGH group was more prominent than the control group. For blood sugar 7 days after operation, the level of rhGH group was higher than that of control group (P＜0.05). The level of serum albumin, transferrin, prealbumin in rhGH group was higher than that of control goup （P＜0.05）. Blood serum total bile acid,total cholesterol, low density lipoprotein,glutamicoxal acetic transaminase, transglutaminase, total bilirubin, endotoxin, tumor necrosis factor and sIL-2R were all decreased compared with control group (P＜0.01). However, no significant difference was observed in renal function and electrolute between the two groups.Conclusion An improvement of nutrition status and immunologic function can be observed in obstructive jaundice patients after the postoperative administration of rhGH.
Objective To investigate the protective effect of melatonin on rat liver injury induced by bile duct ligation. Methods Sixty-four rats were randomly divided into four groups：control group （CN group， n=16）， shamoperation group （SO group， n=16）， bile duct ligation group （BDL group， n=16）， and bile duct ligation with melatonin injection （BDL＋MT group， n=16）. The model of obstructive jaundice was done by ligation of the common bile duct. Melatonin was injected daily （0.5 mg/kg） via peritoneal cavity from 1 d before the operation to 7 d following oper-ation. On day 4 and 8 after the ligation， the plasma levels of total bilirubin （TBIL）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， gamma glutamyl transferase （GGT）， and alkaline phosphatase （AKP） were measured by routine methods. Malonaldehyde （MDA）， superoxide dismutase （SOD）， glutathione （GSH）， catalase （CAT）， and glutathione peroxidase （GSH-Px） in the liver tissue were determined by spectrophtometry， too. Hepatocytes apoptosis was analyzed by terminal deoxynucleotidyl transferase-mediated deoxynuridine triphosphate nick-end labeling （TUNEL） assay. Results Compared with the CN group and SO group， the levels of TBIL， ALT， AST， GGT， and AKP in the plasma， the content of MDA in the liver tissue， and the apoptosis index （AI） in the hepatocyte markedly increased （P＜0.05， P＜0.01）， the content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue markedly decreased（P＜0.01） in the BDL group. Compared with the BDL group， the levels of TBIL， ALT， AST， GGT， and AKP in the plasma， the content of MDA in the liver tissue， and the AI in the hepatocyte markedly decreased （P＜0.01）， the content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue markedly increased （P＜0.01） in the BDL＋MT group. In the BDL group， the level of MDA in the liver tissue and the levels of TBIL， ALT， AST， GGT， and AKP were positively correlated （P＜0.01）， the content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue and TBIL， ALT， AST， GGT， and AKP were negatively correlated （P＜0.01）. The level of MDA in the liver tissue and AI in the hepatocyte was positively correlated （P＜0.01）. The content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue and AI were negatively correlated （P＜0.01）. Conclusions The participation of free radical of oxygen in the pathogenesis and severity of cholestasis produced by the acute obstruction of the extra-hepatic biliary duct is likely. The result of the present study indicates that melatonin exerts a protective effect on cholestatic liver injury in rats with BDL. The mechanism of melatonin’s protection on hepatocyte may be through its antioxidant action and by inhibiting hepatocyte apoptosis.
Objective To summarize the experience of diagnosis and treatment of acute abdominal pain caused by hepatic hydatid. Methods The preoperative diagnosis, the surgical methods and the curative effect after operation of 297 patients with acute abdominal pain caused by hepatic hydatid who were treated in our hospital from 1960 to 2004 were analyzed. Results The healing rate was 95.96% (285/297 cases), and the death rate was 4.04% (12 /297 cases). Six out of 12 cases of death were caused by diffusive biliary peritonitis and allergic shock attributable to the rapture of hydatid into abdominal cavity. Two patients died of malnutrition caused by the spreading of Echinococcus and the correspondingly repeated operations. Another 4 patients with giant hydatid containing 7 000-12 000 ml fluid, died of hepatic insufficiency caused by the postoperative infection in the cyst. Conclusion The acute abdominal pain caused by hepatic hydatid should be treated mainly through emergency operation and the necessary antianaphylaxis, anti-infection and antishock therapies should also be used at the same time.