Objective To explore the effect of artemisinin on the apoptosis of pancreas acinar cells in acute pancreatitis (AP), and to study whether artemisinin can relieve the severity of AP. Methods ① In vivo experiment: twenty one Wistar rats were divided into the following 3 groups randomly: the normal control group, the AP group and the artemisinin group. The model of AP was established by injecting cerulein into the peritoneal cavity of rat. After establishment of AP in the artemisinin group, artemisinin was injected into the peritoneal cavity. Meanwhile normal saline was injected into the peritoneal cavity of rats of the normal control group and the AP group. The apoptosis of pancreas acinar cell was detected by terminal deoxynucleotidyl transferase mediated nick end labeling (TUNEL). The activity of myeloperoxidase was detected by absorption spectrometry. ② In vitro experiment: the pancreas acinar cells of normal rats were isolated through twostep enzyme digestion, and cultured. These acinar cells were divided into 3 groups: the normal control group, the AP group and the artemisinin group. Then, the cells of AP group were cocultured with cerulein, and those of the artemisinin group were cocultured with cerulein and artemisinin. The apoptosis of pancreas acinar cells were detected by AO dyeing and the measurement of the activity of caspase3. And the activity of LDH and AMS in the culture medium of each group were measured. Results ① In vivo: the apoptosis index of the artemisinin group was sigificantly increased and the activity of myeloperoxidase was obviously decreased compared with the AP group (P＜0.05). ② In vitro: the apoptosis index and the activity of caspase3 of the artemisinin group were significantly increased compared with the AP group (P＜0.05); the activities of LDH and AMS of the artemisinin group were more decreased than those of the AP group (P＜0.05). Conclusion Artemisinin could contribute to the apoptosis of rat pancreas acinar cells, decrease the releasing of trypsogen, alleviate the activation of neutrophil and relieve the severity of AP.
【Abstract】Objective To study the liver injury and effects of aescin on liver in rats with acute pancreatitis. Methods The rats were divided into 3 groups (control group, AP group and aescin group). The serum alanine aminotransferase （ALT）, serum lactate dehydrogenase (LDH), hepatic cellular energy charge (EC) and adenosine triphosphate (ATP) were detected. The pathologic changes in pancreas and liver were also observed. Results The serum levels of ALT and LDH in aescin group were significantly lower than those of the AP group. The EC and ATP levels were significantly higher in aescin group than that of the AP group. Conclusion Introvenous injection of aescin can alleviate the liver injury in rats with acute pancreatitis.
【Abstract】ObjectiveTo investigate the effect of ischemia-reperfusion （I/R） injury on apoptosis of pancreatic cells in rats with acute pancreatitis(AP). MethodsFifty-four SD rats were randomized into 3 groups: pancreatitis group (n=24), I/R-injury group (n=24) and control group (n=6). The animal model of AP was induced by retrograde injection of 3% sodium taurocholate into biliopancreatic duct in rats. Pancreatic I/R was caused by blocking the inferior splenic artery and removing the clamp after AP induction. At 1 h, 3 h, 6 h and 12 h, groups of rats were sacrificed. A terminal deoxynucleotidyl transferase-mediated dUTP-biotion nick end labeling (TUNEL) was used to detect pancreatic apoptosis, and histological changes of the pancreas were observed. ResultsPancreatic hemorrhage, necrosis were respectively observed in the pancreatitis rats at 6 h and the I/R-injury rats at 1 h. Histological changes of the pancreatitis rats at 1 h and 3 h were only congestion and edema. Apoptoic acinar cells increased after AP induction, the peak respectively appeared at 6 h in the pancreatitis rats and at 3 h in the I/R-injury rats. Compared with the pancreatitis rats, apoptosis index (AI) of the I/Rinjury rats was significantly higher at 1 h and 3 h (P＜0.01, P＜0.05, respectively), but lower at 6 h and 12 h (P＜0.05, P＜0.01, respectively). ConclusionI/R injury can induce conversion of edematous pancreatitis to hemorrhagic necrotizing pancreatitis and apoptosis of acinar cells. Apoptosis may be a beneficial response to pancreatic injury in AP.
Objective To investigate the CT imaging features of autoimmune pancreatitis (AIP) with report of 4 cases and literature review. Methods The CT imaging data of 4 AIP patients proved on the basis of clinical findings, laboratory tests, response to steroids therapy and follow-up observation were retrospectively collected. Plain CT and contrast-enhanced dual phase CT scan at arterial and portal venous phases were performed for all 4 patients. All imaging data were reviewed, focusing on the shape, size, parenchyma density and enhancement patterns of the pancreas, as well as the biliary and pancreatic ducts, peripancreatic fat, blood vessels, retroperitoneal spaces, lymph nodes, and other positive findings. Results Three patients showed diffuse swelling of the pancreas on CT and 1 had focal enlargement of pancreatic head. Swelled pancreas was hypodense on plain CT images, showed decreased enhancement on artery phase and moderate enhancement on portal venous phase images of contrast-enhanced CT. Capsule-like enhanced rim was found around swelled pancreas in 2 patients. Stricture of distal common bile duct was present in 2 patients, and ERCP showed irregular narrowing of the main pancreatic duct in 1 cases. After steroid therapy, all patients showed significant morphological improvement of the pancreas at follow-up CT examination. Conclusion CT scan reveals certain characteristic imaging findings of AIP, thus it is helpful for the diagnosis of AIP.
Objective To investigate the effect of nitroglycerin on preventing post-endoscopic retrograde cholangiopancreatograph (ERCP) pancreatitis (PEP) and hyperamylasemia. Methods One hundred patients diagnosed as common bile duct stones by CT or MRI and planned to undergo ERCP, EST and stones removal under endoscopy were selected from January to December 2008 in Shandong Jiaotong Hospital. These patients were randomly divided into 2 groups: nitroglycerin group (n=50), in which 0.5 mg nitroglycerin was given sublingually in 5-10 min before ERCP; control group (n=50), in which no nitroglycerin was given. The levels of serum amylase of all the patients before ERCP and at 3 h, 24 h after ERCP were detected and the incidence of hyperamylasemia and PEP were also observed. Results The level of serum amylase between 2 groups before ERCP was not significantly different (P＞0.05). The levels of serum amylase at 3 h and 24 h after ERCP were significantly higher than that before ERCP in 2 groups. The level of serum amylase in nitroglycerin group were respectively lower than that in control group at 3 h and 24 h after ERCP 〔3 h: (108.88±152.07) U/L vs. (196.30±244.41) U/L; 24 h: (97.02±113.38) U/L vs. (234.22±406.05) U/L〕， P＜0.05. The incidence of hyperamylasemia (12.00%, 6/50) and PEP (2.00%, 1/50) in nitroglycerin group was respectively significantly lower than that in control group (hyperamylasemia: 30.00%, 15/50; PEP: 14.00%, 7/50）， P＜0.05. Conclusion Sublingual nitroglycerin can decrease the level of serum amylase and prevent PEP and hyperamylasemia.
In order to choose the appropriate antibiotics for treating secondary pancreatic infection, permeability of antibiotics to pancreatic tissue was investigated on experimental dogs with acute hemorrhagic necrotizing pancreatitis. The concentrations of 8 different antibiotics were determined in the blood and the pancreatic tissue using highperformance liquid chromatography. Pancreatic tissue permeability of Cefotaxime, Ofloxacin, Amikacin, Piperacllin, Cefoperazone, Ampicillin, Metronidazole and Ciprofloxacin was 12%, 19%, 20%, 46%, 55%, 63%, 71% and 132% respectively. The study shows that this eight antibiotics have different permeability to the pancreatic tissue. Such observations support the existence of a bloodpancreas barrier, which acts to restrict the permeation of antibiotics into the pancreas. The results suggest that antibiotics with high permeability rate be used to treat the patient with secondary pancreatic infection.
To observe the changes of intestinal bacteriology in acute necrotizing pancreatitis (ANP). Dog ANP model was induced by injection of sodium taurocholate with trypin into the pancreatic duct. All dogs were sacrificed on the seventh postoperative day, mucosal and luminal microflora of intestine were analyzed quantitatively. The blood and organs were collected for culture. The results showed that population levels of E.coli in the intestinal mucosa and the content in cecum of the ANP dogs showed much higher level than those of the controls (Ｐ＜0.01 or Ｐ＜0.05), while bifidobacterium and lactobacillus were decreased significantly (Ｐ＜0.01), resulting in reversal of bifidobacterium/E.coli ratio. Blood levels of endotoxin were 1-2 times higher in ANP group as compare with the controls. The positive rate of blood and organs were 100% in ANP dogs. E.coli were the major bacteria cultured. The results indicated that microecological disturbance could take place after the onset of ANP, which may take an important role on pancreatic infection complicating ANP.
The aim of this study was to investigate the role of tumor necrosis factor (TNF), interleukin-6(IL-6), C-reactive protein (CRP) in pancreatitis and its systemic complications. Thirty six patients with acute pancreatitis were studied, 12 with mild disease, and 24 severe disease, of whom 9 developed systemic complications. TNF, IL-6, CRP in these patients with pancreatitis was assessed during the first, 4th, 8th days of admission. The serum concentration of TNF, IL-6, CRP were significantly increased, and significantly higher in complicated group than in mild group and severe group. These findings suggest that proinflammatory cytokines play a central role in the pathophysiology of the disease, the host systemic response to pancreatic inflammation and the level of the response did relate to the development of organ dysfunction.
Objective To explore the role and intrinsic mechanism of the injury of intestines induceded by pancreatitis associated ascitic fluid (PAAF) and acute suppurative peritonitis associated ascitic fluid (ASPAAF) in rats. Methods Forty-eight Sprague-Dawley (SD) rats, male or female, were randomly divided into three groups averagely. The control group: 8 ml of normal saline (NS) was injected into the peritoneal cavity; the PAAF group: 8 ml of PAAF was injected into the peritoneal cavity; and the ASPAAF group: 8 ml of ASPAAF was injected into the peritoneal cavity. After peritoneal cavity injection, the rats were put to death in batches at 6 h and 12 h, eight rats per-batch. Levels of TNF-α and endotoxin in serum were measured. The activity of ATP enzyme and level of TNF-α in the intestinal tissues were measured. The pathological changes of intestines were observed by microscope.Results The levels of TNF-α, endotoxin and the degree of injury of the intestines were markedly elevated and the activity of ATP enzyme of the intestinal tissues was decreased in the PAAF group and ASPAAF group compared with those in the control group (P＜0.05). The levels of TNF-α, endotoxin and the degree of injury of the intestines were markedly elevated and the activity of ATP enzyme of the intestinal tissues was decreased in the ASPAAF group compared with those in the PAAF group (P＜0.05). Conclusion PAAF and ASPAAF can induce the injury of intestines, but the injury of intestines induced by ASPAAF is more serious.
OBJECTIVE To observe the effects of basic fibroblast growth factor (bFGF) on repairing injury of intestinal mucosa in acute necrotic pancreatitis (ANP). METHODS Sixteen dogs of ANP animal model were made by injection of 5% sodium taurocholate (0.5 ml/kg) with 3,000 U/kg trypsin into the pancreatic duct. The mucosa structure, content of protein, DNA and malondiethylaldehyde (MDA) were observed after ANP and treatment with bFGF, and the plasma lipopolysaccharide and endothelin-1 were detected. The organs of dogs were made to bacterial culture. Ileal mucosa was collected for histological and ultrastructural studies. RESULTS The results showed that after treatment with bFGF, the injury of intestinal mucosa in ANP was abated. The length, height and area of mucosa microvillus, the content of DNA and protein of ileal mucosa were significantly increased, while the plasma endothelin-1 and lipopolysaccharide were reduced. The organ bacterial translocation rate was also decreased in 50%. CONCLUSION bFGF has good effects on abating injury of intestinal mucosa, protecting gut barrier function, reducing the incidence of lipopolysaccharide and bacterial translocation after ANP.