ABSTRACT
Objective:To study factors associated with postoperative acute pancreatitis (POAP) in patients following pancreaticoduodenectomy.Methods:This retrospective analysis included 60 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Soochow University from Jan 2020 to Aug 2021. Enhanced computed tomography was used to identify POAP during postoperative period of 4 to 9 days. Univariate analysis and multivariate analysis were used to find out the risk factors of POAP.Results:Of the 60 patients, 13 cases (21.7%) developed POAP. The incidence of clinically related pancreatic fistula with abdominal abscess (76.9% vs.19.1%, χ2=15.71, P<0.000 1), postoperative hospital stay (26 d vs. 18 d, U=141.5, P=0.002 5) and the severity of complications (Clavien-Dindo grade≥Ⅲ: 53.8% vs. 21.3%, χ2=5.32, P=0.02) were significantly higher in the POAP group. But there was no significant deviation between the two groups when it comes to the severe post pancreatectomy delayed hemorrhage (7.7% vs. 0, χ2=3.68, P=0.06) and the delayed gastric emptying (30.8% vs. 21.3%, χ2=0.51, P=0.47). In the univariate analysis, patients with higher body mass index ( P=0.000 3), smaller main pancreatic duct diameter ( P<0.000 1) and softer texture of the pancreas ( P=0.009) were more likely to develop POAP after pancreaticoduodenectomy. In the multivariate analysis, the pancreatic duct diameter≤2 mm ( OR=0.005,95% CI 0.000 06-0.44, P=0.020), the softer texture of pancreas ( OR=0.005, 95% CI 0.000 04-0.47, P=0.023) were risk factors for POAP. Conclusions:Patients with postoperative acute pancreatitis increased the incidence of pancreatic fistula complicating abdominal abscess.Small caliber pancreatic tube, soft texture of pancreas were risk factors of POAP.
ABSTRACT
Objective To investigate the distribution and proportion of CD8α+α + T cells in lesions and peripheral blood of patients with psoriasis,and to assess their roles in the pathogenesis of psoriasis.Methods An immunofluorescence assay was performed to observe the distribution of CD8α+α+ T cells in lesions of 5 patients with progressive psoriasis vulgaris and normal skin of 5 healthy human controls.Flow cytometry was conducted to determine the proportion of CD8α+α+ T cells,and to measure the expressions of interferon (IFN)-γ and tumor necrosis factor (TNF)-α in peripheral blood from 10 patients with progressive psoriasis vulgaris and 8 healthy human controls.Statistical analysis was carried out by t test with GraphPad Prism software.Results A massive infiltrate mainly composed of CD8α+α+ T cells but not CD8α+β+ T cells was observed in the upper dermis of lesions from the 5 patients with psoriasis,while there was no infiltrate of CD8α+β+ or CD8α+α+ T cells in the normal skin of 5 healthy human controls.Flow cytometry revealed that the proportion of CD8α+α+ T cells was significantly higher in peripheral blood from 10 patients with psoriasis than in that from 8 healthy human controls (26.47％ ± 12.99％ vs.9.12％ ± 4.80％,t =3.96,P＜ 0.001).Significant differences were also noted between the psoriatic patients and healthy human controls in the percentage of cells secreting IFN-γ (47.36％ ± 19.38％ vs.13.44％ ± 9.21％,t =4.54,P ＜ 0.001) and cells secreting TNF-α (54.14％ ± 21.14％ vs.34.03％ ± 17.22％,t =2.17,P ＜ 0.05) in peripheral blood CD8α+α+ T cells.Conclusions Both the distribution and proportion of CD8α+α+ T cells are increased in lesions and peripheral blood from patients with psoriasis,suggesting that CD8α+α+ T cells may be the main subgroup of CD8+ T cells that contribute to the pathogenesis of psoriasis.