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Objective To examine the levels of plasma tissue factor pathway inhibitor (TFPI) in patients with acute pancreatitis (AP) to assess the clinical value of diagnosis for severe acute pancreatitis ( SAP).Methods Sixty-eight patients were divided into mild acute pancreatitis (MAP)group (n=36) and SAP group (n=32), and twenty volunteers were chosen into normal group ( n=20 ) .Clinical data of these patients were collected, including APACHEⅡscore and Ranson score.Plasma levels of TFPI were measured by ELISA.Results The plasma levels of TFPI in SAP group, MAP group and control group were (4274.25 ±639.83),(3026.81 ±465.76) and (2468.73 ±262.39)pg/ml, respectively(P<0.05).There were significant positive correlations between TFPI and WBC, AST, ALT, TBIL, Cr, PT, APTT, PCT, APACHEⅡscore and Ranson score (P<0.05).The area under the curve (AUC) of TFPI for SAP was 0.902(95%CI=0.845 -0.959, P<0.05 ) .The cutoff value was 4028.83 pg/ml for plasma TFPI with a sensitivity of 87% and a specificity of 78%.Conclusion Plasma levels of TFPI in patients with SAP are significantly increased, which maybe help diagnose SAP.
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With the use of high pure HF and HNO3 reagents, and autoclaves made of high purity Rerfluoroalkoxy ( PFA ) material, a solution sample digestion technique effective for phosphate samples, subjected to high temperature fusion, was established. The whole procedure was concise, fast and of low blank value. Key factors such as the amount and ratios of the reagents, the digestion temperature and time, were systematically optimized, it was found that within 0. 5 h at 150 ℃, only 1. 7 mL of total reagent consumption could lead to a complete sample decomposition. Most importantly, the samples were not required to be ground to fine powder, which greatly reduced the risk of contamination. In addition, an effective liquid_liquid extraction procedure based on 5_nonylsalicylaldehyde oxime as the extractant was established for matrix separation and analyte preconcentration. Under the optimal extraction conditions of 5 mL of 15% extractant, 0. 5% HNO3 of extraction acidity and 20% HNO3 of back_extraction acidity, a matrix separation efficiency of over 99. 999% could be realized and a preconctration factor of 10 could be obtained, which resulted in complete elimination of the matrix_induced interference and great enhancement of the analytical sensitivity. After optimization of the operation parameters of ICP_MS, high signal to background detection of Cu in 20%HNO3 at 840 W of plasma power and low sample uptake rate were realized. The detection limits of 2. 5 ng/g, RSD of 3. 3% for six detections of parallel samples, and the recovery of 94. 3% for spike test were obtained, respectively. The method was finally applied to three real samples analysis, and the results agreed well with the data from laser adsorption loss experiment.
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ObjectiveTo investigate the protective effects of p38MAPK inhibitor SB203580 on acute necrotizing pancreatitis associated lung injuries in rats.Methods Fifty-four SD male rates were randomly divided into 3 groups,including control group,ANP group,SB203580 group with 18 rats in each group.ANP was induced by intraperitoneal injection of L-arginine solution. Rats in control group were intraperitoneally injected with same amount of saline.Before ANP induction,the rats in SB203580 group received 10 μmol/L SB203580 dissolved by dimethyl sulfoxide at a dose of 5mg/kg weight via intraperitoneal injection.The rats were sacrificed at 3,6,and 12 h after operation,the serum levels of amylase,TNF-α,IL-6 was determined.Pathological changes of pancreas and lung were observed.The wet/dry (W/D) weight ratio of lung and MPO were measured.CINC mRNA of lungs was determined by RT PCR. Expression of phosphated-p38MAPK (p-p38MAPK) protein was evaluated by Western blotting.ResultsThe serum levels of amylase,TNF-α,IL-6and wet/dry (W/D) weight ratio of lung,MPO activity,CINC mRNA and p-p38MAPK protein expression of lungs were (1035 ±73)U/L,(0.94 ±0.16)μg/L,(4.77 ±0.86) μg/L,3.92 ±0.29,(0.39 ±0.02)U/g,0.28 ±0.04,0.09 ±0.04 in control group at 6 h after operation,and the corresponding values were (5848 ±656) U/L,(3.84 ±0.32)μg/L,(103.54 ± 15.32)μg/L,4.97 ±0.47,(1.03 ±0.08) U/g,0.62 ±0.06,0.52 ±0.14 in ANP group,while they were (4259 ±286) U/L,( 1.64 ±0.21 ) μg/L,(76.56 ± 11.46) μg/L,4.32 ±0.34,(0.78 ±0.05)U/g,0.37 ±0.04,0.27 ±0.08 in SB203580 group.The values in ANP group were significantly higher than those in control group,and the values in SB203580 group were significantly lower than those in ANP group,but they were still significantly higher than those in control group ( P ＜ 0.01 ).ConclusionsSB203580 may attenuate injury of lung and pancreas in ANP by blocking p38MAPK signal transduction pathway,and decreasing the production of inflammatory cytokines.
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Objective To explore the potential role of monocyte chemotactic protein-1 ( MCP-1 ) gene in the pathogenesis of acute lung injury (ALI) in early acute necrotizing pancreatitis (ANP). Methods Forty SD rats were randomly divided into control group, ANP 3, 6, 12 h group with 10 rats in each group according to a number table. ANP was induced by intraperitoneal injection of 15% L-arginine solution at a dose of 2.0 mg/g body weight. Pathological changes of pancreases and lungs were observed. Lung wet/dry weight ratio was measured. Intrapulmonary expression of MCP-1 mRNA was evaluated by RT-PCR. Results After intraperitoneal injection of 15% L-arginine solution, the rat's pancreas presented with bleeding, necrosis comparable with pathological changes of ANP. Pulmonary tissue edema was obvious. At ANP 3, 6, 12 h group, the pathological scores of the lung were 3.75±0.58,5.50 ±0.63,5.86 ±0.54, the wet/dry weight ratios were 4.85 ±0.38,4.97 ± 0.47,5.03 ± 0. 46, the MCP-1 mRNA expressions were 0.36 ± 0.08, 0. 56 ± 0. 15, 0. 72 ± 0.21,which were significantly higher than those in the control group (0.12 ±0.05,4.32 ±0.33,0.21 ±0.05, P＜0.05 or ＜0.01 ). The MCP-1 mRNA expression in lungs was significantly correlated with the degree of lung damage and wet/dry weight ratio of lungs (r=0.75,r=0.89,P＜0.05).Conclusions MCP-1 mRNA expression was up-regulated in the early phase of ANP in the lungs, and it may play an important role in ALI during ANP.
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Objective To investigate the effects of rhubarb and mirabilite and compound danshen injection on gastrointestinal dysmotility of severe acute pancreatitis (SAP). Methods Forty-one SAP patients were randomly divided into two groups: Integration group (n=21) were treated with rhubarb and mirabilite and compound danshen injection. Control group (n=20) were treated with conventional therapy. Recovery of gastrointestinal motility of two groups was observed, and the complication rate and hospital stay was recorded.Results The recovery of gastrointestinal motility, first defecation and hospital stay in integration group was (3.1±0.8)d, (3.1±0.8)d, (21.5±2.8 )d, which were significantly shorter than those in control group [(5.2±1.4) d, (4.7±1.3 ) d, (32.1±3.60) d, P ＜ 0. 05 or P ＜ 0.01. Five patients in integration group developed complication, which was significantly lower than 8 patients in control group ( P ＜ 0.01 )]. One patient died and one patient received operation in integration group, and one patient died in control group,without significant difference between the two groups (P ＞ 0.05 ). Conclusions The combination of rhubarb and mirabilite and compound danshen injection in severe acute pancreatitis can promote the recovery of gastrointestinal motility.
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Objective To investigate the changes of extraceUular regulated kinase 1/2 (ERK1/2) phosphorylation and assess the effects of blocking the ERK1/2 phosphorylation on rats with acute necrotizing pancreatitis (ANP). Methods The ANP model was induced by retrograde injection of 5% sodium tanrocholate into the biliary and pancreatic duct. 5 rats were treated as normal control. Other 75 Sprague-Dawley (SD) rots were randomly divided into sham operations(SO) group (n =25), ANP group (n =25) and PD98059 group (n =25). The rats were sacrificed at 15 min, 30 min, 1 h, 3 h and 6 h after ANP induction, the blood and pancreatic sample were taken. Pathological changes of pancreas were observed with light microscope and scored. The serum level of TNF-α and IL-1β was determined by ELISA. MPO activities in pancreas were measured by enzyme chemistry assay. Western blotting was performed to determine the phosphorylations of ERK1/2 in the pancreas homogenates. Results There was no significant pathologic changes in rats of SO group;but significant injuries occurred in ANP group, the pathologic score at 3 h was 9.9 ± 0.4;the extent of injuries attenuated in PD98059 group, the pathologic score at 3 h was 4.0 ± 0.4 (P < 0.05). The serum levels of TNF-α at 3 h in SO, ANP and PD98059 groups were (65.8 ± 20.5) pg/ml, (286.5 ± 50.3) pg/ml, (180.4±32.9)pg/ml, respectively;the serum levels of IL-1β at 3 h in SO, ANP and PD98059groups were (85.8 ± 25.5) pg/ml, (293.8 ± 46.3) pg/ml, (200. 5 ± 33.6) pg/ml, respectively;MPOactivities in pancreas were (0. 19 ± 0.02)U/g, (0.61±0.05)U/g, (0.52±0.03) U/g, and the values in ANP and PD98059 groups were significantly higher than those in SO group, while the values in PD98059 group were significantly lower than those in ANP group (P < 0.01). The expression of ERK1/2 phosphorylation in normal pancreas was 1100 ± 141, the expressions of ERK1/2 phosphorylation in ANP group at 15 min, 30 min were 5300 ± 486, 5621 ± 384, respectively;the expressions began to decrease 1 h later and returned the similar level as SO group at 6 h;the expressions of ERK1/2 phosphorylation in PD98059 group at 15 min, 30 rain were 4200 ± 370, 3600 ± 290, respectively;which were signifieanfly lower than those in ANP group (all P value < 0. 01). Conclusions The ERK1/2 signal transduetion pathway plays an important role in the pathogenesis of ANP. Inhibition of ERK1/2 phosphorylation by PD98059 may decrease the production of IL-1β, TNF-α and pancreatic MPO, attenuate the extent of pancreatic pathologic injuries.
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Objective To explore the potential role of cytokine-induced neutrophil chemoattractant (CINC) and monocyte chemoattractant protein-1/JE (MCP-1/JE) in the pathogenesis of early acute pancreatitis(AP). Methods Acute edematous pancreatitis(AEP) and acute necrotizing pancreatitis(ANP) were induced by retrograde infusion of 0.5% or 5% sodium taurocholate into the biliary pancreatic duct. The activity of serum amylase and the level of serum calcium were studied, wet to weight ratio,the activity of myeloperoxidase (MPO) and pathological changes of pancreas were observed. The expression of gene and protein of CINC and MCP-1/JE in pancreatic constitution were detected. Results Compared with that in controls,pancreatic acinar cells were found to express CINC and MCP-1/JE protein in certain intensity. With the induction and the progress of AP,the expression of the activity of MPO,CINC and MCP-1/JE gene in pancreatic parenchyma were all significantly increased ( P
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Objective To explore the potential role of the expression of cytokine-induced neutrophil chemoattractant (CINC)gene in the pathogenesis of acute lung injury(ALI)in early severe acute pancreatitis(SAP). Methods SAP was induced by retrograde injection of 5% sodium taurocholate into the bili-pancreatic duct. Wet to weight ratio and myeloperoxidase(MPO) content of lungs were measured. Pathological changes in the pancreas and lungs were observed. Intrapulmonary expression of CINC gene was assessed by reverse transcription polymerase chain reaction(RT-PCR). Results Compared with that in controls,intrapulmonary expression of CINC gene?wet to weight ratio,and MPO of lungs were increased greatly in twelve hours. The CINC mRNA expression in lungs was significantly correlated with the severity of lung injury,wet to weight ratio,and MPO of lungs. Conclusion Overpexpression of CINC mRNA in the lungs might play an important role in the pathogenesis of ALI in early SAP.
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Objective To study the clinical,endoscopic an d pathologic features of primary gastric malignant lymphoma,and to improve its diagnostic efficiency.Methods The clinical,pathologic and endoscopic data in twenty two cases of primary gastric malignant lymphoma were retrospectively reviewed. Results In these cases,the common presentations include abdomi nal pain、anorexia、loss of weight etc. These patients were all examined by endo scopy with protruding,ulcerative and infiltrative lesions. Submucosal lesions w ith hypo echoes were found by endoscopic ultrasonography in six cases,and enlar ged lymph nodes were found on the exterior of stomach in two cases. Conclusion The primary gastric malignant lymphoma has a rather low incidence,and without specific clinical manifestations, hard to differentia te gastric ulcer from cancer through the manifestation in endoscopy. Further com bination of endoscopy, endoscopic ultrasonography and pathology are helpful to i ts correct diagnosis.