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Objective To evaluate the effect of enteral nutrition by a polymeric formula in patients with severe acute pancreatitis (SAP).Methods Fifty-eight patients with SAP were randomly divided into polymeric group (29 cases) and semi-elemental group (29 cases),and the two groups of patients were treated in accordance with the conventional SAP management protocol,nasojejunal tube was endoscopically inserted for enteral nutrition.The polymeric group received enteral nutritional suspension (TPF),and the semi-elemental group received the same quantity of VIVONEX TEN.The gastrointestinal tolerance (VAS score),incidence of diarrhea,infection,28-day mortality rate,and length of hospital stay was evaluated.Nutritional parameters were evaluated by pre-albumin,albumin,alanine aminotransferase,C reactive protein at the time of admission and one week later.Results The two groups of patients were comparable in terms of VAS score,incidence of diarrhea,infection,28-day mortality rate,and length of hospital stay (P ＞0.05).And the levels of prealbumin,albumin,alanine aminotransferase,C reactive protein after admission were not statistically significant (P ＞ 0.05).Conclusions Compared with the semi-dement formula,the price of polymeric formula is cheap,configuration is convenint,enteral nutrition is well tolerated,and it is suitable for early enteral nutrition in SAP.
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Objective To investigate the effects of Xuebijing injection on expression of myeloid cell triggering receptor-1(TREM-1)and the plasma levels of soluble TREM-1(sTREM-1),tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)in patients with severe sepsis. Methods Twenty patients with severe sepsis admitted into Critical Care Medicine Department,Affiliated Hospital of Nantong University were given comprehensive treatments according to the guidelines for management of severe sepsis and septic shock(2004),and they were divided into Xuebijing group and control group(each 20 cases). The Xuebijing injection group was given Xuebijing injection 50 mL,3 times daily for 5-7 days followed by regular treatments. The changes in blood TREM-1 mRNA expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 were detected before and after treatments on the 3rd and 5th day,and the above indexes were compared between the two groups. Results Before treatments,there were no significant differences in TREM-1 mRNA expression and levels of sTREM-1,TNF-α,IL-6 between two groups (all P>0.05). The TREM-1 expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 of two groups were declined after treatments compared to their baselines,the degree of decline being more prominent in Xuebijing group〔TREM-1 mRNA 3 days:1.065±0.277 vs. 1.217±0.301,t=-3.267,P=0.047;5 days:0.912±0.239 vs. 1.071±0.254,t=-5.072,P=0.032;sTREM-1(ng/L):146.93±13.76 vs. 176.22±19.46,t=-5.442,P=0.033;TNF-α(ng/L):77.51±11.28 vs. 107.72±13.17,t=-4.355,P=0.032;IL-6(ng/L):288.35±14.59 vs. 323.89± 24.51, t=-3.941,P=0.028〕. Conclusion Early implication of Xuebijing injection is of great significance in patients with severe sepsis,it may reduce the expression level of TREM-1 and serum levels of downstream inflammatory mediators,that is beneficial to the control of inflammatory responses and improvement of systemic inflammatory response syndrome in such patients.
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Objective To investigate the influence of streptozocin (STZ)'s dose on the inductive effect of diabetes in C57BL/6J mice, and investigate the dose-effect relationship and the optimal dose range. Methods 145 C57BL/6J mice were randomly divided into 9 diabetic groups (group A to group 1, n = 15 in each group) and I control group (n = I0) to receive intraperitoneal injection of STZ with the dosages of 30, 60, 80, 100, 120, 150, 180, 210, 240 mg/kg and same amount of buffer solution,respectively. Changes of blood glucose, body weight, survival rate at 45 day and serum insulin level were monitored, and the relationship with STZ doses was analyzed. Pancreas and kidneys of the mice were removed for morphological examination, and immunohistochemistry was used for determination of insulin in pancreas and CD<,68> in kidneys. Results Compared with control group, blood glucose in group C ～G increased significantly; body weigh, insulin level decreased significantly (P < 0.05), and the STZ dose was positively correlated with mean blood glucose (r = -0.984, P < 0.05) and was negatively correlated with mean serum insulin levels (r = 0.994, P <0.05). The diabetes modeling rates in group C ～ G (86.7% ～ 100%) were higher than those of group A and B (0 and 40%, P<0.05). At the 45th day, the survival rates of group C ～G (46.7% ～ 73.3%) were higher than those of group H and 1 (13.3% and 0, P <0.05). There was no obvious injury of pancreas and kidneys in group B, whereas, in group C and G, pancreatic island atrophy and decreased insulin secretion were observed; deposits of extracellular matrix and macrophage increased in the mesangium were also present. Conclusions 80 ～ 180 mg/kg of STZ dose was ideal for establishing diabetes model in C57BL/6J mice. Within this range, the modeling rate and survival rate was higher, and target organs injury was typical. The STZ dose was positively correlated with blood glucose and negatively correlated with serum insulin levels.
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Objective To observe the effects of differentiation of mature islet cells of mice on marrowmesenchymal stem cells (mMSCs). To provide transplant source for islet cell transplantation in the treatment of diabetes. Methods The culture, isolation and passage of mMSCs was performed by using patch wall, cell shape was observed by confocal microscope, and flow cytometry analysis was used to determine their biological characteristics. The type Ⅳ collagenase was injected into common bile duct to digest the pancreas, and then gradient centrifugation was used to isolate islet cells. The transwell co-culture system was used for third generation of mMSCs and isolated islet cells, then inversion microscope was used to observe the cell growth and morphological changes, immunochemistry methods was applied to detect the expression of insulin in mMSCs, and insulin release test was performed to determine the secretion of insulin. The control group consisted of cultured mMSCs alone. Results The cells from mouse bone marrow were found to be in long spindle shape with large volume after 48 hours in culture. One week later the cells grew in the form of colony with serial subcultivation. The cell surface molecules including Sca-l, CD29, CD44, CD105 were positive with high level of expression;while the cell surface molecules including CD34, CD45 were negative, all of these results confirmed that the ceils were mMSCs. After 7 days of coculture with mice islet cells, part of mMSCs cells were positively stained by insulin immunohistochemisty, the insulin secretion was (16.83±0. 15)μIU/ml.Conclusions After cocultured with islet cells, mMSCs isolated from mouse bone marrow could differentiate into islet like cells. These cells may be used in the islet cells transplantation in the treatment of diabetes, which provided a solution to the problems of donor-shortage and immunologic rejection.