ABSTRACT
Objective:To investigate the clinical value and safety of ultrasound guided percutaneous transhepatic gallbladder puncture and drainage (PTGBD) in the treatment of pregnancy combined with acute biliary pancreatitis (ABP).Methods:The clinical data of 47 pregnant combined with ABP from 2010 to 2019 in Shengjing Hospital of China Medical University were retrospectively analyzed. Among them, 19 patients received regular medication (conservative group), and the other 28 patients received PTGBD (PTGBD group). Clinical indexes of two groups including acute physiology and chronic health evaluation acute physiology and chronic health evaluationⅡ(APACHEⅡ), serum amylase, white blood cell and total bilirubin were respectively recorded before and 3 days after treatment.Results:There were no statistical difference in the indexes before treatment between 2 groups ( P>0.05). The APACHE Ⅱ, serum amylase, white blood cell and total bilirubin after treatment were significantly lower compared with those before treatment, conservative group: (5.9 ± 1.9) scores vs. (7.2 ± 1.3) scores, (736.8 ± 64.2) U/L vs. (969.2 ± 124.3) U/L, (10.3 ± 1.4) × 10 9/L vs. (14.7 ± 2.1) × 10 9/L and (55.3 ± 9.5) mmol/L vs. (67.1 ± 10.2) mmol/L; PTGBD group: (4.1 ± 1.7) scores vs. (7.0 ± 1.2) scores, (465.5 ± 77.9) U/L vs. (1 001.8 ± 112.5) U/L, (8.4 ± 2.2) × 10 9/L vs. (13.5 ± 2.6) × 10 9/L and (38.4 ± 10.6) mmol/L vs. (73.7 ± 12.5) mmol/L, and the indexes in PTGBD group were statistically lower than those in conservative group, and there were statistical differences ( P<0.05). In conservative group, 5 cases died (both mother and infant) after deterioration of the condition and 1 infant died after birth. In PTGBD group, 3 cases died (both mother and infant) after deterioration of the condition and 1 infant died after birth. The maternal cure rate and fetal survival rate in PTGBD group were statistically higher than those in conservative group PTGBD: 89.3% (25/28) vs. 14/19 and 85.7% (24/28) vs. 13/19, and there were statistical differences ( P<0.05). Conclusions:Among patients with pregnancy combined with ABP, early PTGBD is more effective than conservative medication, and quickly relieves symptoms and reduces complications.
ABSTRACT
Ghrelin is a small active peptide secreted by gastric fundus cell. As an endogenous ligand of growth hormone receptor,it helps to promote growth hormone secretion,increase food intake and participate in energy metabolism. Recently,studies have indicated that Ghrelin,together with other peripheral signals,participate in the regulation of glucose and lipid metabolism. Insulin resistance (IR) is an important pathophysiological basis of the development of type 2 diabetes mellitus (T2DM),while obesity is the common risk factor of both IR and T2DM. It has been confirmed that Ghrelin has a close and complex connection with obesity and T2DM. Further study about Ghrelin may open up a new way to the diagnosis and treatment of obesity and T2DM.
ABSTRACT
Objective: To explore the effects of ulinastatin on the level of MIF in rats with acute necrotic pancreatitis. Method: 52 healthy Wister rats were randomly divided into three groups: normal control group(group C, 12), ANP group(group A, 20)and UTI group(group U, 20). Severe acute pancreatitis rat model in group A were induced by injection of 315 % sodium taurocholate through retrogradely common biliopancreatic ducts via papilla duodeni. After inducing the rat model of ANP through the way above, rats in group U were treated by ulinastatin through portal vein injection. Pancreas and duodenum were only flipped after opening abdominal cavity in group C. Then rats were killed at 3rd, 6th ,12th ,24th hour after operation respectively. Cut the belly open at once, and draw blood in postcava. The levels of serum MIF were determined with ELISA. Blood amylase was detected through biochemistry instrument. Resected pancreas tissues was scored according to the standard of Kusske. Result: Compared to the normal control group, the level of serum MIF , blood amylase and histopathological scores were significantly increased in ANP group, P