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Background:Early administration of enteral nutrition can improve intestinal mucosal barrier in patients with severe acute pancreatitis (SAP),reduce infection and complications;but when should the enteral nutrition be started is still controversial. Aims:To study the effect of different initiation time of enteral nutrition on elderly obese patients with SAP. Methods:The clinical efficacy,hospitalization time,hospitalization cost and the risk of complication were analyzed retrospectively in the two groups of patients with either ultra-early enteral nutrition (group A)or early enteral nutrition (group B),as well as the serum levels of inflammatory cytokines before and after treatment. Results:No significant difference in total effective rate was found between group A and group B (90. 9% vs. 79. 2%,χ2 = 1. 227,P > 0. 05). Compared with group B,the recovery time of blood and urine amylase,and hospitalization time in group A were significantly shortened and the cost of hospitalization was significantly decreased (P < 0. 05). The time of abdominal pain, bloating,vomiting and fever in group A was significantly shorter than that in group B (P < 0. 05). After 14 days of treatment,levels of IL-6,TNF-α and CRP in group A were significantly lower than those in group B (P < 0. 05). The incidence of infection was significantly lower in group A than in group B (P < 0. 05). Conclusions:Compared with early enteral nutrition group,ultra-early enteral nutrition for elderly obese patients with SAP has better efficacy,and has a shorter hospital stay and lower hospitalization cost.
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Objective To investigate the effect of taurine on colonic fibrosis in rats with colitis induced by 2,4,6-trinitrobenzene sulphonic acid(TNBS). Methods Thirty-two SD rats were divided into normal control group, model group, low-dose (400 mg/kg) taurine group and high-dose (800 mg/kg) taurine group. Rats in normal group were administrated with 0.9% NaCl solution enema, and the other three groups received TNBS enema. The rats in low-dose and high-dose taurine groups were administrated with 400 mg/kg and 800 mg/kg of taurine daily, respectively, one week before TNBS enema. Morphology and disease activity index (DAI) were evaluated, and the colonic tissues were histologically examined. Colon length and weight of the rats were also measured. The concentrations of hydroxyproline, collagen type Ⅰ, transforming growth factor-betal(TGF-β1), and Smad3 protein and mRNA in colon tissues were tested. Results In comparison with control group, the body weight and colon length were decreased while DAI score and colon weight were increased obviously in model group (P`0.01). All above parameters were improved after intervention of taurine. The fibrotie score in model group (1.88±0.35) was significantly higher than that in control group (0.25±0.46), low-dose (1.25±0.71) and high-dose (0.75±0.47) taurine groups (all P values <0.05). High levels of hydroxyproline, collagen type Ⅰ, TGF-β1 and Smad3 were detected in model group compared with low-dose and high-dose taurine groups (all P values < 0.05). Conclusions Taurine is effective in prevention of colonic fibrosis induced by TNBS in rats, which is mediated by the down regulation of TGF-β1 and the inhibition of TGF-β/ Smad3 pathway. It may be beneficial in treatment of Crohn's disease with colonic fibrosis and strictures.
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Objective To estimate the effect and the intracellular signal transduction pathway of insulin-like growth factor I (IGF-I) on the expression of stem cell factor(SCF) in colonic smooth-muscle cells(SMC). Methods The SMCs isolated from colon of the SD rats by enzymolysis were cultured and identified by α-actin immunocytochemical method. Colonic SMCs were cultured either with 100 μg/L of IGF-I at different time points (0, 8, 16, 24 and 48 hours) or with different concentrations (0,5,10,50,100 and 150 μg/L) of IGF-I for 16 hours. The expressions of SCF in colonic SMCs pretreated with or without speicific phosphatidylinositol 3-kinase (PI 3-kinase) inhibitor LY-294002 or mitogen-activated protein (MAP) kinase (MEK1) inhibitor PD-98059 were examined by Western blotting and quantitative reverse transeription-polymerase chain reaction and immunofluorescence. Results Low expression of SCF was found in colonic SMCs cultured in the bovine serum free medium. There was no effect of 5 or 10 μg/L of IGF- I on the expression of SCF. However, the expressions of SCF mRNA and protein were increased when stimulated with high concentrations (50,100,150 μg/L) of IGF-I. The peak expression of SCF was showed at the 16th hour after stimulating with 100 μg/L of IGF- I that was considered as the most effective concentration in vitro. The expression of SCF was not influenced by LY-294002, but was partly blocked by PD-98059. Conclusions The expression of SCF in colon SMCs may be induced by IGF-Ⅰ through MAP kinase signaling pathway.
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Objective To investigate the effect of exogenous insulin-like growth factor-1(IGF-1)on growth of gastric smooth muscle cells(SMCs)and synthesis of stem cell factor(SCF).Methods Gastric SMCs were cultured by enzymolysis and were identified by α-actin immunocytochemical method.After that,SMCs were incubated with different concentrations of IGF-1(0,50,100,150μg/L)or IGF-1 receptor monoclonal antibody(0.50,100,150μg/L)for 24 hours.Proliferation of SMCs was measured by MTT.The expressions of SCF protein and RNA were analyzed by Western blotting and quantitative reverse transcription-polymerase chain reaction,respectively.The SCF content in the culture fluid was detected by enzyme-linked immunosorbent assay(ELISA).Results The proliferation of gastric SMCs and the expression of SCF can be enhanced by IGF-1,and 100μg/L of IGF-1 may be the final effective concentration.Nevertheless,these could be inhibited by IGF-1 receptor monoclonal antibody in a dose-dependent manner.ConclusionElevated expression of SCF may be induced by IGF-1 through proliferation of SMC.