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Objective To investigate the role of hepatic Kupffer cells in acute hemorrhagic necrotizing pancreatitis associated lung injury(AHNP LI) and the therapeutic effects of gadolinium chloride(GdcI_3). Methods Forty-two Wistar rats were randomly divided into four groups:(I) sham operation group;(II) AHNP group;(III) Gdcl_3 (protection) group(Gdcl3 10mg/kg);(IV) Gdcl_3control group(Gdcl_3 10mg/kg).In the sham operation group, the (abdominal) vescera were shifted around for several times and the abdomen was closed.The AHNP model was induced by retrograde intraductal administration of 5% sodium taurcholate(1ml/kg,0.1ml/min).In the Gdcl_3 protection group,Gdcl_3 solution was admmistered by caudal vein injection one day before the AHNP model was made.In these 3 group of animals,specimens were obtained in order at 3h and 6h postoperatively:(1)Blood was withdrawn from the abdominal aorta to determine serum amylase,TNF?,IL-1(in addition,in the sham operation group,blood AST and ALT were determined);(2)A portion of liguefied right lung was obtained to determine MPO;another portion was fixed with 10% formalin for tissue pathological examination;(3)Bronchoalveolar lavage fluid of excised left lung was obtained ,and then alveolar macrophages were isolated,collected and purified.After removal of their nuclear (proteins),the alveolar macrophages were tested to determine NF-?B activation with the use of chemical illumination ELISA method;and (4)pancreatic tissue was reserved for pathological examination.In the Gdcl_3 control group, Gdcl_3 was administered by caudal vein injection,the animals were sacrificed 24h later,and blood was obtained to determine blood AST and ALT. Results In the Gdcl_3 prevention group,the level of MPO in lung tissue,serum (levels) of TNP? and IL-1,and NF-?B activation of alveolar (macrophages) were all significanfly reduced as compared with the AHNP model group(in all,P
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Objective To investigate the reasonable operation timing for patients with acute pancreatitis without obvious infectious manifestation. Methods The findings during the operation and pathological changes in 27 pantients with necrotic pancreatitis were analysed retrospectively.Results Six patients underwent surgical treatment with in 3 weeks. The delimitation between non-necrotic pancreas and necrotic pancreas was not very clear, and the abdominal adhesion and edema were serious. Other 14 cases were subjected to the surgical treatment 3-4 weeks after the onset of illness. The delimitation was clear in 9 cases without obviously infectious signs, but the adhesion of the pancreas bed to the greater omentum or the transverse mesocolon was evident. Various degrees of necrosis was found in 3 cases, and the infection together with pancreatic necrosis developed in the other 2 cases. The rest 7 patients were operated on 5-7 weeks after the disease onset, different degrees of infection and necrosis developed in 3 cases, and local pancreatic abscess formation could be observed.There was a lot of necrosis of fatty tissues on the peri-pancreas and the root of mesentery. Conclusions Clear away of necrotic pancreatic tissue is suitable in 3-4 weeks after the onset of illness in patients with non-infectious necrosis of pancreas.If operation is performed in the initial 3 weeks, intraoperative bleeding may be severe because the detachment between the non-necrotic tissues and necrotic tissues of pancreas was not yet formed completely, which may lead to hard to do the operation and result in increasing intraoperative bleeding and even increasing reoperation .If operation was done after 5 weeks, the infection of the necrotic pancreatic tissues can be seen in most of the cases, and the infection degree in the abdominal cavity may also be serious, which may need more operations to treat.
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Objective To observe the effect of 5 fluorouracil (5 FU) on regulating the inflammatory and anti inflammatory cytokines in acute pancreatitis(AP) in rats, and to investigate the mechanism of treatment of AP with 5 FU. Method SD male rats were divided randomly into 3 groups:false operation group (n=6), AP group(n=24) and 5 FU treatment group(n=24). Then, AP group and 5 FU treatment group redivided respectively into 3 subgroups: After the AP model sut up or after 5 Fu treatment 2, 6 and 24 h subgroups (n=8). The animals were killed at the blood samples were taken for measurement of TNF ?, IL 1, IL 6, IL 10 and TGF ?. The wet weight of pancreatic tissue and blood amylase also were observed. Results Both serum inflammatory cytokines (TNF ?,IL 1 and IL 6) and anti inflammatory cytokines (IL 10 and TGF ?) in AP group increased significantly (P
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Objective To investigate the effect of MMP-9 on severe acute pancreatitis(SAP) associated with lung injury,and the preventive function of MMP-9 inhibitor (BB-94) in SAP associated with lung injury in rats. Methods SD rats were randomly divided into three groups: Shamed-operated groups (control groups,n=10);SAP groups (n=14);SAP with MMP-9 inhibitor preconditioning groups (BB-94 group,n=15). The samples for test of the wet weigh index of lung,serum amylase level,white cell count,the number of cells and protein in bronchoalveolus lavage fluid,histologic scoring of lung injury and MMP-9 in lung were detected 24 hours after SAP models were set up.Results The parameters mentioned above in SAP group were significant higher than those in controll group and BB-94 group (P
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Objective To investigate the effects of low molecular weight heparin (LMWH) on severe acute pancreatitis(SAP). Methods Retrospective analysis was made on the clinical features and therapeutic effect on the routine treatment (RT) group in 48 cases and LMWH treatment(LT) group in 31 cases. Results 28 (90.3%) out of 31 cases were cured while 3 (9.7%) died in LT group. 35(72.9%) out of 48 cases were cured whereas 15 (27.1%) died in RT group. The complications occurring in LT group (32.3%,10 patients 18 times ) was significantly lower than that in the RT group (62.5%,30 patients 59 times)(P
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Objective To evaluate activity alteration of the pancreatic tissue phospholipase A 2 (PLA 2) and the therapeutic effects of verapamil in acute pancreatitis (AP) rats. Methods After the model of AP in the rat was established by the closed duodenal loop technique, the changes of PLA 2 activity were observed, and the pancreatic histology was examined by light and electron microscopy. Results At 16 and 24 hours after induction of AP in rats, significant inhibition of PLA 2 avtivity in pancreatic tissue was shown in the treated group (32.34?3.87, 35.26?4.52) as compared with AP group (44.83?5.31,47.77?5.86). The treated animals also showed decreasing in the severity of pancreatic pathology. Conclusions In AP rats exist high activity of PLA 2. Verapamil, a calcium channel blocker, might have therapeutic effects on AP by inhibiting the activity of PLA 2.
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Objective To study the damaging effect of tumor necrosis factor-alpha (TNF-?) and Interleukin-1?(IL-1?) on brain of rats in acute pancreatitis(AP). Mothods AP pancreatitis model in rats was induced by retrograde injection of 5% sodium taurocholate into the pancreatobiliary duct(1ml/kg body weight), then pretreated with normal saline (NS) or TNF-??IL-1?, TNF-? plus IL-1? respectively. Animals were killed at 5 h after drugs administration. The changes of brain water contents, leukocyte accumulation and adhesion were measured, and pathological studies of pancreas and brain were also performed. Results In groups with inflammatory cytokines pretreated, brain water contents, leukocyte accumulation and adhesion increased more significantly than those in control group and in NS pretreated group(P0.05). Conclusions Inflammatory cytokines such as TNF-? and IL-1? play important roles in the formation and acceleration of the brain damage in acute pancreatitis.
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Objective To study the pathological changes of acute hemorrhagic necrotizing pancreatitis(AHNP) complicated with acute lung injury(ALI). Method The model of AHNP with ALI was established in rats. The changes of function and structure of pancreas and lung were observed. Results One hour after induction of the model , pancreas showed mild edema and congestion . 12 hours after introduction of the model , the typical pathological changs of AHNP were found . The lung extravascular water volume and levels of PaCO 2 increased significantly, and the PaCO 2 decreased obviously. Morphological examination demonstrated that inflammatory cell , insterstitial edema , intra-alveolar hemorrhage ,desquamate and disintegration occurred in the lungs. Conclusions The pancreatic and pulmonary morphologic changes in this model is similar to the changes in clinical AHNP with ALI , which suggests that the model can be used to study the mechanism of AHNP with ALI and evaluate the effect of drugs for AHNP with ALI.