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Objective To investigate the effects and mechanisms of poly adenosine diphosphate (ADP)-ribose polymerase inhibitor 3-aminobenzamide (3-AB) on kidney injury in rates with severe acute pancreatitis (SAP).Methods Fifty-six male Wistar rats were divided into the sham operation (SO) group,SAP (3,6,12 hours) groups,and 3-AB + SAP (3,6,12 hours) groups,and there were 8 rats in each group.SAP model was established by retrograde injection of 5％ sodium taurocholate into the biliopancreatic duct.Rats in the 3-AB + SAP group were infused with 3-AB (20 μg/g) via femoral vein 30 minutes before SAP model establishment.The serum amylase,kidney function and renal myeloperoxidase (MPO) were determined,and pathological scores of pancreatic and renal tissues were evaluated under light microscope.Renal poly ADP-ribose formation,intercellular adhesion molecules-1 (ICAM-1) and P-selectin expression were detected by the Western blot.All data were analyzed using the analysis of variance or t test.Renal injury grading was analyzed using the Kruskal-Wallis nonparametric test.Results The levels of serum amylase of SAP 3,6,12 groups were (3806 ± 229)U/L,(4898 ± 295) U/L and (5726 ± 372) U/L,which were significantly higher than (2785 ± 160) U/L,(3241 ± 198) U/L and (3953 ± 249) U/L of the 3-AB + SAP groups (t =3.652,4.672,4.407,P ＜ 0.05).The levels of blood urea nitrogen were (11.6 ± 0.8) mmol/L,(19.3 ± 1.3) mmol/L and (29.6 ± 2.1) mmol/L,which were higher than (7.5 ± 0.5) mmol/L,(10.5 ± 0.7) mmol/L and (21.6 ± 1.5) mmol/L of the 3-AB + SAP groups.There were significant differences in the levels of blood urea nitrogen between the SAP group and the 3-AB + SAP group at the 6 and 12 hours (t =3.836,6.849,P ＜0.05).The levels of creatinine of the SAP 3,6,12 hours groups were (48.7 ±3.1) μmol/L,(58.3 ±3.7) μmol/L and (75.9 ±5.4) μmol/L,which were higher than (40.7 ±2.6)μmol/L,(43.2 ± 2.6) μmol/L and (53.4 ± 3.2) μmol/L of the 3-AB + SAP groups.There were significant differences in the levels of creatinine between the SAP group and the 3-AB + SAP group at the 6 and 12 hours (t =3.279,3.073,P ＜ 0.05).The renal MPO activity of the SAP 3,6,12 hours groups were (0.69 ± 0.06) U/g,(1.07 ± 0.09)U/g and (1.42 ±0.13)U/g,which were higher than (0.57 ±0.05)U/g,(0.75 ±0.06)U/g and (0.89 ± 0.07) U/g of the 3-AB + SAP groups.There were significant differences in the renal MPO activity between the SAP group and the 3-AB + SAP group at the 6 and 12 hours (t =3.066,4.012,P ＜ 0.05).The pancreatic pathological scores of the SAP 3,6 and 12 hours group were 6.50 ± 0.53,9.06 ± 0.66 and 11.75 ± 0.89,which were significantly higher than 4.25 ± 0.31,6.06 ± 0.51 and 7.57 ± 0.59 of the 3-AB + SAP group (t =3.631,3.598,5.147,P ＜ 0.05).The structure of the kidney was normal in the SO group.Congestive changes were observed in glomerulus of kidney,the renal tubular epithelial cell was necrosed,and luminal narrowing or occlusion,hemorrhage in the intercellular substance and inflammatory cell infiltration were observed in the SAP 12 hours group.The pathological changes of the 3-AB + SAP 12 hours group were significantly slighter (P ＜ 0.05).The relative expressions of poly ADP-ribose,ICAM-1 and P-selectin of the SO group were 1.00 ±0.21,1.00 ±0.18,1.00 ± 0.16,which were significantly lower than 3.83 ± 0.63,5.42 ± 0.83,3.71 ± 0.48 of the SAP 12 hours group (t =6.955,23.107,10.352,P ＜ 0.05).The relative expressions of poly-ADP-ribose,ICAM-1 and P-selectin of the 3-AB + SAP 12 hours group were 1.94 ± 0.36,2.35 ± 0.35,2.11 ± 0.29,which were significantly lower than SAP 12 hours group (t =3.977,12.115,5.012,P ＜ 0.05).Conclusions Poly ADP-ribose polymerase inhibitor 3-AB protects kidney from injury in the experimental SAP rats.Poly ADP-ribose polymerase inhibitor 3-AB functions by suppressing the ICAM-1 and P-selectin expression and reducing neutrophil infiltration.
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Objective To investigate the effect of hydroxyethyl starch (HES 130/0. 4) on the expression of aquaporin 1 (AQP-1) and liver injury in rats with severe acute pancreatitis(SAP).Methods Forty-eight male SD rats were randomly divided into three groups: Sham, SAP, and HES;each group was divided into 6 hour and 24 hour timepoints, with 8 in each subgroup. An SAP model was induced by injecting 5% sodium taurodeoxycholate into the biliary pancreatic duct. AMY, ALT,AST and water content in the liver were measured and TNF-a was examined by ELISA, and the expression of liver AQP-1mRNA was determined by RT-PCR, and the expression of liver AQP-Ⅰ protein was evaluated by immunohistochemical methods. Results Compared with the Sham group, the level of AMY, ALT, AST, TNF-a, water content, AQP-1mRNA and AQP-1 protein increased significantly in the SAP group (P＜0.05). Compared with the SAP group, the level of AMY, ALT, AST,TNF-a, water content, AQP-1mRNA and AQP-1 protein decreased significantly in the HES group (P＜0.05). At 6 hours, the expressions of liver AQP-1mRNA were (0. 402 ± 0. 023), (0. 811 ±0. 032) and (0. 595 ± 0. 015) in the Sham, SAP, and HES groups, respectively; at 24 hours, they were(0. 412 ± 0. 017), ( 0. 823 ± 0. 029) and (0. 607 ± 0. 021 ), with significant differences between each group (P＜0. 05). At 6 hours, the expressions of liver AQP-1 proteins were (2.07±0.25),(6.90±0.38)and (4.48±0.29) in the Sham, SAP and HES groups, respectively;at 24 hours, they were (2. 32±0. 31 ), (7. 04 ± 0. 32) and (4. 56 ± 0. 35), with significant differences between each group (P＜0. 05). Compared with the SAP group, the pathology of the pancreas and liver ameliorated significantly in the HES group. Conclusions Hydroxyethyl starch 130/0.4 may ameliorate liver injury of severe acute pancreatitis and alleviate the capillary leak. AQP-1 may play a role in the capillary leak caused by the liver injury of severe acute pancreatitis.
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OBJECTIVE To investigate the clinical character of patients with severe acute pancreatitis(SAP)(infected) with deep fungal organisms and its prevention and treatment with fluconazole.METHODS Among 256(patients) with SAP,46 cases with SAP and deep fungal infection treated by fluconazole were selected as(fluconazole) treatment group,66 patients with suspicious deep fungal infection were randomized into 2 groups: fluconazole(prevention) group(42 cases) and control group(24 cases).RESULTS There were lower incidences of deep fungal(infection) in fluconazole prevention group than that in control one(P
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Objective To evaluate the effect of ameliorating the pancreatic microcirculation in the early stage on the patients with severe acute pancreatitis(SAP). Methods 84 SAP patients admitted from 1995-1998 and 1998-2001 were retrospectively analyzed. Routine united management were given to 44 SAP patients in the former period (FP)(1995-1998),and special regime aimed at improving the microcirculation and preventing cell Ca 2+ overload besides routine management were given to 40 SAP patients in the later period(LP)(1998-2001).Results Cure rate (85.0%) in FP group was significantly higher than that of LP group(68.2%)(P