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Acute necrotizing encephalopathy (ANE) is a rare but distinctive acute encephalopathy with global distribution.It usually begins with a virus-associated febrile illness, which deteriorates rapidly, and leading to convulsion, unconsciousness and even coma.The neuroradiologic features of ANE are multi-focal and symmetrical brain lesions, involving bilateral thalamus.ANE has no specific treatment method at present.The majority of ANE patients are accompanied with varying degrees of neurological sequelae, and even death.In this review, we summarized the epidemiology, diagnosis and prognosis of this rare but fatal disease in children.
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Objective To investigate the effects of rhubarb and mirabilite and compound danshen injection on gastrointestinal dysmotility of severe acute pancreatitis (SAP). Methods Forty-one SAP patients were randomly divided into two groups: Integration group (n=21) were treated with rhubarb and mirabilite and compound danshen injection. Control group (n=20) were treated with conventional therapy. Recovery of gastrointestinal motility of two groups was observed, and the complication rate and hospital stay was recorded.Results The recovery of gastrointestinal motility, first defecation and hospital stay in integration group was (3.1±0.8)d, (3.1±0.8)d, (21.5±2.8 )d, which were significantly shorter than those in control group [(5.2±1.4) d, (4.7±1.3 ) d, (32.1±3.60) d, P ＜ 0. 05 or P ＜ 0.01. Five patients in integration group developed complication, which was significantly lower than 8 patients in control group ( P ＜ 0.01 )]. One patient died and one patient received operation in integration group, and one patient died in control group,without significant difference between the two groups (P ＞ 0.05 ). Conclusions The combination of rhubarb and mirabilite and compound danshen injection in severe acute pancreatitis can promote the recovery of gastrointestinal motility.
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Objective To investigate whether emodin(1,3,8-trihydroxy-6-methylanthraquinone) can attenuate inflammatory response in rats' lungs with acute necrotic pancreatitis (ANP). Method Acute necrotic pancreatitis model was induced by injection of 3% sodium taurocholic acid into the subcapsular of pancreas and emodin was administered by intestine perfusion. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis was measured together with the detection of IL-1β, IL-6 and IL-10 mRNA expressions in rats' lungs by semi-quantitative RT-PCR. Immunohistochemistry was detected the expression of IL-1β converting enzyme (ICE) in the rats' lungs. Result Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis groups are obviously high as compared with normal group(P＜0.05). Plasma amylase was (1 611.20±218.72)IU/L in normal group. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis groups were (1 981.40±56.81)IU/L, (3 287.40±612.37)IU/L and (4 914.60±746.82)IU/L. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis after treatment with emodin groups were obviously low as compared with acute necrotic pancreatitis groups. The plasma amylase was(1 617.20±136.80)IU/L,(2 323.40±318.19) IU/L and (2 670.20±390.03)IU/L respectively. The study showed that the mRNA expression of pro-inflammatory cytokin IL-1β and the expression of IL-6, as well as the expression of IL-1β converting enzyme(ICE) were decreased and IL-10 was increased. Conclusion The study demonstrates that emodin plays an important role in reducing plasma amylase level. Emodin exerts anti-inflammatory effects in acute necrotic pancreatitis rats' lungs by downregulating the mRNA expression of IL-1β and IL-6 and upregulating the mRNA expression of IL-10.
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Study on 70 acute pancreatitis patients (40 males, 30 females, aged 19 - 76) operated in Viet Duc Hospital from January 1999 to May 2002. Exclusive criteria: edema acute pancreatitis, necrotic pancreatitis without operation, necrotic pancreatitis was operated in basic settings. The results: the most of necrotic pancreatitis had no clear causes (74.28%). Mechanic causes included gallstone, worm (17.15%), acute pancreatitis after gall-pancreas area operation (1.43%). The disease was common in adults, mainly in 41-60 years old. In necrotic pancreatitis, pancreas could be necrotic very fast during the first 24 hours with shock, multi-organs failure, tympanites, vomit, peritoneum reaction and induction signs. The common symptoms were : increased blood amylase and urine amylase, leukocyte, blood urea, blood glucose; decreased blood calcium. CT scanner with a high accuracy rate (100%), was a gold criterion in diagnosis of necrotic pancreatitis. In operation, should minimized intervention. It is necessary to perform jejunotomy to decrease the expense due to intravenous feeding regularly.
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Pancreatitis , TherapeuticsABSTRACT
Objective To explore the effect of pyrrolidine dithiocarbamate(PDTC) on the expression of E-selectin and the activities of enzymes in oxidative stress in the pancreas of rats with severe acute pancreatitis(SAP).Methods Rat model of ASP was build by intraperitoneal injection of L-arginine(totally 5 g/kg,twice in an interval of 1 h).Thirty-six SD rats were assigned to 6 groups randomly and equally,that is,normal control,SAP,PDTC pretreatment group 1(1 mg/kg) and 2(100 mg/kg),and PDTC treatment group 1(1 mg/kg) and 2(100 mg/kg).PDTC pretreatment was preformed by subcutaneous injection of PDTC 1 h before first injection of L-arginine.For the animals in treatment groups,PDTC was given 3 h after first injection.Normal control was given intraperitoneal injection of normal saline.In 24 h after the first injection of L-arginine,the activity of myeloperoxidase(MPO),lipid peroxide(LPO) and nitric oxide synthase(NOS) were detected.Expressions of E-selectin was detected through inmmunohistochemical method,and activity of NF-?B-DNA binding were detected by electrophoretic mobility shift assay(EMSA).Results In SAP groups and PDTC pretreatment and treatment groups,the expression of E-selectin,activities of NF-?B,MPO,LPO,and inducible NOS(iNOS) were higher,but the activity of constitutive NOS(cNOS) was lower than those in the normal control(P0.05).Conclusion PDTC of 1 mg/kg can alleviate the inflammation in SAP by blocking the translocation of NF-?B,however,the 100 mg/kg PDTC shows little protection in this process.
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OBJECTIVE:To observe the pharmacological effect of Ulinastatin on acute necrotizing pancreatitis in rats.METHODS:Animal models were divided into3groups:group A,sham operation;group B,acute necrotic pancreatitis given no treatment;group C,acute necrotic pancreatitis treated with Ulinastatin.The changes of AMS and TNF-?were compared at different time among3groups.RESULTS:AMS and TNF-?in group C were significantly different from those in group A and in group B.CONCLUSION:Ulinastatin could remarkably improve the prognosis of acute necrotic pancreatitis.