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Background: Acute pancreatitis (AP) is a common acute abdominal disease in clinical practice. Severe AP (SAP) usually progresses rapidly, leading to systemic inflammatory response syndrome, multiple organ failure, and even death. Early identification of severe cases with timely and effective treatment can improve patient's prognosis and reduce mortality. Aims: To explore the value of single and combined detection of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) in the early assessment of severity of AP. Methods: A total of 472 AP patients hospitalized in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2020 were enrolled retrospectively. The laboratory data within 48 h of admission were extracted, and the patients were allocated into mild AP (MAP) group and SAP group (including moderately severe and severe AP) according to the 2012 revised Atlanta classification. The differences of CRP, IL-6 and PCT between the two groups were statistically analyzed, and the value of single and combined detection of the three indicators for predicting the disease severity was determined by ROC curve analysis. Results: The levels of CRP, IL-6 and PCT in SAP group were significantly higher than those in MAP group (all P< 0.05). ROC curve analysis revealed that the area under the curve (AUC) of single, two and three indicators combined for predicting SAP was all higher than 0.7, which represented a moderately diagnostic accuracy. Three indicators combined demonstrated the highest diagnostic accuracy (AUC=0.826); with an optimal cut-off value, the sensitivity and specificity were 71.4% and 79.3%, respectively. Conclusions: CRP, IL-6 and PCT are meaningful in early assessment of severity of AP. The overall diagnostic value of combined detection of three indicators is superior to single and two indicators combination in predicting SAP.
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Objective To investigate the effect and possible mechanism of erlotinib,an epidermal growth factor recceptor inhibitor,on human pancreatic cancer cell lines BxPC3 in vitro.Methods Methyhhiazolyhetrazolium(MTT)assay was used to detected the proliferation of BxPC3 after exposure to erlotinib,apoptosis and cell cycle changes were studied by flow eytometry and terminal deoxynucleotidyl transferase-mediated nick end labeling assay(TUNEL).The expressions of bcl-2 mRNA,bax mRNA,bcl-xL mRNA and bak mRNA were determined by reverse transcriptase polymerase chain reaction(RT-PCR). Results Edotinib inhibited BxPC3 cells growth in a dose and time dependent manner in vitro.The cell viabilities in erlotinib 1 μmol/L and 100 μmol/L groups 72 h later were(90.25 ±2.62)%and(40.75 ±2.98)%,and the difference was statistically significant(P<0.01).The cell viability in edotinib 50 μmol/L groups 24 h and 96 h after BxPC3 exposure were(74.0±4.08)%and(49.50 ±1.29)%,and the difference was statistically significant(P<0.01).Cell apoptosis rate in erlotinib 50 μmol/L group was(11.0 μ1.1)%,which was significantly higher than(6.2 ±1.1)%in control group(P<0.01).G_0/G_1 cell accounted for (73.4±1.3)%of all the cells,which was significantly higher than(63.3 ±1.O)%in control group.With transmission electron microscope,the morphology of BxPC3 ceils showed typical apoptosis and apoptotic body. The expressions of bcl-2 mRNA,bel-xl mRNA were down-regulated,while the expression of bax mRNA was slightly up-regulated,and the expression of bak mRNA was not affected.Conclusions The growth of BxPC3 cells could be suppressed by erlotinib and possible mechanisms involved blocking cell cycle,up-regulating apoptosis proteins and down-regulating apoptosis inhibitor proteins.