Effect of rhubarb-free anthraquinone in the treatment of acute pancreatitis with adipose-derived stem cell transplantation in rats / 中国组织工程研究

BACKGROUND: Studies have shown that rhubarb-free anthraquinone can protect the stability of the intestinal mucosa cell structure and function. However, the combination of rhubarb-free anthraquinone with adipose-derived stem cells to treat acute pancreatitis in rats has not yet been reported. OBJECTIVE: To investigate the effects of rhubarb-free anthraquinone on the treatment of acute pancreatitis by fat stem cell transplantation in rats. METHODS: Cryopreserved mouse adipose-derived stem cells (provided by the Chinese Academy of Medical Sciences) were rapidly recovered and cultured in vitro. The survival cells were labeled using PKH-26, and then the cell survival rate of adipose-derived stem cells was determined by MTT colorimetry. Sprague-Dawley rats provided by Beijing Vital River Laboratory Animal Technology Co., Ltd. were equally randomized into four groups. Animal models of acute pancreatitis were made in all rats through intestinal wall puncture for retrograde administration of 5％ sodium taurocholate to the pancreaticobiliary tube, and then the model rats were given tail vein injection of L-DMEM complete medium (0.5 mL) in the model group, intragastric administration of 200 mg/kg rhubarb-free anthraquinone in the rhubarb-free anthraquinone group, tail vein injection of adipose-derived stem cells (1×107 cells/L, 0.5 mL) in the cell transplantation group, and intragastric administration of 200 mg/kg rhubarb-free anthraquinone plus tail vein injection of 1×107 adipose-derived stem cells (0.5 mL) in the combined treatment group. All interventions in each group were performed once a day, for 3 continuous days. RESULTS AND CONCLUSION: (1) The levels of serum amylase and interleukin-6 were significantly reduced in the rhubarb-free anthraquinone group and cell transplantation group compared with the model group (P < 0.05) , while the level of trypsinogen activation peptide significantly increased (P < 0.05). In the combined treatment group, the levels of three indicators mentioned above were significantly decreased compared with the rhubarb-free anthraquinone group and cell transplantation group (P < 0.05). (2) The results of hematoxylin-eosin staining showed that the pathological changes in the pancreatic tissue of rats were significantly reduced in the rhubarb-free anthraquinone group and cell transplantation group, such as fatty degeneration, hemorrhage, cell necrosis and inflammatory cell infiltration. The remission of pathological changes was more obvious in the combined treatment group. (3) The number of positive cells labeled by PKH-26 was the highest in the combined treatment group, followed by the cell transplantation group, while there were no PKH-26-positive cells in the rhubarb-free anthraquinone group and model group (P < 0.05). (4) Compared with the model group, the number of apoptotic cells in the pancreatic tissue was significantly reduced in the rhubarb-free anthraquinone group and cell transplantation group, and lowest in the combined treatment group (P < 0.01). (5) The expression of transforming growth factor-β1 and Smad2/3 at gene and protein levels was highest in the model group, followed by the rhubarb-free anthraquinone group and cell transplantation group (P < 0.05) , and lowest in the combined treatment group (P < 0.01). To conclude, the combined intervention of rhubarb-free anthraquinone and adipose-derived stem cell transplantation could effectively improve the blood biochemical index level in the rats with acute pancreatitis, significantly relieve the degree of inflammatory response, pancreatic tissue morphology, and apoptosis of pancreatic cells, which may be related to the reduction of the transforming growth factor-β/Smad signal pathway.

Effect of rhubarb-free anthraquinone in the treatment of acute pancreatitis with adipose-derived stem cell transplantation in rats / 中国组织工程研究

BACKGROUND: Studies have shown that rhubarb-free anthraquinone can protect the stability of the intestinal mucosa cell structure and function. However, the combination of rhubarb-free anthraquinone with adipose-derived stem cells to treat acute pancreatitis in rats has not yet been reported. OBJECTIVE: To investigate the effects of rhubarb-free anthraquinone on the treatment of acute pancreatitis by fat stem cell transplantation in rats. METHODS: Cryopreserved mouse adipose-derived stem cells (provided by the Chinese Academy of Medical Sciences) were rapidly recovered and cultured in vitro. The survival cells were labeled using PKH-26, and then the cell survival rate of adipose-derived stem cells was determined by MTT colorimetry. Sprague-Dawley rats provided by Beijing Vital River Laboratory Animal Technology Co., Ltd. were equally randomized into four groups. Animal models of acute pancreatitis were made in all rats through intestinal wall puncture for retrograde administration of 5％ sodium taurocholate to the pancreaticobiliary tube, and then the model rats were given tail vein injection of L-DMEM complete medium (0.5 mL) in the model group, intragastric administration of 200 mg/kg rhubarb-free anthraquinone in the rhubarb-free anthraquinone group, tail vein injection of adipose-derived stem cells (1×107 cells/L, 0.5 mL) in the cell transplantation group, and intragastric administration of 200 mg/kg rhubarb-free anthraquinone plus tail vein injection of 1×107 adipose-derived stem cells (0.5 mL) in the combined treatment group. All interventions in each group were performed once a day, for 3 continuous days. RESULTS AND CONCLUSION: (1) The levels of serum amylase and interleukin-6 were significantly reduced in the rhubarb-free anthraquinone group and cell transplantation group compared with the model group (P < 0.05), while the level of trypsinogen activation peptide significantly increased (P < 0.05). In the combined treatment group, the levels of three indicators mentioned above were significantly decreased compared with the rhubarb-free anthraquinone group and cell transplantation group (P < 0.05). (2) The results of hematoxylin-eosin staining showed that the pathological changes in the pancreatic tissue of rats were significantly reduced in the rhubarb-free anthraquinone group and cell transplantation group, such as fatty degeneration, hemorrhage, cell necrosis and inflammatory cell infiltration. The remission of pathological changes was more obvious in the combined treatment group. (3) The number of positive cells labeled by PKH-26 was the highest in the combined treatment group, followed by the cell transplantation group, while there were no PKH-26-positive cells in the rhubarb-free anthraquinone group and model group (P < 0.05). (4) Compared with the model group, the number of apoptotic cells in the pancreatic tissue was significantly reduced in the rhubarb-free anthraquinone group and cell transplantation group, and lowest in the combined treatment group (P < 0.01). (5) The expression of transforming growth factor-β1 and Smad2/3 at gene and protein levels was highest in the model group, followed by the rhubarb-free anthraquinone group and cell transplantation group (P < 0.05), and lowest in the combined treatment group (P < 0.01). To conclude, the combined intervention of rhubarb-free anthraquinone and adipose-derived stem cell transplantation could effectively improve the blood biochemical index level in the rats with acute pancreatitis, significantly relieve the degree of inflammatory response, pancreatic tissue morphology, and apoptosis of pancreatic cells, which may be related to the reduction of the transforming growth factor-β/Smad signal pathway.

Probiotics inhibit immune fluctuation in the intestinal mucous layer in rats.

PURPOSE: Innate lymphocytes play a key role in maintaining the immune bowel barrier, which provides resistance to infection. However, the effects of probiotics on changes in the function of innate lymphocytes in the postoperative intestine remain known. METHODS: Ninety-six male SD rats were divided into the blank group and the preoperative Lactobacillus intervention group, and parts of the ileum were sampled on days 0, 3, 5 and 7 after partial small bowel resection. Distal ileum samples were evaluated using immunohistochemistry to detect IL-5, IL-13, IL-17a and IL-22. RESULTS: (1) There were more immune cells in the experimental group than in the blank group on day. (2) After the first 3 days, the levels of IL-22 and IL-5 (p = 0.024) were higher in the experimental group than in the blank group. From the third to the fifth day, the IL-5 and IL-22 levels were higher and the IL-13 and IL-17A levels were lower in the experimental group than in the blank group. From the fifth to the seventh day, the IL-5 and IL-13 levels were lower and the IL-22 and IL17A levels were higher in the experimental group than in the blank group. CONCLUSIONS: Probiotics stabilize the fluctuation of the intestinal immune system postoperatively.

Immunohistochemical evaluation of midkine and nuclear factor-kB as markers for diagnosis and prediction of synchronous metastasis in papillary thyroid cancer / 中华内分泌代谢杂志

Objective Midkine ( MK ) and nuclear factor-kappa B ( NF-kB ) play pivotal roles in tumorigenesis, which are considered as promising cancer biomarkers. The efficacy of MK and NF-kB as markers for diagnosis and prediction of synchronous metastasis in papillary thyroid cancer ( PTC ) was the aim of present investigation. Methods Seventy six cases of PTC and seventy cases of multi-nodular goiter ( MNG ) were retrieved. The PTC group was further divided into subgroup 1 (16 cases with synchronous metastasis) and subgroup 2 (60 cases without metastases). A retrospective review of clinical information, radiological examinations,131 I treatments and post-131 I-therapy scans were done. Immunohistochemistry of MK, NF-kB p65, and Ki-67 was performed on paraffin-embedded specimens and results were quantified. Diagnostic values of the parameters were conducted by receiver operating characteristic (ROC) curves. Diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were determined. Protein levels of MK and NF-kB p65 were then confirmed by Western blot. Results Immunoreactivities of MK and NF-kB p65, and positive percentage of Ki-67 were significantly higher in PTC group than in MNG group (all P<0. 01). ROC showed good differential diagnostic capabilities of all three parameters with diagnostic accuracies of 82. 192% , 80. 137% , and 84. 091%respectively. Moreover, all three parameters were significantly higher in subgroup 1 than those in subgroup 2 (all P<0. 01). ROC showed good predicting efficacies in synchronous metastasis of all three parameters with diagnostic accuracies of 82. 895% , 80. 263% , and 76. 316% respectively. By one-way analysis of variance, Western blot showed that MK and NF-kB p65 protein levels in lesions from subgroup 1 were significantly higher than those from subgroup 2, both were significantly higher than those in MNG lesions ( P<0. 01). Conclusion MK and NF-kB immunohistochemistry can potentially be used for differential diagnosis between PTC and MNG, and for prediction of synchronous metastases.

Impact of diabetes mellitus and postoperative blood glucose level on the prognosis of pancreatic carcinoma / 中华肝胆外科杂志

Objective To study the impact of diabetes mellitus (DM) and postoperative blood glucose control on the clinicopathological characteristics and prognosis of patients with pancreatic cancer who underwent radical surgery.Methods From January 2010 to January 2015, the clinical and follow-up data of 83 patients with pancreatic cancer who underwent radical surgery at Tianjin Medical University General Hospital were retrospectively studied.Patients were classified into the diabetic group (28 cases) and the non-diabetic group (55 cases) according to the preoperative status of DM.The clinicopathological characteristics, postoperative conditions and prognosis were compared.Results The incidences in the two groups of patients whose postoperative blood glucose levels were poorly controlled were 71.4％ (20/28) and 20.0％ (11/55) in the diabetes group and the non-diabetic groups, respectively.The difference was significant (P ＜0.05).The 3-year survival rate of the diabetic and the non-diabetic groups were 11.3％ and 31.8％ , respectively.The difference was significant (P ＜ 0.05).The 3-year survival rate of patients with poorly-controlled blood glucose levels were 8.8％, and 34.6％, respectively.The difference was significant (P ＜ 0.05).Conclusions The postoperative blood glucose level in pancreatic cancer patients with DM was poorly controlled after radical surgery.The prognosis of pancreatic cancer patients with DM or poorly postoperative blood glucose control was poor after radical surgery.

Diagnosis and treatment of duodenal gastrointestinal stromal tumors / 中华胃肠外科杂志

In order to promote clinical capability on duodenal gastrointestinal stromal tumor(GIST), literature review and experience summary were documented in this paper. Duodenal GIST is not rare in clinical practice. With the similar pathologic conditions, GIST in duodenum present a higher malignant risk than that in stomach. The cases who would receive imatinib mesylate as preoperative therapy require a precise preoperative diagnosis obtained by endoscopic ultrasound and fine needle aspiration cytology. Therapeutic strategy should be based on surgical R0 resection with clear margins, preserving pancreatic function and avoiding adjacent organs resection when possible. Limited resection is appropriate and results in similar oncological outcome compared with extensive procedure in suitable cases.

Approach to the patient with parathyroid adenoma combined with asymptomatic pheochromocytoma / 中华内分泌代谢杂志

Clinical characteristics were retrospectively analyzed in a patient with parathyroid crisis as the main symptoms of parathyroid adenoma and asymptomatic pheochromocytoma.This analysis was aimed to implement specific diagnosis and treatment and to accumulate experience in managing these diseases.

Surgical treatment for the pancreatic benign tumor following organ preserve principle / 中华肝胆外科杂志

Objective To summery the value of treatment for pancreatic benign tumor following the organ preserve principle.Methods The clinical data of 77 patients with pancreatic benign tumor at the General Hospital of Tianjin Medical University from Jan 2002 to Jan 2012 was analyzed.All patients were divided into traditional pancreatic surgical treatment group (n=24) which include pancreaticduodenectomy(PD) and pancreatic body and tail resection plus spleenectomy(DP) and treatment following organ preserve principle (n =53).Results There are tumor evacuation,segmentectomy,pancreatic head resection with duodenum preserving and pancreatic body and tail resection with spleen preserving in the group of treatment following organ preserve principle.Pathology diagnosis showed insulinoma 30 cases,mucinous cystadenoma 16,serous cystadenoma 10,intraductal papillary mucinous tumor 17,solid pseudopseudopapillary tumor 3 and 1 case of pancreatic intraductal hyperplasia.The rate of pancreatic leakage were 26.3％ (5/19) in traditional surgical treatment group and 24.3％ (9/37) in group of treatment following organ preserving respectively.There was no significant difference between these two groups(P＞0.05).The rate of new development diabetis and aggrasive of the preexist diabetis post the pancreatic surgery were 20.8 ％ (5/24),20 ％ (1/5),13.2(7/53),30 ％ (3/10)respectively.There was no significant difference between these two groups(P=0.485,P=1.000).Conclusions The surgical treatment following the organ preserving is a safe and effective procedure for the patients with pancreatic benign tumor.This new method can preserve the pancreatic parenchymal maximally,avoid the extra-and endo-secrete function loss and preserving the function of spleen.

Appoach to the patient with parathyroid adenoma and primary biliary cirrhosis;diagnosis and treatment / 中华内分泌代谢杂志

In patient with primary biliary cirrhosis,the metabolism of calcium and vitamin D could be affected and osteomalacia and secondary hyperparathyroidism might occurr.Besides,hypoalbuminemia may mask the real level of serum calcium and thus lead to misdiagnosis of coexisting parathyroid adenoma.Therefore,a rare case of parathyroid adenoma associated with primary biliary cirrhosis was herewith presented to call attention to the effect of hypoalbuminemia on serum calcium.

Approach to the patient with parathyroid adenoma and thyroid remnant goiter / 中华内分泌代谢杂志

Parathyroid adenoma is the main cause of primary hyperparathyroidism and often associated with thyroid nodular goiter.Thyrothymic thyroid rest belong to the ectopic thyroids which are classified into 4 grades according to the state of their connection with the proper neck thyroid gland.Thyrothymic thyroid remnant can also develop into nodular goiter and may be difficult to be distinguished from parathyroid adenoma.We present herewith the diagnosis and treatment of a rare case of parathyroid adenoma accompanied by thyrothymic thyroid remnant nodular goiter in order to remind clinicians of the attention to the thyrothymic thyroid remnant disease.

The palliative treatment of malignant gastroduodenal obstruction / 国际外科学杂志

Malignant obstruction of the stomach or duodenum is a preterminal event in patients with ad-vanced malignancies of the upper gastrointestinal.It severely limits the quality of life in affected patients.Most patients are in bad conditions and have an short expecting live time,so they not only can not bear but also do not need such an invasive operation.Because of this,a minimally invasive but effective palliative treatment is quite necessary.This paper makes a summary and contrastive analysis of several ways of pallia-five treatment which are widely used for malignant gastroduodenal obstruction in recent years.