摘要:目的: 探討益活清下法治療重癥急性胰腺炎(severe acute pancreatitis, SAP)對血清單核趨化蛋白1及對器官功能不全的影響。 方法 : 依據納入和排除標準,選取SAP患者24例,按1︰1隨機分為治療組和對照組,在接受相同西醫治療的基礎上,治療組使用中藥“益活清下”法治療,對照組同時接受中藥安慰劑治療。測定患者第0、1、3、5、7天血清MCP1的濃度水平,比較各器官功能不全的發生率與持續時間。 結果 :兩組入院時Rason評分、CT評分、急性生理和慢性健康評價指標Ⅱ評分無統計學差異(〖WTBX〗P gt;005)。對照組第3天MCP1濃度水平明顯高于治療組,差異有統計學意義(〖WTBX〗P lt;005),對照組腸、肝功能不全的發生率高于治療組,持續時間長于治療組,但無統計學差異(〖WTBX〗P gt;005)。 結論 :益活清下法治療重癥急性胰腺炎,可降低患者血清MCP1的水平。Abstract: Objective: To investigated the impact of Yihuo Qingxia method on the serum monocyte chemoattractant protein1 of severe acute pancreatitis (SAP)and on the organs disfunction. Methods : Twentyfour SAP patients who admitted to hospital within 72h after onset were randomized into treatment group (n=12) and control group (n=12). The patients in the treatment group were treated by Yihuo Qingxia method, and the control group were administrated with placebo.The level of the serum mcp1 of the patients on the first,3rd,5th,7thday were measured, as well as the incidence and the duration of disfunction of the organs were compared.〖WTHZ〗Results :There were no statistical significance in admission Rason scores, CT scores, Acute physiology and chronic health evaltionⅡscores(APACHEⅡscores)(Pgt;005). The level of the serum Monocyte chemoattractant protein1 of the treatment group was lower than that of the placebo group generally(Plt;005).At the 3rd day after onset,the serum mcp1 level of the control group was significantly higher than that of the treament group(Plt;005).The incidence of the control group of the intestin disfunction and hepatic inadequacy was obviously higher than those of the treatment group,and the duration of the former was longer than that of the latter,but with no satistical significance. Conclusion :Yihuo Qingxia method can effectively cut down the level of the serum mcp1 of severe pancreatitis patients.
目的探討胰管結石的診斷、治療及發病原因。方法 回顧分析1998年1月1日至2004年11月31日期間收治的有完整病史資料的88例胰管結石患者的臨床特點、診斷和治療方法。結果88例患者病史不典型，以上腹部疼痛最常見，所有病例均伴有慢性胰腺炎。B超檢查81例，診斷為胰管結石76例，胰腺鈣化5例； CT檢查51例，診斷為胰管結石47例，鈣化4例，其中有5例疑伴胰腺癌； MRCP檢查47例，診斷為胰管結石45例，胰腺鈣化1例，胰腺鈣化伴胰管擴張1例，其中6例疑伴胰腺癌。56例行手術治療，53例痊愈出院，2例好轉出院，1例胰管結石伴酒精性肝硬變，門靜脈高壓癥患者術后第23 d死于肝、腎功能衰竭。25例行中西醫結合治療，17例痊愈，8例好轉出院。另7例主動放棄治療。結論 B超是胰管結石的首選檢查方法，MRCP對其診斷和治療有指導意義； 胰管結石伴有嚴重的臨床癥狀或疑伴胰腺癌時，手術是其最佳選擇。
In order to observe activity of tumor necrosis factor (TNF) in the serum, pancreatic histopathological damage, as well as their relationships in acute necrotizing pancreatitis (ANP), thirty five SD rats were randomly divided into 7 groups according to their sampling time with 5 in each group. ANP was induced by retrograde infusion of 5% sodium taurocholate through biliopancreatic duct in 6 experimental groups (Group B1～B6).Blood and pancreatic tissue samples were obtained at hour 0,0.5,2,4,6 or 8 respectively when the animals were sacrificed.Results showed that serum level of TNF activity rose significantly in Group B2,and reached the maximal value in Group B4.The pancreatic histopathological damage in ANP rats was getting worse along with time. Serum TNF activity had close relation to pancreatic histopathological score (r=0.63, Ｐ＜0.01),suggesting that serum TNF may play an important role in the process of deterioration of pancreatic tissue damage during ANP.
ObjectiveTo summarize the current status and progress of nutritional support therapy for pancreatic cancer in order to improve the understanding of the impact of nutritional support treatment on pancreatic cancer and guide clinical work.MethodThe literatures about nutritional support and chemotherapy for pancreatic cancer at home and abroad were read and reviewed.ResultsFor most patients with malignant pancreatic tumors, nutritional risk or malnutrition might accompany them for a lifetime. Regular nutritional risk screening, timely nutritional assessment and necessary nutritional treatment played an extremely important role in the process of comprehensive anti-tumor treatment.ConclusionAlthough there are still some core problems to be solved in nutritional support therapy and chemotherapy for pancreatic cancer, its efficacy is gradually recognized and widely used by clinical workers, which might be helpful to improve the prognosis of patients with pancreatic cancer.
To introduce a rat model of the conversion of acute edematous pancreatitis (AEP) to necrotizing pancreatitis (ANP). One hundred and seven Sprague-Dawley rats were randomized in three experimental groups as follows: sham operation control group and AEP group and ANP group. AEP was induced by pancreatic duct ligation and exocrine stimulation, ANP was induced same as AEP，but with a large dose of dextran-110 (500mg/kg) intravenously. The serum concentration of amylase increased significantly in AEP group and ANP group. Cytosolic free Ca2+ concentration in isolated pancreatic acinar cells increased consistently after induction of ANP. Homorrhage, parenchymal necrosis and calcium deposits in acinar cells were observed in pancreas in ANP group. Ultrastructural examination showed desquamation and necrosis of the endothelium of the pancreatic capillary in ANP group. These results suggest that ischemia may induce the conversion of AEP to ANP via acinar cell Ca2+ overloading. The rat model would seem to be a suitable animal model for studying aggravating mechanism of acute pancreatitis.
【Abstract】Objective To investigate the protective effect of improving the pancreatic ischemia and calcium channel blockers on preventing the progression of acute pancreatitis. Methods Twenty-four patients with mild acute pancreatitis were randomly divided into two groups： control group and treated group. Within the first 72 hours from the onset of AP, routine conservative managements were performed in control group, improving the pancreatic ischemia and preventing Ca2+ overload were performed in treated group for two weeks. The hemorrheological parameters were measured at 1,4,7,14 days after adimission, simultanously, serum TNFα, IL-1β, C-reactive protein and plasma TXB2, 6-keto-PGF1α levels were determined with ELISA methods. Results The hemorrheological changes were improved in treated group, serum TNFα, IL-1β, C-reactive protein and plasma TXB2, 6-keto-PGF1α levels were significantly decreased each time point in treated group as compared with control group. Conclusion Improving the pancreatic ischemia and calcium channel blockers have protective effect through reducing the generation of cytokines and inflammatory mediators on preventing the progression of acute pancreatitis.
ObjectiveTo explore effect of α-adrenoceptor on modulating water of lung in severe acute pancrea-titis (SAP) rat. MethodsThe SD rats were randomly divided into sham operation group (n=5) and SAP group,the SAP group was divided into subgroups of SAP-4 h (n=5) and SAP-24 h (n=5).SAP model was made by injecting taurocholate into bilopancreatic duct.The wet-to-dry ratio,alveolar fluid clearance (AFC),and AFC affected by α1-adrenoceptor inhibitor-prazosin and α2-adrenoceptor inhibitor-yohimbine separately or together were measured in the lungs.The α1-adrenoceptor and α2-adrenoceptor mRNA expressions in the lungs tissues were measured by real-time PCR. Results① The wet-to-dry ratios in the SAP-4 h group and SAP-24 h group were obviously decreased as compared with the sham operation group (P<0.05),which in the SAP-24 h group was significantly lower than that in the SAP-4 h group (P<0.05).② The AFCs in the SAP-4 h group and SAP-24 h group were obviously increased as compared with the sham operation group (P<0.05).The AFCs in the SAP with α1-adrenoceptor inhibitor-prazosin or α2-adrenocpetor inhibitor-yohimbine or prazosin combined with yohimbine were all obviously decreased as compared with the SAP group (P<0.05).③ The α1 adrenoceptor and α2 adrenoceptor mRNAs in the SAP-4 h group and SAP-24 h group were obviously increased as compared with the sham operation group (P<0.05). ConclusionAFC might be modulated by α-adrenoceptor in SAP rat.
ObjectiveTo explore the new gene therapy method for tumor, the recombinant Caspase3 gene (rcaspase3) eukaryotic expression plasmid was constructed by molecular biologic method. MethodsThe eukaryotic expression plasmid pcDNA3.1(+)/rCaspase3 was constructed by rearrangement of the large subunit and small subunit of Caspase3 and it was transfected into pancreatic carcinoma cells(PCⅡ). After being transfected, the expression of rCaspase3 mRNA in pancreatic carcinoma cells was detected by RTPCR and it’s apoptotic activity was detected by FCM. ResultsThe sequence of rCaspase3 showed that the recombinant molecules (rCaspase3) now had its’ small subunit preceding its’ large subunit. After pancreatic carcinoma cells being transfected with the pcDNA3.1(+)/rCaspase3 by liposomes, a 894 bp strap was observed by RTPCR. No strap was found in control groups. A transparent hypodiploid karyotype peak was found by FCM.ConclusionThe plasmid of pcDNA3.1(+)/rCaspase3 has been constructed successfully. rCaspase3 has apoptotic activity and can be used as target gene in gene therapy for pancreatic carcinoma.