【Abstract】Objective To investigate the protective effects of epidermal growth factor (EGF) on pancreas of rats with acute pancreatitis(AP). Methods Seventytwo male SpragueDawley rats were randomly divided into 3 groups: Control group, AP group and AP-EGF group. Subcutaneously injection of EGF (0.1 μg/g) were given to animals in the AP-EGF group after the establishment of the model of AP. The other two groups of animals received the same volume of saline. At 6 h, 12 h and 24 h after induction of AP, 8 animals in each group were sacrificed respectively， 4 ml of blood sample was withdrawn from heart，2 ml for the analysis of amylase activity and 2 ml for MDA content in serum. Ascites was sucked with dry gauzes and was weighed thereafter. Changes of pancreas morphology were evaluated at every time point. The same part of pancreas was removed for measurement of MDA content, apoptotic index (AI) and histologic changes. Results Histologic injury of the animals in the APEGF group was milder than that in the AP group. Ascites weight in the AP-EGF group decreased significantly compared with that in the AP group at 12 h and 24 h 〔(4.53±1.29) g vs (6.58±1.47) g, (7.64±1.85) g vs (11.96±2.13) g，P＜0.05，P＜0.01〕. Amylase activity in the APEGF group also decreased significantly compared with that in the AP group at 12 h and 24 h 〔(142.0±8.3) U/L vs (187.9±10.4) U/L, (194.3±10.4) U/L vs (253.3±8.6) U/L, P＜0.05，P＜0.01〕. MDA content in plasm 〔(2.34±0.23) μmol/L vs (3.15±0.38) μmol/L, P＜0.05〕 and in pancreas 〔(5.21±1.46) μmol/g vs (7.68±1.63) μmol/g, P＜0.01〕 in the APEGF group decreased significantly compared with those in the AP group at 24 h. AI of pancreas in the APEGF group increased significantly compared withthatintheAPgroupafteroperation〔(16.22±3.53)%〖KG4vs (7.35±1.04)%, (11.67±2.40)% vs (4.81±0.86)%, (6.38±1.42)% vs (1.97±0.21)%, P＜0.01〕. Conclusion EGF may accelerate the restoration of pathologic injury and alleviate the hemorrhage and edema of pancreas. It may also depress MDA content in plasm and in pancreas so that to lessen oxidative damage. EGF may protect pancreas by inducing cellular apoptosis.
Objective To investigate the pathogenesis of acute lung injury in rats induced by intra-peritoneally injection of perforative peritonitis ascitic fluids（PPAF） and the role of L-arginine （L-Arg） in acute lung injury in this model. Methods Perforative peritonitis （PP） models were established in 60 rats and PPAF were collected. Forty-eight rats were randomly divided equally into NS group，PPAF group, and L-Arg group. Rats were randomly subjected to death at 7 h and 12 h. Peripheral blood WBC were counted，levels of NO and malondialdehyde （MDA） in serum were examined. Lung injury score and wet/dry ratio were evaluated， and level of myeloperoxidase （MPO） in lung tissues and lung cell apoptosis were tested. Results WBC count of peripheral blood, levels of NO and MDA in serum， level of MPO in lung tissue, lung injury score， wet/dry ratio， and lung cell apoptosis rate in PPAF group were significantly higher than that in NS group at each time point（P＜0.01）. Level of NO in serum in L-Arg group was higher than that in PPAF group （P＜0.01）， but lower level of MDA in serum， lower level of MPO in lung tissue and lung injury score，lower wet/dry ratio， and lung cell apoptosis rate were observed in L-Arg group（P＜0.05）. In PPAF group and L-Arg group， level of NO in serum， wet/dry ratio, and lung cell apoptosis rate were higher at 12 h than that at 7 h（P=0.000）. Serum NO level was in negative correlation with serum MDA level （r=-0.257，P=0.021）， MPO level in lung tissue（r=-0.444， P=0.011），and lung cell apoptosis（r=-0.351， P =0.010） in PPAF group and L-Arg group， but serum MDA level was in positive correlation with cell apoptosis（r=0.969， P＜0.001） in each group. Conclusions Acute lung injury rats model can be established by intra-peritoneally injection of PPAF. Enhanced oxidizing reaction and cell apoptosis take part in the occurrence of acute lung injury. L-Arg plays a protective role in acute lung injury.
ObjectiveTo understand the application progress of interventional therapy for chylous ascites (CA). MethodsThe domestic and foreign literature related to the diagnosis, imaging examination methods, and interventional treatment of CA in recent years were retrieved and summarized. ResultsThe sources of CA are diverse, the aetiology is different, and the treatment modalities will vary greatly, with the diagnosis of the source of lymphatic leakage being the basis for the effectiveness of interventional therapy. Through interventional treatment, such as intranodal lymphography, hepatic lymphogram, balloon occlusion retrograde abdominal lymphangiography, lymphatic leakage that is difficult to identify in traditional imaging examinations (CT, MRI, etc.) can be located and embolised to improve the diagnosis and treatment of CA. As an emerging means for the treatment of CA, interventional therapy has the advantages of less trauma, quick effect, and fewer complications. ConclusionsWith the continuous improvement of the interventional treatment approach, angiography, embolization materials, and the continuous accumulation of clinical experience, the interventional of CA will have more significant therapeutic effects and a broader application prospect.
Objective To study the effect and intrinsic mechanism of acute suppurative peritonitis associated ascitic fluid (ASPAAF) on experimental liver injury of rats. Methods Thirty-two male or female Sprague-Dawley (SD) rats were randomly divided into two groups: ASPAAF group (n=16) and control group (n=16), in which 8 ml ASPAAF or normal saline (NS) were injected into the peritoneal cavity, respectively. The rats were killed at each time intervals after peritoneal cavity injection (6 h and 12 h) respectively in two groups and specimens were made to detect the levels of serum TNF-α, endotoxin and liver function (AST, ALT and STB). The level of TNF-α in liver tissues was measured. The pathological change of liver was observed by microscope. Results The levels of TNF-α, endotoxin, ALT, AST and STB in serum and the levels of TNF-α in liver tissues at different time points were markedly higher in ASPAAF group compared with those in control group (P＜0.05), and these indexes increased with increasing time in ASPAAF group (P＜0.05). In ASPAAF group, hepatic tissue appeared hydrops, even spotty necrosis and the changes at 6 h and 12 h were not obvious different. No abnormal pathological change of hepatic tissue was found in control group. Conclusion ASPAAF can induce the injury of the liver in rats, which may involved in TNF-α and endotoxin.
Objective To explore the feasibility of inguinal hernia repair in patients with cirrhotic ascites under day surgical mode. Methods The clinical data of patients undergoing elective inguinal hernia repair with concurrent cirrhotic ascites under the day surgical mode admitted to Xijing Hospital, the First Affiliated Hospital of the Air Force Military Medical University between December 2015 and March 2023 were retrospectively analyzed. The diagnosis, treatment, and postoperative conditions of the patients were analyzed and summarized. Results Ultimately, 8 patients undergoing elective inguinal hernia repair with concurrent cirrhotic ascites under day surgical mode were included. Some patients had bilateral hernias, with a total of 11 cases of hernias. All of these hernias were oblique hernias, including 1 case of recurrent hernia. The surgical methods for 10 cases of hernia were Lichtenstein surgery, and 1 case used laparoscopic retroperitoneal hernia repair. All 8 patients did not use antibiotics during the perioperative period. Only 1 case of recurrent inguinal hernia occurred after surgery. Another patient was admitted to liver disease specialist ward due to ascites, and later improved. No patients experienced serious complication or surgery related death. ConclusionsUnder the premise of effectively improving complications of cirrhosis, patients with stable cirrhotic ascites who have undergone strict screening can undergo inguinal hernia repair surgery under the day surgical mode. However, further large-scale studies are needed in the future to clarify their specific application conditions and indications for the use of antibiotic.
Objective To explore the role and intrinsic mechanism of the injury of intestines induceded by pancreatitis associated ascitic fluid (PAAF) and acute suppurative peritonitis associated ascitic fluid (ASPAAF) in rats. Methods Forty-eight Sprague-Dawley (SD) rats, male or female, were randomly divided into three groups averagely. The control group: 8 ml of normal saline (NS) was injected into the peritoneal cavity; the PAAF group: 8 ml of PAAF was injected into the peritoneal cavity; and the ASPAAF group: 8 ml of ASPAAF was injected into the peritoneal cavity. After peritoneal cavity injection, the rats were put to death in batches at 6 h and 12 h, eight rats per-batch. Levels of TNF-α and endotoxin in serum were measured. The activity of ATP enzyme and level of TNF-α in the intestinal tissues were measured. The pathological changes of intestines were observed by microscope.Results The levels of TNF-α, endotoxin and the degree of injury of the intestines were markedly elevated and the activity of ATP enzyme of the intestinal tissues was decreased in the PAAF group and ASPAAF group compared with those in the control group (P＜0.05). The levels of TNF-α, endotoxin and the degree of injury of the intestines were markedly elevated and the activity of ATP enzyme of the intestinal tissues was decreased in the ASPAAF group compared with those in the PAAF group (P＜0.05). Conclusion PAAF and ASPAAF can induce the injury of intestines, but the injury of intestines induced by ASPAAF is more serious.
目的:观察持续腹腔引流治疗顽固性腹水的疗效。方法:将顽固性腹水患者74例分为两组,治疗组38例,采用腹腔置管,持续腹腔引流腹水,3000mL/天;对照组36例,以常规补充白蛋白、限钠、限水、利尿治疗为主,比较两组的疗效。观察治疗组治疗前后患者尿量、腹围和体重变化,并比较治疗组与对照组在肝、肾功能及电解质的变化及总体疗效。结果:治疗组疗效优于对照组(Plt;0.05),与治疗前比较,治疗组治疗后尿量、腹围、体重有明显改变(Plt;0.01), 肝、肾功能及电解质与对照组比较无明显变化(Pgt;0.05)。结论:持续腹腔引流治疗顽固性腹水经济适用,不良反应少,患者依从性好。
目的 探讨布-加综合征的个体化治疗。 方法 我们对首都医科大学附属复兴医院及宣武医院、二炮总医院及其他医院2004年2月至2009年5月期间会诊收治的20例布-加综合征患者的临床资料进行回顾性分析。结果 20例患者中术后24 h死亡1例（5.0%），死于DIC； 19例顺利出院。19例患者术后均获随访，随访时间（34.7±3.3）个月，其中恢复良好者占73.7%（14/19）； 1例（5.3%）行肠-腔-颈转流术者，术后间断出现肝性脑病，短期住院治疗后可以改善； 术后18个月1例（5.3%）行肠-腔转流术者因全身脏器衰竭死亡。结论 个体化手术治疗方案可明显提高布-加综合征患者的生存率。