ObjectiveTo study the function of selectin in the pathogenesis and advancement of acute pancreatitis(AP), so as to guide further investigation and clinical treatment. MethodsCorrelative articles in recent years were reviewed. ResultsSelectins act as an indicator of the activation of endothelium. Their expression changes markedly during AP and is closely related to cytokines, oxygen free radicals and complements. Conclusion Selectin is a component which is engaged in the pathology of AP, the level of selectin is useful in guiding clinical observation and treatment.
To evaluate the effects of different pressure and duration of autologous bile perfusion into dog’s pancreatic duct on the severity of induced acute pancreatitis. Thirty mongrel dogs were divided into five groups, with each group consisting of six dogs. Histological changes of pancreas were observed. Results: Histological changes of pancreas were correlated with the pressure and duration of autologous bile perfusion into pancreatic duct. It was easier to produce acute hemorrhagic necrotizing pancreatitis in the groups with a higher pressure and a longer duration of perfusion than in the groups with a lower pressure and a shorter duration. The results indicated that there was a significant effect of higher pressure and longer duration bile perfusion into pancreatic duct on the severity of induced acute pancreatitis.
ObjectiveTo evaluate the effect of polymorphonuclear neutrophils (PMN) on liver damage in acute pancreatitis. MethodsSeventytwo wistar rats were randomly divided into acute pancreatitis (AP) group, acute pancreatitis with PMN depleted (APD) group and sham operation (SO) group. Liver damage was assessed by histological changes and the level of alanine aminotransferase (ALT) in serum. The number of PMN infiltration in liver was reflected by myeloperoxidase (MPO). ResultsMPO significantly increased from 6 to 24 hours in AP and APD groups. However, the level of MPO was significantly higher in AP group than that in APD group. ALT significantly increased from 3 to 24 hours in these two groups, but the level of ALT was significantly lower in APD group than that in AP group. Meanwhile, the hepatic pathological changes were more severe in AP group than that in APD group. ConclusionPMN play an important role in liver damage during acute pancreatitis.
Objective To investigate therapeutic effects of continous regional arterial infusion with verapamil on preventing the progression of acute pancreatitis. Methods Forty-five patients with mild acute pancreatitis were randomly divided into three groups: conventional treatment group, intravenous treatment group and arterial infusion group. After admission, conventional treatments were performed in conventional treatment group. Reasonable fluid and verapamil were intravenously injected to the patients in intravenous treatment group, and fluid treatments and continous regional arterial infusion with verapamil were performed in arterial infusion group for 1－2 weeks. The levels of serum TNF-α, IL-1β, ICAM-1 and P-selectin were determined on the 1st, 4th and 7th day after treatment, respectively. Results On the 4th and 7th day after treatment, the levels of serum TNF-α and P-selectin significantly decreased in arterial infusion group compared with the other two groups （P＜0.05）, while the level of serum IL-1β significantly decreased in arterial infusion group and intravenous treatment group compared with the conventional treatment group （P＜0.05）. The level of serum ICAM-1 significantly decreased in arterial infusion group compared with the conventional treatment group （P＜0.05）.Conclusion Continous regional arterial infusion with verapamil could reduce the production of inflammatory cytokines and inhibit the up-regulation of adhesion molecules ICAM-1 and P-selectin, and prevent the progression of acute pancreatitis ultimately.
【Abstract】Objective To summarize the effects of vasoactive mediators on local microvasculature in acute pancreatitis（AP）. Methods Literatures concerning metabolism, receptors, action mechanisms of vasoactive mediators and their effects in AP were reviewed. Results Bradykinin, endothelin, platelet activating factor and nitric oxide were important mediators in the development of microcirculatory disturbance in AP, however the results of experiments were inconsistent. Conclusion The roles which vasoactive mediators play in microcirculatory disturbance of AP are affected by many factors, and await further study.
Objective To investigate the change of the platelet parameter and to study the therapeutic effects of ulinastatin (UTI) on platelet parameter in patients with acute pancreatitis (AP). Methods The data of 80 patients with AP were analyzed retrospectively. All patients were divided into two groups: mild acute pancreatitis (MAP, n=43) and severe acute pancreatitis (SAP, n=37). Thirty people who took the medical examination and whose results were normal were included as control group. The autocytometer was used to test PLT, PCT, MPV and PDW in different periods of SAP. Results On admission, there were no significant differences of PLT, PCT between MAP group and control group (Pgt;0.05), but MPV and PDW in MAP group were higher than those of control group (plt;0.05). Compared with MAP group, PLT and PCT decreased markedly in SAP group (plt;0.01), while MPV and PDW significantly increased (plt;0.05). After 1-week treatment of UTI, PLT and PCT in MAP group didn’t change dramatically, while MPV and PDW decreased significantly (plt;0.05). While in SAP group, PLT and PCT increased significantly (plt;0.05, plt;0.01), and MPV and PDW decreased significantly (plt;0.01, plt;0.05). Compared with conventional treatment， PLT and PCT in MAP group increased significantly in UTI treatment group （plt;0.05）, but there was no statistical difference in terms of MPV and PDW （Pgt;0.05）. However, SAP group showed significant increase of PLT and PCT （plt;0.01， plt;0.05） and decrease of MPV and PDW in UTI treatment group compared with patients treated by conventional methods （plt;0.01）. Conclusion The platelet parameter changes in patients with acute pancreatitis, and the changes of SAP patients are more mark than those of MAP patients. UTI can significantly increase PLT and PCT, and significantly decrease the activity of the platelet. Therefore, UTI may take a role in the treatment and prevention for SAP.
【Abstract】Objective To study the change of pancreatic microcirculation in the early phase of acute pancreatitis. MethodsLiteratures on acute pancreatitis and microcirculation were collected and reviewed.ResultsPancreatic microcirculation has changed in the early phase of acute pancreatitis, including contraction of interlobular arteriole, slowing of blood fluid, increasing of pancreatic vascular permeability, leukocyte adherence in postcapillary venules, and decreasing of pancreatic perfusion.Conclusion Impairment of pancreatic microcirculation in the early phase of acute pancreatitis may play a key role in the progression of this disease.
ObjectiveTo determine the characters of symptomatic pancreatic pseudocyst due to acute pancreatitis and effects of surgical treatment with two kinds of procedure （internal drainage or external drainage）. MethodsOne hundred and fifteen cases hospitalized during recent ten years were retrospectively analyzed.ResultsWe found that necrotic tissue existed in the pseudocyst in most cases and infection might occur in these pseudocyst. Although effect of two kinds of surgery was similar, the clinical course was different. The complications after surgery were fewer in patients underwent internal drainage than that with procedure of external drainage, and average hospital day was 7d in cases with internal drainage and 11d in cases with external one respectively. Surgery of internal drainage used in treatment was not only successful in noninfectious and single pseudocyst, but in infectious or multiple seudocyst.ConclusionInternal drainage should be used in most cases and considered as the first selection in surgery of pseudocyst due to acute pancreatitis.
Objective To identify the therapeutic targets and molecular mechanisms of Da Chaihu Decoction in the treatment of acute pancreatitis (AP) based on network pharmacology and molecular docking. Methods From March to May 2024, the active compounds and targets of Da Chaihu Decoction were retrieved from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, and the targets related to AP were obtained from the GeneCards database. The intersection of these yielded the common targets of Da Chaihu Decoction for AP treatment. The STRING platform was used to construct a protein-protein interaction network, and Cytoscape 3.9.1 software was employed for network topology analysis to identify core targets and compounds. The Metascape platform was applied for gene ontology functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, with bubble charts generated using Python 3.8 software. Molecular docking was conducted using AutoDock 1.5.6 software to predict binding affinities between core compounds and targets. Results A total of 84 common targets of Da Chaihu Decoction for AP treatment were identified. The core compounds included quercetin, β-sitosterol, kaempferol, luteolin, and baicalein. The key proteins included AKT1, B-cell leukemia/lymphoma 2 (BCL2), Jun proto-oncogene (JUN), interleukin 1 Beta (IL1B), and nuclear factor kappa B subunit 1 (NFKB1), all of which were enriched in pathways such as lipid and atherosclerosis, PI3K-Akt signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, tumor necrosis factor (TNF) signaling pathway, and apoptosis. The binding energies of some core compounds with key proteins were below –5.0 kJ/mol. Conclusion Da Chaihu Decoction may exert anti-inflammatory and anti-apoptotic effects in AP by modulating key protein targets, including AKT1, BCL2, JUN, IL1B, and NFKB1, within pathways such as lipid and atherosclerosis, PI3K-Akt signaling, MAPK signaling, TNF signaling, and apoptosis.
Objective To summarize the change in the cytokine network, the classification of various cytokines, interaction, and systemic impact on patients with acute pancreatitis (AP). Methods The recently published literatures in domestic and abroad about advancement of cytokines in AP were reviewed. Results Cytokines had a complex network and interactions. There were a variety of regulatory mechanisms. The tumor necrosis factor-α (TNF-α) and interleukin cytokines played important roles in the progress of AP. Conclusions Change of cytokines during AP is a complex process. Any separate regulation for the release of sigle factor has no significant effect on the disease. The treatment according to immune balance should be a better direction.