Objective To investigate the therapeutic effects of glucocorticoids(GC)on brain damage in rats with severe acute pancreatitis(SAP).Methods Thirty two rats were randomized into the normal control group(Group A),acute pancreatitis group(Group B),common carotid therapeutic group(Group C)and lateral ventricle therapeutic group(Group D).The rats in group C and D were respectively given methylprednisolone through common carotid artery and lateral ventricle. All rats were killed 24r h later to determine the weight of water content in the brain.The pancreatic and brain tissues were stained with HE.Meanwhile,the brain samples were immunohistochemically stained and the medulla sheath specially stained to determine TNF-α and IL-2.Histopathological scoring of pancreas and counting of leukocytes in the brain were conducted.Results Group A had no obvious pathologic changes.Group C and D had fewer TNF-α positive cells in the brain than Group B.IL-2 was negative in each group.Brain edema,leukocyte number and demylination of myelinated nerves in Group C and D were significantly different from those in Group B(P＜0.05).Conclusion Demylination of myelinated nerves is the characteristic change in SAP.Brain edema,leukocyte infiltration and nerve cell degeneration would happen as well.TNF-α plays an important role in the development of SAP.GC has effects on prevention and therapy of brain damage in rats with SAP.

Objective:To observe the effects of preemptive analgesia with parecoxib sodium on differentiation of peripheral T helper cells(Th) in patients with radical mastectomy .Methods :A toal of 50 patients with radical mastectomy were randomly di-vided into parecoxib group(Group P) and the control group(Group C) .Parecoxib sodium(40 mg ,diluted with normal saline into 5 mL ,the same below ) was intravenously injected 1 h before operation in Group P ,and 12 h after the first injection .The same dose of normal saline was intravenously injected in Group C at the same time-point .Patient-controlled intravenous analgesia (PCIA) with fentanyl had implemented in two groups after operation .The levels of interferon-γ(IFN-γ) ,interleukin-4(IL-4) in Th1 and Th2 were measured by flow cytometry before anesthesia(T0) ,2 h(T1) ,12 h(T2) ,24 h(T3) ,48 h(T4)after operation in the two groups .Th1 cell was marked by CD3+ CD8- IFN-γ+ .Th2 cell was marked by CD3+ CD8- IL-4+ .Th1/Th2 was calculated by the level of IFN-γ+ /IL-4+ .The visual analogue scale (VAS) ,Bruggemann comfort scale(BCS) ,dosage of fenta-nyl at each time-point in two groups were compared .Results:VAS scores in group P were significantly lower than those in Group C at T2 ,T3 ,T4 .BCS scores at T1 ,T2 ,T3 in group P were significantly higher than those in Group C .The dosages of fentany at T2 ,T3 in Group P were significantly lower than those in Group C .Compared with T0 ,Th1/Th2 ratios in the two groups at T2 ,T3 ,T4 were lower(P<0 .05) .Th1/Th2 in Group P was higher than those in Group C at T2 ,T3 ,T4(P<0 .05) . Conclusions :Th1/Th2 in patients decreases after radical mastectomy .Preemptive analgesia with parecoxib sodium assisted with fentanyl PCIA can inhibit the shift of the balance of Th1/Th2 towards Th2 type .