Objective To evaluate the dynamic changes in CD4 + CD25 high regulatory T cells (Treg), Foxp3, IL-10, IFN-γand IL-4, in peripheral blood of severe acute pancreatitis(SAP) patients and the clinical significance. Methods From August 2008 to June 2009, 42 hospitalized SAP cases were divided by stage according to the course of disease: phase Ⅰ (the period of SIRS) ;phase Ⅱ (the period in which SIRS ends); phase Ⅲ ( the period during which complication related infection developes). Results were compared with those of hospitalized 38 mild acute pancreatitis(MAP) cases during the same period.Treg and Foxp3 were measured by flow cytometry, the levels of IFN-γ、IL-4 and IL-10 were detected by enzyme-linked immunosorbent assay( ELISA), and the relationships between these indicators were analyzed using Pearson correlation analysis test. Results The percentages of Treg and levels of IL-4 increased in phase Ⅰ SAP(Treg: 1.37% ± 1.12% ;IL-4:22.92 ±4. 17) ,soared in phase Ⅱ (Treg:3.12% ± 1.21%;IL-4:35.42 ± 12. 50) ,culminated in phase Ⅲ( Treg:4. 47% ± 1.04%; IL-4:76. 04 ± 14. 58 ); IFN-γ level was the highest in phase Ⅰ SAP(978.57 ±213.29), decreased in phase Ⅱ (571.43 ± 157. 14) ,and the lowest in phase Ⅲ ( 357. 14 ± 150.00 ); The differences were statistically significant between the three periods(P＜0.05). All that in these three periods were higher than that in MAP controls(P ＜0.05).Pearson correlation analysis test showed that quantities of Treg were negatively proportional to the levels of IFN-γ( r = - 0.895, P ＜ 0.01 ), and positively proportional to the levels of IL-4 ( r = 0.813, P ＜ 0.01 ).Conclusions By suppressing IFN-γand promoting IL-4 ,Treg may protect patients against damage resulting from excessive inflammatory response.

Objective To investigate the relations between microRNA-451 (miR-451) expression and gastric cancer (GC).Methods Expression of miR-451 in tumor and paired non-cancerous tissues was measured by real-time quantitative polymerase chain reaction.The association of miR-451 expression with clinical pathological characteristics and prognosis was statistically analyzed;in addition,slow virus LV-mir-451 was applied to infect human gastric cancer cell line BGC-823 and MKN-45,and construct miR-451 over-expressed stable cell lines.Finally,to detect cell proliferation,migration and invasion.Results miR-451 expression decreased in GC tissues vs.pericarcinous tissues (0.010 ± 0.007 vs.0.014 ± 0.008,t =3.015,P ＜ 0.05),and its down-regulation positively correlated with lymphatic metastasis,clinical staging and shorter overall survival.miR-451 expression in BGC-823 and MKN-45 cells did not impact on cell proliferation,but did reduce migration rates (0.863 ±0.026 vs.1.107 ±0.032,t =9.820,P＜0.05;0.863 ±0.026 vs.1.060±0.054,t =4.369,P＜0.05) and invasion rates (1.040 ± 0.055 vs.1.522 ± 0.001,t =5.84,P ＜ 0.05;1.040 ± 0.055 vs.1.696 ± 0.078,t =10.16,P ＜ 0.05) in BGC-823 cells.Conclusions miR-451 may act as a prognostic marker in GC.

Objective To evaluate the prevention and treatment of massive bleeding complicated by severe acute pancreatitis(SAP).Methods From 1999 to 2008,massive intraabdominal bleeding was encountered in 65 cases out of 790 SAP patients admitted in pancreas surgery center,Union Hospital.Results From 1999.1 to 2003.12.44 out of 387 SAP cases(11.37%)suffered from massive bleeding,among them there were 12 cases of gastrointestinal bleeding and 32 cases of intra-abdominal bleeding.19 cases died of hemorrhage(4.91%);From 2004.1 to 2008.12,severe hemorrhage occurred in 21 out of 403 SAP cases(5.21%),including 8 cases of gastrointestinal bleeding,and 13 cases of intra-abdominal bleeding.5 cases(1.24%)died.The difference of bleeding related morbidity and mortality was statistically significant between these two periods(P<0.01).Conclusions Early and timely enteral nutrition and immunotherapy,effective peritoneal drainage,and appropriate surgical laparotomy were effective measures to decrease the risk of massive bleeding related morbidity and mortality in SAP cases.