Objective To explore the therapeutic effects of peroxisome proliferator activating receptor γagonist-rosiglitazone on HMGB1 expression in liver tissue of rats with SAP. Method A hundred and twenty Wistar rats were randomly (random number) divided into the sham operation group(SO group, n = 20) ,SAP group ( n=80) and ROSI treatment group (n =20). SAP group were randomly further divided into the 3 h, 6h, 12 h and 24h subgroups with 20 rats in each group. SAP model was made by retrograde injection of 5 % sodium deoxycholate into the biliopancreatic duct. The serum amylase, AST and ALT, and pathological scores of pancreas and liver tissue were observed. The expression of NF-κB mRNA and the level of HMGB1 protein were investigated respectively by Reverse transcription polymerase chain reaction (RT-PCR) and Westem blot method, respectively. SPSS 16.0software was used to make one-way ANOVA, q -test and correlation analysis. Results Serum amylase, AST and ALT, and pathological scores of pancreas and liver tissue, and the level of HMGB1 protein were markedly increased in each subgroup of SAP compared with SO group ( P ＜ 0.01). The level of HMGB1 protein was positively correlated with the changes of AST, ALT and pathological scores of pancreas and liver tissue. Correlation was not found between HMGB1 and amylase. Treatment with ROSI could significantly reduce the expression of NF-κB mR-NA and the levels of HMGB1 protein, serum AMY, AST and ALT, and pathological scores of pancreas and liver tissue in comparison with 24 h subgroup of SAP (P ＜0.01). Conclusions As a late-acting mediator of inflammation, HMGB1 was involved in the pathophysiological process of SAP-related liver injury. ROSI can reduce the liver injury by inhibition of the expression of the HMGB1.

Objective To assess the long-term health-related quality of life and emotional health in patients with severe acute pancreatitis (SAP) after combined therapy. Methods The hospital records of 61 patients with SAP treated in our hospital from June 2005 to August 2008 were reviewed. The Rand 36-item Health Survey with accessory question and SAS were mailed to each patient to analyze quality of life and emotional health. Results The means and deviations for each of eight acales (RP, VT, RE, MH, SF, PF, GH, BP) scorea of SF-36 in SAP patients were 66. 5±12. 3, 69. 3± 13.8, 76. 8±10. 5, 69. 4±11.0, 70. 9±10. 5, 83. 7±7.1, 82. 0±9. 5, 75. 5±12. 7. Compared with general people, SAP patient's long-term HRQOL total scores were good except that RP, MH and SF were lower than those of general population (P<0. 05). Multivariate backward regression analysis showed that the cause of suffering, outcome of complication, recall the experience in hospital were the most effectively ones (P<0. 05). Conclusions The total scores of SAP patient's long-term HRQOL after combined therapy are good as compared with general population. The cause of suffering, outcome of complication, recalling the experience in hospital have an effect on anxiety.

Objective To observe the dose-response relationship of the GSK-3β inhibitor TDZD-8 in severe acute pancreatitis (SAP) associated kidney injury in rats. In order to identify the most effective class of GSK-3β inhibitor and its effective and reasonable safe dose in SAP associated kidney injury model in rats by comparing three kinds of frequently-used GSK-3β inhibitor TDZD-8, lithium chloride (LiCL), SB216763 in this model. Methods Totally 96 SPF male Wistar rats were randomly(random number) divided into 8 groups (n=12): sham operation group (SO group), severe acute pancreatitis group (SAP group), TDZD-8 pretreatment groups (TD group, marked TD1, TD2, TD3 and TD4 group, respectively) at different dosage (0.25, 0.5, 1.0 and 2.0 mg/kg), LiCL pretreatment groups (L group, 40 mg/kg), and SB216763 pretreatment group (SB group, 1 mg/kg). SAP model was induced by retrograde infusion of 5％ sodium taurocholate into the biliopancreatic duct. Rats in each group were sacrificed at 12 h after operation. Then the mortality, quantity of ascites, serum AMY, Cr, BUN and ALT were recorded, and the pathological changes of pancreatic tissues and kidney tissues were observed. Results Compared with the SO group, the levels of ascites, serum AMY, Cr, BUN, ALT and pancreatic and renal pathologic score in the SAP group were all significantly increased (P<0.05). Compared with the TD1 group, quantity of ascites, serum AMY, Cr, BUN,ALT and pancreatic tissue pathological grading were reduced in different degrees in the TD2, TD3 and TD4 groups with statistically significant difference (P<0.05); ALT values were reduce in different degrees in the TD2 and TD3 groups as compared with the SAP group (P<0.05), while ALT value in the TD4 group was similar to that in the SAP group; compared with the TD2 group, all the indexes in the TD3 group were significant better (P<0.05); Compared with TD3 group (the best group in TD group), the levels of ascites and serum ALT in the L group and SB group had no significant difference (P>0.05), but the levels of AMY, Cr, BUN, ALT, pancreatic and renal pathologic score were significantly reduced in the TD3 group than those in the L and SB groups (P<0.05); compared with the SB group, the values of Cr, BUN, pancreatic and renal pathologic score in the L group were lower (P<0.05). GSK-3βprotein expression in all groups showed no obvious difference (P>0.05), while p-GSK-3β ser9 protein expression in the SAP group was lower than that in the SO group (P<0.05), and p-GSK-3β ser9 protein expression in the TD3, L and SB groups were stronger than that in the SAP group. Among them, p-GSK-3βser9 protein expression was highest in the TD3 group, followed by the L group, finally the SB group, and the differences were statistically significant (P<0.05). Conclusions Among the three different GSK-3βinhibitors, TDZD-8 is the most effective GSK-3β inhibitor for SAP associated with kidney injury in rats. The GSK-3β inhibitor TDZD-81 mg/kg administered intravenously is safe, effective and optimal dosage for attenuating the severity of severe acute pancreatitis associated with kidney injury.

Objective:To establish and evaluate a predictive model for recurrence risk of Graves′ disease after antithyroid drugs(ATD) withdrawal.Methods:Among 308 patients with newly onset Graves′ disease taking ATD from 2012 to 2019, 170 patients who completed follow-up were enrolled and divided into relapse and remission groups according to whether hyperthyroidism reoccurred within 2 years after ATD withdrawal to establish the discovery cohort. An internal validation cohort was constructed by repeating the sampling with bootstrap. Cox regression analysis was used to screen risk factors and establish a predictive model, named Graves′ Recurrence Evaluation System(GRES). The differentiation and accuracy of GRES model were evaluated and compared with the GREAT score.Results:Of 170 patients, 90 Graves′ disease cases relapsed within 2 years after ATD withdrawal. According to Cox regression analysis, family history of Graves′ disease, younger age(<30 years), grade Ⅱ-Ⅲ goiter, high level of TRAb(≥13 IU/L), large thyroid volume(≥26.4 cm 3) and low 25(OH) D(<14.7 ng/mL) were included in the predictive model: PI=0.672×family history+ 0.405×age+ 0.491×severity of goiter+ 0.808×TRAb+ 1.423×thyroid volume+ 0.579×25(OH) D. PI≥1.449 was associated with a higher risk of recurrence after drug withdrawal. The GRES model has good prediction in assessing Graves′ disease relapse within 2 years after ATD withdrawal and better than GREAT score. Conclusion:GRES model can be used to evaluate the recurrence risk within 2 years for patients with newly onset Graves′ disease after ATD withdrawal, and facilitate clinicians to reasonably select treatment modalities in order to improve the remission rate.