Objective:To explore the relationship between visceral adipose tissue (VAT) and the severity and prognosis of obese patients with acute pancreatitis (AP).Methods:The clinical data of 224 obese patients with AP admitted to The Third Affiliated Hospital of Chongqing Medical University and Chongqing Dongnan Hospital from January 2020 to December 2023 were collected, retrospectively. According to the severity of AP, they were divided into mild AP group (MAP group), moderately severe AP group (MSAP group), and severe AP group (SAP group). According to the in-hospital treatment outcomes of the patients, they were divided into the survival group and death group (death within 7-30 days after admission). The basic information of AP patients, the severity score of AP and laboratory indicators were collected. The visceral adiposity index (VAI) was calculated through the values of waist circumference, body mass index, triglycerides and high-density lipoprotein cholesterol; and the VAT area was measured by CT scan. The Spearman rank correlation analysis method was used to evaluate the correlation between the VAT area and the AP severity index as well as other indicators. Multivariate logistic regression analysis was used to analyze the influencing factors of in-hospital mortality in obese patients with AP. The receiver operating characteristic curve (ROC) was drawn, and the area under curve (AUC), cut-off value, sensitivity and specificity were calculated to evaluate the predictive value of VAT area for SAP, as well as the predictive value of VAT area for in-hospital mortality in obese AP patients.Results:The VAI of MAP group, MSAP group and SAP group were 1.63(1.21, 2.74), 2.30(1.28, 3.36) and 3.01(2.17, 3.86), respectively, and the VAT area were 138.90(121.30, 155.10)cm 2, 149.90(135.10, 166.70)cm 2 and 192.30(168.80, 223.80)cm 2, respectively. There were significant differences in VAI and VAT area among the three groups (all P values <0.05). Compared with MAP group, the area of VAI and VAT area in MSAP group and SAP group were significantly increased ( P<0.05), and the area of VAT in SAP group was further increased than that in MSAP group, the differences were statistically significant (all P values <0.05). Spearman analysis showed that the VAT area was significantly positively correlated with acute physiology and chronic health evaluationⅡ scoring system (APACHEⅡ) score, modified CT severity index (MCTSI), and Balthazar CT grading score (all P values <0.05). It was also significantly positively correlated with body mass index, serum glycated hemoglobin, triglycerides, low-density lipoprotein cholesterol and VAI (all P values <0.05). ROC analysis showed that the AUC value of VAI in identifying SAP was 0.641 (95% CI 0.562-0.720), the corresponding cut-off value was 2.75, the sensitivity was 57.6%, and the specificity was 69.0%; The AUC value of VAT area in identifying SAP was 0.869 (95% CI 0.813-0.924), the corresponding cut-off value was 165.85 cm 2, the sensitivity was 78.8%, and the specificity was 84.8%, and the predictive value of VAT area was significantly better than that of VAI ( P<0.001). The APACHEⅡ, MCTSI, Balthazar CT grading score, VAI and VAT area in the death group were significantly higher than those in the survival group, and the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that VAT area was an independent predictor of in-hospital mortality in obese AP patients ( P<0.05), with an AUC value of 0.831 (95% CI 0.756-0.907), a cutoff value of 173.70 cm 2, a sensitivity of 77.8%, and a specificity of 85.5%. Conclusions:The VAT area is significantly associated with the aggravation of AP and the increased risk of in-hospital mortality in obese patients, and is expected to serve as a reliable indicator for predicting the severity and prognosis of obese patients with AP.

Objective:To explore the relationship between visceral adipose tissue (VAT) and the severity and prognosis of obese patients with acute pancreatitis (AP).Methods:The clinical data of 224 obese patients with AP admitted to The Third Affiliated Hospital of Chongqing Medical University and Chongqing Dongnan Hospital from January 2020 to December 2023 were collected, retrospectively. According to the severity of AP, they were divided into mild AP group (MAP group), moderately severe AP group (MSAP group), and severe AP group (SAP group). According to the in-hospital treatment outcomes of the patients, they were divided into the survival group and death group (death within 7-30 days after admission). The basic information of AP patients, the severity score of AP and laboratory indicators were collected. The visceral adiposity index (VAI) was calculated through the values of waist circumference, body mass index, triglycerides and high-density lipoprotein cholesterol; and the VAT area was measured by CT scan. The Spearman rank correlation analysis method was used to evaluate the correlation between the VAT area and the AP severity index as well as other indicators. Multivariate logistic regression analysis was used to analyze the influencing factors of in-hospital mortality in obese patients with AP. The receiver operating characteristic curve (ROC) was drawn, and the area under curve (AUC), cut-off value, sensitivity and specificity were calculated to evaluate the predictive value of VAT area for SAP, as well as the predictive value of VAT area for in-hospital mortality in obese AP patients.Results:The VAI of MAP group, MSAP group and SAP group were 1.63(1.21, 2.74), 2.30(1.28, 3.36) and 3.01(2.17, 3.86), respectively, and the VAT area were 138.90(121.30, 155.10)cm 2, 149.90(135.10, 166.70)cm 2 and 192.30(168.80, 223.80)cm 2, respectively. There were significant differences in VAI and VAT area among the three groups (all P values <0.05). Compared with MAP group, the area of VAI and VAT area in MSAP group and SAP group were significantly increased ( P<0.05), and the area of VAT in SAP group was further increased than that in MSAP group, the differences were statistically significant (all P values <0.05). Spearman analysis showed that the VAT area was significantly positively correlated with acute physiology and chronic health evaluationⅡ scoring system (APACHEⅡ) score, modified CT severity index (MCTSI), and Balthazar CT grading score (all P values <0.05). It was also significantly positively correlated with body mass index, serum glycated hemoglobin, triglycerides, low-density lipoprotein cholesterol and VAI (all P values <0.05). ROC analysis showed that the AUC value of VAI in identifying SAP was 0.641 (95% CI 0.562-0.720), the corresponding cut-off value was 2.75, the sensitivity was 57.6%, and the specificity was 69.0%; The AUC value of VAT area in identifying SAP was 0.869 (95% CI 0.813-0.924), the corresponding cut-off value was 165.85 cm 2, the sensitivity was 78.8%, and the specificity was 84.8%, and the predictive value of VAT area was significantly better than that of VAI ( P<0.001). The APACHEⅡ, MCTSI, Balthazar CT grading score, VAI and VAT area in the death group were significantly higher than those in the survival group, and the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that VAT area was an independent predictor of in-hospital mortality in obese AP patients ( P<0.05), with an AUC value of 0.831 (95% CI 0.756-0.907), a cutoff value of 173.70 cm 2, a sensitivity of 77.8%, and a specificity of 85.5%. Conclusions:The VAT area is significantly associated with the aggravation of AP and the increased risk of in-hospital mortality in obese patients, and is expected to serve as a reliable indicator for predicting the severity and prognosis of obese patients with AP.

Objective To investigate the effects of epidermal growth factor receptor(EGFR)interference on activation of astrocytes after intra-cerebral hemorrhage and its mechanism.Methods Rat model of intra-cerebral hemorrhage was induced by injection of Ⅶ collagenase.Sham operation group was set as control.After 7 d,the neurological function score was used to judge whether the model was successful or not.The expression of EGFR and GFAP in brain tissue of rats in intra-cerebral hemorrhage group and sham operation group were detected by SP immunohistochemical method.Astrocytes were isolated from newborn rats' cerebral cortex and cultured in vivo.Effects of EGFR interference on activation of astrocytes were observed.The experimental rats were divided into 4 groups: ① control group was not handled.② CNTF group was added with 20 μg/L CNTF.③ Negative group was added with 20 μg/L CNTF,and EGFR siRNA negative control was transfected.④ EGFR group was added with 20 μg/L CNTF,and EGFR siRNA was transfected.The expressions of EGFR,GFAP,p-JAK1,p-STAT3 were detected by real-time PCR and Western blot.Results The modeling success rate was 89.5％(17/19).The expressions of EGFR and GFAP in brain tissue of rats with intra-cerebral hemorrhage were significantly higher than those in sham operation group(P<0.05).The relative expressions of EGFR mRNA and protein in EGFR group were significantly lower than those in control group,CNTF group and negative group(P<0.05).The relative expressions of GFAP mRNA and protein in the CNTF group and the negative group were significantly higher than those in the controlgroup and the EGFR group(P<0.05),but there was no significant difference between the control group and the EGFR group(P>0.05).The relative expressions of p-JAK1 and p-STAT3 protein in the CNTF group and the negative group were significantly higher than those in the control group and the EGFR group(P<0.05),but there was no significant difference between the control group and the EGFR group(P>0.05).Conclusion The expressions of EGFR and GFAP significantly increase in the rats with intra-cerebral hemorrhage.Interference of EGFR expression can inhibit the activation of astrocytes in rats,which may be related with the inhibition of JAK1 and STAT3 phosphorylation.

Objective To investigate the effects of epidermal growth factor receptor(EGFR)interference on activation of astrocytes after intra-cerebral hemorrhage and its mechanism.Methods Rat model of intra-cerebral hemorrhage was induced by injection of Ⅶ collagenase.Sham operation group was set as control.After 7 d,the neurological function score was used to judge whether the model was successful or not.The expression of EGFR and GFAP in brain tissue of rats in intra-cerebral hemorrhage group and sham operation group were detected by SP immunohistochemical method.Astrocytes were isolated from newborn rats' cerebral cortex and cultured in vivo.Effects of EGFR interference on activation of astrocytes were observed.The experimental rats were divided into 4 groups: ① control group was not handled.② CNTF group was added with 20 μg/L CNTF.③ Negative group was added with 20 μg/L CNTF,and EGFR siRNA negative control was transfected.④ EGFR group was added with 20 μg/L CNTF,and EGFR siRNA was transfected.The expressions of EGFR,GFAP,p-JAK1,p-STAT3 were detected by real-time PCR and Western blot.Results The modeling success rate was 89.5％(17/19).The expressions of EGFR and GFAP in brain tissue of rats with intra-cerebral hemorrhage were significantly higher than those in sham operation group(P<0.05).The relative expressions of EGFR mRNA and protein in EGFR group were significantly lower than those in control group,CNTF group and negative group(P<0.05).The relative expressions of GFAP mRNA and protein in the CNTF group and the negative group were significantly higher than those in the controlgroup and the EGFR group(P<0.05),but there was no significant difference between the control group and the EGFR group(P>0.05).The relative expressions of p-JAK1 and p-STAT3 protein in the CNTF group and the negative group were significantly higher than those in the control group and the EGFR group(P<0.05),but there was no significant difference between the control group and the EGFR group(P>0.05).Conclusion The expressions of EGFR and GFAP significantly increase in the rats with intra-cerebral hemorrhage.Interference of EGFR expression can inhibit the activation of astrocytes in rats,which may be related with the inhibition of JAK1 and STAT3 phosphorylation.