Autoimmune pancreatitis (AIP),a special type of chronic pancreatitis,is autoimmune-mediated and can be accompanied by swelling of the pancreas and irregular stenosis of the pancreatic duct. The main pathological features are fibrosis of pancreatic duct with IgG4-positive lymphoplasmacytic infiltration. Different typing methods of AIP can have differerent disease conditions. This paper reviews the history,clinical presentation,diagnostic criteria,and treatment of different AIP types to provide a new basis for the diagnosis and treatment.
Autoimmune Diseases ; diagnosis ; therapy ; Fibrosis ; Humans ; Immunoglobulin G ; blood ; Pancreas ; physiopathology ; Pancreatitis ; diagnosis ; therapy

OBJECTIVETo explore the role and mechanism of oxidative inflammatory cascade in pancreatic fibrosis progression of chronic pancreatitis (CP) in mice induced by dibutyltin dichloride (DBTC) plus ethanol.

METHODSThirty-six KM mice were randomly divided into 2 groups (n = 18): control group and model group (DBTC combined with ethanol). The mice in model group were intravenously injected with DBTC (8 mg/kg) in tail vein and drink 10% ethanol. After modeling 2 weeks, 4 weeks and 8 weeks, the mice were anesthetized and sacrificed, the pathological changes and the degree of fibrosis in the pancreas were observed by HE and Masson staining, the F4/80 expression level were detected by immunohistochemistry, the content of superoxide dismutase (SOD), malondialdehyde(MDA) and myeloperoxidase (MPO) were measured in the pancreatic homogenates.

RESULTSThe fibroblasts and macrophages (f4/80 positive staining) could be seen obviously in pancreas of model group at 2 weeks. At 4 weeks and 8 weeks, macrophages infiltration increased and pancreatic tissue was substituted by the proliferation of fibrosis significantly. At every time-point, in pancreatic homogenates SOD was decreased, MDA and MPO markedly increased. There was significant differences between two groups (P < 0.05).

CONCLUSIONDBTC injection joint ethanol drinking can successfully establish the model of chronic pancreatitis and pancreatic fibrosis in mice. Oxidative inflammatory cascade plays an important role in the progression of pancreatic fibrosis.

Animals ; Disease Progression ; Ethanol ; adverse effects ; Fibrosis ; Immunohistochemistry ; Malondialdehyde ; metabolism ; Mice ; Organotin Compounds ; adverse effects ; Oxidative Stress ; Pancreas ; pathology ; Pancreatitis, Chronic ; chemically induced ; physiopathology ; Peroxidase ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the effect of hyperglycemia induced by different doses of strepzotozocin (STZ) on the liver, kidneys and eyes in rats.

METHODSFifty SD rats were divided equally into 5 groups to receive intraperitoneal injections with a single dose of STZ (40, 50, or 60 mg/kg), 3 doses of 25 mg/kg STZ (given at the interval of 24 h), or no treatment (blank control). The dynamic change of blood glucose was observed within 72 h after the first injection. Blood glucose was then monitored every 3 days and the general conditions of the rats were recorded. In the 9th week, fasting blood samples were collected for biochemical analysis and the pancreas, kidney, liver, and eye were examined for pathologies.

RESULTSWithin 72 h after STZ injection, blood glucose first slightly increased and then decreased and again increased to maintain a high level. Death occurred in rats receiving injections with 50 and 60 mg/kg STZ on the third day. In the surviving rats in the 4 STZ-injected groups, the success rate of modeling was 70%, 89%, 100%, and 100%, respectively. Blood glucose showed an inverse correlation with the body weight of the rats. Cataract was observed in the 10th week in rats injected with 40 mg/kg STZ and in the 8th week in the other groups. In the 9th week, the rats receiving 40 mg/kg STZ showed normal insulin, C-peptide, urea, UA, Cr, ALT, AST, TP, and ALB levels, but the rats in the other groups all showed variations in these biochemical indices, which corresponded to the pathological findings in the pancreas, kidneys, and liver.

CONCLUSIONSThree STZ doses of 25 mg/kg is optimal and efficient for inducing diabetes in rats with stable hyperglycemia. Both fasting and random blood glucose tests contribute to the evaluation of the complications of diabetes. The eyes are the most sensitive to hyperglycemia, followed by the kidneys and then by the liver.

Animals ; Blood Glucose ; Body Weight ; Diabetes Mellitus, Experimental ; physiopathology ; Eye ; physiopathology ; Hyperglycemia ; physiopathology ; Kidney ; physiopathology ; Liver ; physiopathology ; Pancreas ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Streptozocin

In this study, the rat type 2 diabetes mellitus (T2DM) model was established through tail vein injection with low dose of streptozotocin (STZ) and high fat diet for 8 weeks, and then treated with Jiaotai Pill. The oral glucose tolerance test (OGTT), fasting serum insulin (FINS), free fatty acid(FFA) levels and blood lipid were assayed. HOMA-IR was calculated. Pancreatic pathology was performed. And pancreatic triglyceride (TG) content was examined by the lipid extraction method. Pancreatic islet cell apoptosis were detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL). According to the results, the model group showed abnormal OGTT, increased FINS, HOMA-IR, FFA, lipid disorder, obvious fat accumulation and significantly increased TG content in pancreatic tissues, and enhanced pancreatic islet cell apoptosis. Compared with the model group, the Jiaotai Pill group displayed improved OGTT, reduced FINS, HOMA-IR, FFA, recovered lipid disorder, decreased fat accumulation and significantly declined TG content in pancreatic tissues, and lowered pancreatic islet cell apoptosis. In summary, Jiaotai pill could effectively treat type 2 diabetes in rats. Its mechanism may be related to the reduction in pancreatic fat accumulation and islet cell apoptosis.
Animals ; Apoptosis ; drug effects ; Diabetes Mellitus, Type 2 ; drug therapy ; metabolism ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; Fats ; metabolism ; Glucose Tolerance Test ; Humans ; Islets of Langerhans ; cytology ; drug effects ; Male ; Pancreas ; drug effects ; metabolism ; Rats ; Rats, Wistar

BACKGROUND/AIMS: Intra-abdominal hypertension (IAH) is being increasingly reported in patients with severe acute pancreatitis (SAP) with worsened outcomes. The present study was undertaken to evaluate intra-abdominal pressure (IAP) as a marker of severity in the entire spectrum of acute pancreatitis and to ascertain the relationship between IAP and development of complications in patients with SAP. METHODS: IAP was measured via the transvesical route by measurements performed at admission, once after controlling pain and then every 4 hours. Data were collected on the length of the hospital stay, the development of systemic inflammatory response syndrome (SIRS), multiorgan failure, the extent of necrosis, the presence of infection, pleural effusion, and mortality. RESULTS: In total, 40 patients were enrolled and followed up for 30 days. The development of IAH was exclusively associated with SAP with an APACHE II score > or =8 and/or persistent SIRS, identifying all patients who were going to develop abdominal compartment syndrome (ACS). The presence of ACS was associated with a significantly increased extent of pancreatic necrosis, multiple organ failure, and mortality. The mean admission IAP value did not differ significantly from the value obtained after pain control or the maximum IAP measured in the first 5 days. CONCLUSIONS: IAH is reliable marker of severe disease, and patients who manifest organ failure, persistent SIRS, or an Acute Physiology and Chronic health Evaluation II score > or =8 should be offered IAP surveillance. Severe pancreatitis is not a homogenous entity.
APACHE ; Acute Disease ; Adult ; Female ; Humans ; Intra-Abdominal Hypertension/*etiology ; Length of Stay ; Male ; Middle Aged ; Multiple Organ Failure/etiology ; Necrosis/etiology ; Pancreas/*pathology ; Pancreatitis/*complications/mortality/physiopathology ; Pleural Effusion/etiology ; Prospective Studies ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/etiology

OBJECTIVETo investigate the relationship between the type 1 diabetic rats residual islet function and postoperative glycemia of gastric bypass procedure (GBP).

METHODSIntraperitoneal injection of STZ was used to produce type 1 diabetic rat model. According to the level of serum glucose, rats were divided into two groups: group 1 (fasting glucose 16.7-22.0 mmol/L, n=42) and group 2 (fasting glucose>22.0 mmol/L, n=54). Half rats of group 1 and group 2 received GBP, which were OP1 group (n=21) and OP2 group (n=27). The normal control group included 20 Wistar rats. The fasting glycemia and fasting C-peptide (C-P) were tested at postoperative weeks 1, 2, 3, and pancreas pathological slices were examined 3 weeks after surgery under microscope.

RESULTSAfter GBP, the C-P was elevated and the glycemia was well controlled in OP1 group compared with group 1 (P<0.05). But the C-P was not significantly increased and the glycemia control was poor compared with group 2 (P>0.05). Pathological examination revealed that there were partial islets residual in pancrease of group 1, the islets were shown obvious hyperplasia in OP1 group after GBP. There were almost no islets residual in pancrease of group 2, and the islets were shown no obvious hyperplasia in OP2 group after GBP.

CONCLUSIONSResidual islet function determines the glycemia changes of type 1 diabetic rats after gastric bypass.

Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; physiopathology ; surgery ; Female ; Gastric Bypass ; Male ; Pancreas ; physiopathology ; Postoperative Period ; Rats ; Rats, Wistar

OBJECTIVETo get a better understanding of the mechanisms underlying type 1 diabetes mellitus, the differentially expressed pancreatic proteins from multiple low-dose streptozotocin (MLD-SIZ) mouse and normal mouse were analyzed and compared.

METHODS20 male rats were separated into 2 groups (n=10): model mice treated with MLD-STZ and normal mice,differences of pancreatic proteome among in the two groups of mice, were analyzed by two dimensional polyacryamide gel electrophoresis (2DE). Protein quantification was analyzed and the differentially expressed spots were identified using mass spectrometry and MASCOT database searching.

RESULTSCompared with control group, 23 proteins had changed significantly in the model group, 8 proteins expression were up-regulated, 15 proteins expressions down-regulated significantly. Using MALDI-TOF-MS, 15 proteins with significant change were identified by peptide fingerprinting map and the results were searched in MASCOT database. The function analyzed showed that proteins with change were associated with metabolic, anti-oxidant, structural, catalytic enzymes and chaperone, et al.

CONCLUSIONType 1 diabetes is probably exerted via multi-target and multi-path mechanism. The proteins with significant change are newly target for type 1 diabetes early diagnosis and treatment.

Animals ; Diabetes Mellitus, Experimental ; physiopathology ; Diabetes Mellitus, Type 1 ; chemically induced ; metabolism ; physiopathology ; Male ; Mice ; Pancreas ; metabolism ; Proteins ; metabolism ; Proteomics ; methods ; Streptozocin

Meckel diverticulum (MD), a congenital gastrointestinal anomaly, is often involved in pediatrics, but less in the adult population. The patient in this report was a 69-year-old female presented with massive gastrointestinal bleeding causing hemorrhagic shock due to MD containing ectopic pancreatic tissue. A review of the literature revealed that gastrointestinal bleeding from MD containing ectopic pancreatic tissue is rare in adults and difficult to be identified preoperation. MD should be considered as one of the differential diagnosis for lower gastrointestinal bleeding, although scarce in adults, especially when the patient has massive painless bleeding.
Aged ; Choristoma ; diagnosis ; physiopathology ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Humans ; Meckel Diverticulum ; diagnosis ; physiopathology ; Pancreas ; pathology

Adult ; Bone Marrow Transplantation ; Humans ; Male ; Pancreas ; pathology ; Pancreatic Neoplasms ; diagnosis ; secondary ; surgery ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; diagnosis ; physiopathology

OBJECTIVETo explore the mechanism of EA in treatment of acute pancreatitis.

METHODSTwenty-four healthy male Wistar rats were randomly divided into 3 groups, a control group, a model group and an EA group. In the model group, rat acute pancreatitis model was prearpared by intraperitoneal injection of Caerulein, and in the EA group, EA was given at "Zusanli" (ST 36) and "Tianshu" (ST 25) of the model rat. The gastric emptying rate, small intestinal impelling ratio, myeloperoxidase activity in the pancreas tissue, pathological score of the pancreas and serum amylase were detected.

RESULTSCompared with the control group, both the gastric emptying rate and the intestinal impelling ratio significantly decreased in the model group (P<0.05), and they significantly increased in the EA group compared with the model group (P<0.05). Myeloperoxidase activity in the pancreas tissue, pathological score of the pancreas and serum amylase activity significantly decreased in the EA group as compared with the model group (P<0.05).

CONCLUSIONEA can significantly improve the disturbance of gastrointestinal motility induced by acute pancreatitis and relieve pathological damage of pancreas.

Acute Disease ; Amylases ; blood ; Animals ; Electroacupuncture ; Gastrointestinal Motility ; Male ; Pancreas ; pathology ; Pancreatitis ; physiopathology ; therapy ; Peroxidase ; metabolism ; Rats ; Rats, Wistar