OBJECTIVETo discuss the role of alveolar macrophage activation in rats with acute necrotizing pancreatitis (ANP) associated with lung injury.

METHODS30 adult Sprague-Dawley rats were randomly divided into five groups (n = 6): normal control group, one-hour group, three-hour group, six-hour group and twelve-hour group after ANP induction. ANP was induced by intraductal administration of 3% sodium taurocholate, while the normal control received an infusion of physiological saline. Alveolar macrophages were harvested by bronchoalveolar lavage. The protein content of lavage fluids, the myeloperoxidase of lung tissue (MPO), and tumor necrosis factor alpha (TNFalpha) and nitric oxide (NO) secreted by alveolar macrophages were examined. The expression of TNFalpha mRNA and inducible nitric oxide synthase (iNOS) mRNA was measured with reverse transcription-polymerase chain reaction technique. Histology of the lung and pancreas was scored in a blinded fashion.

RESULTSLung injury was gradually aggravated with disease progression. The level of myeloperoxidase of lung tissue and protein content of bronchoalveolar lavage fluids increased progressively and reached the peak at 12 hour [(10.78 +/- 0.58) U/g for MPO and (2 011.0 +/- 105.5) micro g/ml for protein respectively]. TNFalpha and NO secreted by alveolar macrophages were gradually elevated and peaked on the sixth hour, the maximums were (1 624.2 +/- 149.2) pg/ml and (88.8 +/- 6.5) micro mol/L respectively, but decreased on the twelfth hour. The expression of TNFalpha mRNA and iNOS mRNA was similar with the changes of TNFalpha and NO, upregulated after induction of acute necrotizing pancreatitis and reached their peaks on the sixth hour, then downregulated on the twelfth hour. All the parameters of ANP groups compared to control group were statistical significant (P < 0.05). The histology scores demonstrated an increasing damage of the lung. The expression of TNFalpha mRNA and iNOS mRNA is closely related to lung injury (r = 0.67 for TNFalpha mRNA and r = 0.64 for iNOS mRNA respectively, P < 0.01).

CONCLUSIONThe activation of alveolar macrophage may play an important role in lung injury associated with acute necrotizing pancreatitis.

Animals ; Bronchoalveolar Lavage Fluid ; chemistry ; Female ; Lung ; pathology ; Macrophage Activation ; Macrophages, Alveolar ; physiology ; Male ; Nitric Oxide ; Nitric Oxide Synthase ; genetics ; Nitric Oxide Synthase Type II ; Pancreatitis, Acute Necrotizing ; complications ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Respiratory Distress Syndrome, Adult ; etiology ; Tumor Necrosis Factor-alpha ; genetics

Objective: Our purpose was to study the effect of L-arginine (L-Arg) on the kidneys of rats with obstructive jaundice and the underlying mechanism. Methods: Forty male Sprague-Dowley rats, weighting 200 to 230 g, were randomly assigned to four groups (n=10): sham-operation group, control group, L-Arg group, L-NG-nitroarginine methyl (L-NAME) group.Except the sham-operation group,the other groups rendered jaundiced by doubly ligating the common bile duct. Fourteen days later,we administrated L-Arg to L-Arg group,and L-NAME to L-NAME group for 7 days.On the 21st day after bile duct ligation, we measured the amount of nitric oxide (NO), malondrialdehyde (MDA), and superoxide dismutase (SOD) in the kidneys, and assessed the changes of the renal function.We also observed the morphological changes of the kidneys. Results: In the control group,the amount of NO and MDA increased while that of SOD decreased (P<0.01, P<0.01and P<0.01), and the renal function and the nephric tissue were impaired on the 21st day after bile duct ligation compared with the sham-operation group.In the L-Arg group, the amount of NO and SOD increased significantly (P<0.01, P<0.01), whereas that of MDA decreased (P<0.05), and the damage in the nephric tissue and renal function was alleviated,as compared with the control group.On the contrary, the amount of NO in the L-NAME group decreased significantly (P<0.05) compared with the control group.Although there was no significant difference in the levels of SOD, MDA, and the parameters of the renal function between the L-NAME group and control group,those indexes in the L-NAME group tended to be aggravated. Moreover, the damage in the nephric tissue of the L-NAME group was not alleviated. Conclusion: L-arginine may protect the kidney from impairment in rats with obstructive jaundice through L-Arg-NO pathway.

Objective: Our purpose was to study whether exogenous adenosine triphosphate (ATP) could enter liver cell or not. Methods: Using continuous hypothermic machine perfusion model of rat liver, we used autoradiography in this experiment. Results: The light microscope pictures of group A(no ［α-32P］ ATP in the perfusate) showed that there was no specially labeled silver pellet in or out of rat liver cell. But the light microscope pictures of group B (37 MBq ［α- 32P］ATP in the perfusate) showed that distribution of numerous ［α-32P］ATP autoradiographic silver pellets in rat liver cell, and no autoradiographic silver pellet was found in the hepatic sinus and vessel. Conclusion: Exogenous ATP could enter cold storaged rat liver cell.

Objective To study the effect of nuclear factor-?B(NF?B) on cytokins expression and neutrophil accumulation in murine liver transplantation. Methods Donor and recipient Wistar rats were pretreated by introperitoneal injection of proline dithiocarbamates(ProDTC, 15 mg/kg) 15 min before transplantation. Results Compared with NS control rats the level of NF?B p65 significantly decreased suppressing the transcription of TNF-?,MIP-2 and ICAM-1 and the release of serum TNF-? and MIP-2 as well as the activity of myeloperoxidase(MPO) in rats receiving ProDTC(all P

ObjectiveTo investigate the methods of hepatic arterial reconstruction in orthotopic liver (transplantation)(OLT), and the prevention and management of associated complications, so as to improve the therapeatic results and donor survival rate of OLT.MethodsThe clinical data of 85 cases of orthotopic liver transplantation performed in our institute from May 1995 to May 2004 were retrospectively analysed. Hepatic artery reconstruction was made by use of Carrels patch of donor celiac artery or bifurcation of donor common hepatic artery and splenic artery anastoniosed to left and right hepatic artery of recipient in 16 cases((18.82)%), to bifurcation of gastroduodenal and proper hepatic arteries of recipient in 61 cases((71.76)%), or use of donor iliac artery interposition graft to abdominal aorta in 8 cases(9.42%). Regular heparin or low-molecular-weight heparin as a prophylactic anticoagulation therapy was maintained during and after (operation) as indicated by prothrombin time. Intra-and postoperative Doppler ultrasonography was used to (monitor) hepatic arterial blood supply.ResultsHepatic artery thrombosis(HAT) was observed in 1 case (intraoperatively)(overall incidence 1.2%).Thrombectomy and reconstruction of the arterial anastomosis were performed immediately.This patient currently has a survival time of 13 months without HAT. HAT was not observed in any of the other 84 cases during the follow up of 2 to 52 months.Conclusions Hepatic artery thrombosis may be minimized by proper selection of anastomotic site of hepatic artery reconstruction and (effective) use of postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt diagnosis of HAT, salvage grafts and avoid re-transplantation.

Objective To investigate the diagnosis and therapeutic methods of primary tumors of duodenum(PTD).Methods Clinical data of 86 patients with primary duodenal tumors who were hospitalized in the First Affiliated Hospital of China Medical University during 26 years were analyzed retrospectively.Of all the tumors,18 cases were benign tumors and 68 cases were malignant tumors.Results The clinical(manifestations) were symptoms of bile duct obstruction,GI and nonspecific symptoms,and signs included(fever),anemia and weight loss.The correct preoperative diagnostic rate by auxiliary examinations were:(duodenal) endoscopy 92%,air barium double radiography 89%,MRCP 85%,BUS 33%,CT 51%,MRI 75%,and duodenal endoscopy combined with air barium double radiography were 95%.Tumors were mostly located in the descending portion of duodenum(71 cases).Eighteen cases of benign PTDs were resected(completely) with a 5-year survival of 92.3%.Among the 68 maligant PTD cases,35 cases underwent(pancreatoduodenectomy),and 8 cases received segmental duodenectomy,with a resection rate of 63.2% and the 5-year survival rate of 31.0%.The remaining 25 cases,in which the tumors were unresectable,were treated by bypass operations,the 5-year survival rate was 0%.Conclusions Patients with PTD usually lack specific symptoms and signs,but combination of endoscopy,GI air barium double radiography and other(examinations) can improve the preoperative positive diagnostic rate.Segmental duodenectomy and simple tumor resection are curable for primary benign tumors of duodenum;while for primary malignant tumors of(duodenum),the therapy of choice should be pancreatoduodenectomy.

ObjectiveTo evaluate the hemostatic effect of human thrombin in surgery.Methods A prospective, randomized, controlled and multicenter study was designed to evaluate the hemostatic effect of human thrombin on abdominal operation incision (96 cases) and liver wound (40 cases). Human thrombin was insufflated topically in study group, with 0 9% NS as control. Results The average hemostatic time of abdominal incision in study group was (104?70) s, hemorrhagic volume per square unit was (0 4?0 3)g/cm 2, in liver wound the average hemostatic time was (106?78) s, the hemorrhagic volume per square unit was (1 0?0 7) g/cm 2, the difference was all statistically significant ( P

The rat islets were isolated by using collagenase digestive method, purified by Fi-coll density gradient centrifugation, and rat hepatocytes isolated simultaneously.Twenty-four cas-es of diabetic models, developed in mice with streptozotocin, were divided into 3 groups randomly.In experimental group, donor rat hepatocytes were infused first, followed by transplantation of cultured islets from same donor via portal vein on the 6th day.In Control group 1 no intervention was performed, and in control group 2, simple infusion of islets was done.The results showed group.Significant difference was noted between the two groups(P＜0.05).The decreased blood glucose level were maintained about a week in experimental group.This result reveals that hepa-tocytes can induce immunotolerance and prolong the survival of xenografts to some extent.

Objective To evaluate the effect of operation method in surgical treatment of pancreatic cyst. Method Retrospectively stastical analysis on 118 cases of pancreatic cyst was carried out.Result Thirty-one cases underwent external drainage,54 cases were subjected to internal drainage,and 33 cases to resection.Con- clusion For a genuine cyst,it is better to have it reacted.External drainage is only indicated for pseudocysts in emergent situations such as infection,hemorrhage or rupture,but is often accompanied with multiple complica- tions.Internal drainage is indicated for unresectable cysts and is superior to the external one,but it has some com- plications too.Resection of the pancreatic body and tail is the first choice for cysts located there,and it shows a good and thorough therapeutic effect with seldom recurrence.

Objective To determine the effect of PGE1 on liver microcirculation disturbance following orthotopic liver transplantation in rats.Methods Forty male adult Wistar rats were divided randomly into 3 groups. Eight transplantations were established in both the experimental and control group, while in the sham group, the liver was dissected like in the experimental group, but no resection was performed. In the experimental group, PGE1 (0.5 μg/kg*min-1) was injected intravenously into the donor before the operation, and added (1 mg/L)to the flush and preservation fluid, while PGE1 was replaced by normal saline in the control group. Confocal laser scan microscopy, biochemical test, and optical and electronic microscopy were used.Results In the control group the reperfusion state was poor,leukocyte infiltration appeared in the center of lobule,and transaminase rose after transplantation. In the experimental group distinctive improvement was seen as compared with the control group (P<0.05). Histological findings showed progressive degeneration and necrosis following transplantation in the control group, while in the experimental group the histological changes were improved to some degree by the use of PGE1.Conclusions In liver transplantation, ischemic reperfusion damage may lead to hepatic microcirculation disturbance, which is the major cause of graft failure. Infusing PGE1 into the donor intravenously before ischemia and adding PGE1 to the cold storage fluid could improve hepatic microcirculation, and thus reducing ischemic reperfusion damage in liver transplantation.In liver transplantation, ischemic reperfusion damage may lead to hepatic microcirculation disturbance, which is the major cause of graft failure. Infusing PGE1 into the donor intravenously before ischemia and adding PGE1 to the cold storage fluid could improve hepatic microcirculation, and thus reducing ischemic reperfusion damage in liver transplantation.