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Honokiol Prevents Intestinal Barrier Dysfunction in Mice with severe acute pancreatitis and Inhibits JAK/STAT1 Pathway and Acetylation of HMGB1

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Chinese Journal of Integrative Medicine 2024年第6期30卷 534-542页

作者： LI Jie CHEN Ya-feng GAO Lei LI Yi-jie FENG Dian-xu Department of General Surgery Putuo HospitalShanghai University of Traditional Chinese MedicineShanghai200062China

Objective To investigate the effect of honokiol(HON)and the role of high-mobility group protein B1(HMGB1)on the pathogenesis of severe acute pancreatitis(SAP).Methods Thirty mice were numbered according to weight,and randomly divided into 5 groups using a random number table,including control,SAP,SAP and normal saline(SAP+NS),SAP and ethyl pyruvate(SAP+EP),or SAP+HON groups,6 mice in each group.Samples of pancreas,intestine,and blood were collected 12 h after SAP model induction for examination of pathologic changes,immune function alterations by enzyme linked immunosorbent assay(ELISA),and Western blot.In vitro experiments,macrophages were divided into 5 groups,the control,lipopolysaccharide(LPS),LPS+DMSO(DMSO),LPS+anti-HMGB1 monoclonal antibody(mAb),and LPS+HON groups.The tight connection level was determined by transmission electron microscopy and fluorescein isothiocyanate-labeled.The location and acetylation of HMGB1 were measured by Western blot.Finally,pyridone 6 and silencing signal transducer and activator of the transcription 1(siSTAT1)combined with honokiol were added to determine whether the Janus kinase(JAK)/STAT1 participated in the regulation of honokiol on HMGB1.The protein expression levels of HMGB1,JAK,and STAT1 were detected using Western blot.Results Mice with SAP had inflammatory injury in the pancreas,bleeding of intestinal tissues,and cells with disrupted histology.Mice in the SAP+HON group had significantly fewer pathological changes.Mice with SAP also had significant increases in the serum levels of amylase,lipase,HMGB1,tumor necrosis factor-α,interleukin-6,diamine oxidase,endotoxin-1,and procalcitonin.Mice in the SAP+HON group did not show these abnormalities(P<0.01).Studies of Caco-2 cells indicated that LPS increased the levels of occludin and claudin-1 as well as tight junction permeability,decreased the levels of junctional adhesion molecule C,and elevated intercellular permeability(P<0.01).HON treatment blocked these effects.Studies of macrophages indicated that LPS led to low nucle

关键词： severe acute pancreatitis intestinal barrier dysfunction honokiol high-mobility group protein B1 Januskinase signal transducerand activatorof transcription1

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Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 59-66页

作者： Xue-Lan Zheng Wan-Ling Li Yan-Ping Lin Ting-Long Huang Department of Critical Care Medicine The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou 362000Fujian ProvinceChina CT Room The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou 362000Fujian ProvinceChina

BACKGROUND severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of pa

关键词： Computerized tomography guidance Therapeutic percutaneous puncture catheter drainage Somatostatin severe acute pancreatitis Efficacy and safety

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Different timing for abdominal paracentesis catheter placement and drainage in severe acute pancreatitis complicated by intraabdominal fluid accumulation

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 134-142页

作者： Rui Chen Hua-Qiang Chen Rui-Die Li Hui-Min Lu Department of General Surgery Chengdu Sixth People’s HospitalChengdu 610058Sichuan ProvinceChina West China Center of Exellence for pancreatitis Institute of Integrated Traditional Chinese and Western MedicineWest ChinaDivision of Pancreatic SurgeryDepartment of General SurgeryWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina HospitalSichuan University

BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than

关键词： Abdominal paracentesis catheter drainage Timing severe acute pancreatitis Intra-abdominal fluid Application value

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Application of psychological intervention in intensive care unit nursing for patients with severe acute pancreatitis

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World Journal of Psychiatry 2024年第6期14卷 913-919页

作者： Chun-Xia Huang Xiao-Yan Xu Dong-Mei Gu Hui-Ping Xue Department of Outpatient The Affiliated Hospital of Nantong UniversityNantong 226001Jiangsu ProvinceChina Emergency Intensive Care Unit The Affiliated Hospital of Nantong UniversityNantong 226001Jiangsu ProvinceChina Department of Nursing The Affiliated Hospital of Nantong UniversityNantong 226001Jiangsu ProvinceChina

BACKGROUND severe acute pancreatitis(SAP)is a familiar critical disease in the intensive care unit(ICU)patients.Nursing staff are important spiritual pillars during the treatment of patients,and in addition to routine nursing,more attention needs be paid to the patient’s psychological changes.AIM To investigate the effects of psychological intervention in ICU patients with SAP.METHODS One hundred ICU patients with SAP were hospitalized in the authors’hospital between 2020 and 2023 were selected,and divided into observation and control groups per the hospitalization order.The control and observation groups received routine nursing and psychological interventions,respectively.Two groups are being compared,using the Self-rating Anxiety Scale(SAS),Self-Determination Scale(SDS),acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ,and 36-item Short Form Health Survey(SF-36)scores;nursing satisfaction of patients;ICU care duration;length of stay;hospitalization expenses;and the incidence of complications.RESULTS After nursing,the SDS,SAS,and APACHEⅡ scores in the experimental group were significantly lower than in the control group(P<0.05).The SF-36 scores in the observation group were significantly higher than those in the control group(P<0.05).The nursing satisfaction of patients in the experimental group was 94.5%,considerably higher than that of 75.6% in the control group(P<0.05).The ICU care duration,length of stay,and hospitalization expenses in the observation group were significantly lower than those in the control group,and the incidence of complications was lower(P<0.05).CONCLUSION For patients with SAP,the implementation of standardized psychological intervention measures can effectively alleviate adverse psychological conditions.

关键词： severe acute pancreatitis Intensive care unit nursing Psychological intervention Changes of psychological status Short Form Health Survey

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A Study on the Application of Evidence-Based Nursing in The Care of Patients with severe acute pancreatitis

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Journal of Clinical and Nursing Research 2024年第4期8卷 128-131页

作者： Zhe Chen Rui Cao Department of Gastroenterology Shaanxi Provincial People’s HospitalXi’an710068Shaanxi ProvinceChina

Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.

关键词： severe acute pancreatitis Evidence-based nursing Applied research

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Emodin attenuates severe acute pancreatitis-associated acute lung injury by suppressing pancreatic exosome-mediated alveolar macrophage activation

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Acta Pharmaceutica Sinica B 2022年第10期12卷 3986-4003页

作者： Qian Hu Jiaqi Yao Xiajia Wu Juan Li Guixiang Li Wenfu Tang Jingping Liu Meihua Wan Department of Integrated Traditional Chinese and Western Medicine National Clinical Research Center for GeriatricsWest China HospitalSichuan UniversityChengdu 610041China NHC Key Laboratory of Transplant Engineering and Immunology Frontiers Science Center for Disease-Related Molecular NetworkWest China HospitalSichuan UniversityChengdu 610041China

severe acute pancreatitis-associated acute lung injury(SAP-ALI) is a serious disease associated with high mortality. Emodin has been applied to alleviate SAP-ALI;however, the mechanism remains unclear. We report that the therapeutic role of emodin in attenuating SAP-ALI is partly dependent on an exosomal mechanism. SAP rats had increased levels of plasma exosomes with altered protein contents compared to the sham rats. These infused plasma exosomes tended to accumulate in the lungs and promoted the hyper-activation of alveolar macrophages and inflammatory damage. Conversely,emodin treatment decreased the plasma/pancreatic exosome levels in the SAP rats. Emodin-primed exosomes showed less pro-inflammatory effects in alveolar macrophages and lung tissues than SAP exosomes. In detail, emodin-primed exosomes suppressed the NF-κB pathway to reduce the activation of alveolar macrophage and ameliorate lung inflammation by regulating PPARγ pathway, while these effects were amplified/abolished by PPARγ agonist/antagonist. Blockage of pancreatic acinar cell exosome biogenesis also exhibited suppression of alveolar macrophage activation and reduction of lung inflammation. This study suggests a vital role of exosomes in participating inflammation-associated organ-injury,and indicates emodin can attenuate SAP-ALI by reducing the pancreatic exosome-mediated alveolar macrophage activation.

关键词： severe acute pancreatitis acute lung injury Emodin Exosome Macrophages Lisocitrate dehydrogenase 1 Peroxisome proliferatoractivated receptorγ Nuclear factor kB

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Role of neutrophil extracellular traps in inflammatory evolution in severe acute pancreatitis

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Chinese Medical Journal 2022年第23期135卷 2773-2784页

作者： Hongxin Kang Yue Yang Lv Zhu Xianlin Zhao Juan Li Wenfu Tang Meihua Wan Department of Integrated Traditional Chinese and Western Medicine National Clinical Research Center for GeriatricsWest China HospitalSichuan UniversityChengduSichuan 610041China

severe acute pancreatitis(SAP)is a life-threatening acute abdominal disease with two peaks of death:the first in the early stage,characterized by systemic inflammatory response-associated organ failure;and the second in the late stage,characterized by infectious complications.Neutrophils are the main immune cells participating in the whole process of SAP.In addition to the traditional recognition of neutrophils as the origination of chemokine and cytokine cascades or phagocytosis and degranulation of pathogens,neutrophil extracellular traps(NETs)also play an important roles in inflammatory reactions.We reviewed the role of NETs in the occurrence and development of SAP and its fatal complications,including multiple organs injury,infected pancreatic necrosis,and thrombosis.This review provides novel insights into the involvement of NETs throughout the entire process of SAP,showing that targeting NETs might be a promising strategy in SAP treatment.However,precision therapeutic options targeting NETs in different situations require further investigation.

关键词： Inflammation Neutrophil extracellular traps Organ injury Sepsis severe acute pancreatitis Thrombus

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Influence of Intestinal Lymphatic Ligation on Pulmonary Injury in Rats with severe acute pancreatitis

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Current Medical Science 2022年第4期42卷 711-719页

作者： Yuan-qi LIU Lu-lu WANG Li CHEN Yu-xia XIONG Department of Pharmacology School of PharmacySouthwest Medical UniversityLuzhou 646000China Chengdu Vocational and Technical College Chengdu610000China Department of Pharmacy the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical UniversityLuzhou 646000China

Objective:The present study explored the mechanisms involved in intestinal lymphatic ligation in rats with severe acute pancreatitis(SAP).Methods:Male Sprague Dawley rats were randomly divided into 4 groups:saline group,saline+ligation group,SAP group,and SAP+ligation group.Rats in the SAP group were administered sodium taurocholate solution.Isolated mesenteric lymph duct ligation was administered to the saline+ligation and SAP+ligation groups.Endotoxin(ET),nitric oxide(NO),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),myeloperoxidase(MPO),and superoxide dismutase(SOD)were detected.Nuclear factor-KB(NF-κB)and intercellular cell adhesion molecule-1(ICAM-1)proteins were observed.The mRNA of inducible nitric oxide synthase(iNOS)and Toll-like receptor 4(TLR4)was detected by PCR.Results:Pathomorphological analysis showed that necrosis was present in the lung of rats in the SAP group,but only mild lesions in the SAP+ligation group.ET,NO,TNF-α,and IL-1 in the serum and lung tissue were significantly decreased and MPO was increased in the SAP+ligation group as compared with the SAP group.However,MPO was increased.The expression of NF-κB and ICAM-1,either iNOS or TLR4,was upregulated in the SAP group,but downregulated in the SAP+ligation group.Intestinal lymph duct ligation prevented ET translocation,the release of inflammation factors,and inflammation injury.Conclusion:The intestinal lymph duct ligation could alleviate SAP-induced pulmonary injury by suppressing NF-κB activation in rats.

关键词： intestinal lymphatic ligation severe acute pancreatitis lung injury intestinal bacterial translocation

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Medical imaging for pancreatic diseases:Prediction of severe acute pancreatitis complicated with acute respiratory distress syndrome

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World Journal of Gastroenterology 2022年第44期28卷 6206-6212页

作者： Ling-Ji Song Bo Xiao Department of Radiology Affiliated Hospital of North Sichuan Medical CollegeNanchong 637000Sichuan ProvinceChina

In this editorial we comment on the article published in the recent issue of the World Journal of Gastroenterology[2022;28(19):2123-2136].We pay attention to how to construct a simpler and more reliable new clinical predictive model to early identify patients at high risk of acute respiratory distress syndrome(ARDS)associated with severe acute pancreatitis(SAP),and to early predict the severity of organ failure from chest computed tomography(CT)findings in SAP patients.As we all know,SAP has a sudden onset,is a rapidly changing condition,and can be complicated with ARDS and even multiple organ dysfunction syndrome,and its mortality rate has remained high.At present,there are many clinical scoring systems for AP,including the bedside index for severity in AP,acute physiology and chronic health evaluation II,systemic inflammatory response syndrome,Japanese severe score,quick sepsis-related organ failure assessment,etc.However,some of these scoring systems are complex and require multiple and difficult clinical parameters for risk stratification.Although the aforementioned biomarkers are readily available,their ability to predict ARDS varies.Accordingly,it is extremely necessary to establish a simple and valuable novel model to predict the development of ARDS in AP.In addition,the extra-pancreatic manifestations of AP patients often involve the chest,among which pleural effusion and pulmonary consolidation are the more common complications.Therefore,by measuring the semi-quantitative indexes of chest CT in AP patients,such as the amount of pleural effusion and the number of lobes involved as pulmonary consolidation,it has important reference value for the early diagnosis of SAP complicated with ARDS and is expected to provide a basis for the early treatment of ARDS.

关键词： severe acute pancreatitis acute respiratory distress syndrome Clinical scoring system Prediction model Semi-quantitative

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Risk factors and their interactive effects on severe acute pancreatitis complicated with acute gastrointestinal injury

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世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1712-1718页

作者： Jian-Hui Chen Mei-Fen Zhang Wen-Chao Du Yan-An Zhang Emergency Department Longyan First Affiliated Hospital of Fujian Medical UniversityLongyan 364000Fujian ProvinceChina

BACKGROUND There are many risk factors for severe acute pancreatitis(SAP)complicated with acute gastrointestinal injury(AGI),but few reports on the interaction between these risk factors.AIM To analyze the risk factors for SAP complicated with AGI and their interactive effects.METHODS We selected 168 SAP patients admitted to our hospital between December 2019 and June 2022.They were divided into AGI group and non-AGI group according to whether AGI was present.Demographic data and laboratory test data were compared between the two groups.The risk factors for SAP with concomitant AGI were analyzed using multifactorial logistic regression,and an analysis of the interaction of the risk factors was performed.RESULTS The percentage of patients with multiple organ dysfunction syndrome,acute physiological and chronic health scoring system II(APACHE II)score,white blood cell count and creatinine(CRE)level was higher in the AGI group than in the non-AGI group.There was a statistically significant difference between the two groups(P15 and CRE>100μmol/L were risk factors for SAP complicating AGI.The interaction index of APACHE II score and CRE level was 3.123.CONCLUSION An APACHE II score>15 and CRE level>100μmol/L are independent risk factors for SAP complicated with AGI,and there is a positive interaction between them.

关键词： severe acute pancreatitis acute gastrointestinal injury Risk factors Interactions acute physiological and chronic health scoring system II Creatinine

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