检索结果-南通市图书馆

静脉注射异丙酚引起的急性胰腺炎:通过系统综述评估其因果关系

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2019年第1期7卷 13-23,I0001页

作者： Samir Haffar Ravinder Jeet Kaur Sushil Kumar Garg Joseph A.Hyder M.Hassan Murad Barham K.Abu Dayyeh Fateh Bazerbachi Digestive Center for Diagnosis&Treatment 29 Ayar StreetDamascusSyrian Arab Republic Division of Gastroenterology and Hepatology Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Anesthesiology and Perioperative Medicine Mayo Clinic200 First Street SWRochesterMN 55905USA Division of Health Care Policy and Research Mayo Clinic200 First Street SWRochesterMN 55905USA

背景:异丙酚注射引起急性胰腺炎(AP)已有报道,但两者之间的因果关系尚不明了。因此,我们通过系统综述对其因果关系进行评估。方法:我们于2017年8月16日对多个数据库进行检索,由两人按预设标准对检索出的研究进行评估和筛选。使用Naranj... 详细信息

背景:异丙酚注射引起急性胰腺炎(AP)已有报道,但两者之间的因果关系尚不明了。因此,我们通过系统综述对其因果关系进行评估。方法:我们于2017年8月16日对多个数据库进行检索,由两人按预设标准对检索出的研究进行评估和筛选。使用Naranjo量表和Badalov分级评估异丙酚注射与AP的因果关系。结果:我们筛选出来自11个国家的18项研究,病例总数为21例,大多数研究都有高质量的方法学。21例患者中位年龄35岁(4-77岁),10例(48%)为男性。8例患者注射异丙酚是用于镇静,13例为麻醉诱导/维持,异丙酚中位注射剂量为200 mg。14例(67%)患者具有一个中等时长(1-30天)的潜伏期(异丙酚注射至AP诊断)。4例患者甘油三酯水平>1000 mg/dL。4例(19%)患者出现严重AP。2例患者在AP治疗好转后再次接受异丙酚注射,其中1例出现了AP复发。AP相关病死率为14%(3/21)。按Naranjo量表评估,在19例(89%)患者中,异丙酚注射是AP的可能原因。结论:在Badalov Ib级别的证据支持下,可以认为异丙酚注射是AP发生的一个可能原因。高甘油三酯血症并不是异丙酚诱发AP的唯一机制。异丙酚引起的AP中,有19%为严重AP,病死率高达14%。未来研究需要评估如果合并应用其他一些本身就有导致胰腺炎风险的操作(如ERCP),异丙酚引起的AP发生概率是否会增加。

关键词： acute pancreatitis drug-induced pancreatitis propofol systematic review

acute pancreatitis induced by transarterial chemoembolization:a single-center experience of over 1500 cases

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 93-98页

作者： Wong Hoi She Albert CY Chan Tan To Cheung Kenneth SH Chok See Ching Chan Ronnie TP Poon Chung Mau Lo Division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation Department of SurgeryThe University of Hong Kong

BACKGROUND： acute pancreatitis is a relatively rare but po- tentially lethal complication after transarterial chemotherapy. This study aimed to review the complications such as acute pancreatitis after transarterial chemotherapy with or without embolization for hepatocellular carcinoma. METHODS： A total of 1632 patients with hepatocellular car- cinoma who had undergone transarterial chemoembolization from ]anuary 2000 to February 2014 in a single-center were reviewed retrospectively. We investigated the potential com- plications of transarterial chemoembolization, such as acute pancreatitis and acute pancreatitis-related complications. RESULTS： Of the 1632 patients with hepatocellular carcinoma who had undergone 5434 transarterial chemoembolizations, 1328 were male and 304 female. The median age of these pa- tients was 61 years. Most （79.6%） of the patients suffered from HBV-related hepatoceUular carcinoma. The median tumor size was 5.2 cm. Of the 1632 patients, 145 patients underwent transarterial chemoembolization with doxorubicin elut- ing bead, making up a total of 538 episodes. The remaining patients underwent transarterial chemoembolization with cisplatin. Seven （0.4%） patients suffered from acute pancre- atitis post-chemoembolization. Six patients had chemoembo- lization with doxorubicin and one had chemoembolization with cisplatin. Patients who received doxornbicin eluting bead had a higher risk of acute pancreatitis [6/145 （4.1%） vs 1/1487 （0.1%）, P〈0.0001]. Two patients had anatomical arterial variations. Four patients developed acute pancreatitis- related complications including necrotizing pancreatitis （n=3） and pseudocyst formation （n=1）. All of the 4 patients resolved after the use of antibiotics and other conservative treatment. Three patients had further transarterial chemoembolization without any complication. CONCLUSIONS： acute pancreatitis after transarterial chemo- embolization could result in serious complications, especially after treatment with doxorubicin eluting bead. Continuation of curr

关键词： transarterial chemoembolization acute pancreatitis hepatocellular carcinoma

Mesenteric adipose tissue B lymphocytes promote intestinal injury in severe acute pancreatitis by mediating enteric pyroptosis

在线全文

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 300-309页

作者： Qing Huang Jia-Wen Liu Hai-Bin Dong Zheng-Jie Wei Jin-Zhe Liu Yu-Tang Ren Xuan Jiang Bo Jiang Department of Gastroenterology Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China

Background:Visceral adipose tissue(VAT)has been linked to the severe acute pancreatitis(SAP)prognosis,although the underlying mechanism remains unclear.It has been reported that pyroptosis worsens SAP.The present study aimed to verify whether mesenteric adipose tissue(MAT,a component of VAT)can cause secondary intestinal injury through the pyroptotic pathway.Methods:Thirty-six male Sprague Dawley(SD)rats were divided into six different groups.Twelve rats were randomly divided into the SAP and control groups.We monitored the changes of MAT and B lymphocytes infiltration in MAT of SAP rats.Twelve SAP rats were injected with MAT B lymphocytes or phosphate buffer solution(PBS).The remaining twelve SAP rats were first injected with MAT B lymphocytes,and then with MCC950(NLRP3 inhibitor)or PBS.We collected blood and tissue samples from pancreas,gut and MAT for analysis.Results:Compared to the control rats,the SAP group showed inflammation in MAT,including higher expression of tumor necrosis factor(TNF-α)and interleukin-6(IL-6),lower expression of IL-10,and histological changes.Flow cytometry analysis revealed B lymphocytes infiltration in MAT but not T lymphocytes and macrophages.The SAP rats also exhibited intestinal injury,characterized by lower expression of zonula occludens-1(ZO-1)and occludin,higher levels of lipopolysaccharide and diamine oxidase,and pathological changes.The expression of NLRP3 and n-GSDMD,which are responsible for pyroptosis,was increased in the intestine of SAP rats.The injection of MAT B lymphocytes into SAP rats exacerbated the inflammation in MAT.The upregulation of pyroptosis reduced tight junction in the intestine,which contributed to the SAP progression,including higher inflammatory indicators and worse histological changes.The administration of MCC950 to SAP+MAT B rats downregulated pyroptosis,which subsequently improved the intestinal barrier and ameliorated inflammatory response of SAP.Conclusions:In SAP,MAT B lymphocytes aggravated local inflammation,and promoted the injury to the int

关键词： acute pancreatitis Mesenteric adipose tissue B lymphocyte Intestinal barrier Pyroptosis

acute pancreatitis:A review of diagnosis,severity prediction and prognosis assessment from imaging technology,scoring system and artificial intelligence

在线全文

学校读者我要写书评

暂无评论

世界胃肠病学杂志:英文版 2023年第37期29卷 5268-5291页

作者： Jian-Xiong Hu Cheng-Fei Zhao Shu-Ling Wang Xiao-Yan Tu Wei-Bin Huang Jun-Nian Chen Ying Xie Cun-Rong Chen Intensive Care Unit The Affiliated Hospital of Putian UniversityPutian 351100Fujian ProvinceChina School of Pharmacy and Medical Technology Putian UniversityPutian 351100Fujian ProvinceChina Key Laboratory of Pharmaceutical Analysis and Laboratory Medicine Putian UniversityPutian 351100Fujian ProvinceChina Department of Critical Care Medicine Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina School of Mechanical Electrical and Information EngineeringPutian UniversityPutian 351100Fujian ProvinceChina

acute pancreatitis(AP)is a potentially life-threatening inflammatory disease of the pancreas,with clinical management determined by the severity of the disease.Diagnosis,severity prediction,and prognosis assessment of AP typically involve the use of imaging technologies,such as computed tomography,magnetic resonance imaging,and ultrasound,and scoring systems,including Ranson,acute Physiology and Chronic Health Evaluation II,and Bedside Index for Severity in AP scores.Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity,while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications.Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild,moderate,or severe categories,guiding treatment decisions,such as intensive care unit admission,early enteral feeding,and antibiotic use.Despite the central role of imaging technologies and scoring systems in AP management,these methods have limitations in terms of accuracy,reproducibility,practicality and economics.Recent advancements of artificial intelligence(AI)provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data.AI algorithms can analyze large amounts of clinical and imaging data,identify scoring system patterns,and predict the clinical course of disease.AI-based models have shown promising results in predicting the severity and mortality of AP,but further validation and standardization are required before widespread clinical application.In addition,understanding the correlation between these three technologies will aid in developing new methods that can accurately,sensitively,and specifically be used in the diagnosis,severity prediction,and prognosis assessment of AP through complementary advantages.

关键词： acute pancreatitis Imaging technology Scoring system Artificial intelligence Severity prediction Prognosis assessment

Rheum palmatum L. and Salvia miltiorrhiza Bge. Alleviates acute pancreatitis by Regulating Th17 Cell Differentiation: An Integrated Network Pharmacology Analysis, Molecular Dynamics Simulation and Experimental Validation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Journal of Integrative Medicine 2024年第5期30卷 408-420页

作者： FENG Min-chao LUO Fang HUANG Liang-jiang LI Kai CHEN Zu-min LI Hui YAO Chun QIN Bai-jun CHEN Guo-zhong The First Clinical Medical College Guangxi University of Traditional Chinese MedicineNanning 530000China Guangxi Key Laboratory of Molecular Biology of Traditional Chinese Medicine and Preventive Medicine Nanning 530000China Graduate School Guangxi University of Traditional Chinese MedicineNanning 530000China Department of Gastroenterology the First Affiliated Hospital of Guangxi University of Traditional Chinese MedicineNanning 530023China

Objective: To identify the core targets of Rheum palmatum L. and Salvia miltiorrhiza Bge.,(Dahuang-Danshen, DH-DS) and the mechanism underlying its therapeutic efficacy in acute pancreatitis(AP)using a network pharmacology approach and validate the findings in animal experiments. Methods: Network pharmacology analysis was used to elucidate the mechanisms underlying the therapeutic effects of DH-DS in AP. The reliability of the results was verified by molecular docking simulation and molecular dynamics simulation.Finally, the results of network pharmacology enrichment analysis were verified by immunohistochemistry,Western blot analysis and real-time quantitative PCR, respectively. Results: Sixty-seven common targets of DH-DS in AP were identified and mitogen-activated protein kinase 3(MAPK3), Janus kinase 2(JAK2), signal transducer and activator of transcription 3(STAT3), protein c-Fos(FOS) were identified as core targets in the protein interaction(PPI) network analysis. Gene ontology analysis showed that cellular response to organic substance was the main functions of DH-DS in AP, and Kyoto Encyclopedia of Genes and Genomes analysis showed that the main pathway included Th17 cell differentiation. Molecular docking simulation confirmed that DH-DS binds with strong affinity to MAPK3, STAT3 and FOS. Molecular dynamics simulation revealed that FOS-isotanshinone Ⅱ and STAT3-dan-shexinkum d had good binding capacity. Animal experiments indicated that compared with the AP model group, DH-DS treatment effectively alleviated AP by inhibiting the expression of interleukin-1β, interleukin-6 and tumor necrosis factor-α, and blocking the activation of Th17 cell differentiation(P<0.01). Conclusion: DH-DS could inhibit the expression of inflammatory factors and protect pancreatic tissues,which would be functioned by regulating Th17 cell differentiation-related m RNA and protein expressions.

关键词： Rheum palmatum L. Salvia miltiorrhiza Bge. molecular docking simulation network pharmacology acute pancreatitis Th17 cell differentiation

acute pancreatitis as a rare complication of gastrointestinal endoscopy:A case report

在线全文

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2022年第13期10卷 4185-4189页

作者： Mu-Gen Dai Li-Fen Li Hai-Yan Cheng Jian-Bo Wang Bin Ye Fei-Yun He Department of Gastroenterology The Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui 323000Zhejiang ProvinceChina Department of Gastroenterology Liandu District People's HospitalLishui 323000Zhejiang ProvinceChina Department of Nursing Liandu District People's HospitalLishui 323000Zhejiang ProvinceChina Department of Gastroenterology Lishui Chinese Medicine HospitalLishui 323000Zhejiang ProvinceChina

BACKGROUND acute pancreatitis is an uncommon complication of gastrointestinal endoscopy,especially if the patient has none of the common risk factors associated with pancreatitis;such as alcoholism,gallstones,hypertriglyceridemia,hypercalcemia or the use of certain drugs.CASE SUMMARY A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy.The pain was predominantly in the upper and middle abdomen and was persistent and severe.The patient was diagnosed with acute pancreatitis.Treatment included complete fasting,octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion,ulinastatin injection to inhibit pancreatic enzymes activity,esomeprazole for gastric acid suppression,fluid replacement and nutritional support.Over the next 3 d,the patient's symptoms improved.The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state.CONCLUSION pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.

关键词： acute pancreatitis Gastrointestinal endoscopy Complication Bile reflux Case report

acute pancreatitis as a complication of acute COVID-19 in kidney transplant recipients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2024年第6期12卷 1104-1110页

作者： Nikolina Basic-Jukic Ivana Juric Lea Katalinic Vesna Furic-Cunko Vibor Sesa Anna Mrzljak Department of Nephrology Arterial HypertensionDialysis and TransplantationUniversity Hospital Centre ZagrebZagreb 10000Croatia Department of Medicine School of MedicineZagreb 10000Croatia Department of Gastroenterology and Hepatology University Hospital Centre ZagrebZagreb 10000Croatia

BACKGROUND acute pancreatitis is a rare extrapulmonary manifestation of coronavirus disease 2019(COVID-19)but its full correlation with COVID-19 infection remains unknown.AIM To identify acute pancreatitis’occurrence,clinical presentation and outcomes in a cohort of kidney transplant recipients with acute COVID-19.METHODS A retrospective observational single-centre cohort study from a transplant centre in Croatia for all adult renal transplant recipients with a functioning kidney allograft between March 2020 and August 2022 to record cases of acute pancreatitis during acute COVID-19.Data were obtained from hospital electronic medical records.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection was proven by a positive SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction on the nasopharyngeal swab.RESULTS Four hundred and eight out of 1432(28.49%)patients who received a renal allograft developed COVID-19 disease.The analyzed cohort included 321 patients(57%males).One hundred and fifty patients(46.7%)received at least one dose of the anti-SARS-CoV-2 vaccine before the infection.One hundred twenty-five(39.1%)patients required hospitalization,141(44.1%)developed pneumonia and four patients(1.3%)required mechanical ventilation.Treatment included immunosuppression modification in 233 patients(77.1%)and remdesivir in 53 patients(16.6%),besides the other supportive measures.In the study cohort,only one transplant recipient(0.3%)developed acute pancreatitis during acute COVID-19,presenting with abdominal pain and significantly elevated pancreatic enzymes.She survived without complications with a stable kidney allograft function.CONCLUSION Although rare,acute pancreatitis may complicate the course of acute COVID-19 in kidney transplant recipients.The mechanism of injury to the pancreas and its correlation with the severity of the COVID-19 infection in kidney transplant recipients warrants further research.

关键词： acute pancreatitis COVID-19 Kidney transplant Angiotensin-converting enzyme-2 receptor Immunosuppressive agents

acute pancreatitis-induced thrombotic thrombocytopenic purpura:A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2022年第12期10卷 3808-3813页

作者： Chun-Hua Wang Hai-Feng Jin Wen-Ge Liu Ying Guo Zhen Liu Department of Gastroenterology The 980^(th) Hospital of the People's Liberation Army Joint Service(Bethune International Peace Hospital)Shijiazhuang 050082Hebei ProvinceChina

BACKGROUND Thrombotic thrombocytopenic purpura(TTP)is a life-threatening but treatable disorder.acute pancreatitis is a well-described consequence of TTP,but TTP as a consequence of acute pancreatitis is rare.CASE SUMMARY A 32-year-old male developed acute pancreatitis due to a fatty diet and suffered splenectomy 3 years ago due to trauma.From day 4 of his onset of pain the blood examination showed the platelet extremely reduced,bilirubin elevated and creatinine increased.High clinical suspicion of TTP was made and prompt initiation of plasma exchange was given followed intravenous drip methylprednisolone.After 7 sessions of plasm exchange and the laboratory parameters were back to normal and the patient was discharged from the hospital on the 13th day of admission.CONCLUSION Patients develop acute pancreatitis with no apparent causes for hemolytic anemia and thrombocytopenia,the possibility of TTP should be considered.Treatments for TTP including plasm exchange should be evaluated as soon as a diagnosis is made.

关键词： Thrombotic thrombocytopenic purpura acute pancreatitis Case report Plasm exchange Glucocorticoid

Etiology and classification of acute pancreatitis in children admitted to ICU using the Pediatric Sequential Organ Failure Assessment (pSOFA) score

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatobiliary & Pancreatic Diseases International 2023年第3期22卷 317-322页

作者： Vratislav Smolka Marie Rohanova Miroslav Seda Eva Karaskova Oksana Tkachyk Martin Zapalka Jana Volejnikova Department of Pediatrics Faculty of Medicine and DentistryPalacky University and University Hospital OlomoucI.P.Pavlova 185/6Olomouc 77900Czech Republic

Background:Pediatric acute pancreatitis(AP)is rare but increasing.Severe AP is associated with higher morbidity and mortality.However,there are no universally accepted prognostic criteria for AP.Methods:This retrospective study included children with AP admitted to an intensive care unit(ICU)of our tertiary pediatric center between January 2009 and December 2018.The severity of organ dysfunction in AP was assessed according to the modified Atlanta criteria using the Pediatric Sequential Organ Failure Assessment(p SOFA)and Computed Tomography Severity Index(CTSI).Results:Seventy acute episodes of AP were evaluated in 55 children with primary pancreatitis.In addition,secondary AP was diagnosed in 15 patients originally admitted to ICU for different indications.Mild AP[no organ dysfunction,normal computed tomography(CT)finding]was the most prevalent(64/85 episodes in 49 children),followed by moderate AP(15 children;p SOFA 2-9 points,CTSI 3-4 points on admission).Severe AP(p SOFA 4-17 points,CTSI 6-10 points)was diagnosed in 6 children with traumatic or secondary AP.The most frequent etiologies of primary AP episodes were idiopathic(39%)and biliary(31%).Children with idiopathic AP had frequent relapses and comorbidities.Hereditary AP was typically mild,but presented with high pancreatic enzyme levels and recurrence rates.Admission at ICU and an interval without enteral nutrition(EN)were relatively short in drug-induced AP and relatively long in secondary and traumatic AP.Endoscopic retrograde cholangiopancreatography(ERCP)was performed in 13 patients with biliary AP and in 4 patients with traumatic AP.No AP-related death was observed.Conclusion:p SOFA score accurately reflects the severity and prognosis of AP in children.

关键词： acute pancreatitis Children Organ dysfunction Prognosis pSOFA score