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Intra-abdominal pressure monitoring in predicting outcome of patients with severe acute pancreatitis

Hepatobiliary & Pancreatic Diseases International 2007年第4期6卷 420-423页

作者： Zhang, Wei-Fang Ni, Yun-Lan Cai, Ling Li, Tong Fang, Xue-Ling Zhang, Yun-Tao Zhejiang Univ Sch Med Affiliated Hosp 1 Intens Care Unit Hangzhou 310003 Peoples R China hangzhou hosp tradit chinese med Dept Resp Syst Hangzhou 310003 Peoples R China

BACKGROUND: Severe acute pancreatitis (SAP) is a serious disease with many complications, high mortality and poor prognosis. It is characterized by rapid deterioration and poses one of the most difficult challenges in clinical practice. Previous investigations suggest that SAP is one of the main causes of intra-abdominal pressure (IAP) increase. The aim of this study was to evaluate the utility of IAP-monitoring in predicting the severity and prognosis of SAP. METHODS: Eighty-nine patients with SAP who had been treated from February 2001 to December 2005 were studied. Since bladder pressure accurately reflects IAP, we measured it instead of IAP. Bladder pressure was measured at the time of admission and every 12 hours in the course of the disease, 9 consecutive times in all. The APACHE II scores of all patients were obtained within 24 hours after admission. According to a maximum bladder pressure <10 cmH(2)O, all patients were divided into two groups, mildly-elevated and severely-elevated. Mortality and mean APACHE II scores in the two groups were calculated. In addition, the mean bladder pressure and APACHE II scores in survivors were compared with those in deaths. RESULTS: Sixty-eight of the 89 patients were in the severely-elevated group. Mortality and mean APACHE II scores in this group were much higher than those in the mildly-elevated group (mortality, 39.71% vs. 9.52%; mean APACHE II score, 23.15 +/- 7.42 vs. 15.95 +/- 5.35, P<0.01). The mean bladder pressures and APACHE II scores in deaths were significantly greater than those in survivors (mean bladder pressure, 14.1 +/- 3.8 vs. 9.2 +/- 2.3 cmH(2)O, P<0.01; mean APACHE II score, 27.83 +/- 4.87 vs. 18.37 +/- 6.74, P<0.01). CONCLUSION: It is suggested that IAP may be used as a marker of the severity and prognosis of SAP.

关键词： severe acute pancreatitis intra-abdominal pressure APACHE II score mortality

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Pathological changes at early stage of multiple organ injury in a rat model of severe acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 83-87页

作者： Zhang, Xi-Ping Zhang, Jie Ma, Mei-Li Cai, Yang Xu, Ru-Jun Xie, Qi Jiang, Xin-Ge Ye, Qian hangzhou First Peoples hosp Dept Gen Surg Hangzhou 310006 Zhejiang Peoples R China hangzhou First Peoples hosp Dept Pathol Hangzhou 310006 Zhejiang Peoples R China Zhejiang Univ tradit chinese med Hangzhou 310053 Zhejiang Peoples R China

BACKGROUND: Severe acute pancreatitis (SAP) is a commonly seen acute abdominal syndrome characterized by sudden onset, rapid progression and high mortality rate. The damage in peripheral organs may be more severe than that in the pancreas, and can even lead to multiple organ dysfunction. It is critical to recognize early pathological changes in multiple organs. This study aimed to assess the early pathological features of damaged organs in a rat model of SAP. METHODS: Thirty clean grade healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into a model control group (n=15) and a sham-operated group (n=15). The SAP rat model was induced by sodium taurocholate. Samples of blood and from multiple organs were collected 3 hours after operation. We assessed the levels of IL-6, TNF-alpha, PLA2, NO, ET-1, MDA, amylases and endotoxin in blood and observed the early pathological changes in multiple damaged organs. RESULTS: Levels of IL-6, TNF-alpha, PLA2, NO, ET-1 and MDA in serum and of amylase and endotoxin in plasma of the model control group rats were significantly higher than those of the sham-operated group (P<0.01). Different degrees of pathological change were observed in multiple damaged organs. CONCLUSION: Multiple organ injury may occur at the early stage of SAP in rats.

关键词： severe acute pancreatitis pathological changes multiple organs injury

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Sishengtang decoction in alleviation of toxic and side effects of transarterial embolization

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World Journal of Gastroenterology 1998年第2期4卷 79-81页

作者： Chen, Z Ling, CQ Huang, XQ Zhang, HW Second Mil med Univ Changhai Hosp Dept Tradit Chinese Med Shanghai 200433 Peoples R China

AIM To observe the therapeutic effects of Sishengtang decoction in alleviating the toxic and side effects of transarterial embolization (TAE). METHODS Fifty four patients with liver cancer were divided randomly into Sishengtang decoction group (34 cases) and control group (20 cases). The changes of clinical symptoms and peripheral hemogram and some cellular immune functions were observed before and two weeks after TAE. RESULTS Sishengtang decoction was superior to the control group in improving the digestive tract reaction. The leucocytes of peripheral blood and cellular immune functions (activities of NK cells and LAK cells) of control group decreased obviously after TAE, while that of Sishengtang decoction group decreased slightly, without obvious difference as compared with that of preoperation. CONCLUSIONS Sishengtang decoction might improve the clinical symptoms and increase the leucocytes of peripheral blood and the cellular immune functions of TAE patients.

关键词： Sishengtang decoction liver neoplasms/therapy embolization, therapeutic immunity , cellular killer cell, natural killer cell , lymphokine activated leucocytes

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Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis:a meta-analysis

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Hepatobiliary & Pancreatic Diseases International 2009年第1期8卷 11-16页

作者： Dai, Hui-Fen Wang, Xiao-Wen Zhao, Kui Zhejiang Univ Sch Med Affiliated Hosp 1 PET Ctr Hangzhou 310003 Zhejiang Peoples R China Zhejiang Univ Sch Med Hangzhou 310058 Zhejiang Peoples R China Zhejiang Univ Sch Med Affiliated Hosp 2 Dept Tradit Chinese Med Hangzhou 310009 Zhejiang Peoples R China

BACKGROUND: The role of prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is debated. We performed a meta-analysis of all published randomized controlled trials to evaluate the efficacy of NSAIDs in the prevention of post-ERCP pancreatitis. DATA SOURCES: Searches were conducted in the databases Pubmed, EMBASE and the Cochrane Library. Six randomized clinical trials that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Data were extracted by two independent observers according to predetermined criteria. RESULTS: The risk of pancreatitis was lower in the NSAID group than in the placebo, group (OR: 0.46, 95% CI: 0.32 to 0.65, P < 0.0001). Two hours after ERCP, prophylactic administration of NSAIDs was associated with a lower serum amylase level (WMD: -91.09,95% CI: -149.78 to -32.40, P=0.002), but there was no difference in mean 24-hour serum amylase values (WMD: -379.00, 95% CI: -805.75 to 47.76, P=0.08). No deaths or NSAID-related complications were noted. CONCLUSIONS: Prophylactic administration of NSAIDs can reduce the incidence of post-ERCP pancreatitis; this administration in patients undergoing ERCP is recommended. Further randomized controlled trials are required before its introduction into routine care.

关键词： meta-analysis nonsteroidal anti-inflammatory drugs endoscopic retrograde cholangiopancreatography pancreatitis

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Inflammatory mediators and microcirculatory disturbance in acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2009年第4期8卷 351-357页

作者： Zhang, Xi-Ping Li, Zhi-Jun Zhang, Jie hangzhou First Peoples hosp Dept Gen Surg Hangzhou 310006 Zhejiang Peoples R China Shaoxing Sixth Peoples hosp Dept Gerontol Shaoxing 312000 Peoples R China Zhejiang Univ tradit chinese med Hangzhou 310053 Zhejiang Peoples R China

BACKGROUND: Inflammatory mediators are not only initiation factors of acute pancreatitis (AP) but also key factors causing pancreatic hemorrhage and necrosis, which damage important organs such as the heart, brain, liver, kidney and lung. Microcirculatory disturbance in AP has attracted widespread attention. In order to provide a theoretical basis for clinical therapy of AP, it is very important to explore the effect of inflammatory mediators on microcirculatory disturbance in this disease. DATA SOURCES: In this review, the impact of inflammatory mediators on microcirculatory disturbance in AP was reviewed according to the literature, especially the articles indexed in Pubmed and books published in China and reports from websites. RESULTS: At present, inflammatory mediation and microcirculatory disturbance are the two major hypotheses to explain the development of AP. Although experimental studies have shown that inflammatory mediators induce or aggravate microcirculatory disturbance, the clinical application of these findings is still difficult because the inflammatory mediators are diverse and their research is not comprehensive and thorough. CONCLUSION: It is very important to explore the influence of inflammatory mediators on microcirculatory disturbance in AP.

关键词： acute pancreatitis inflammatory mediators microcirculation

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Pathological changes in multiple organs of rats with severe acute pancreatitis treated by baicalin and octreotide

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Hepatobiliary & Pancreatic Diseases International 2009年第1期8卷 85-92页

作者： Zhang, Xi-Ping Tian, Hua Wu, Di-Jiong Feng, Guang-Hua Chen, Li Zhang, Jie Xu, Ru-Jun Cai, Yang Ju, Tong-Fa Xie, Qi hangzhou First Peoples hosp Dept Gen Surg Hangzhou 310006 Zhejiang Peoples R China hangzhou First Peoples hosp Dept Pathol Hangzhou 310006 Zhejiang Peoples R China Zhejiang Univ Sch Med Affiliated Hosp 2 Dept Gen Surg Hangzhou 310009 Zhejiang Peoples R China Zhejiang Univ tradit chinese med Hangzhou 310053 Zhejiang Peoples R China

BACKGROUND: Severe acute pancreatitis (SAP) features fatal pathogenetic conditions and high mortality rate. The study of SAP complicated with multiple organ injuries is of important significance. In this study, we explored the protective effect of baicalin on multiple organs of SAP rats and compared it with that of octreotide through light and electron microscopic observations of the pathological changes. METHODS: The improved Aho method was used to prepare SAP rat models. These rats were then randomly divided into a sham-operated group (n=45), a model control group (n=45), baicalin-treated group (n=45) and octreotide-treated group (n=45). Based on the difference in time points after operation, these groups were subdivided into 3, 6 and 12 hour subgroups (n=15). At the corresponding time point after operation, the mortality rate of rats was recorded, and then the rats were humanely killed to take samples of multiple organs that were subsequently examined for pathological changes under light and electron microscopy. RESULTS: At 12 hours after operation, the mortality rate of rats in the baicalin- and octreotide-treated groups was lower than that in the model control group (P < 0.05). Compared to the model control group, the pathological changes and pathological scores in the baicalin- and octreotide-treated groups were mitigated and relieved to varying degrees. The pathological changes under electron microscopy were also improved. CONCLUSIONS: Both baicalin and octreotide show good protective effects on multiple organs of SAP rats. Baicalin as a new drug has good prospects in the treatment of SAP.

关键词： severe acute pancreatitis pathological changes traditional chinese medicine baicalin octreotide

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Natural taurine promotes apoptosis of human hepatic stellate cells in proteomics analysis

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World Journal of Gastroenterology 2010年第15期16卷 1916-1923页

作者： Deng, Xin Liang, Jian Lin, Zhi-Xiu Wu, Fa-Sheng Zhang, Ya-Ping Zhang, Zhi-Wei Guangxi tradit chinese med Univ Affiliated Ruikang Hosp Nanning 530011 Guangxi Zhuang Peoples R China chinese Univ Hong Kong Sch Chinese Med Shatin Hong Kong Peoples R China

AIM:To study the differential expression of proteins between natural taurine treated hepatic stellate cells and controls, and investigate the underlying regulatory mechanism of natural taurine in inhibiting hepatic ***: A proteomic strategy combining two-dimensional gel electrophoresis and ultraperform ance liquid chromatographyelectrospray ionizationtandem mass spectrometry (UPLCESIMS/MS) was used to study the differential expression of proteins and Western blotting was used to validate the results. Gene ontology (GO) method was utilized to analyze the functional enrichment of differentially expressed proteins. Flow cytometry was performed to compare the apoptosis rate between taurinetreated and untreated hepatic stellate cells (HSCs).RESULTS: Nineteen differentially expressed proteins (11 upregulated and 8 downregulated) were identifiedby 2D/MS, and the expression profiles of GLO1 and ANXA1 were validated by Western blotting. GO analysis found that these differentially expressed proteins were enriched within biological processes such as "cellular apoptosis", "oxidation reaction" and "metabolic process" in clusters. Flow cytometric analysis showed that taurinetreated HSCs had a significantly increased apoptosis rate when compared with the control ***: Natural taurine can promote HSC apoptosis so as to inhibit hepatic fibrosis.

关键词： Natural taurine Proteomics Hepatic stellate cell Hepatic f ibrosis Apoptosis

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New triterpenoid sapoin from Ardisia gigantifolia Stapf.

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chinese Chemical Letters 2010年第4期21卷 449-452页

作者： Gong, Qiang Qiang Mu, Li Hua Liu, Ping Yang, Shi Lin Wang, Bo Feng, Yu Lin Gen hosp PLA Dept Clin Pharmacol Beijing 100853 Peoples R China JiangXi Univ tradit chinese med Nanchang 330006 Peoples R China

One new triterpenoid sapoin with two known triterpenoid sapoins:3β-O-{α-L-rhamnopyranosyl-(1→3)-[β-D-xylopyranose-(1→2)]-β-D-glucopyranosyl-(1→4)-α-L-arabinopyranosyl}-3β-hydroxy-13β,28-epoxy-oleanan-16-oxo-30-al(1),3β-O-{α-L-rhamnopyranosyl-(1→3)-[(β-D-xylopyranosyl-(1→2)]-β-D-galactopyranosyl-(1→4)-[(β-D-glucopyranosyl-(1→2)]-α-L-ara-binopyranoside}-16α-hydroxy-13,28-epoxy-oleanane(2) and cyclamiretin A 3β-O-α-L-rhamnopyranosyl-(l→3)-[P-D-xylopyranosyl-(1→2)]-β-D-glucopyranosyl-(1→4)-[β-D-glucopyranosyl-(...

关键词： Ardisia gigantifolia Stapf. Myrsinaceae Triterpenoid sapoin

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Diels-Alder Reaction of Hedychenone and Maleic Anhydride

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chinese Chemical Letters 1999年第7期10卷 531-532页

作者： Qing ZHAO Cheng ZOU Xiao Jiang HAO Yao Zu CHEN(Yunnan College of traditional chinese medicine,Kunming 650200)(Faculty of Pharmacy, Kunming medical College. Kunming 650031)(Kunming Institute of Botany, the chinese Academy of Sciences-Kunming 650204)(Zhe Yunnan Coll tradit chinese med Kunming 650200 Peoples R China Kunming med Coll Fac Pharm Kunming 650031 Peoples R China chinese Acad Sci Kunming Inst Bot Kunming 650204 Peoples R China Zhejiang Univ Hangzhou 310027 Peoples R China

Diels-Alder reaction of hedychenone 1 and maleic anhydride 2 gave several products 4 similar to 7, whose structures were identified by spectral methods. Effect of temperature on the reaction was disscussed.

关键词： Diels-Alder reaction hedychenone antitumor activity hedychium genus

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Double-balloon enteroscopy for obscure gastrointestinal bleeding: A single center experience in China

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World Journal of Gastroenterology 2010年第13期16卷 1655-1659页

作者： Chen, Li-Hua Chen, Wen-Guo Cao, Hai-Jun Zhang, Hong Shan, Guo-Dong Li, Lin Zhang, Bing-Ling Xu, Cheng-Fu Ding, Kai-Li Fang, Ying Cheng, Ying Wu, Chen-Jiao Xu, Guo-Qiang Zhejiang Univ Dept Gastroenterol Affiliated Hosp 1 Coll Med Hangzhou 310003 Zhejiang Peoples R China Zhejiang Univ chinese med Dept Gastroenterol Affiliated Hosp 1 Hangzhou 310003 Zhejiang Peoples R China Dongyang Peoples hosp 1 Dept Gastroenterol Jinhua 322100 Zhejiang Peoples R China Zhejiang Univ Dept Endoscopy Ctr Affiliated Hosp 1 Coll Med Hangzhou 310003 Zhejiang Peoples R China

AIM: To evaluate the diagnostic value of double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding (OGIB). METHODS: The data about 75 OGIB patients who underwent DBE in January 2007-June 2009 in our hospital were retrospectively analyzed. RESULTS: DBE was successfully performed in all 75 patients without complication. Of the 75 patients, 44 (58.7%) had positive DBE findings, 22 had negative DBE findings but had potential bleeding at surgery and capsule endoscopy, etc . These 66 patients were finally diagnosed as OGIB which was most commonly caused by small bowel tumor (28.0%), angiodysplasia (18.7%) and Crohn’s disease (10.7%). Lesions occurred more frequently in proximal small bowel than in distal small bowel (49.3% vs 33.3%, P = 0.047). CONCLUSION: DBE is a safe, effective and accurate procedure for the diagnosis of OGIB.

关键词： Double-balloon enteroscopy Capsule endoscopy Obscure gastrointestinal bleeding Diagnosis

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