scholarly journals Combined effect of ultrasound-guided percutaneous abdominal paracentesis drainage and ulinastatin on severe acute pancreatitis

2021 ◽  
Vol 20 (10) ◽  
pp. 2187-2192
Author(s):  
Chuanmin Liu ◽  
Fei Yuan ◽  
Baowei Wang ◽  
Xuezhen Wang
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Study Groups ◽  
Control Group ◽  
Amylase Level ◽  
Study Group ◽  
Research Subjects ◽  
Ultrasound Guided ◽  
Beneficial Effects ◽  
Abdominal Paracentesis

Purpose: To study the clinical effect of a combination of ultrasound-guided percutaneous abdominal paracentesis drainage (APD) and ulinastatin on severe acute pancreatitis (AP).Methods: A total of 94 patients with severe AP in Intensive Care Unit, Jiaozhou Central Hospital, Qingdao, from December 2017 to December 2018 were selected as the research subjects. They were divided into control and study groups, with 47 patients in each group. Patients in the control group underwent laparotomy drainage, while patients in the study group underwent ultrasound-guidedpercutaneous APD. Patients in both groups received ulinastatin perfusion. Subsequently, clinical effectsand other relevant indicators were determined.Results: Overall response was significantly higher in the study group than in the control group (p < 0.05). The times taken for disappearance of postoperative symptoms, normalization of serum amylase level, and hospitalization were significantly shorter in the study group than in the control group (p < 0.05). For every indicator, the study group exhibited more benefits after than before treatment; however, post-treatment levels of blood glucose, hemodiastase and urinary amylase were better than those in the control group (p < 0.05). Incidence of postoperative complications was lower in the study group than in control group (p < 0.05).Conclusion: The combination of ultrasound-guided percutaneous APD with ulinastatin produces marked beneficial effects on severe AP patients. It facilitates the remission of adverse symptoms, and enhances  normalization of indicator levels. Moreover, it displays low incidence of complications, better prognosis and recovery, and absence of post-operation infections.

scholarly journals The effect of enteral nutrition on intra-abdominal pressure in severe acute pancreatitis patients

2017 ◽  
Author(s):  
Mingjie Zhang ◽  
Li-Ping Cao ◽  
Guoping Ding
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Occurrence Rate ◽  
Control Group ◽  
Abdominal Pressure ◽  
Therapeutic Effects ◽  
Study Group ◽  
Time Operation ◽  
Operation Rate

Abstract BACKGROUND: To investigate the effect of enteral nutrition (EN) on intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) patients and the relationship between the decreasion of IAP and the the therapeutic effect of EN. METHODS: Eighty SAP patients were randomly divided into study group and control group (40 patients in each group). Patients in the study group received EN and Patients in the control group received total parenteral nutrition (TPN) for 7 days. Intra-cystic pressure (ICP) of the two groups was measured during treatment period. The outcomes of treatment were observed, APACHE Ⅱ scores, NB data were applied in analysis. RESULTS: The ICP data was lower in the study group than in the control group on days 4 and 5 of treatment (P &lt; 0.05). On days 3-5 of treatment, the APACHE Ⅱ scores of the study group were lower than which of the control group (P &lt; 0.05). Nitrogen balance (NB) date increased significantly in study group than in the control group (P &lt; 0.05). abdominalgia relief time, operation rate were different between the two groups (P &lt; 0.05). The abdominal compartment syndrome (ACS) occurrence rate of the two groups have no significant difference. The ICP data and APACHE Ⅱscores, abdominalgia relief time, operation rate of pancreas debridement show positive correlation (P &lt; 0.05). ICP and NB date show negative correlation (P &lt; 0.05). CONCLUSION: EN can decrease the IAP of SAP, which may be the reason for EN show preventive and therapeutic effects on SAP.

scholarly journals Ketorolac and Predicted Severe Acute Pancreatitis: A Randomized, Controlled Clinical Trial

2020 ◽  
Author(s):  
Shaahin Shahbazi ◽  
Zahra Vahdat Shariatpanahi ◽  
Erfan Shahbazi
Keyword(s):  
Acute Pancreatitis ◽  
Serum Level ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Rank Test ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Group Frequency ◽  
Hs Crp

Abstract Background: We evaluated effect of ketorolac on reducing the severity of acute pancreatitis.Methods: Fifty six adult patients, with predicted severe acute pancreatitis were randomly divided into two groups. The patients in the study group received intravenous ketorolac, 10 mg, 3 times daily from time of enrollment for a maximum of 5 days as needed along with standard medical treatment. Primary outcome measure was the change in the serum level of hs-CRP. Patients were also followed up in terms of hospitalization duration, need for ICU care, development of organ failure, persistent organ failure, pancreatic necrosis, nutritional assessment and mortality. The study was continued to gather clinical follow up information up to 4 months.Results: Serum level of hs-CRP was significantly lower in the ketorolac group than in the control group on days 3, 4, and 5. Organ failure, pseudocyst formation, acute necrotic collection and intensive care unit transfer occurred non-significantly more in the control group than in the ketorolac group. Median days of hospitalization were significantly lower in the study group than in the control group. Based on the Log rank test, survival within 4 months was marginally lower in the control group (P=0.076). The time to start feeding was significantly shorter in the study group than in the control group with no need to artificial enteral nutrition in the ketorolac group. Frequency of NPO (not per oral) was significantly lower in the ketorolac group.Conclusion: The use of ketorolac may improve feeding and clinical outcomes in severe acute pancreatitis.ClinicalTrials.gov: NCT02885441, Date: August 31, 2016

Abdominal paracentesis drainage attenuates intestinal mucosal barrier damage through macrophage polarization in severe acute pancreatitis

2021 ◽  
pp. 153537022110151
Author(s):  
Xiaohui Yuan ◽  
Chen Luo ◽  
Jun Wu ◽  
Wei Li ◽  
Xin Guo ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Sham Group ◽  
Intestinal Injury ◽  
Mucosal Barrier ◽  
Control Group ◽  
Jnk Pathway ◽  
Intestinal Mucosal Barrier ◽  
Abdominal Paracentesis ◽  
M2 Phenotype

Abdominal paracentesis drainage (APD), as an effective treatment of severe acute pancreatitis (SAP) in clinical settings, can ameliorate intestinal barrier damage and the overall severity of SAP. However, the mechanism underlying therapeutic effects of APD on damaged intestinal mucosal barrier during SAP is still unclear. Here, SAP was induced by injecting 5% Na-taurocholate retrograde into the biliopancreatic duct of rats to confirm the benefits of APD on enteral injury of SAP and further explore the possible mechanism. Abdominal catheter was placed after SAP was induced in APD group. As control group, the sham group received no operation except abdominal opening and closure. By comparing changes among control group, sham group, and APD group, APD treatment obviously lowered the intestinal damage and reduced the permeation of intestinal mucosal barrier, which was evidenced by intestinal H&E staining, enteral expression of tight junction proteins, intestinal apoptosis measurement and detection of serum diamine oxidase, intestinal fatty acid binding protein and D-lactic acid. Furthermore, we found that APD polarized intestinal macrophages toward M2 phenotype by the determination of immunofluorescence and western blotting, and this accounts for the benefits of APD for intestinal injury in SAP. Importantly, the protective effect against intestinal injury by APD treatment was mediated through the inhibited ASK1/JNK pathway. In summary, APD improved the intestinal mucosal barrier damage in rats with SAP through an increasing portion of M2 phenotype macrophages in intestine via inhibiting ASK1/JNK pathway.

Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells (huMSCs) Carrying MicroRNA-342 Relieve Protect Severe Acute Pancreatitis Injury (SAP)

2021 ◽  
Vol 11 (9) ◽  
pp. 1838-1843
Author(s):  
Xiaohong Zhou ◽  
Xuzhong Hao ◽  
Feifei He
Keyword(s):  
Stem Cells ◽  
Acute Pancreatitis ◽  
Mesenchymal Stem Cells ◽  
Umbilical Cord ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Tissue ◽  
Inflammatory Factors ◽  
Control Group ◽  
Human Umbilical Cord Blood ◽  
Human Umbilical Cord

To investigate whether exosomes (exo) derived from human umbilical cord mesenchymal stem cells (huMSCs) and microRNA (miRNA)-342 have a protective effect on severe acute pancreatitis (SAP). Human umbilical cord blood was collected to extract huMSC-exo. With sham-operated mice as control group (n = 10), the other mice were induced to SAP model (n = 20), while 10 of the SAP mice received treatment with huMSC-exo. ELISA was performed to determine amylase and TAP level as well as inflammatory factors and HE staining to evaluate pathological changes of pancreatic tissue. The expression of miR-342 and Shh, Ptchl, and Smo in the Hh signal pathway was detected using RT-qPCR. The expression of miR-342 and the mRNA expression of Shh, Ptchl, and Smo was higher than that in model group (p < 0.05). The level of serum amylase, trypsinogen, and IFN-γ,Fasl, and IL-6 was upregulated in pancreas tissues of SAP mice relative to healthy mice, but their levels were decreased upon treatment with huMSC-exo and slightly higher than those of the control group, just not significantly. Collectively, the huMSC-exo may activate the Hh signaling pathway by regulating the expression of miR-342 increasing the expression of Shh, Ptchl, and Smo, and thereby healing of damaged pancreatic tissues in SAP.

scholarly journals A randomised, open label comparative study of hydroxychloroquine with betamethasone oral mini pulse in the management of patients with alopecia areata

2021 ◽  
Vol 10 (2) ◽  
pp. 187
Author(s):  
Jeyasudha Jambusayee ◽  
Kulur Mukhyaprana Sudha
Keyword(s):  
Alopecia Areata ◽  
Life Quality ◽  
Autoimmune Disorder ◽  
Study Groups ◽  
Pulse Therapy ◽  
The Body ◽  
Control Group ◽  
Study Group ◽  
Open Label ◽  
Significant Difference

Background: Alopecia areata is an autoimmune disorder causing patchy hair loss on scalp and other parts of the body and leading to poor self-esteem and anxiety in patients. Treatment with topical or systemic drugs like steroids or other immunosuppressants is associated with adverse effects. Hydroxychloroquine is an antimalarial drug, with T cell modulating function. This study was undertaken to assess the safety, efficacy and tolerability of Hydroxychloroquine in Alopecia areata compared to betamethasone oral mini pulse (OMP) therapy. Methods: 60 patients with alopecia areata were randomized into two groups of 30 each. Control group received tab. betamethasone 5 mg/day on two consecutive days of week for 12 weeks and Study group received tab. hydroxychloroquine 200 mg/day for 12 weeks. They were followed-up for further 12 weeks. Scale of alopecia tool, dermatology life quality index and global assessment at baseline, 12 weeks and 24 weeks were used to assess the outcome.Results: 94 patients were screened and 60 patients were included. All patients completed the study. At the end of 12 weeks, there was a statistically significant reduction in SALT and DLQI scores in both control and study groups. But at the end of 24 weeks, the study group showed an increase in the scores. Relapses were more in the study group. No significant difference in the incidence of adverse events was noted between the two groups.Conclusions: Hydroxychloroquine 200 mg/day is less efficacious in the management of alopecia areata in comparison to betamethasone oral mini pulse therapy.

scholarly journals Anesthetic Effect of Compound Artevacaine Hydrochloride in Patients Undergoing Oral Implantation

2021 ◽  
Vol 5 (4) ◽  
pp. 220-224
Author(s):  
Chengxi Chi ◽  
Mengmeng Zhao ◽  
Jiajing He ◽  
Yanli Wang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Research Subjects ◽  
Implant Surgery ◽  
Anesthetic Effect ◽  
Significant Difference ◽  
Oral Implant

Objective: To investigate and analyze the anesthetic effect of compound artevacaine hydrochloride in patients undergoing oral implantation. Methods: In this study, 60 patients receiving oral implant surgery in our hospital were selected as the research subjects, and the operation time was from July 2019 to March 2021. Patients were randomly selected and divided into groups for the study. 30 patients receiving lidocaine hydrochloride anesthesia were used as the control group, and 30 patients receiving compound artevacaine hydrochloride anesthesia were used as the research group. The anesthetic effect and safety of the two groups were compared and analyzed. Results: The anesthetic effect of the study group was significantly better than that of the control group (P < 0.05). The blood pressure and heart rate in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups before anesthesia (P > 0.05). There was no significant difference in the incidence of ADR between the two groups (P > 0.05). Conclusions: For patients undergoing oral implant surgery, choosing compound artevacaine hydrochloride as anesthetic drug has obvious anesthetic effect and can stabilize patients' life indexes. The anesthetic effect is obvious, and there is no obvious adverse reaction, and the clinical value is obvious.

VEGFR2 expressions in Th1 and CD8+ cytotoxic T lymphocytes (CTL) in colon cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15535-e15535
Author(s):  
Mehmet Artac ◽  
Ayca Ceylan ◽  
Melek Karakurt Eryılmaz ◽  
Murat Araz ◽  
Mustafa Karaagac ◽  
...  
Keyword(s):  
Colon Cancer ◽  
T Cell ◽  
Cancer Patients ◽  
Study Groups ◽  
T Cell Subsets ◽  
Control Group ◽  
Study Group ◽  
Metastatic Colon Cancer ◽  
Vegf Receptors ◽  
Cancer History

e15535 Background: VEGF receptors have an important role for inhibiting adaptive immun response in colon cancer. Therefore, we analyzed VEGF receptors in circulating T cell subsets according to stage in colon cancer patients. Methods: The prospective study group consisted of 50 patients with histologically confirmed colon cancer and 30 person without any cancer history as a control group. Peripheral blood specimens were collected from the patients after the diagnosis before inducing chemotherapy and radiotherapy. Patients with active infections or autoimmune disorders, who were treated with steroids and antibiotics in the last four weeks before the study enrollment were excluded from the study group. VEGFR2 expressions in circulating T cell subsets (Th1, Th2, Th17, CTL) were analyzed by flow cyctometry. Results: Age and gender were not different between the all study groups. Mean circulating CD4+ folicullar cells were less in colon cancer patients (9.54%±3.99) than the control group (12.03%±4.34), (p < 0.01). Mean circulating CD8+ follicular cells were higher in metastatic colon cancer (n = 26) 2.48% ± 1.68, than the non-metastatic colon cancer patients (n = 24) 1.63% ± 1.37, (p = 0.02). Mean VEGFR2 expressions in Th1 cells were higher in colon cancer patients 248.8 (Mean Flourescein intensity-MFI) than the control group 224.6, (P = 0.006). Mean VEGFR2 expressions in CTL were higher in colon cancer patients (381.8) than the control group (284.7), (p < 0.001). PD-1 expressions were not different between the colon cancer patients and the control group in all circulating T cell subsets. Mean VEGFR2 expressions in Th17 cells were higher non-metastatic colon cancer patients than the metastatic colon cancer patients (326.5 and 268.4 MFI, respectively, p = 0.02). Conclusions: VEGFR2 expressions are increased in circulating Th1 and CTL subsets in colon cancer patients. Whereas PD-1 expressions were not different in circulating T cell subsets than the control. VEGFRs may play an important role for the inhibition of circulating T cell subsets in colon cancer.

scholarly journals Therapeutic benefit of aripiprazole-olanzapine combination in the treatment of senile Alzheimer’s disease complicated by mental disorders

2020 ◽  
Vol 19 (2) ◽  
pp. 441-446
Author(s):  
Na Zheng ◽  
Ning Wang ◽  
Ji-Min Jia
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental Disorders ◽  
Clinical Efficacy ◽  
Lower Incidence ◽  
Adverse Reactions ◽  
Study Groups ◽  
Therapeutic Benefit ◽  
Control Group ◽  
Study Group

Purpose: To determine the clinical efficacy of aripiprazole-olanzapine combination treatment in elderly Alzheimer’s disease complicated with mental disorders. Methods: Ninety-two elderly patients with Alzheimer’s disease and mental disorders who were admitted to Binzhou People's Hospital, were enrolled in the study. They were randomized into control and study groups. Control group was treated with olanzapine, while the study group was treated with aripiprazole as an adjuvant therapy in addition to olanzapine. The clinical efficacy, scores on different scales (MMSE, ADAS-cog, CDR, ADL, NPI and CMAI), and incidence of adverse reactions were determined. Results: The overall degree of response was significantly higher in the study group than in the control group (p < 0.05). There were no significant differences in MMSE, ADAS-cog, CDR, ADL, NPI and CMAI scores between the two groups before treatment (p > 0.05). The MMSE score of the study group was significantly higher than that of the control group, and the scores in the other scales in the study group were significantly lower after treatment (p < 0.05). The study group had significantly lower incidence of adverse reactions than control group (p < 0.05). Conclusion: Aripiprazole-olanzapine combination has significant therapeutic benefit in the treatment of elderly Alzheimer’s disease patients complicated with mental disorders. It promotes recovery of neurological function, as well as produces a lower incidence of adverse reactions. Keywords: Aripiprazole, Olanzapine, Alzheimer’s disease, Mental disorders

scholarly journals Pancreatoduodenectomy for Periampullary Tumors Presenting with Acute Pancreatitis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xuefeng Cao ◽  
Xixiu Wang ◽  
Xiaoliang Xu ◽  
Yanmin Lu ◽  
Baolei Zhao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Operative Time ◽  
Laboratory Data ◽  
Biliary Fistula ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Course Of Disease ◽  
Periampullary Tumors ◽  
Medical University

Background. Periampullary tumors (PT) may rarely present as acute pancreatitis (AP) or acute recurrent pancreatitis (ARP). Unlike other cases of AP and ARP, these conditions necessitate pancreaticoduodenectomy (PD), and timely diagnosis is crucial. Materials and Methods. A retrospective review of clinical, radiological, surgical, and pathological data was conducted for patients admitted to the Binzhou Medical University Hospital during the period from January 2010 to December 2017, for AP or ARP caused by PT. All patients included in the study group had undergone PD. The perioperative data for these patients was compared with data for patients with PT but without AP or ARP who underwent PD during the same period (control group). Results. During the study period, 412 patients with AP or ARP were treated; among this group, 15 patients had PT. Compared with controls, patients in the study group were younger in age and had a longer course of disease, more frequent hospitalizations, and more severe derangements in laboratory data (P<0.05). Operative time and intraoperative blood loss were significantly higher in the study group, but the incidence of postoperative outcomes such as pancreatic/biliary fistula, abdominal infection, postoperative hospital stay, and mortality were similar between groups (P>0.05). Conclusions. Neither AP nor ARP has any adverse impact on the outcomes of PD. However, in the treatment of younger patients suffering from AP or ARP, unexplained pancreatic duct dilation and weight loss should raise the suspicion of PT. EUS and EUS-FNA may be helpful in making the diagnosis.

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