[Clinical study of Yihuo Qingxia method in treating hyperlipoidemia-related severe acute pancreatitis in early stage].

OBJECTIVE: To investigate the therapeutic effect of Yihuo Qingxia method, a traditional Chinese medicine therapeutic method for replenishing qi to activate blood, clearing away heat and dredging intestines, in treating hyperlipoidemia-related severe acute pancreatitis (SAP) in early stage. METHODS: One hundred and four patients with hyperlipoidemia-related SAP were divided into two groups: early group (admitted to hospital within 3 days after onset) and late group (admitted to hospital from 3 days to 7 days after onset). There were 52 cases in each group. All the patients were treated by Yihuo Qingxia method. RESULTS: There were no statistical differences in 48-hour Ranson scores, CT scores, 24-hour acute physiology and chronic heath evaluation II scores (APACHE II scores), and the levels of 24-hour serum triglyceride (TG) and serum glucose in the two groups (P>0.05). At the 10th day after onset, the serum TG level in early group was lower than that in late group (P<0.01). The incidences of acute respiratory distress syndrome, acute renal failure, hepatic inadequacy, congestive heart failure, shock, encephalopathy, infection and alimentary tract hemorrhage in early group were higher than those in late group (P<0.05). The mortality in early group was lower than that in the late group (P<0.05). The length of hospital stay in early group was shorter than that in late group (P<0.05). CONCLUSION: Yihuo Qingxia method has a good efficacy in treating hyperlipoidemia-related SAP in early stage.

Comparison of integrated Chinese and Western medicine with and without somatostatin supplement in the treatment of severe acute pancreatitis.

AIM: To evaluate the therapeutic effect of the combined use of early short-term somatostatin and conventional integrated Chinese and Western medicine in treating severe acute pancreatitis. METHODS: Sixty patients with severe acute pancreatitis were divided at random into a somatostatin group and a basic treatment group. Both groups received integrated traditional Chinese and Western medicine without surgery. For patients in the somatostatin group, somatostatin was infused intravenously 250 microg/h for 72 h; other medications were the same as in the basic treatment group. In both groups, comparisons of therapeutic effectiveness were made in terms of morbidity of organic dysfunction and mortality rate, and severity of the disease according to serum levels of C-reaction protein, scores of acute physiology and chronic health evaluation (APACHE II), and scores of Balthazar-CT. RESULTS: The indexes for C-reaction protein levels on the fourth and seventh days, and APACHE II scores on the seventh day after treatment, were significantly improved in the somatostatin group than in the basic treatment group. The morbidity of organic dysfunction was lower in the somatostatin group than in the basic treatment group, although the difference was not statistically significant. There was no significant difference in mortality between the two groups. CONCLUSION: We conclude that combined traditional Chinese and Western medicines with an early short-term use of somatostatin can improve the condition of patients with severe acute pancreatitis.

[Impact of traditional Chinese medicine WPY on ICAM-1 expression and MPO activity in pancreas and lungs of rats with acute necrotizing pancreatitis].

OBJECTIVE: To explore the character of the ICAM-1 induced change of polymorphonuclear neutrophil (PMN) in the pancreas and lung of rats with acute necrotizing pancreatitis (ANP) and to evaluate the effects of Chinese medicine WPY on ANP. METHODS: ANP model was induced by retrograde injection of 3.5% sodium taurocholic acid into the biliopancreatic duct of Wistar rats. Expression of ICAM-1 at different time points in pancreas and lung was assessed by immunohistochemistry. The quantity of polymorphonuclear neutrophil (PMN) in tissues was measured by the level of myeloperoxidase activity (MPO). In addition, the indices above were also observed after the administration of WPY. RESULTS: In the ANP group, ICAM-1 expression and MPO activity were evidently up-regulated at 3 h in pancreas and at 6 h in lung, and both reached their highest level at 12 h. In the WPY treated group, ICAM-1 expression and MPO activity in pancreas and lung were significantly decreased at 12 h. CONCLUSION: The numerous PMNs infiltration mediated by ICAM-1 plays an important role in the damage to pancreas and lung caused by ANP. The traditional Chinese medicine WPY can attenuate ICAM-1 expression and MPO activity in pancreas and lung during ANP.

[Improvement of the model of pancreas-duodenal transplantation in swines].

OBJECTIVE: To improve the procedures of pancreas-duodenal transplantation in swines in order to establish a technically stable model that accords with the physiological situation. METHODS: The whole pancreatoduodenal graft was harvested with in situ flush using 4 degrees C preservation solution. Type 1 diabetes was induced surgically by total pancreatectomy. By end-to-side fashion, the segment of abdominal aorta containing the celiac artery and the anterior mesenteric artery (equal to superior mesenteric artery in human) was anastomosed to the abdominal aorta of recipient which is behind the renal artery, the portal vein was anastomosed to the anterior mesenteric vein of the recipient, the duodenum was anastomosed to the jejunum of the recipient. The graft was placed in the anterior right peritoneal cavity. RESULTS: A total of 28 swines were used as recipients. Of them, two died of anesthetic accident, another two died of hyperacute rejection 2 hours, 19 hours after operation respectively; the others underwent the operation uneventfully. Their survival time was 5-21 days, blood sugar was (11.33+/-1.66) mmol/L on the first day after operation, and (5.65+/-0.89) mmol/L on the third day. CONCLUSION: This kind of model is stable, and the operative method and procedures are relatively simple and practicable.

[Clinical study on the treatment of severe acute pancreatitis by integrated traditional Chinese medicine and Western medicine].

OBJECTIVE: To sum up clinical experiences and formulate a new treatment program for the effective managment of severe acute pancreatitis(SAP) by integrated TCM and western medicine. METHODS: The therapeutic regimens and end results of 1376 cases of SAP in three periods were reviewed and analyzed. Period I (1980-1990) was characterized by early surgical intervention supplemented with integrated traditional Chinese and western medical therapy, period II (1991-1993) by integrated traditional Chinese and western medical therapy supplemented with surgery for early complications, and period III (1994-2003) by integrated traditional Chinese and western medical therapy supplemented with surgery for local infectious complications at a late stage in the course of disease. RESULTS: With use of integrated traditional Chinese and western medical therapy in the treatment of SAP, the proportion of surgical operation and the case-fatality rate kept declining in the three consecutive periods, the proportions of operation being 77.59%, 54.54% and 19.38%, and the case-fatality rates being 40.52%, 17.17% and 10.77%, respectively. CONCLUSION: Integrated TCM and western medicine is effective for most SAP cases, and surgery is indicated mainly for late complications such as necrotizing infection. Early surgery should be handled with more circumspection and strictness in most of the patients with SAP.

[Mollusicidal effects of some species of plants in hilly and mountainous areas].

OBJECTIVE: To valuate the mollusicidal effects of some plants cultivated in the hilly and mountainous areas on Oncomelania hupensis and screen the plants against O. hupensis snails. METHODS: The mollusicidal effects of water extracts of plant materials were tested in laboratory. RESULT: The LC50 of all the species in 24 h, 48 h, and 120 h reached the middle noxious level against O. hupensis snails. According to the taxis of LC50(s) in 120 h, Eucalyptus camaldulensis was best with a LC50 of 0.013%, and Ailanthus altissima, Zanthoxylum bungeanum, Juglans regia, Melia azedarach, Nerium indicum, Pterocarva stenobtera, Cinnamomum camphora, Vetiveria zizanioides, and Citrus reticulata were the second with LC50 (s) between 0.020% and 0.370%, and Zingiber officinale had a lower effect on snail control with a LC50 of above 0.500%. There was a correlation between the death rate of snails and soak time. CONCLUSION: The resources of snail-restrained plants are very abundant, and four plants, such as Eucalyptus camaldulensis, Ailanthus altissima, Cinnamomum camphora, and Vetiveria zizanioides have some mollusicidal effect.

Experimental study of Tong Xia purgative method in ameliorating lung injury in acute necrotizing pancreatitis.

AIM:To investigate the role of tumor necrosis factor (TNF) in lung injury during acute necrotizing pancreatitis (ANP), and the therapeutic effect of Tong Xia purgative method in minimizing the severity of lung injury.METHODS:Fourteen canines were randomly divided into 3 groups:the Tong Xia treatment group (n = 5) using Dachengqitang; saline control group (n = 5), and the sham operation group (n =4). TNF activity in serum and in bronchoalveolar lavage fluid (BALF), the serum endotoxin levels were measured,and the severity of lung injury evaluated.RESULTS:Elevation of TNF activity was more prominent in BALF than in serum. TNF activity in serum at 6 and 12 hours and in BALF was significantly decreased in the Tong Xia treatment group than in the saline control one (q = 21.11, q = 12.07, q = 9.03, respectively, P <0.01) and the lung injury was significantly alleviated at 12 hours as compared with that in the saline group, manifested as amelioration of the lung wet/dry weight ratio, decrease in protein concentration and neutrophils count in BALF, and improvement of pulmonary inflammatory changes. A positive correlation was demonstrated between serum TNF activity and endotoxin level.CONCLUSION:Hypersecretion of TNF is shown to be one of the major causes of lung injury during ANP; Tong Xia purgative method could alleviate the degree of lung injury mediated by TNF.