Protective effects of a prostaglandin E1 oligomer on taurocholate-induced rat pancreatitis

Alprostadil combined with peritoneal lavage therapy for treatment of hyperlipidemic severe acute pancreatitis

AIM: To evaluate the clinical effects of alprostadil combined with peritoneal lavage therapy in the treatment of hyperlipidemic severe acute pancreatitis (HSAP).

METHODS: Twenty-seven patients with HSAP were randomly divided into two groups: a control group (13 patients) and a treatment group (14 patients). Both groups received the same conventional medical therapy, and the treatment group additionally received alprostadil and peritoneal lavage therapy (14 d as a cycle). Curative effects were compared between the two groups.

RESULTS: Compared with the control group, the time to patient's condition improvement (5.55 d ± 3.12 d vs 8.18 d ± 4.09 d, 4.14 d ± 2.94 d vs 6.75 d ± 3.58 d), the time to improvement of triacylglycerol (5.42 d ± 2.06 d vs 8.28 d ± 3.55 d), total response rate (85.71% vs 61.54%), rates of complications (21.6% vs 38.5%) and mortality (7.14% vs 15.38%), average hospital stay (23.84 d ± 7.54 d vs 31.98 d ± 12.18 d), and total expenses of the medical treatment (34.56 ± 13.44 vs 41.29 ± 18.81) were significantly better in the treatment group (P < 0.05 or P < 0.01).

CONCLUSION: Alprostadil combined with peritoneal lavage therapy is a safe and effective therapy for HSAP. It may become a basic choice for treating HSAP.

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Influencing factors of pancreatic microcirculatory impairment in acute panceatitis

Pancreatic microcirculatory disturbance plays an important role in the pathogenesis of acute pancreatitis, and it involves a series of changes including vasoconstriction, ischaemia, increased vascular permeability, impairment of nutritive tissue perfusion, ischaemia/reperfusion, leukocyte adherence, hemorrheological changes and impaired lymphatic drainage. Ischaemia possibly acts as an initiating factor of pancreatic microcirculatory injury in acute pancreatitis, or as an aggravating/continuing mechanism. The end-artery feature of the intralobular arterioles suggests that the pancreatic microcirculation is highly susceptible to ischaemia. Various vasoactive mediators, as bradykinin, platelet activating factor, endothelin and nitric oxide participate in the development of microcirculatory failure.

Time-course magnetic resonance imaging of rat pancreatic cyst after experimental pancreatitis

Fast magnetic resonance (MR) imaging of the rat pancreas was carried out using a snapshot method to observe three-dimensional (3D) and temporal development of the pancreatic cyst after experimental pancreatitis. Acute pancreatitis was induced by a retrograde infusion of the trypsin-taurocholate solution into the pancreatic duct in 23 rats, of which seven survived for one month. Under 2% enflurane anesthesia, (1)H images of the rat abdomen were taken by a 4.7 T magnetic resonance spectrometer under spontaneous breathing. 3D images of the pancreas and cyst were reconstructed from the axial, sagittal and coronal images taken before, 24 h, 7 days, 14 days, 21 days and 28 days after the induction of pancreatitis. The 3D images reconstructed from different slice orientations at each time point showed good agreement with each other. The calculated volumes of the cyst on 7th, 14th, 21st, and 28th day were 0.3 +/- 0.1, 0.8 +/- 0.3, 2.1 +/- 0.6, 6.5 +/- 1.3 mL, respectively. The cystic fluid volume on 28th day was 6.4 +/- 1.4 mL, which confirmed reliability of volume measurement by MR imaging. Fast MR imaging (snapshot) together with 3D reconstruction allows us to understand the detailed chronological and spatial development of pancreatic cyst after acute pancreatitis in rats.