Effects of prostaglandin E1 on hepatic blood flow in conscious dogs with chronic biliary obstruction

Prostaglandin E1 Preconditioning Attenuates Liver Ischemia Reperfusion Injury in a Rat Model of Extrahepatic Cholestasis

The aim of this study is to explore the hepatoprotective effect of intraportal prostaglandin E1 (PGE1) on liver ischemia reperfusion (IR) injury using an extrahepatic cholestatic model, observing oxidative stress markers, proinflammatory factors, apoptotic marker proteins, and an adhesion molecule. The extrahepatic cholestatic model was induced by common bile duct ligation. After seven days, rats were subjected to ischemia by Pringle maneuver for 15 min, followed by 1, 6, or 24 h of reperfusion. Prostaglandin E1 (PGE group) or normal saline (NS group) was continuously infused from 15 min before liver ischemia to 1 h after reperfusion. After reperfusion, histopathological evaluation of the liver was performed, as were measurements of bilirubin, biochemical enzymes, oxidative stress markers (GSH and MDA), proinflammatory factors (MPO, TNF-α, and IL-1β), apoptotic marker proteins (Bcl-2 and Bax), and the adhesion molecule (ICAM-1). PGE1 pretreatment attenuated IR injury in extrahepatic cholestatic liver probably by suppressing MDA, MPO, TNF-α, IL-1β, ICAM-1, and Bax levels and improving GSH and Bcl-2 levels. In conclusion, PGE1 protects extrahepatic cholestatic liver from IR injury by improving hepatic microcirculation and reducing oxidative stress damage, intrahepatic neutrophil infiltration, and hepatocyte apoptosis.

Yinhu cholagogue mixture combined with endoscopic naso-biliary drainage in treatment of patients with obstructive jaundice: an analysis of 30 cases

AIM: To observe the clinical efficacy and mechanism of Yinhu cholagogue mixture (YCM) combined with endoscopic naso-biliary drainage (ENBD) in the treatment of patients with obstructive jaundice (OJ).

METHODS: A total of 90 OJ patients were randomly divided into surgery control group (n = 30), endoscopy control group (n = 30) and YCM group (n = 30), treated with traditional open surgery, ENBD alone and YCM plus ENBD, respectively. We observed the T-tube and naso-biliary drainage situation, while monitored the serum TBIL, DBIL, AKP, GPT, GOT, LPS and IL-6 levels before and after operation.

RESULTS: On the 14^th d after sugery, LPS, IL-6 levels and the liver function markers such as TBIL, DBIL, AKP, GPT and GOT in all the patients decreased obviously, and these indexes were markedly lower in YCM group than those in the surgery control group and endoscopy control group (0.07 ± 0.01 vs 0.12±0.03, 0.13 ± 0.03; 166.5 ± 31.62 vs 230.2 ± 41.08, 225.6 ± 42.69; 24.3 ± 7.91 vs 43.3 ± 9.49, 46.7 ± 11.07; 12.6 ± 4.74 vs 32.2 ± 6.33, 46.7 ± 11.07; 67.5 ± 25.30 vs 102.5 ± 36.37, 114.9 ± 39.53; 36.8 ± 14.23 vs 79.0 ± 35.88, 82.3 ± 34.79; 46.2 ± 11.07 vs 84.5 ± 34.79, 80.3 ± 31.62, respectively; P < 0.05 or 0.01); there were no marked differences between the two control groups. On the 5^th d after operation, combined therapy was superior to the other two treatments in bile drainage (P < 0.05 or 0.01), but there was no significant difference between the two control groups.

CONCLUSION: YCM in combination with ENBD can effectively restore liver function, promote bile excretion and lower LPS and IL-6 levels in OJ patients.

An improved rat model of obstructive jaundice and its reversal by internal and external drainage

BACKGROUND

A simple and reproducible rat model that allows studies of the reversal of obstructive jaundice (OJ) by internal (ID) and external (ED) drainage is not available at present.

METHODS

OJ was induced in rats by double ligation and division of the common bile duct. To minimize tissue handling and dissection the duodenum was extracted with a ophthalmic muscle hook and the common bile duct isolated using very fine forceps. One week after bile duct ligation, ID was accomplished by implanting a length of infant feeding tube between the dilated bile duct and the duodenum. ED was achieved by placing a PVC tube into the dilated bile duct and exteriorizing the other end at the nape of the neck.

RESULTS

Minimal adhesions were found around the dilated common bile duct, which made relaparotomy for drainage easy. Alanine transaminase, total bilirubin, alkaline phosphatase, and gamma-glutamyltransferase were significantly raised after bile duct ligation. All parameters returned to control levels after ID for 7 days. In the ED group plasma albumin was significantly decreased and alkaline phosphatase remained marginally elevated.

CONCLUSIONS

We have developed a simple and reproducible rat model that allows for the study of reversal of OJ by ID or ED. We also demonstrated that ID is superior to ED in reversing impaired liver function in OJ.