[Clinical value of the early use of ulinastatin in patients with moderately severe or severe acute pancreatitis]

Objective: To observe the clinical efficacy and the effects on serum inflammatory factors of early use of ulinastatin in patients with moderately severe or severe acute pancreatitis (MSAP/SAP). Methods: This prospective, randomized, controlled trial was conducted in the First Affiliated Hospital of Soochow University from September 2013 to May 2016. A total of 42 cases were enrolled and assigned into either observation group or conventional treatment group (n=21 each). The conventional treatment group received somatostatin, while the observation group received somatostatin combined with ulinastatin. After treatment, clinical characteristics, serum indicators, clinical complications and serum level of inflammatory factors were analyzed. Results: Intra-abdominal pressure and relief time of abdominal pain were significantly decreased in observation group [ (10.4±2.1) cmH(2)O; (2.5±1.2) d ] compared with the conventional treatment group [ (11.7±2.2) cmH(2)O; (3.33± 1.2) d ], P<0.05. White blood cells (WBC) were lower in observation group than those in conventional treatment group [ (11.2±1.8) ×10(9)/L vs (12.5±2.3) ×10(9)/L; P<0.05 ]. After treatment serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α(TNF-α) in observation group [ (30.5±3.3), (34.7± 6.5), (22.6±4.0) μg/L] were significantly lower than those in conventional treatment group [ (39.6±4.0), (40.9±3.4), (33.1±6.6) μg/L], P<0.05. There were no differences between the two groups in modified CT severity index (MCTSI), recovery time of defecation, ICU length of stay, serum amylase, C-reactive protein (CRP) and incidence rates of clinical complications. Conclusions: The early use of ulinastatin in the patients with MSAP/SAP can down-regulated the levels of TNF-α, IL-6 and IL-8, reduce the inflammatory response, decrease intra-abdominal pressure and shorten abdominal pain time. It was beneficial and worthy of wider popularization.

[Structural elucidation of a new tetrahydroxystilbene of Radix Polygoni Multiflori Preparata and study on its cardiovascular activity]

AIM

To investigate the cardiovascular active constituents of Radix Polygoni multiflori Preparata.

METHODS

Compounds were isolated from the water soluble extract with column chromatography of Sephadex, ODS and HPLC. The compounds were identified on the basis of spectral analysis (IR, EI-MS, FAB-MS, 1HNMR, 13CNMR, 2D-NMR) and phytochemical properties. Its inhibitory effect on the proliferation of bovine vascular smooth muscle cells were bioassayed in vitro.

RESULTS

One compound was isolated and identified as: 2,3,5,4'-tetrahydroxystilbene-2-O-(6"-O-alpha-D- glucopyranosyl)-beta-D-glucopyranoside.

CONCLUSION

Compound I is a new compound with cardiovascular activity.

Inhibitory effect of recombinant TGF alpha-PE40 on vascular smooth muscle cell proliferation

AIM

To study inhibitory effect of recombinant transforming growth factor alpha-Pseudomonas exotoxin fusion protein (TP40) on proliferation of the cultured vascular smooth muscle cells (SMC).

METHODS

Expression of epidermal growth factor receptor (EGFR) mRNA and EGFR in cultured proliferating and quiescent SMC was analyzed with Northern blot and immunohistochemistry. Inhibitory effects of TP40 on SMC proliferation and protein synthesis were analyzed with crystal violet staining and [3H]leucine incorporation. Competition assays were performed by the addition of 100-fold excess of EGF.

RESULTS

Expression of EGFR mRNA and EGFR in rapidly proliferating SMC increased than that in quiescent SMC. When the concentration of TP40 was 10 or 100 micrograms.L-1, inhibitory effects of TP40 on rapidly proliferating SMC proliferation and protein synthesis were much higher than that on quiescent SMC (P < 0.01), and the IC50 of [3H]leucine incorporation against rapidly proliferating and quiescent SMC were 8.01 (5.05-12.69) and 121.95 (90.98-163.47) micrograms.L-1. Excess EGF completely blocked inhibitory effects of TP40.

CONCLUSION

The rapidly proliferating SMC express EGFR at a high level. TP40 selectively inhibited the proliferation of rapidly proliferating SMC. The cytotoxic effects of TP40 were specifically mediated by EGFR.

Effects of pentoxifylline and protein kinase C inhibitor on phorbol ester-induced intercellular adhesion molecule-1 expression in brain microvascular endothelial cells

AIM

To study the potential roles of protein kinase C (PKC) on expression of intercellular adhesion molecule-1 (ICAM-1) in rat brain microvascular endothelial cells (RBMEC).

METHODS

ICAM-1 expression in RBMEC was measured by ELISA analyses.

RESULTS

Phorbol ester (PMA) enhanced the expression of ICAM-1 in a concentration (10-100 nmol.L-1) and time (4-16 h)-dependent manner in RBMEC. Pentoxifylline (PTX) 1-100 mumol.L-1 and the PKC inhibitor H7 5-50 mumol.L-1 prevented PMA-induced stimulation of ICAM-1 expression. At PTX 100 mumol.L-1 and H7 50 mumol.L-1, they reached maximal inhibitory effects [ICAM-1 expression (A) from (0.410 +/- 0.014) to (0.175 +/- 0.022) and (0.182 +/- 0.013), respectively; P < 0.01].

CONCLUSION

Activation of PKC in RBMEC is associated with increased expression of ICAM-1 in RBMEC. PTX and H7 preincubation may inhibit PKC-induced up-regulation of ICAM-1.