ObjectiveTo explore the value of Aquaporin-3 (AQP-3) on the detection of early renal function damage by investigating the expressions of renal AQP-3 mRNA and protein of rats with obstructive jaundice (OJ). MethodsForty mature male Wistar rats were divided into two groups randomly: experimental group (n=20) in which the model of OJ rats was established, and control group (n=20, sham operation group). The levels of serum total bilirubin (TBIL), direct bilirubin (DBIL), creatinine (Cr)， and blood urea nitrogen (BUN) were detected by fullautomatic biochemical analyzer on 7 d and 14 d after operation. The expressions of renal AQP-3 mRNA and protein of rats were detected by RT-PCR and Western blotting, respectively. ResultsThe levels of serum TBIL and DBIL were significantly higher on 14 d than those on 7 d after operation in experimental group (P=0.000), which were significantly higher than those at corresponding time point in control group (P=0.000), while the difference within control group was not significant (P=0.154). Thus, the OJ models of rats were established successfully. The difference of serum Cr levels of rats between inter-and intragroup were not significant (Pgt;0.05). Serum BUN level on 14 d after operation in experimental group was significantly higher than those on 7 d after operation in experimental group and on 14 d after operation in control group (P=0.001), although serum Cr levels were not different between 7 d and 14 d after operation in control group (P=0.288). The expressions of AQP-3 protein of rats on 7 d and 14 d after operation in experimental group were significantly lower than those at corresponding time point in control group (P=0.033, P=0.000), meanwhile on 14 d after operation in experimental group was significantly lower than those on 7 d after operation in experimental group (P=0.000). The expressions of AQP-3 mRNA of rats on 7 d and 14 d after operation in experimental group were significantly higher than those at corresponding time point in control group (P=0.000), but the difference at different time point in two groups was not significant (P=0.139, P=0.059). ConclusionsThe changes of renal AQP-3 protein and mRNA expressions are prior to the changes of serum Cr and BUN levels of rats suffered from OJ complicated renal function damage, which are promised to improve the early diagnosis rate of renal function damage in rats with OJ.
Light emitting diode (LED) can be used in the treatment of jaundice. Blue and green LED irradiation affected with the newborn is currently considered the most effective treatment of the jaundice in the world. A jaundice phototherapy system with blue and green LED as light source utilizing fly eye lens array was built to achieve uniform illumination in the present study. AMC7150 chip was used to build the constant current drive module, and AT89C52 MCU and LCD12864 LCD screen were used to build the human-computer interaction module. Based on national particular phototherapy equipment requirements (YY0669-2008) for the safety, we designed and implemented a phototherapy system which spot area was 250 mm×500 mm, blue light irradiance reached 2 mW/cm2, green light irradiance reached 1.5 mW/cm2, and the uniformity of light was over 90%. Compared with the traditional system, the new one designed in this study has better therapeutic effect, higher biological safety, easier to achieve man-machine interaction, and more economical and convenient.
Objective To study the change of immunologic function of the patient with obstructive jaundice. Methods The level of the sIL-2R, TNF-α, IL-6 and IL-8 in 36 cases of obstructive jaundice before and after operation were measured. Results The level of the sIL-2R, TNF-α, IL-6 and IL-8 in 36 cases of obstructive jaundice before operation was higher than normal control group (Ｐ＜0.01). It decreased after the obstruction was removed, and it was close to normal control on 14th day after operation. Conclusion The result suggest that relief of jaundice could improve the immunologic function of the patient.
【Abstract】Objective To investigate the expressions of TNF-α and superoxide dismutase (SOD) mRNA in myocardium of rats with obstructive jaundice (OJ). Methods The expressions of TNF-α and SOD mRNA were semi-quantitatively analyzed after amplification of cDNA in myocardium of the rats with OJ by RTPCR. Results The expression of TNF-α mRNA increased and that of SOD mRNA decreased in the myocardium of rats with OJ. The level of plasm TNF-α increased and SOD synthesis in myocardium decreased. Conclusion The injury of myocardium in OJ is correlated with increasing expression of TNF-α mRNA and decreasing expression of SOD mRNA.
ObjectiveTo investigate the efficacy of different methods of reducing jaundice in patients with low malignant obstructive jaundice undergoing pancreaticoduodenectomy. Methods A retrospective analysis was performed on the clinicopathological data of patients admitted to the Department of Hepatobiliary Surgery of The Affiliated Hospital of Guizhou Medical University from January 2014 to June 2020 who were considered to have low malignant obstructive jaundice before operation and confirmed by postoperative pathological examination as pancreatic cancer, ampulla cancer, duodenal cancer or carcinoma of the lower segment of the common bile duct. Patients were devide into percutaneous transhepatic cholangial drainage (PTCD) group and endoscopic retrograde biliary drainage (ERBD) group according to preoperative biliary drainage (PBD) methods. In order to reduce selection bias, SPSS propensity matching module was used for propensity score matching analysis. The age, basic diseases (hypertension, diabetes), biochemical indexes, time of reduction of jaundice, total hospitalization time, and postoperative complications of PBD and pancreaticoduodenectomy were compared between the 2 groups. Then, the patients were divided into pancreatic cancer group and non-pancreatic cancer group (including ampulla cancer, duodenal carcinoma and lower common bile duct carcinoma) by tumor type, and compared the effect of two groups of patients receiving different PBD methods. Results A total of 84 patients, 43 males and 41 females, were included in this study, 58 (69.0%) patients with PTCD and 26 (31.0%) patients with ERBD. After PBD the serum total bilirubin, direct bilirubin, γ-glutamyl transferase, and alkaline phosphatase of the PTCD and the ERBD groups patients were lower than before PBD, the differences were statistically significant (P<0.05). Alanine aminotransferase did not change significantly before and after PBD with PTCD (P>0.05), but decreased significantly after PBD with ERBD (P<0.05). Aspartate aminotransferase did not change significantly before and after PBD with ERBD (P>0.05), but decreased significantly after PBD with PTCD(P<0.05). The PBD time and total hospitalization time of the ERBD group were shorter than those of the PTCD group, the differences were statistically significant (P<0.05). The incidences of PBD related complications (cholangitis and pancreatitis) in the ERBD group were higher than those the PTCD group, and the incidence of bleeding in the ERBD group was lower than that the PTCD group, but the differences were not statistically significant (P>0.05). In the patients with pancreatic cancer group, the PBD time by ERBD was shorter than that of the receiving PTCD, the difference was statistically significant (P=0.006). In the non-pancreatic cancer group, the total hospitalization time and PBD time of patients receiving ERBD were shorter than those receiving PTCD, and the differences were statistically significant (P<0.05). In all patients, the median survival time of PTCD group (14 months) was shorter than that in ERBD group (18 months), P=0.002; pancreatic cancer group (12 months) was shorter than non-pancreatic cancer group (16 months), P=0.034; in non-pancreatic cancer group, ERBD group (20 months) was longer than PTCD group (15 months), P=0.008. Conclusions ERBD can shorten the waiting time of operation and hospital stay as compared with PTCD, and has a longer median survival time. It can be used as the first choice for PBD in patients with low malignant obstructive jaundice.
Objective To investigate the effects and mechanisms of bile on small intestine mucosal barrier.Methods Fifty Wistar rats were assinged into 3 groups randomly: obstructive jaundice (OJ) group （n=20）, biliary external drainage group （n=20） and control group （n=10）. Ten days after operation, the plasma endotoxin level was determinated, the terminal ileum mucosas was obtained to be morphologically measured by light microscope, and immunohistochemistry and Western blot were uesd to examine the expressions of tight junction proteins zona occludens-1 (ZO-1) and occludin in the mucosas. Results Atrophy significantly appeared in the distal ileum mucosas in OJ group. Compared with control group, the intestinal villus height, mucosa thickness and crypt depth in OJ group were obviously decreased 27.8%, 21.7%, and 25.4% (P=0.001, 0.001, 0.040). There were no differences between external drainage group and control group (P=0.050, 0.070, 0.080); While the values of external drainage group were significantly higher than those in OJ group (all P=0.001). The level of plasma endotoxin was up to (1.49±0.27) EU/ml in OJ group compared with control group 〔（0.27±0.09） EU/ml〕, P=0.001. In external drainage group, the value was （0.91±0.25） EU/ml, which was obviously higher than that in control group and lower than that in OJ group （all P=0.001）. Immunohistochemical study showed b positive expression of ZO-1 dropped from 7/10 in the control group to 6/20 in OJ group （P=0.040）, occludin expression was 8/10 in control group and 7/20 in OJ Group （P=0.020）; expressions of them in external drainage group 〔8/20 （P=0.100,0.210） and 9/20 （P=0.060, 0.200）〕 displayed no significant differences compared with the other twogroups. Quantitative testing of Western blot showed the expressions of ZO-1 and occludin in OJ group were significantly lower than those in control group (P=0.001, 0.010), the values in external drainage group were higher than those in OJ group （P=0.005, 0.014）. The expression of ZO-1 was lower in external drainage group than that in control group (P=0.001), and there was no significant difference of occludin between the two groups (P=0.062）. Conclusion Lack of intestinal bile will undermine the intestinal tight junction protein composition, and make intestinal mucosal barrier impaired. The intestinal barrier more severely injured when biliary tract obstructs because of multiple factors. Bile plays an important role in the maintenance of intestinal mucosal barrier.
The comparison made between two experimental models with obstructive jaundice, which were newly established reversible model and traditional bile duct ligation and internal drainage model, showed that the new model was superior to the traditional one. This study suggests that the new model would be an ideal model, which could replace the traditional one for studying obstructive jaundice.
Objective To evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in obstructive jaundice. Methods Forty eight consecutive patients with obstructive jaundice were examined by MRCP, all results were testified during and /or after operation. Results Different causes of obstruction had their own characteristic manifestations. Level of obstruction was accurate in 100%, the accuracy in distinguishing obstructive causes was 93.8%. Conclusion MRCP is quite effective, safe and reliable in diagnosis of obstructive jaundice.
Objective To compare the therapeutic effect of percutaneous transhepatic cholangial drainage (PTCD) and operation drainage for the patients with inoperable malignant obstructive jaundice. Methods A total of 131 patients with inoperable malignant obstructive jaundice were treated in this hospital, in which 102 patients had PTCD by placement of metallic stent and (or) plastic tubes to remove obstruction of bile duct (interventional treatment group). Simultaneously 29 patients were selected for operation by intraexternal drainage (operation drainage group). The patients were followed up for comparison of the serum level of total bilirubin, postoperative complications, average length of hospitalization and average cost between the two groups. Results PTCD was successfully performed in all the patients of the interventional treatment group. There were no significant differences of 50% decrease period of average total bilirubin level or postoperative complications between the two groups (Pgt;0.05). The average length of hospitalization and average cost of interventional treatment group were less than those of operation drainage group (Plt;0.05). Conclusions Compare with operation drainage, interventional treatment can reduce average length of hospitalization and average cost, without increase of postoperative complications, which is a main chance of treatment for malignant obstructive jaundice.
Objective To investigate the effect of renal cell apoptosis induced by obstructive jaundice on the expression of bcl-2 in rats, and to explore the mechanism of renal impairment induced by obstructive jaundice. Methods Thirty-two male SD rats were randomly divided into 2 groups: SO group and BDL group. The rats in SO group received sham operation. Bile ducts of rats in BDL group were ligated. Pathology of kidneys was observed under the microscope. The levels of D-Bil, TBA, GOT, GPT, Cr and BUN in serum and β2-MG in urine were measured. The apoptotic rate of renal cells was calculated by flow cytometry and the forms of DNA fragmentation in renal cells were detected by agarose gel electrophoresis. The expression of inhibitory gene bcl-2 in the renal tissues was detected by immunohistochemistry. Results The color of urine in BDL group became dark yellow in day 2 after operation; The ears, tails and the muscle of abdominal wall and splanchnic organs, such as liver and kidney, also became yellow and swollen in day 7. The D-Bil, TBA, GOT, GPT, BUN of serum and β2 -MG of urine in BDL group were higher than those in SO group (P＜0.05, P＜0.01), and each value (except β2 -MG) in BDL group of 14 d was higher than that in BDL group of 7 d (P＜0.05, P＜0.01), respectively. The result of flow cytometry showed that the apoptotic rate of SO group and BDL (7 d and 14 d) group were (2.10±0.75)%， (18.17±0.86)% and (36.39±2.23)% respectively, there were significantly difference among them (P＜0.05). The expression rate of bcl-2 of renal cell in BDL group of 7 d was higher than that in BDL group of 14 d. Conclusion Obstructive jaundice could induce apoptosis of the renal cells, and activate the expression of bcl-2 of the renal tubular epithelial cells in feedback, which may regulate the process of apoptosis.