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不同年龄段人群发生急性胰腺炎的临床特点回顾分析 被引量:6
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作者 韦慧芬 唐国都 +6 位作者 梁志海 覃蒙斌 杨慧莹 吴青 唐永凤 张琪月 许梦桃 《世界华人消化杂志》 CAS 2019年第10期624-631,共8页
背景急性胰腺炎(acute pancreatitis, AP)是临床常见的急腹症之一,以往认为AP患者以青壮年居多,然而,近年来随着我国人口的增长及社会老龄化的形成,老年及儿童AP的发病率也呈上升趋势.不同年龄段人群因其生理学特性从而导致AP发病时的... 背景急性胰腺炎(acute pancreatitis, AP)是临床常见的急腹症之一,以往认为AP患者以青壮年居多,然而,近年来随着我国人口的增长及社会老龄化的形成,老年及儿童AP的发病率也呈上升趋势.不同年龄段人群因其生理学特性从而导致AP发病时的临床表现略有差异.老年及儿童患者临床表现不典型,极易造成误诊、漏诊.本文通过回顾性分析不同年龄段AP患者的临床特点,旨在总结临床经验,为临床诊治提供参考.目的探讨不同年龄段人群发生AP的临床特点.方法回顾性分析2003-01/2016-06 1758例AP的临床资料,根据年龄进行分组:未成年组(<18岁);中青年组(18-60岁);老年组(≥60岁).总结不同年龄段人群发病的一般资料、病因、严重程度、并发症、临床经过及预后以及相关实验室指标的特点.结果未成年组AP男性发病率稍高于女性;轻度AP(mildacute pancreatitis, MAP)比例(78.5%)较另外两组高;并发症的发生率、病死率较其他两组低(P <0.05).中青年组AP男性构成比(71.0%)较高,酒精性、高脂血症性胰腺炎发病率(13.4%、21.5%)较其他两组高(P <0.05);中青年AP胰腺坏死的发生率(23.4%)最高,发生胰周渗出、胸腔积液、急性呼吸窘迫综合征、急性肾功能不全的比例也高于未成年组(P <0.05).老年组AP男性发病率稍高于女性,发生恶心症状的比例(58.2%)最高(P <0.05).老年AP病因中胆源性所占比例(61.2%)最高(P <0.05);老年AP发生中度重症AP的比例(43.5%)较其他两组高(P <0.05).未成年组AP住院时间(17.97±12.14 d)最长,老年组AP入住重症监护病房的比例(4.1%)及病死率(13.1%)最高(P <0.05),不同年龄段AP患者在住院费用方面差异不明显(P >0.05).实验室指标结果对比显示,三组外周血白细胞计数差异无统计学意义(P >0.05);未成年组C反应蛋白均值较其他两组低,老年组血清淀粉酶较中青年组高;老年组脂肪酶(lipase, LPS)较其他两组高(P <0.05),LPS均值在未成年组及中青年组中的差异无统计学意义(P >0.05).结论中青年较其他年龄段人群的酒精性、高脂血症性胰腺炎的发病率高;老年AP患者发病时最容易出现恶心,且病死率最高;当未成年患者出现不明原因的呕吐、腹胀时,应警惕AP可能. 展开更多
关键词 急性胰腺炎 不同年龄段 病因 并发症 预后
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双气囊小肠镜对小肠疾病诊断的临床价值分析 被引量:4
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作者 和四伟 刘诗权 +5 位作者 梁志海 黄雪 覃山羽 黄杰安 唐国都 姜海行 《中国内镜杂志》 北大核心 2017年第10期42-46,共5页
目的探讨双气囊小肠镜(DBE)对于小肠疾病诊断的临床应用价值。方法选取2008年1月-2016年5月广西医科大学第一附属医院收治的231例疑似小肠疾病且行DBE检查的患者。记录检查所见、诊断结果及并发症等情况。结果 231例患者共行257次小肠... 目的探讨双气囊小肠镜(DBE)对于小肠疾病诊断的临床应用价值。方法选取2008年1月-2016年5月广西医科大学第一附属医院收治的231例疑似小肠疾病且行DBE检查的患者。记录检查所见、诊断结果及并发症等情况。结果 231例患者共行257次小肠镜检查,包括经口检查112例,经肛检查93例,双向入镜检查26例。小肠疾病检出阳性率64.9%(150/231)。其中,非特异性肠炎33例,占总病例数的14.3%,克罗恩病27例(11.7%),溃疡19例(8.2%),血管病变13例(5.6%),间质瘤12例(5.2%)。腹痛104例,确诊62例,阳性率59.6%(62/104),不明原因消化道出血94例,确诊63例,阳性率67.0%(63/94)。所有患者中,有1例出现小肠穿孔,其余患者均无严重并发症出现。结论 DBE对小肠疾病阳性检出率高,相对安全可靠,对临床疑似小肠疾病患者的诊断和治疗具有一定的临床应用价值。 展开更多
关键词 双气囊小肠镜 小肠疾病 诊断
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Effects of ginsenoside Rh2 on growth and migration of pancreatic cancer cells 被引量:19
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作者 Xi-Ping tang guo-du tang +2 位作者 Chun-Yun Fang Zhi-Hai Liang Lu-Yi Zhang 《World Journal of Gastroenterology》 SCIE CAS 2013年第10期1582-1592,共11页
AIM:To investigate the effects of ginsenoside Rh2 on the human pancreatic cancer cell line Bxpc-3.METHODS:The human pancreatic cancer cell line Bxpc-3 was cultured in vitro and treated with or without ginsenoside Rh2.... AIM:To investigate the effects of ginsenoside Rh2 on the human pancreatic cancer cell line Bxpc-3.METHODS:The human pancreatic cancer cell line Bxpc-3 was cultured in vitro and treated with or without ginsenoside Rh2.Growth rates for Bxpc-3 cells were assessed by methyl thiazolyl tetrazolium(MTT) and colony formation assays.Cell cycle changes were analyzed by flow cytometry.Apoptosis was measured by flow cytometry and Hoechst 33258 fluorescence staining.A scratch assay and a Matrigel invasion assay were used to detect cell migration and invasion.Expression of Bax,Bcl-2,survivin,cyclin D1,matrix metalloproteinase(MMP)-2,MMP-9,cleaved caspase-3,caspase-8,and caspase-9 mRNA were determined by reverse transcriptase-polymerase chain reaction(RT-PCR).Bax,Bcl-2,survivin,cyclin D1,cleaved caspase-3,caspase-8 and caspase-9 protein levels were examined by western blotting.Expression of MMP-2 and MMP-9 proteins in culture supernatants were determined by enzymelinked immunosorbent assay(ELISA).RESULTS:Rh2 significantly inhibited Bxpc-3 cell proliferation in a dose-and time-dependent manner,as evaluated by the MTT(P < 0.05) and colony formation assays(P < 0.05).Compared to the control group,Rh2 significantly increased the percentage of Bxpc-3 cells in the G 0 /G 1 phase from 43.32% ± 2.17% to 71.32% ± 1.16%,which was accompanied by a decrease in S phase(from 50.86% ± 1.29% to 28.48% ± 1.18%) and G 2 /M phase(from 5.81% ± 1.19% to 0.20% ± 0.05%) in a dose-dependent manner(P < 0.05),suggesting that Rh2 arrested cell cycle progression at the G 0 /G 1 phase,as measured by flow cytometry.Compared to the control group,cells treated with Rh2 showed significantly higher apoptosis ratios in a dosedependent manner(percentage of early apoptotic cells:from 5.29% ± 2.28% to 38.90% ± 3.42%(F = 56.20,P < 0.05);percentage of late apoptotic cells:from 4.58% ± 1.42% to 36.32% ± 2.73%(F = 86.70,P < 0.05).Rh2 inhibited Bxpc-3 cell migration and invasion,as detected by scratch wound healing assay and Matrigel invasion assay [percentages of scratch wound healing for 12 h,24 h and 48 h(control vs experimental group):37.3% ± 4.8%vs 18.30% ± 1.65%,58.7% ± 3.5% vs 38.00% ± 4.09% and 93.83% ± 4.65% vs 65.50% ± 4.09%,respectively;t = 6.489,t = 6.656 and t = 7.926,respectively,P < 0.05;the number of cells invading at various concentrations(0 μmol/L,35 μmol/L,45 μmol/L and 55 μmol/L):81.10 ± 9.55,46.40 ± 6.95,24.70 ± 6.88 and 8.70 ± 3.34,respectively(F = 502.713,P < 0.05)].RT-PCR,western blotting or ELISA showed that mRNA and protein expression of Bax,cleaved caspase-3 and caspase-9 were upregulated(P < 0.05),while mRNA and protein expression of Bcl-2,survivin,cyclin D1,MMP-2 and MMP-9 were downregulated(P < 0.05).CONCLUSION:Ginsenoside Rh2 inhibits proliferation,migration and invasion and induces apoptosis of the human pancreatic cancer cell line Bxpc-3. 展开更多
关键词 GINSENOSIDE Rh2 Human PANCREATIC cancer BXPC-3 cell PROLIFERATION APOPTOSIS MIGRATION
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Placement of prophylactic pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: A meta-analysis 被引量:15
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作者 Qing-Qing Shi Xiao-Yi Ning +2 位作者 Ling-Ling Zhan guo-du tang Xiao-Ping Lv 《World Journal of Gastroenterology》 SCIE CAS 2014年第22期7040-7048,共9页
AIM:To assess the effectiveness of pancreatic stents for preventing pancreatitis in high-risk patients after endoscopic retrograde cholangiopancreatography(ERCP).METHODS:PubMed,Embase,Science Citation Index,and Cochra... AIM:To assess the effectiveness of pancreatic stents for preventing pancreatitis in high-risk patients after endoscopic retrograde cholangiopancreatography(ERCP).METHODS:PubMed,Embase,Science Citation Index,and Cochrane Controlled Trials Register were searched to identify relevant trials published in English.Inclu-sion and exclusion criteria were used to screen for suitable studies.Two reviewers independently judged the study eligibility while screening the citations.The methodological quality of the included trials was assessed using the Jadad scoring system.All results were expressed as OR and 95%CI.Data were analyzed using Stata12.0 software.RESULTS:Ten eligible randomized controlled trials were selected,including 1176 patients.A fixed-effects model in meta-analysis supported that pancreatic duct stents significantly decreased the incidence of postERCP pancreatitis(PEP)in high-risk patients(OR=0.25;95%CI:0.17-0.38;P<0.001).Pancreatic stents also alleviated the severity of PEP(mild pancreatitis after ERCP:OR=0.33;95%CI:0.21-0.54;P<0.001;moderate pancreatitis after ERCP:OR=0.30;95%CI:0.13-0.67;P=0.004).The result of severe pancreatitis after ERCP was handled more rigorously(OR=0.24;95%CI:0.05-1.16;P=0.077).Serum amylase levels were not different between patients with pancreatic stents and control patients(OR=1.08;95%CI:0.82-1.41;P=0.586).CONCLUSION:Placement of prophylactic pancreatic stents may lower the incidence of post-ERCP pancreatitis in high-risk patients and alleviate the severity of this condition. 展开更多
关键词 PANCREATIC STENT Endoscopic RETROGRADE cholangiopa
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Ghrelin inhibits IKKβ/NF-κB activation and reduces pro-inflammatory cytokine production in pancreatic acinar AR42J cells treated with cerulein 被引量:3
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作者 Ren-Jie Chang Hui-Lin Wang +5 位作者 Meng-Bin Qin Zhi-Hai Liang Jia-Ping He Yu-Le Wei Hong-Zong Fu guo-du tang 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2021年第4期366-375,共10页
Background: Previous studies have provided conflicting results regarding whether the serum ghrelin concentration can reflect the severity of acute pancreatitis(AP). The present study examined the correlation between t... Background: Previous studies have provided conflicting results regarding whether the serum ghrelin concentration can reflect the severity of acute pancreatitis(AP). The present study examined the correlation between the serum ghrelin concentration and AP severity in animal models and investigated whether altered ghrelin expression in pancreatic acinar cells influences IKK β/NF-κ B signaling and pro-inflammatory cytokine production. Methods: Mild or severe AP was induced in rats by intraperitoneal injection of cerulein or retrograde cholangiopancreatic duct injection of sodium taurocholate, respectively. After successful model induction, serum ghrelin, tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) concentrations were determined by enzyme-linked immunosorbent assay, and IKK β/NF-κ B activation was assessed by immunohistochemistry. Subsequently, stable overexpression or knockdown of ghrelin in AR42 J cells was achieved by lentiviral transfection. After transfected cells and control cells were treated with cerulein for 24 h, the TNF-αand IL-1 β levels in the supernatants were determined by enzyme-linked immunosorbent assay, and the expression levels of p-p65, IKK β, and p-IKK β were detected by Western blotting. Results: In rat AP models, AP severity was correlated with increased IKK β/NF-κ B activation, proinflammatory cytokine production, and ghrelin secretion. The levels of pro-inflammatory cytokines TNF-αand IL-1 β as well as IKK β/NF-κ B signaling activity were increased upon knockdown of ghrelin in the AP acinar cell model and decreased with ghrelin overexpression. Conclusions: Serum ghrelin is related to the severity of AP. Ghrelin may play a protective role in the pathogenesis of AP by inhibiting the pro-inflammatory cytokines and the activation of the IKK β/NF-κ B signaling pathway. 展开更多
关键词 Acute pancreatitis GHRELIN Inflammatory cytokine Acinar cells
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Relationship between onset of peptic ulcer and meteorological factors 被引量:2
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作者 Da-Yun Liu An-Ning Gao +7 位作者 guo-du tang Wang-Yue Yang Jiang Qin Xin-Guo Wu Dong-Cai Zhu Gui-Ning Wang Jin-Jiang Liu Zhong-Hui Liang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第9期1463-1467,共5页
瞄准:讨论在消化性溃疡(PU ) 和气象学的因素(MF ) 的发作之间的关系。方法:24,252 个病人的一个总数从 1992 ~ 1997 在南宁从 17 所医院在胃镜检查的 104,121 件样品与活跃 PU 被发现。PU (DRPU ) 的可检测的率每个月,每十天和每... 瞄准:讨论在消化性溃疡(PU ) 和气象学的因素(MF ) 的发作之间的关系。方法:24,252 个病人的一个总数从 1992 ~ 1997 在南宁从 17 所医院在胃镜检查的 104,121 件样品与活跃 PU 被发现。PU (DRPU ) 的可检测的率每个月,每十天和每五天被计算。DRPU 和 MF 的分析在一年的一样的时期被做。一个预报模型基于以前的月的 MF 被建立。真实并且预报价值被测试并且验证。结果:在 6 年期间,到 4 月的从 11 月的 DRPU 是 24.4 -28.8% 。山峰价值(28.8%) 在 1 月。到 10 月的从 5 月的 DRPU 是 20.0-22.6% ,与它在 6 月的低山峰(20.0%) 。DRPU 从冬季和春天减少了到夏天和秋天(P【0.005 ) 。在 DRPU 和平均温度价值之间的相关系数是 -0.8704,-0.6624,-0.5384 一个月,十天,五天分别地(P【0.01 ) 。在 DRPU 和平均最高的温度价值之间的相关系数分别地是 -0.8000,-0.6470,-0.5167 (P【0.01 ) 。在 DRPU 和平均最低温度价值之间的相关系数分别地是 -0.8091,-0.6617,-0.5384 (P【0.01 ) 。在 DRPU 和平均露点温度之间的相关系数分别地是 -0.7812,-0.6246,-0.4936 (P【0.01 ) 。在 DRPU 和平均气压价值之间的相关系数是 0.7320, 0.5777, 0.4579 分别地(P【0.01 ) 。平均温度,平均最高、最低的温度,平均气压和以前的月,十天和五天的平均露点温度价值能预报 PU 的发作,与它的真实并且相应于 71.8% , 67.9% 和 66.6% 的预报价值分别地。结论:DRPU 仔细为一样的时期与平均温度,平均最高、最低的温度,平均气压和每个月,每十天和每五天的平均露点温度被联系。当 MF 被改变时,人的身体生产 PU 的发作的长期、中部术语的基于的医药气象学的预报能根据这更精确地被做的一系列压力 actions.A。 展开更多
关键词 胃蛋白酶 胃溃疡 气象因子 病理机制
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Cronkhite-Canada syndrome with steroid dependency: A case report
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作者 Dan Jiang guo-du tang +2 位作者 Ming-Yu Lai Zhen-Ning Huang Zhi-Hai Liang 《World Journal of Clinical Cases》 SCIE 2021年第14期3466-3471,共6页
BACKGROUND Cronkhite-Canada syndrome(CCS)is a rare nonhereditary disease characterized by chronic diarrhoea,diffuse gastrointestinal polyposis and ectodermal manifestations.The lethality of CCS can be up to 50%if it i... BACKGROUND Cronkhite-Canada syndrome(CCS)is a rare nonhereditary disease characterized by chronic diarrhoea,diffuse gastrointestinal polyposis and ectodermal manifestations.The lethality of CCS can be up to 50%if it is untreated or if treatment is delayed or inadequate.More than 35%of the patients do not achieve long-term clinical remission after corticosteroid administration,with relapse occurring during or after the cessation of glucocorticoid use.The optimal strategy of maintenance therapy of this disease is controversial.CASE SUMMARY A 47-year-old man presented to the hospital with a 3-mo history of frequent watery diarrhoea,accompanied by macular skin pigmentation that included the palms and soles,and onychodystrophy of the fingernails and toenails.Gastroscopy and colonoscopy revealed numerous polyps in the stomach and colon.After other possibilities were ruled out by a series of examinations,CCS was diagnosed and treated with prednisone.The patient took prednisone for more than 1 year before achieving complete resolution of his symptoms and endoscopic findings.The patient was then given prednisone 5 mg/d for 6 mo of maintenance therapy.With clinical improvement and polyp regression,prednisone was discontinued.Eight mo after the discontinuation of prednisone,the diarrhoea and gastrointestinal polyps relapsed.Therefore,the patient was given the same dose of prednisone,and complete remission was achieved again.CONCLUSION It is necessary to extend the duration of prednisone maintenance therapy for CCS.Prednisone is still effective when readministered after relapse.Surveillance endoscopy at intervals of 1 year or less is recommended to assess mucosal disease activity. 展开更多
关键词 Cronkhite-Canada syndrome Endoscopy PREDNISONE RELAPSE Maintenance therapy Case report
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