Effect of ESBD on immune function, stress, blood amylase and urinary trypsinogen-2 in patients with common bile duct stones

Objective:To investigate the effects of endoscopic small sphincterotomy and balloon dilatation (ESBD) on immune function, stress, serum amylase and urinary trypsinogen-2 levels in patients with common bile duct stones.Methods: The clinical data of 150 patients with common bile duct stones admitted to Wuxi people's Hospital affiliated to Nanjing Medical University from January 2015 to December 2017 were retrospectively analyzed. According to the different surgical methods, the study group and the control group were divided into 75 cases. The study group was treated with ESBD, and the control group was treated with endoscopic sphincterotomy (EST). The changes of inflammation [high mobility group protein B1 (HMGB1), glycoprotein antigen 19-9 (CA19-9) and procalcitonin (PCT)] and stress response [C peptide (C-P), natural killer cell (NK) and cortisol (Cor)], blood amylase (AMS) and trypsinogen-2 (Try-2) were compared between the two groups.Results: The levels of C-P, NK and Cor, the HMGB1, CA19-9 and PCT, and the AMS and Try-2 in two groups before the operation were not significant difference (P>0.05). The levels of NK, CA19-9 was significantly decreased and C-P, Cor, HMGB1, PCT, AMS and Try-2 were significantly increased in both groups after operation (P<0.05). The levels of CP and Cor levels in the study group were (1.16±0.13) nmol/L and (150.23±15.12) nmol/L, respectively, which were lower than the control group (P<0.05). The levels of NK was (25.27±2.39)%, which were higher than the control group (P<0.05). The HMGB1, CA19-9 and PCT levels in the study group were (12.02±1.10) μg/L, (20.31±2.26) U/mL and (5.33±0.53) μg/L, respectively, which were lower than the control group (P<0.05). The AMS and Try-2 levels in the study group were (250.02±25.20) U/L and (36.11±3.51) ng/mL, respectively, which were lower than the control group (P<0.05).Conclusion: ESBD can effectively alleviate inflammatory reaction and stress response, and has little effect on blood amylase and urinary trypsin-2 in patients with common bile duct stones, which is worthy of clinical promotion.

Comparison of the serum contents of inflammatory mediators and oxidative stress mediators between patients with gram-positive bacteria and gram-negative bacteria infection

Objective: To compare the serum contents of inflammatory mediators and oxidative stress mediators between patients with gram-positive bacteria and gram-negative bacteria infection. Methods: Patients who were diagnosed with bloodstream bacterial infection in Zigong Third People's Hospital between March 2015 and April 2017 were selected as the research subjects and divided into gram-positive group and gram-negative group according to the results of blood culture and strain identification, and serum levels of inflammatory mediators PCT, IL-1β, IL-6, sTREM-1, TNF-α, NGAL, SAA, HPT and hs-CRP as well as oxidative stress mediators MDA, AOPP, TAC, CAT and SOD were determined. Results: Serum PCT, IL-1β, IL-6, sTREM-1, TNF-α, NGAL, SAA, HPT, hs-CRP, MDA and AOPP levels of gram-negative group were greatly higher than those of gram-positive group while TAC, CAT and SOD levels were greatly lower than those of gram-positive group. Conclusion: The changes of inflammatory mediators and oxidative stress mediators in the serum of patients with gram-negative bacteria infection are more significant than those of patients with gram-positive bacteria infection.