Are gastric mucosal macrophages responsible for gastric injury in acute pancreatitis?

AIM:To investigate the protective effect of clodronatecontaining liposomes against severe acute pancreatitis(SAP)-triggered acute gastric mucosal injury(AGMI) in rats.METHODS:Clodronate- and phosphate-buffered saline(PBS)-containing liposomes were prepared by reverse-phase evaporation.The SAP rat model was established by injecting sodium taurocholate into the pancreatic subcapsular space.Sprague-Dawley rats were randomly divided into three groups:control(C),SAP plus PBS-containing liposome(P) and SAP plus clodronate-containing liposome(T).Serum tumor necrosis factor(TNF)-α levels were estimated by ELISA.Pathological changes in the gastric mucosa and pancreas were observed by hematoxylin and eosin(HE) staining.Apoptotic cells were detected by terminal deoxynucleotidyl transferase d UTP nick end labeling staining.The numbers of macrophages in the gastric mucosa were analyzed by CD68 immunohistochemical staining.RESULTS:The liposomes had a mean diameter of 150 ± 30 nm.The TNF-α levels were significantly higher in the P group than that in the C group(2 h,145.13 ± 11.50 vs 23.2 ± 2.03; 6 h,245.06 ± 12.11 vs 30.28 ± 6.07,P < 0.05),and they were significantly lower in the T group than that in the P group(2 h,93.24 ± 23.11 vs 145.13 ± 11.50; 6 h,135.18 ± 13.10 vs 245.06 ± 12.11,P < 0.05).The pathological scores of the pancreas were lower in the T group than in the P group(2 h,1.88 ± 0.83 vs 4.13 ± 0.83; 6 h,2.87 ± 0.64 vs 6.25 ± 0.88,P < 0.01).The pathological scores of the gastric mucosa were also lower in the T group than in the P group(2 h,1.12 ± 0.64 vs 2 ± 0.75; 6 h,1.58 ± 0.53 vs 3 ± 1.31,P < 0.05).In addition,increased CD68 levels were observed in the gastric mucosa of the P group compared with the C group.Clodronate-containing liposomes decreased the CD68 levels in the mucosa of the T group.The apoptotic indexes of the gastric mucosa were higher in the T group than in the P group(2 h,15.7 ± 0.92 vs 11.5 ± 1.64; 6 h,21.12 ± 1.06 vs 12.6 ± 2.44,P < 0.01).CONCLUSION:Gastric macrophages contribute to the pathogenesis of gastric injury in SAP.Clodronatecontaining liposomes have protective effects against AGMI in rats with SAP.

Effect of Chinese national holidays and weekends versus weekday admission on clinical outcomes in patients with STEMI undergoing primary PCI

关于有提高圣的心肌的梗塞(STEMI ) 的病人的结果上的周末和中国国家假期承认的影响的 BackgroundData 正在缺乏。这研究寻求了 .MethodsPatients 在症状发作的 12 h 以内与 STEMI 介绍与经历主要经皮的冠的干预(PPCI ) 的 STEMI 在病人在结果上调查中国国家假期和周末承认的效果经历了 PPCI 的人，回顾地被注册。在介绍中国国家假期和周末对工作日的病人的在里面医院死亡和主要不利心血管的事件的主要结果是 441 个 STEMI 病人全部的 evaluated.ResultsA 在这研究被注册。这些， 129 (29.3%) 病人们在中国国家假期和周末期间被招收并且 312 (70.7%) 在工作日期间。病人们在假期期间承认了，周末是更可能的与 Killip 班 III-IV 介绍。病人们在假期期间承认了，周末经历了一显著地更长的 door-to-balloon 时间，症状 onset-to-door 时间以及症状 onset-to-balloon 时间。在介绍假期和周末对工作日的病人之间的在里面医院死亡是可比较的。然而，在假期和周末期间招收的病人有在里面医院的显著地更高的率主要不利心血管的事件。Multivariate 分析证明假期和周末承认独立地与不利 outcomes.ConclusionsIn 中国被联系，在国家假期和周末期间经历 PPCI 的 STEMI 病人有与那些相比的结果在工作日期间承认了的更坏的在里面医院。这些调查结果建议连续努力应该被承担提高中国保健系统并且保证可比较的结果不管表示的时间为所有 STEMI 病人被完成。