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 investigate the changes of renal medulla aquaporin 2 expression and morphological changes of epithelia of collecting tube after bile duct recanalizaiton operation. Methods Thirty rats were divided into two groups randomly. Common bile duct ligation was performed on 20 experimental rats with silicon tubes 2 mm in extre-diameter, and sham operation on the other 10 rats. Seven days later, bile duct recanalizaiton was performed on obstructive jaundice group and sham operation on contrast group. Experimental rats were divided into two subgroups randomly. Half of them were killed immediately and the others would be killed 24 hours later. Serum of each rat was collected to detect hepatic function and renal function. Renal medulla was fixed for microscopic examination and was kept in the -80 ℃ refrigerator for aquaporin 2 expression measurement by Western blot technique. Results All of the animals accomplished the experiment smoothly. Golden ascites were found in the rats of obstructive jaundice group. Twenty-four hours after recanalization, serum bilirubin levels decreased 〔(45.95±8.39) μmol/L〕, P＜0.01, and there was no significant change in blood urine and creatine level. Compared with sham operation group (21 966.20±1 544.70), expression of aquaporin 2 decreased significantly after common bile duct ligation in obstructive jaundice group (15 665.30±1 181.85), P＜0.01. After recanalizaion, the expression of aquaporin 2 in obstructive jaundice group increased (19 490.80±4 239.32), P＜0.01. Conclusion Common bile duct obstruction would lead to epithelium injury of renal collecting tube, and down regulate the aquaporin 2 expression.
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.
Kupffer cell phagocytic function and plasma endotoxin level in 36 patients with obstructive jaundice were observed. The results indicated that kupffer cell phagocytic function was inhibited and the plasma endotoxemia level was markedly increased as compared with those in the control group Ｐ＜0.05 and Ｐ＜0.01 respectively. Kupffer cell phagocytic function were recoverd and plasma endotoxemia alleviated while the biliary obstruction was released by surgery.
Objective To research the changes in plasma endothelin, LPS, TNF-α, IL-6 and IL-8 in the patients with obstructive jaundice (OJ) and non-obstructive jaundice (NOJ) after surgery. Methods The plasma ET, LPS, TNF-α, IL-6 and IL-8 were measured in 15 patients without jaundice as controls. Results As compared with NOJ, the postoperative changes of ET, LPS, TNF-α, IL-6 and IL-8 in OJ group increased significantly at multiple time points (P＜0.05). Conclusion There is interaction between ET,LPS, TNF-α, IL-6 and IL-8 and damage to multiple organ function in patients with OJ after surgery.
Sixteen cases unresectable carcinoma of the head of the pancreas complicated with jaundice were treated by one stage cholecysto-jejunal and gastro-jejunal loop double anastomosis, the same result of jaundice drainage and prevention of bile reflux were obtained when compared with simple cholecysto-jejunal loop anastomosis, on the other hand, the obstructive symptoms resulting from postoperative cancerous comppression of duodenum and pylorus were avoided as well. The operation is simple with less physiologic disturbance and the patient can lead better postoperative live.
【Abstract】ObjectiveTo investigate the protective effect of melatonin on renal injury induced by bile duct ligation in rats. MethodsSixtyfour rats were randomly divided into four experimental groups (n=16 rats per group): the control group (CN), sham operative group (SO), bile duct ligation group (BDL) and bile duct ligation melatonin treatment group (BDL+Mel). Obstructive jaundice was induced by common bile duct ligation. Plasma level of nitric oxide (NO), total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN) and creatinine (Cr) were measured 4 d and 8 d after operation. NO and inducible nitric oxide synthase (iNOS) in renal tissue were detected at the same time point, too. Histopathological changes of kidneys were examined by HE staining. ResultsIn BDL group, the plasma levels of NO, TB, DB, ALT, AST, BUN and Cr were higher than those of SO group (P＜0.01）, and the level of NO and activities of iNOS in renal tissue were significantly increased (P＜0.01）. However, in BDL+Mel group, the plasma levels of NO, ALT, AST, BUN and Cr were lower than those of the BDL group (P＜0.01）, and the level of NO and activities of iNOS in renal tissue were significantly suppressed (P＜0.01）; histopathological changes of kidneys were improved.ConclusionAugmentation of iNOS activities and increasing of NO production in local tissue contributed to renal injury induced by bile duct ligation, and the mode of melatonin’s protective actions, at least in part, relates to interference with no pathways.
【Abstract】Objective To study the expression of serum soluble interleukin-2 receptor (sIL-2R) level in perioperative period of patients with obstructive jaundice and its clinical significance. Methods Serum sIL-2R was measured during perioperative period in 30 patients with obstructive jaundice by using a sandwich enzyme linked immunosorbent assay (ELISA). Results The preoperative serum sIL-2R level in patients with obstructive jaundice was increased obviously. The expression of serum sIL-2R level in them was correlated with the degree and duration of obstructive jaundice and nutritional status respectively (r=0.734, P＜0.01; r=0.646, P＜0.01; r=0.594, P＜0.05). The serum sIL-2R in the patients with malignant obstructive jaundice was significantly higher than that with benign obstructive jaundice (P＜0.05). Among the patients with malignant obstructive jaundice, the serum sIL-2R level in the patients with metastasis was higher than in those without metastasis (P＜0.05). The immunologic function underwent a process from temporary suppression to gradual recovery during perioperative period. On the 21th day after operation the sIL-2R was recovered to normal level in patients with benign obstructive jaundice while it only recovered to preoperative level in patients with malignant obstructive. Conclusion Depressed immunity is observed in patients with obstructive jaundice. The abnormal expression of sIL-2R is related to the type, degree and duration of obstructive jaundice and the nutritional status and metastasis. The result that preoperative sIL-2R might be used to evaluate the state of immunity, clinical condition, and treatment and prognosis of patients with obstructive jaundice.
ObjectiveTo evaluate the role of N-methyl-D-aspartate (NMDA) receptor in central nervous system (CNS) injury of obstructive jaundice. MethodThe related literatures about NMDA receptor and the CNS injury caused by hyperbilirubinemia were retrieved and reviewed. ResultsThe CNS injury of obstructive jaundice was related to overactivation of NMDA receptor, which finally resulted in degeneration and necrosis of nerve cells. The NMDA receptor antagonist MK-801 could relieve the CNS injury of obstructive jaundice. ConclusionsNMDA receptor plays an important role in the CNS injury caused by hyperbilirubinemia, and the blocker of NMDA receptor has protective effects in this process. However, there is no report of MK-801 in clinical application when hyperbilirubinemia happened.
【Abstract】Objective To study the changes of insulin-like growth factor-1(IGF-1) in serum of patients with obstructive jaundice.Methods The clinical data of 20 patients with obstructive jaundice were collected and the measurement of serum TNFα,ALT, ALP, endotoxin and IGF-1 were performed. Results The serum IGF-1 in obstructive jaundice was significantly lower than that in gallbladder stone(P＜0.01), while endotoxin, TNF-α, ALT，ALP and TB were higher(P＜0.01). After the biliary duct obstruction was removed, the serum IGF1 in obstructive jaundice was significantly higher than that before operation and serum endotoxin， TNF-α, ALT， ALP and TB were significantly lower than that before operation(P＜0.01). A significant negative correlation was found between serum IGF-1 and serum endotoxin in benign obstructive jaundice(r=-0.761, P＜0.01). ConclusionIn obstructive jaundice, endotoxemia can affect the secretion of IGF-1 from liver. IGF-1 can be used as an index to judge the liver function in obstructive jaundice.