AIM:To establish a one-stage model of experimental acute necrotizing pancreatitis(ANP)in rats characterized by the simplicity of performance and a high degree of repeatability.METHODS:ANP modeling in rats was performe...AIM:To establish a one-stage model of experimental acute necrotizing pancreatitis(ANP)in rats characterized by the simplicity of performance and a high degree of repeatability.METHODS:ANP modeling in rats was performed based on modification of the ligation model as follows:synthetic material ligature using an atraumatic needle was performed to capture pancreatic gland ducts and marginal duodenum vessels.Ligature tips were exteriorized to the abdominal wall,and the ligature was skinned over to avoid catching intestine loops.Pancreatic macroscopic appearance and histological changes were observed.Blood biochemical and hemostatic indicators were also determined.RESULTS:Laboratory analysis of rats with experimental ANP showed a pattern of disturbances similar to that observed during pancreatic necrosis in humans as soon as the first day.General blood analysis revealed enhanced leukocytosis and alterations in leukogram characteristics,indicating acute inflammation.Serum levels of amylase,aspartate aminotransferase and creatinine significantly increased(P<0.05).Hemostatic indicators showed alterations indicating formation of disseminated intravascular coagulation,and signs of endotoxicosis were observed.These typical pancreatic necrosis patterns of disturbances were validated by the results of histological investigation.CONCLUSION:Histological changes and laboratory indicators confirm the development of a suitable model of ANP.展开更多
背景既往关于口咽初乳对坏死性小肠结肠炎(NEC)发生率影响的文献结论不一。目的系统检索文献,更新Meta分析,探讨口咽初乳能否有效降低NEC发生率。设计系统评价/Meta分析。方法检索英文数据库(PubMed、Embase、Web of Science、Cochrane ...背景既往关于口咽初乳对坏死性小肠结肠炎(NEC)发生率影响的文献结论不一。目的系统检索文献,更新Meta分析,探讨口咽初乳能否有效降低NEC发生率。设计系统评价/Meta分析。方法检索英文数据库(PubMed、Embase、Web of Science、Cochrane Library)和中文数据库(中国知网、万方、维普、中华医学期刊全文数据库),检索时间为建库至2025年1月8日。纳入研究对象为胎龄<37周的新生儿(不限制出生体重),试验组采用口咽初乳、初乳涂抹或初乳滴注,对照组采用等量无菌水、生理盐水进行相同操作或常规护理,结局指标包含NEC的中英文RCT文献。由2名研究者独立筛选文献、提取数据,并根据Cochrane系统评价手册6.1提供的偏倚风险评估工具对文献进行偏倚风险评估。主要结局指标NEC(Ⅱ期或以上)发生率。结果27篇RCT(英文18篇,中文9篇)共纳入2950例早产儿,干预组1462例,对照组1488例。口咽初乳的剂量以0.2 mL为主(89%),间隔时间以2~4 h为主(85%),持续时间以3~7 d为主(70%)。Meta分析显示,干预组NECⅡ期或以上的发生率(65/1462)与对照组(147/1488)差异有统计学意义(OR=0.44,95%CI:0.32~0.61,P<0.01),漏斗图分析显示文献发表偏倚不明显。次要结局指标:口咽初乳可降低新生儿败血症(OR=0.55,95%CI:0.42~0.72)、喂养不耐受(OR=0.46,95%CI:0.27~0.78)、新生儿呼吸机相关性肺炎(VAP,OR=0.51,95%CI:0.29~0.92)发生率,缩短达到完全肠内营养时间[-2.50(-4.08~-0.91)d]、住院时间[-4.43(-6.32~-2.54)d]、抗生素使用时间[-2.56(-4.12~-1.01)d]。干预组和对照组的全因死亡率以及脑室内出血(IVH)、慢性肺病(CLD)、早产儿视网膜病变(ROP)发生率差异均无统计学意义。结论口咽初乳可以降低早产儿NEC、新生儿败血症、喂养不耐受、VAP的发生率,缩短早产儿完全肠内营养时间、住院时间及抗生素使用时间。展开更多
基金Supported by a Special Research Grant for interdisciplinary projects between the Institute of Immunology and Physiology and the Institute of Organic Synthesis,the Ural Branch of Russian Academy of Sciences(2009-2012)
文摘AIM:To establish a one-stage model of experimental acute necrotizing pancreatitis(ANP)in rats characterized by the simplicity of performance and a high degree of repeatability.METHODS:ANP modeling in rats was performed based on modification of the ligation model as follows:synthetic material ligature using an atraumatic needle was performed to capture pancreatic gland ducts and marginal duodenum vessels.Ligature tips were exteriorized to the abdominal wall,and the ligature was skinned over to avoid catching intestine loops.Pancreatic macroscopic appearance and histological changes were observed.Blood biochemical and hemostatic indicators were also determined.RESULTS:Laboratory analysis of rats with experimental ANP showed a pattern of disturbances similar to that observed during pancreatic necrosis in humans as soon as the first day.General blood analysis revealed enhanced leukocytosis and alterations in leukogram characteristics,indicating acute inflammation.Serum levels of amylase,aspartate aminotransferase and creatinine significantly increased(P<0.05).Hemostatic indicators showed alterations indicating formation of disseminated intravascular coagulation,and signs of endotoxicosis were observed.These typical pancreatic necrosis patterns of disturbances were validated by the results of histological investigation.CONCLUSION:Histological changes and laboratory indicators confirm the development of a suitable model of ANP.
