Interleukin 6 (IL-6) levels in the monitoring of surgical trauma

Interleukin 6 (IL-6) is involved in the processes of inflammation and tissue repair. We have been looking for the correlation between IL-6 concentration in patient's serum and the other factors related to the gravity of surgical trauma. Out of 25 patients with acute cholecystitis, 11 were randomly selected for laparoscopic cholecystectomy and the other 14 for open (laparotomic) cholecystectomy. The diagnostic and prognostic factors, age, and duration of disease did not differ significantly in either group. IL-6 serum levels were monitored by using commercially available ELISA tests throughout 72 h following the surgery. In patients who underwent laparoscopy, average IL-6 serum levels were significantly (up to fourfold) lower than in their laparotomy-treated counterparts, and the monitoring of IL-6 serum levels seems to be useful in the evaluation of the extent of trauma caused by surgery.     

人巨细胞病毒感染对肾移植受者血清白细胞介素－6水平的影响

应用ＰＣＲ检测ＨＣＭＶ－ＤＮＡ，ＥＬＩＳＡ检测ＨＣＭＶ－ＩｇＭ、ＩｇＧ，诊断肾移植受者ＨＣＭＶ感染，６５例受者中ＨＣＭＶ感染者３９例，非感染者２６例。应用ＭＴＴ法检测受者血清ＩＬ－６生物活性，阐明了ＨＣＭＶ感染对肾移植受者血清ＩＬ－６水平的影响。结果表明：感染与非感染组间血清ＩＬ－６水平差异无显著性（Ｐ＞０．０５）；６例原发性感染者血清ＩＬ－６水平随感染时间延长呈增高及降低双相改变，表明慢性迁延性感染者血清ＩＬ－６水平降低。临床工作中监测ＨＣＭＶ感染的肾移植受者血清ＩＬ－６水平变化具有重要意义。     

Simvastatin抑制白介素-6的产生促进大鼠坐骨神经再生

[目的]探讨他汀类（statins）药物Simvastatin促进大鼠坐骨神经修复及其免疫调节机制。[方法]制作SD大鼠坐骨神经钳夹损伤（crush）模型，分别予Simvastatin和溶媒（0．3％羧甲基纤维素钠）对照干预2周，并设立假手术组。手术后作行为学、神经电生理学、组织学计价和血清TNF-α和IL-6检测。[结果]Simvastatin干预组趾展功能指数在术后5、8d较对照组大，2周肌肉复合动作电位（CMAP）幅度高，4周神经传导速度（NCV）快；手术后5d，血清IL-6和TNF—α水平均低于对照组，尤以IL-6为明显；Simvastatin干预组神经再生形态优于对照组。[结论]Simvastain可能通过减少血清IL-6和TNF—α的生成，抑制免疫反应，对大鼠坐骨神经crush损伤修复产生促进作用。     

血清IL-6水平与胆管癌及肿瘤负荷的相关性研究

目的 检测胆管良、恶性疾病患者的血清ＩＬ－６水平,探讨胆管癌和胆管良性疾病的鉴别以及与肿瘤负荷的相关性。方法 采用ＥＬＩＳＡ双抗体夹心法测定３０例胆管良性疾病患者,２５例胆管癌患者和２０例健康者的血清ＩＬ－６水平,并对胆管癌患者手术前后血清ＩＬ－６的水平变化进行观察。结果 ２５例胆管癌患者血清ＩＬ－６水平明显高于胆管良性疾病及健康者（Ｐ〈０．０５）,胆管癌手术后血清ＩＬ－６水平明显低于手术前,差异     

颅脑损伤后血清TNF-α和IL-6的表达及对预后影响的临床研究

目的探讨颅脑损伤后血清TNF-α和IL-6的表达及对预后的影响。方法采用双抗体夹心ABC-ELISA方法,检测颅脑损伤后血清中TNF-α和IL-6的含量,比较颅脑损伤分级与血清中TNF-α和IL-6含量之间的关系以及外伤后的变化趋势,并探讨其对临床预后的影响。结果重型颅脑损伤后血清TNF-α和IL-6明显升高,在不同时间轻型、中型颅脑损伤组对比有明显差异(P<0.01)。结论血清中TNF-α和IL-6表达在重型颅脑损伤中明显增高,与颅脑损伤轻重成正比,并与预后密切相关。     

白介素6在动物多器官衰竭中的变化及其意义

在家兔多器官衰竭ＭＯＦ模型上动态观察了白介素６（ＩＬ－６）水平变化，并对ＩＬ－６在ＭＯＦ的发生和发展过程中的意义进行了探讨。结果显示，实验组动物于休克及注射内毒素后ＩＬ－６水平明显升高；ＭＯＦ动物ＩＬ－６水平明显高于ＮＭＯＦ动物；衰竭器官≥３的动物ＩＬ－６水平明显高于２个器官衰竭的动物；３６ｈ以内死亡的动物显著高于３６ｈ以后死亡的动物；ＩＬ－６水平与各主要器官功能变化，ＭＯＦ发生率，器官衰竭数目。     

辛伐他汀对结直肠癌患者IL-6与IL-8血清表达及癌细胞分泌影响的研究

目的:研究辛伐他汀对结直肠癌患者IL-6及IL-8血清表达和癌细胞分泌的影响,初步探讨辛伐他汀在结直肠癌中的治疗机制。方法:应用ELISA检测结直肠癌患者与健康对照者血清中IL-6及IL-8水平,应用RT-PCR比较IL-6与IL-8在结直肠癌及癌旁组织的表达情况;应用ELISA检测结直肠癌患者辛伐他汀治疗后血清IL-6与IL-8的变化规律。应用ELISA检测辛伐他汀干预后结直肠癌细胞株(HT-29与Ca-co-2)上清中IL-6与IL-8变化。结果:结直肠癌患者血清IL-6与IL-8水平显著高于健康对照者(P<0.05)。IL-8 mRNA表达水平在癌组织明显高于癌旁组织(P<0.05);而IL-6 mRNA在癌组织与癌旁组织表达差异无统计学意义(P>0.05)。结肠癌患者应用辛伐他汀(80 mg/d)治疗14 d后,血清IL-6水平显著降低(P<0.05),而IL-8无明显变化(P>0.05)。应用浓度达到5μmol/L以上辛伐他汀干预结直肠癌细胞株HT-29与Caco-2后,其IL-6及IL-8分泌明显下降(P<0.05)。结论:辛伐他汀可以降低结直肠癌患者血清IL-6的水平,并可以抑制结直肠癌细胞IL-8与IL-6分泌。     

血CRP、IL-6、IL-10在不同类型胆囊切除术中的变化研究

目的探讨日间腹腔镜胆囊切除术与常规胆囊切除术两种手术方法对患者血c反应蛋白（CRP）、白细胞介素6（IL-6）、白细胞介素10（IL-10）的影响,比较两种手术对患者身体的损伤程度及优越性。方法90例胆囊疾病患者随机分为两组,60例行腹腔镜胆囊切除术,30例行常规胆囊切除术。其中行腹腔镜胆囊切除术60例病例随机分为两组,30例行腹腔镜胆囊切除术30mjn内完成,30例行腹腔镜胆囊切除术在30min以上完成。比较2种术式手术时间、术前和术后及行腹腔镜胆囊切除术30min内完成和30min以上完成的血C反应蛋白（CRP）、白细胞介素6（IL-6）、白细胞介10（IL-10）的变化,术后抗生素使用率。结果腹腔镜组的手术效果明显优于对照组,血CRP、IL-6、IL-10明显低于对照组（P〈0．05）;腹腔镜手术30min内完成的手术效果明显优于腹腔镜手术30min以上,血CRP、IL-6、IL—10明显低于对照组（P〈0．05）。结论日问腹腔镜胆囊切除术是一种安全可靠的手术方法,与传统的开腹手术相比具有创伤小、出血少、术野清楚、切口美观、术后恢复快、抗生素使用率低、住院时间短等优点,将成为胆囊切除术的首选术式。     

IL-6 and IL-8 response to erythropoietin therapy in radical hysterectomy

BACKGROUND: The use of recombinant human erythropoietin (rHuEPO) improves autologous blood donation before elective surgery. However, there are other studies indicating that rHuEPO may suppress postoperative endogenous production of erythropoietin and stimulate inflammatory mediator release. Weekly donations generate only a moderate increase in endogenous erythropoietin production. We scheduled patients with cancer to predeposit three units of blood in 2 weeks, with or without rHuEPO therapy. The aim was to determine whether rHuEPO therapy and/or an aggressive donation schedule alter perioperative erythropoietin concentrations and whether rHuEPO therapy leads to the release of the pro-inflammatory cytokines IL-6 and IL-8. METHODS: Thirty women scheduled for radical hysterectomy and pelvic lymphadenectomy were randomly assigned to either a control group with no rHuEPO therapy or to receive rHuEPO. Three units of whole blood were collected from each patient before the operation. Concentrations of haemoglobin, erythropoietin (s-EPO) and cytokines (IL-6 and IL-8) were repeatedly analyzed before and after the operation. RESULTS: During the preoperative donation period, median s-EPO levels in the control group increased from 7 to 14 IU l(-1). There was a great increase in s-EPO concentrations 1 h postoperatively in the rHuEPO group compared with the control group (P < 0.001). IL-6 and IL-8 were not significantly changed after intravenous administration of rHuEPO. CONCLUSION: The use of rHuEPO therapy to optimise autologous blood donation does not influence IL-6 and IL-8 release. 1 h postoperatively rHuEPO therapy resulted in elevated s-EPO concentrations. There was, however, no difference in s-EPO between the groups from day 1 postoperatively and until the end of the study.     

Laparoscopic management of surgical complications after a recent laparotomy

Background The use of laparoscopy in the scarred abdomen is now well established. However, recent laparotomy and the presence of a fresh abdominal wound usually preclude laparoscopic intervention. Thus, early postlaparotomy complications, which mandate surgical interventions, are usually treated by a second laparotomy. We report our experience with the use of laparoscopy for the treatment of postoperative complications, after open abdominal procedures.Methods Fourteen patients were operated for a variety of conditions, and postoperative complications, such as bowel obstruction, intraabdominal infection, or anastomotic insufficiency, were handled laparoscopically.Results Eleven patients recovered from the acute condition. One patient died from sepsis, one retroperitoneal abscess was missed and later drained percutaneously, and one conversion to open surgery was necessary because of adhesions and lack of working space.Conclusions We conclude that a recent laparotomy is not a contraindication for laparoscopic management of acute abdominal conditions. Postlaparotomy complications can be successfully treated by laparoscopy. Avoiding the reopening of the abdominal wound and a second laparotomy may reduce the additional surgical trauma, and thus result in easier recovery.     

血清及尿白细胞介素-6检测在肾移植中的意义

目的探讨血、尿ＩＬ－６检测在肾移植急性排斥（ＡＲ）诊断及鉴别诊断中的作用。方法应用ＥＬＩＳＡ技术，分别对肾移植术后不同状态下患者血、尿ＩＬ－６水平进行检测。结果急性排斥及感染患者血ＩＬ－６水平较环孢素（ＣｓＡ）中毒、急性肾小管坏死（ＡＴＮ）、移植肾功能正常及正常对照组高。尿ＩＬ－６在急性排斥及感染组也较ＣｓＡ中毒、ＡＴＮ、移植肾功能正常组有明显升高，而急性排斥组较感染组升高更明显。结论血、尿ＩＬ－６水平的升高可作为判断肾移植急性排斥的指标之一；也可作为鉴别急性排斥反应与ＣｓＡ中毒、ＡＴＮ的重要参考指标；对鉴别急性排斥反应和感染具一定的参考价值     

急性胰腺炎时IL-6、TNF-α的变化及大黄干预的研究

目的:探讨大黄对大鼠急性胰腺炎治疗作用的机理。方法:通过胰胆管逆行注射5 %牛磺胆酸钠制作大鼠急性胰腺炎模型,检测血清TNF -α、IL - 6水平及大黄治疗后的变化。结果:大黄治疗后AP大鼠血清TNF -α、IL - 6明显降低。结论:大黄通过降低血清TNF -α、IL - 6水平,可以对实验性急性胰腺炎的治疗产生一定的有益帮助     

Effect of immunosuppressive agents FK506 and cyclosporin and steroids on the expression of IL-6 and its receptor by stimulated lymphocytes and monocytes

Abstract The interaction of interleukin-6 (IL-6) with its receptor (IL- 6R) is not well understood. In the present study, we investigated the effect of different immunosuppressive agents on the expression of the couple IL-6/ IL-6R on cultured lymphocytes and monocytes. IL-6 in culture supernatants from cultured monocytes were analyzed by ELISA. The expression of IL-6R was studied by flow cytometry. Dexamethazone, cyclosporin (CyA), and FK506 at immunosuppressive concentrations induced a dose-dependent inhibition of IL-6 secretion from adherent monocytes (MO) stimulated with phytohemagglutinin (PHA). Dexamethazone was the most effective agent in inhibiting IL-6 secretion, while the inhibitory effect observed with 1 ngyml FK506 was comparable with that obtained with 100 ng/ml CyA. Unstimulated MO strongly expressed IL-6R (80% positive cells). Stimulation of MO with PHA resulted in a significant downregulation of IL-6R expression. Treatment of PHA-timulated adherent MO with different concentrations of CyA and FK S06 induced a restoration of IL-6 R expression. FKS06 was 100 time more effective in restoring IL-6R than CyA. This restoration of IL-6R was incomplete. FK506, CyA, and steroids may exert their immunosuppressive effect by inhibiting IL-6 secretion and partially restoring MO IL-6R, which may be important in protecting the cell target against IL-6 autocrine stimulation.     

Follow-up after emergency laparotomy suggests high one- and five-year mortality with risk stratified by ASA

IntroductionWe investigated all-cause mortality following emergency laparotomy at 1 and 5 years. We aimed to establish a basis from which to advise patients and relatives on long-term mortality.MethodsLocal data from a historical audit of emergency laparotomies from 2010 to 2012 were combined with National Emergency Laparotomy Audit (NELA) data from 2017 to 2020. Covariates collected included deprivation status, preoperative blood work, baseline renal function, age, American Society of Anesthesiologists (ASA) grade, operative time, anaesthetic time and gender. Associations between covariates and survival were determined using multivariate logistic regression and Kaplan–Meier analysis. We used patients undergoing laparoscopic cholecystectomy between 2015 and 2020 as controls.ResultsASA grade was the best discriminator of long-term outcome following laparotomy (n=894) but was not a predictor of survival following cholecystectomy (n=1,834), with mortality being significantly greater in the laparotomy group. Following cholecystectomy, 95% confidence intervals for survival at 5 years were 98–99%. Following laparotomy these intervals were: ASA grade 1, 79–96%; ASA grade 2, 69–82%; ASA grade 3, 44–58%; ASA grade 4, 33–48%; and ASA grade 5, 4–51%. The majority of deaths occurred after 30 days.ConclusionsEmergency laparotomy is associated with a significantly increased risk of death in the following 5 years. The risk is strongly correlated to ASA grade. Thirty-day mortality estimation is not a good basis on which to advise patients and carers on long-term outcomes. ASA grade can be used to predict long-term outcomes and to guide patient counsel.     

祛风通络方对系膜增生性肾小球肾炎大鼠蛋白尿及血清IL-6与IL-8的影响

目的：探讨祛风通络方对系膜增生性肾小球肾炎大鼠蛋白尿及血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）的影响。方法：采用免疫法制备系膜增生性肾小球肾炎大鼠模型,应用磺柳酸法测定大鼠24h尿蛋白定量,双抗体夹心ELISA法检测大鼠血清IL-6、IL-8,光镜下观察各组大鼠肾小球系膜区（GMC）及细胞外基质（ECM）积聚变化。结果：模型组与正常对照组比较24h尿蛋白定量及血清IL-6、IL-8明显升高（P〈0.01）;祛风通络方组24h尿蛋白定量及血清IL-6、IL-8均明显低于模型组（P〈0.01）;肾组织形态学观察显示祛风通络方组个别区域肾小球系膜细胞轻度增生,系膜区轻度增宽,管腔无挤压现象,较模型组明显改善。结论：祛风通络方组降低系膜增生性肾小球肾炎大鼠尿蛋白,降低血清IL-6、IL-8水平,减轻系膜细胞增生和细胞外基质增加,延缓或减轻肾组织损伤,保护肾功能。     

丹红注射液治疗急性脑梗死对神经功能及IL-6、IL-10水平的影响

目的：探讨丹红注射液治疗急性脑梗死患者对神经功能及血清IL-6、IL-10的影响。方法回顾性分析2013年5月～2014年3月我院收治的急性脑梗死患者105例（轻型34例,中型60例,重型11例）,选取健康研究对象50例。按照治疗方法将患者分为两组,对照组52例采用常规治疗,观察组53例在对照组的基础上采用丹红注射液治疗。结果轻型、中型及重型急性脑梗死患者的IL-6、IL-10水平与健康对照组比较明显较高,三组的IL-6、IL-10水平随着神经功能缺损程度评分越高而越高,三组间差异有统计学意义（P＜0.05）。观察组7d、14d的IL-6、IL-10水平及30d的神经功能缺损程度评分与对照组比较明显较低,两组差异有统计学意义（P＜0.05）。结论丹红注射液治疗急性脑梗死患者疗效显著,能使患者血清IL-6、IL-10水平快速降低及神经功能的改善。     

爆炸伤创面IL-1、IL-6、TNF-α、CRP的测定

[目的]检测兔肢体爆炸伤创面组织IL-1、IL-6、TNF-α和CRP含量。[方法]新西兰大白兔24只,随机分为炸伤后即刻取材组（A组,n=12）和炸后1h取材组（B组,n=12）;0.9g铜壳单质猛黑索金炸药（RDX）以海绵间隔5cm,绑于左下肢股部中段前外侧,电引爆,分别取爆炸中心区（Ⅰ区）、爆炸边缘区（Ⅱ区）、爆震区（Ⅲ区）的肌肉组织,测IL-1、IL-6、TNF-α、CRP的含量并取对侧肢体肌肉组织做对照研究。[结果]炸伤后两组各区标本IL-1、IL-6、TNF-α、CRP含量均比正常组织高,差异显著（P〈0.05）,且从Ⅰ区、Ⅱ区到Ⅲ区,含量依次降低,差异显著（P〈0.05）：A组：Ⅱ区与Ⅲ区的IL-1含量差别有显著意义（P〈0.05）。Ⅰ区与Ⅲ区、Ⅱ区与Ⅲ区的IL-6含量差别有极显著意义（P〈0.01）。Ⅰ区与Ⅲ区的TNF-α、CRP含量差别有极显著意义（P〈0.01）,Ⅰ区与Ⅱ区、Ⅱ区与Ⅲ区的含量差别有显著意义（P〈0.05）。其余各区的含量无统计学差异（P〉0.05）;B组：Ⅱ区与Ⅲ区的Ⅱ-1、IL-6、TNF-α含量差别有显著意义（P〈0.05）。Ⅰ区与Ⅲ区、Ⅰ区与Ⅱ区、Ⅱ区与Ⅲ区的CRP含量差别有显著意义（P〈0.05）。其余各区的含量无统计学差异（P〉0.05）。A、B两组比较,炸后组织中上述因子表达虽有增强,但差异无显著意义（P〉0.05）。[结论]肢体爆炸伤1h内,创面组织中IL-1、IL-6、TNF-α、CRP表达增强,不同区域间表达有差异。     

Expression of heat shock protein 70 mRNA in polymorphonuclear cells responding to surgical stress

Purpose. This study was performed to investigate the expression of heat shock protein (HSP) 70 mRNA in polymorphonuclear neustrophils (PMN) as a possible new biomarker for surgical stress. Methods. The HSP70 mRNA in PMN of 10 patients who underwent lobectomy was evaluated by Northern blot analysis. Their leukocyte counts, including white blood cells (WBC) and PMN, plasma cortisol levels, and plasma interleukin-6 (IL-6) levels, were obtained by cell counting, radioimmunoassay, and enzyme-linked immunosorbent assay, respectively. Results. The level of HSP70 mRNA in PMN slightly increased at the end of surgery and showed a significant increase 6 h after surgery. It promptly decreased at 24 h postoperatively and returned to the basal preanesthetic level 48 h after surgery. On the other hand, WBC/PMN counts, plasma cortisol, and IL-6 significantly increased at the end of surgery. WBC/PMN counts remained at increased levels until 48 h postoperatively. Cortisol peaked at 6 h postoperatively and gradually decreased. IL-6 reached a maximum at 1 h postoperatively, then tapered down to its basal level at 48 h postoperatively. Conclusion. Expression of HSP70 mRNA in PMN that is induced after thoracic surgery appears to be a promising candidate as a marker for evaluating surgical stress. Received for publication on August 31, 1998; accepted on March 10, 1999