Two rare cases of benign hyperlipasemia in children

Gullo’s syndrome is a newly identified condition characterized by a chronic elevation of pancreatic amylase and/or lipase in the absence of pancreatic disease. Until now, only one case of benign isolated hyperlipasemia in children has been recorded. We describe two children with benign and not familial increase of serum lipase. Case 1: a six year old girl presented with occasional discovery of serum lipase elevation. Medical history was silent for pancreatic hyperenzymemia. The screening for possible causes for elevated lipase (genetic, autoimmune and infectious diseases) was normal. The serum lipase increased three fold over the upper limit (193 U/L; reference range 0-60 U/L), with daily fluctuation of values. Both ultrasound scan and magnetic resonance imaging were normal. The genetic mutation associated with chronic pancreatitis was negative. We followed up this patient for two years with blood tests every six months and she did not show any signs or symptoms of pancreatic disease, except for the high level of lipase serum. Case 2: an eight year old girl complained of nausea, vomiting and severe abdominal pain in the epigastric region after eating for the last two weeks. Full blood count, electrolytes, C-reactive protein, liver and renal function were normal. Serum lipase was 96 U/L (reference range 0-60 U/L). The screening for the possible causes of pancreatic disease was negative. Endoscopy of the upper gastrointestinal tract, ultrasound, computed tomography scan and magnetic resonance imaging were normal. One year after the presentation of the symptoms, the patient became asymptomatic although the level of serum lipase continued to be high.     

Stability of human α-salivary amylase in aged forensic samples

The unequivocal tissue identification in forensic casework samples is a key step for crime scene reconstruction. Just knowing the origin of a fluid can sometimes be enough to either prove or disprove a fact in court. Despite the importance of this test, very few data are available in literature concerning human saliva identification in old forensic caseworks. In this work the stability of human α-amylase activity in aged samples is described by using three different methods integrated with DNA profiling techniques. This analytical protocol was successfully applied on 26-years old samples coming from anonymous threat letters sent to prosecutors who were working on “the Monster of Florence”, a case of serial murders happened around Florence (Italy) between 1968 and 1985.     

血清淀粉酶同工酶谱诊断胰胆管连接异常的初步临床应用

目的 通过血清淀粉酶同工酶谱检测诊断伴有胆管轻度扩张的胰胆管连接异常。方法 采仪式 8例胆管轻度扩张并经术中造影证实PBM的患儿术前、术后血清,另取8例正常儿童血清作对照,应用不连续缓冲系统苤膜电泳法行酶谱分析。结果 政党组仅存在P1和P2,PBM患儿术前血清淀粉酶同工酶波峰除有P1和P2外,还出现P3,P4、P5等异常波峰,无优势波峰,该血清酶学异常在胰胆分流术后基本消失,结论 PBM患儿即使仅伴有胆管轻度扩张。其血清淀粉酶同工酶谱仍存在异常,具一定特异性,有助于PBM的临床诊断。     

急性胰腺炎患者PCT、ALB、AMY及CRP水平检测的临床价值

目的探讨急性胰腺炎患者降钙素原(PCT)、血清白蛋白(ALB)、淀粉酶(AMY)及C反应蛋白(CRP)水平检测的临床价值。方法选取2016年11月至2017年12月在我院接受治疗的急性胰腺炎(AP)患者109例作为AP组,包括50例轻症急性胰腺炎(MAP)患者和59例重症急性胰腺炎(SAP)患者,同时选取在我院体检的50例健康人作为对照组。分别采用电化学发光法、溴甲酚绿法、干片法和免疫比浊法对血清PCT、ALB、AMY及CRP水平进行检测。分析4种指标单独及联合检测对急性胰腺炎诊断的意义。结果 AP组患者血清PCT、AMY和CRP水平明显高于对照组(P<0.05),且SAP组患者血清PCT、AMY和CRP水平与MAP组相比有明显升高(P<0.05);AP组患者血清ALB水平与对照组相比显著降低(P <0.05),与MAP组相比,SAP组患者血清ALB水平降低程度更为显著(P <0. 05)。AP组PCT、ALB、AMY及CRP单独及联合检测的阳性率均高于对照组(P <0. 05),且AP组联合检测的阳性率均显著高于单项指标检测(P <0. 05)。PCT、ALB、AMY及CRP联合检测的灵敏度为94.50%,准确度为89.31%,明显高于单项检测指标的结果 (P <0.05)。结论 PCT、ALB、AMY及CRP联合检测可显著提高急性胰腺炎诊断的灵敏度和准确度,具有较好的临床应用价值。     

脂肪酶抑制剂产生菌筛选

为了开发减肥用品的微生物菌种 ,用脂肪酶活性为筛选模型分别以肉汤培养基和马铃薯培养基培养土壤分离获得 1 1个菌株LA、LB、LC、LD、LE、LF、LG、MA、MB、MC和MD ,且同时考察了各菌株发酵液对淀粉酶、蛋白酶的抑制效果 ,结果表明LC、LE、LF、LG、MC和MD对淀粉酶有抑制作用 ,其抑制率分别为3 7%、5 8%、32 %、3 2 %、70 2 %和 73 5 % ;LA、LB、LC、MB对蛋白酶有抑制效果 ,抑制率分别为 55 %、31 2 5 %、37 5 %和 2 7 3 % ;LA、LB、LC、LD、LE、LF、MC和MD对脂肪酶有抑制效果 ,抑制率分别为 79%、54 8%、2 0 9%、1 2 9%、61 3 %、80 6 %、2 4 7%和 35 1 %。菌种LF对脂肪酶有较强的抑制作用 ,对淀粉酶抑制作用较小 ,对蛋白酶没有抑制作用。初步鉴定该菌属于芽孢杆菌属 ,命名为BacillusspLF。     

联合检测血清PCT、IL-6、CRP、AMY 及LPS对急性胰腺炎的诊断价值

目的 通过检测急性胰腺炎（AP）患者外周血清降钙素原（PCT）、白细胞介素6（IL-6）、C反应蛋白（CRP）、淀粉酶（AMY）和脂肪酶（LPS）的水平,分析这5种血清指标联合检测在AP临床诊断中的价值。 方法 选取2015年1月～2017年1月在成都上锦南府医院确诊为急性胰腺炎患者117例为观察组,其中重症急性胰腺炎患者（SAP）62例,轻症急性胰腺炎患者（MAP）55例。另选取同期体检健康者110例为对照组。检测SAP者、MAP者和对照组血清中PCT、IL-6、CRP、AMY和LPS的浓度,并比较水平差异。 结果 SAP者及MAP者的PCT、IL-6、CRP、AMY和LPS水平均显著高于对照组（均P＜0.05）。SAP者的PCT、IL-6、CRP水平均高于MAP者（P＜0.05）,而AMY、LPS水平比较,差异无统计学意义（P＞0.05）。PCT、IL-6、CRP、AMY和LPS的ROC曲线面积分为0.72、0.87、0.84、0.88、0.86,灵敏度分别为为60.40%、71.80%、67.50%、70.90%、78.60%,特异度分别为82.70%、86.40%、90.90%、88.20%、85.50%。多种血清指标联合检测对AP诊断的曲线面积为0.97,灵敏度为86.80%,特异度为99.10%。 结论 血清PCT、IL-6、CRP、AMY及LPS指标联合检测对AP的诊断具有较高的敏感性和特异性,可有效提升AP患者的临床诊断准确率,可在临床推广、应用。     

Capillary electrophoresis as a screening tool for alpha amylase inhibitors in plant extracts

Capillary electrophoresis (CE) method was developed for screening plant extract for potential alpha amylase (AA) inhibitory activity. The method was validated against a well established UV method. Overall, the proposed method was shown able to detect plants with significant alpha amylase inhibitory activity but not those with rather clinically insignificant activities. Fifty plant species were screened using both the proposed CE method and the UV method and seven plant species were found to possess significant AA inhibitory activities. Two plant species were proved to have alpha amylase inhibitory activity for the first time.     

Salivary alpha amylase and cortisol responses to different stress tasks: Impact of sex

Neuro-endocrine markers such as salivary alpha amylase (sAA) and cortisol (CORT) play an important role in establishing human responses to stressful events. Whereas sAA levels reflect sympathetic system activity, salivary cortisol appears to be a valid measure for HPA axis activity. Although many studies looked at either sAA or CORT responses in reaction to stress, work still has to be done to look at the way these systems interact, especially when both systems are activated. Additionally, sex effects in CORT responses have been investigated relatively often, but possible sex differences in sAA levels and responses, or the way both systems interact has not been the focus of sufficient studies to yield a univocal conclusion. In this study we presented a group of healthy participants (n=80) with two mildly stressful tasks, consisting of an aversive picture rating task and a cold pressor stress (CPS) task. The second task was compared with a control task. We expected a rise in sAA level in response to the first task and sAA as well as CORT responses on the second task and explored the interaction between the two responses. Results indicate that sAA is indeed a sensitive marker in both psychologically and physically induced arousal paradigms, whereas a cortisol response was only observed in the CPS task. Men had higher sAA levels than women during the complete course of the study, but men and women were comparable in their responsivity to the tasks. No strong correlations between sAA and CORT responses were found.     

柴芩承气汤联合早期肠内营养治疗重症胰腺炎及对患者淀粉酶、脂肪酶、乳酸脱氢酶与免疫功能的影响

目的:研究探讨柴芩承气汤联合早期肠内营养治疗重症胰腺炎及对患者淀粉酶(AMY)、脂肪酶(LIPA)、乳酸脱氢酶(LDH)及免疫功能的影响.方法:以回顾性分析的方法选取80例重症胰腺炎患者,按患者治疗方案不同分为观察组、对照组,各40例.对照组以早期肠内营养治疗干预,观察组以柴芩承气汤联合早期肠内营养治疗.综合评估患者的...     

Insufficient etiological workup of COVID-19-associated acute pancreatitis: A systematic review

BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection, mostly causing respiratory symptoms, is also known to affect the gastrointestinal tract. Several case reports hypothesize that SARS-CoV-2 could be an etiological factor in acute pancreatitis(AP).AIM To assess all the available evidence in the literature relating to coronavirus disease 2019(COVID-19) and AP.METHODS We performed a systematic review of the available literature on the topic. The systematic search was conducted on 15 May 2020 on MEDLINE, EMBASE, CENTRAL, Web of Science and Scopus with a search key using the terms "amylase," "lipase," "pancr*," "COVID-19" and synonyms. Due to the low quality and poor comparability of the studies, a meta-analysis was not performed.RESULTS Six case reports and two retrospective cohorts were included, containing data on eleven COVID-19 patients with AP. Five patients had AP according to the Atlanta classification. Other publications did not provide sufficient information on the diagnostic criteria. Most cases were considered SARS-CoV-2-induced, while several established etiological factors were not investigated. We were able to identify other possible causes in most of them.CONCLUSION We strongly highlight the need for adherence to the guidelines during a diagnostic and etiological workup, which could alter therapy.