A case of gallbladder carcinoma associated with pancreatobiliary reflux in the absence of a pancreaticobiliary maljunction： A hint for early diagnosis of gallbladder carcinoma

A 62-year-old man with progressive thickening of the gallbladder wall visited our outpatient clinic. The biliary amylase level in the common bile duct was 19900 IU/L and that of the gallbladder was 127000 IU/L, although endoscopic retrograde cholangiopancreatography revealed no pancreaticobiliary maljunction. Histology demonstrated a moderately differentiated adenocarcinoma of the gallbladder. Pancreatobiliary reflux and associated gallbladder carcinoma were confirmed in the present case, in the absence of a pancreaticobiliary maljunction. Earlier detection of the pancreatobiliary reflux and progressive thickening of the gallbladder wall might have led to an earlier resection of the gallbladder and improved this patient's poor prognosis.     

血清淀粉酶、脂肪酶、乳酸脱氢酶在急性胰腺炎的临床诊断意义

目的探讨急性胰腺炎（AP）中血清淀粉酶（AMY）、脂肪酶（LIP）、乳酸脱氢酶（LDH）的敏感性和特异性及相互关系,为临床诊断提供实验依据。方法采用强生VIROS 5600干化学分析仪速率法检测血清AMY、LIP、LDH。结果发病时重型胰腺炎（SAP）组和轻型胰腺炎（MAP）组及非胰腺炎急腹症组血清AMY、LIP、LDH明显高于对照组,在疾病早期（48 h内）联合测定血清AMY、LIP、LDH,诊断AP的阳性率显著高于单项检测,且AMY、LIP、LDH呈正相关。结论联合检测有助于AP的早期诊断、病变程度判定、治疗效果观察及预后判断。     

Screening of Jordanian Flora for α-Amylase Inhibitory Activity

Thirty-five plant species that belong to different families were tested for α -amylase inhibitory activity. Four of the screened plants exhibited significant (more than 80%) α -amylase inhibitory activity. IC₅₀ values for these plants were estimated based on the dried crude extract and found to be 0.08, 0.13, 0.32, and 0.47 mg/ml, for Osyris alba L. (Santalaceae), Sarcopotarium spinosum L. (Rosaceae), Hypericum triquetrifolium Turra (Hypericaceae) and Arbutus andrachne L. (Ericaceae), respectively. Amylase inhibitory activity was also evaluated in vivo using female rats. Results showed that the tested extracts had a favorable effect on blood glucose level after ingestion of a high dose of sucrose. The most potent extract in controlling the surge of glucose after sucrose ingestion appeared to be O. alba which also exhibited the highest α -amylase inhibitory activity in vitro.     

Metabolism of wheat proteins by intestinal microbes: Implications for wheat related disorders

Wheat is a common cereal in the Western diet and an important source of protein as well as fiber. However, some individuals develop adverse reactions to a wheat-containing diet. The best characterized is celiac disease which develops after intake of gluten in individuals with genetic predisposition. Other wheat-related conditions are less well defined in terms of diagnosis, specific trigger and underlying pathways. Despite this, the overall prevalence of wheat-related disorders has increased in the last decades and the role of microbial factors has been suggested. Several studies have described an altered intestinal microbiota in celiac patients compared to healthy subjects, but less information is available regarding other wheat-related disorders. Here, we discuss the importance of the intestinal microbiota in the metabolism of wheat proteins and the development of inflammatory or functional conditions. Understanding these interactions will open new directions for therapeutic development using bacteria with optimal wheat protein degrading capacity.     

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。     

急性有机磷农药中毒患者血液淀粉酶和血糖的变化及临床意义

为探讨急性有机磷农药中毒患者血液淀粉酶（ＡＭＳ）活性和血糖浓度的变化及临床意义。血液ＡＭＳ活性检测采用磺－－淀粉比色法;血糖检测采用葡萄糖氧化酶电极法。急性有机磷农药中毒患者血液ＡＭＳ活性和血糖浓度,均显示高于健康对照组（Ｐ〈０．０１）;中、重度中毒患者显著高于轻度中毒患者（Ｐ〈０．０１）。急性有机磷农药中毒患者血液ＡＭＳ活性和血糖浓度明显升高,且与中毒程度相关。     

血清淀粉酶及白蛋白联合乳酸脱氢酶检测在急性胰腺炎临床诊断及病情评估中的作用

目的 探讨血清淀粉酶、白蛋白联合乳酸脱氢酶检测在急性胰腺炎临床诊断、病情评估中的作用。方法 回顾性分析2018年2月～2021年10月于首都医科大学附属北京世纪坛医院治疗的123例急性胰腺炎患者的临床资料,将其设为观察组,同时选取同时期进行健康体检的87例患者设为健康组。根据病情严重程度将观察组分为轻症组(n=44)和重症组(n=79),比较患者不同病情程度者淀粉酶、白蛋白、乳酸脱氢酶水平,分析影响急性胰腺炎发生的危险因素及血清淀粉酶、白蛋白联合乳酸脱氢酶检测对急性胰腺炎的临床诊断价值。结果 观察组患者淀粉酶、乳酸脱氢酶水平均高于健康组,白蛋白水平低于健康组(均P<0.05)。轻症组与重症组淀粉酶水平差异无统计学意义(P>0.05),轻症组患者乳酸脱氢酶水平及白蛋白水平均低于重症组(P<0.05)。经多因素Logistic回归模型分析结果得出,暴饮暴食、酗酒、淀粉酶、白蛋白、乳酸脱氢酶为影响急性胰腺炎发生的独立危险因素(P<0.05)。ROC曲线示：淀粉酶、白蛋白、乳酸脱氢酶单独检测为0.793、0.701、0.725,三者联合检测为0.896,三者联合检测AU...     

清胰通腑汤治疗重症急性胰腺炎疗效观察

目的 观察清胰通腑汤对急性胰腺炎的临床疗效.方法 将78例急性胰腺炎随机分为治疗组(40例)和对照组(38例),对照组给予禁饮食、持续胃肠减压、广谱抗生素、维持水/电解质及酸碱平衡、奥曲肽等治疗:治疗组在对照组基础上加用清胰通腑汤,每次150 mL鼻饲管内灌入,每日2～3次.结果 治疗组的首次排大便时间、腹胀痛消失时间、血尿淀粉酶恢复正常时间、白细胞恢复正常时间、住院时间明显短于对照组.结论 清胰通腑汤结合常规西医治疗急性胰腺炎的疗效较佳.     

王家岭3·28透水事故获救矿工消化功能的分析

目的分析长期饥饿应激条件对消化系统的影响。方法2010年3月28日王家岭煤矿透水事故中153名矿工,被困井下,处于断食、应激状态。8d后115例矿工获救并住院,均男性,年龄（38．7±7．6）岁（19。54岁）。观察其消化系统症状,入院后连续7～10d检测转氨酶、胆红索、脂肪酶、淀粉酶、电解质等生化指标。结果115例矿工中,21例矿工表现腹部不适和腹痛,有2例矿工表现恶心,但未有呕吐等症状;49．6％的矿工有低白蛋白血症;33．3％的矿工丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）增高;40．3％的矿工总胆红素增高;74．5％的矿工有电解质异常,表现为低钠血症、低钾血症和,或低钙血症。结论长时间的饥饿应激可致低白蛋白血症及血生化紊乱,循序渐进的进食方案及补液治疗有助于恢复。     

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.