| 【Background】 the pancreatic encephalopathy (PE) which was the central nervoussystem (CNS) symptomsof the SAP was one of the early complicationsof the Severeacute pancreatitis(SAP).18.2%of SAP patients have the compilcation of PE, whoseprognosis was poor, the mortality associated with PE is67%. its main clinicalmanifestation was CNS symptoms,such as disorientation, depression, confusion,irritability, unresponsive and indifference. The Chinese materia medica preparation ofqingyi grains (QYG) which obviously alleviated the symptoms of SAP patients,shorten the course and reduced the complications was used of the treatment of SAP inclinical. The QYG is the solid dosage forms for qingyitang, further exploreQYG forthe mechanism and effective of brain injury in SAP,it is helpful to the research anddevelopment QYG and to explore the pathogenesis of PE.【objective】 established PE model ofthe rat，in order to explore the the expressionof AQP-4and the changes of blood brain barrier permeability inbrain inPE model,and discusse the expression of AQP-4and the changes of blood brain barrier afterthetreatment of QYG for PE, to explore the relation of protection mechanism after thetreatment of QYG,to provide experimental basis for clinical treatment of PE in QYG.【methods】90healthy adult SD (Sprague wrote-Dawley) rats, male and female inhalf, randomly divided into3groups: sham-operation(SO) group (30);PE group(30);QYG treatment group (30).10rats was executed In12,24and48hours time.0.9%NaCl injected into the pancreatic duct in SO group;5%sodium taurocholate(STC)(0.1ml/100g) injected into the pancreatic duct in PE group;forming moldafter 2hoursin QYG group, the dissolved QYG lavage rats give once time after12huor,other group used0.9%NaCl instead ofQYG.(1) HE dyeing observedthe change ofpancreatic pathological;(2) the Evans blue method determinedthe permeability ofblood brain barrier;(3) ELISA determinedthe contentof TNF-alpha and AQP-4inbrain tissue;(4) immunohistochemical detected the expression of AQP-4protein inbrain tissue;(5) quantitative reverse transcription polymerase reaction (RT-PCR)determinedthe expression of AQP-4-mRNA.【results】(1)pancreasappear a number of the infiltration of inflammatory cells in PEgroup, calcifications, different degree of hemorrhage and necrosis, somekaryolysis ordisappear of cells, the acinar structures of residual swelling, the edema of lobularinterstitial, the disappear of cell polarity;QYG group acinar structures can be observedfrom mild swelling, send out a small amount of congestion and necrosis, compared toPE group the degree of pathological changes reduce, compared with PE grouppathological scores decreased significantly (P<0.05), compared with theSO grouppathological scores were significantly higherin the PE and QYG group(P<0.05).(2)QYG is possible effecttiveto protect pancreas in PE model.(3)the BBB permeabilitybegan to rise from12hour in PE group, peak within24hour,48h our is still at thehigher level.Compared with the SO group,BBB permeability increased significantlyin PE group and QYG group (P<0.05);Compared with PE group, BBB permeabilitydecreased significantlyin the group QYG (P<0.05).(4) the brain of the level of TNF-αin PE group and QYG group were higher than the SO group, it is obviously increasedmore in PE group with rendering time increasingin PE group, the the level of TNF-αdecreased significantly after the treatment of QYG (P<0.05), QYG curative effect istime dependent.(5) the expression level of AQP-4was differentin each group rats,AQP QYG therapy organization-4protein expression significantly reduced, ELISA,immunohistochemistry and Q-PCR results similar trends.(6) the statistical correlationanalysis, TNF-a and AQP-4in brain tissue exist positive correlation (r=0.936),between BBB permeability and AQP-4presents positive correlation (r=0.757),BBBpermeability and TNF-a presents positive correlation (r=0.804). 【conclusion】(1) successed PE model rats, BBB permeability was significantlyincreased in PE model group, to24hour peak, the treatment of QYGcan reduce thelevelof BBB permeability.(2) QYG is possible effecttiveto protect pancreas in PEmodel.(3) The expression of tumor necrosis factor alpha was significantly increasedinthe brain tissue in the PE model group, TNF-α level was significantly decreasedafterthe treatment of QYG, explain QYG have anti-inflammatory effects.(4) the expressionof AQP-4protein significantly increased in brain tissuein the PE model group, whilethe expression of the level of AQP-4protein decreased after the treatment ofQYG, it issuggested the QYG plays a protective role to AQP-4mediated brain injury.(5)levelsof TNF-α and AQP-4in the brain showed a trend of risingin PE model group andQYG treatment group, them and BBB permeability was significantly related, and thepositive correlation, it is suggest the changes of TNF-α and AQP-4May lead to therise of BBB permeability and cause brain injure. |
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