Evaluation of serum TWEAK concentration in patients with acute pancreatitis

Serum TNF-related weak inducer of apoptosis (TWEAK) and TNF-related apoptosis-inducing ligand (TRAIL) levels of patients with bipolar disorder in manic episode, in remission and healthy controls

TNF-related weak inducer of apoptosis (TWEAK) and TNF-related apoptosis-inducing ligand (TRAIL) are members of TNF superfamily, which has various roles in immunologic and inflammatory reactions in the organism. Pathophysiology in bipolar disorder is still under investigation and altered serum levels of cytokines are often encountered. Aim of this study is to detect serum TWEAK and TRAIL levels of patients with bipolar disorder and healthy controls. For this purpose, 55 patients with bipolar disorder -27 manic episode (ME), 28 remission (RE) and 29 healthy controls (HC) were included. TWEAK levels of ME and RE groups were significantly lower than HC. TWEAK levels of bipolar patients (BP) were also lower than HC. TRAIL levels of ME, RE, HC groups and BP, HC groups were statistically similar. In our knowledge, this is the first study concerning about TWEAK and TRAIL levels in bipolar disorder and our results pointed that TWEAK-related immune response might be impaired in bipolar disorder, but our study fails to eradicate the confounders such as medication, smoking and body mass index. Studies having larger samples and limited confounders are needed to be able to evaluate these changes better and detect possible alterations about TRAIL and other TNF superfamily members.

Efficacy of different routes of administration of magnesium sulfate in treatment of severe acute pancreatitis

AIM: To evaluate the clinical effects of different routes of administration of magnesium sulfate in the treatment of severe acute pancreatitis (SAP).

METHODS: Fifty-six patients diagnosed with SAP were randomly divided into an oral magnesium sulfate treatment group and a venous magnesium sulfate treatment group. Blood tests, liver and kidney function, electrolytes, blood and urine amylase, and glucose were monitored. C-reaction protein (CRP), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE-Ⅱ) score and abdominal pressure were determined. Blood gas analysis and abdominal ultrasound or CT were performed. Time to first defecation and time to relief of abdominal pain and distension were recorded. The rates of requiring blood filtration and operation, serious complications, and total duration of hospitalization were also recorded.

RESULTS: After defecation, blood and urine amylase and abdominal pressure significantly declined, and CRP gradually decreased in both groups (P < 0.05). Compared with the venous magnesium sulfate treatment group, blood and urine amylase, CRP, abdominal pressure, and APACHE-Ⅱ score were significantly lower in the oral magnesium sulfate treatment group (P < 0.05). Time to first defecation, time to relief of abdominal distention and abdominal pain, rate of the need for blood filtration and surgical treatment, rate of complications, and total duration of hospitalization were significantly lower in the oral treatment group than in the venous treatment group (P < 0.05).

CONCLUSION: Compared with intravenous infusion of magnesium sulfate, oral magnesium sulfate can effectively reduce intra-abdominal pressure, the inflammatory response, and the rate of serious complications in SAP, thus improving the cure rate.