BACKGROUND Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography(ERCP).Currently,there is no suitable treatment for post-ERCP pancreatitis(PEP)prophylaxis.Few studies hav...BACKGROUND Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography(ERCP).Currently,there is no suitable treatment for post-ERCP pancreatitis(PEP)prophylaxis.Few studies have prospectively evaluated interventions to prevent PEP in children.AIM To assess the efficacy and safety of the external use of mirabilite to prevent PEP in children.METHODS This multicenter,randomized controlled clinical trial enrolled patients with chronic pancreatitis scheduled for ERCP according to eligibility criteria.Patients were randomly divided into the external use of mirabilite group(external use of mirabilite in a bag on the projected abdominal area within 30 min before ERCP)and blank group.The primary outcome was the incidence of PEP.The secondary outcomes included the severity of PEP,abdominal pain scores,levels of serum inflammatory markers[tumor necrosis factor-alpha(TNF-α)and serum interleukin-10(IL-10)],and intestinal barrier function markers[diamine oxidase(DAO),D-lactic acid,and endotoxin].Additionally,the side effects of topical mirabilite were investigated.RESULTSA total of 234 patients were enrolled,including 117 in the external use of mirabilite group and theother 117 in the blank group.The pre-procedure and procedure-related factors were notsignificantly different between the two groups.The incidence of PEP in the external use ofmirabilite group was significantly lower than that in the blank group(7.7%vs 26.5%,P<0.001).The severity of PEP decreased in the mirabilite group(P=0.023).At 24 h after the procedure,thevisual analog scale score in the external use of mirabilite group was lower than that in the blankgroup(P=0.001).Compared with those in the blank group,the TNF-αexpressions weresignificantly lower and the IL-10 expressions were significantly higher at 24 h after the procedurein the external use of mirabilite group(P=0.032 and P=0.011,respectively).There were nosignificant differences in serum DAO,D-lactic acid,and endotoxin levels before and after ERCPbetween the two groups.No adverse effects of mirabilite were observed.CONCLUSIONExternal use of mirabilite reduced the PEP occurrence.It significantly alleviated post-proceduralpain and reduced inflammatory response.Our results favor the external use of mirabilite toprevent PEP in children.展开更多
The authors investigated lacustrine chemical sediments on terrace-I of DongCo-a salt lake in the interior of the northern Tibetan Plateau and firstly discovered borax and acomplete sedimentary section with five pure m...The authors investigated lacustrine chemical sediments on terrace-I of DongCo-a salt lake in the interior of the northern Tibetan Plateau and firstly discovered borax and acomplete sedimentary section with five pure mirabilite beds. According to the sedimentarycharacteristics of rhythmic layering, palaeotemperatures for the formation of the cold-phasemineral-mirabilite-at the profiles and ^(14)C dating, the authors applied the theory and method ofcomparative salinology in the study of the history of the palaeoclimate and palaeoenvironment ofDong Co in the early and middle Holocene and drew the conclusion that the salt lake had experiencedthe following climatic evolution: the warm and moist stage (>8470 a HP and possibly to 10500 aHP)->cold and dry stage (8470-8170 a BP)->warm and moist stage (8170-7590 a BP)->stage of repeatedclimatic oscillations (7590-7400 a BP, alternation of three dry oscillations and three moistoscillations in a generally cold climatic background)->cold and dry stage (7400-6940 a BP)->warm andmoist stage (6940-6620 a BP)->cold and dry stage (6620-6410 a BP)->warm and moist stage (after 6410a HP).展开更多
柴达木盆地马海盐湖含钾地层下部沉积了厚层芒硝。与钾盐通常形成于干热气候不同,芒硝是典型的冷相盐类矿物,因此厚层芒硝的沉积特征及成因的研究对认识古环境演变过程及其对钾盐成矿影响具有重要意义。文章以柴达木盆地马海矿区发育的...柴达木盆地马海盐湖含钾地层下部沉积了厚层芒硝。与钾盐通常形成于干热气候不同,芒硝是典型的冷相盐类矿物,因此厚层芒硝的沉积特征及成因的研究对认识古环境演变过程及其对钾盐成矿影响具有重要意义。文章以柴达木盆地马海矿区发育的厚层芒硝的地层剖面为研究对象,通过系统取样开展薄片鉴定、化学组分、矿物类型和硫同位素分析,研究了剖面化学组分、矿物类型和硫同位素的变化规律。结果显示,该剖面的盐类矿物主要有石盐、石膏、芒硝及钙芒硝;芒硝层沉积的最大年龄为275.3±47.9 ka BP;剖面自下而上表现为由厚层纯净芒硝向含石膏石盐岩演变的特征,下部为芒硝层,中下部出现钙芒硝,中上部石盐含量最高,上部石盐含量相对减少,石膏含量增加,与之相对应的是沉积物化学组成中钾、镁和钙的含量稳定增高,硫酸根和钠含量总体降低。厚层芒硝沉积时期,马海盐湖处于持续干冷的气候条件,有利于盐湖卤水中钾、镁持续富集,为在局部富集形成固体钾矿奠定了基础。展开更多
基金Supported by Shanghai Municipal Health Commission of China,No. 2018LP018
文摘BACKGROUND Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography(ERCP).Currently,there is no suitable treatment for post-ERCP pancreatitis(PEP)prophylaxis.Few studies have prospectively evaluated interventions to prevent PEP in children.AIM To assess the efficacy and safety of the external use of mirabilite to prevent PEP in children.METHODS This multicenter,randomized controlled clinical trial enrolled patients with chronic pancreatitis scheduled for ERCP according to eligibility criteria.Patients were randomly divided into the external use of mirabilite group(external use of mirabilite in a bag on the projected abdominal area within 30 min before ERCP)and blank group.The primary outcome was the incidence of PEP.The secondary outcomes included the severity of PEP,abdominal pain scores,levels of serum inflammatory markers[tumor necrosis factor-alpha(TNF-α)and serum interleukin-10(IL-10)],and intestinal barrier function markers[diamine oxidase(DAO),D-lactic acid,and endotoxin].Additionally,the side effects of topical mirabilite were investigated.RESULTSA total of 234 patients were enrolled,including 117 in the external use of mirabilite group and theother 117 in the blank group.The pre-procedure and procedure-related factors were notsignificantly different between the two groups.The incidence of PEP in the external use ofmirabilite group was significantly lower than that in the blank group(7.7%vs 26.5%,P<0.001).The severity of PEP decreased in the mirabilite group(P=0.023).At 24 h after the procedure,thevisual analog scale score in the external use of mirabilite group was lower than that in the blankgroup(P=0.001).Compared with those in the blank group,the TNF-αexpressions weresignificantly lower and the IL-10 expressions were significantly higher at 24 h after the procedurein the external use of mirabilite group(P=0.032 and P=0.011,respectively).There were nosignificant differences in serum DAO,D-lactic acid,and endotoxin levels before and after ERCPbetween the two groups.No adverse effects of mirabilite were observed.CONCLUSIONExternal use of mirabilite reduced the PEP occurrence.It significantly alleviated post-proceduralpain and reduced inflammatory response.Our results favor the external use of mirabilite toprevent PEP in children.
基金National Natural Science Foundation grant 49833010.
文摘The authors investigated lacustrine chemical sediments on terrace-I of DongCo-a salt lake in the interior of the northern Tibetan Plateau and firstly discovered borax and acomplete sedimentary section with five pure mirabilite beds. According to the sedimentarycharacteristics of rhythmic layering, palaeotemperatures for the formation of the cold-phasemineral-mirabilite-at the profiles and ^(14)C dating, the authors applied the theory and method ofcomparative salinology in the study of the history of the palaeoclimate and palaeoenvironment ofDong Co in the early and middle Holocene and drew the conclusion that the salt lake had experiencedthe following climatic evolution: the warm and moist stage (>8470 a HP and possibly to 10500 aHP)->cold and dry stage (8470-8170 a BP)->warm and moist stage (8170-7590 a BP)->stage of repeatedclimatic oscillations (7590-7400 a BP, alternation of three dry oscillations and three moistoscillations in a generally cold climatic background)->cold and dry stage (7400-6940 a BP)->warm andmoist stage (6940-6620 a BP)->cold and dry stage (6620-6410 a BP)->warm and moist stage (after 6410a HP).
文摘柴达木盆地马海盐湖含钾地层下部沉积了厚层芒硝。与钾盐通常形成于干热气候不同,芒硝是典型的冷相盐类矿物,因此厚层芒硝的沉积特征及成因的研究对认识古环境演变过程及其对钾盐成矿影响具有重要意义。文章以柴达木盆地马海矿区发育的厚层芒硝的地层剖面为研究对象,通过系统取样开展薄片鉴定、化学组分、矿物类型和硫同位素分析,研究了剖面化学组分、矿物类型和硫同位素的变化规律。结果显示,该剖面的盐类矿物主要有石盐、石膏、芒硝及钙芒硝;芒硝层沉积的最大年龄为275.3±47.9 ka BP;剖面自下而上表现为由厚层纯净芒硝向含石膏石盐岩演变的特征,下部为芒硝层,中下部出现钙芒硝,中上部石盐含量最高,上部石盐含量相对减少,石膏含量增加,与之相对应的是沉积物化学组成中钾、镁和钙的含量稳定增高,硫酸根和钠含量总体降低。厚层芒硝沉积时期,马海盐湖处于持续干冷的气候条件,有利于盐湖卤水中钾、镁持续富集,为在局部富集形成固体钾矿奠定了基础。
