| Objective: Acute pancreatitis (AP) is one of the acute abdominal disease of surgery, which is classified with acute edema pancreatitis and acute necrosis pancreatitis. Acute necrosis pancreatitis is a severe disease, with high mortality and fast clinical development. ANP is not only a local disease, but also a systematic disease. Despite of the pancreatic ischemia and necrosis, ANP manifests clinically as systematically multiple organ dysfunction or multiple organ dysfunction syndrome. Especially the acute lung injury, or acute respiratory distress syndrome, always firstly manifests on patients with acute necrosis pancreatitis. Acute lung injury occurs as a result of a cascade of cellular events initiated by either infection or noninfection inflammatory stimuli. The sequestration, activation, and postponing apoptosis of neutrophils play an important role in acute necrosis pancreatitis associated lung injury. Leukocyte adhesion to endothelial cell is a prelude to leukocyte transmigration across the endothelial barrier and into areas of lung tissue .In this study, we investigated Wistar rat model of acute necrosis pancreatitis combined with acute lung injury and treated it with Chinese traditional medicine "Yi Yan He Ji". We aimed at studying the expression of ICAM-1 mRNA in lung tissue and evaluating the effect of "Yi Yan He Ji" by contrast among five groups. Methods: The model of acute necrosis pancreatitis combined with acute lung injury was induced by retrograde injection of 5% sodium taurocholate into the biliopancreatic duct. 240 healthy Wistar rats, weight 250~300g, randomly divided into 5 groups. Model group, "Yi Yan He Ji" treated group, ulinastatia treated group, sodium chloride treated group and sham group, with 48 rats in each group. But 0.9% sodium chloride took the place of 5% sodium taurocholate in sham group. Put rats to death after operation and treatment at 6h, 12h, 24h, 48h, 72h, 96h. The severity of pancreatitis was evaluated by quantitating serum amylase and observing pancreatic acinar cell necrosis. Lung injury was evaluated by observing change of morphology, quantitating lung myeloperoxidase activity (i.e. neutrophil content ) and wet/dry weight ratio. ICAM-1 mRNA was semiquantitated by ICAM-1 in situ hybridization (ISH) detection. Analyze the data with statistics software. (SAS 6.12)Results: The experimental model of acute necrosis pancreatitis combined with acute lung injury was successfully induced 6h after 5% sodium taurocholate injected into the biliopancreatic duct. Serum amylase, myeloperoxidase (MPO) activity and expression of ICAM-1 mRNA were all within normal scope in sham group. In model group, intrapulmonary expression of ICAM-1 gene had already increased at 6h, peaked at 12h, gradually decreased, and remained elevated at 96h. As for MPO activity of lung tissue, there was a significant increase since 6h, peaked at 24h, remained elevated throughout the experiment. W/D weight ratio was in highest phase from 24h to 48h. There were positive correlations among the three parameters. To contrast with model group, there was a similar trend, but the quantitative evaluation of the three parameter all significantly declined at respective five timing (P<0.01) except 12h in MPO activity and W/D weight ratio, pathological changes of general observation and optical microscopy took on milder inflammation in the "Yi Yan He Ji" treated group. There was no significance while "Yi Yan He Ji" treated group contrasted with ulinastatia treated group (p>0.05), so did between model group and sodium chloride group.Conclusions: The method of retrograde injected 5% sodium taurocholate into the biliopancreatic duct to induce acute necrosis pancreatitis combined with acute lung injury experimental model is simplified, duplicated easily, and valuable. There were positive correlations among intrapulmonary expression of ICAM-1 gene, the degree of neutrophil accumulation in lung tissue (as detected by MPO activity) and the severity of lung injury in rats with ANP-associated pulmonary...
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