AIM： To identify cancer stern cells （CSCs） in human gallbladder carcinomas （GBCs）. METHODS： Primary GBC cells were cultured under serum-free conditions to produce floating spheres. The stem-cell properties of th...AIM： To identify cancer stern cells （CSCs） in human gallbladder carcinomas （GBCs）. METHODS： Primary GBC cells were cultured under serum-free conditions to produce floating spheres. The stem-cell properties of the sphere-forming cells, including self-renewal, differentiation potential, chemoresistance and tumorigenicity, were determined in vitro or in vivo. Cell surface expression of CD133 was investigated in primary tumors and in spheroid cells using flow cytometry. The sphere-colony-formation ability and tumorigenicity of CD133＋ cells were assayed.floating spheroids were generated from primary GBC cells, and these sphere-forming cells could generate new progeny spheroids in serum-free media. Spheroid cells were differentiated under serum-containing conditions with downregulation of the stem cell markers Oct-4, Nanog, and nestin （P 〈 0.05）. The differentiated cells showed lower spheroid-colony-formation ability than the original spheroid cells （P 〈 0.05）. Spheroid ceils were more resistant to chemotherapeutic reagents than the congenetic adherent cells （P 〈 0.05）. Flow cytometry showed enriched CD133＋ population in sphereforming cells （P 〈 0.05）. CD133＋ cells possessed high colony-formation ability than the CD133 population （P 〈 0.01）. CD133＋ cells injected into nude mice revealed higher tumorigenicity than their antigen-negative counterparts （P 〈 0.05）. CONCLUSION： CD133 may be a cell surface marker for CSCs in GBC.展开更多
BACKGROUND： The treatment of borderline resectable pancreatic head cancer（BRPHC） is still controversial and challenging. The artery-first approaches are described to be the important options for the early determina...BACKGROUND： The treatment of borderline resectable pancreatic head cancer（BRPHC） is still controversial and challenging. The artery-first approaches are described to be the important options for the early determination. Whether these approaches can achieve an increase R0 rate, better bleeding control and increasing long-term survival for BRPHC are still controversial. We compared a previously reported technique, a modified artery-first approach（MAFA）, with conventional techniques for the surgical treatment of BRPHC.METHODS： A total of 117 patients with BRPHC undergone pancreaticoduodenectomy（PD） from January 2013 to June 2015 were included. They were divided into an MAFA group（n=78） and a conventional-technique group（n=39）. Background characteristics, operative data and complications were compared between the two groups.RESULTS： Mean operation time was significantly shorter in the MAFA group than that in the conventional-technique group（313 vs 384 min; P=0.014）; mean volume of intraoperative blood loss was significantly lower in the MAFA group than that in the conventional-technique group（534 vs 756 m L; P=0.043）; and mean rate of venous resection was significantly higher in the conventional-technique group than that in the MAFA group（61.5% vs 35.9%; P=0.014）. Pathologic data, early mortality and morbidity were not different significantly between the two groups.CONCLUSIONS： MAFA is safe, simple, less time-consuming, less intraoperative blood loss and less venous resection, and therefore, may become a standard surgical approach to PD for BRPHC with the superior mesenteric vein-portal vein involvement but without superior mesenteric artery invasion.展开更多
BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas.Increasing attention has been paid to changes in quality of life(QOL)after pancreatic surgery.AIM To summarize and a...BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas.Increasing attention has been paid to changes in quality of life(QOL)after pancreatic surgery.AIM To summarize and analyze current research results on QOL after pancreatic surgery.METHODS A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Relevant studies were identified by screening the references of retrieved articles.Studies on patients’QOL after pancreatic surgery published after January 1,2012,were included.These included prospective and retrospective studies on patients'QOL after several types of pancreatic surgeries.The results of these primary studies were summarized inductively.RESULTS A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more accurate.Although TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after TP.The QOL was better after DPPHR than PD.However,the superiority of the QOL between patients who underwent CP and PD remains controversial.The decrease in exocrine and endocrine functions postoperatively was the main factor affecting the QOL.Minimally invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic surgery.The article covers the discussion and analysis of the QOL of various pancreatic surgeries.Which kind of surgical procedure has better QOL is controversial.The long-term benefits on QOL of minimally invasive surgery over open surgery are contro-INTRODUCT展开更多
Preoperative biliary drainage may increase the morbidity and mortality of pancreatico-duodenectomy.Studies on percutaneous transhepatic biliary drainage(PTBD)before laparoscopic pancreaticoduodenectomy(LPD),however,ar...Preoperative biliary drainage may increase the morbidity and mortality of pancreatico-duodenectomy.Studies on percutaneous transhepatic biliary drainage(PTBD)before laparoscopic pancreaticoduodenectomy(LPD),however,are scarce.The aim of this study was to examine the impact of PTBD on clinical outcomes of patients with malignant obstructive jaundice undergoing LPD.Clinical data of 172 patients who had malignant obstructive jaundice and underwent LPD from 2014 to 2017 in our hospital were retrospectively analyzed.Demographics,catheterrelated complications,postoperative complications,and oncological outcormes were collected and analyzed.Propensity score matching was performed to minimize selection bias associated with the comparison of data between patients who underwent PTBD and then LPD(PTBD group),and those given LPD alone(LPD group).The results showed that,in the PTBD group relative to the LPD group,the operating time was significantly shortened(250.28±69.95 vs.278.58±86.51 min,P=0.0196),the intraopcrative blood loss was markedly reduced(271.96±403.47 vs.429.72±482.47 mL,P=0.022),and overall rates of complications(16.33%vs.36.49%,P=0.0025)including postoperative haemorrhage(2.04%vs.12.16%,P=0.0072)and delayed gastric emptying(4.08% vs.13.51%,P=0.0251)were greatly decreased.The propensity score-matched analysis,with 48 patients enrolled in each group,revealed no statistically significant differences in operating duration(262.71±68.64 vs.280.25±83.52 min,P=0.264),intraoperative blood loss(290.21±407.71 vs.373.75±422.33 mL,P=0.327)and delayed gastric emptying(4.17% vs.12.50%,P=0.1396).PTBD group had lower incidences in overall complications(22.92% vs.39.58%,P=0.0481)and postoperative haemorrhage(2.08% vs.12.50%,P=0.0497)than LPD group.In conclusion,patients with malignant obstructive jaundice may benefit from PTBD procedure before LPD in terms of perioperative outcomes.展开更多
Excessive inflammation post-traumatic spinal cord injury(SCI)induces microglial activation,which leads to prolonged neurological dysfunction.However,the mechanism underlying microglial activation-induced neuroinflamma...Excessive inflammation post-traumatic spinal cord injury(SCI)induces microglial activation,which leads to prolonged neurological dysfunction.However,the mechanism underlying microglial activation-induced neuroinflammation remains poorly understood.Ruxolitinib(RUX),a selective inhibitor of JAK1/2,was recently reported to inhibit inflammatory storms caused by SARS-CoV-2 in the lung.However,its role in disrupting inflammation post-SCI has not been confirmed.In this study,microglia were treated with RUX for 24 hours and then activated with interferon-γfor 6 hours.The results showed that interferon-γ-induced phosphorylation of JAK and STAT in microglia was inhibited,and the mRNA expression levels of pro-inflammatory cytokines tumor necrosis factor-α,interleukin-1β,interleukin-6,and cell proliferation marker Ki67 were reduced.In further in vivo experiments,a mouse model of spinal cord injury was treated intragastrically with RUX for 3 successive days,and the findings suggest that RUX can inhibit microglial proliferation by inhibiting the interferon-γ/JAK/STAT pathway.Moreover,microglia treated with RUX centripetally migrated toward injured foci,remaining limited and compacted within the glial scar,which resulted in axon preservation and less demyelination.Moreover,the protein expression levels of tumor necrosis factor-α,interleukin-1β,and interleukin-6 were reduced.The neuromotor function of SCI mice also recovered.These findings suggest that RUX can inhibit neuroinflammation through inhibiting the interferon-γ/JAK/STAT pathway,thereby reducing secondary injury after SCI and producing neuroprotective effects.展开更多
BACKGROUND： Myeloid-derived suppressor cells （MDSCs） are heterogeneous cell types that suppress T-cell responses in cancer patients and animal models, some MDSC subpopulations are increased in patients with pancrea...BACKGROUND： Myeloid-derived suppressor cells （MDSCs） are heterogeneous cell types that suppress T-cell responses in cancer patients and animal models, some MDSC subpopulations are increased in patients with pancreatic cancer. The present study was to investigate a specific subset of MDSCs in patients with pancreatic cancer and the mechanism of MDSCs increase in these patients. METHODS： Myeloid cells from whole blood were collected from 37 patients with pancreatic cancer, 17 with cholangiocarcinoma, and 47 healthy controls. Four pancreatic cancer cell lines were co- cultured with normal peripheral blood mononudear cells （PBMCs） to test the effect of tumor cells on the conversion of PBMCs to MDSCs. Levels of granulocyte-macrophage colony-stimulating factor （GM-CSF） and arginase activity in the plasma of cancer patients were analyzed by enzyme-linked immunosorbent assay. RESULTS： CD14＋/CD11b＋/HLA-DR MDSCs were increased in patients with pancreatic or bile duct cancer compared with those in healthy controls, and this increase was correlated with clinical cancer stage. Pancreatic cancer cell lines induced PBMCs to MDSCs in a dose-dependent manner. GM-CSF and arginase activity levels were significantly increased in the se rum of patients with pancreatic cancer. CONCLUSIONS： MDSCs were tumor related： tumor cells induced PBMCs to MDSCs in a dose-dependent manner and circulating CD14＋/CD11b＋/HLA-DR- MDSCs in pancreatic cancer patients were positively correlated with tumor burden. MDSCs might be useful markers for pancreatic cancer detection and progression.展开更多
Acute pancreatitis(AP)is an inflammatory disease of the pancreas which involves the pancreas and surrounding tissue,and systemic inflammation with a characteristic systemic increase of vascular permeability and increa...Acute pancreatitis(AP)is an inflammatory disease of the pancreas which involves the pancreas and surrounding tissue,and systemic inflammation with a characteristic systemic increase of vascular permeability and increased risk of multiple organ dysfunction.Currently,the pathogenesis of AP is fuzzy,and the diagnosis and treatment need to be standardized.Nevertheless,increased knowledge of AP may achieve more thorough understanding of the pathogenesis.The use of further advanced diagnostic tools and superior treatment,potentially will help clinicians to manage AP at an appropriate stage.However,in view of the multi factorial disease and the complex clinical manifestations,the management of patients with AP is also remaining areas for improvement.展开更多
Objective:Conversion of normal cells to cancer cells is often accompanied by abnormal synthesis of serum enzymes.Both alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)have been reported to have prognostic value ...Objective:Conversion of normal cells to cancer cells is often accompanied by abnormal synthesis of serum enzymes.Both alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)have been reported to have prognostic value in a variety of malignancies.The aim of this study was to investigate the effect of preoperative serum ALP and LDH levels on the prognosis of patients with periampullary carcinoma who underwent pancreatoduodenectomy(PD).展开更多
Objective: To explore the objective basis of the time and characterstics of refeeding of patients with acute pancreatitis (AP). Methods: AP patients were randomly divided into routine group (n=105) and special group (...Objective: To explore the objective basis of the time and characterstics of refeeding of patients with acute pancreatitis (AP). Methods: AP patients were randomly divided into routine group (n=105) and special group (n=99). The refeeding time and characteristics of the routine group were based on their levels of blood and urine amylase, function of the gastrointestinal tract, and symptoms and signs, and those of the special group on their imaging changes of ultrasonography and CT of the pancreas. Clinical data from the groups were analyzed prospectively and statistically. Results: At the beginning of refeeding, patients of the two groups showed a high recurrence rate of ab- dominal pain (routine group, 9.1%; special group, 10.5%), but no AP relapse. Three days to 2 weeks after refeeding, the patients of the routine group had a higher recurrence rate of abdominal pain (11.1%) and a relapse rate of AP (14.1%) as compared with those of the special group (P<0. 05). Two weeks later, both rates decreased apparently. However, 3 days to 4 weeks after refeeding, the patients of the special group had no recurrence of abdominal pain and relapse of AP. Imaging changes of the pancreas and peripancreatic tissue were not consistent with the symptoms and signs of AP patients. The higher the Balthazar CT grading and APACHE-Ⅱ score, the higher the recurrence rate of abdominal pain and the relapse rate of AP after refeeding (P<0. 05). Conclusions: Symptoms and signs were usually dis- cordant to the imaging changes of the pancreas in AP patients. Imaging changes of the pancreas might serve as a basis for the best occasion of refeeding light semi-fluid or light food in AP patients.展开更多
BACKGROUND： Postoperative pancreatic fistula remains the most common complication of pancreaticoduodenectomy （PD） and is potentially lethal. It contributes significantly to prolonged hospitalization and mortality. ...BACKGROUND： Postoperative pancreatic fistula remains the most common complication of pancreaticoduodenectomy （PD） and is potentially lethal. It contributes significantly to prolonged hospitalization and mortality. In this study, we introduced a new technical approach, a modified Roux-en-Y reconstruction and evaluated its safety and feasibility. METHODS： We retrospectively reviewed the patients who had undergone PD with the modified Roux-en-Y reconstructive technique for periampullary malignancies from January 2011 to June 2012. The data on complications, hospital stay and outcomes after the modified Roux-en-Y reconstruction were analyzed. RESULTS： The reconstruction was performed in 171 patients, of whom 92 received pancreaticogastrostomy and 79 received pancreaticojejunostomy. The median duration of surgery was 4.0 hours （range 3.1-6.9） in all patients, and the median blood loss was 530 mL （range 200-2000）. Sixty-nine patients were subjected to transfusions, with a median transfusion volume of 430 mL （range 200-1400）. The median hospital stay of the patients was 14 days （range 11-38）. Their operative mortality was zero and overall morbidity was 18.1% （31 patients）. Only four patients （2.3%） developed pancreatic fistulas （grade A fistulas in two patients and grade B in two patients）; no patients developed grade C fistula. None of the patients developed bile reflux gastritis. CONCLUSIONS： The modified Roux-en-Y reconstruction, which isolates biliary anastomosis from pancreatic, gastric or jejunalanastomosis, is a safe, reliable, and favorable technique. But it needs further investigation in randomized controlled trials.展开更多
目的探讨嗅觉受体家族2亚家族W成员3(olfactory receptor family 2 subfamily W member,OR2W3)在胰腺癌(pancreatic cancer,PC)组织中的表达及其临床意义.方法采用免疫组织化学法检测50例PC组织及癌旁组织石蜡切片中的OR2W3的表达,分析O...目的探讨嗅觉受体家族2亚家族W成员3(olfactory receptor family 2 subfamily W member,OR2W3)在胰腺癌(pancreatic cancer,PC)组织中的表达及其临床意义.方法采用免疫组织化学法检测50例PC组织及癌旁组织石蜡切片中的OR2W3的表达,分析OR2W3蛋白表达与临床病理因素的关系.结果 OR2W3蛋白在PC组织中高表达和低表达率分别为78.0%(39/50)和22.0%(11/50),而在癌旁组织中高表达和低表达率分别为12.0%(6/50)和为88.0%(44/50),两者差异有统计学意义(χ2=44.00,P<0.05).单因素分析显示OR2W3表达与PC的组织分化程度、临床分期、淋巴结转移密切相关,该3因素分组间的差异均有统计学意义(均P<0.05).结论 OR2W3的高表达可能在PC发生、发展中起重要作用.展开更多
文摘AIM： To identify cancer stern cells （CSCs） in human gallbladder carcinomas （GBCs）. METHODS： Primary GBC cells were cultured under serum-free conditions to produce floating spheres. The stem-cell properties of the sphere-forming cells, including self-renewal, differentiation potential, chemoresistance and tumorigenicity, were determined in vitro or in vivo. Cell surface expression of CD133 was investigated in primary tumors and in spheroid cells using flow cytometry. The sphere-colony-formation ability and tumorigenicity of CD133＋ cells were assayed.floating spheroids were generated from primary GBC cells, and these sphere-forming cells could generate new progeny spheroids in serum-free media. Spheroid cells were differentiated under serum-containing conditions with downregulation of the stem cell markers Oct-4, Nanog, and nestin （P 〈 0.05）. The differentiated cells showed lower spheroid-colony-formation ability than the original spheroid cells （P 〈 0.05）. Spheroid ceils were more resistant to chemotherapeutic reagents than the congenetic adherent cells （P 〈 0.05）. Flow cytometry showed enriched CD133＋ population in sphereforming cells （P 〈 0.05）. CD133＋ cells possessed high colony-formation ability than the CD133 population （P 〈 0.01）. CD133＋ cells injected into nude mice revealed higher tumorigenicity than their antigen-negative counterparts （P 〈 0.05）. CONCLUSION： CD133 may be a cell surface marker for CSCs in GBC.
基金supported by grants from The National Natural Science Foundation of China(81071775,81272659,81101621,81172064,81001068 and 81272425)Key Projects of Science Foundation of Hubei Province(2011CDA030)Research Fund of Young Scholars for the Doctoral Program of Higher Education of China(20110142120014)
文摘BACKGROUND： The treatment of borderline resectable pancreatic head cancer（BRPHC） is still controversial and challenging. The artery-first approaches are described to be the important options for the early determination. Whether these approaches can achieve an increase R0 rate, better bleeding control and increasing long-term survival for BRPHC are still controversial. We compared a previously reported technique, a modified artery-first approach（MAFA）, with conventional techniques for the surgical treatment of BRPHC.METHODS： A total of 117 patients with BRPHC undergone pancreaticoduodenectomy（PD） from January 2013 to June 2015 were included. They were divided into an MAFA group（n=78） and a conventional-technique group（n=39）. Background characteristics, operative data and complications were compared between the two groups.RESULTS： Mean operation time was significantly shorter in the MAFA group than that in the conventional-technique group（313 vs 384 min; P=0.014）; mean volume of intraoperative blood loss was significantly lower in the MAFA group than that in the conventional-technique group（534 vs 756 m L; P=0.043）; and mean rate of venous resection was significantly higher in the conventional-technique group than that in the MAFA group（61.5% vs 35.9%; P=0.014）. Pathologic data, early mortality and morbidity were not different significantly between the two groups.CONCLUSIONS： MAFA is safe, simple, less time-consuming, less intraoperative blood loss and less venous resection, and therefore, may become a standard surgical approach to PD for BRPHC with the superior mesenteric vein-portal vein involvement but without superior mesenteric artery invasion.
基金National Natural Science Foundation of China,No.82273442 and No.82273438.
文摘BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas.Increasing attention has been paid to changes in quality of life(QOL)after pancreatic surgery.AIM To summarize and analyze current research results on QOL after pancreatic surgery.METHODS A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Relevant studies were identified by screening the references of retrieved articles.Studies on patients’QOL after pancreatic surgery published after January 1,2012,were included.These included prospective and retrospective studies on patients'QOL after several types of pancreatic surgeries.The results of these primary studies were summarized inductively.RESULTS A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more accurate.Although TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after TP.The QOL was better after DPPHR than PD.However,the superiority of the QOL between patients who underwent CP and PD remains controversial.The decrease in exocrine and endocrine functions postoperatively was the main factor affecting the QOL.Minimally invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic surgery.The article covers the discussion and analysis of the QOL of various pancreatic surgeries.Which kind of surgical procedure has better QOL is controversial.The long-term benefits on QOL of minimally invasive surgery over open surgery are contro-INTRODUCT
文摘Preoperative biliary drainage may increase the morbidity and mortality of pancreatico-duodenectomy.Studies on percutaneous transhepatic biliary drainage(PTBD)before laparoscopic pancreaticoduodenectomy(LPD),however,are scarce.The aim of this study was to examine the impact of PTBD on clinical outcomes of patients with malignant obstructive jaundice undergoing LPD.Clinical data of 172 patients who had malignant obstructive jaundice and underwent LPD from 2014 to 2017 in our hospital were retrospectively analyzed.Demographics,catheterrelated complications,postoperative complications,and oncological outcormes were collected and analyzed.Propensity score matching was performed to minimize selection bias associated with the comparison of data between patients who underwent PTBD and then LPD(PTBD group),and those given LPD alone(LPD group).The results showed that,in the PTBD group relative to the LPD group,the operating time was significantly shortened(250.28±69.95 vs.278.58±86.51 min,P=0.0196),the intraopcrative blood loss was markedly reduced(271.96±403.47 vs.429.72±482.47 mL,P=0.022),and overall rates of complications(16.33%vs.36.49%,P=0.0025)including postoperative haemorrhage(2.04%vs.12.16%,P=0.0072)and delayed gastric emptying(4.08% vs.13.51%,P=0.0251)were greatly decreased.The propensity score-matched analysis,with 48 patients enrolled in each group,revealed no statistically significant differences in operating duration(262.71±68.64 vs.280.25±83.52 min,P=0.264),intraoperative blood loss(290.21±407.71 vs.373.75±422.33 mL,P=0.327)and delayed gastric emptying(4.17% vs.12.50%,P=0.1396).PTBD group had lower incidences in overall complications(22.92% vs.39.58%,P=0.0481)and postoperative haemorrhage(2.08% vs.12.50%,P=0.0497)than LPD group.In conclusion,patients with malignant obstructive jaundice may benefit from PTBD procedure before LPD in terms of perioperative outcomes.
基金supported by the National Natural Science Foundation of China,Nos.81871773(to XJC),81672152(to XJC),81802149(to LY)Primary Research and Development Plan of Jiangsu Province of China,No.BE2018132(to XJC)Scientific Research Project of Health Commission of Jiangsu Province of China,No.LGY2020068(to HJL).
文摘Excessive inflammation post-traumatic spinal cord injury(SCI)induces microglial activation,which leads to prolonged neurological dysfunction.However,the mechanism underlying microglial activation-induced neuroinflammation remains poorly understood.Ruxolitinib(RUX),a selective inhibitor of JAK1/2,was recently reported to inhibit inflammatory storms caused by SARS-CoV-2 in the lung.However,its role in disrupting inflammation post-SCI has not been confirmed.In this study,microglia were treated with RUX for 24 hours and then activated with interferon-γfor 6 hours.The results showed that interferon-γ-induced phosphorylation of JAK and STAT in microglia was inhibited,and the mRNA expression levels of pro-inflammatory cytokines tumor necrosis factor-α,interleukin-1β,interleukin-6,and cell proliferation marker Ki67 were reduced.In further in vivo experiments,a mouse model of spinal cord injury was treated intragastrically with RUX for 3 successive days,and the findings suggest that RUX can inhibit microglial proliferation by inhibiting the interferon-γ/JAK/STAT pathway.Moreover,microglia treated with RUX centripetally migrated toward injured foci,remaining limited and compacted within the glial scar,which resulted in axon preservation and less demyelination.Moreover,the protein expression levels of tumor necrosis factor-α,interleukin-1β,and interleukin-6 were reduced.The neuromotor function of SCI mice also recovered.These findings suggest that RUX can inhibit neuroinflammation through inhibiting the interferon-γ/JAK/STAT pathway,thereby reducing secondary injury after SCI and producing neuroprotective effects.
基金supported by grants from the National Natural Science Foundation of China(81071775,81272659,81101621,81160311,81172064,81001068,81272425 and 81101870)National“Eleventh Five-Year”Scientific and Technological Support Projects(2006BAI02A13-402)+1 种基金Key Projects of Science Foundation of Hubei Province(2011CDA030)Research Fund of Young Scholars for the Doctoral Program of Higher Education of China(20110142120014)
文摘BACKGROUND： Myeloid-derived suppressor cells （MDSCs） are heterogeneous cell types that suppress T-cell responses in cancer patients and animal models, some MDSC subpopulations are increased in patients with pancreatic cancer. The present study was to investigate a specific subset of MDSCs in patients with pancreatic cancer and the mechanism of MDSCs increase in these patients. METHODS： Myeloid cells from whole blood were collected from 37 patients with pancreatic cancer, 17 with cholangiocarcinoma, and 47 healthy controls. Four pancreatic cancer cell lines were co- cultured with normal peripheral blood mononudear cells （PBMCs） to test the effect of tumor cells on the conversion of PBMCs to MDSCs. Levels of granulocyte-macrophage colony-stimulating factor （GM-CSF） and arginase activity in the plasma of cancer patients were analyzed by enzyme-linked immunosorbent assay. RESULTS： CD14＋/CD11b＋/HLA-DR MDSCs were increased in patients with pancreatic or bile duct cancer compared with those in healthy controls, and this increase was correlated with clinical cancer stage. Pancreatic cancer cell lines induced PBMCs to MDSCs in a dose-dependent manner. GM-CSF and arginase activity levels were significantly increased in the se rum of patients with pancreatic cancer. CONCLUSIONS： MDSCs were tumor related： tumor cells induced PBMCs to MDSCs in a dose-dependent manner and circulating CD14＋/CD11b＋/HLA-DR- MDSCs in pancreatic cancer patients were positively correlated with tumor burden. MDSCs might be useful markers for pancreatic cancer detection and progression.
基金Supported by Grants from National Natural Science Foundation of China to Ren-Yi Qin,No.81071775 and No.81272659,Min Wang,No.81101621National"Eleventh Five-Year"Scientific and Technological Support Projects to Ren-Yi Qin,No.2006BAI02A13-402+1 种基金Key Projects of Science Foundation of Hubei Province to Ren-Yi Qin,No.2011CDA030Research Fund of Young Scholars for the Doctoral Program of Higher Education of China to Min Wang,No.20110142120014
文摘Acute pancreatitis(AP)is an inflammatory disease of the pancreas which involves the pancreas and surrounding tissue,and systemic inflammation with a characteristic systemic increase of vascular permeability and increased risk of multiple organ dysfunction.Currently,the pathogenesis of AP is fuzzy,and the diagnosis and treatment need to be standardized.Nevertheless,increased knowledge of AP may achieve more thorough understanding of the pathogenesis.The use of further advanced diagnostic tools and superior treatment,potentially will help clinicians to manage AP at an appropriate stage.However,in view of the multi factorial disease and the complex clinical manifestations,the management of patients with AP is also remaining areas for improvement.
基金This study was supported by the National Natural Science Foundation of China(No.81772950).
文摘Objective:Conversion of normal cells to cancer cells is often accompanied by abnormal synthesis of serum enzymes.Both alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)have been reported to have prognostic value in a variety of malignancies.The aim of this study was to investigate the effect of preoperative serum ALP and LDH levels on the prognosis of patients with periampullary carcinoma who underwent pancreatoduodenectomy(PD).
文摘Objective: To explore the objective basis of the time and characterstics of refeeding of patients with acute pancreatitis (AP). Methods: AP patients were randomly divided into routine group (n=105) and special group (n=99). The refeeding time and characteristics of the routine group were based on their levels of blood and urine amylase, function of the gastrointestinal tract, and symptoms and signs, and those of the special group on their imaging changes of ultrasonography and CT of the pancreas. Clinical data from the groups were analyzed prospectively and statistically. Results: At the beginning of refeeding, patients of the two groups showed a high recurrence rate of ab- dominal pain (routine group, 9.1%; special group, 10.5%), but no AP relapse. Three days to 2 weeks after refeeding, the patients of the routine group had a higher recurrence rate of abdominal pain (11.1%) and a relapse rate of AP (14.1%) as compared with those of the special group (P<0. 05). Two weeks later, both rates decreased apparently. However, 3 days to 4 weeks after refeeding, the patients of the special group had no recurrence of abdominal pain and relapse of AP. Imaging changes of the pancreas and peripancreatic tissue were not consistent with the symptoms and signs of AP patients. The higher the Balthazar CT grading and APACHE-Ⅱ score, the higher the recurrence rate of abdominal pain and the relapse rate of AP after refeeding (P<0. 05). Conclusions: Symptoms and signs were usually dis- cordant to the imaging changes of the pancreas in AP patients. Imaging changes of the pancreas might serve as a basis for the best occasion of refeeding light semi-fluid or light food in AP patients.
基金supported by grants from the National Natural Science Foundation of China (81272659, 81101621 and 81372353)
文摘BACKGROUND： Postoperative pancreatic fistula remains the most common complication of pancreaticoduodenectomy （PD） and is potentially lethal. It contributes significantly to prolonged hospitalization and mortality. In this study, we introduced a new technical approach, a modified Roux-en-Y reconstruction and evaluated its safety and feasibility. METHODS： We retrospectively reviewed the patients who had undergone PD with the modified Roux-en-Y reconstructive technique for periampullary malignancies from January 2011 to June 2012. The data on complications, hospital stay and outcomes after the modified Roux-en-Y reconstruction were analyzed. RESULTS： The reconstruction was performed in 171 patients, of whom 92 received pancreaticogastrostomy and 79 received pancreaticojejunostomy. The median duration of surgery was 4.0 hours （range 3.1-6.9） in all patients, and the median blood loss was 530 mL （range 200-2000）. Sixty-nine patients were subjected to transfusions, with a median transfusion volume of 430 mL （range 200-1400）. The median hospital stay of the patients was 14 days （range 11-38）. Their operative mortality was zero and overall morbidity was 18.1% （31 patients）. Only four patients （2.3%） developed pancreatic fistulas （grade A fistulas in two patients and grade B in two patients）; no patients developed grade C fistula. None of the patients developed bile reflux gastritis. CONCLUSIONS： The modified Roux-en-Y reconstruction, which isolates biliary anastomosis from pancreatic, gastric or jejunalanastomosis, is a safe, reliable, and favorable technique. But it needs further investigation in randomized controlled trials.
文摘目的探讨嗅觉受体家族2亚家族W成员3(olfactory receptor family 2 subfamily W member,OR2W3)在胰腺癌(pancreatic cancer,PC)组织中的表达及其临床意义.方法采用免疫组织化学法检测50例PC组织及癌旁组织石蜡切片中的OR2W3的表达,分析OR2W3蛋白表达与临床病理因素的关系.结果 OR2W3蛋白在PC组织中高表达和低表达率分别为78.0%(39/50)和22.0%(11/50),而在癌旁组织中高表达和低表达率分别为12.0%(6/50)和为88.0%(44/50),两者差异有统计学意义(χ2=44.00,P<0.05).单因素分析显示OR2W3表达与PC的组织分化程度、临床分期、淋巴结转移密切相关,该3因素分组间的差异均有统计学意义(均P<0.05).结论 OR2W3的高表达可能在PC发生、发展中起重要作用.
