AIM: To evaluate the effect of dietary cholesterol and serum total cholesterol(TC) on the risk of pancreatic cancer. METHODS: A literature search was performed up to June 2014 in Pub Med, EMBASE, China National Knowle...AIM: To evaluate the effect of dietary cholesterol and serum total cholesterol(TC) on the risk of pancreatic cancer. METHODS: A literature search was performed up to June 2014 in Pub Med, EMBASE, China National Knowledge Infrastructure and China Biology Medicalliterature database for relevant articles published in English or Chinese. Pooled relative risks(RRs) with 95% confidence intervals(CIs) were calculated with a random-effects model. RESULTS: We included 14 published articles with 439355 participants for dietary cholesterol, and 6 published articles with 1805697 participants for serum TC. For the highest vs lowest category of dietary cholesterol, the pooled RR(95%CI) of pancreatic cancer was 1.308(1.097-1.559). After excluding two studies(RR > 3.0), the pooled RR(95%CI) was 1.204(1.050-1.380). In subgroup analysis stratified by study design, the pooled RRs(95%CIs) were 1.523(1.226-1.893) for case-control studies and 1.023(0.871-1.200) for cohort studies. The association of dietary cholesterol with the risk of pancreatic cancer was significant for studies conducted in North America [1.275(1.058-1.537)] and others [2.495(1.565-3.977)], but not in Europe [1.149(0.863-1.531)]. No significant association [1.003(0.859-1.171)] was found between the risk of pancreatic cancer and serum TC. CONCLUSION: Dietary cholesterol may be associated with an increased risk of pancreatic cancer in worldwide populations, except for Europeans. The results need to be confirmed further.展开更多
A pancreatic pseudocyst(PPC)is a collection of pancreatic fluid enclosed by a non-epithelialized,fibrous or granulomatous wall.Endoscopic pancreatic pseudocyst drainage(PPD)has been widely used clinically to treat PPC...A pancreatic pseudocyst(PPC)is a collection of pancreatic fluid enclosed by a non-epithelialized,fibrous or granulomatous wall.Endoscopic pancreatic pseudocyst drainage(PPD)has been widely used clinically to treat PPCs.The success and complications of endoscopic PPD are comparable with surgical interventions.Stent displacement is a rare complication after endoscopic PPD.Almost all the complications of endoscopic PPD have been managed surgically,and there is rare report involving the endoscopic treatment of intraperitoneal stent displacement.We report here a case of stent displacementafter endoscopic ultrasound-and fluoroscopy-guided PPD in a 41-year-old female patient with a PPC in the tail of the pancreas.The endoscopic treatment was successfully performed to remove the displaced stent.The clinical course of the patient was unremarkable.The cyst had significantly reduced and disappeared by 12 wk.We found that both endoscopic ultrasound and fluoroscopy should be used during endoscopic PPD to avoid stent displacement.The displaced stent can be successfully treated by endoscopic removal.展开更多
2010229 Expression and significance of phosphtidylinositol 3-kinase/protein kinase B signal transduction pathway in severe acute pancrceatitis-associated lung injury. KANG Xin(康新),et al. Dept Emerg Med,Zhongshan Hos...2010229 Expression and significance of phosphtidylinositol 3-kinase/protein kinase B signal transduction pathway in severe acute pancrceatitis-associated lung injury. KANG Xin(康新),et al. Dept Emerg Med,Zhongshan Hosp,Dalian Univ, Dalian 116001.Natl Med J China 2010;90(11):732-777.展开更多
目的:检测Hippo-YAP信号通路中主要效应蛋白Yes相关蛋白(Yes-associated protein,YAP)在正常胰腺组织和胰腺癌组织中的表达,探讨其表达强度与临床病理因素之间的关系及意义.方法:应用免疫组织化学EnVision法测定Hippo信号通路中YAP蛋白...目的:检测Hippo-YAP信号通路中主要效应蛋白Yes相关蛋白(Yes-associated protein,YAP)在正常胰腺组织和胰腺癌组织中的表达,探讨其表达强度与临床病理因素之间的关系及意义.方法:应用免疫组织化学EnVision法测定Hippo信号通路中YAP蛋白在45例胰腺癌及15例正常胰腺组织中的表达,应用RT-PCR方法检测YAP mRNA在45例胰腺癌及15例正常胰腺组织中的表达.结果:胰腺癌组织中YAP蛋白主要表达于胰腺导管上皮细胞,45例胰腺癌组织中YAP的阳性表达率为93.33%(42/45),15例正常胰腺组织中YAP阳性表达率为26.67%(4/15),两组间的表达差异具有统计学意义(2=27.95,P<0.01).在胰腺癌组织中YAP的表达与肿瘤分化程度密切相关(P=0.048),与年龄、性别、吸烟、饮酒、肥胖、糖耐量异常、糖尿病、慢性胰腺炎及临床分期等无关(P值分别是0.577、0.565、0.541、0.224、1.000、0.542、0.555、0.571、0.926).胰腺癌患者血清CA19-9水平与胰腺癌组织中YAP阳性程度呈正相关.YAP m R N A在胰腺癌组织中的表达较正常胰腺组织明显升高(0.3682±0.0783 vs 0.0394±0.0091,P<0.01).结论:Hippo-YAP通路可能在胰腺癌的发生、发展中发挥重要作用.并有可能成为胰腺癌治疗中新的靶点.展开更多
Magnetic resonance(MR)imaging plays an important role in the diagnosis and staging of acute and chronic pancreatitis and may represent the best imaging technique in the setting of pancreatitis due to its unmatched sof...Magnetic resonance(MR)imaging plays an important role in the diagnosis and staging of acute and chronic pancreatitis and may represent the best imaging technique in the setting of pancreatitis due to its unmatched soft tissue contrast resolution as well as nonionizing nature and higher safety profile of intravascular contrast media,making it particularly valuable in radiosensitive populations such as pregnant patients,and patients with recurrent pancreatitis requiring multiple follow-up examinations.Additional advantages include the ability to detect early forms of chronic pancreatitis and to better differentiate adenocarcinoma from focal chronic pancreatitis.This review addresses new trends in clinical pancreatic MR imaging emphasizing its role in imaging all types of acute and chronic pancreatitis,pancreatitis complications and other important differential diagnoses that mimic pancreatitis.展开更多
Pancreatic cancer is one of the most lethal of human malignancies ranking 4th among cancer-related death in the western world and in the United States,and potent therapeutic options are lacking.Although during the las...Pancreatic cancer is one of the most lethal of human malignancies ranking 4th among cancer-related death in the western world and in the United States,and potent therapeutic options are lacking.Although during the last few years there have been important advances in the understanding of the molecular events responsible for the development of pancreatic cancer,currently specific mechanisms of treatment resistance remain poorly understood and new effective systemic drugs need to be developed and probed.In vivo models to study pancreatic cancer and approach this issue remain limited and present different molecular features that must be considered in the studies depending on the purpose to fit special research themes.In the last few years,several genetically engineered mouse models of pancreatic exocrine neoplasia have been developed.These models mimic the disease as they reproduce genetic alterations implicated in the progression of pancreatic cancer.Genetic alterations such as activating mutations in KRas,or TGFb and/or inactivation of tumoral suppressors such as p53,INK4A/ARF BRCA2 and Smad4 are the most common drivers to pancreatic carcinogenesis and have been used to create transgenic mice.These mouse models have a spectrum of pathologic changes,from pancreatic intraepithelial neoplasia to lesions that progress histologically culminating in fully invasive and metastatic disease and represent the most useful preclinical model system.These models can characterize the cellular and molecular pathology of pancreatic neoplasia and cancer and constitute the best tool to investigate new therapeutic approaches,chemopreventive and/or anticancer treatments.Here,we review and update the current mouse models that reproduce different stages of human pancreatic ductal adenocarcinoma and will have clinical relevance in future pancreatic cancer developments.展开更多
BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underw...BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum.The operative times were 220 and 239 min,and the blood loss was 70 and 270 g,respectively.The patients were discharged on the 14^(th) and 10^(th) postoperative day,respectively.Thirty-two patients underwent EPD for the treatment of neoplastic bleeding.The mean operative time was 361.6 min,and the mean blood loss was 747.3 g.The comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.展开更多
文摘AIM: To evaluate the effect of dietary cholesterol and serum total cholesterol(TC) on the risk of pancreatic cancer. METHODS: A literature search was performed up to June 2014 in Pub Med, EMBASE, China National Knowledge Infrastructure and China Biology Medicalliterature database for relevant articles published in English or Chinese. Pooled relative risks(RRs) with 95% confidence intervals(CIs) were calculated with a random-effects model. RESULTS: We included 14 published articles with 439355 participants for dietary cholesterol, and 6 published articles with 1805697 participants for serum TC. For the highest vs lowest category of dietary cholesterol, the pooled RR(95%CI) of pancreatic cancer was 1.308(1.097-1.559). After excluding two studies(RR > 3.0), the pooled RR(95%CI) was 1.204(1.050-1.380). In subgroup analysis stratified by study design, the pooled RRs(95%CIs) were 1.523(1.226-1.893) for case-control studies and 1.023(0.871-1.200) for cohort studies. The association of dietary cholesterol with the risk of pancreatic cancer was significant for studies conducted in North America [1.275(1.058-1.537)] and others [2.495(1.565-3.977)], but not in Europe [1.149(0.863-1.531)]. No significant association [1.003(0.859-1.171)] was found between the risk of pancreatic cancer and serum TC. CONCLUSION: Dietary cholesterol may be associated with an increased risk of pancreatic cancer in worldwide populations, except for Europeans. The results need to be confirmed further.
文摘A pancreatic pseudocyst(PPC)is a collection of pancreatic fluid enclosed by a non-epithelialized,fibrous or granulomatous wall.Endoscopic pancreatic pseudocyst drainage(PPD)has been widely used clinically to treat PPCs.The success and complications of endoscopic PPD are comparable with surgical interventions.Stent displacement is a rare complication after endoscopic PPD.Almost all the complications of endoscopic PPD have been managed surgically,and there is rare report involving the endoscopic treatment of intraperitoneal stent displacement.We report here a case of stent displacementafter endoscopic ultrasound-and fluoroscopy-guided PPD in a 41-year-old female patient with a PPC in the tail of the pancreas.The endoscopic treatment was successfully performed to remove the displaced stent.The clinical course of the patient was unremarkable.The cyst had significantly reduced and disappeared by 12 wk.We found that both endoscopic ultrasound and fluoroscopy should be used during endoscopic PPD to avoid stent displacement.The displaced stent can be successfully treated by endoscopic removal.
文摘2010229 Expression and significance of phosphtidylinositol 3-kinase/protein kinase B signal transduction pathway in severe acute pancrceatitis-associated lung injury. KANG Xin(康新),et al. Dept Emerg Med,Zhongshan Hosp,Dalian Univ, Dalian 116001.Natl Med J China 2010;90(11):732-777.
文摘目的:检测Hippo-YAP信号通路中主要效应蛋白Yes相关蛋白(Yes-associated protein,YAP)在正常胰腺组织和胰腺癌组织中的表达,探讨其表达强度与临床病理因素之间的关系及意义.方法:应用免疫组织化学EnVision法测定Hippo信号通路中YAP蛋白在45例胰腺癌及15例正常胰腺组织中的表达,应用RT-PCR方法检测YAP mRNA在45例胰腺癌及15例正常胰腺组织中的表达.结果:胰腺癌组织中YAP蛋白主要表达于胰腺导管上皮细胞,45例胰腺癌组织中YAP的阳性表达率为93.33%(42/45),15例正常胰腺组织中YAP阳性表达率为26.67%(4/15),两组间的表达差异具有统计学意义(2=27.95,P<0.01).在胰腺癌组织中YAP的表达与肿瘤分化程度密切相关(P=0.048),与年龄、性别、吸烟、饮酒、肥胖、糖耐量异常、糖尿病、慢性胰腺炎及临床分期等无关(P值分别是0.577、0.565、0.541、0.224、1.000、0.542、0.555、0.571、0.926).胰腺癌患者血清CA19-9水平与胰腺癌组织中YAP阳性程度呈正相关.YAP m R N A在胰腺癌组织中的表达较正常胰腺组织明显升高(0.3682±0.0783 vs 0.0394±0.0091,P<0.01).结论:Hippo-YAP通路可能在胰腺癌的发生、发展中发挥重要作用.并有可能成为胰腺癌治疗中新的靶点.
文摘Magnetic resonance(MR)imaging plays an important role in the diagnosis and staging of acute and chronic pancreatitis and may represent the best imaging technique in the setting of pancreatitis due to its unmatched soft tissue contrast resolution as well as nonionizing nature and higher safety profile of intravascular contrast media,making it particularly valuable in radiosensitive populations such as pregnant patients,and patients with recurrent pancreatitis requiring multiple follow-up examinations.Additional advantages include the ability to detect early forms of chronic pancreatitis and to better differentiate adenocarcinoma from focal chronic pancreatitis.This review addresses new trends in clinical pancreatic MR imaging emphasizing its role in imaging all types of acute and chronic pancreatitis,pancreatitis complications and other important differential diagnoses that mimic pancreatitis.
基金Supported by Instituto de Salud Carlos (CIBERehd)
文摘Pancreatic cancer is one of the most lethal of human malignancies ranking 4th among cancer-related death in the western world and in the United States,and potent therapeutic options are lacking.Although during the last few years there have been important advances in the understanding of the molecular events responsible for the development of pancreatic cancer,currently specific mechanisms of treatment resistance remain poorly understood and new effective systemic drugs need to be developed and probed.In vivo models to study pancreatic cancer and approach this issue remain limited and present different molecular features that must be considered in the studies depending on the purpose to fit special research themes.In the last few years,several genetically engineered mouse models of pancreatic exocrine neoplasia have been developed.These models mimic the disease as they reproduce genetic alterations implicated in the progression of pancreatic cancer.Genetic alterations such as activating mutations in KRas,or TGFb and/or inactivation of tumoral suppressors such as p53,INK4A/ARF BRCA2 and Smad4 are the most common drivers to pancreatic carcinogenesis and have been used to create transgenic mice.These mouse models have a spectrum of pathologic changes,from pancreatic intraepithelial neoplasia to lesions that progress histologically culminating in fully invasive and metastatic disease and represent the most useful preclinical model system.These models can characterize the cellular and molecular pathology of pancreatic neoplasia and cancer and constitute the best tool to investigate new therapeutic approaches,chemopreventive and/or anticancer treatments.Here,we review and update the current mouse models that reproduce different stages of human pancreatic ductal adenocarcinoma and will have clinical relevance in future pancreatic cancer developments.
文摘BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum.The operative times were 220 and 239 min,and the blood loss was 70 and 270 g,respectively.The patients were discharged on the 14^(th) and 10^(th) postoperative day,respectively.Thirty-two patients underwent EPD for the treatment of neoplastic bleeding.The mean operative time was 361.6 min,and the mean blood loss was 747.3 g.The comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.
