Retrospective study of steroid therapy for patients with autoimmune pancreatitis in a Chinese population

AIM:To explore the optimal steroid therapeutic strategy for autoimmune pancreatitis(AIP).METHODS:This study was conducted retrospectively in two large institutions in China.Patients with clinically,radiologically and biochemically diagnosed AIP were enrolled.The performed radiological investigations and biochemical tests,the regimen of the given steroid treatment,remission and relapse whether with and without steroid therapy were analyzed.RESULTS:Twenty-eight patients with AIP received steroid treatment,while 40 patients were treated surgically by pancreatoduodenectomy,distal pancreatectomy and choledochojejunostomy,radiofrequency ablation for the enlarged pancreatic head,percutaneous transhepatic biliary drainage and endoscopic biliary drainage.The starting oral prednisolone dose was 30 mg/d in 18(64.3%) patients and 40 mg/d in 10(35.7%) patients administered for 3 wk.The remission rate of AIP patients with steroid treatment(96.4%) was significantly higher than in those without steroid treatment(75%).Maintenance therapy(oral prednisolone dose 5 mg/d) was performed after remission for at least 6-12 mo to complete the treatment course.Similarly,the relapse rate was significantly lower in AIP patients with steroid treatment(28.6%) than in those without steroid treatment(42.5%).Steroid re-treatment was effective in all relapsed patients with or without steroid therapy.CONCLUSION:Steroid therapy should be considered in all patients with active inflammatory phase of AIP.However,the optimal regimen still should be trailed in larger numbers of patients with AIP.

Pancreas-sparing duodenectomy with regional lymph node dissection for early-stage ampullary carcinoma: A case control study using propensity scoring methods

AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.

MnO_(2)/carbon nanocomposite based on silkworm excrement for high-performance supercapacitors

MnO_(2)/biomass carbon nanocomposite was synthesized by a facile hydrothermal reaction.Silkworm excrement acted as a carbon precursor,which was activated by ZnCl_(2) and FeCl_(3) combining chemical agents under Ar atmosphere.Thin and flower-like MnO_(2) nanowires were in-situ anchored on the surface of the biomass carbon.The biomass carbon not only offered high conductivity and good structural stability but also relieved the large volume expansion during the charge/discharge process.The obtained MnO_(2)/biomass carbon nanocomposite electrode exhibited a high specific capacitance(238 F·g^(-1) at 0.5 A·g^(-1))and a superior cycling stability with only 7% degradation after 2000 cycles.The observed good electrochemical performance is accredited to the materials’high specific surface area,multilevel hierarchical structure,and good conductivity.This study proposes a promising method that utilizes biological waste and broadens MnO_(2)-based electrode material application for next-generation energy storage and conversion devices.

Monitoring the Progression of Renal Fibrosis by T2-weighted Signal Intensity and Diffusion Weighted Magnetic Resonance Imaging in Cisplatin induced Rat Models

Background：Diffusion weighted imaging （DWI）,with the applying of intravoxel incoherent motion model,has showed promising results in obtaining additional information about microperfusion and tubular flow associated with morphologic changes in chronic kidney diseases.The study aims to evaluate the potential of T2-weighted signal intensity （SI） and DWI with mono-and bi-exponential models to reflect the serial changes on cisplatin （CP） induced rat renal fibrosis models.Methods：Magnetic resonance exams were performed prior to and 2nd day,4th day,6th day,8th day,2nd week,3rd week and 4th week after CP injection at a 3.0T with an animal coil.Besides T2-weighted images （T2WI）,DWI of 13 b values from 0 to 1500 s/mm^2 was acquired.Apparent diffusion coefficient （ADC）,fluid fraction f,pure diffusivity D and pseudodiffusivity D＊ values were calculated.The regions of interest were placed on cortex （CO）,outer stripe of the outer medulla （OM） and inner stripe of the outer medulla （OM）,parameters were measured and compared among different time points.Five rats were scarified at each time point for pathological examination.Results：OM revealed remarkable hyperintense and broadened before it became an obscure thread,while CO demonstrated moderate hyperintense and IM didn＇t show significant change on T2WI.On all three stripes,ADC values decreased firstly then kept increasing since the 4th day;f values decreased on all stripes; D values had a tendency to increase with fluctuations but the changes didn＇t achieve statistical significance; D＊ values increased at the 2nd day then tended to be steady thereafter.Pathological findings revealed tubules epitheliums swelling followed by inflammation cells infiltration,interstitial fibrosis was observed since the 2nd week.Conclusions：All of T2-weighted SI,ADC,and biexponential models parameters vary during fibrotic process; biexponential model is superior to monoexponential model in separating changes of microperfusion together with tubular flow from pure diffusion.

Gold Nanoparticle Enantiomers and Their Chiral-Morphology Dependence of Cellular Uptake

Chiral molecules are widely prevalent in nature and biological systems,and artificial chiral nanoparticles have drawn enormous interest owing to their unique optical and physical properties.However,nanoparticles with chiral morphologies and their potential role in biology have been rarely explored.Herein,we report a seed-mediated synthesis of enantiomorphic Au nanooctopods(NOPs)and their chiralmorphology dependence of cellular uptake.With a high yield(∼80%),the chiral NOPs possess eight uniform arms that bend from<111>to<100>directions,like a propeller structure.The chiral NOPs synthesized with L-or D-glutathione(GSH)have opposite handedness,resulting in opposite circular dichroism signals,which is consistent with finite-difference time-domain simulations.D-GSH NOPs demonstrate greater than 30%(ca.15%)enhanced cellular uptake in GL261 and bEnd.3 cells compared with L-GSH NOPs(racemic NOPs).Moreover,D-GSH NOPs modified with poly(ethylene glycol)or L-GSH are also preferred by the cells,proving the chiral-morphology dependence of cellular uptake.Our study develops the exploration of the chiral-specific interaction in biological systems,providing potential applications for drug delivery,biosensing,and tumor detection.