Contrast-enhanced computed tomography(CT)contributes to the increasing detection of pancreatic neuroendocrine neoplasms(PNENs).Nevertheless,its value for differentiating pathological tumor grades is not well recognize...Contrast-enhanced computed tomography(CT)contributes to the increasing detection of pancreatic neuroendocrine neoplasms(PNENs).Nevertheless,its value for differentiating pathological tumor grades is not well recognized.In this report,we have conducted a retrospective study on the relationship between the 2017 World Health Organization(WHO)classification and CT imaging features in 94 patients.Most of the investigated features eventually provided statistically significant indicators for discerning PNENs G3 from PNENs G1/G2,including tumor size,shape,margin,heterogeneity,intratumoral blood vessels,vascular invasion,enhancement pattern in both contrast phases,enhancement degree in both phases,tumor-to-pancreas contrast ratio in both phases,common bile duct dilatation,lymph node metastases,and liver metastases.Ill-defined tumor margin was an independent predictor for PNENs G3 with the highest area under the curve(AUC)of 0.906 in the multivariable logistic regression and receiver operating characteristic curve analysis.The portal enhancement ratio(PER)was shown the highest AUC of 0.855 in terms of quantitative features.Our data suggest that the traditional contrastenhanced CT still plays a vital role in differentiation of tumor grades and heterogeneity analysis prior to treatment.展开更多
Primary cultures of pancreatic stellate cells（PSCs） remain an important basis for in vitro study.However,effective methods for isolating abundant PSCs are currently lacking.We report on a novel approach to isolating...Primary cultures of pancreatic stellate cells（PSCs） remain an important basis for in vitro study.However,effective methods for isolating abundant PSCs are currently lacking.We report on a novel approach to isolating PSCs from normal rat pancreases and human pancreatic ductal adenocarcinoma（PDAC） tissue.After anaesthesia and laparotomy of the rat,a blunt cannula was inserted into the pancreatic duct through the anti-mesentery side of the duodenum,and the pancreas was slowly infused with an enzyme solution until all lobules were fully dispersed.The pancreas was then pre-incubated,finely minced and incubated to procure a cell suspension.PSCs were obtained after the cell suspension was filtered,washed and subject to gradient centrifugation with Nycodenz solution.Fresh human PDAC tissue was finely minced into 1×1×l mm^3 cubes with sharp blades.Tissue blocks were placed at the bottom of a culture plate with fresh plasma（EDTA-anti-coagulated plasma from the same patient,mixed with CaCL） sprinkled around the sample.After culture for 5-10 days under appropriate conditions,activated PSCs were harvested.An intraductal perfusion of an enzyme solution simplified the procedure of isolation of rat PSCs,as compared with the multiple injections technique,and a modified outgrowth method significantly shortened the outgrowth time of the activated cells.Our modification in PSC isolation methods significantly increased the isolation efficiency and shortened the culture period,thus facilitating future PSC-related research.展开更多
Acute pancreatitis(AP)can vary widely in its severity,from being clinically self-limiting to a rapidly fatal course.[1]Necrotizing pancreatitis(NP)is the most serious form and is associated with a poor prognosis;the m...Acute pancreatitis(AP)can vary widely in its severity,from being clinically self-limiting to a rapidly fatal course.[1]Necrotizing pancreatitis(NP)is the most serious form and is associated with a poor prognosis;the mortality rate is approximately 15%,or up to 30%for cases of infected necrotizing pancreatitis(INP),which often progresses to sepsis and multiple organ failure,the major cause of death and severe complications.[2]The approach to the management of INP has significantly changed during the last 20 years and continues to evolve with the accumulation of experience,new techniques,and research data.Major surgical intervention and debridement were once the mainstay of therapy for patients with symptomatic necrotic foci,but a minimally invasive approach that focuses on percutaneous and/or endoscopic drainage or debridement is now favored.[2]The"step-up"approach,which involves minimally invasive techniques,represents a new paradigm for the treatment of patients with INP,and open pancreatic debridement is now considered to be the final step in the treatment of NP.[2]展开更多
A consensus statement on the diagnosis and treatment of pancreatic exocrine insufficiency(PEI)after pancreatic surgery was developed based on the latest references,combined with China’s actual situation.More than 20 ...A consensus statement on the diagnosis and treatment of pancreatic exocrine insufficiency(PEI)after pancreatic surgery was developed based on the latest references,combined with China’s actual situation.More than 20 Chinese excellent experts participated in this work and contributed many thorough discussions.This consensus discusses the definition,epidemiology,diagnosis,treatment,and follow-up of PEI after pancreatic surgery.The authors hope this consensus will promote the standard procedure of diagnosis and treatment of PEI in China.展开更多
基金This study was supported by a grant from the Innovation Capability Development Project of Jiangsu Province(No.BM2015004).
文摘Contrast-enhanced computed tomography(CT)contributes to the increasing detection of pancreatic neuroendocrine neoplasms(PNENs).Nevertheless,its value for differentiating pathological tumor grades is not well recognized.In this report,we have conducted a retrospective study on the relationship between the 2017 World Health Organization(WHO)classification and CT imaging features in 94 patients.Most of the investigated features eventually provided statistically significant indicators for discerning PNENs G3 from PNENs G1/G2,including tumor size,shape,margin,heterogeneity,intratumoral blood vessels,vascular invasion,enhancement pattern in both contrast phases,enhancement degree in both phases,tumor-to-pancreas contrast ratio in both phases,common bile duct dilatation,lymph node metastases,and liver metastases.Ill-defined tumor margin was an independent predictor for PNENs G3 with the highest area under the curve(AUC)of 0.906 in the multivariable logistic regression and receiver operating characteristic curve analysis.The portal enhancement ratio(PER)was shown the highest AUC of 0.855 in terms of quantitative features.Our data suggest that the traditional contrastenhanced CT still plays a vital role in differentiation of tumor grades and heterogeneity analysis prior to treatment.
基金partially supported by the National Natural Science Foundation of China(81300351, 81272239,81170336)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD,JX10231801)
文摘Primary cultures of pancreatic stellate cells（PSCs） remain an important basis for in vitro study.However,effective methods for isolating abundant PSCs are currently lacking.We report on a novel approach to isolating PSCs from normal rat pancreases and human pancreatic ductal adenocarcinoma（PDAC） tissue.After anaesthesia and laparotomy of the rat,a blunt cannula was inserted into the pancreatic duct through the anti-mesentery side of the duodenum,and the pancreas was slowly infused with an enzyme solution until all lobules were fully dispersed.The pancreas was then pre-incubated,finely minced and incubated to procure a cell suspension.PSCs were obtained after the cell suspension was filtered,washed and subject to gradient centrifugation with Nycodenz solution.Fresh human PDAC tissue was finely minced into 1×1×l mm^3 cubes with sharp blades.Tissue blocks were placed at the bottom of a culture plate with fresh plasma（EDTA-anti-coagulated plasma from the same patient,mixed with CaCL） sprinkled around the sample.After culture for 5-10 days under appropriate conditions,activated PSCs were harvested.An intraductal perfusion of an enzyme solution simplified the procedure of isolation of rat PSCs,as compared with the multiple injections technique,and a modified outgrowth method significantly shortened the outgrowth time of the activated cells.Our modification in PSC isolation methods significantly increased the isolation efficiency and shortened the culture period,thus facilitating future PSC-related research.
基金This work was supported by a grant from the National Natural Sciences Foundation of China(No.81672449)。
文摘Acute pancreatitis(AP)can vary widely in its severity,from being clinically self-limiting to a rapidly fatal course.[1]Necrotizing pancreatitis(NP)is the most serious form and is associated with a poor prognosis;the mortality rate is approximately 15%,or up to 30%for cases of infected necrotizing pancreatitis(INP),which often progresses to sepsis and multiple organ failure,the major cause of death and severe complications.[2]The approach to the management of INP has significantly changed during the last 20 years and continues to evolve with the accumulation of experience,new techniques,and research data.Major surgical intervention and debridement were once the mainstay of therapy for patients with symptomatic necrotic foci,but a minimally invasive approach that focuses on percutaneous and/or endoscopic drainage or debridement is now favored.[2]The"step-up"approach,which involves minimally invasive techniques,represents a new paradigm for the treatment of patients with INP,and open pancreatic debridement is now considered to be the final step in the treatment of NP.[2]
文摘A consensus statement on the diagnosis and treatment of pancreatic exocrine insufficiency(PEI)after pancreatic surgery was developed based on the latest references,combined with China’s actual situation.More than 20 Chinese excellent experts participated in this work and contributed many thorough discussions.This consensus discusses the definition,epidemiology,diagnosis,treatment,and follow-up of PEI after pancreatic surgery.The authors hope this consensus will promote the standard procedure of diagnosis and treatment of PEI in China.
