AIM: To compare gemcitabine-based combination therapy and gemcitabine (GEM) alone in patients with advanced pancreatic cancer (APCa) through meta- analysis. METHODS: MEDLINE and EMBASE searches were supplemented by in...AIM: To compare gemcitabine-based combination therapy and gemcitabine (GEM) alone in patients with advanced pancreatic cancer (APCa) through meta- analysis. METHODS: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-based combination therapy and GEM alone for APCa. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The meta-analysis involved overall survival (OS), objective remission rate (ORR), clinical benefit rate (CBR), time to progress/progress free survival (TTP/PFS) and toxicity. RESULTS: The meta-analysis included 22 RCTs. There was significant improvement in the GEM combination group with regard to the 6-mo survival rate (RD = 0.04, 95% CI 0.01-0.06, P = 0.008), 1-year survival rate (RD = 0.03, 95% CI 0.01-0.05, P = 0.01), ORR (RD = 0.04, 95% CI 0.01-0.07, P = 0.02), CBR (RD = 0.10, 95% CI 0.02-0.17, P = 0.01) and 6-mo TTP/PFS (RD = 0.07, 95% CI 0.04-0.10, P < 0.00001). However, the Grade 3-4 toxicity set by WHO was higher for the GEM combination group for neutropenia (RD = 0.05, 95% CI 0.01-0.10, P = 0.02), thrombocytopenia (RD = 0.05, 95% CI 0.02-0.08, P = 0.002) and vomiting/nausea (RD = 0.03, 95% CI 0.00-0.05, P = 0.02). CONCLUSION: GEM-based combination therapy may improve the overall survival and palliation in optimalpatients with APCa as compared with GEM alone.展开更多
AIM： To investigate the effects of Tat-NEMO-binding domain （NBD） peptide on taurocholate-induced pancreatitis and lipopolysaccharide （LPS）-stimulated AR42J acinus ceils inflammatory response in rats. METHODS： So...AIM： To investigate the effects of Tat-NEMO-binding domain （NBD） peptide on taurocholate-induced pancreatitis and lipopolysaccharide （LPS）-stimulated AR42J acinus ceils inflammatory response in rats. METHODS： Sodium taurocholate （5%） was used to induce the pancreatitis model. Forty-eight rats from the taurocholate group received an intravenous bolus of 13 mg/kg Tat-NBD （wild-type, WT） peptide, Tat- NBD （mutant-type, MT） peptide, NBD peptide or Tat peptide. The pancreatic histopathology was analyzed by hematoxylin staining. LPS was added to the culture medium to stimulate the AR42J cells. For pretreatment, cells were incubated with different peptides for 2 h before LPS stimulation. Expression of IL-1β and TNF-α mRNA was analyzed using a semi-quantitative reverse-transcript polymerase chain reaction （RT-PCR） method. IL-1β and TNF-α protein in culture medium were detected by enzyme linked immunosorbent assay （ELISA）. NF-KB DNA-binding in pancreas was examined by electrophoretic mobility shift assays. P65 expression of AR42J was determined by Strept Actividin-Biotin Complex （SABC） method. RESULTS： Pretreatment with Tat-NBD （WT） peptide at a concentration of 13 mg/kg body wt showed beneficial effect in pancreaitis model. LPS （10 mg/L） resulted in an increase of IL-1β mRNA, IL-1β protein, TNF-α mRNA and TNF-α protein, whereas significantly inhibitory effects were observed when cells were incubated with Tat-NBD （WT）. Consisting with p65 expression decrease analyzed by SABC method, NF-KB DNA-binding activity significantly decreased in Tat-NBD （WT） pretreatment group, especially at the largest dose. No significant changes were found in the control peptide group. CONCLUSION： Our result supports that active NF-KB participates in the pathogenesis of STC-induced acute pancreatitis in rats. Tat-NBD （WT） peptide has anti- inflammatory effects in this model and inhibits the inflammation of acinus simulated by LPS.展开更多
Ectopic pancreas is defined as pancreatic tissue found outside the usual anatomic location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It may b...Ectopic pancreas is defined as pancreatic tissue found outside the usual anatomic location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It may become clinically evident when complicated by pathologic changes such as inflammation, bleeding, obstruction, and malignant transformation. In this report, a 40 years old woman with epigastric pain due to ectopic pancreatic tissue in the stomach is described. The difficulty of making an ac- curate diagnosis is highlighted. The patient has remained free of symptoms since she underwent wedge resection of the lesion three years ago. Frozen sections may help in deciding the extent of resection intraoperatively. Al- though ectopic pancreas is rare, it should be considered in the differential diagnosis of a submucosal gastric tumour.展开更多
Acute pancreatitis in its severe form is complicated by multiple organ system dysfunction, most importantly by pulmonary complications which include hypoxia, acute respiratory distress syndrome, atelectasis, and pleur...Acute pancreatitis in its severe form is complicated by multiple organ system dysfunction, most importantly by pulmonary complications which include hypoxia, acute respiratory distress syndrome, atelectasis, and pleural effusion. The pathogenesis of some of the above complications is attributed to the production of noxious cytokines. Clinically significant is the early onset of pleural effusion, which heralds a poor outcome of acute pancreatitis. The role of circulating trypsin, phospholipase A2, platelet activating factor, release of free fatty acids, chemoattractants such as tumor necrsosis factor （TNF）- alpha, interleukin （IL）-1, IL-6, IL-8, fMet-leu-phe （a bacterial wall product）, nitric oxide, substance P, and macrophage inhlbitor factor is currently studied. The hope is that future management of acute pancreatitis with a better understanding of the pathogenesis of lung injury will be directed against the production of noxious cytokines.展开更多
AIM： To detect the therapeutic effects of chemical destruction of celiac ganglion in patients with pancreatic carcinoma with intractable pain. METHODS： Ninety-seven cases with advanced pancreatic carcinoma received ...AIM： To detect the therapeutic effects of chemical destruction of celiac ganglion in patients with pancreatic carcinoma with intractable pain. METHODS： Ninety-seven cases with advanced pancreatic carcinoma received chemical destruction of celiac ganglion-5 mL pure alcohol injection around celiac artery under ultrasonic guidance. The changes of visual analogue scale （VAS）, serum substance P （Sub P）, β-endopeptide （β-EP） and T-lymphocyte subtypes level were compared between pre- and post-therapy. RESULTS： Successful rate of puncture was 98.7%, with one failure. No serious complications such as traumatic pancreatitis, pancreatic fistula, abdominal cavity hemorrhage or peritoneal infection occurred. VAS, serum Sub P and β-EP level significantly changed after treatment （8.0 ± 2.3 vs 4.6 ± 2.1, 254.1 ± 96.7 vs 182.4 ± 77.6, 3.2 ± 0.8 vs 8.8 ± 2.1, P 〈 0.01, P 〈 0.05, P 〈 0.01） with complete relief rate 54.2%, partial relief rate 21.9%, ineffective rate 12.5% and recurrent rate 10.7%. The T-lymphocyte subtypes level remarkably increased when compared with that of pre-therapy （46.7 ± 3.7 vs 62.5 ± 5.5, P 〈 0.01）. CONCLUSION： Our study suggests that chemical destruction of celiac ganglion under ultrasonic guidance is highly safe, and can evidently relieve cancer pain and improve the cellular immunity in patients with advanced pancreatic carcinoma.展开更多
文摘AIM: To compare gemcitabine-based combination therapy and gemcitabine (GEM) alone in patients with advanced pancreatic cancer (APCa) through meta- analysis. METHODS: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-based combination therapy and GEM alone for APCa. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The meta-analysis involved overall survival (OS), objective remission rate (ORR), clinical benefit rate (CBR), time to progress/progress free survival (TTP/PFS) and toxicity. RESULTS: The meta-analysis included 22 RCTs. There was significant improvement in the GEM combination group with regard to the 6-mo survival rate (RD = 0.04, 95% CI 0.01-0.06, P = 0.008), 1-year survival rate (RD = 0.03, 95% CI 0.01-0.05, P = 0.01), ORR (RD = 0.04, 95% CI 0.01-0.07, P = 0.02), CBR (RD = 0.10, 95% CI 0.02-0.17, P = 0.01) and 6-mo TTP/PFS (RD = 0.07, 95% CI 0.04-0.10, P < 0.00001). However, the Grade 3-4 toxicity set by WHO was higher for the GEM combination group for neutropenia (RD = 0.05, 95% CI 0.01-0.10, P = 0.02), thrombocytopenia (RD = 0.05, 95% CI 0.02-0.08, P = 0.002) and vomiting/nausea (RD = 0.03, 95% CI 0.00-0.05, P = 0.02). CONCLUSION: GEM-based combination therapy may improve the overall survival and palliation in optimalpatients with APCa as compared with GEM alone.
基金Supported by The Natural Science Foundation, No. 04009624
文摘AIM： To investigate the effects of Tat-NEMO-binding domain （NBD） peptide on taurocholate-induced pancreatitis and lipopolysaccharide （LPS）-stimulated AR42J acinus ceils inflammatory response in rats. METHODS： Sodium taurocholate （5%） was used to induce the pancreatitis model. Forty-eight rats from the taurocholate group received an intravenous bolus of 13 mg/kg Tat-NBD （wild-type, WT） peptide, Tat- NBD （mutant-type, MT） peptide, NBD peptide or Tat peptide. The pancreatic histopathology was analyzed by hematoxylin staining. LPS was added to the culture medium to stimulate the AR42J cells. For pretreatment, cells were incubated with different peptides for 2 h before LPS stimulation. Expression of IL-1β and TNF-α mRNA was analyzed using a semi-quantitative reverse-transcript polymerase chain reaction （RT-PCR） method. IL-1β and TNF-α protein in culture medium were detected by enzyme linked immunosorbent assay （ELISA）. NF-KB DNA-binding in pancreas was examined by electrophoretic mobility shift assays. P65 expression of AR42J was determined by Strept Actividin-Biotin Complex （SABC） method. RESULTS： Pretreatment with Tat-NBD （WT） peptide at a concentration of 13 mg/kg body wt showed beneficial effect in pancreaitis model. LPS （10 mg/L） resulted in an increase of IL-1β mRNA, IL-1β protein, TNF-α mRNA and TNF-α protein, whereas significantly inhibitory effects were observed when cells were incubated with Tat-NBD （WT）. Consisting with p65 expression decrease analyzed by SABC method, NF-KB DNA-binding activity significantly decreased in Tat-NBD （WT） pretreatment group, especially at the largest dose. No significant changes were found in the control peptide group. CONCLUSION： Our result supports that active NF-KB participates in the pathogenesis of STC-induced acute pancreatitis in rats. Tat-NBD （WT） peptide has anti- inflammatory effects in this model and inhibits the inflammation of acinus simulated by LPS.
文摘Ectopic pancreas is defined as pancreatic tissue found outside the usual anatomic location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It may become clinically evident when complicated by pathologic changes such as inflammation, bleeding, obstruction, and malignant transformation. In this report, a 40 years old woman with epigastric pain due to ectopic pancreatic tissue in the stomach is described. The difficulty of making an ac- curate diagnosis is highlighted. The patient has remained free of symptoms since she underwent wedge resection of the lesion three years ago. Frozen sections may help in deciding the extent of resection intraoperatively. Al- though ectopic pancreas is rare, it should be considered in the differential diagnosis of a submucosal gastric tumour.
文摘Acute pancreatitis in its severe form is complicated by multiple organ system dysfunction, most importantly by pulmonary complications which include hypoxia, acute respiratory distress syndrome, atelectasis, and pleural effusion. The pathogenesis of some of the above complications is attributed to the production of noxious cytokines. Clinically significant is the early onset of pleural effusion, which heralds a poor outcome of acute pancreatitis. The role of circulating trypsin, phospholipase A2, platelet activating factor, release of free fatty acids, chemoattractants such as tumor necrsosis factor （TNF）- alpha, interleukin （IL）-1, IL-6, IL-8, fMet-leu-phe （a bacterial wall product）, nitric oxide, substance P, and macrophage inhlbitor factor is currently studied. The hope is that future management of acute pancreatitis with a better understanding of the pathogenesis of lung injury will be directed against the production of noxious cytokines.
文摘AIM： To detect the therapeutic effects of chemical destruction of celiac ganglion in patients with pancreatic carcinoma with intractable pain. METHODS： Ninety-seven cases with advanced pancreatic carcinoma received chemical destruction of celiac ganglion-5 mL pure alcohol injection around celiac artery under ultrasonic guidance. The changes of visual analogue scale （VAS）, serum substance P （Sub P）, β-endopeptide （β-EP） and T-lymphocyte subtypes level were compared between pre- and post-therapy. RESULTS： Successful rate of puncture was 98.7%, with one failure. No serious complications such as traumatic pancreatitis, pancreatic fistula, abdominal cavity hemorrhage or peritoneal infection occurred. VAS, serum Sub P and β-EP level significantly changed after treatment （8.0 ± 2.3 vs 4.6 ± 2.1, 254.1 ± 96.7 vs 182.4 ± 77.6, 3.2 ± 0.8 vs 8.8 ± 2.1, P 〈 0.01, P 〈 0.05, P 〈 0.01） with complete relief rate 54.2%, partial relief rate 21.9%, ineffective rate 12.5% and recurrent rate 10.7%. The T-lymphocyte subtypes level remarkably increased when compared with that of pre-therapy （46.7 ± 3.7 vs 62.5 ± 5.5, P 〈 0.01）. CONCLUSION： Our study suggests that chemical destruction of celiac ganglion under ultrasonic guidance is highly safe, and can evidently relieve cancer pain and improve the cellular immunity in patients with advanced pancreatic carcinoma.
