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
CT scan is regarded as the imaging modality of choice in patients with pancreaticobiliary ductal abnormalities. However, the axial orientation of the CT images provides only limited anatomical view of pancreaticobilia...CT scan is regarded as the imaging modality of choice in patients with pancreaticobiliary ductal abnormalities. However, the axial orientation of the CT images provides only limited anatomical view of pancreaticobiliary ductal abnormalities. The technological advances of multi-de-tector row CT and three-dimensional image processing in workstations allows rapid image acquisition and a short postprocessing time. In particular, multiplanar reforma-tions (MPR) and minimum intensity projections (MinIP) offer rapid and accurate images of the anatomy and ab-normalities of the pancreaticobiliary tree. Moreover, MPR and MinIP help determine the relationship between the pancreaticobiliary ductal anatomy and the surrounding structures. This pictorial review illustrates the wide spec-trum of images obtained by the MPR and MinIP of the anomalies and disorders of the pancreaticobiliary tree.展开更多
AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallb...AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was evaluated.RESULTS: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.展开更多
AIM： To evaluate the use of the trypsinogen-2 dipstick （Actim Pancreatitis） test for early diagnosis and prediction of severity in acute pancreatitis （AP）. METHODS： Ninety-two patients with AP were included in t...AIM： To evaluate the use of the trypsinogen-2 dipstick （Actim Pancreatitis） test for early diagnosis and prediction of severity in acute pancreatitis （AP）. METHODS： Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test （UTDT） and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis. RESULTS： UTDT was positive in 87 （94.6%） of the AP patients and in two （8%） controls （P 〈 0.05）. Positive UTDT was found in 61 （92.4%） of 66 （71.7%） patients with mild pancreatitis and in all （100%） of the 26 （28.3%） with severe pancreatitis （P 〉 0.05）. UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis （6.2 ＋ 2.5 d vs 2.0 ＋ 1.43 d, P 〈 0.05）. The sensitivity, specificity, positive predictive value, negative predictive value （NPV）, positive likelihood ratio （PLR） and negative likelihood ratio （NLR） of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively. CONCLUSION： UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.展开更多
AIM： TO analyze the factors influencing radical （R0） resection rate and surgical outcome for malignant tumor of the pancreatic body and tail. METHODS： The clinical and operative data and follow- up results of 214 ...AIM： TO analyze the factors influencing radical （R0） resection rate and surgical outcome for malignant tumor of the pancreatic body and tail. METHODS： The clinical and operative data and follow- up results of 214 pancreatic body and tail cancer patients were analyzed retrospectively. RESULTS： One hundred and twenty/214 pancreatic body and tail cancer patients underwent surgical treatment; the overall resection rate was 59.2% （71/120）, and the R0 resection rate was 40.8% （49/120）. Compared with non-R0 treatment, the patients receiving an R0 resection had smaller size tumor （P 〈 0.01）, cystadenocarcinoma （P 〈 0.01）, less lymph node metastasis （P 〈 0.01）, less peri-pancreatic organ involvement （P 〈 0.01） and earlier stage disease （P 〈 0.01）. The overall 1-, 3- and 5-year survival rates for pancreatic body and tail cancer patients were 12.7% （251197）, 7.6% （151197） and 2.5% （5/197）, respectively, and ductal adenocarcinoma patients had worse survival rates [15.0% （9/60）, 6.7% （4/60） and 1.7% （1/60）, respectively] than cystadenocarcinoma patients [53.8% （21139）, 28.2% （11139） and 10.3% （4139）] （P 〈 0.01）. Moreover, the 1-, 3- and 5-year overall survival rates in patients with RO resection were 55.3% （26/47）, 31.9% （15/47） and 10.6% （5/47）, respectively, significantly better than those in patients with palliative resection [9.5% （2/21）, 0 and 0] and in patients with bypass or laparotomy [1.2% （1/81）, 0 and 0] （P 〈 0.01）. CONCLUSION： Early diagnosis is crucial for increasing the radical resection rate, and radical resection plays an important role in improving survival for pancreatic body and tail cancer patients.展开更多
In spite of continuous research efforts directed at early detection and treatment of pancreatic cancer, the outlook for patients affected by the disease remains dismal. With most cases still being diagnosed at advance...In spite of continuous research efforts directed at early detection and treatment of pancreatic cancer, the outlook for patients affected by the disease remains dismal. With most cases still being diagnosed at advanced stages, no improvement in survival prognosis is achieved with current diagnostic imaging approaches. In the absence of a dominant precancerous condition, several risk factors have been identified including family history, chronic pancreatitis, smoking, diabetes mellitus, as well as certain genetic disorders such as hereditary pancreatitis, cystic fibrosis, familial atypical multiple mole melanoma, and Peutz-Jeghers and Lynch syn- dromes. Most pancreatic carcinomas, however, remain sporadic. Current progress in experimental molecular techniques has enabled detailed understanding of the molecular processes of pancreatic cancer development. According to the latest information, malignant pancre- atic transformation involves multiple oncogenes and tumor-suppressor genes that are involved in a variety of signaling pathways. The most characteristic aberrations （somatic point mutations and allelic losses） affect onco- genes and tumor-suppressor genes within RAS, AK-I- and Wnt signaling, and have a key role in transcription and proliferation, as well as systems that regulate the cell cycle （SMAD/DPC, CDKN2A/p16） and apoptosis （TP53）. Understanding of the underlying molecular mechanisms should promote development of new methodology for early diagnosis and facilitate improvement in current approaches for pancreatic cancer treatment.展开更多
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CT scan is regarded as the imaging modality of choice in patients with pancreaticobiliary ductal abnormalities. However, the axial orientation of the CT images provides only limited anatomical view of pancreaticobiliary ductal abnormalities. The technological advances of multi-de-tector row CT and three-dimensional image processing in workstations allows rapid image acquisition and a short postprocessing time. In particular, multiplanar reforma-tions (MPR) and minimum intensity projections (MinIP) offer rapid and accurate images of the anatomy and ab-normalities of the pancreaticobiliary tree. Moreover, MPR and MinIP help determine the relationship between the pancreaticobiliary ductal anatomy and the surrounding structures. This pictorial review illustrates the wide spec-trum of images obtained by the MPR and MinIP of the anomalies and disorders of the pancreaticobiliary tree.
文摘AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was evaluated.RESULTS: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.
文摘AIM： To evaluate the use of the trypsinogen-2 dipstick （Actim Pancreatitis） test for early diagnosis and prediction of severity in acute pancreatitis （AP）. METHODS： Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test （UTDT） and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis. RESULTS： UTDT was positive in 87 （94.6%） of the AP patients and in two （8%） controls （P 〈 0.05）. Positive UTDT was found in 61 （92.4%） of 66 （71.7%） patients with mild pancreatitis and in all （100%） of the 26 （28.3%） with severe pancreatitis （P 〉 0.05）. UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis （6.2 ＋ 2.5 d vs 2.0 ＋ 1.43 d, P 〈 0.05）. The sensitivity, specificity, positive predictive value, negative predictive value （NPV）, positive likelihood ratio （PLR） and negative likelihood ratio （NLR） of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively. CONCLUSION： UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.
文摘AIM： TO analyze the factors influencing radical （R0） resection rate and surgical outcome for malignant tumor of the pancreatic body and tail. METHODS： The clinical and operative data and follow- up results of 214 pancreatic body and tail cancer patients were analyzed retrospectively. RESULTS： One hundred and twenty/214 pancreatic body and tail cancer patients underwent surgical treatment; the overall resection rate was 59.2% （71/120）, and the R0 resection rate was 40.8% （49/120）. Compared with non-R0 treatment, the patients receiving an R0 resection had smaller size tumor （P 〈 0.01）, cystadenocarcinoma （P 〈 0.01）, less lymph node metastasis （P 〈 0.01）, less peri-pancreatic organ involvement （P 〈 0.01） and earlier stage disease （P 〈 0.01）. The overall 1-, 3- and 5-year survival rates for pancreatic body and tail cancer patients were 12.7% （251197）, 7.6% （151197） and 2.5% （5/197）, respectively, and ductal adenocarcinoma patients had worse survival rates [15.0% （9/60）, 6.7% （4/60） and 1.7% （1/60）, respectively] than cystadenocarcinoma patients [53.8% （21139）, 28.2% （11139） and 10.3% （4139）] （P 〈 0.01）. Moreover, the 1-, 3- and 5-year overall survival rates in patients with RO resection were 55.3% （26/47）, 31.9% （15/47） and 10.6% （5/47）, respectively, significantly better than those in patients with palliative resection [9.5% （2/21）, 0 and 0] and in patients with bypass or laparotomy [1.2% （1/81）, 0 and 0] （P 〈 0.01）. CONCLUSION： Early diagnosis is crucial for increasing the radical resection rate, and radical resection plays an important role in improving survival for pancreatic body and tail cancer patients.
文摘In spite of continuous research efforts directed at early detection and treatment of pancreatic cancer, the outlook for patients affected by the disease remains dismal. With most cases still being diagnosed at advanced stages, no improvement in survival prognosis is achieved with current diagnostic imaging approaches. In the absence of a dominant precancerous condition, several risk factors have been identified including family history, chronic pancreatitis, smoking, diabetes mellitus, as well as certain genetic disorders such as hereditary pancreatitis, cystic fibrosis, familial atypical multiple mole melanoma, and Peutz-Jeghers and Lynch syn- dromes. Most pancreatic carcinomas, however, remain sporadic. Current progress in experimental molecular techniques has enabled detailed understanding of the molecular processes of pancreatic cancer development. According to the latest information, malignant pancre- atic transformation involves multiple oncogenes and tumor-suppressor genes that are involved in a variety of signaling pathways. The most characteristic aberrations （somatic point mutations and allelic losses） affect onco- genes and tumor-suppressor genes within RAS, AK-I- and Wnt signaling, and have a key role in transcription and proliferation, as well as systems that regulate the cell cycle （SMAD/DPC, CDKN2A/p16） and apoptosis （TP53）. Understanding of the underlying molecular mechanisms should promote development of new methodology for early diagnosis and facilitate improvement in current approaches for pancreatic cancer treatment.
