BACKGROUND:?Pancreaticoduodenectomy? is? a? high? risk,?complex,? technically? challenging? operation? associated? with?signiifcant?perioperative?morbidity?and?mortality.?This?study?on?the?surgical?management?of?periampullary?cancer?patients?is?based?on?our?experience?in?a?period?of?nearly?13?years.METHODS:?The? study? was? conducted? on? two? groups? of?patients:?group?A?included?42?patients?who?were?treated?between?January?2000?and?September?2005?and?group?B?included?134?patients?who?were?treated?between?October?2005?to?October?2012.?Preoperative,?intraoperative?and?postoperative?details?of?all?these?patients?were?collected,?tabulated?and?analyzed?to?assess?the?impact?of?the?selective?approach?introduced?in?the?department?with?effect?from?October?2005.RESULTS:?Intraoperative? details? revealed? highly? signiifcant?differences?in?the?management?of?the?two?groups?of?patients?in?respect?of?operative?time?(250.4?vs?126.6?minutes;?P<0.001),?operative? blood? loss? (1070.2? vs? 414.9? mL;? P<0.001)? and?intraoperative?blood?transfusion?(1.4?vs?0.2?units;?P<0.001).?Variations? between? the? two? groups? in? the? frequency? of?complications? were? found? to? be? statistically? insigniifcant.?However,?the?difference?between?the?two?groups?in?the?overall?morbidity?of?patients?(47.6%?vs?26.1%;?P=0.009)?and?the?length?of?their?hospital?stay?(11.8?vs?7.8?days;?P<0.001)?were?signiifcant. CONCLUSION:?A?selective?approach?applied?to?the?surgical?management?of?periampullary?cancer?patients?is?a?step?in?the?right?direction.
作者： 刊期： 2014年第06期
BACKGROUND:?Fibrolamellar? hepatocellular? carcinoma?(FLHCC)? is? a? rare? disease? with? an? indolent? behavior.? Its?prognosis?is?better?than?that?of?patients?with?hepatocellular?carcinoma.?The?authors?present?their?experience?with?resection?of?FLHCC.METHODS:?Twenty-one?patients?with?FLHCC?were?treated?at?our?institution?between?1990?and?2012.?Of?these?patients,?14?were?subjected?to?resection?of?the?tumor.?Patient?demographics,?medical?history,?results?of?imaging?studies?and?laboratory?tests,?surgical?data,?and?pathologic?ifndings?were?evaluated.RESULTS:?The?median?age?of?the?patients?at?the?diagnosis?of?the?tumor?was?20?years?and?14?patients?were?female.?None?of?the?patients?had?tumor-associated?chronic?liver?disease?or?cirrhosis.?The?mean?tumor?size?was?12.8?cm?(range?6-19)?and?18?patients?had?a?single?liver?nodule.?Fourteen?patients?were?subjected?to?hepatectomy?and?six?of?them?had?lymph?node?metastases?resected.?Pathologic?evaluation?revealed?that?5?(35.7%)?patients?had?major?vascular?invasion.?Tumor?recurrence?was?seen?in?8?patients?(66.7%),?during?a?follow-up.?The?median?survival?time?for?patients?who?were?subjected?to?resection?was?36?months.?The?5-year?overall?survival?rate?and?disease?free?survival?rate?were?28.0%?and?8.5%,?respectively.?Univariate?analysis?showed?that?vascular?invasion?was?the?only?variable?associated?with?the?disease?free?survival?rate.CONCLUSIONS:?Despite? an? aggressive? treatment,? patients?with?FLHCC?presented?unexpected?low?survival?rates.?It?seems?that?an?underestimated?malignant?behavior?is?attributed?to?this?disease,?and?that?the?forms?of?adjuvant?treatment?should?be?urgently?evaluated.
作者： 刊期： 2014年第06期
BACKGROUND: Postoperative pancreatic fistula remains the most common complication of pancreaticoduodenectomy (PD) and is potentially lethal. It contributes significantly to prolonged hospitalization and mortality. In this study, we introduced a new technical approach, a modified Roux-en-Y reconstruction and evaluated its safety and feasibility.METHODS: We retrospectively reviewed the patients who had undergone PD with the modified Roux-en-Y reconstructive technique for periampullary malignancies from January 2011 to June 2012. The data on complications, hospital stay and outcomes after the modified Roux-en-Y reconstruction were analyzed.RESULTS: The reconstruction was performed in 171 patients, of whom 92 received pancreaticogastrostomy and 79 received pancreaticojejunostomy. The median duration of surgery was 4.0 hours (range 3.1-6.9) in all patients, and the median blood loss was 530 mL (range 200-2000). Sixty-nine patients were subjected to transfusions, with a median transfusion volume of 430 mL (range 200-1400). The median hospital stay of the patients was 14 days (range 11-38). Their operative mortality was zero and overall morbidity was 18.1% (31 patients). Only four patients (2.3%) developed pancreatic fistulas (grade A fistulas in two patients and grade B in two patients); no patients developed grade C fistula. None of the patients developed bile reflux gastritis.CONCLUSIONS: The modified Roux-en-Y reconstruction, which isolates biliary anastomosis from pancreatic, gastric or jejunal anastomosis,?is?a?safe,?reliable,?and?favorable?technique.?But?it?needs?further?investigation?in?randomized?controlled?trials.
作者： 刊期： 2014年第06期
BACKGROUND:?The?peripheral?morphologic?characteristics?of?hepatocellular?carcinoma?(HCC)?relfect?tumor?growth?patterns.?Computed?tomography?(CT)?perfusion?is?a?new?method?to?analyze?hemodynamic?changes?in?tissues.?We?assessed?the?relationship?between?CT?perfusion?and?histopathologic?ifndings?in?the?periphery?of?HCC?lesions.METHODS:?Non-contrast?CT,?enhanced?dual-phase?CT,?and?CT?perfusion?were?performed?on?77?subjects?(47?patients?and?30?controls).?Based?on?the?imaging?ifndings?of?enhanced?dual-phase?CT,?the?tumor?edges?were?classiifed?into?three?types:?type?I?(sharp);?type?II?(blurry);?and?type?III?(mixed).?The?CT?perfusion? parameters? included? hepatic? blood? lfow,? hepatic?arterial?fraction,?hepatic?arterial?perfusion,?and?hepatic?portal?perfusion.?The?tissue?sections?from?resected?specimens?were?subjected? to? routine? hematoxylin? and? eosin? staining? and?immunohistochemical? staining? for? CD34.? The? correlations?between?microvessel?density?(MVD)?and?the?CT?perfusion?parameters?were?analyzed?using?Pearson's?product-moment?correlation?coefifcient.?Changes?in?the?perfusion?parameters?in?tumor?edges?of?different?tumor?types?were?evaluated.RESULTS:?Type?I?(sharp):?the?pathologic?ifndings?showed?ifbrous?connective?tissue?capsules?in?the?tumor?edges,?and?an?MVD?≤?30/mm2.?Type?II?(blurry):?the?histology?showed?that?the?edges?were?clear?with?no?capsules?and?an?MVD?>30/mm2.?Type?III(mixed):?the?pathology?was?similar?to?that?of?types?I?and?II,?and?an?MVD?>30/mm2.?Hepatic?blood?lfow,?hepatic?arterial?fraction,?hepatic?arterial?perfusion,?and?hepatic?portal?perfusion?were?signiifcantly?increased?in?the?tumor?edges?of?HCC?patients?compared?to?those?of?the?controls?(P<0.05).?The?correlation?between?CT?perfusion?parameters?and?MVD?was?higher?in?blurry?tumor?edges?of?type?II?than?in?those?of?types?I?or?III.CONCLUSION:?CT?perfusion?imaging?of?tumor?edges?may?be?helpful?in?revealing?histopathological?features,?and?indirectly?relfect?angiogenic?changes?of?HCCs.
作者： 刊期： 2014年第06期
BACKGROUND:?A?previous?report?has?identiifed?a?signiifcantly?higher?sensitivity?of?cancer?detection?for?dedicated?grasping?basket?than?brushing?at?endoscopic?retrograde?cholangiopancreato- graphy?(ERCP).?This?study?aimed?to?compare?the?diagnostic?accuracy?of?Geenen?brush?and?Dormia?basket?cytology?in?the?differential?diagnosis?of?bile?duct?stricture.METHOD:? The? current? study? enrolled? one? hundred? and?fourteen?patients?who?underwent?ERCP?with?both?Geenen?brush?and?Dormia?basket?cytology?for?the?differential?diagnosis?of?bile?duct?stricture?at?our?institution?between?January?2008?and?December?2012.RESULTS:?We?adopted?sequential?performances?of?cytologic?samplings? by? using? initial? Geenen? brush? and? subsequent?Dormia?basket?cytology?in?59?patients?and?initial?Dormia?basket?and?subsequent?Geenen?brush?cytology?in?55?patients.?Presampling?balloon?dilatations?and?biliary?stentings?for?the?stricture?were?performed?in?17?(14.9%)?and?107?patients?(93.9%),?respectively.?The?sensitivity,?speciifcity,?positive?predictive?value,?negative?predictive?value,?and?accuracy?of?Geenen?brush?cytology?for?the?diagnosis?of?malignant?bile?duct?stricture?were?75.0%,?100.0%,?100.0%,?66.7%?and?83.3%,?respectively,?and?those?of?Dormia?basket?cytology?were?64.5%,?100.0%,?100.0%,?58.5%?and?76.3%,?respectively?(P=0.347?and?0.827?for?sensitivity?and?accuracy,?respectively).?The?good?and?excellent?cellular?yields?(≥?grade?2)?were?obtained?by?Geenen?brush?and?Dormia?basket?cytology?in?88?(77.2%)?and?79?(69.3%)?patients,?respectively.CONCLUSION:?The? sensitivity,? speciifcity? and? accuracy? of?biliary?sampling?with?a?Dormia?basket?are?comparable?to?those?with?conventional?Geenen?brush?cytology?in?the?detection?of?malignant?bile?duct?stricture.
作者： 刊期： 2014年第06期
BACKGROUND:?Autoimmune?pancreatitis?(AIP)?is?increasingly?recognized?as?a?unique?subtype?of?pancreatitis.?This?study?aimed?to?analyze?the?diagnosis?and?treatment?of?AIP?patients?from?a?tertiary?care?center?in?China.METHODS:?One?hundred?patients?with?AIP?who?had?been?treated?from?January?2005?to?December?2012?in?our?hospital?were?enrolled?in?this?study.?We?retrospectively?reviewed?the?data?of?clinical?manifestations,?laboratory?tests,?imaging?examinations,?pathological?examinations,?treatment?and?outcomes?of?the?patients.RESULTS:?The?median?age?of?the?patients?at?onset?was?57?years?(range?23-82)?with?a?male?to?female?ratio?of?8.1:1.?The?common?manifestations?of?the?patients?included?obstructive?jaundice?(49?patients,?49.0%),?abdominal?pain?(30,?30.0%),?and?acute?pancreatitis?(11,?11.0%).?Biliary?involvement?was?one?of?the?most? extrapancreatic? manifestations? (64,? 64.0%).? Fifty-six?(56.0%)?and?43?(43.0%)?patients?were?classiifed?into?focal-type?and?diffuse-type?respectively?according?to?the?imaging?examinations.?The?levels?of?serum?IgG?and?IgG4?were?elevated?in?69.4%?(43/62)?and?92.0%?(69/75)?patients.?Pathological?analysis?of?specimens?from?27?patients?supported?the?diagnosis?of?lymphoplasmacytic?sclerosing?pancreatitis,?and?marked?(>10?cells/HPF)?IgG4?positive?cells?were?found?in?20?(74.1%)?patients.?Steroid?treatment?and?surgery?as?the?main?initial?treatments?were?given?to?41?(41.0%)?and?28?(28.0%)?patients,?respectively.?The?remission?rate?after?the?initial?treatment?was?85.0%.?Steroid?was?given?as?the?treatment?after?relapse?in?most?of?the?patients?and?the?total?remission?rate?at?the?end?of?follow-up?was?96.0%. CONCLUSIONS:?Clinical?manifestations,?laboratory?tests,?imaging?and?pathology?examinations?in?combination?could?increase?the?diagnostic?accuracy?of?AIP.?Steroid?treatment?with?an?initial?dose?of?30?or?40?mg?prednisone?is?effective?and?safe?in?most?patients?with?AIP.
作者： 刊期： 2014年第06期
BACKGROUND:?Ectopic?pancreatic?tissue?is?relatively?uncommon,?and?is?characterized?as?pancreatic?tissue?with?no?contact?with?the?normal?pancreas,?and?with?its?own?ductal?system?and?blood?supply.?It?is?usually?asymptomatic,?and?can?be?incidentally?diagnosed?by?conventional?imaging?studies. METHOD:?A? 69-year-old? woman? with? a? prior? history? of?bilateral?breast?carcinoma?presented?with?ectopic?pancreatic?intraepithelial?neoplasia?(PanIN)?that?was?identiifed?incidentally?in? the? small? bowel? during? an? oncological? resection? of? a?synchronous?primary?pancreatic?adenocarcinoma,?and?renal?cell?carcinoma. RESULTS:?The?patient?underwent?subtotal?pancreatectomy?with?splenectomy,?regional?lymphadenectomy,?radical?left?nephrectomy,?and?small?bowel?resection?with?primary?anastomosis?of?ectopic?PanIN-2.? She? had? an? uneventful? hospitalization? and? was?discharged?home?on?postoperative?day?7. CONCLUSIONS:?The?occurrence?of?ectopic?PanIN?is?extremely?unusual?with?only?few?cases?previously?reported?in?the?literature.?The?need?for?negative?margins?after?surgical?resection?of?ectopic?PanIN?lesions?remains?controversial.
作者： 刊期： 2014年第06期
作者： 刊期： 2014年第06期
作者： 刊期： 2014年第06期
BACKGROUND: There is a growing evidence that matrix metalloproteinase (MMP)-2 and MMP-9 (gelatinases) play an important role in the pathogenesis of numerous disorders, especially with inflammatory etiology and extracellular matrix (ECM) remodeling. Despite the fact that gelatinases involve in liver cirrhosis is provided in the literature, their role in the pathogenesis of chronic pancreatitis and non-specific inflammatory bowel diseases is still under investigation.DATA SOURCES: We carried out a PubMed search of Englishlanguage articles relevant to the involvement of gelatinases in the pathogenesis of liver fibrosis, pancreatitis, and non-specific inflammatory bowel diseases.RESULTS: The decreased activity of gelatinases, especially MMP-2, is related to the development of liver fibrosis, probably due to the decrease of capability for ECM remodeling. Similar situation can be found in chronic pancreatitis; however, reports on this matter are rare. The presence of non-specific inflammatory bowel diseases results in MMP-9 activity elevation.CONCLUSION: The fluctuation of gelatinases activity during liver fibrosis, chronic pancreatitis and non-specific inflammatorybowel?diseases?is?observed,?but?the?exact?role?of?these?enzymes?demands?further?studies.
作者： 刊期： 2014年第06期
作者： 刊期： 2014年第06期
ABSTRACT:?CD98?has?been?described?to?play?a?crucial?role?in?tumor?progression?and?survival.?However,?the?role?of?CD98?in?biliary?tract?cancer?remains?unclear.?We?found?that?36.7%?of?all?patients?with?biliary?tract?cancer?had?a?high?CD98?expression.?Statistical?analysis?using?Spearman's?rank?correlation?showed?that?CD98?was?signiifcantly?correlated?with?L-type?amino?acid?transporter?1?(LAT1,?r=0.562,?P<0.001),?Ki-67?(r=0.230,?P=0.006)?and?CD34?(r=0.290,?P=0.005).?Multivariate?analysis?conifrmed?that?a?high?CD98?expression?was?an?independent?prognostic?factor?for?predicting?poor?outcome.?CD98?is?closely?associated?with?tumor?growth,?biological?aggressiveness,?and?survival?of?patients.?With?these?data?we?proposed?that?CD98?expression?is?necessary?for?the?development?and?pathogenesis?of?biliary?tract?cancer.
作者： 刊期： 2014年第06期
作者： 刊期： 2014年第06期
作者： 刊期： 2014年第06期
作者： 刊期： 2014年第06期
BACKGROUND:?In? order? to? preserve? functional? liver? paren-chyma,?extended?central?hepatectomy?(segments?4,?5,?7?and?8?resection)?was?proposed?for?the?management?of?centrally?lo-cated?hepatocellular?carcinoma?invading?the?right?and?middle?hepatic?veins,?reconstructing?segment?6?outflow?in?the?absence?of?the?thick?inferior?right?hepatic?vein.?The?present?study?was?to?describe?our?surgical?techniques?of?extended?central?hepa-tectomy.METHODS:?Between?2008?and?2012,?5?patients?with?centrally?located?hepatocellular?carcinoma?invading?or?in?the?vicinity?of? the? right? and? middle? hepatic? veins? underwent? extended?central?hepatectomy.?The?thick?inferior?right?hepatic?vein?was?preserved?during?dissection.?Gore-Tex?graft?was?used?for?seg-ment?6?outflow?reconstruction?in?the?absence?of?the?thick?infe-rior?right?hepatic?vein.RESULTS:?The? mean? future? remnant? liver? volume? for? seg-ments?2?and?3?was?28%?versus?45%?on?segment?6?preservation.?The?mean?tumor?diameter?was?7.4?cm.?The?thick?inferior?right?hepatic?vein?was?found?in?1?patient.?Outflow?reconstruction?from? segment? 6? was? performed? in? 4? patients.? Postoperative?complications? included? bile? leakage? (1? patient),? pleural? effu-sion?(2)?and?liver?failure?(1).?The?rate?of?graft?patency?was?75%.?There?was?no?perioperative?mortality.CONCLUSION:?Extended?central?hepatectomy?is?a?safe?alter-native? for? extended? hepatic? resection? in? selected? patients? at-tempting?to?preserve?the?functional?liver?parenchyma.
作者： 刊期： 2015年第01期
BACKGROUND: Gadolinium chloride (GdCl3) selectively in-activates Kupffer cells and protects against ischemia/reperfu-sion and endotoxin injury. However, the effect of Kupffer cell inactivation on liver regeneration after partial liver transplan-tation (PLTx) is not clear. This study was to investigate the role of GdCl3 pretreatment in graft function after PLTx, and to explore the potential mechanism involved in this process.METHODS: PLTx (30% partial liver transplantation) was per-formed using Kamada's cuff technique, without hepatic artery reconstruction. Rats were randomly divided into the control low-dose (5 mg/kg) and high-dose (10 mg/kg) GdCl3 groups. Liver injury was determined by the plasma levels of alanine aminotransferase and aspartate aminotransferase, liver regen-eration by PCNA staining and BrdU uptake, apoptosis by TU-NEL assay. IL-6 and p-STAT3 levels were measured by ELISA and Western blotting.RESULTS: GdCl3 depleted Kupffer cells and decreased animal survival rates, but did not significantly affect alanine amino-transferase and aspartate aminotransferase (P>0.05). GdCl3 pretreatment induced apoptosis and inhibited IL-6 overex-pression and STAT3 phosphorylation after PLTx in graft tissues.CONCLUSION: Kupffer cells may contribute to the liver re-generation after PLTx through inhibition of apoptosis and activation of the IL-6/p-STAT3 signal pathway.
作者： 刊期： 2015年第01期
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Most of the patients with HCC lose the surgical opportunity at the time of diagno-sis. Some novel therapeutic modalities, like gene therapy, are promising for the treatment of HCC. However, the success of gene therapy depends on two aspects: efficient gene materials and gene delivery vectors. The present study was to develop new chitosan-based nanoparticles for a midkine-siRNA (anti-HCC gene drug) delivery.METHODS: The novel gene delivery vector (MixNCH) was syn-thesized by hybrid-type modification of chitosan with 2-chloro-ethylaminehydrochlorideandN,N-dimethyl-2-chloroethylamine hydrochloride. The chemical structure of MixNCH was char-acterized by FT-IR and 1HNMR. The cytotoxicity of MixNCH was determined by MTS assay. The gene condensation ability and size, zeta potential and morphology of MixNCH/MK-siRNA nanoparticles were measured. The in vitro transfection and gene knockdown efficiency of midkine by MixNCH/MK-siRNA nanoparticles was detected by qRT-PCR and Western blotting. Gene knockdown effect at the molecule level on the proliferation of HepG2 in vitro was determined by MTS assay.RESULTS: MixNCH was successfully acquired by aminoalkyl-ation modification of chitosan. The MixNCH could condense MK-siRNA well above the weight ratio of 3. The average size of MixNCH/MK-siRNA nanoparticles was 100-200 nm, and the surface charge was about +5 mV. Morphologically, MixNCH/MK-siRNA nanoparticles were in regular spherical shape with no aggregation. Regarding to the in vitro transfection of nanoparticles, the MixNCH/MK-siRNA nanoparticles reduced MK mRNA level to 14.03%±4.03%, which were comparable to Biotrans (8.94%±3.77%). MixNCH/MK-siRNA effectively inhibited the proliferation of HepG2 in vitro.CONCLUSION: MixNCH/MK-siRNA nanoparticles could be effective for the treatment of hepatocellular carcinoma.
作者： 刊期： 2015年第01期
BACKGROUND:?At?the?time?of?diagnosis,?most?patients?with?gallbladder? cancer? are? in? advanced? stage? and? the? cancer? is?unresectable.?Long-term?survivors?are?usually?seen?in?a?small?number? of? patients? with? incidental? gallbladder? cancer.? This?study?aimed?to?identify?preoperative?predictors?of?incidental?gallbladder?cancer?in?elderly?patients.METHODS:?A?total?of?4014?patients?of?more?than?44?years?old?who?had?undergone?cholecystectomy?at?our?department?from?January?2000?to?December?2010?were?retrospectively?reviewed.?Univariate?and?multivariate?modalities?were?used?to?identify?the?predictive?factors?of?incidental?gallbladder?cancer.RESULTS:?Twenty-nine? of? the? 4014? patients? who? had? under-gone? cholecystectomy? for? benign? gallbladder? diseases? were?histologically?diagnosed?as?having?incidental?gallbladder?can-cer.?Multivariate?analysis?identified?that?elevated?carbohydrate?antigen? 19-9? combined? with? carcinoembryonic? antigen? and/or? carbohydrate? antigen? 125? (P=0.045),? a? gallbladder? polyp?greater?than?or?equal?to?1.2?cm?(P=0.043)?and?focal?gallblad-der?wall?thickening?of?more?than?or?equal?to?5?mm?(P=0.002)?were?predictive?factors?of?incidental?gallbladder?cancer.CONCLUSION:?Cholecystectomy? is? suggested? for? patients?with?these?predictive?factors?and?intraoperative?frozen?section?should?be?considered?to?rule?out?carcinoma.
作者： 刊期： 2015年第01期
BACKGROUND: Liver resection is currently the most efficient curative approach for a wide variety of liver tumors. The ap-plication of modern techniques and new surgical devices has improved operative outcomes. Radiofrequency ablation is used more often for liver parenchymal transection. This study aimed to assess the efficacy and safety of radiofrequency abla-tion-assisted liver resection.METHODS: A retrospective study of 145 consecutive patients who underwent radiofrequency ablation-assisted liver resec-tion was performed. Intraoperative blood loss, need for trans-fusion or intraoperative Pringle maneuver, the duration of liver parenchymal transection, perioperative complications, and postoperative morbidity and mortality were all evaluated.RESULTS: Fifty minor and ninety-five major liver resections were performed. The mean intraoperative blood loss was 251 mL, with a transfusion rate of 11.7%. The Pringle maneuver was necessary in 12 patients (8.3%). The mean duration for parenchymal transection was 51.75 minutes. There were 47 patients (32.4%) with postoperative complications. There is no mortality within 30 days after surgery.CONCLUSIONS: Radiofrequency ablation-assisted liver re-section permits both major and minor liver resections with minimal blood loss and without occlusion of hepatic inflow. Furthermore it decreases the need for blood transfusion and reduces morbidity and mortality.
作者： 刊期： 2015年第01期
BACKGROUND:?The?mitogen-activated?protein?kinases?(MAPKs)?signaling?pathway?is?involved?in?inflammatory?process.?However,?the?mechanism?is?not?clear.?The?present?study?was?to?investi-gate?the?role?of?p38?MAPK?in?acute?pancreatitis?in?mice.METHODS:?Mice?were?divided?into?4?groups:?saline?control;?acute? pancreatitis? induced? with? repeated? injections? of? ceru-lein;? control? plus? p38? MAPK? inhibitor? SB203580;? and? acute?pancreatitis?plus?SB203580.?The?pancreatic?histology,?pancre-atic?enzymes,?cytokines,?myeloperoxidase?activity,?p38?MAPK?and?heat?shock?protein?(HSP)?60?and?70?were?evaluated.RESULTS:?Repeated? injections? of? cerulein? resulted? in? acute?pancreatitis? in? mice,? accompanying? with? the? activation? of?p38? MAPK? and? overexpression? of? HSP60? and? HSP70? in? the?pancreatic?tissues.?Treatment?with?SB203580?significantly?in-hibited?the?activation?of?p38?MAPK,?and?furthermore,?inhib-ited?the?expression?of?HSP60?and?HSP70?in?the?pancreas,?the?inflammatory? cytokines? in? the? serum,? and? myeloperoxidase?activity?in?the?lung.CONCLUSION:?The?p38?MAPK?signaling?pathway?is?involved?in? the? regulation? of? inflammatory? response? and? the? expres-sion?of?HSP60?and?HSP70?in?acute?pancreatitis.
作者： 刊期： 2015年第01期
BACKGROUND: Pancreaticobiliary maljunction is a high risk factor of pancreatitis and biliary tract cancer. How this mal-junction affects the liver remains obscure. This study aimed to examine the effects of pancreaticobiliary maljunction on the liver, pancreas and gallbladder in a cat model.METHODS: A model of choledocho-pancreatic side-to-side ductal anastomosis was created in ten cats.Before the procedure, a small piece of tissue from the liver, pancreas and gallbladder was collected as a control. The common channel formation was checked by cholecystography. The livers, pancreases and gall-bladders of these cats were harvested for histological examina-tion. The expression of proliferating cell nuclear antigen in the gallbladder was examined with immunohistochemistry.RESULTS: Seven of the 10 cats survived for 6 months after surgery. The color of the liver was darker in the PBM model than the control specimen, with nodules on the surface. His-tological examination showed ballooning changes and inflam-matory infiltrations and the histopathological score increased significantly (P<0.05). Also, mitochondria swelling and lipid droplet in cytoplasm were observed under an electron micro-scope. The pancreas also appeared darker in the PBM model than the control specimen and dilated pancreatic ducts were found in three cats. Histopathological examination revealed vascular proliferation and inflammatory infiltration with nu-merous neutrophils. Gallbladder epithelial cells were featured by expanded endoplasmic reticulum, increased intercellular space and cellular nucleus deformation. The positive cells of proliferating cell nuclear antigen were increased significantly (P<0.05).CONCLUSION: The present study demonstrated that pancreatico-biliary maljunction can lead to the injuries of the liver, pancreas and gallbladder.
作者： 刊期： 2015年第01期
