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BACKGROUND: Skeletal muscle is composed of muscle fibers with different physiological characteristics, which plays an important role in regulating skeletal muscle metabolism, movement and body homeostasis. The type of skeletal muscle fiber directly affects meat quality. However, the transcriptome and gene interactions between different types of muscle fibers are not well understood. RESULTS: In this paper, we selected 180-days-old Large White pigs and found that longissimus dorsi (LD) muscle was dominated by fast-fermenting myofibrils and soleus (SOL) muscle was dominated by slow-oxidizing myofibrils by frozen sections and related mRNA and protein assays. Here, we selected LD muscle and SOL muscle for transcriptomic sequencing, and identified 312 differentially expressed mRNA (DEmRs), 30 differentially expressed miRNA (DEmiRs), 183 differentially expressed lncRNA (DElRs), and 3417 differentially expressed circRNA (DEcRs). The ceRNA network included ssc-miR-378, ssc-miR-378b-3p, ssc-miR-24-3p, XR_308817, XR_308823, SMIM8, MAVS and FOS as multiple core nodes that play important roles in muscle development. Moreover, we found that different members of the miR-10 family expressed differently in oxidized and glycolytic muscle fibers, among which miR-10a-5p was highly expressed in glycolytic muscle fibers (LD) and could target MYBPH gene mRNA. Therefore, we speculate that miR-10a-5p may be involved in the transformation of muscle fiber types by targeting the MYHBP gene. In addition, PPI analysis of differentially expressed mRNA genes showed that ACTC1, ACTG2 and ACTN2 gene had the highest node degree, suggesting that this gene may play a key role in the regulatory network of muscle fiber type determination. CONCLUSIONS: We can conclude that these genes play a key role in regulating muscle fiber type transformation. Our study provides transcriptomic profiles and ceRNA interaction networks for different muscle fiber types in pigs, providing reference for the transformation of pig muscle fiber types and the improvement of meat quality.
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Redes Reguladoras de Genes , Animais , Suínos , MicroRNAs/genética , MicroRNAs/metabolismo , Perfilação da Expressão Gênica , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/metabolismo , Transcriptoma , RNA Mensageiro/genética , RNA Mensageiro/metabolismoRESUMO
GOALS: To comprehensively compare the wet suction technique with the conventional dry suction technique for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in solid lesions. BACKGROUND: Optimal suction techniques for EUS-FNA remain uncertain when approaching solid lesions. STUDY: We performed a retrospective study of EUS-FNA at 3 medical centers in China. A total of 203 patients were enrolled who received 2 passes of EUS-FNA with 22-G needles. If the first pass underwent dry suction, the second pass was wet suction. Otherwise, the order of suction technique is opposite. Diagnostic accuracy, sample quality (including cellularity and blood contamination), and sample quantity (including specimen adequacy, the maximum intact specimen length, and the total specimen length) were compared between wet-suction and dry-suction techniques. RESULTS: The patients included 143 pancreatic lesions and 60 nonpancreatic lesions. Compared with the dry suction technique, the wet suction technique yielded a significantly higher diagnostic accuracy (85.22% vs. 72.41%, P =0.002), better specimen adequacy score and cellularity score ( P <0.0001), and lower blood contamination score ( P <0.0001). In the subgroup analysis, wet suction provided significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis ( P <0.05), and better cellularity score and specimen adequacy score, lower blood contamination score, and longer maximum intact specimen length and total specimen length in various lesions than that in dry suction. CONCLUSIONS: The wet suction technique resulted in significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis, and better cellularity and histologic specimen in most of solid lesions.
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Neoplasias Pancreáticas , Pancreatite Crônica , Humanos , Estudos Retrospectivos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Sucção/métodos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Pâncreas , ChinaRESUMO
BACKGROUND: An increasing number of studies have shown that microRNAs play an important role in the occurrence and development of small cell lung cancer, which mainly manifest as oncogenic and tumor inhibition. Therefore, microRNAs may affect the survival of patients with small cell lung cancer. In this meta-analysis, we will evaluate the role of microRNAs in the overall survival of patients with small cell lung cancer, which may provide valuable information for the treatment of small cell lung cancer. METHODS: We searched the PubMed, Embase, and Web of Science online databases to determine the effect of microRNAs on the prognosis of patients with small cell lung cancer. The data and characteristics of each study were extracted, and the hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to estimate the effect. RESULTS: A total of 7 articles, involving 427 subjects and 15 studies, were included in this meta-analysis. The pooled HR of the relationship between the microRNA expression level and the overall survival rate of small cell lung cancer patients was 1.25 (95% CI: 1.06-1.47). There was a significant difference in the prognostic value of oncogenic and tumor inhibition microRNAs among patients with small cell lung cancer, with pooled HRs of 1.60 (95% CI: 1.35-1.90) and 0.42 (95% CI: 0.30-0.57), respectively. CONCLUSIONS: MicroRNAs have a significant impact on the overall survival of small cell lung cancer patients, suggesting that microRNAs can be used as potential prognostic markers and may provide treatment strategies for small cell lung cancer patients. TRIAL REGISTRATION: The protocol was registered on PROSPERO website with the registration number of CRD42022334363. The relevant registration information can be obtained from the website https://www.crd.york.ac.uk/prospero/#searchadvanced .
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Neoplasias Pulmonares , MicroRNAs , Carcinoma de Pequenas Células do Pulmão , Humanos , MicroRNAs/genética , Prognóstico , Carcinoma de Pequenas Células do Pulmão/genética , Carcinogênese , Neoplasias Pulmonares/genéticaRESUMO
BACKGROUND: Tissue sampling for biliary stricture is important for differential diagnosis and further treatment. The aim of this study was to assess a novel dilation catheter-guided mini-forceps biopsy (DCMB) method in the diagnosis of malignant biliary strictures. METHODS: 42 patients with malignant biliary stricture who underwent both brush cytology and DCMB during endoscopic retrograde cholangiopancreatography between October 2014 and November 2015 were retrospectively included. During DCMB, the mini biopsy forceps was introduced into the biliary stricture through the dilation catheter, and then the position and direction of the forceps were adjusted to obtain tissue samples. RESULTS: The positive rate of DCMB was significantly higher than that of brush cytology (81.0â% [34/42] vs. 38.1â% [16/42]; Pâ<â0.001). No severe complications occurred; three patients (7.1â%) experienced mild procedure-related acute pancreatitis. CONCLUSIONS: The novel DCMB technique was a practical, safe, efficient, and low-costing method for diagnosing malignant biliary stricture with a high accuracy rate.
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Carcinoma/diagnóstico , Colestase/etiologia , Neoplasias do Sistema Digestório/diagnóstico , Biópsia Guiada por Imagem/métodos , Idoso , Carcinoma/complicações , Carcinoma/patologia , Catéteres , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Neoplasias do Sistema Digestório/complicações , Neoplasias do Sistema Digestório/patologia , Feminino , Humanos , Biópsia Guiada por Imagem/efeitos adversos , Biópsia Guiada por Imagem/instrumentação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Instrumentos CirúrgicosRESUMO
Eicosapentaenoic acid regulates glucose uptake in skeletal muscle and significantly affects whole-body energy metabolism. However, the underlying molecular mechanism remains unclear. Here we report that eicosapentaenoic acid activates phosphoglycerate mutase 2, which mediates the conversion of 2-phosphoglycerate into 3-phosphoglycerate. This enzyme plays a pivotal role in glycerol degradation, thereby facilitating the proliferation and differentiation of satellite cells in skeletal muscle. Interestingly, phosphoglycerate mutase 2 inhibits mitochondrial metabolism, promoting the formation of fast-type muscle fibers. Treatment with eicosapentaenoic acid and phosphoglycerate mutase 2 knockdown induced opposite transcriptomic changes, most of which were enriched in the PI3K-AKT signaling pathway. Phosphoglycerate mutase 2 activated the PI3K-AKT signaling pathway, which inhibited the phosphorylation of FOXO1, and, in turn, inhibited mitochondrial function and promoted the formation of fast-type muscle fibers. Our results suggest that eicosapentaenoic acid promotes skeletal muscle growth and regulates glucose metabolism by targeting phosphoglycerate mutase 2 and activating the PI3K/AKT signaling pathway.
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Ácido Eicosapentaenoico , Músculo Esquelético , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt , Transdução de Sinais , Animais , Masculino , Camundongos , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Ácido Eicosapentaenoico/farmacologia , Camundongos Endogâmicos C57BL , Mitocôndrias/metabolismo , Mitocôndrias/efeitos dos fármacos , Desenvolvimento Muscular/efeitos dos fármacos , Músculo Esquelético/metabolismo , Músculo Esquelético/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Fosfoglicerato Mutase/metabolismo , Fosfoglicerato Mutase/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , SuínosRESUMO
The temperature/pH dual-responsive gel spheres were prepared by orthogonal experiments and response surface methodology, and finally, the optimal synthesis conditions were obtained by a composite score, including swelling, mechanical properties, mass transfer properties, and so forth. The results showed that a sodium alginate concentration of 3% (w/v), CaCl2 concentration of 2% (w/v), gelling time of 40 h, drop height of 14 cm, NaCl concentration of 0.6% (w/v), N-isopropylacrylamide concentration of 0.03% (w/v), and acrylic acid concentration of 4.06% (w/v) were optimal synthesis conditions. The environmental change tolerance experiments showed that the nitrogen removal of the dual-response nitrifying gel spheres was better than the domesticated sludge at low temperatures (4 °C) and in alkaline (pH 9 and 10) conditions. The as-obtained gel spheres can respond intelligently to the changes in ambient temperature and pH. It is hoped that this study will provide technical parameters for the development and application of microbial immobilization carriers.
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Rapid progression and metastasis are the major causes of death in patients with pancreatic ductal adenocarcinoma (PDAC). ELK3, a member of the ternary complex factor (TCF), has been associated with the initiation and progression of various cancers. However, the role of ELK3 in PDAC is not yet fully understood. Online databases and immunohistochemistry were used to analyze the ELK3 levels in PDAC tissues. The function of ELK3 was confirmed by a series of in vivo and in vitro studies. Western blotting and immunofluorescence were used to detect the molecular mechanisms of PDAC. ChIP-qPCR was used to study the mechanism responsible for the elevation of ELK3 expression in PDAC. The ELK3 levels were higher in PDAC tissues than in adjacent normal tissues. Functionally, we demonstrated that ELK3 acted as an oncogene to promote PDAC tumorigenesis and metastasis. Further study suggested that ELK3 promoted PDAC cell migration and invasion by activating the Wnt/ß-catenin pathway, and proved that ZEB1 could directly bind to the promoter of ELK3 to increase its transcription. Finally, both were associated with the patients' clinicopathological features and worse overall survival. Conclusively, our findings enrich the role of ELK3 in PDAC, and provide potential avenues for exploring more effective biomarkers and therapeutic strategies for the treatment of PDAC.
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Severe acute pancreatitis (AP) is a life-threatening disease with up to 30% mortality. Therefore, prevention of AP aggravation and promotion of pancreatic regeneration are critical during the course and treatment of AP. Hypertriglyceridemia (HTG) is an established aggravating factor for AP that hinders pancreatic regeneration; however, its exact mechanism remains unclear. Using miRNA sequencing and further verification, we found that miRNA-153 (miR-153) was upregulated in the pancreas of HTG animal models and in the plasma of patients with HTG-AP. Increased miR-153 aggravated HTG-AP and delayed pancreatic repair via targeting TRAF3. Furthermore, miR-153 was transcriptionally suppressed by sterol regulatory element-binding transcription factor 1c (SREBP1c), which was suppressed by lipoprotein lipase malfunction-induced HTG. Overexpressing SREBP1c suppressed miR-153 expression, alleviated the severity of AP, and facilitated tissue regeneration in vivo. Finally, therapeutic administration of insulin also protected against HTG-AP via upregulating SREBP1c. Collectively, our results not only provide evidence that HTG leads to the development of more severe AP and hinders pancreatic regeneration via inducing persistent dysregulation of SREBP1c/miR-153 signaling, but also demonstrate that SREBP1c activators, including insulin, might be used to treat HTG-AP in patients.
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Hipertrigliceridemia/complicações , MicroRNAs/genética , Pancreatite/complicações , Proteína de Ligação a Elemento Regulador de Esterol 1/metabolismo , Animais , Modelos Animais de Doenças , Humanos , Hipertrigliceridemia/genética , Hipertrigliceridemia/fisiopatologia , Insulina/administração & dosagem , Lipase Lipoproteica/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs/metabolismo , Pâncreas/efeitos dos fármacos , Pâncreas/patologia , Pâncreas/fisiopatologia , Pancreatite/genética , Pancreatite/fisiopatologia , Ratos , Ratos Sprague-Dawley , Regeneração/genética , Regeneração/fisiologia , Transdução de Sinais , Fator 3 Associado a Receptor de TNF/metabolismo , Regulação para CimaRESUMO
Molecular classifications of gastric cancer (GC) by the Asian Cancer Research Group (ACRG) and The Cancer Genome Atlas Consortium (TCGA) are useful for diagnosis and treatment of GC. However, their clinical significance is unknown. The present study aims to explore the associations between subtypes of GC and prognosis of patients with GC. Immunohistochemistry (IHC) was used in the ACRG molecular classification of GC, while nextgeneration sequencing technology was used in TCGA molecular classification. The results indicated that, out of a total of 65 cases of GC, some were classified as EpsteinBarr virus positive type (9.2%, 6 of 65), some as microsatellite instability (MSI) type (23.1%, 15 of 65), some as gene stable type (21.5%, 14 of 65) and some as chromosome instability type (46.2%, 30 of 65) according to TCGA typing standard. Of the total 65 GC cases, some were classified as MSI (21.5%, 14 of 65), some as microsatellite stable/epithelialmesenchymal transition (MSS/EMT; 20.0%, 13 of 65), some as MSS/tumor protein 53 active (TP53+; 15.4%, 10 of 65) and some as MSS/TP53 inactive (43.1%, 28 of 65) according to ACRG typing standard. ARCG molecular subtype (P=0.010) and Lauren classification (P=0.011) were independently correlated with the overall survival of patients with GC. In conclusion, TCGA classification based on a Chinese population is the same as TCGA typing based on a European population in terms of proportion and clinical characteristics, but there are differences in gene amplification and gene mutation. ACRG molecular classification could be performed by IHC analysis and may be a valuable independent prognostic marker for patients with GC.
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Povo Asiático/genética , Biomarcadores Tumorais/análise , Neoplasias Gástricas/classificação , Neoplasias Gástricas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Genéticas , Feminino , Genômica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem Molecular , Prognóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologiaRESUMO
Chronic pancreatitis (CP) is a major risk factor for pancreatic cancer; however, little is known about the pathogenic mechanisms underlying the development of CP. Legumain (Lgmn) has been linked to some chronic inflammatory diseases. The present study investigated the role of legumain in pancreatic fibrogenesis. We induced CP in wild type C57BL6 (WT), Lgmn-deficient (Lgmn-/-), Lgmnflox/flox and Lgmnflox/flox × LysMCre mice by intraperitoneal injection of caerulein for 4 weeks. Pancreata were collected and analyzed by quantitative reverse transcription polymerase chain reaction, Western blotting, and histology. Pancreatic stellate cells and macrophages were isolated and studied using immunofluorescence, gelatin zymography, and enzyme-linked immunosorbent assay. The effects of inhibition of legumain were investigated in vivo by administration of the specific legumain inhibitor, RR-11a. Legumain was found to be upregulated in the serum and pancreatic tissues of mice with caerulein-induced CP. Mice with global and macrophage-specific legumain deficiency exhibited significantly reduced development of pancreatic fibrosis compared with control mice, based on pancreas size, histology, and expression of fibrosis-associated genes. Our results indicate that legumain promotes activation of pancreatic stellate cells and increases synthesis of extracellular matrix proteins via activation of matrix metalloproteinase-2(MMP-2), which hydrolyzes the transforming growth factor-ß1 (TGF-ß1) precursor to form active TGF-ß1. Administration of RR-11a markedly attenuated pancreatic fibrosis in mice with CP. Deficiency or inhibition of legumain significantly reduces the severity of pancreatic fibrosis by suppressing activation of the TGF-ß1 precursor. Our results highlight the potential of legumain as a novel therapeutic target for CP. KEY MESSAGES: ⢠Legumain expression was markedly upregulated in CP mice. ⢠Deletion of legumain attenuated pancreatic fibrosis in CP mice. ⢠Legumain promotes fibrosis via MMP-2 activation, which hydrolyzed the TGF-ß1 precursor to the active form. ⢠Legumain is a potential therapeutic target for the management of CP.
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Cisteína Endopeptidases/genética , Suscetibilidade a Doenças , Pancreatite Crônica/etiologia , Pancreatite Crônica/metabolismo , Fator de Crescimento Transformador beta1/metabolismo , Animais , Biomarcadores , Cisteína Endopeptidases/metabolismo , Modelos Animais de Doenças , Fibrose , Imunofluorescência , Regulação da Expressão Gênica , Imunofenotipagem , Macrófagos/metabolismo , Macrófagos/patologia , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Camundongos , Camundongos Knockout , Camundongos Transgênicos , Modelos Biológicos , Pancreatite Crônica/patologiaRESUMO
This study was designed to investigate the biocompatibility and the degradation behavior of a Zn-3Cu alloy, a Zn-3Cu coating alloy, a Mg-Nd-Zn-Zr (denoted as JDBM) alloy and a JDBM coating alloy to choose the optimal alloy for common bile duct (CBD) surgery. In the in vitro degradation experiments, we observed the surface morphology of the samples and determined the elements of the corrosion products. In the in vitro cytotoxicity experiments, the cell morphology and cytotoxicity were observed and tested. In the in vivo experiments, in addition to analyzing the samples, we also analyzed the variations in serum magnesium, serum creatinine (CREA), blood urea nitrogen (BUN), total bilirubin (TB) and glutamic pyruvic transaminase (GPT). Moreover, important tissue samples from the CBD, liver, kidney and spleen were taken for histological evaluation. The in vitro degradation experiments revealed that the surface corrosion of the JDBM and JDBM coating alloys were more obvious than that of Zn-3Cu and Zn-3Cu coating alloys, and the degradation rate of the JDBM coating alloy was the slowest. The in vitro cytotoxicity assessment showed that the JDBM alloy and JDBM coating alloy extracts were biologically safe for L-929 cells, while the Zn-3Cu alloy and Zn-3Cu coating alloy extracts were harmful to L-929 cells. In the in vivo experiments, neither the JDBM alloy nor the JDBM coating alloy affected the function or morphology of the bile duct, liver, kidney or spleen. Similar to the in vitro degradation behavior, the surface corrosion of the JDBM alloy was more significant than that of the JDBM coating alloy. Our data suggested that the JDBM coating alloy is a safe, biodegradable material for CBD surgery.
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BACKGROUND/AIMS: Although endoscopic metal biliary endoprosthesis (EMBE) is widely accepted as the most suitable drainage method for patients with unresectable malignant obstruction, uncontrolled post-procedural cholangitis is still a problem. We aimed to validate a new treatment modality to prevent post-ERCP cholangitis in patients with unresectable cholangiocarcinoma. PATIENTS AND METHODS: A total of 378 patients who were diagnosed with unresectable malignant biliary obstruction and underwent EMBE or temporary endoscopic nasobiliary drainage (ENBD) following EMBE placement, from January 2010 to July 2016, were enrolled in this retrospective study. Incidence of cholangitis, related infectious indicators, success rate of biliary drainage, and occurrence of complications were evaluated. RESULTS: The risk of overall cholangitis and related infectious indicators was significantly lower in EMBE plus ENBD group than that in EMBE group. The occurrence of cholangitis was 2.4% versus 11.9% (P = 0.004). On further analysis of subgroups, although no difference was detected in nonhilar cholangiocarcinoma subgroup, the incidence of cholangitis and related infectious indicators in hilar cholangiocarcinoma subgroup with EMBE modality were distinctly higher than that with EMBE plus ENBD modality (type I + II was 18.5% vs 0%, P < 0.05; type III + IV was 19.8% vs 3.8%, P < 0.05). No significant difference was found in successful biliary drainage rate and procedure-related complications when all subgroups were compared. CONCLUSIONS: The temporary placement of ENBD following EMBE is a simple and effective treatment modality to prevent post-ERCP cholangitis, especially in patients with hilar cholangiocarcinoma.
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Colangiocarcinoma/diagnóstico por imagem , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colangite/prevenção & controle , Drenagem/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Colangiocarcinoma/complicações , Colangiocarcinoma/patologia , Colangiocarcinoma/cirurgia , Colangite/epidemiologia , Feminino , Humanos , Incidência , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Stents/efeitos adversosRESUMO
Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant cancer that lacks effective targets for therapy. Alteration of epidermal growth factor (EGF) expression has been recognized as an essential molecular event in pancreatic carcinogenesis. Accumulating studies have demonstrated that miRNAs play critical roles in EGF signaling regulation, tumor initiation, cell proliferation and apoptosis. Here, we demonstrated that miR-21 expression was induced by EGF in pancreatic cancer cells. miR-21 promoted EGF-induced proliferation, inhibited cell apoptosis and accelerated cell cycle progression. In vivo experiments confirmed the influence of miR-21 on tumor growth. Mechanistic studies revealed that miR-21 targeted MAPK/ERK and PI3K/AKT signaling pathways to modulate cell proliferation. In addition, Spry2 was proven to be a target of miR-21. Furthermore, miR-21 and Spry2 were significantly related to clinical features and may be valuable predictors of PDAC patient prognosis.
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Adenocarcinoma/genética , Carcinoma Ductal Pancreático/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , Proteínas de Membrana/genética , MicroRNAs/genética , Adenocarcinoma/patologia , Idoso , Animais , Apoptose/genética , Carcinogênese/genética , Carcinoma Ductal Pancreático/patologia , Ciclo Celular/genética , Movimento Celular/genética , Proliferação de Células/genética , Intervalo Livre de Doença , Fator de Crescimento Epidérmico/genética , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Xenoenxertos , Humanos , Estimativa de Kaplan-Meier , Masculino , Camundongos , Pessoa de Meia-Idade , Fosfatidilinositol 3-Quinases/genética , Proteínas Proto-Oncogênicas c-akt/genética , Transdução de Sinais/genéticaRESUMO
BACKGROUND: Endoscopic ultrasonography-guided drainage has been established as a good treatment modality in the management of walled-off pancreatic necrosis, but the unmanageable infection of postoperation is still a thorny problem due to the poor drainage ability for solid necrotic debris only through transmural stent and nasocystic catheter. AIMS: Introduce a novel therapeutic method, namely endoscopic ultrasonography-guided drainage combined with cyclic irrigation technique in managing patients with walled-off pancreatic necrosis. METHODS: 18 patients with severe acute pancreatitis complicated with walled-off pancreatic necrosis received treatment with endoscopic ultrasonography-guided drainage combined with cyclic irrigation were involved in this retrospective study. RESULTS: 17 of 18 patients with walled-off pancreatic necrosis were treated by this new therapeutic method. Subsequent surgery was performed in 1 case due to uncontrolled infection, complications such as perforation, bleeding or multiple organ failure were not observed. Treatment success rate was high (16 in 17, 94.12%). CONCLUSION: Endoscopic ultrasonography-guided drainage combined with cyclic irrigation is an effective treatment option for symptomatic walled-off pancreatic necrosis to facilitate drainage and obviate the need for subsequent surgery or endoscopic necrosectomy.