Preliminary Study on Prognostic Factors of New-onset Diabetes Mellitus After Distal Pancreatectomy for Pancreatic Cystic Tumor / 中国微创外科杂志

Objective To explore the prognostic factors of new-onset diabetes mellitus(NODM)in patients with pancreatic cystic tumor after distal pancreatectomy(DP).Methods Between January 2010 and December 2019,92 patients with cystic pancreatic tumors in our hospital underwent laparoscopic DP.According to the inclusion and exclusion criteria,a total of 74 cases were included and divided into NODM group or normal glucose metabolism group based on whether postoperative NODM occurred.A univariate analysis was used to evaluate the prognostic factors of laparoscopic DP for pancreatic cystic tumors.P<0.05 was considered statistically significant,OR>4 was considered as a potential prognostic factor of clinical significance for NODM.Results NODM was diagnosed in26 cases(35.1%),with a median diagnosis time of 9 months(range,3-56 months)after surgery.Univariate analysis showed that transecting pancreas in the neck(OR = 11.000,P = 0.000),BMI≥25.0(OR = 4.333,P = 0.007),and family history of diabetes mellitus(OR =5.000,P =0.004)were prognostic factors of postoperative NODM.Conclusions When performing DP for pancreatic cystic tumors,it is advisable to preserve as much pancreatic tissue as possible and avoid cutting off the pancreas in the neck.Precise postoperative strategy of glucose metabolism surveillance for patients with BMI≥25.0 and family history of diabetes mellitus should be promoted.

Clinical impact of neoadjuvant chemotherapy on different types of borderline resectable pancreatic cancer / 中华普通外科杂志

Objective:To investigate the clinical effects of neoadjuvant chemotherapy on different types of borderline resectable pancreatic cancer.Methods:The clinical data of 46 patients with borderline resectable pancreatic cancer admitted to Peking University Third Hospital from Jan 2017 to Aug 2021 were retrospectively analyzed, including 26 with arterial borderline resectable pancreatic cancer (ABRPC) and 20 with venous borderline resectable pancreatic cancer (VBRPC). Eighteen patients of VBRPC and 15 patients of ABRPC were then successfully received surgical resection.Results:After neoadjuvant chemotherapy, CA19-9 levels decreased significantly ( P<0.05), while other indicators were not statistically different ( P>0.05). Compared with the non-surgical group, the diameter of the tumour was significantly reduced after neoadjuvant chemotherapy ( P<0.05). The surgical resection rate of 90.0% in the VBRPC group was higher than that of 57.7% in the ABRPC group ( P=0.037). Conclusions:Patients with significantly tumour progress after neoadjuvant chemotherapy are difficult to benefit from neoadjuvant chemotherapy; Venous borderline resectable pancreatic cancer patients had a higher surgical resection rate than those with ABRPC after neoadjuvant chemotherapy.

Application of targeted therapy and immunotherapy in adjuvant and neoadjuvant therapy of hepatocellular carcinoma / 国际外科学杂志

There are significant differences between eastern and western guidelines for the treatment of hepatocellular carcinoma, and the treatment of advanced liver cancer is still a major challenge. With the development of systematic therapy for hepatocellular carcinoma, these drugs have gradually moved from clinical trials to clinical practice, from second-line to first-line treatment. Up to now, we have entered the era of targeted therapy combined with immunotherapy, which provided us with new strategies for adjuvant; neoadjuvant and conversion therapy in the treatment of hepatocellular carcinoma. Hepatocellular carcinoma has a very high recurrence rate after operation. At present, there is no effective postoperative adjuvant therapy strategy to reduce recurrence. With the promoting of clinical trials, application of adjuvant therapy in selected patients based on the risk of recurrence may be the future research directions. For neoadjuvant therapy and conversion therapy, the most urgent issue may be the controversial criteria. Through further basic and clinical research, precise and individualized targeted therapy and immunotherapy for hepatocellular carcinoma is the future development direction.

Comparison of the detection rates of colorectal cancer liver metastasis using different MRI sequences and enhanced CT / 中华肝胆外科杂志

Objective:To study the detection rates of using different MRI sequences and enhanced CT in colorectal cancer liver metastasis (CRLM).Methods:The imaging data of CRLM patients who were treated at Peking University Third Hospital from March 2018 to September 2021 were retrospectively analyzed. Sixty-six CRLM lesions with a maximum diameter ≤10 mm were selected. Different MRI sequences such as T 1 weighted imaging (T 1WI), T 2 weighted imaging (T 2WI), diffusion weighted imaging (DWI), dynamic enhanced phase of MRI (MR-Dyn), gadolinium-etoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), enhanced hepatobiliary phase of MRI (HBP) and CT enhancement phase (CT-Dyn) were reviewed independently to determine whether the target lesions were detected. The pathological results were used as the gold standard. Paired chi-square test was used to compare the detection rate of CRLM in each group. Results:Among the 66 liver metastases, 15, 31, 55, 21, 56 and 20 were detected by T 1WI, T 2WI, DWI, MR-Dyn, HBP and CT-Dyn, respectively. Their detection rates were 22.7%, 47.0%, 83.3%, 31.8%, 84.8% and 30.3%, respectively. The detection rates of HBP and DWI were higher than those of T 2WI, MR-Dyn, CT-Dyn and T 1WI, respectively (all P<0.05). The detection rate of T 2WI was higher than that of MR-Dyn, CT-Dyn and T 1WI (all P<0.05). The detection efficiencies of non-contrast MRI and Gd-EOB-DTPA enhanced MRI for CRLM were highly consistent ( Kappa=0.745). Conclusions:The detection rates of HBP, DWI and T 2WI for CRLM were high. Non-contrast MRI could replace Gd-EOB-DTPA enhanced MRI for detection of large CRLM.

Laparoscopic simultaneous resection of synchronous colorectal cancer liver metastases / 中华肝胆外科杂志

Objective:This research was designed to investigate the safety and efficiency of laparoscopic simultaneous resection in the treatment of synchronous colorectal cancer liver metastases (sCRLM).Methods:From January 2009 to December 2019, 121 patients diagnosed as sCRLM received radical resection in Peking University Third Hospital were included in the research. According to the surgery approaches, the patients were divided into laparoscopic surgery group and open surgery group. Statistical analysis of general patient data, surgical data, postoperative complications and follow-up of the two groups of patients.Results:There were 79 cases in the laparoscopic surgery group including 30 females and 49 males, and the average age was 61.5 years. There were 42 cases in the open surgery group including 15 females and 27 males, and the average age was 63.2 years. There were no significant differences in the preoperative demographic characteristics, the location of primary tumor, gene status, the size of liver metastases, the proportion of multiple liver metastases, the level of tumor markers and the proportion of neoadjuvant chemotherapy between laparoscopic surgery group and the open surgery group ( P>0.05). The complication rate was 15.2% (12/79) in the laparoscopic surgery group and 23.8% (10/42) in the open surgery group. There were no significant differences between the two groups ( P>0.05). The 3-year and 5-year survival rates in laparoscopic surgery group were 52.9% and 44.4%, which were 42.5% and 23.0% respectively in open surgery group. There were no significant differences between the two groups ( P>0.05). The 1-year and 3-year disease-free survival rate in laparoscopic surgery group were 50.6% and 41.2%, which were 44.7% and 19.4% respectively in open surgery group. There were no significant differences between the two groups ( P>0.05). Conclusions:Laparoscopic simultaneous resection was safe and feasible for patients with sCRLM. Comparing with the open surgery, the laparoscopic surgeries had similar incidence of perioperative complications and long-term oncological efficiency.

Surgical experience on Roux-en-Y pancreaticojejunostomy after local pancreatic head resection for benign tumors of the pancreatic head / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the value of Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in treating benign tumors of pancreatic head (BTPH).</p><p><b>METHODS</b>The clinical data of 12 patients diagnosed as BTPH and treated by Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in Department of General Surgery, Peking University Third Hospital from November 2006 to October 2013 were retrospectively analyzed.Of the 12 cases, 5 patients were male, 7 patients were female, the age of patients ranged from 21 to 64 years(average 42.3 years). Diameter of tumors was 3.0-4.8 cm.Diameter of pancreatic wound after resection was 5.1-7.9 cm, and main pancreatic duct injury happened in 1 case.</p><p><b>RESULTS</b>Two cases of mucinous cystadenoma, 2 insulinoma, 3 solid pseudopapillary tumor and 4 nonfunctional pancreatic neuroendocrine tumors were confirmed histopathologically.No mortality and pancreatic leakage occurred during the perioperative period.All the 12 patients had no sign of recurrence.Experienced good life quality without occurrence of diabetes during the follow-up period of 24-108 months(more than 60 months in 4 cases).</p><p><b>CONCLUSIONS</b>Roux-en-Y pancreaticojejunostomy after local pancreatic head resection is a reasonable choice for benign tumors of the pancreatic head as long as the patient is properly selected.</p>

Data analysis of 36 cases with intraductal papillary mucinous neoplasm of the pancreas for their clinicopathological features, diagnosis, and treatment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intraductal papillary mucinous neoplasm (IPMN) is a rare pancreatic cystic neoplasm, accounting for 1% of all exocrine pancreatic neoplasms. This study aimed to summarize the clinicopathological and biological behaviors, as well as the experience in diagnosis and treatment of IPMN.</p><p><b>METHODS</b>Clinicopathological data were collected from 36 cases with IPMN who were treated in Department of General Surgery, Peking University Third Hospital from May 2001 to July 2011.</p><p><b>RESULTS</b>The 36 cases of IPMN patients included 27 males and 9 females (M:F = 3:1). The age of patients ranged from 52 to 78 years, with an average of 67.3 years. Regarding tumor location, 20 tumors were located in pancreatic head, 3 in pancreatic neck, 10 in pancreatic body and tail, and 3 in the whole pancreas. All the 36 cases underwent surgical treatment, with 13 cases of pancreaticoduodenectomy, 3 cases of middle pancreatectomy, 7 cases of tumor resection plus pancreaticojejunostomy, 3 cases of distal pancreatectomy, 7 cases of distal pancreatectomy plus spleen resection, and 3 cases of total pancreaticoduodenectomy. Of the 36 patients, 9 patients underwent the operations under laparoscopy. The 36 cases included main duct type (14 cases, 38.9%), branch duct type (10 cases, 27.7%), and mixed duct type (12 cases, 33.3%). Pathologically, of the 36 cases, there were 7 IPMN adenomas, 11 borderline IPMNs, 6 IPMN with carcinomas in situ, and 12 IPMNs with invasive carcinomas. All the 36 cases were followed up. During an average of 42 months follow-up period (26-129 months), no recurrence occurred.</p><p><b>CONCLUSIONS</b>IPMN, which primarily occurs in male, is a low-grade malignancy which may involve any part of the pancreas, with specific clinicopathological features. IPMN is a different malignancy type from pancreatic ductal carcinoma. Imaging and laboratory examination are helpful for the diagnosis and differential diagnosis. The prediction of invasive IPMN is still difficult. Surgical resection is recommended as the first choice of treatment. Aggressive and proper operation procedure produces better prognosis. Long-term follow-up is necessary for patients after operation. Laparoscopic distal pancreatectomy is a feasible and safe procedure for the indicated patients.</p>

Analysis of risk factors affecting the prognosis of pancreatic neuroendocrine tumors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pancreatic neuroendocrine tumors (pNETs) are a type of tumors with the characteristics of easy metastasis and recurrence. Till date, the risk factors affecting the prognosis are still in the debate. In this study, several risk factors will be discussed combined with our cases and experience.</p><p><b>METHODS</b>Thirty-three patients diagnosed as pNETs were enrolled and the clinical features, blood tests, pathological features, surgical treatment, and follow-up data of these patients were collected and analyzed.</p><p><b>RESULTS</b>In this study, operation time of G3 cases was longer than G1/G2 cases (P = 0.017). The elevated level of tumor markers such as AFP, CEA, Ca125, and Ca19-9 may predict easier metastasis, earlier recurrence, and poor prognosis (P = 0.007). The presence of cancer embolus and nerve invasion increases along with the TNM stage (P = 0.037 and P = 0.040), and the incidence of positive surgical margin increased (P = 0.007). When the presence of nerve invasion occurs, the chance of cancer embolus and lymph node metastasis also increases (P = 0.016 and P = 0.026).</p><p><b>CONCLUSIONS</b>pNETs were tumors with the features of easy recurrence and metastasis and many risk factors could affect its prognosis such as the elevated levels of tumor markers and the presence of nerve invasion, except some recognized risk factors. If one or more of these factors existed, postoperative treatments may be needed to improve prognosis.</p>

Thoracoscopic hepatectomy for hepatic carcinoma in 3 cases / 中华普通外科杂志

Objective To study the safety,feasibility and efficacy of thoracoscopic hepatectomy for liver carcinoma. Methods Thoracoscopic hepatectomy was performed in 3 cases with single liver neoplasm from 2007 to 2011,including hepatocellular carcinoma ( HCC ) in one case and metastatic liver cancer in 2 cases.By preoperative imaging the tumor was located accurately to simulate the port position in operation.Patients were placed in a left lateral decubitus position,and 3 ports were inserted into the chest wall surrounding the tumor. Through the use of intra-operative thoracoscopic uhrasonography (IOTU),the diaphragm just above the tumor was opened.IOTU was performed on the liver surface and the resection line was marked.Throughout the course of parenchymal transection,IOTU was performed repeatedly to guide the resection line,and ensure the complete removal of the tumor.After meticulous hemostasis of the resection surface,the diaphragm was closed. A thoracic drain was left. Results Thoracoscopic hepatectomy succeeded in all 3 cases,the median total operating time was 150 min (110 -210 min),and the medianblood loss was 297 ml (130 -600 ml). Patients recovered quickly and had no major post-operative complications.During 9 to 42 months' follow-up,one patients died of other cause,no relapse of the diseases was found. Conclusions Thoracoscopic hepatectomy is a safe and feasible operation in selected patients and has advantages in post-operative morbidity and in hospital time.

Expression of Neuroglobin Gene in Hypoxic-ischemic Brain Injury of Newborn Rat / 中华围产医学杂志

Objective To investigate the expression and change of neuroglobin (NGB) gene on hypoxic-ischemic brain injury. Methods Fourty-eight wistar rats of 7days old were divided into 6 groups randomly. Five study groups, study (1 min), study (5 min), study (15 min), study (30 min), study (60 min), and control group. The brain tissues were taken at 1 min, 5 min, 15 min, 30 min and 60 min after brain hypoxic-ischemia injury, and nucleic and immunohistochemistry method were used. One-way method of Stata soft-bage was used for statistics. Results There were time-depended pattern of the expression of NGB gene. It increased rapidly at 1 min after ischemia (A:1.236), there was significant difference from control group (A:0.641; P

EXPRESSION OF fos IN NEURON OF HANTAAN VIRUS INFECTION / 解放军医学杂志

Cortical neurons of mouse embryo were cultured for 7 days.The infection group was co cultured with HTNV(A9 strain) and the control group with devitalized HTNV(A9 strain) for 4h.Both groups were divided randomly into 9 subgroups acccording to different time points.The expression of fos gene was stained with immunohistochemistry.The resulfs showed that cell nuclei of neurons in the infection group displaying a purple blue color.At o,1,2,3,and 4h after infection,the expression rates of fos positive cells were 50 0%( P

A novel strategy for subtracting high-abundance proteins in human milk by immunoaffinity chromatography / 解放军医学杂志

Objective To establish and evaluate a novel method for subtracting high-abundance proteins in order to enrich low abundance proteins in human milk, with the aim of discovering important bioactive factors by proteomics approach in the future. Methods The whole proteins in human milk were used as immunogens to prepare polyclonal antibody, and the high-abundance proteins were subtracted by immunoaffinity chromatography. The effect was subsequently evaluated by immunoblotting. Results Anti-human milk polyclonal antibody was successfully prepared following routine method. After immunoaffinity chromatography analysis, four kinds of high-abundance proteins in human milk were removed. Conclusions These data indicated that the anti-human milk polyclonal antibodies prepared by whole protein samples were available for the removal of high-abundance proteins and enriching low abundance proteins of the samples. Accordingly, this method could also be used in detecting low abundance proteins in sample such as serum.

THE LOCALIZATION OF NGB mRNA IN ADULT RAT BRAIN / 解剖学报

Objective In order to explore the localization of NGB mRNA in adult rat brain. Methods In the present study,the localization of NGB mRNA in brain of the adult rat was examined by in situ hybridization histochemistry using digoxigenin labelled cRNA probes. Results Transcripts of NGB mRNA were showed to be widely distributed throughout the adult rat brain,including cerebral cortex,hippocampus,thalamus,hypothalamus,cerebellum and olfactory bulb.Conclusion\ Our result suggested that NGB gene might play an important role in the central nervous system,possibly related to the oxygen supply of the neuron.

Transient Expression of Hantaan Virus S segment Gene Coding region in vitro of Vero-E6 cells / 中国病毒学

The coding region of S genome segment of Hantaan virus (76/118 strain) was inserted into the eukarytic expression plasmidpVR1012. The recombinant expression plasmid pVRS22 was constructed. Vero-E6 cells were transiently transfected in vitro with pVRS22 plasmid. The transient expression of Hantaan virus nucleocapsid proteins in Vero-E6 cells was detected by indirect immunofluorescence assay (IFA) with monoclonal antibody 5H5 against Hantaan virus.