Early Predictors of Infected Pancreatic Necrosis in Severe Acute Pancreatitis: Implications of Neutrophil to Lymphocyte Ratio, Blood Procalcitonin Concentration, and Modified CT Severity Index.

BACKGROUND: Infected pancreatic necrosis (IPN) accounts for 30% mortality in severe acute pancreatitis (SAP). Early prediction of IPN occurrence is critical for prophylactic measures to be taken. This study aimed to evaluate the predicting value for IPN of combined markers at early stages of SAP. METHODS: The clinical records of 324 SAP patients admitted within 48 h after disease onset were retrospectively analyzed. As potential predictors, the neutrophil to lymphocyte ratio (NLR), blood procalcitonin (PCT) concentration on the 1st, 4th, and 7th day post admission, as well as modified computerized tomography severity index (MCTSI) on the 5-7th day post admission, were extracted. Correlations between these features with IPN were analyzed using logistic regression, and predictive values were estimated using the receiver operating characteristic curve analyses. RESULTS: NLR, PCT, body mass index, and MCTSI were significantly higher in the IPN group (p < 0.001) compared to the control, among which NLR, PCT, and MCTSI were identified as independent predictors for IPN in logistic regression model. Combination of these parameters yielded significant predicting values with an area under curve of 0.92, sensitivity of 97.2%, and specificity of 77.2% in receiver operating characteristic curve analysis. CONCLUSION: Combination of NLR, PCT, MCTSI might facilitate the prediction of IPN occurrence in SAP patients.

Preparation of an aptamer based organic-inorganic hybrid monolithic column with gold nanoparticles as an intermediary for the enrichment of proteins.

A novel strategy for the preparation of an aptamer based organic-inorganic hybrid affinity monolithic column was developed successfully using gold nanoparticles (GNPs) as an intermediary for a sandwich structure to realize the functional modification of the surface of the monolithic matrix. This monolithic matrix was facilely pre-synthesized via one-step co-condensation. Due to the high surface-to-volume ratio of GNPs and the large specific surface area of the hybrid matrix, the average coverage density of aptamers on the hybrid monolith reached 342 pmol µL(-1). With the combination of an aptamer based hybrid affinity monolithic column and enzymatic chromogenic assay, the quantitation and detection limits of thrombin were as low as 5 nM and 2 nM, respectively. These results indicated that the GNPs attached monolith provided a novel technique to immobilize aptamers on an organic-inorganic hybrid monolith and it could be used to achieve highly selective recognition and determination of trace proteins.

Preparation of thiol- and amine-bifunctionalized hybrid monolithic column via "one-pot" and applications in speciation of inorganic arsenic.

A thiol- and amine-bifunctionalized organic-inorganic hybrid monolithic column was prepared for the first time via one-pot co-condensation of 3-mercaptopropyltrimethoxysilane, N-(2-aminoethyl)-3-aminopropyltriethoxysilane and tetraethylorthosilicate, and utilized for separation and enrichment of inorganic arsenic species. Various parameters of solid phase microextraction (SPME) operation and analytical performance were also investigated systematically. Under the optimum condition, both As(III) and As(V) can be adsorbed over a wide pH range (3.0-8.0) and eluted in turn, in which 3% HNO3 (v/v) was firstly used to selectively release As(V), and then 3% HNO3 with 0.01 mol L-1 KIO3 or 15% mercaptosuccinic acid (MSA) (m/v) to selectively release As(III). Meanwhile, the elution mechanism of As(III) and As(V) was elucidated comprehensively, and notably, the novel eluent, HNO3 + MSA, was recommended for eluting As(III). Therefore, the thiol- and amine-bifunctionalized organic-inorganic hybrid monolithic column as an ideal SPME matrix for the speciation analysis of arsenic in environmental waters has the merits of facile preparation, low cost, high adsorption capacity and selective desorption. In addition, compared with thiol- and amine-bifunctionalized mesoporous silica, the bifunctional hybrid monolith based SPME protocol with less time and reagent consumption is promising to be applied not only to filed sampling but also to on-line analysis.

Speciation analysis of chromium by carboxylic group functionalized mesoporous silica with inductively coupled plasma mass spectrometry.

Carboxyl-group functionalized mesoporous silica (CFMS) prepared by one-pot co-condensation method was employed for the solid phase extraction (SPE) of chromium species for the first time. A new approach of SPE coupled to inductively coupled plasma mass spectrometry (ICP-MS) was thus established for the speciation of chromium in environmental water samples. The influences of pH, volume of sample, extraction time, amount of adsorbent, elution conditions, co-existing ions and adsorption capacity were investigated on adsorption or elution of chromium species. Cr(VI) was not retained on the CFMS material in the pH range of 1.0-9.0, while Cr(III) was quantitatively adsorbed at pH 5.0-9.0. The captured Cr(III) was enriched by using 1.5 mol L-1 HNO3 as elution solvent and detected by ICP-MS. Under the optimized SPE conditions, the maximum adsorption capacity of the CFMS for Cr(III) was 57.67 mg g-1 and the enrichment factor was 25, with the detection limit (LOD) of 0.02 µg L-1. The proposed protocol has been successfully applied to chromium speciation in rain, lake and river water samples, which exhibited a prospect in field separation and enrichment of chromium species in environmental waters.

Effect of recombinant adenovirus vector mediated human interleukin-24 gene transfection on pancreatic carcinoma growth.

BACKGROUND: Pancreatic cancer is a highly malignant tumor affecting an ever increasing number of patients with a mean 5-year survival rate below 4%. Therefore, gene therapy for cancer has become a potential novel therapeutic modality. In this study we sought to determine the inhibitory effects of adenovirus-mediated human interleukin-24 (AdhIL-24) on pancreatic cancer. METHODS: Human interleukin-24 gene was cloned into replication-defective adenovirus specific for patu8988 tumor cells by virus recombination technology. Reverse transcription-polymerase chain reaction and Western blotting analysis were used to determine the expression of human interleukin-24 mRNA in patu8988 cells in vitro. Induction of apoptosis by overexpression of human interleukin-24 in patu8988 cells was determined by flow cytometry. In vivo efficacy of adenoviral delivery of human interleukin-24 was assessed in nude mice (n = 10 for each group) bearing patu8988 pancreatic cancer cell lines by determining inhibition of tumor growth, endothelial growth factor and CD34 expression, and intratumoral microvessel density (MVD). RESULTS: The recombinant adenovirus vector AdVGFP/IL-24 was constructed with a packaged recombinant retrovirus titer of 1.0 x 10(10) pfu/ml and successfully expressed of both mRNA and protein in patu8988 cells. The AdVGFP/IL-24 induced apoptosis of patu8988 tumor cells in vitro and significantly inhibited tumor growth in vivo (P < 0.05). The intratumoral MVD decreased significantly in the treated tumors (P < 0.05). CONCLUSION: The recombinant adenovirus AdGFP/IL-24 can effectively express biologically active human interleukin-24, which results in inhibition of pancreatic cancer growth.

Preparation and analytical application of novel thiol-functionalized solid extraction matrices: From mesoporous silica to hybrid monolithic capillary column.

A comprehensively comparative study of thiol-functionalized mesoporous silica and organic-inorganic hybrid monolithic column was reported, aiming at the separation and enrichment of inorganic arsenic. Thiol-functionalized mesoporous silica was synthesized based on the one-step co-condensation method. At the same time, a novel thiol-functionalized organic-inorganic hybrid monolithic column was synthesized using an unconventional ternary weak basic solvent system via one-step sol-gel process. The approach to prepare monolithic column through mild condition remarkably improved delamination phenomenon of thiol-functionalized hybrid monolithic column easily caused by conventional methods. As(III) can be selectively uptaken by the hybrid monolithic column and homemade syringe-based solid phase extraction device containing mesoporous silica through chelation in a wide range of pH, while As(V) cannot, and then the captured As(III) was eluted by 3% HNO3 (v/v) with 0.01 mol L-1 KIO3. Under the optimized conditions, the extraction recoveries were 91-102% and 93-103% for mesoporous silica and monolithic column, respectively. Although both two materials were ideal solid matrices for the removal and speciation analysis of As(III) in environmental waters, the monolith-based solid phase microextration protocol was more fast and reagent-saving than the other, which endued monolithic columns with more application prospects for trace elemental analysis and speciation. Even so, the exploration of mesoporous silica could efficiently pilot the synthesis of monolithic columns.

[Expression and diagnostic value of mesothelin in specimen of pancreas fine-needle aspiration].

OBJECTIVE: To investigate the expression of mesothelin in specimen of pancreas fine-needle aspiration and to evaluate the potential contribution of immunohistochemical labeling of mesothelin to the interpretation of pancreas fine-needle aspiration (FNA). METHODS: Specimens from 27 patients were selected for immunolabeling. Immunohistochemical EnVision method was used to detect the expression of mesothelin in specimen of pancreas fine-needle aspiration. The labeling in each patient was scored as positive or negative. These results were compared with the cytologic diagnosis and the follow-up data. RESULTS: Nineteen of the 27 patients were ultimately shown to have an adenocarcinoma, and 8 had no evidence of malignancy on follow-up. Initial cytologic diagnosis of malignancy correlated with carcinoma on follow-up in 10 of 10 cases, and initial benign cytologic diagnosis correlated with benign follow-up in 4 of 6 cases. Seven of the 11 patients with suspicious cytology were found to have carcinomas on follow-up. Mesothelin labeling was seen in 14 of the 19 patients ultimately shown to have carcinomas and was absent in 7 of the 8 benign lesions (sensitivity, 73.7%; specificity, 87.5%). Five of the 7 cytologically suspicious cases with malignant follow-up labeled for mesothelin. Positive mesothelin labeling was observed in one of the 4 suspicious cases who finally proved to be benign during follow-up. CONCLUSION: Immunohistochemical labeling for mesothelin may be a highly specific tool for the detection of pancreatic adenocarcinoma in FNA specimens and is useful in categorizing cytologically suspicious lesions.

Ampulla dilation with different sized balloons to remove common bile duct stones.

AIM: To assess the outcomes of ampulla dilation with different sized balloons to remove common bile duct (CBD) stones. METHODS: Patients (n = 208) were divided into five groups based on the largest CBD stone size of < 5, 6-8, 8-12, 12-14, and > 14 mm. Patients underwent limited endoscopic sphincterotomy (EST) alone or limited EST followed by endoscopic papillary balloon dilation with 8, 10, 12 and 14 mm balloons, such that the size of each balloon did not exceed the size of the CBD. Short- and long-term outcomes, such as post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, perforation, bleeding, and pneumobilia were compared among the five groups. RESULTS: The overall rate of successful stone removal in all groups was 100%, and all patients were cured. Eight (3.85%) patients had post-ERCP pancreatitis, none had perforations, and 6 (2.9%) had bleeding requiring transfusion. There were no significant differences in early complication rates among the five groups. We observed significant correlations between increased balloon size and the short- and long-term rates of post-ERCP pneumobilia. Post-ERCP pancreatitis and bleeding correlated significantly with age, with post-ERCP pancreatitis occurring more frequently in patients aged < 60 years, and bleeding occurring more frequently in patients aged > 70 years. We observed a significant correlation between patient age and the diameter of the largest CBD stone, with stones > 12 mm occurring more frequently in patients > 60 years old. CONCLUSION: Choosing a balloon size based on the largest stone diameter is safe and effective for removing CBD stones. Balloon size should not exceed 15 mm.