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Objective:To investigate the clinical manifestations ,diagnosis and treatment of autoimmune pancreatitis (AIP).Methods:The clinical data of 17 AIP patients admitted at the First Affiliated Hospital of Soochow University from Apr 2021 to Jan 2023 were retrospectively analyzed.Results:Among the 17 AIP patients, 12 were male (70.6%). Ten complained abdominal pain (58.8%), and 8 had jaundice (47.1%). Fifteen patients had elevated IgG4 levels more than twice the normal value (88.2%), and 14 patients had elevated liver enzymes (82.3%). The imaging manifestations of 17 patients were all diffuse or limited enlargement of the pancreas. All patients had diffuse or limited enlargement of the pancreas, some were accompanied by a dilatation of the pancreatic duct or bile duct. Fourteen patients were diagnosed by combining the clinical manifestations, imaging examination, laboratory examination, and puncture pathology, and in 3 cases the diagnosis was confirmed by postoperative pathology. Fourteen patients showed significant improvement in clinical symptoms and imaging manifestations after hormone therapy, 2 patients stopped hormone medication on their own after the improvement of the imaging, and 1 suffered recurrence,which was responsible to hormone readministration.Conclusions:AIP, as a rare and easily misdiagnosed immune disease, involves the pancreas leading to an inflammatory response and often encroaches peri-pancreatic areas such as the bile ducts, causing biliary stenosis and jaundice. Most patients respond well to glucocorticoid therapy and surgery was usually not indicated in those with definite AIP diagnosis.
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Objective:To study factors associated with postoperative acute pancreatitis (POAP) in patients following pancreaticoduodenectomy.Methods:This retrospective analysis included 60 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Soochow University from Jan 2020 to Aug 2021. Enhanced computed tomography was used to identify POAP during postoperative period of 4 to 9 days. Univariate analysis and multivariate analysis were used to find out the risk factors of POAP.Results:Of the 60 patients, 13 cases (21.7%) developed POAP. The incidence of clinically related pancreatic fistula with abdominal abscess (76.9% vs.19.1%, χ2=15.71, P<0.000 1), postoperative hospital stay (26 d vs. 18 d, U=141.5, P=0.002 5) and the severity of complications (Clavien-Dindo grade≥Ⅲ: 53.8% vs. 21.3%, χ2=5.32, P=0.02) were significantly higher in the POAP group. But there was no significant deviation between the two groups when it comes to the severe post pancreatectomy delayed hemorrhage (7.7% vs. 0, χ2=3.68, P=0.06) and the delayed gastric emptying (30.8% vs. 21.3%, χ2=0.51, P=0.47). In the univariate analysis, patients with higher body mass index ( P=0.000 3), smaller main pancreatic duct diameter ( P<0.000 1) and softer texture of the pancreas ( P=0.009) were more likely to develop POAP after pancreaticoduodenectomy. In the multivariate analysis, the pancreatic duct diameter≤2 mm ( OR=0.005,95% CI 0.000 06-0.44, P=0.020), the softer texture of pancreas ( OR=0.005, 95% CI 0.000 04-0.47, P=0.023) were risk factors for POAP. Conclusions:Patients with postoperative acute pancreatitis increased the incidence of pancreatic fistula complicating abdominal abscess.Small caliber pancreatic tube, soft texture of pancreas were risk factors of POAP.
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Objective To investigate the expression and clinical significance of migration inhibitory factor ( MIF) and matrix metalloproteinase-9(MMP-9) in human gastric cancer tissue and corresponding adjacent normal tissue. Methods Selected surgery and pathologically confirmed 80 cases of gastric cancer as the experimental group, took another 80 cases of corresponding adjacent tissues as a control group. The expressions of MIF and MMP-9 were de-tected in 80 cases of gastric cancer patients cancer tissue and corresponding adjacent normal tissue by immunohisto-chemical SP method. Results ①The expression of MIF and MMP-9 of gastric cancer in varying degrees:The pos-itive rates of MIF and MMP-9 were 68. 8% and 67. 5%,which were higher than that in adjacent normal tissues, 32. 5% and 37.5% (P <0.05);② The expression of MIF was significantly associated with the clinical stage, depth of invasion,degree of differentiation,lymph node metastasis and TNM staging (P<0.05), nothing to do with other clinicopathological parameters;the expression of MMP-9 was significantly associated with the depth of inva-sion,degree of differentiation, lymph node metastasis and TNM staging (P<0.05), nothing to do with other clini-copathological parameters;③ There was positive correlation between the expression of MIF and MMP-9 in gastric cancer tissue (χ2 =9. 154, P<0. 01,r=0.338). Conclusion The expressions of MIF and MMP-9 show a posi-tive expression in gastric carcinoma, there maybe have a positive correlation between MIF and MMP-9. Their ex-pressions of varying degrees are closely related with the occurrence and development of gastric cancer, guidance gastric diagnosis, treatment and prognosis.