[Diagnostic value of lipoprotein-associated phospholipase A2 in OPBR combined with gallbladder cholesterol deposition].

Objective: To study the diagnostic value of lipoprotein-associated phospholipase A2(LP-PL-A2) in occult pancreaticobiliary reflux(OPBR) combined with gallbladder cholesterol deposition. Methods: This was a case-control study. Forty-six patients with OPBR who underwent gallbladder surgery at Shanghai East Hospital from December 2020 to October 2021, with gallbladder cholesterol deposition as the case group and the remainder as the control group, were included for analysis of their clinical data. Results: There were 21 cases in the case group, with 10 males and 11 females, and aged (57±12) years; 25 cases in the control group, with 11 males and 14 females, and aged (56±10) years. Serum LP-PL-A2 [(551.62±128.69) U/L] was significantly higher in the case group than in the control group [(436.70±135.88) U/L] (t=-2.80,P<0.01).Univariate analysis showed that LP-PL-A2 was a risk factor for OPBR combined with gallbladder cholesterol deposition, OR(95%CI):1.007(1.002-1.012), P=0.011. The area under the receiver operating characteristic curve (ROC) curve was 0.742, P=0.005. Conclusion: LP-PL-A2 is of diagnostic value in OPBR combined with gallbladder cholesterol deposition.

[Clinical analysis of the correlation between gallbladder adenomyomatosis and occult pancreaticobiliary reflux].

Objective: To explore the association between gallbladder adenomyomatosis (GA) and occult pancreaticobiliary reflux (OPBR). Methods: A total of 81 patients with GA who underwent cholecystectomy in Shanghai East Hospital from December 2020 to January 2022 were enrolled, including 48 cases of fundal type, 28 cases of segmental type and 5 cases of diffuse type. Patient's intraoperative bile was coltected and tested for amylase. According to gallbladder bile amylase level, patients were divided into OPBR group (bile amylase>110 U/L) and the control group (bile amylase≤110 U/L). Results: Among 81 patients, 32 were male and 49 were female, and aged (49.1±13.2) years; there were 66 cases in control group, including 27 males and 39 females, and aged (50.0±12.9)years; there were 15 patients in the OPBR group, including 5 males and 10 females, and aged (45.1±14.2) years. In terms of the clinical features of the two groups, there was no significant difference (all P>0.05), except for a significant increase in biliary amylase in the OPBR group compared with the control group (P<0.001). However, the incidence of OPBR was significantly different in the three types of GA, with a lower incidence of OPBR in the fundal type (10.4%, 5/48) than in the segmental type (28.6%, 8/28) and diffuse type (2/5) (P=0.038). In addition, segmental GA was more likely to be combined with gallbladder stones (85.7%, 24/28) than fundal GA (58.3%, 28/48) and diffuse GA (3/5) (P=0.031). Univariate and multivariate logistic regression analyses showed OPBR [OR (95%CI)=3.410 (1.010 to 11.513), P=0.048] and combined gallbladder stones [OR (95%CI)=2.974 (1.011 to 8.745), P=0.048] indepenclently correlated with segmental and diffuse GA. Conclusions: The incidence of OPBR is higher in segmental and diffuse GA, and gallstones and OPBR are independently associated with the occurrence of segmental and diffuse GA. These results suggest that OPBR may be the initiating factor for the occurrence and carcinogenesis of segmental and diffuse GA.

Clinical significance of lncRNA MIR31HG in melanoma.

OBJECTIVE: The aim of this study was to explore the expression of long non-coding RNA (lncRNA) MIR31HG in malignant melanoma (MM), and to investigate its clinical significance. PATIENTS AND METHODS: The quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to detect the expression of lncRNA MIR31HG in MM tissues and cells. The relationship between lncRNA MIR31HG expression and the clinicopathological characteristics was analyzed. Furthermore, the cell counting kit-8 (CCK-8) and the transwell assays were performed to assess the effect of MIR31HG on cell proliferation and metastasis in vitro, respectively. RESULTS: The expression of MIR31HG was significantly upregulated in MM tissues and cells. To explore the relationship between MIR31HG expression and clinical features, the patients were divided into two groups according to the mean expression of MIR31HG, including high expression group and low expression group. The subsequent results indicated that MIR31HG expression was correlated with lymph nodes metastasis, distal metastasis, and TNM stage. The multivariate analysis indicated that a high expression of MIR31HG could be used as an independent prognostic factor for MM. MIR31HG low-expression cells were constructed in vitro. Compared with the control cells, the cells with low expression of MIR31HG showed significantly low malignancy, including decreased cell proliferation rate and migration and invasion rates. CONCLUSIONS: LncRNA MIR31HG was a novel factor involved in MM progression, which could be used as a potential biomarker and therapeutic target for MM.

Mucinous pancreatic ductal ectasia of latent malignancy: an emerging clinicopathologic entity.

The natural history of classic mucinous cystic neoplasms of the pancreas has been previously defined. In this report, an unusual variant of a pancreatic mucinous cystic neoplasm, termed "mucinous pancreatic duct ectasia of latent malignancy," is described. The lesion is characterized by massive dilatation of the main pancreatic duct and its tributaries. Histologically, the ducts are lined by epithelium, which is indistinguishable from the classic mucinous cystic neoplasms. Until the natural history of classic mucinous cystic neoplasm is better documented, resection appears to be the treatment of choice.

Choledochoscopy in management of retained biliary stones and recurrent lesions.

Postoperative choledochofiberscopy was performed in 188 patients with retained biliary stones and recurrent lesions. The following entrances to the biliary tract for choledochoscopy were used: the T-tube tract (129 patients), an afferent jejunal limb of a choledochojejunostomy (43), the jejunostomy tube tract of an efferent limb (12), an U-tube tract (2), and a ductal fistula after segmental liver resection (2). 380 choledochoscopic sessions were carried out, 2 sessions on the average for each patient. The overall success rate of stone removal was 90.5%. No mortality was related to this procedure. Eleven patients developed fever and chills after manipulations but all responded to antibiotics. Two patients had perforation of the T-tube tract during the removal of stones and were reoperated on for abdominal drainage. They recovered eventually. Stone extraction with a flexible choledochoscope is a proven procedure. For residual intrahepatic stones, however, a satisfactory entrance into the biliary tree should be provided for subsequent stone removals. We believe that the jejunostomy tube tract of an efferent limb of an afferent jejunal limb of a choledochojejunostomy is a useful entrance for choledochoscopy because it is permanent in meeting therapeutic demands.

[Observations on the function of Oddi's sphincter in patients with primary bile duct stones].

We recorded the pressure of Oddi's sphincter (SO) in 54 patients with gall stones and 25 patients as controls who had no biliary disease. Endoscopic manometry used in this study recorded the dynamic changes of the intraluminal pressure of SO as well as the static pressure of the common bile duct. It was found that in control group, common bile duct pressure was 1.54 +/- 0.15 kPa, basic pressure of SO 2.12 +/- 0.22 kPa, SO-bile duct pressure difference 0.58 +/- 0.07 kPa, and SO peak pressure 5.56 +/- 0.47 kPa, respectively. There was no significant difference between patients with gallbladder stones and secondary cholelithiasis and those in control group. But the pressure of SO was significantly lower in patients with primary bile duct stones than that in controls. This phenomenon indicates that in such patients the contraction strength of SO is weak or lost. This may explain retrograde cholangitis often seen in some patients. We suggest that in order to prevent retrograde cholangitis, adequate procedure should be taken in operation on patients with functional impairment of SO.