Octreotide acetate long-acting release in treatment of pancreatic neuroendocrine tumors

Pancreatic neuroendocrine tumours are uncommon neoplasms of the pancreas, accounting for around 2% of all primary pancreatic tumors. This specific group of tumours includes insulinoma, gastrinoma, glucagonoma, VIPoma, somatostatinoma and others. They may cause a clinical syndrome due to hormone overproduction. These tumours tend to be less aggressive than pancreatic adenocarcinoma, however, more than 50% of them have metastasized to the liver at the time of diagnosis. Under this circumstance, surgery is impossible to resect all metastases. Thus other various medical measures have been explored in the treatment of these tumors.     

Pancreatic and peri-pancreatic lesions mimic pancreatic islet

Objective  This pictorial review aimed to summarize the most possible differential diagnosis of pancreatic islet cell tumor (PICT).

Data sources  Data used in this review were mainly from Medline and Pubmed in English. And all clinical images in this review were from Department of Radiology, Peking Union Medical College Hospital, Beijing, China.

Study selection  Cases of pancreatic cystadenoma, solid pseudo-papillary tumor of the pancreas, pancreatic metastasis, pancreatic adenocarcinoma, para-pancreatic neuroendocrine tumors, Castleman disease, gastrointestinal stromal tumor, splenic artery aneurysm and accessory spleen were selected in this pictorial review for differential diagnosis of PICT.

Results  Careful analysis of imaging features and correlation with the clinical manifestations may allow a more specific diagnosis. It is also important that the radiologist is familiar with the anatomic variants and disease entities which mimic pancreatic islet cell tumor in order to avoid an improper treatment protocol.

Conclusions  Many congenital anatomic variants or other pancreatic and peri-pancreatic diseases may mimic MDCT appearance of pancreatic islet cell tumor. Radiological, clinical and pathological characteristics should be considered for the final diagnosis.

     

Recurrent ischemic stroke as an initial manifestation of an concealed pancreatic adenocarcinoma: Trousseau’s syndrome

In rare instances, stroke may preceed a diagnosis of cancer and be the first clinical evidence of an underlying malignancy. Cerebral infarction mostly complicates lymphomas, carcinomas, and solid tumors. Malignancy-related thromboembolism can present as acute cerebral infarction, nonbacterial thrombotic endocarditis and migratory thrombophlebitis. It is generally attributed to a cancer-related hypercoagulable period, chronic dissemiated intravascular coagulopathy (DIC), or tumor embolism. We reported a case of malignancy-releated thromboembolism from an undiagnosed pancreatic adenocarcinoma in a 54-year-old man, who presented with recurrent ischemic stroke due to chronic DIC. He died of the underlying malignancy despite the appropriate institution of anticoagulation therapy.

This case emphasizes that cerebral infarction may be the first manifestation of an undiagnosed cancer. If there is laboratory or clinical evidence associated with DIC, patients with a cerebral infarct of an unknown etiology should be investigated for a malignant process. The optimal method of anticoagulation in cancer patients with thromboembolic disease (TED) remains unclear.

     

溶血磷脂酸及其受体在人胰腺癌中的表达和临床诊治的评价(英文)

Lysophosphatidic acid(LPA) is a naturally occurring phospholipid with diverse effects in various cells,ranging from immediate morphological alteration to long lasting cellular function changes,such as induction of stimulation of cell proliferation,survival,drug resistance and motility.Like many other biomediators,LPA interacts with cells through specific cell surface receptors(G protein-coupled receptors).LPA1/Edg-2,LPA2/Edg-4 and LPA3/Edg-7,named as Edg/LP subfamily,are the three most common lysophosphatidic acid receptors.LPA plays a critical role as a general growth,survival and pro-angiogenic factor in the regulation of pathophysiological processes in vivo and in vitro.Recent literatures suggest that abnormalities in LPA metabolism and function in pancreatic cancer patients may contribute to the initiation and progression of the disease.Thus,LPA might be a potential target for clinical pancreatic cancer diagnosis and therapy.Herein we review the expression of LPA and its receptors in the carcinogenesis of human malignancies,with focus on human pancreatic cancer,and also clinical diagnosis and treatment has been evaluated.     

Isolated Pancreatic Tuberculosis in Non-immunocompromised Patient Treated by Whipple＇s Procedure： a Case Report

PANCREATIC tuberculosis （TB） is a rare disease and its diagnosis is difficult because of the lack of specific clinical manifestations. Computed tomography （CT） and magnetic resonance imaging （MRI）have some diagnostic values in this disease, but it is easy to misdiagnose pancreatic TB as a pancreatic tumor.1 In this article, we present a case of non-immunocompromised patient developing an isolated pancreatic TB, report the CT and MRI findings, and the surgical procedure for it,     

Diagnosis and treatment of malignant tumors using integrated traditional and western medicine: Progress, challenges and reflections

Malignant tumors are one of the leading causes of death in the world.Considerable progresses have been made on the treatment of tumors in recent decades,especially in the prevention,early diagnosis and the model changing of therapeutics.But we are still facing tough challenges,including the increasing treatment burden and limited improvement of efficacy.In China, Chinese medicine(CM) provides a powerful arsenal to fight against tumors.CM can be well applied to the onset and progression of tumors in China,bearing the characteristics of multi-target,multi-phase and multi-effect.But there are also many problems demanding urgent attention in the use of CM.Some most debated problems in this field were summarized.We should upgrade our concepts in using CM,find its position scientifically,and establish evidence of its effect by high quality clinical research.     

SURGICAL TREATMENT OF MALIGNANTESOPHAGEAL TUMORS IN PUMC HOSPITAL

To study how to prolong the postoperative survival time of the patients with malignant esophageal tumors. The clinical data of 1098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed.The deletion of fragile histnmine triplet (FHIT) gene (a tumor suppressor gene) in 30 fresh esophageal samples obtained in 1996 was detected with PCR and RT-PCR method. The resectability was raised gradually and the operatire morbidity and mortality decreased year by year, but there was no significant improvement on the postoperative 5-year survival rate. Delayed diagnosis and irradical resection influenced the long-term survival. The deletion of cDNA of FHIT gene was 64. 2% in esophageal cancer and 20% in the resected margin of the cancer. We believe that high-grade atypical hyperphsia in esophageal epithelium and deletion of FHIT gene in esophageal cancer and its resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively,and the latter may be one of the molecular markers for the resection. Early diagnosis and treatment, radical.resection, and postoperative nutritional support are very important for the improvement of the postoperative survival time of the patients.     

Diagnosis and treatment of epistaxis caused by non-traumatic pseudoaneurysms of carotid artery

Epistaxis remains one of the most common otolaryngology emergencies. Severe epistaxis may be caused by internal carotid artery （ICA） pseudoaneurysm or cavernous fistula, which is clinically rare but life threatening if it is not diagnosed and treated timely. Most ICA pseudoaneurysms are mainly caused by trauma with few other causes. From January 1998 to December 2005, a total of 8 cases with non-traumatic carotid artery pseudoaneurysm were correctly diagnosed through digital subtraction angiography （DSA） in Ganzhou People＇s Hospital. The patients had suffered from serious nose bleeding repeatedly and had been resistant to routine treatments.     

Effects of Iron on Growth and Intracellular Chemical Contents of Microcystis aeruginosa

Objective To investigate the effect of iron on the growth, physiology and photosynthesis of cyanobacteria. Methods A gradient of iron concentrations was employed to investigate the growth, photo-pigments （chlorophyll A and phycocyanin）, and cell chemical contents （C, N, P） of Microcystis aeruginosa in response to different iron additions. Results The specific growth rate during the exponential growth phase, as well as the cell chlorophyll A and the phycocyanin content, was limited by iron below 12.3μmol Fe.L^-1. The growth was inhibited when the iron concentration was at 24.6 μmol Fe.L^-1. The cell chlorophyll A and the phycocyanin content were saturated when the iron concentration was above 12.3μmol Fe.L^-1 and declined slightly at 24.6 μmol Fe.L^-1. At a low iron concentration （about 6.15 μmol Fe-L^-1 and less）, the cell nitrogen and carbohydrate content were iron limited, and the variation of the cell phosphorus content was similar to that of the nitrogen and carbohydrate, with a transition point of 12.3 μmol Fe.L^-1. Conclusion The variation ofcynobacteria growth is synchronous with that of the photo-pigments or the cell chemical content, and there exist relationships among photosynthesis, growth and internal chemical content, which could be useful for the growth estimation from the cell characteristics.     

Comparison in vitro permeation of curcumin from topical gels by liquid chromatography tandem mass spectrometry

Objective： To fred a more effective method of topical transdermal delivery of curcumin. Methods： We prepared curcumin carbopol （CRB） 974P and hydroxypropylcellulose （HPC） gel formulations containing menthol or Azone as permeation enhancers In this study, negative mode electrospray ionization and a triple quadruple LC/MS/MS instrument operated in multiple reaction mode was used for curcumin detection. The assay was linear over a concentration range of 10 ng/mL to 400 ng/mL for curcumin （average R2 = 0.997 2）. Excised nude mouse dorsal side skin was used in an in vitro skirt permeation study performed using the method of Franz. Results： Our results showed that all of the topical gel formulations we developed were free from skin irritation. The percutaneous flux and enhancement ratio of curcumin across nude mouse epidermis were enhanced markedly by the addition of menthol or Azone to both types of gel formulations. We found that the HPC gels containing quantities of Azone showed an enhanced permeation effect as compared to gels containing menthol. In the case of HPC gels containing Azone, the increase in permeability was significant （P〈0.05） as compared to the gels containing menthol. Conclusion： Azone shows a significantly more remarkable permeation effect than menthol. As such, this novel delivery strategy offers significant promise and is worthy of further exploration in attempts to enhance the medicinal application of curcumin     

The role of central nervous system on hypoglycemia and the feasibility of the brain theory in traditional Chinese medicine on treatment of diabetes mellitus

The central nervous system （CNS） plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine （TCM） has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究:津液辨证(英文)

Intraditional Chinese medicine (TCM),the so-called津液refers to all the fluid and liquid flowingand maintaining inside the human body.In Chineselanguage,津液is a phrase composed of twoChinese characters which describes two differentkinds of fluid or liquid in the human body .According to the theory of TCM,津refers to thepart of fluid that is thin in texture and flowss moothly inside the body while液refers to thepart of fluid that is thick in texture and mainlymaintains in the joints of the body to nourish andlubr...     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：八纲辨证（一）（英文）

The so-called eight principles include阴,阳,表,里,寒,热,虚,实which are usually transliterated and translated as yin,yang,exterior, interior,cold,heat,deficiency and excess.These eight principles serve as a theoretical basis for treatment based on syndrome differentiation. These eight principles are easy to understand, translate and standardize.     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究：各科辨证（二）

外伤瘀滞证pattern/syndrome of stasis and stagnation due to traumatic injury：a pattern/syndrome attributedtotraumaticinjury causinglocal stagnation of qi and blood,manifested by local ecchymosis,pain and tendernessIn Chinese language,瘀and滞are two concepts which are si milar to each other in meaning under certain context,