Loss of heterozygosity at 18q21 region in gastric cancer involves a number of cancer-related genes and correlates with stage and histology,but lacks independent prognostic value

Identification of neuroendocrine differentiation in tumours has important implications for prognosis and therapy. The aim of the present study was to evaluate monoclonal antibodies against synaptic vesicle protein 2 (SV2) as histopathological markers for neuroendocrine differentiation in tumours of the gastrointestinal tract and pancreas. Paraffin blocks from 211 gastrointestinal tumours were examined by immunocytochemistry, using a monoclonal antibody against SV2. Virtually all endocrine tumours of the gastrointestinal tract (11/11 gastric, 53/53 ileal, 16/21 appendiceal, and 22/22 rectal) and pancreas (24/24) were positively labelled. SV2 labelling was also demonstrated in gastrointestinal pacemaker cell tumours (8/8), while adenocarcinomas of the gastrointestinal tract and pancreas were negative, with the exception of occasional adenocarcinomas demonstrating weak SV2 labelling (stomach 1/22, rectum 1/29, and pancreas 0/21). Western blotting of tumour biopsies confirmed expression of SV2 in endocrine tumours of the gastrointestinal tract and pancreas. No relationship was observed between SV2 expression in tumours and hormone production or malignant potential. In conclusion, SV2 is expressed in neuroendocrine tumours of the gastrointestinal tract and pancreas, but not in non-endocrine tumours. The SV2 monoclonal antibody can therefore be used as a general marker for neuroendocrine differentiation in gastrointestinal and pancreatic tumours.     

Secretin dissipates red aridine orange fluoescence from pancreatic duct epithelium

This study was undertaken to elucidate whether duct cells in the pancreas contain acidic cytoplasmic compartments regulated by secretion. Microdissected pancreatic ducts from pigs were examined by acridibe orange (AO) and 2′, 7′-biscarboxyethyl-5(6)-carboxyfluorescein/tetraacetioxymethyl ester (BCECF/AM) epifluorescence microscopy. Estimated cytoplasmic pH using BCECF fluorescence was 7.43pL0.04 and was not changed by altering CO₂ tension in the incubation mdium. The epithelium of acridine orange incbated peripheral interlobular pancreatic ducts exhibited green and fluorescence was sen in resting pancreatic ducts and was greatly accentuated by raising CO₂ in the incubation medium with chloroqyuine or NH₄Cl or the protonophores carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP) or carbonyl cyanide M-chlorophenylhydrazone (CCCP), leaving uniform gren fluoresence. These findings suggest that pancreatic duct cells contain CO₂-dependent acidic compartments which vanishduring seceatin stimulation and which may be cytoplasmic tubulovesicles.     

Cholinergic control of gastric acid secretion

Summary In the perfused stomach preparation of the anaesthetized rat the cholinergic agonists acetylcholine (ACh) and bethanechol stimulated gastric acid secretion. Both agonists produced similar maximal acid output (70 mol/15 min) when infused intravenously. However, bethanechol was more potent, eliciting half maximal stimulation at 1.98 mol/kg/h. Secretory responses to either agonist were antagonized in a dose related fashion by blockade of muscarinic receptors with atropine. In contrast, inhibition of nicotinic receptors with hexamethonium produced a striking potentiation of ACh stimulated secretion whilst the bethanechol elicited secretion remained unaffected. In the presence of full nicotinic receptor blockade the ACh response curve was shifted to the left sixfold, half maximal stimulation being produced at 1.79 mol/kg/h. Cimetidine partially inhibited the secretory responses elicited by either ACh or bethanechol while blockade of adrenoceptors ( and ) did not affect acid output induced by cholinergic agonists. Secretion elicited by ACh is interpreted as being the composite effect of prosecretory action and an inhibitory mechanism due to the activation of nicotinic receptors. Hexamethonium, through nicotinic receptor blockade, inhibits the restricting mechanism and thus reveals the full stimulatory action of ACh.     

胰腺电子计算机体层扫描增强扫描参数研究

目的 :研究不同扫描参数对胰腺电子计算机体层扫描 (CT)增强的影响 ,以得出合适的扫描方案。方法 :1预试验 10例 ,按 1.5 ml/ kg、3ml/ s注射造影剂 (Omnipaque 30 0 mg I/ m l)行胰腺薄层三期扫描 ,动脉期、胰腺期及门脉期的延迟时间各为 18s、40 s、70 s,分别测量平均胰腺 CT增强值并作比较。2将 40例患者按不同剂量和注射速度随机分成 4组 , 组 (1.5 ml/ kg、3.0ml/ s) , 组 (1.5 ml/ kg、2 .5 m l/ s) , 组 (1.0 ml/ kg、3.0 m l/ s) , 组 (1.0 ml/ kg、2 .5 ml/ s)每组各 10例 ,分别行胰腺期、门脉期扫描 ,分别测量平均胰腺 CT增强值并作比较。结果 :预试验中发现平均胰腺 CT增强值 ,胰腺期 [(6 9.5 6± 10 .6 ) Hu]比动脉期[(2 4.81± 14.98) Hu]高 (P<0 .0 5 ) ,胰腺期 [(6 9.5 6± 10 .6 ) Hu]比门脉期 [(5 4.38± 10 .34 ) Hu]高 (P<0 .0 5 )。40例对照研究中 ,胰腺期平均胰腺 CT增强值 : 组为 (71.0 5± 9.6 4) Hu, 组为 (6 2 .2 7± 12 .2 9) Hu, 组为 (42 .3± 11.75 ) Hu, 组为(44 .16± 11.2 7) Hu、 组与 组相比 (P<0 .0 5 )、 组与 组相比 (P<0 .0 5 )。 组与 组、 组与 组相比无明显差异。结论 :平均胰腺实质增强胰腺期比动脉期、门脉期好 ,以 1.5 ml/ kg剂量 ,2 .5～ 3.0 m l/ s     

大鼠全胰十二指肠移植术并发症的分析及预防

目的 :探讨建立稳定的大鼠全胰十二指肠移植模型。方法 :采用大鼠全胰十二指肠移植肠道引流术式进行移植手术 50例 ,对术中及术后发生并发症及死亡的 12只大鼠进行解剖 ,分析其死亡原因。结果 :在前 2 5例中 ,由于并发症在 1周内死亡的大鼠 10只 ,存活率为 60 % ;在后 2 5例中 ,对手术操作加以改进 ,有效地防止了并发症的发生 ,1周内死亡 2只 ,存活率达 92 %。结论 :术中及术后发生的并发症多与手术操作有关     

Pancreatic solid pseudopapillary neoplasm

Pancreatic solid pseudopapillary neoplasm (SPN) is a rare low grade malignant tumour. Distinguishing this entity from other pancreatic neoplasms is critical for therapeutic decision making and prognostication. It predominantly affects young female patients <40 years of age, with excellent clinical outcome following surgical removal. The gold standard diagnostic test is cytopathological or histopathological assessment of fine needle aspirate. There are two main difficulties with this. First, SPN can present with morphological and immunohistochemical appearances that can closely mimic other pancreatic tumours, in particular, pancreatic neuroendocrine tumour (NET). Second, the amount of diagnostic material from fine needle aspiration can be limited. Here, we present a cytopathological case with both challenges during the pre-operative investigation of SPN. The case exemplifies the importance of combining morphological features with a targeted panel of immunohistochemistry to arrive at the diagnosis.     

腹腔镜胰腺外科手术缝合技术与缝合材料选择中国专家共识（2021版）

正胰十二指肠切除术(pancreaticoduodenectomy,PD)及胰体尾切除术(distal pancreatectomy, DP)作为治疗壶腹周围及胰体尾肿瘤的经典术式,具有手术难度大、技术要求高及术后并发症多等特点,是腹部外科极具代表性及挑战性的术式之一。随着手术理念、技术及缝合材料的更新、进步与优化,PD术后围手术期死亡率已降至3%以下,但术后并发症特别是胰瘘的发生率仍高达10%～30%。     

胆胰手术后假性动脉瘤诊断及治疗

胆胰疾病病人经外科手术、介入或内镜治疗后发生迟发性大出血时,救治困难、病死率高,而术后假性动脉瘤形成和破裂是主要原因。胆胰手术后假性动脉瘤成因复杂多样,瘤体破裂出血前临床症状隐匿。从致病机制源头预防假性动脉瘤形成、重视前哨出血等特征性临床症状,将会有效确保胆胰疾病病人围手术期安全性,提高术后迟发性大出血的救治成功率。