奥曲肽选择性动脉介入治疗重症急性胰腺炎的临床观察

目的 观察奥曲肽选择性动脉介入治疗重症急性胰腺炎(SAP)的疗效。方法 将67例SAP患者分为对照组和治疗组,对照组35例采用常规治疗,治疗组32例除常规治疗外,采用数字减影(DSA)装置,以奥曲肽25 μg·h~(-1)直接经胰腺供血动脉连续输注24～48 h。两组疗效进行对比。结果 治疗组血液淀粉酶较对照组下降迅速,胃肠减压量治疗组与对照组相比差异显著(P<0.05),临床治愈时间治疗组比对照组明显缩短(P=0.02),并发症发生率和死亡率,治疗组分别为15.6％和6.3％、对照组分别为45.7％和25.7％,均达统计学意义。结论 奥曲肽介入治疗SAP疗效显著且优于常规治疗。     

大鼠胰岛细胞原代培养模型的研究

目的：建立一种客观的用于糖尿病和降血糖药物研究的大鼠胰岛细胞原代培养模型。方法：大鼠胰腺经胶原酶消化后，利用细胞贴壁时间、紧密程度及存活时间的差异，获得较为纯净的胰岛细胞。通过胰岛素含量测定，葡萄糖刺激实验及移植实验评价该细胞的功能。结果：分离得到的胰岛细胞成活率可达95％以上；双硫腙染色表明大部分细胞团为含有β细胞的胰岛细胞团；经RPMI 1640培养的细胞，其上清及细胞内的胰岛素含量均高于DMEM组，且对葡萄糖刺激的敏感性优于DMEM组：培养的胰岛细胞移植入1型糖尿病模型小鼠体内，可使糖尿病小鼠的血糖降至正常。结论：利用该方法得到的胰岛细胞活力和纯度均较高，体外培养后细胞功能正常，有望成为一种实用的降糖药研究的细胞模型。     

胰腺导管腺癌中microRNA-21与TGF-β1信号通路相关

目的：对胰腺导管腺癌样本进行基因分析,筛选与胰腺导管腺癌相关的microRNA(miRNA),并初步分析目标miRNA与胰腺癌转化生长因子-β1(TGF-β1)信号通路的相关性。方法：收集在海南省中医院住院的胰腺导管癌患者术前外周静脉血血清标本19份,健康体检人群的外周静脉血血清标本21份作为非胰腺导管癌对照组。利用GCBI(Gene-Cloud Biotechnology Information)数据平台筛选与胰腺导管腺癌样本有关的基因并对其进行生物信息学分析,将筛选出的基因作为研究对象,用real-time PCR和蛋白质印迹法验证该基因在胰腺导管腺癌中的表达。通过改变胰腺导管腺癌细胞中该基因的表达水平观察其与TGF-β1之间的关系。结果：通过聚类分析和基因功能富集分析筛选出miRNA-21为胰腺导管癌相关基因。MiRNA-21在胰腺导管腺癌患者体内高表达。在miRNA-21过表达的PANC-1细胞中,TGF-β1表达受到抑制;但当miRNA-21的表达受到抑制时,TGF-β1的表达明显上升。结论：MiRNA-21在胰腺导管腺癌患者体内高表达,可调控TGF-β1的表达,从而参与胰腺导管腺癌的发生发展。     

HIF1α-siRNA and gemcitabine combination-based GE-11 peptide antibody-targeted nanomedicine for enhanced therapeutic efficacy in pancreatic cancers

Abstract

Pancreatic cancer is one of the deadliest cancers across the world with an average 5-year survival rate of less than <6%. In this study, gemcitabine (GEM) and HIF1α-siRNA loaded GE-11 peptide conjugated liposome was successfully prepared and evaluated for its antitumor efficacy in pancreatic cancer cells. The GE11 increased the targeting specificity of liposome carrier and increased the intracellular concentrations in the cancer cells. Furthermore, synergistic combination of GEM and HIF1a-siRNA exhibited remarkable improvement in the declining of cancer cell proliferations. siRNA could effectively decrease the expression of HIF1a gene in the cancer cells. Importantly, GE-11 peptide-conjugated GEM/siRNA-loaded liposomes (GE-GML/siRNA) increased the total amount of apoptosis cells with higher proportion of cells in late apoptosis phase. GE-GML induced remarkable apoptosis of cancer cells and induced chromatin condensation and nuclear fragmentation which are considered to be typical features of apoptosis and cell death. GE-GML/siRNA showed a significant reduction in the tumour burden suggesting the superior anticancer efficacy of this formulation. GE-GML/siRNA showed four-fold reduction in tumour compared to control and two-fold reduction compared to GE-GML, respectively. Overall, present work lays foundation for the combination of GEM and HIF1a-siRNA loaded in a targeted nanocarrier system as a unique therapeutic option in pancreatic cancer treatment.     

Pharmacotherapy of Zollinger–Ellison syndrome

Introduction: The role of pharmacotherapy in the management of patients with Zollinger–Ellison syndrome (ZES) is often equated with the medical management of acid hypersecretion. However, pharmacotherapy is also increasingly involved in the other management areas of these patients.

Areas covered: This paper reviews the role of pharmacotherapy in all aspects of the management of patients with ZES. Newer aspects are emphasized. This includes the difficulty of diagnosing ZES in patients taking proton pump inhibitors. Also covered is the role of pharmacotherapy in controlling acid hypersecretion and other hormonal hypersecretory states these patients may develop, including hyperparathyroidism in patients with multiple endocrine neoplasia type 1 and ZES; tumor localization; and the treatment of advanced metastatic disease. The last includes chemotherapy, liver-directed therapies, biotherapy (somatostatin/interferon), peptide radio-receptor therapy and molecular-targeted therapies including the use of mTor inhibitors (everolimus) and tyrosine kinase inhibitors (sunitinib).

Expert opinion: Pharmacotherapy is now involved in all aspects of the management of patients with ZES, with the result that ZES has progressed from being considered an entirely surgical disease initially to the present where medical treatment plays a major role in almost all aspects of the management of these patients.     

Emphysema induced by elastase enhances acute inflammatory pulmonary response to intraperitoneal LPS in rats

Abnormalities in lungs caused by emphysema might alter their response to sepsis and the occurrence of acute lung injury (ALI). This study compared the extension of ALI in response to intraperitoneal lipopolysaccharide (LPS) injection in Wistar rats with and without emphysema induced by elastase. Adult male Wistar rats were randomized into four groups: control, emphysema without sepsis, normal lung with sepsis and emphysema with sepsis. Sepsis was induced, and 24 h later the rats were euthanised. The following analysis was performed: blood gas measurements, bronchoalveolar lavage (BAL), lung permeability and histology. Animals that received LPS showed significant increase in a lung injury scoring system, inflammatory cells in bronchoalveolar lavage (BAL) and IL‐6, TNF‐α and CXCL2 mRNA expression in lung tissue. Animals with emphysema and sepsis showed increased alveolocapillary membrane permeability, demonstrated by higher BAL/serum albumin ratio. In conclusion, the presence of emphysema induced by elastase increases the inflammatory response in the lungs to a systemic stimulus, represented in this model by the intraperitoneal injection of LPS.     

Post-irradiation Lymphocyte Reaction

Summary

The authors summarize their experimental experience with the evaluation of lymphocyte changes following exogenous irradiation, and their diagnostic and prognostic value for the assessment of damage in the post-irradiation syndrome.     

Impact of Margin Status on Survival in Patients with Pancreatic Ductal Adenocarcinoma Receiving Neoadjuvant Chemotherapy

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中国胰腺癌诊治指南（2021）

正胰腺癌的发病率在世界范围内呈持续上升态势。2021年统计数据显示,在美国所有恶性肿瘤中,胰腺癌新发病例男性居第10位,女性居第9位,占恶性肿瘤相关病死率的第4位~([1])。中国国家癌症中心2017年统计数据显示,胰腺癌位列我国男性恶性肿瘤发病率的第7位,女性第11位,占恶性肿瘤相关病死率的第6位~([2])。作为预后极差的消化道肿瘤,胰腺癌具有早期诊断困难、手术切除率低、术后易复发转移等临床特点,临床诊治极具挑战性。