2型糖尿病患者血清中4种胰岛自身抗体检测的临床意义

目的:探讨2型糖尿病(T2DM)患者血清谷氨酸脱羧酶抗体(GADA)、酪氨酸磷酸酶抗体(IA2)、抗胰岛细胞抗体(ICA)和抗胰岛素抗体(IAA)4种胰岛自身抗体检测的临床价值。方法:对978例T2DM患者和80例正常对照者血清中4种胰岛自身抗体进行检测、比较。结果:GADA、IAA、IA2和ICA在T2DM患者中的阳性率分别为7.1%、7.2%、3.3%和0.5%,联合检测总阳性率为16.0%,明显高于正常对照组3.8%的阳性率。GADA和IA2两种抗体联合检测阳性率为9.2%。T2DM患者中各抗体阳性较少重叠。结论:GADA和IA2两种抗体联合检测对检出T2DM中的成人隐匿性自身免疫性糖尿病(LADA)有重要指导价值,以利于对患者尽快采取有效措施保护胰岛B细胞功能,减少进一步的损伤。     

神经生长因子对白细胞介素-1β抑制的胰岛B细胞功能的影响

目的：观察神经生长因子（NGF）对白细胞介素－β（IL－1β）作用后的胰岛B细胞分泌功能的影响。方法：实验分为正常对照组，IL－1β作用组，不同浓度NGF对IL-1β处理后胰岛作用组，采用胰岛细胞培养的方法，观察NGF对IL－1β作用后的胰细胞胰岛素基础分泌量、葡萄糖刺激分泌量和对MTT还原的影响，通过斑点印迹检测c-fos mRNA。结果：（1）IL－1β作用的胰岛B细胞胰岛素基础分泌量和葡萄糖刺激分泌量明显低于对照组，不同浓度NGF对IL－1β处理后胰岛作用组的胰岛细胞胰岛素基础分泌量和葡萄糖刺激分泌量明显高于IL－1β作用组；（2）IL－1β抑制胰岛细胞还原MTT，NGF能使MTT还原得到恢复；（3）NGF和IL－1β均诱导c-fos mRNA。结论：NGF具有促进IL－1β抑制的胰岛B细胞功能恢复作用，其机制可能是通过促进细胞代谢，调节基因表达影响细胞内蛋白质的合成。     

胰腺癌组织DKK-1的检测及临床意义探讨

目的：探讨胰腺占位性病变患者Dickkopf-1（DKK-1）的表达及对胰腺癌的诊断及鉴别诊断价值。方法：收集63例胰腺占位性病变患者的石蜡切片,采用免疫组织化学法对DKK-1在胰腺癌组织及胰腺炎等组织中的表达情况进行检测,全自动标记免疫发光分析仪检测血CA19-9,分析DKK-1与患者临床病理特征及CA19-9的关系。结果：胰腺癌组织中DKK-1阳性率68.2%,明显高于胰腺良性病变组织中的DKK-1阳性率5.3%（P〈0.01）;DKK-1的表达在胰腺癌的分化程度和TNM分期间差异均有统计学意义（P〈0.05）;单一DKK-1阳性率68.2%,单一血CA19-9阳性率为65.9%,联合检测有一项阳性表达计为阳性,阳性率为88.6%,差异均有统计学意义（P〈0.01）;DKK-1＋CA19-9联合诊断胰腺癌均较DKK-1和CA19-9单一诊断的灵敏度、约登指数及符合率增高。结论：DKK-1在胰腺癌组织表达明显高于胰腺良性病变组织,在胰腺肿瘤的形成、发展中起到一定作用,DKK-1的检测有助于胰腺癌的诊断、预后评估。     

趋化因子Fractalkine通过调控IL-6/STAT3信号通路对人胰腺癌细胞株增殖和侵袭的影响研究

目的 探讨趋化因子Fractalkine(FKN)通过调控白细胞介素(IL)-6/信号传导与转录激活因子(STAT)3信号通路对人胰腺癌细胞株PANC-1和SW-1990增殖、侵袭的影响.方法 以腺病毒为载体构建、合成FKN-小干扰RNA(siRNA)并转染PANC-1和SW-1990.应用CCK-8法和Transwell检测细胞增殖和侵袭力,蛋白质印迹法(Western blot)和实时荧光定量聚合酶链式反应(RT-qPCR)法检测FKN、IL-6和STAT3蛋白及mRNA的表达.结果 转染FKN-siRNA 24 h时,PANC-1及SW-1990各组细胞吸光度值(A值)无明显变化,在48 h和72 h时,FKN-siRNA组A值明显高于对照组和FKN-siRNA阴性组(P＜0.05).转染FKN-siRNA后,PANC-1及SW-1990 FKN-siRNA组细胞侵袭力明显强于对照组和FKN-siRNA阴性组(P＜0.05).PANC-1及SW-1990转染FKN-siRNA后,与对照组和FKN-siRNA阴性组相比较,FKN-siRNA组细胞FKN蛋白和mRNA的表达明显减少(P＜0.05),IL-6与STAT3蛋白和mRNA的表达明显增加(P＜0.05).结论 趋化因子FKN可能通过IL-6/STAT3信号通路对胰腺癌细胞生物学活性发挥了抑制作用.     

A Structure—Activity Relationship Study of the Inhibition of α-Amylase by Benzoic Acid and Its Derivatives

Phenolic acids are widely found in fruits and vegetables. The inhibitory effect of phenolic acids on α-amylase, a key enzyme for starch digestion, has attracted the attention of researchers. To further investigate the effects of different substituents on the benzene ring of phenolic acid on the inhibition of α-amylase activity, in vitro experiments and molecular docking were used. The structure-activity relationships of 17 phenolic acids with benzoic acid as the parent nucleus were analyzed by determining their half inhibitory concentration (IC₅₀) toward α-amylase. The results showed that 2,3,4-trihydroxybenzoic acid had the strongest inhibitory effect on α-amylase with an IC₅₀ value of 17.30 ± 0.73 mM. According to the structure-activity analysis, the hydroxyl group at the 2-position on the benzene ring had a strong positive effect on the inhibitory activity of α-amylase, while methoxylation at the 2-position and hydroxylation at the 5-position had a negative effect. Molecular docking revealed that hydrogen bonding and hydrophobic interactions were involved in the inhibition, with hydrogen bonding being the primary force. These findings provide a more comprehensive understanding of phenolic acids as inhibitors of α-amylase and provide new ideas for the design of dietary formulations for diabetic patients.     

miR-32-5p通过靶向下调EZH2的表达抑制胰腺癌PANC-1细胞的恶性生物学行为与裸鼠移植瘤生长

目的:探究miR-32-5p通过靶向zeste基因增强子人类同源物2(EZH2)对胰腺癌PANC-1细胞恶性生物学行为的影响及其分子机制。方法:利用GEPIA数据库分析胰腺癌组织中EZH2的表达水平及其与患者的预后生存期的关系,并分析miR-32-5p表达与患者临床病理因素的关系。qPCR法检测正常胰腺HPDE6-C7细胞和胰腺癌PANC-1、AsPC-1、SW1990细胞中miR-32-5p和EZH2 mRNA的表达,通过Lipofectamine^TM2000将miR-NC、miR-32-5p mimic、miR-32-5p inhibitor、pcDNA-NC、pcDNA EZH2质粒分别转染PANC-1细胞,其分为对照组(不转染)、miR-NC组(转染miR-NC)、miR-32-5p mimic组(转染miR-32-5p mimic)、Anti-miR-32-5p组(转染miR-32-5p inhibitor)、miR-NC+pcDNA-NC组(转染miR-NC+pcDNA-NC)、miR-NC+pcDNA EZH2组(转染miR-NC+pcDNA EZH...     

不规则胰腺切除术对胰腺良性肿瘤的治疗价值分析(附54例报道)

目的 探讨不规则胰腺切除术对胰腺良性肿瘤的治疗价值,分析各种术式与术后胰瘘发生的关系.方法 回顾性分析14年间应用多种手术方式治疗的54例胰腺良性肿瘤患者的临床资料.结果 54例病人中21例行规则性切除术.33例行不规则切除术.摘除术23例有14例术后发生胰瘘,17例胰体尾脾切除术中有10例发生胰瘘,胰十二指肠切除术4例和保留脾的胰体尾切除术3例均未发生胰瘘,6例中段胰腺切除术仅有1例发生胰瘘,胰瘘的发生与手术方式密切相关(P=0.025).26例术后应用生长抑素,其中10例发生胰瘘,28例未应用生长抑素,其中15例发生胰瘘,两组之间相比较差异无显著性(P=0.266).25例胰瘘患者中有15例应用生长抑素,胰瘘闭合时间平均为10 d.10例未应用患者平均达21.5 d,应用生长抑素可以明显缩短胰瘘愈合时间(P=0.03).结论 对于胰腺良性肿瘤应该首选不规则胰腺切除术.生长抑素不能预防胰瘘的发生,但是可以缩短胰瘘的愈合时间.     

戊型肝炎病毒感染与胰腺癌发病的相关性临床分析

目的：分析戊型肝炎病毒（HEV）感染与胰腺癌发病的相关性。方法：以12例HEV感染的胰腺癌患者（感染组）和47例非HEV感染的胰腺癌患者（非感染组）为研究对象,收集相关临床资料包括胰腺、肝脏的病理表现等,分析HEV感染的胰腺癌患者的临床特征,并且用HEVRNA直接测序技术对合并HEV感染的胰腺癌患者的胰腺组织进行HEV定位分析。结果：感染组合并肝癌、肝硬化的概率高于非感染组,感染组胰腺癌发病的平均年龄较非感染组提前8.5年,2例HEV感染的胰腺癌患者的胰腺组织中检测到HEVORF2片段。结论：HEV感染与胰腺癌发病存在相关性。     

单纯性胰腺创伤后大鼠胰腺细胞增殖状况的实验研究

目的：构建大鼠单纯性胰腺创伤模型观察胰腺细胞增殖变化特点并探讨胰腺细胞增殖与组织损伤的关系。方法将60只Wistar大鼠分为2组：撞击组（采用BIM‐Ⅲ生物撞击机构建胰腺创伤大鼠模型,40只）和对照组（假手术组,20只）,每组大鼠于建模后6、24、72 h ,7 d处死,采用分光光度法检测各组大鼠血清淀粉酶（AMS）、脂肪酶（LPS）活性,通过TUNEL染色和流式细胞技术测定胰腺组织细胞死亡并分析细胞周期分布特点,Western blot测定胰腺组织Bcl‐2、Bax蛋白的表达。结果撞击组大鼠LPS活性升高时相点晚于AMS且持续时间较长,TUNEL染色、流式细胞检测、Western blot结果揭示胰腺创伤可诱导胰腺组织细胞凋亡和代偿性增生。胰腺细胞增殖变化特点表明胰腺创伤后的最佳治疗时间是发病24 h内。结论同时检测AMS和L PS有助于判定胰腺的外分泌功能受损情况。     

Diagnosing pancreatic cancer in general practice: a cross-sectional study on associations between suspicion of cancer,urgent referral and time to diagnosis

ObjectiveThis study aimed to investigate the first point of contact in patients diagnosed with pancreatic cancer, and to study factors associated with the GP’s suspicion of cancer, Cancer Patient Pathway (CPP) referral and long diagnostic interval.DesignCross-sectional study combining register and survey data.PatientsPatients with incident pancreatic cancer recorded in the Danish National Patient Register (n = 303).Main outcome measuresThe patient’s first point of symptoms presentation, GP’s cancer suspicion, CPP referral and diagnostic interval.ResultsGeneral practice was the first point of contact for 85.5% of the population. At the first consultation, cancer was suspected in 32.7% and 22.9% were referred to a CPP. The GPs were more likely to suspect cancer or serious illness in patients aged >70 years (prevalence rate ratio (PRR) 1.34, 95% CI 1.09–1.66) and among patients with high comorbidity (PRR 1.23, 95% CI 1.04–1.47). A CPP referral was less likely among patients with low education. The median diagnostic interval was 39 days (interquartile range: 15–72). When the GP initially did not suspect cancer, the likelihood of longer diagnostic interval increased.ConclusionThe majority of patients with pancreatic cancer began their diagnostic route in general practice. Diagnosing pancreatic cancer swiftly in general practice was challenging; the GP did often not initially suspect cancer or refer to a CPP and several of the patient characteristics were associated with the GPs initial suspicion of cancer or CPP referral. Thus, there may be room for improvements in the diagnostics of pancreatic cancer in general practice.

Key points

• Patients with pancreatic cancer have a poor prognosis, as pancreatic cancer is often diagnosed in late stage.
• The majority of patients with pancreatic cancer began their diagnostic process in general practice.
• General practitioners (GPs) suspected cancer at the first consultation in one out of three patients with pancreatic cancer; more often in older and comorbid patients.
• The GPs suspicion of cancer was associated with urgent referral and shorter time to diagnosis.