Objectives:To investigate the morphologic changes of the colon in the rats after a total small bowel resection. Methods:Ten male Sprague Dawley(350～370 g) rats in the experimental group were undergone resection of total small bowel,and ten normal rats were randomly chosen as the control group.After supported by enteral nutrition for 3 months,rats were sacrificed and the colon harvested for morphologic parameters study. Results:The length,diameter,wet weight,crypt depth,mucosal thickness and kerckring height of the colon in the experimental group were significantly higher than those in the control group( P

Objective To investigate 15 N glycine absorption in the colon of the short bowel rats. Methods Rats undergoing resection of 80% small intestine and were treated by enteral nutrition for 21 days. The concentration of 15 N glycine in perfusate samples was measured by the technique of HPLC. The atom percent enrichment of 15 N glycine in blood plasma was measured by the technique of isotopic dilution method Results fter 3 hours, the colonic water absorption was 1?0 5 ml, 15 N glycine absorption was zero, and the atom percent enrichment was near zero in normal group, vs. (2 6?0 82) ml ( P

Objectives:To study the colonic adaptation of short bowel rats by enteral nutrition plus fiber treatment.　Methods:The short bowel rats were randomized into two groups:feed by Pepti-2000(EN) and by Pepti-2000 plus fiber(EF);and another normal rats as control(CONT) group.The nutritional states and morphologic changes of the colon were investigated.　Results:From postoperative days(PODs) 15,the weight of EF group was increasing and greater than EN group after PODs 18.The net nitrogen balance in EF group was almost the same as CONT,but greater than EN group.All the mucosal thickness,villous height and surface area of the colon in EF group were greater than CONT and EN group(P<0.001).DNA index and percentage of S phase cells of the colonic mucous in study groups were higher than CONT group(P<0.05).Also the levels of colonic mucous IGF-1 mRNA in study groups were higher than in CONT group(P<0.05).　Conclusions:Enteral nutrition plus fiber can not only promote nutritional states;but enhance colonic adaptation to the short bowel rats.

Objective To investigate the outcome of intraductual papillary mucious neoplasms (IPMN) of the pancreas after surgical resection. Method Clinical data of 76 patients with intraductal papillary neoplasms of the pancreas undergoing surgical resection at Zhongshan Hospital, Fudan University between January 1999 and December 2008 were retrospectively analyzed. Results Among the 76 patients,49 were male, 37 were female. 32 had noninvasive IPMNs, including adenomas( n = 16), borderline tumors (n =6 ), carcinomas in situ (n = 10 ). 44 had invasive IPMNs. Lesions were present in the head in 63 cases, in the body or tail in 10, in the whole pancreas in 3. There were significant difference in age,jaundice, weight loss, asymptomatic cases and CA199 value between noninvasive and invasive IPMNs.Three patients underwent total pancreatectomy, 59 patients underwent pancreaticoduodenectomy, 4 patients underwent pancreaticoduodenectomy with portal vein resection and reconstruction, six patients underwent distal pancreatectomy, two patients each underwent central pancreatectomy or enucleation. The overall postoperative morbidity rate were 28.9%, there was no operative mortality. Positive pancreatic margin was identified in seven patients of noninvasive neoplasms, among thoee one developed recurrence after 67 months. The five-year survival rate for patients with noninvasive and invasive neolpasms was 100% and 35% ,respectively. Size and lymph node metastasis were significant prognostic factors after surgical resection of the invasive IPMNs. Conclusions Surgical resection provides a favorable outcome for patients with noninvasive IPMNs. In contrast, invasive IPMNs was associated with a poor survival. Early resection is essential for improving survival. Long-term follow-up is necessary for all patients with IPMNs after resection.

Objective To identify difference between intraductal papillary mucinous neoplasms (IPMN) and pancreatic common ductal adenocarcinoma. Methods Between March 2003 and June 2006, 29 patients with pathological diagnosis of IPMN and 46 patients with pancreatic adenocarcinoma in Zhongshan Hospital were retrospectively reviewed. Clinical, biochemical, and histopathologic factors were retrospectively analyzed. Prognosis between two groups were compared by log-rank test.Results The proportion with no symptom visit in IPMN was obviously higher than in pancreatic cancer. Twenty-one of 29 specimens were malignant in IPMN. Stage of the malignant IPMN was significantly earlier than that of the pancreatic adenocarcinoma (P=0.017). Intrapancreatic neural invasion was more common in pancreatic adenocarcinoma than in malignant IPMN (P=0.005). The survival curve of the malignant IPMN was significantly better than that of the pancreatic adenocarcinoma (P=0.014). Conclusion IPMN with less aggressive bionomics can be diagnosed and treated in an earlier stage. So its prognosis is better than that of pancreatic ductal adenocarcinoma. Prognosis of malignant IPMN which is more invasive than stage Ⅱ B is simular to that of common pancreatic cancer. However, this conclusion should be further investigated.

Objective To investigate the adaptive expression of brush-border disaccharidases in the residual digestive tract of rats following a total small bowel resection. Methods Mucosa was scraped off with a piece of glass from the colon,the cecum and the duodenum of the rats with a total small bowel resection (experimental group,n =10) and normal rats (control group,n =10). Diaccharidase activities were determined in accordance with the method of Dahlqvist. Results Specific activities and total activities of sucrase,maltase in the colon,the cecum and the duodenum in the experimental group were significantly greater than those in the control group( P 0.05). Conclusions Total small bowel resection caused significant adaptive expression of brush-border sucrase and maltase in the residual digestive tract in the rats after a total small bowel resection.

ObjectiveSmall interfering RNA (siRNA) was used to silence the fibroblast activation protein4 (FAP) expression of mouse pancreatic cancer related fibroblast cells (mPCa-FCs-1212),and to observe the effects of mPCa-FCs-1212 silencing FAP gene on mouse pancreatic cancer cells (mPCa-1212) proliferation and apoptosis.MethodsThe small interfering RNA targeting FAP gene was designed; the recombinant siRNA plasmid siFAP and control plasmid siMOCK was constructed,which were transfected into mPCa-FCs-1212,respectively.The FAP mRNA and protein expression in transfected cells were examined by real-time PCR and Western blotting.The mPCa-1212 and transfected mPCa-FCs-1212 were co-cultured with a 1:1 ratio in vitro.The growth inhibitory rates and apoptosis rates of mPCa-1212 were detected by MTT assay and Annexin V-FTTC/PI staining and FCM assay.ResultsThe mRNA and protein expressions of FAP in siFAP transfected mPCa-FCs-1212 were significantly down-regulated when compared with that in siMOCK transfected mPCa-FCs-1212[0.584 ±0.029vs.1.052±0.281,P=0.0213; (27.18±3.23)％ vs.(61.58±4.72)％,P=0.0317].The mPCa-1212 was co-cultured with the mPCa-FCs-1212 transfected with siFAP or siMOCK for 3 d,and the inhibitory rates of mPCa-1212 were (23.02 ±3.32)％ and (1.11 ±0.23)％,and the apoptosis rates were (42.31 ±5.34)％ and (7.38 ± 2.09)％,the difference between the two groups was statistically significant (P =0.000).ConclusionsmPCa-FCs-1212 silencing FAP gene can inhibit the proliferation of mPCa-1212 in vitro and induce cell apoptosis,and may be a potential new approach to gene therapy.

Objectives: To investigate the role of glutamine on splanchnic blood flow in SAP rats and underling mechanism. Methods: 32 rats were randomized divided into 2 groups:glutamine group(Gln group, n =16) and SAP group ( n =16).Jejunotomy was performed. Gln group received glutamine.SAP group received saline.All groups were subdivided into 2 groups.8 normal rats were used as the controls.At 12,24hours after the induction of SAP,8 rats in each group were sacrificed.Plasma glutamine concentrations were measured by HPLC.The regional pancreatic microvascular blood flow was measured by Dopplar ultrasound,the blood flow of portal vein,spleen artery and superior mesenteric artery was also measured. Results: Enterally administered Gln was well tolerated by the rats.There was an increase in plasma Gln levels after Gln supplementation on Gln group.The regional pancreatic microvascular blood flow decreased significantly in SAP group( P

Objective To investigate the clinical characteristics and surgical outcomes of pancreatic acinar cell carcinoma (PACC).Methods The clinical and follow up data of PACC patients treated with surgery in Zhongshan Hospital of Fudan University between 1999 and 2012 were analyzed retrospectively.Results A total of 16 PACC were identified including 13 male and 3 female patients.The age of the patients ranged from 38 to 71 with an average of 57 years old.Six patients presented as abdominal pain,while low back pain in 3 patients,abdominal distention in 2 patients,emaciation in 2 patients,jaundice in 2 patients and melena in 1 patient.Elevated CA19-9 level was observed in 8 patients and 2 patients had elevated serum CEA.The tumors were located in the uncinate process in 1 patient,head in 9,body and tail in 6.The superior mesenteric vein was invaded in 2 cases and 1 patient had hepatic artery invasion.The tumor invaded both the celiac trunk and splenic artery in 1 patient.One patient had just undergone intra-operative needle aspiration biopsy due to unresectable tumor.All the other 15 patients underwent surgical excision with R0 resection.Among the 10 patients received pancreaticoduodenectomy,2 had superior mesenteric vein resection and replacement and 1 had hepatic artery resection.Five patients underwent distal pancreatectomy without spleen preservation.The mean size of these tumors was 5.7 cm × 4.6 cm,12 cases had a surrounding envelope,while lymphatic metastasis was observed in 8 cases.The follow up data of 15 patients were collected and the median postoperative survival was 21 months,and the survival rate of 1,3,5 year was 71.4％,28.6％,7.1％.Conclusions Pre-operative diagnosis of PACC is extremely difficult due to lack of specific clinical features and lab tests.Surgery is the first line treatment for PACC,and the prognosis of PACC is better than that of pancreatic ductal adenocarcinoma.

Objective To analyse the factors that have effects on patients' procalcitonin (PCT)level after gastic surgery and to evaluate PCT as a parameter for detection of infectious complications.Methods A total of 153 patients undergoing gastric surgery were included in the study between Jul 2011 and Jan 2013.Temperature and routine blood samples for determining PCT level,neutrophil ratio,white blood cell count were obtained on postoperative days (POD) 1,3,7.Predictive values for each of the markers were examined.Results Postoperative complication,preoperative infection and surgery type affected the PCT level of patients on POD 1.Meanwhile,the independent factor that had influence on PCT level on POD 3 and 7 was postoperative complication.After excluding those patients with preoperative infection,patients with infectious complication exhibited significantly higher PCT levels (t =2.92,P ＜0.01,t =5.34,P ＜0.01,t =4.03,P ＜0.05) on POD 1,3,7 respectively),neutrophil ratio (on POD 3 and 7) and WBC count (on POD 3) than did those without complication.According to receiver operating characteristic analysis,PCT showed the highest AUC on POD 1,7 (AUC =0.89 and 0.87 respectively).In the patients without complication,the mean PCT value was (0.47 ± 0.97),(0.36 ± 0.50),(0.23 ± 0.24) ng/ml on POD 1,3,7 respectively.The PCT level declined 55％ from POD 1 to POD 3 and from POD 3 to POD 7.Conclusions The serum PCT level of patients without any complication showed a decreasing trend while PCT level of those with infectious complications increased significantly.Continuous monitoring PCT level could serve as a diagnostic tool for the early identification of infectious complication after gastric surgery.