Pancreatic resection is the treatment choice for pancreatic malignancy and cer-tain benign pancreatic disorders. Althogh, pancreatic resection requires high techndogy whereas current mortality after a pancreaticoduodenectomy has dropped to below 3 % in expe-rienced high-volume centers and post-operative morbidity is still as high as 50%. At pres-ent, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and proce-dures, and can result in life-threatening complications. Early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating con-sequences; however there is no universally accepted definition of PF that would allow stand-ardized reporting and proper comparison of outcomes between different centers. The present article reviews the conlept evolution of PF and discusses the current preventive strategies.

NF-κB is a nuclear transcription factor with multiple adjustion. The activation of NF-κB can occur by three different mechanisms. The multiple NF-κB activation pathways are important due to the large number of genes that are regulated by NF-κB and their effects on cancer cells. These gene products can promote growth and tumori-genesis, inhibit apoptosis, allow metastasis and invasion, promote angingenesis, and cause chemoresistance. All of these roles in pancreatic cancer make NF-κB a promising target in treatment. Therefore, inhibiting the activity of NF-κB becomes a hot spot and novel idea of preventing and treating pancreatic cancer.

Objective To summarize the experience in the diagnosis and treatment of adenosquamous carcinoma of the pancreas to better our understanding of this rare exocrine pancreatic neoplasm. Methods The clinical data of five cases of adenosquamous carcinoma of pancreas admitted between July 2002 and June 2008 were analyzed retrospectively, and relevant literature was reviewed and discussed. Results Pancreatic adenosquamous carcinoma was found in 3 men and 2 women with a mean age of 64 ± 18 years old. Tumor was located in the head of pancreas in 2 patients, body and tail in 3 cases. One patient was submitted to pancreaticoduodenectomy, three patients underwent distal pancreatectomy and splenectomy and one had cholecystojejunostomy and gastric bypass surgery, as well as 1251 implantation. The mean size of the tumor was 4.5 cm. One patient had posterior stomach wall, descending duodenum, portal vein involvement; spleen was invaded in 2 cases; neural and vessel invasion was present in 2 cases. Lymph node metastasis was present in 1 case. Pathologically primary tumor and liver metastasis were mixture of adenocarcinoma and squamous cell carcinoma. In all 5 patients with complete follow up, 3 died of tumor recurrence or liver metastasis with a mean postoperative survival time of 11.2 momths (8.5 ~ 13.5 months). The other 2 cases survived for 6 and 56 months , respectively. Conclusions Pancreatic adenosquamous carcinoma was likely to be found in patients in their 60s, and confirmative diagnosis was difficult. The prognosis of this rare tumor appeared to be dismal due to the high degree of malignancy.

Objective:To observe the occlusal changes of patients with chronic periodontitis(CP)after initial periodontal therapy an-alysed by T-scan Ш occlusal analysis system.Methods:26 patients with CP were included.The patients were treated by initial perio-dontal therapy,including scaling,subgingival curettage,root planning and oral hygiene instruction.The occlusion time(OT),disoclu-sion time(DT),center of force trajectory(COFT),the percentage of bite force for maximum movie force at maximum area frame (MABF /MMF)and the bite force distribution balance between the left and right sides (BFDB)were measured by T-scan III occlusal analysis system before and six weeks after the treatment.All the data were statistically analyzed.Results:After initial periodontal treatment,the OT and DT extended for (0.20 ±0.14)s and (0.11 ±0.08)s respectively(P <0.05),the COFT increased by (0.81 ±1.19)mm(P <0.05).Moreover,the MABF /MMF and BFDB decreased by(7.20 ±4.41)% and (8.90 ±7.71)% respectively (P <0.05).Conclusion:Initial periodontal treatment may improve the occlusion of patients with chronic periodontitis.

Objective To investigate the clinicopathological characteristics,diagnosis and therapy,as well as the prognosis of accessory breast cancer. Methods Twenty-two cases were diagnosed as accessory breast cancer from Jan 1,1984 to Dec 31,2008, their clinicopatholgical data were analyzed retrospectively.Results Up to Mar. 1, 2010,2 cases had local recurrence;7 cases had long-distance metastasis;6 cases died. In the current study,the 5-year survival rate of accessory breast cancer was 43. 7%. Conclusions Accessory breast cancer is aggressive. The diagnosis was mainly based on clinical characteristics and postoperative pathology. The combined therapies may improve the survival rate.

Transient receptor potential (TRP) channels affect several inflammatory and neoplastic conditions.and are widely distributed and activated by multiple stimuli.Mean while,as the sensor to the changes in cellular local environments,TRP channels have multiple functions,including thermal,mechanical and taste sensing,as well as ion homeostasis maintaining.They can regulate muscle contractions,transmitter release,cell multiplication,cell differentiation,genetic transcription,apoptosis and molecular death.TRPM8,a nonselective cation channel,was originally cloned as a prostate-specific protein.Now,TRPM8 is found in carcinoma of colon,lung cancer,mammary cancer,pancreatic cancer and cutaneum carcinoma.The aim of this review is to summarize data reported so far on the expression and functional role of TRPM8 channels in different types of cancers.

Objective: To compare the diagnostic performance between panoramic radiography(PR)and cone beam computed tomography(CBCT)in the assessment of external root resorption(ERR)of mandibular second molars associated with impacted third molars. Methods: A total number of 832 patients with 1 074 mesially and horizontally impacted mandibular third molars treated at our institution from January 2019 to December 2020 were retrospectively analyzed. Presence of ERR on the adjacent second molar was investigated with PR and CBCT. Factors affecting the diagnostic accuracy of PR were determined. Results: The overall incidence of ERR in second molars was 33.15%(356/1 074)as detected by CBCT images. The accuracy of PR was 66.39%. Multivariate Logistic regression analyses further revealed that middle and Class Ⅲ impaction, crown contact or overlap with the root of adjacent tooth were risk factors for inaccurate diagnosis of PR(P<0.05). Conclusion The accuracy of detection on ERR of mandibular second molar associated with impacted third molar using panoramic radiography is lower. CBCT is recommended for this clinical scenario.

Objective To summarize the therapeutic experience of 23 patients of traumatic head injuries with a score of 3 on GCS,Methods 23 most severe head injuried patients with a score of 3 on GCS who admitted were analyzed retrospectively.Results 8 cases(34%)survived in which 5 cases(21%)had a good recovery or moderate disability,and other 3 cases(13%)with severe deficits.The other 15 cases(66%)dead after therapy.Conclusion The prognosis of most severe head injured patients with a score of 3 on GCS could be improved by early evacuation of intracranial hematoma with large decompressive cranietomies,early moderate hypothermia therapy,early assistant ventilation and effective prevention and treatment of complications.

Objective To investigate the effect of Gum mastic combined with gemcitabine on human pancreatic carcinoma BxPc-3 cells and its mechanism.Methods Cell proliferation and apoptosis were examined using the methyl thiazolyl tetrazolium assay and propidium iodine staining,respectively.After BxPc-3 cells were treated with different concentrations of Gum mastic and gemcitabine,the expression of NF-κB p65 subunit,IkB,Bcl-2 and Bax proteins was detected by Western blot.BxPc-3 cells were injected subcytaneously into nude mice to establish pancreatic xenograft tumors,and the changes of tumor volume were monitored.Results Compared to either single agent,treatment with Gum mastic (40 mg/L) combined with gemcitabine (10 mg/L) for 72 h signi cantly inhibited the proliferation of BxPc 3 cells (P＜0.01).Its rate of apoptosis(45.13±4.01)was more than Gum mastic,gemcitabine(P＜0.01) and control group (5.07 ± 1.37,P＜ 0.01).When cells were treated with gemcitabine in combination with gum mastic in human pancreatic carcinoma BxPc-3 cells for 48 h,the IκB level was increased,whereas NF-κB activation was blocked; the expression of Bax protein was substantially increased,but Bcl-2 protein was down-regulated; gum mastic or combined with gemcitabine could significantly inhibit the growth of pancreatic xenograft tumors (P ＜ 0.05).Conclusions Gum mastic could effectively strengthen the sensitivity of human pancreatic carcinoma BxPc-3 cells to gemcitabine.It may inhibit the expression of NF-κB p65 subunit and Bcl-2 proteins and increase the expression of IκB and Bax proteins.

Object To develop a resonance scattering spectral(RSS) method for the determination of total flavone in Shuxuening Tablet, and study the cause of RSS enhancement. Methods The BSA Mo (Ⅵ) qucercetin (Qu) system was investigated by RSS method. Results There were two resonance sacttering peaks at 470 and 525 nm. The Qu concentration in the range of 0-2 4 mg/L is linear to the resonance scattering intensity I 470 nm , with a detection limit of 0 3 mg/L. Conclusion This method is simple, sensitive and suitable for the determination of total flavone in Shuxuening Tablet. The spectral results demonstrate that the formation of [BSA Mo Qu] n associated particle and the interface between the particle solid phase and water phase results to its enhanced RSS.