Neural invasion is an important invasion pathway of pancreatic cancer.New research shows that neural invasion of pancreatic cancer related genes in the sequential role effect,through the cell signal transduction,regulation of specific growth factors,adhesion molecules,matrix metallopmteinase and other related systems,then changed in the generation,resulting in the cancer cells invasion of the nerve tissue eventually.We reviewed the progress of neural invasion of pancreatic cancer in this paper.

Objective To explore the key points of diagnosis,treatment and the reasonable surgical methods in 39 cases of pancreas trauma.Methods A retrospective review and analysis the cause and classification of injury,surgical methods of 39 cases of pancreatic trauma in the Department of General Surgery of Affiliated Provinical Hospital of Anhui Medical University during Jan.1990 to Dec.2011.Results In the 39 patients who underwent surgery,38 patients were cured,1 dead duing to craniocerebral injuries,3 patients with complications of pancreatic leakage cured after adequate drainage.Two patients with pancreatic pseudocyst pancreatic pseudocystcyst cured after pancreatic pseudocyst jejunum anastomosis.One patients with traumatic pancreatitis cured after conservative treatment.Conclusions Blunt injury is the most common cause of pancreas trauma.Imaging examination has high value in the early diagnosis of pancreas trauma.The reasonable surgical methods and careful examination during operation can improve the cure rate and reduce the mortality and incidence of complications of pancreatic trauma.If the patient's condition allowed,endoscopy not only contributes to the diagnosis of pancreatic trauma,but is an effective method for treatment of it.

Purpose To study clinical pathological characteristics,margin status and its influencing factors in different type of facial basal cell carcinoma (BCC).Methods The histopathological features,margin status of the first frozen section and influencing factors was retrospectively analyzed,with review of the relevant literature.The primary outcome variable was the rate of initially positive frozen section margins.Multivariable Logistic regression was used to study histologic subtype,surgical margins,tumor size,location and other factors influence on the rate of initially positive frozen section margins.Results The pathological subtype is the major risk factor,the infiltrative (OR =4.463,95％ CI =1.919-10.380,P ＜0.05) and morpheaform (OR=5.018,95％CI=2.025-16.623,P＜0.05) had higher risk on positive surgical margin compared with the nodular.The rate of initially positive frozen section margins of nodular and superficial BCC at different margins were observed but the difference were not significant (P ＞ 0.05).Conclusion The pathological subtype is the major risk factor.Surgical excision with a 3 mm margin can achieve ideal results for nodular and superficial BCC in facial area.

Pancreatic cancer is a commonly malignant gastrointestinal tumor with an significantly increasing incidence.Those patients without nonspecific symptoms at early stage had mostly lost the opportunity of surgical therapy when pancreatic cancer was detected at advanced stage,and its prognosis is poor.Therefore,it is rather important to improve the early diagnosis of pancreatic cancer.In recent years,proteomics is developing rapidly.Proteomics technologies have been widely used in clinical research.Using proteomics technology screening pancreatic cancer tumor markers becomes the research focus,thus we try to find a kind of or a group of pancreatic tumor markers,so as to improve the diagnosis of pancreatic cancer.

ObjectiveTo find out the inhibitory effects of CD4 - CD8 - DNT cells on growth of which depresses the pancreatic cancer in vitro and in vivo.Methods The inhibitory effects of DNT cells on the growth of Panc- 1 were studied in vitro by MTT method.Eighteen BALB/c mice were divided into 3 groups randomly.Human pancreatic cancer xenografts were established in 2 groups randomly.The last group was injected the cell suspension which comprises DNT and Panc- 1 cells ( Panc- 1∶ DNT =1∶ 5 ).When the diameter of tumor was about 5 mm,the first 2 group mice were further divided into 2 groups randomly.One was control,treated with distilled water.The other was treated with celebrex (4 mg/d).The size of the tumors was calculated every 2 weeks and tumor growth curve was depicted.At the end of the treatments,the mice were sacrific and the tumors were harvested.The tumor inhibition rate was calculated.Results( 1 ) MTT study showed that DNT cells produced a dose- dependent inhibition of Panc- 1 proliferation in vitro.(2) The growth of transplanted pancreatic cancer was down-regulated by treatment of DNT cells.ConclusionDNT cells can inhibit the growth of pancreatic cancer in vitro and in vivo.

ObjectiveTo summarize the clinical features and surgical outcomes in solid pseudopapillary tumor of pancreas.MethodsA retrospective clinical analysis was made on 18 cases of solid pseudopapillary tumor of pancreas confirmed by pathological diagnosis from Jan.2000 to Feb.2011.ResultsThe median age of these cases was 27.8 years,ranging from 15 to 46 years.Fifteen cases were female and 3 cases were male.The size of the tumor ranged from 4.0 cm to 15.0 cm,with an average size of 7.1 cm.Eleven of 18 tumors(61.1％ ) had a well-defined capsule,and 5 tumors (27.8％ ) extended beyond the pancreas.Nine of the 18 tumors (50.0％) had a cystic component,and calcification was observed in 3 tumors ( 16.7％ ).The frequency of microscopic venous invasion,lymphatic invasion,and nerve invasion was 16％ (3 of 18),0 and 0 respectively.No lymph node involvement or liver metastasis was observed.Distal pancreatectomy plus splenectomy was done in 5 patients,spleen- preserving distal pancreatectomy in 3,medial pancreatectomy in 1,subtotal stomach- preserving pancreatoduodenectomy in 1,enucleation in 9.Fifteen patients were still alive without recurrent disease or metastasis after a median follow-up of 48 months.Conclusions These results demonstrated that solid pseudopapillary tumor of pancreas occurs mainly in young women,patients with solid pseudopapillary tumor of the pancreas had a favorable outcome after surgical treatment,including enucleation.

Objective To investigate the clinicopathological features of patients with serous cystadenomas of the pancreas (SCAP).Methods The clinical and pathological features of 21 cases of SCAP were retrospectively analyzed.Results The mean age of the 21 cases was 61 years old,male:female ratio was 1∶ 1.33,18 (85.7％) patients presented with abdominal pain,bloating,abdominal mass,weight loss,and 3 (14.3％) patients were found during check-up.The tumors were located in pancreatic head in 9 patients,in pancreatic body and tail in 12 patients.The clinical manifestations were pancreatic cystic lesions.All patients underwent surgery.Histologically,the cyst wall was complete and lined with flat or cuboidal epithelium,cytoplasm was translucent,nucleus were round or oval with similar size,no significant nuclear atypia and mitotic activity was found.The pathologic diagnosis was micro-cyst type in 15 cases,single-cyst type in 6 cases.Immunohistochemistry method showed EMA,CK7,CK19 positive and PAS staining positive.The positive expression rate of Ki 67 was between 1％ and 3％.After follow-up of 19 cases ranging from 3 months to 7 years,no recurrence and metastasis was detected.Conclusions SCAP is seen predominantly in elderly female patients with significant symptoms.A majority of tumors are located in the pancreatic body and tail.SCAP presents with characteristics of pancreatic ductal epithelial,and the prognosis is excellent.

Objective:To investigate the clinical feature, diagnosis and treatment of autoimmune pancreatitis(AIP).Methods:Clinical data of 20 AIP patients admitted to the First Affiliated Hospital of University of Science and Technology of China from Jan 2014 to Dec 2019 were retrospectively analyzed.Results:Nineteen patients were diagnosed with type 1 AIP and 1 patient was with type 2 AIP. Fifteen patients were diagnosed by imaging, serology and other organ involvement, and 5 patients were confirmed by postoperative histopathology. Thirteen patients received glucocorticoid therapy. Five patients have not received glucocorticoid therapy after surgery.One patient refused treatment, and 1 patient is currently under clinical observation. Seventeen of the 20 patients were followed up, 11 patients were on glucocorticoid therapy with related clinical symptoms being gradually improved, serum IgG4 decreased and imaging findings improved. Five patients did not relapse after drug withdrawal. Three patients had recurrence of jaundice after drug withdrawal. One patient had recurrence of pancreatic lesions after drug withdrawal. Two patients had recurrence of high serum IgG4 after tapering the doses, these 6 patients were treated with steroid maintenance therapy. One patient died of repeated gastrointestinal bleeding 2 months later, and another 4 surgical patients and 1 patient under clinical observation are in good condition.Conclusions:AIP should be diagnosed in combination with clinical manifestations, serological examination, imaging examination and histopathology, especially focal lesions should be differentiated from pancreatic cancer, so as to avoid missed diagnosis and unnecessary surgical intervention.

Objective To determine the expression of brain-derived neurotrophic factor (BDNF) in pancreatic ductal adenocarcinoma and its clinical significance.Methods SP immunohistochemical staining method was used to detect the expression of BDNF in 46 cases of pancreatic ductal adenocarcinoma,38 cases of benign pancreatic diseases and 20 cases of normal pancreatic tissue.Real time PCR and Western blot was used to detect the protein and mRNA expression levels.The relationship between BDNF expression and clinicopathological parameters of pancreatic cancer was determined.Results The positive expression rate of BDNF was 52.2％ (24/46) in pancreatic ductal adenocarcinoma pancreatic ductal adenocarcinoma,7.8％ (3/38) in benign pancreatic diseases,and none of the normal pancreatic tissue was BDNF positive.The BDNF protein expression levels in pancreatic ductal adenocarcinoma,benign pancreatic diseases and normal pancreatic tissue were 0.38± 0.01,0.56± 0.01,0.97± 0.01,respectively,and the BDNF mRNA expression levels were 0.85 ± 0.14,1.67 ± 0.21,3.45 ± 0.67,respectively,and the expression levels in pancreatic ductal adenocarcinoma and benign pancreatic diseases were significantly higher than that in normal pancreatic tissue,while the expression level in pancreatic ductal adenocarcinoma was significantly higher than that in benign pancreatic diseases (P ＜0.05).Positive BDNF expression was correlated with nerve infiltration and lymph node metastasis of pancreatic ductal adenocarcinoma,but it was not related to age,sex,tumor size,location and differentiated degree (P ＞ 0.05).Conclusions BDNF is involved in the development and growth of pancreatic cancer,and it may be related with patient's prognosis.

Objective To discuss the diagnosis and treatment of systemic lupus erythematosus(SLE)patients associated with pancreatic pleural effusion and pancreatic:panniculitis.Methods Retrospectively analyzed the clinical data,therapy and experiences.Results A 40-year-old female SLE patient associated with pancreatitis,huge pancreatic pseudocysts,pancreatic pleural effusion,pancreatic panniculitis.Abdominal computed tomography(CT)showed an edematous swelling of the pancreas and several pseudocysts,the biggest one measuring 230 mm×95 am.Markedly elevated amylase (11 327 U/L)was contained in the massive pleural effusion.Erythema nodosum tissue pathology revealed the pancreatic panniculitis.The pscudocyst did not completely resolve with high-dose steroid.Growth hormone release inhibiting hormone (GIH),ulinastatin,nasojejunal feeding,and it was later complicated by infection and rupture.After a surgical percutaneous drainage for the complicated pseudocyst,the clinical symptoms and signs were markedly improved.Conclusion This case shows the importance of performing eady drainage rather than conservative treatment for pancreatic pseudocyst in patients with lupus-associated pancreatitis.