uld remarkably inhibit the systemic inflammatory reaction and attenuate the severity of pancreatic injury,and the mechanism may include inhibit the release of TNF-α and IL-1 as well as up-regulate the production of IL-10.

Objective: To review the lately new progress of fish collagen as biomedical materials, and then analyze feasibility and risk management of its application as a substitute of collagen originated from mammals in clinical practice. Methods: Based on extensive research on new application and investigation of fish collagen, the paper was prepared to bring comprehensive analysis of its research and application status, and then several key points were focused on. Results: Fish collagen has been proved to be a novel collagen of rich source, low risk of virus transmission, low biological risk, less religious barrier, and high biocompatibility. Fish collagen has promising prospect when applied in clinical practice as novel collagen especially as a substitute of collagen derived from mammals. However, very few related translational medicine research of fish collagen has been reported up to now in China. Conclusion: As a novel potential substitute of collagen source derived from mammals, fish collagen is concerned to be clinical feasible and necessary in translational medicine. However, massive applied basic researches should be focused on in the further investigations.

Objective To investigate the protective effect of carbon monoxide releasing molecule (CORM-2) on severe acute pancreatitis (SAP) induced lung injury in rats.Methods Thirty male Wistar rats were randomly divided into three groups (n= 10) including sham group, SAP group and CORM-2 group.The model of SAP was induced by retrograde infusion of 3.5% sodium taurocholate into the pancreatobiliary duct.CORM-2 (8 mg/kg) was infused through the dorsal artery of penis 0.5 h after establishing the model of SAP in CORM-2 group.All animals were sacrificed 6 h after SAP in-duction.The serum level of tumor necrosis factor-α (TNF-α), pulmonary cytokine induced neutrophil chemoattractant (CINC), intercellular adhesion molecule-1 (ICAM-1) mRNA expression as well as the activity of myeloperoxidase (MPO) in the lung were examined in each group.The wet/dry ratio of the lung was also determined.The lung was scored on the basis of pathological changes.Results Compared with SAP group, pulmonary over-expression of CINC and ICAM-1 mRNA was obviously inhibited in CORM-2 group and the serum TNF-α level, the MPO activity in lung tissue, the wet/dry ratio of lung, and the pathological score of lung injury were significantly lower (P＜0.05).Conclusion Administration of CORM-2 can remarkably reduce the severity of SAP induced lung injury through in-hibiting the over-expression of CINC and ICAM-1 mRNA, down-regulating the serum TNF-α level and subsequently decreasing pulmonary neutrophil infiltration.

Objective To summarize the experience in surgical management of hilar cholangiocarcinoma.Methods The clinical data of 88 patients with hilar cholangiocarcinoma who received surgical treatment at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.All the patients were diagnosed by imaging examination.According to the severity of jaundice and predictive remnant liver volume,19 patients received percutaneous transhepatic cholangial drainage (PTCD) and 4 received portal vein embolization.The fundamental operation consisted of hilar cholangiocarcinoma resection,skeletonization of hepatoduodenum ligament and Roux-en-Y cholangiojejunostomy,and the transanastomotic stent was placed for 6 months.The count data were analyzed using the chi-square test; the survival rate was analysed using the Kaplan-Meier method; the survival was analyzed using the Log-rank test.Results Of the 88 patients,58 patients (including 11 patients who received PTCD) received hilar cholangiocarcinoma resection.Of the 58 patients,43 (including 4 patients who received portal vein embolization preoperatively) received R0 resection,and 15 received palliative resection.Thirty patients received internal and (or) external drainage.Commitant partial hepatectomy was performed on 22 patients (including 9 received left hemihepatectomy,2 received extended left hemihepatectomy,7 received left hemihepatectomy + caudate lobectomy,4 received right hemihepatectomy).Commitant pancreatico-duodenectomy was performed on 7 patients,commitant hepatic artery resection on 3 patients,and commitant portal vein resection on 2 patients.According to the modified Bismuth-Corlette classification,there were 17 patients with type Ⅰ,19 with type Ⅱ,21 with type Ⅲa,20 with type Ⅲb,and 11 with type Ⅳ.Of the 58 patients who received hilar cholangiocarcinoma resection,19 had postoperative complications,and 2 patients died within 30 days after operation.Seventy-three patients were followed up,and the overall 1-,3-,5-year survival rates were 68.5％,28.8％,11.0％,respectively.The 1-,3-,5-year survival rates of patients who received R0 resection were 94.6％,43.2％,18.9％,respectively,which were significantly higher than 78.6％,35.7％ and 7.1％ of patients who received palliative resection (x2=4.77,P ＜0.05).The 1-,3-,5-year survival rates of patients who received palliative resection were significantly higher than 18.2％,0,0 of patients who received biliary drainage (x2 =13.26,P ＜ 0.05).Conclusions R0 resection is the best choice for patients with hilar cholangiocarcinoma,and biliary drainage with no resection is the last choice.Sufficient preoperative treatment,optimized choice of surgical procedure and exquisite surgical techniques are important for the improvement of the prognosis.

Low shear stress is a component of the tumor microenvironment in vivo and plays a key role in regulating cancer cell migration and invasion. The integrin, as a mechano-sensors mediating and integrating mechanical and chemical signals, induce the adhesion between cells and extracellular matrix (ECM). The purpose of this study is to investigate the effect of low shear stress (1.4 dyn/cm2)on the migration of HepG2 cells and the expression of integrin. Scratch wound migration assay was performed to examine the effect of low shear stress on the migration of HepG2 cells at 0 h, 1 h, 2 h and 4 h, respectively. F-actin staining was used to detect the expression of F-actin in HepG2 cells treated with low shear stress at 2 h and 4 h. Western blot analysis was carried out to determine the effect of low shear stress on the expression of integrin at different durations. The results showed that the migrated distance of HepG2 cells and the expression of F-actin increased significantly compared with the controls. The integrin alpha subunits showed a different time-dependent expression, suggesting that various subunits of integrin exhibit different effects in low shear stress regulating cancer cells migration.
Actins ; physiology ; Cell Movement ; Extracellular Matrix ; physiology ; Hep G2 Cells ; Humans ; Integrins ; physiology ; Stress, Mechanical

Objective To evaluate a new gene therapy for the treatment of experimental occlusive arterial disease Methods Magnetic nanospheres were produced, VEGF gene was cloned for subsequent construction of eukaryotic expression plasmid The magnetic gelatin microspheres used in targeted gene therapy were prepared by emulsion crosslinking method The microspheres were injected intrafemorally in rabbits through contralateral femoral artery, and the ischemic limb was placed in a magnetic field Angiography was performed on day 10 and day 30 respectively The capillary density and the capillary to muscle fiber ratio were determined histochemically Results Compared to the controls there was significant collateral artery development in VEGF transfected group The capillary density and the capillary to muscle fiber ratio were significantly higher for the VEGF transfected group than for the control group. The capillary density of control was (125?23)/mm 2, and in VEGF group was (298?27)/mm 2, P

Objective To investigate the diagnosis and treatment of intraductal papillary mucinous neoplasm (IPMN) of the pancreas.Methods The clinical data of patients with pathologically verified IPMN who underwent surgical treatment between January 2006 to April 2014 in the First Affiliated Hospital of Harbin Medical University were studied retrospectively.There were 27 males and 21 females.The average age was (57.8 ± 8.8) years old.The average caliber of the main pancreatic duct was (1.1 ± 0.6) cm.The average size of the branch duct IPMN was (4.6 ± 1.5) cm.Results 35 patients underwent pancreaticoduodenectomy.Eight patients underwent distal pancreatectomy.Two patients underwent duodenum-preserving pancreatic head resection.Two patients underwent splenic-preserving distal pancreatectomy and one patient underwent total pancreatectomy.No patient died in perioperative period,and the median length of hospital stay after surgery was 14.3 days.Postoperative pathological examination revealed 5 (10.4％) adenoma,12 (25.0％) moderate-grade dysplasia,14 (29.2％) high-grade dysplasia and 17 (35.4％) invasive carcinoma.The postoperative complication rate was 22.9％.The mean follow up period for the noninvasive tumors was 48.9 months,with no recurrence or deaths.The mean follow up period of the invasive tumors was 43.2 months,with 1 death and no recurrence.Conclusions The indications for resection of IPMN should be based on treatment guidelines and on the patient' s general condition.It is suggested that the diagnosis and treatment of IPMN should be conducted in specialized pancreatic surgery centers.

Objective To study the impact of blood transfusion on postoperative complications of pancreaticoduodenectomy.Methods The medical data of 356 patients who underwent pancreaticoduodenectomy from January 2005 to December 2011 were retrospectively analyzed.242 patients in the transfusion group received blood transfusion while the remaining patients in the non transfusion group received no blood transfusion.Results The rates of pancreatic fistula and pulmonary infection,mean operative time,intraoperative blood loss,and hospital stay were 17.8％,16.5％,6.4 h,920.0 ml and 29.1 d in the transfusion group compared with 8.8％,6.1％,5.4 h,150.0 ml and 25.9 d in the non-transfusion group,respectively (P＜0.05).However,there were no significant differences between the two groups in the rates of biliary fistula,gastrointestinal and intraabdominal bleeding,delayed gastric emptying and death.Conclusions Patients undergoing pancreaticoduodenectomy in the non-transfusion group had significantly lower rates of pancreatic fistula and pulmonary infection,shorter operative time and hospital stay,and less intraoperative blood loss.This study suggested that a reduction in intraoperative blood loss by advanced instruments and techniques,with operations carried out by experienced pancreatic surgeons in specialized pancreatic center,could result in a significantly lower postoperative complication rate.

Objective To investigate the clinical efficacy of total pancreatectomy (TP) tor pancreatic cancer.Methods The retrospective descriptive study was conducted.The clinicopathological data of 11 patients who underwent TP for pancreatic cancer in the First Affiliated Hospital of Harbin Medical University from March 2009 to January 2016 were collected.Patients received planned TP or unplanned TP and digestive tract reconstruction using biliojejunal end-to-side anastomosis and side-to-side gastrojejunostomy.Observation indicators included:(1) treatment situations;(2) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect the level of fasting blood glucose,glycosylated hemoglobin,dosages of insulin and pancreatic enzymes,symptoms of emaciation and diarrhea and patients' prognosis up to November 2016.Measurement data were represented as (x)±s,average (range) and M (range).Results (1) Treatment situations:all the 11 patients underwent successful TP,including 4 undergoing planned TP due to pancreatic multiple spaceoccupying lesions by preoperative imaging examination and 7 undergoing unplanned TP.Two patients received partial resection of the superior mesenteric vein and artificial vascular replacement due to tumor invading superior mesenteric vein.Two patients without cholangiectasis received external drainage through intraoperative biliary stent placement,and drainage tube was removed at month 1 postoperatively.Operation time was 270-640 minutes,with an average of 450 minutes.Volume of intraoperative blood loss was 200-1 500 mL,with an average of 564 mL.Five patients had intraoperative blood transfusion,with volume of 400-1 600 mL.Results of postoperative pathological examination of 11 patients:R0 and R1 resection were respectively detected in 10 and 1 patients;4 and 7 patients were in stage Ⅱ A and Ⅱ B,showing pancreatic ductal adenocarcinoma.Number of lymph node dissected with an average of 17.2±2.3 per case.Seven patients were complicated with local lymph node metastases,with a number of 2.1 per case.Three of 11 patients received postoperative 6-cycle chemotherapy regimens of gemcitabine and cisplatin.Four patients with postoperative complications were improved by conservative treatment,including 2 with infection,1 with bile leakage and 1 with delayed gastric emptying,without death.Duration of hospital stay was 15-56 days,with an average of 24 days.(2) Follow-up situation:11 patients were followed up for 5-24 months.During follow-up,levels of fasting blood glucose and glycosylated hemoglobin were respectively 5.0-10.0 mmol/L and 5.4％-10.4％,with averages of 7.6 mmol/L and 7.5％.Dosages of insulin and pancreatic enzymes were respectively 18.0-28.0 U/d and 450-900 mg/d,with averages of 22.7 U/d and 640 mg/d.During follow-up,4,5 and 2 patients had respectively increased,normal and decreased appetites.Three,4 and 4 patients had respectively increased,unchanged and decreased body weights.Symptoms of diarrhea,fatty liver (outpatient reexamination) and hypoglycemia were occurred in 2,2 and 1 patients,respectively.Of 11 patients,2 had tumorfree survival,and 9 had survival with tumor,with a median survival time of 12 months (range,5-23 months),including 3 with abdominal metastases or recurrence,2 with liver metastases,2 with pulmonary metastases and 2 with retroperitoneal lymphatic metastasis.Conclusion TP is safe and feasible for pancreatic cancer,it can also provide better quality of life for patients under conditions of regulating blood glucose and supplying pancreatic enzyme.

OBJECTIVETo investigate the effect of utilizing octreotide during perioperative period on pancreatic fistula after pancreaticoduodenectomy (PD).

METHODSThree hundreds and six patients admitted from January 2010 to October 2014, who prepared to undergo pancreaticoduodenectomy (PD) were randomly divided into octreotide group (147 cases) and control group (159 cases). In octreotide group, octreotide was used in subcutaneous injection instantly after PD, each 8 hours until postoperative 10(th) day, and patients in control group were injected with the same volume of saline. Differences of pancreatic fistula (Grade A, Grade B, Grade C), hospitalization days and treatment cost were compared. χ(2) test, t-test and Fisher exact test were used to analyzed to the data, respectively.

RESULTSNo statistical significance (P>0.05) between two groups in the incidence of pancreatic fistula after PD (Grade A: 8.8% vs. 10.2%, Grade B: 2.7% vs. 4.4%, Grade C: 0.7% vs. 1.3%; χ(2)=0.197, 0.700, 0.288; P=0.657, 0.403, 0.591), the length of hospitalization((12.1±1.2)days vs. (13.0±1.2)days)(t=1.711, P=0.104) and treatment cost (79 700±6 700 vs. 77 600±5 200)(t=1.378, P=0.185). When accompanied with high risk factors, such as soft texture of pancreas, pancreatic duct size less than 3 mm, BMI≥25 kg/m(2) and diabetes, compared with control group, octreotide group had the lower incidence rate of pancreatic fistula and clinical correlative pancreatic fistula(all P<0.05) after PD.

CONCLUSIONSGenerally, octreotide makes no contribution to reduce the incidence of pancreatic fistula after PD. However, for patients who is accompanied with high risk factors, such as soft texture of pancreas, pancreatic duct size less than 3 mm, BMI≥25 kg/m(2) and diabetes, octreotide can effectively prevent pancreatic fistula after PD.

Anastomosis, Surgical ; Humans ; Incidence ; Octreotide ; therapeutic use ; Pancreas ; pathology ; Pancreatectomy ; Pancreatic Ducts ; pathology ; Pancreatic Fistula ; drug therapy ; Pancreaticoduodenectomy ; adverse effects ; Perioperative Period ; Prospective Studies