BACKGROUND:In recent years, the morbidity of chronic pancreatitis has been increasing dramaticaly with lifestyle changes. Fortunately, endoscopic pancreatic stenting for patients with chronic pancreatitis shows favorable clinical prospects.OBJECTIVE:To introduce the advantages and disadvantages of various stent materials and to review the development and clinical application of pancreatic stents.METHODS: With the key words of chronic pancreatitis, pancreatic stent in Chinese and English, respectively, a computer-based search was performed for articles published in CNKI and PubMed databases from January 2005 to November 2016. After the initial screening, articles related to endoscopic pancreatic stenting usedin vitro,in vivo or in clinic were included.RESULTS AND CONCLUSION: Endoscopic pancreatic stenting has become a recognized treatment for chronic pancreatitis in recent years. Therefore, the development and application of the materials of pancreatic duct stents appear to be particularly important. According to different materials, pancreatic duct stents can be classified into plastic stents, fully covered self-expandable metal stents, and biodegradable stents. The complications, including stent migration and secondary surgery, frequently appear in the clinical use of plastic pancreatic duct stents and self-expandable metal stents, although they have been widely used in clinical practice. Biodegradable pancreatic duct stents can be degraded completely in the pancreatic duct within the expected time, and thereby avoid several complications. Consequently, the exploitation and application of biodegradable pancreatic duct stents have become an issue of concern.

Objective To observe the impact of RNA interference-induced ADAR1 down-regulation on cell proliferation of liver cancer.Methods Small interfering RNA (siRNA) was transfected into liver cancer cell line SMMC-7721.ADAR1 expression was detected by RT-PCR and Western blotting.Cell proliferation was determined by methyl thiazol tetrazolium (MTT) assay.Results After transfection for 24,48,and 72 h,ADAR1 mRNA expression was 0.612 ± 0.086,0.264 ± 0.018,0.156 ± 0.063 in experimental group and 1.032 ± 0.107,0.898 ± 0.092,0.968 ± 0.074 in control group,respectively.Experimental group had significantly lower ADAR1 mRNA than the other groups (P ＜ 0.05),and there was no statistically significant difference between control and blank group (P ＞ 0.05).ADAR1 protein relative expression was 0.684 ± 0.079,0.324 ± 0.042,0.145 ± 0.058 in experimental group and 1.002 ± 0.092,0.917 ± 0.068,0.972 ± 0.073 in control group,respectively,which was statistically significant (P ＜ 0.05).After transfection with siRNA,the proliferation ability of SMMC-7721 cells was enormously inhibited (P ＜ 0.05).Conclusion ADAR1 mRNA and protein level could be significantly decreased by specific RNA interference,and cell proliferation in SMMC-7721 cells were also greatly inhibited.

Objective:To observe the role of enteral nutritional support in treating superior mesenteric artery syndrome. Methods: Enteral nutritional support was used in two patients with superior mesenteric syndrome after percutanous endoscopic jejunostomy.Enteral nutrition was used for 69 days and 180 days.The symptoms were observed.Body weight and index of nutrition were measured.Results: After enteral nutritional support,symptoms of two patients disappeared.Body weight and fibronectin and prealnumin increased.Conclution: Enteral nutritional support is one of effective methods of treating superior mesenteric artery syndrome.

Objective To observe and classify the characteristics of optical coherence tomography (OCT) for several common diseases which could lead to submacular choroidal neovascularization (CNV), and to provide the warrant to make the differential diagnosis and treatment of CNV. Methods The data of OCT of 165 patients (187 eyes) with CNV due to AMD, CEC, high myopia and ICNV diagnosed by fundus photography and fundus fluorescein angiography (FFA) were retrospectively analyzed, and the images of OCT were classified considering the results of FFA, and the characteristics of different types of the images were sumerized. Results Well-defined fusiform thickening of retinal pigment epithelial (RPE) and choriocapillary layer in CNV with well-defined border (60 eyes), dispersed backscattering increase in poorly-defined CNV (101 eyes), optic darkspace beneath RPE layer in serous detachment of RPE layer (19 eyes), quickly decreased high backscattering region under RPE layer in hemorrhagic detachment of RPE layer (11 eyes), slight to moderate backscattering region between RPE layer in fibrovascular detachment of RPE layer (10 eyes), and detachment of neurepithelial layer from RPE layer with the optic darkspace between the layers in detachment of neurepithelial layer (45 eyes) were observed. Conclusions The images of OCT for the common diseases which could lead to submacular choroidal neovascularization may be divided into 6 types. Analyzing the characteristics of images of OCT is helpful in differential diagnosis and treatment of CNV.

Objective To investigate the effect of triamcinolone acetonide (TA) with different dosage and excipient on retina. Methods Thirty-two purebred New Zealand white rabbits randomly divided into 4 groups underwent intravitreous injection with TA. Group 1:4 mg TA without excipient; group 2:25 mg TA without excipient; group 3:4 mg TA with excipient; group 4:25 mg TA with excipient. Electroretinography (ERG) was performed on each rabbit before intravitreal injection, 1 week, 1 and 2 months after the injection. All the animals were killed and the eyeballs were extirpated 2 months after the injection, and pathological examinations including light and electron microscopy were performed. Results No significant difference was found in the latent period of ERG at the points of time before and after the injection in all the groups, but the amplitudes of ERG waves was lower in groups containing excipient than that before the treatment (P

Objective To evaluate percutaneous endoscopic gastrostomy (PEG) for long-term enteral nutrition in patients with cancers of head and neck. Methods PEGs were performed for 12 patients with head and neck cancers, the indication for which included serious buccal mucositis, difficulty in swallowing, anorexia, and obstruction of the digestive tract. Before PEG and 8 weeks after PEG, serum concentrations of total protein and albumin of the patients were measured, body composition including body weight, free fat mass, and fat mass were measured by bioelectric impedance analysis (BIA), and Karnofsky performance score ( KPS) was evaluated. Results After enteral nutrition for 8 weeks through PEG, the serum concentrations of total protein and albumin of the patients increased significantly (63.8?0.3g/L vs 57.4?0.2g/L, P

Background Combination of cataractopiesis with intraocular lens (IOL) is believed to improve the patient' s quality of life. However, 1OL power and axial length measured by traditional method in silicone-filled eye is normally bias to the actual levels. The optical coherence biometry technology has been widely used in the measurement of IOL, but little studies have been conducted to demonstrate the IOL power difference between those methods. Objective This study was to evaluate the predictability of IOL power calculations using the IOLMaster and adjusting contact ultrasound A-scan method in silicone oil-filled eyes. Methods Forty-four silicone-filled eyes of 42 patients were divided into 2 groups according to the intraocular pressure (IOP) ( group A: ≥ 10 mmHg group,29 eyes;group B:＜10 mmHg group, 15 eyes). IOLMaster and ocular ultrasonic measurement were used to measure the axis length before and after silicone oil was removed. The preoperatively measured eye axis and cornea curve were used to calculate the theoretical IOL. Results In normal IOP group ( T≥ 10 mmHg,29 eyes), the precision and stability of IOLMaster for axial length ( AL ) measurements and IOL power calculations were better than adjusted ultrasound A-scan( ZIOLMasterdependent = -2. 236, P = 0. 025 ), although in low IOP group ( T＜ 10 mmHg, 15 eyes),there were too much differences in axial length mesurement and IOL power calculation between the IOLMaster and adjusted ultrasound A-scan, so the post-operative imformation was not predicted accurately. Conclusion For anticipatory normal postoperative IOP eyes, the refractive outcome in cataract surgery in silicone oil-filled eyes can be predicted reliably and accurately with IOLMaster. But for complicated or anticipatory unstable postoperative IOP eyes,secondary implantation of IOL would be better.

Objective To study the clinical efficacy of intra-operative implantation of I125 seeds to treat advanced pancreatic cancer.Methods We retrospectively analyzed the clinical data of 28 patients who underwent intra-operative implantation of I125 between January 2009 and June 2010 to treat advanced pancreatic cancer.Patients who received conservative treatment (n =136) at the same period were used as the control group.Results The mean tumor diameter was (5.7 ± 1.7) cm.The average number of implanted seeds were 50.There were no patients who suffered from pancreatic fistula or post-operative bleeding,and no patient died from the treatment.Twenty-five patients were regularly followed up,and the follow-up rate was 85.7％.The survival rates at one month,half a year and one year were 100％,70.8％ and 26.9％,respectively.The average survival time was (9.9 ± 1.4) months.The survival data were significantly higher than that in the control group.Conclusion Intra-operative implantation of I125 seeds was an efficacious treatment for patients with advanced pancreatic cancer.

Objective To investigate the incidence of contrast induced nephropathy (CIN) among different patient groups after contrast agent injection.Methods A total of 1243 patients were included in this study (male =694,female =549).The SCr level one week before and 72 hours after the CT examination and the incidence of CIN were recorded and comparison was made among groups according to sex,age,body mass index (BMI),the history of high blood pressure (HBP),diabetes mellitus (DM),chronic kidney disease (CKD),chronic heart failure (CHF),tumor,nephrotoxicity drug (NTD) usage.The frequency,type,dose and injection velocity of the contrast media(CM)were also recorded.Multivariate predictors of CIN were identified by Logistic regression using step-wise selection with entry and exit criteria of P ＜0.10,results were tabulated as odds ratios (OR) with 95％ confidence intervals (CI).Results Among 1243 consecutive patients,the incidence of CIN was 5.5％ (68/1243).Patients with a history of HBP,DM,CHF,CKD or tumor presented with higher incidence of CIN than that of controls (5.9％,51/868 vs.4.5％,17/375).CIN developed in 9 of 203 patients (4.4％,9/203) with CKD and in 59 of 1040 patients (5.7％,59/1040)without CKD.There was no significant difference between the two groups(x2 =0.51,P =0.30).In CKD (-) group,the incidence of CIN was higher in females,patients with DM and patients using LOCM than those of males,DM (-) and using low osmolality contrast medium (IOCM) (P ＜ 0.05),but there was no statistical significance in CKD (+) group.Logistic regression analysis showed that women,age ≥ 75 years,DM,LOCM,NTD,tumor,the time of using CM more than once per month were the most significant predictors of CIN (OR ＞ 1).Conclusion Women,age ≥ 75 years,LOCM,NTD,tumor,and the frequency of using CM more than once per month were more likely to develop CIN.

Objective To evaluate risk factors of hepatitis B virus (HBV) reactivation after transarterial chemoembolization (TACE) in patients with HBV-related hepatocellular carcinoma (HCC) with undetectable HBV DNA levels.Methods From August 2012 to Sepemter 2015,all patients who underwent TACE for HBV-related HCC with HBV DNA level less than 103 copies/ml in the First Affiliated Hospital of Soochow University were enrolled into the study.These patients were followed-up for at least 6 months after TACE to assess HBV reactivation.Univariate and multivariate logistic regression analyses were done to evaluate the risk factors related to HBV reactivation in these patients.Results With predetermined inclusion and exclusion criteria,99 patients were enrolled into the study.Twenty-four patients (24.2％) developed HBV reactivation after TACE in the followed-up period.The level of transaminase was significantly higher in the HBV reactivation group than the non HBV reactivation group (P ＜ 0.05).HBeAg positivity and tumors more than 3 in number were independent risk factors of HBV reactivation.Conclusion HCC patients with undetectable levels of HBV DNA had a significant risk of HBV reactivation after TACE.