OBJECTIVETo study the diagnosis and treatment of glucagonoma.

METHODSA retrospective review of glucagonoma cases was committed between June 1993 and July 2008 in Peking Union Medical College Hospital. It was measured by sex, age, misdiagnosis, clinical symptoms, laboratory data, imaging studies, diagnosis, treatment procedures and so on.

RESULTSThe tumors of eleven cases were found in the tail, and one case was in the head of the pancreas at the same time. Ten had solitary lesion, one had multiple lesions. The average diameter of the lesions was 3.9 cm. Nine patients had the metastasis out of pancreas and all of them had the liver metastasis. One case was a member of multiple endocrine neoplasia type 1 (MEN-1) syndromes. Eight patients being treated with operation had the detailed pathological reports. The glucagon was detected by immunohistochemistry and was positive in five patients. Six patients were pathologically malignant. Multimodal treatments included tumor resection, chemoembolization, treated with somatostatin analogues and (or) radionuclides and so on were applied to all patients.

CONCLUSIONSGlucagonoma is a rare pancreatic endocrine tumor. Radical tumor surgery is used as the first choice. Multimodal approach may improve the prognosis.

Adult ; Female ; Follow-Up Studies ; Glucagonoma ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; therapy ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo analyze and identify the membrane proteins of endomembrane system in human pancreatic cancer cell by proteomics.

METHODSMembrane protein was extracted from pancreatic cancer cell lines Capan-1, MiaPaCa-2, Panc-1. The membrane protein mixture of the three pancreatic cancer cell lines were separated by two-dimensional electrophoresis (2-DE). Positive dots of staining 2-DE gel were identified by MALDI-TOF mass spectrometry and PMF matching, and then evaluated by bio-informatics searching in NCBI and ExPASy databases. Information of membrane proteins were acquired like sequence, molecular weight, isoelectric point, location and biological functions.

RESULTSForty-nine membrane proteins out of 166 protein dots which could be seen on the 2-DE gel were identified as channel carrier proteins (4 proteins), signal transduction proteins (5 proteins), transcription regulatory and translation modification protein (7 proteins), proliferation and apoptosis related proteins (4 proteins), invasion and migration associated proteins (2 proteins), cytoskeleton proteins (3 proteins), metabolism pathway proteins (14 proteins), and function unknown protein (10 proteins).

CONCLUSIONSEndomembrane proteins of pancreatic cancer cell play key roles in tumor malignant behavior like proliferation, metabolism, motility, adhesion and migration. These membrane proteins might become candidate biomarkers or targets of therapy of pancreatic cancer.

Biomarkers, Tumor ; analysis ; Cell Line, Tumor ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Membrane Proteins ; analysis ; Pancreatic Neoplasms ; metabolism ; Peptide Mapping ; Proteomics ; methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVETo understand the status of occupational health of female migrant workers in different kinds of pharmaceutical industries in Gansu province and to provide the basis for improving occupational health condition.

METHODSOne thousand eight hundreds and one female workers from 16 enterprises were selected by cluster sampling in Gansu province and investigated by interviewing and questionnaires.

RESULTSThere were statistical significances of education level, status of residency registrations, employment relationship and occupational hazards among female workers in three types of enterprises (P < 0.05 or P < 0.01). The morbidities of skin disease in female workers for three kinds of enterprises were 4.46%, 2.53% and 3.70%, respectively. The morbidities of reproductive system disease in female workers for three kinds of enterprises were 48.57%, 36.70% and 36.11%, respectively.

CONCLUSIONThe levels of education and working conditions of female workers in the traditional Chinese medicine, western medicine plants are low. There are more severe occupational hazards in female workers of the traditional Chinese medicine plants.

Adolescent ; Adult ; Drug Industry ; Female ; Health Status ; Humans ; Middle Aged ; Occupational Exposure ; Occupational Health ; Surveys and Questionnaires ; Transients and Migrants ; Young Adult

OBJECTIVETo study the clinical characteristics and outcomes of the hereditary medullary thyroid carcinoma (HMTC) and the sporadic medullary thyroid carcinoma (SMTC).

METHODSThe clinical data of 78 patients with medullary thyroid carcinoma who underwent surgery in our hospital between July 1980 and May 2011 were retrospectively analyzed.

RESULTSOf these 78 patients, there were 23 HMTC cases and 55 SMTC cases. The HMTC group was significantly younger age of onset [(36.4±13.5) years vs. (46.6±11.2) years, P<0.01] and a lower pre/post-operative serum calcitonin levels [(850.4±110.20) ng/L vs. (1450.4±118.3) ng/L, P<0.01 and (410.8±133.2) ng/L vs. (1585.4±129.5) ng/L, P<0.01] than the SMTC group. In addition, the mean tumor diameter was also significantly smaller in the HMTC group (14.3 mm vs. 21.0 mm in SMTC group, P<0.05). Tumor multifocality was seen in a significantly higher proportion of HMTC cases compared with the SMTC cases (56.6% vs. 29.1%, P<0.05). The overall 10-year survival was 100% in HMTC group and 80.2% in SMTC group (P<0.05).

CONCLUSIONHMTC has a better prognosis than SMTC.

Adolescent ; Adult ; Age of Onset ; Aged ; Carcinoma, Medullary ; classification ; genetics ; pathology ; Carcinoma, Neuroendocrine ; Female ; Genetic Diseases, Inborn ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; classification ; genetics ; pathology ; Young Adult

OBJECTIVETo observe the effect of local injection of recombinant hirudin on survival of skin flaps with venous congestion in a rabbit model.

METHODSEighteen healthy rabbits were enrolled and divided into heparin-treatment (HT), recombinant hirudin treatment (RHT) and control (C) groups according to the random number table, with 6 rabbits in each group. After intravenous anesthesia with 20 g/L pentobarbital sodium, model of skin flaps with venous congestion in the size of 6 cm × 3 cm was reproduced in the dorsal side of left ear of each rabbit, in which central artery of ear served as the only blood supply, and a pedicle of 1 cm in width including central vessel of ear and its accompanying nerves as the only venous return pathway. Each flap in RHT, HT, C groups was respectively given 1 mL recombinant hirudin (1 U), low-molecular-weight heparin (625 U), and isotonic saline via multi-point and homogenous injection, then they were sutured in site. Appearance and survival rate of the flaps were observed after operation. Specimens of the distal part of flaps were harvested for determination of thromboxane B2 (TXB2) on post operation day (POD) 1, 3, 5, 7. Data were processed with one-way analysis of variance and t test.

RESULTSRabbit model of skin flaps with venous congestion was reproduced successfully. Obvious hair loss was observed in completely necrotic parts of flap in each group. Obvious edema was observed in all flaps with venous congestion at distal site. The color of flaps in HT and RHT groups were lighter as compared with that in C group, and apparent hematoma of flap was observed in 1 rabbit of RHT group, 2 rabbits of HT group, 4 rabbits of C group on POD 1. The survival rate of flap in HT and RHT groups was respectively (92.3 ± 1.7)% and (94.8 ± 1.9)%, both higher than that in C group [(77.9 ± 1.2)%, F = 191.29, P < 0.05]. There was no statistical difference in survival rate of flap between HT group and RHT group (t = 2.75,P > 0.05). The content of TXB2 in HT and RHT groups on POD 3, 5 was respectively lower than that in C group (with t value from 6.68 to 30.55, P values all below 0.01), but there was no statistical difference between HT and RHT groups (with t value respectively 1.22, 6.44, P values all above 0.05).

CONCLUSIONSLocal injection of low-molecular-weight heparin or recombinant hirudin can significantly ameliorate venous congestion of skin flap in rabbit ear, and improve its survival rate.

Animals ; Ear ; blood supply ; Graft Survival ; drug effects ; Hirudins ; pharmacology ; Hyperemia ; Rabbits ; Recombinant Proteins ; pharmacology ; Skin ; blood supply ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the value of the noninvasive examinations for localization of insulinoma.

METHODSThe clinical materials of 88 cases of insulinoma treated in Peking Union Medical College Hospital between January 2005 and November 2008 were analyzed retrospectively. There were 40 males and 48 females aged from 15 to 74 years old (averaged, 46.5 years old).

RESULTSThe positive rates for localization were 19.3% (17/88), 52.4% (11/21), 95.5% (64/67), 1/6, 30.0% (6/20), 83.9% (26/31), 8/8 and 5/5 respectively in transabdominal ultrasound, enhanced CT, multislice spiral CT pancreatic perfusion, MRI, somatostatin receptor scintigraphy, endoscopic ultrasound, laparoscopic ultrasound and intraoperative ultrasound. Thirty-one multiple tumors in 8 patients were resected. The positive rates of locating the multiple insulinomas of multislice spiral CT pancreatic perfusion and Intraoperative Ultrasound were 48.4% (15/31) and 100% (14/14) respectively.

CONCLUSIONSThe locating diagnosis of insulinoma has came to noninvasive examination era. Multislice spiral CT pancreatic perfusion is the first choice for localization. Intraoperative ultrasound might play an important role in locating tumors for patients with multiple insulinomas.

Adolescent ; Adult ; Aged ; Female ; Humans ; Insulinoma ; diagnosis ; Male ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; Retrospective Studies ; Young Adult

OBJECTIVETo screen and identify the immunogenic membrane antigens in human pancreatic cancer for early diagnosis.

METHODSMembrane protein was extracted from pancreatic cancer cell lines and separated by using 2-DE. One of the two parallel 2-DE gels went for staining while the other underwent immunoblot. Serum IgG, which was purified from clinically collected sera of pancreatic cancer patients, was used as the primary antibodies for the immunoblot. Positive dots of immunoblot were identified by MALDI-TOF mass spectrometry and PMF matching, and then evaluated by bio-informatics methods. The candidate membrane antigens were further validated respectively in cell lines and tissues by RT-PCR and immunohistochemistry.

RESULTSThe immunoblot of mixed membrane protein with serum IgG from cancer patients showed eight positive dots. These dots were identified with MALDI and PMF as: VDAC-1, VDAC-2, CHCHD3, SLP-2 and TOM40. RT-PCR showed that these membrane antigens were expressed in several pancreatic cancer cell lines. Immunohistochemistry showed prominent SLP-2 over expression in cancer tissue.

CONCLUSIONSVDAC-1, VDAC-2, CHCHD3, SLP-2, and TOM40 are the new candidate immunogenic membrane antigens of pancreatic cancer. These membrane antigens can be subsequently tested in high dangerous population for early diagnosis of pancreatic cancer.

Biomarkers, Tumor ; analysis ; Cell Line, Tumor ; Early Diagnosis ; Female ; Humans ; Immunoblotting ; Immunoelectrophoresis, Two-Dimensional ; Immunoglobulin G ; blood ; immunology ; Immunohistochemistry ; Male ; Mass Screening ; methods ; Membrane Proteins ; analysis ; genetics ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; immunology ; metabolism ; Proteomics ; methods ; Reverse Transcriptase Polymerase Chain Reaction ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVETo study the expression of the gene and coding protein of catechol o-methyltransferase (COMT) in the colorectal cancer and distant normal mucosa.

METHODSThe tumor tissues and distant normal mucosa of 22 patients with colorectal cancer received surgical treatment from January to August 2009 were collected. Total RNA and protein were extracted and tested using reverse transcription polymerase chain reaction (RT-PCR), Western blot was used to detect the expression of COMT in the tumor tissue and normal mucosa. Tissue array was performed to verify the COMT protein expression. The gray scale scan was used to differentiate the COMT expression level of the mRNA and protein between the two groups.

RESULTSThe tested mean light density of COMT mRNA was 53 514 +/- 15 513 in the tumor tissue group and 4529 +/- 1698 in the normal mucosa group, the expression of COMT gene in colorectal cancer tissue was significantly higher than that in the normal mucosa (P < 0.05). Western blot results showed that the expression level of soluble COMT protein in the colorectal cancer tissue was significantly higher than that in the corresponding distant normal mucosa (mean light density 54 967 +/- 11 919 vs. 25 962 +/- 6713) (P < 0.05), but the expression of membrane-bound COMT protein was not statistically different between the two groups. Tissue array revealed that the COMT protein mainly located in the cytoplasm, and it was significantly over-expressed in the colorectal cancer tissue than in the normal mucosa (P < 0.05).

CONCLUSIONSThe COMT gene and encoding protein is over-expressed in the colorectal cancer tissue than in the distant normal mucosa. The COMT gene might be involved in the biological behavior of the colorectal cancer.

Adult ; Aged ; Aged, 80 and over ; Catechol O-Methyltransferase ; genetics ; metabolism ; Colorectal Neoplasms ; enzymology ; pathology ; Female ; Humans ; Male ; Middle Aged ; RNA, Messenger ; genetics

OBJECTIVETo explore the clinical significance of improvement gastrostomy in pancreaticoduodenectomy.

METHODSClinical data of 82 patients who underwent pancreaticoduodenectomy and jejunostomy from November 2004 to December 2006 were collected, among which 36 patients received improvement gastrostomy (treatment group), 24 patients accepted traditionary gastrostomy (control group 1) and 22 patients without any gastrostomy (control group 2). Operative time, postoperative duration of gastrointestinal decompression tube, postoperative gastroparesis, pancreatic fistula, biliary fistula, and abdominal cavity infection were compared.

RESULTSThe incidence of postoperative gastroparesis in the treatment group and control group 2 were can significantly lower than that in the control group 1 (P < 0.05). The postoperative duration of gastrointestinal decompression tube of the treatment group was significant shorter than that of control group 2 (P < 0.01). There were no significant difference in other items.

CONCLUSIONSThe improvement gastrostomy in pancreaticoduodenectomy is simple and secure. It can significantly shorten the postoperative duration of gastrointestinal decompression tube and also obviously reduce the incidence of postoperative gastroparesis compared with traditionary gastrostomy.

Adult ; Aged ; Female ; Gastroparesis ; etiology ; prevention & control ; Gastrostomy ; methods ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; methods ; Postoperative Complications ; etiology ; prevention & control ; Treatment Outcome

OBJECTIVETo evaluate the effect of different procedures in the treatment of pancreatic pseudocyst.

METHODThis retrospective review analyzed the outcome of 114 patients with pancreatic pseudocysts managed in PUMC Hospital from January 1990 to March 2002.

RESULTThere were 25 patients without intervention, the spontaneous resolution of pseudocysts occurred in 23 of these patients during follow up. Twenty-nine cases underwent CT-guided percutaneous catheter drainage; the effective rate of therapy was 67.85%. Surgical procedures performed in 60 cases and the overall mortality was 5% (3/60). The procedures included external drainage (8 cases) with 1 death (12.5%), excision (13 cases), cyst-duodenostomy (1 cases), cyst-gastrostomy (19 cases) with 7 postoperative gastrointestinal bleeding (36.8%) and 1 death (5.26%), Roux-en-Y cyst-jejunostomy (19 cases) with 3 postoperative gastrointestinal bleeding (15.8%) and 1 death (5.26%).

CONCLUSIONSCT-guided percutaneous catheter drainage has the advantage of minimal invasive and simple technique; it can be as an effective substitute method of traditional open external drainage. Although minimally invasive techniques offer a variety of treatment options, surgical procedures are still indicated for significant number of patients. The incidence of postoperative gastrointestinal bleeding in cyst-gastrostomy was higher than those patients with Roux-en-Y cyst-jejunostomy, but most of them were not difficult to treatment, so cyst-gastrostomy is still a simple and reasonable procedure for selected patients. Excision is a correct choice for cases in which pseudocysts cannot be differentiated from neoplastic cysts.

Adolescent ; Adult ; Aged ; Anastomosis, Roux-en-Y ; Drainage ; methods ; Endosonography ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Pancreatic Pseudocyst ; surgery ; therapy ; Retrospective Studies ; Treatment Outcome