Pancreatic duct stones are one of the benign pancreatic diseases. It is often combined with chronic pancreatitis. The disease will progress to pancreatic cancer without timely treatment, thus reducing the quality of life of patients and seriously affecting their physical and psychological health. In recent years, with the development of imaging technology, the detection rate of pancreatic duct stones has been increasing year by year. This article reviewed the etiology, diagnosis and treatment strategies for pancreatic duct stones in recent years.

Objective:To investigate the effect of surgical resection on the prognosis of patients with gastroenteropancreatic neuroendocrine tumors with liver metastases.Methods:Through meta-analysis, this study used "Gastroenteropancreatic neuroendocrine tumor" "liver metastasis" "liver resection" and "primary tumor". "resection" were English keywords, and the search period was from 1 January 2000 to 30 July 2022. CNKI, Pubmed, Embase, and the Cochrane library were searched for studies on liver metastases from gastroenteropancreatic neuroendocrine tumors. After quality evaluation of the included studies, a meta-analysis was performed using Review Manager 5.4.1 and STATA 17 software.Results:Complying with the standard total of 16 papers, systematic analysis showed that compared with non-surgical treatment, the mortality rate of patients treated surgically (primary tumor resection, liver metastasectomy, primary tumor resection + liver metastasectomy) was significantly lower, and the difference was statistically significant ( P<0.01); for patients with resectable liver metastases, primary tumor resection alone versus primary tumor resection + liver metastase for patients with resectable liver metastases, 5-year overall survival was statistically significant ( P<0.01) compared with primary tumor resection + liver metastases resection, and their primary tumor resection + liver metastases resection prolonged the median survival; for patients with liver metastases, 5-year survival was statistically different from the size of liver metastases to liver volume ( P<0.01), and metastases greater than 50% had poor prognosis. Conclusion:Surgical treatment can significantly improve the survival time of patients with neuroendocrine tumors with liver metastases, and resection of only the primary site or metastases is also effective in improving the prognosis of patients.

OBJECTIVE：To study the effec ts of Tibetan Codonopsis tralictrifolia extract （called“ZDS”for short ） on collagen-induced arthritis （CIA）model rats and its mechanism. METHODS ：Eight of 48 rats were randomly selected as normal control group （normal saline ），and the remaining 40 rats were used to establish CIA model. After successful modeling ，the rats were randomly divided into model group （normal saline ），ZDS low-dose ，medium-dose and high-dose groups （0.44，0.88，1.76 g/kg，by crude drug ），dexamethasone group （positive control ，0.002 5 g/kg），with 8 rats in each group. They were given relevant medicine intragastrically ，the volume of 400 μL，once a day ，for consecutive 28 days. The body weight of rats were weighed before medication （0 d），7，14，21 and 28 days after medication ；and arthritis indexes were scored. The pathological changes of the knee joint synoviual tissue were observed after last medication. The thymus index ，spleen index ，the levels of serum inflammatory factors （IL-1β，TNF-α，IL-6），protein expressions of NF-κB p65，p-NF-κB p65，IκB and p-IκB in synovial tissue were detected. RESULTS ：Compared with normal control group ，the body weight （14，21，28 days after administration ）of rats in model group was significantly reduced （P＜0.05）；the arthritis index score （before administration and different administration time）was significantly increased （P＜0.05）；the joint synovial tissue was pathologically damaged ；the thymus and spleen index ， inflammation factor level ，the protein expression of p-NF-κB p65 and p-IκB were increased significantly（P＜0.05），while the protein expression of IκB was decreased significantly（P＜0.05）. Compared with model group ，the level of IL- 1β was decreased significantly in ZDS low-dose group （P＜0.05）. Body weight of rats （21，28 days after administration ）were increased significantly in ZDS medium-dose and high-dose groups ，dexamethasone group （P＜0.05），while arthritis index score （14，21，28 days after administration ） was decreased significantly （P＜0.05）. The pathological damage of joint synovial tissue was significantly relieved ；thymus and spleen index ，inflammation factor level ，the protein expression of p-NF-κB p65 and p-IκB were significantly reduced，while the protein expression of IκB was significantly increased （P＜0.05）. CONCLUSIONS ：ZDS can improve CIA model rats to some extent ，and its mechanism may be related to the inhibition of NF-κB signaling pathway.