and persistence of the SIRS,retrieve the unbalance of the pro-/anti-inflammatory,and improve the severe disease conditions.Therefore,it provides a new and feasible way to reglate SIRS in the early phase of SAP.

The aim of this study was to explore the effects of parenteral supplementation with omega-3 fish oil emulsion (Omegaven) on systemic inflammatory response syndrome (SIRS) during the initial stage of severe acute pancreatitis (SAP). In a prospective, randomized and controlled trial, 60 patients with SAP were randomized either to treat with conventional therapy (Con group, n=30) or conventional therapy plus intravenous supplementation with omega-3 fish oil emulsion 0.2 g/kg every day (FO group, n=30). The effects were analyzed by the SIRS-related indexes. The results showed that APACHE-II scores in FO group were significantly lower, and the gap increased much farther after the 4th day than those in Con group (P<0.05). Fluid equilibrium time became shorter markedly in FO group than in Con group (5.1+/-2.2 days vs 8.4+/-2.3 days). In FO group, SIRS scores were markedly decreased and the SIRS state vanished after the 4th day; Plasma level of TNF-alpha was significantly reduced, while IL-10 decreased markedly, most prominently between the 4th and 7th day, and the ratio of IL-10/TNF-alpha raised as compared with Con group (P<0.05). During the initial stage of SAP, parenteral supplementation with omega-3 fish oil emulsion could efficiently lower the magnitude and persistence time of the SIRS, markedly retrieve the unbalance of the pro-/anti-inflammatory cytokines, improve severe condition of illness and may provide a new way to regulate the SIRS.
Dietary Supplements ; Emulsions ; Fatty Acids, Omega-3/*administration & dosage ; Fish Oils/*administration & dosage ; Pancreatitis, Acute Necrotizing/complications ; Pancreatitis, Acute Necrotizing/*therapy ; Parenteral Nutrition/methods ; Prospective Studies ; Systemic Inflammatory Response Syndrome/etiology ; Systemic Inflammatory Response Syndrome/*therapy ; Young Adult

Objective To detect the expression of Toll-like receptor 9 (TLR9) in pancreatic cancer,and to explore its clinical significance. Methods The real-time PCR, Western blotting and immunohistochemistry were used to examine the expression of TLR9 in 30 samples of pancreatic cancer and the adjacent tissues, and 10 samples of normal pancreatic tissues. The relationships of TLR9 with clinicopathological parameters were analyzed. Results Compared with normal pancreatic tissues, the amplification value of TLR9 mRNA expression was 2.32 fold (1.41 ～ 3.22 ) in human pancreatic cancer, was 1.23 fold (1.18 ～ 1.28) in paracancerous tissues, respectively, and the difference was statistically significant (P ＜ 0.05 ). The percentage of positive cells expressing TLR9 protein in human pancreatic cancer tissues,paracancerous tissues and normal tissues were 73.3% (22/30), 33.3% (10/30) and 20.0% (2/10), and the relative expressions of TLR9 protein were 0.780 ±0. 026,0. 400 ±0.018,0. 173 ±0.043 ,respectively, and the difference was statistically significant( P ＜ 0.05 ). The highly expressed TLR9 was positively correlated with the degree of tumor differentiation, TNM stage and lymph node metastasis. Conclusions TLR9 was highly expressed in pancreatic cancer tissues. TLR9 expression plays a role in the canceration of pancreatic tissues.

Objective To compare the safety and efficiency of nasogastric ( NG ) feeding with nasojejunal (NJ) feeding in treating severe acute pancreatitis ( SAP).Methods The terms NG tube,NJ tube,SAPand enteral nutritionwere used for literature search in PubMed , Embase, Cochrane Library, WanFang and CNKI databases and the publication deadline was June 1, 2016.Random effect model was used for Meta analysis .Results A total of 5 random clinical trials involving 264 patients ( 136 in NG group and 128 in NJ group ) were included .There was no statistical difference on the incidence of adverse events (mortality:RR=0.77, 95%CI 0.42~1.41, P=0.39; infection complications: RR=0.77, 95%CI 0.45~1.30, P=0.39; digestive complications: RR=1.26, 95%CI 0.73~2.16, P=0.41; stopping nasogastric proportion:RR=0.66, 95%CI 0.10~4.10, P=0.65;MODS rate:RR=0.98, 95%CI 0.71~1.35, P=0.90; the percentage of energy balance: RR=1.00, 95%CI 0.97~1.03, P=0.39 and the average length of hospital stay:RR=0.98, 95%CI 0.71~1.35, P=0.90).Conclusions NG feeding was safe and effective , which was comparable with NJ feeding .NG feeding was more convenient with a higher clinical value .

Objective To detect the expression of Toll-like receptor 9 (TLR9) in pancreatic cancer and to study the effect of CPG ODN2216 on the biological behavior of pancreatic cell carcinoma, and to explore their clinical significance. Methods Immunohistochemical method was used to examine the expression of TLR9 protein in pancreatic cancer tissue and immunofluorescence staining was also performed to detect TLR9 protein expression in pancreatic carcinoma cells. In vitro cell adhesion, wound-healing scrape assay, transwell invasion assay and cell colony formation assay were performed to assess the effect of CPG ODN2216 on the invasive properties of Panc-1 cells. Results TLR9 were highly expressed in the pancreatic cancer tissue and pancreatic carcinoma cells. In vitro experiments as cell spreading assays, cell adhesion, colony formation assay and invasion assays showed the cell adhesion and cell motility properties of CPG ODN 2216 group to be apparently weakened compared with the control group. MTT assay showed cell proliferation ability in the CPG ODN group to be notably decreased, and CPG ODN2216 had inhibitive effects on the growth of panc-1 cells in a dose and time-dependent manner. Conclusions TLR9 gene was correlated with the invasive and metastatic potentials of pancreatic carcinoma. The used of CPG ODN2216 induced the inhibition of migration and invasion of the Panc-1 cell line.

The aim of this study was to explore the effects of parenteral supplementation with ω-3 fish oil emulsion (Omegaven ) on systemic inflammatory response syndrome (SIRS) during the ini-tial stage of severe acute pancreatitis (SAP).In a prospective,randomized and controlled trial,60 pa-tients with SAP were randomized either to treat with conventional therapy (Con group,n=30) or conventional therapy plus intravenous supplementation with 0-3 fish oil emulsion 0.2 g/kg every day (FO group,n=30).The effects were analyzed by the SIRS-related indexes.The results showed that APACHE-II scores in FO group were significantly lower,and the gap increased much farther after the 4th day than those in Con group (P<0.05).Fluid equilibrium time became shorter markedly in FO group than in Con group (5.1±9.2 days vs 8.4±2.3 days).In FO group,SIRS scores were markedly duced,while IL-10 decreased markedly,most prominently between the 4th and 7th day,and the ratio euteral supplementation with ω-3 fish oil emulsion could efficiently lower the magnitude and persis-tence time of the SIRS,markedly retrieve the unbalance of the pro-/anti-inflammatory cytokines,im-prove severe condition of illness and may provide a new way to regulate the SIRS.

Small cell lung cancer (SCLC) is a type of malignancy with poor prognosis, and no advance in medication has been made for about 30 years except immune checkpoint inhibitor (ICI), which demonstrated efficacy in recent years. The response rate of programmed death-1 (PD-1) inhibitor alone or its combination with cytotoxic T-lymphocyte antigen-4 (CTLA-4) inhibitor as subsequent therapy was 10%-33% and the response duration was persistent. The combination of programmed death ligand-1 (PD-L1) inhibitor with chemotherapy resulted in longer survival versus chemotherapy alone. Nevertheless, comparing with immunotherapy-sensitive tumors such as non-small cell lung cancer (NSCLC), efficacy in SCLC is still unsatisfied and this is maybe associated with its immune inhibitory characteristics. This review describes the current research about immune characteristics of SCLC, including tumor infiltrating of lymphocytes (TIL) and immune inhibitory cells, PD-L1 and major histocompatibility complex (MHC) expression in tumor as well as changes of peripheral immune cells. We also review the prognostic and predictive values of these immune characteristics.
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Objective: Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology associated with venous sinus stenosis. This study aimed to develop a magnetic resonance venography (MRV)-based radiomics model for predicting a high trans-stenotic pressure gradient (TPG) in IIH patients diagnosed with venous sinus stenosis. Materials and Methods: This retrospective study included 105 IIH patients (median age [interquartile range], 35 years [27– 42 years]; female:male, 82:23) who underwent MRV and catheter venography complemented by venous manometry. Contrast enhanced-MRV was conducted under 1.5 Tesla system, and the images were reconstructed using a standard algorithm. Shape features were derived from MRV images via the PyRadiomics package and selected by utilizing the least absolute shrinkage and selection operator (LASSO) method. A radiomics score for predicting high TPG (≥ 8 mmHg) in IIH patients was formulated using multivariable logistic regression; its discrimination performance was assessed using the area under the receiver operating characteristic curve (AUROC). A nomogram was constructed by incorporating the radiomics scores and clinical features. Results: Data from 105 patients were randomly divided into two distinct datasets for model training (n = 73; 50 and 23 with and without high TPG, respectively) and testing (n = 32; 22 and 10 with and without high TPG, respectively). Three informative shape features were identified in the training datasets: least axis length, sphericity, and maximum three-dimensional diameter.The radiomics score for predicting high TPG in IIH patients demonstrated an AUROC of 0.906 (95% confidence interval, 0.836– 0.976) in the training dataset and 0.877 (95% confidence interval, 0.755–0.999) in the test dataset. The nomogram showed good calibration. Conclusion Our study presents the feasibility of a novel model for predicting high TPG in IIH patients using radiomics analysis of noninvasive MRV-based shape features. This information may aid clinicians in identifying patients who may benefit from stenting.

Objective To investigate clinicopathological features of pancreatic carcinoma with or without lymph node metastasis,and to explore the relationship between the lymph node metastasis and the prognosis of pancreatic carcinoma.Methods The clinical and follow up data of 216 patients with pancreatic carcinoma from 2001 to 2015 were retrospectively analyzed.Kaplan-Meier method was used to estimate survival rates and plot survival curves.Results The postoperative survival time was 4-86 months,the median survival time was 19 months,and the postoperative 1,3 and 5 year survival rates were 65.1％,33.8％,20.5％,respectively.Patients with positive lymph node metastasis were with 1,3,5 year survival rates of 36.5％,12.2％,0％,those with no lymph node metastasis were with 1,3,5 year survival rates of 70.3％,38.0％,21.4％ (x2 =15.803,P ＜ 0.001).Conclusions Lymph node metastasis in patients with pancreatic cancer is worse than that without lymph node metastasis.Lymph node metastasis is one of the main prognostic factors in patients after radical resection of the pancreatic cancer.

Objective To analyze the correlation between the status of the donation after brain and cardiac death (DBCD)donors and postoperative recovery of the organ function in the liver and renal transplant recipients.Methods The assessment data and organ protection measures of 12 DBCD donors admitted to the Organ Transplantation Center in Sichuan Provincial People’s Hospital from August 2011 to November 2013 were retrospectively analyzed.The parameters of postoperative recovery of 12 liver and 22 renal transplant recipients were also assessed.The correlation between the parameters of the donors and postoperative recovery of the liver and renal transplant recipients was statistically analyzed.Results Among 12 liver transplant recipients,1 patient had primary non-function (PNF)(1 /12,8%)and 11 cases developed delayed graft function (DGF) after renal transplantation (11 /22,50%).Intensive care unit (ICU)period,liver function,maintaining systolic blood pressure (SBP),blood coagulation function,blood glucose level and electrolyte (Na +/K +) were significantly correlated with postoperative recovery of the liver and kidney function in the recipients (all in P <0.05 ).Age,cause of brain death,maintaining diastolic blood pressure (DBP),activated partial thromboplastin time (APTT)and pH of arterial blood gas (ABG)were associated with postoperative recovery of the liver function.Total bilirubin and white blood cell count (WBC)were correlated with postoperative recovery of kidney function.Conclusions DBCD donors cater to the specific conditions in China.The incidence of postoperative PNF in liver recipients is relatively low whereas and the incidence of DGF after renal transplantation is relatively high.Assessment of the DBCD donors and organ protection measures should be specifically taken to enhance the clinical efficacy of liver and renal transplantation from DBCD donors.