Pancreatic cancer is a one of the most malignant digestive cancer.Because the lack of effective methods for early diagnosis,most patients have been ineligible for surgical resection when diagnosed.Kallikrein family is a group of serine proteases,because of its ability to decompose the extracellular matrix proteins,it may be closely related to the invasion and metastasis of various cancers.And some members of kallikrein family may become cancer diagnostic biomarkers.This paper reviews all the recent articles about kallikrein family study in pancreatic cancer.

Objective EGFR targeted therapy mediated by adeno-associated virus is a promising way to treat pancreatic cancer.This study aimed to assess the feasibility and activity of combining rAAV-anti EGFR,gemcitabine,and radiation in pancreatic cancer cells.Methods Aspc-1 human pancreatic carcinoma cells were divided into several groups,in vitro and in vivo,which were respectively exposed to gemcitabine alone,radiation alone,rAAV-anti EGFR alone,the combination of rAAV-anti EGFR with gemcitabine,the combination of rAAV-anti EGFR with radiation,and the combination of all three agents.The pancreatic cancer tumor growth and apoptotic rate were measured.Results The apoptotic rate was higher in cells treated with a single or combination of agents compared to the negative control (P＜0.05).The combination of rAAV-EGFR,gemcitabine,and radiation produced the highest induction of apoptosis compared to a single agent alone (P ＜ 0.05).Treatment with rAAV-anti EGFR greatly inhibited growth in the tumor xenografts (P＜0.05),and a synergistic effect of rAAV-anti EGFR,gemcitabine,and radiation was found.The number of tissue cancer cells that expressed cleaved caspase-3 after treatment with rAAV EGFR was more than that of the control group (P＜0.05).The combined treatment of rAAV-anti EGFR,gemcitabine,and radiation induced the highest numbers of cells expressing cleaved caspase-3 compared to that with a single agent alone (P＜0.05).Conclusions The rAAV-anti EGFR therapy in combination with chemotherapy and radiation therapy demonstrated a greater efficacy over therapy with a single agent alone.rAAV-anti EGFR increased the efficacy of gemcitabine and radiation in the treatment of pancreatic cancer cells.

Objective To study the clinical features of intraductal papillary mucinous neoplasm of the biliary tract (BT-IPMN) and to analyse the diagnostic and surgical patterns.Method The data of 19 patients with BT-IPMN admitted from Jun.2012 to Jul.2016 were retrospectively analyzed.Results These 19 (2.3％) patients with BT-IPMN came from 815 patients with biliary tract tumors who were treated in our institution.There were 9 males and 10 females.The male to female ratio was 1.0∶ 1.1.The mean age was 60.6 ± 12.9 years with a range from 25 to 78 years.Jaundice (in 10 patients) and abdominal discomfort (in 6 patients) were the most common presenting symptoms.Bile duct dilatation and intraluminal mass were typical preoperative imaging findings.All these 19 patients were diagnosed to have BT-IPMN histopathologically.18 patients underwent surgery in our hospital.Left lateral hepatic sectionectomy or left hepatectomy was performed in 8 patients,pancreaticoduodenectomy in 6,local excision of bile duct and cholangiojejunostomy in 3 and central hepatectomy in 1.The average operating time was 280 minutes and the average amount of intra-operative bleeding was 515 ml.Fourteen patients underwent regional lymph node dissection and 3 positive lymph nodes were detected out of 94 resected lymph nodes.Sixteen patients were followed up from 1 to 51 months with a mean of (25.7 ± 19.5) months.Fourteen of these patients were still surviving.Two patients died 3 and 17 months after operation due to the tumor.Conclusions Intraductal papillary mucinous neoplasm of the biliary tract was very rare.Early diagnosis was not easy.There was a low percentage of lymphatic metastasis.Surgery was the first choice of treatment and complete resection of BT-IPMN was associated with good long-term survival.

Objective To construct a recombinant adeno-associated virus(rAAV)vector containing a human anti-epidermal growth factor receptor(anti-EGFR)single-chain variable fragment antibody gene,and observe its inhibitory effects on pancreatic cancer cell lines.Methods Human anti-EGFR single-chain variable fragment antibody gene was inserted into the Kpn I and Bgl Ⅱ sites to construct a rAAV-anti EGFR vector,and then rAAV1-EGFP group and rAAV1-anti EGFR group were established.The expression of anti-EGFR antibody was observed.Antibody expression was detected by Western blot,and the inhibition and apoptosis rates of human pancreatic cancer cell lines(PCT-3,SW1990,Capan-1,ASPC-1,MiaPaCa-2 and PANC-1 cells)were detected by CCK-8 assay and flow cytometry,respectively.All data were analyzed using the t test.Results The results of Western blot assay demonstrated that anti-EGFR antibody was expressed in 6 pancreatic cancer cell lines.The inhibition rates of rAAV1-EGFP and rAAVl-anti EGFR on pancreatic ASPC-1 cells were 1.1%± 2.4% and 15.1%±3.5%,respectively,with a significant difference between the 2 groups(t =6.598,P ＜0.05).The apoptosis rates of PANC-1 cells were 7.0% ± 3.0% in the rAAV1-EGFP group and 1 1.4% ± 2.5% in the rAAV1-anti EGFR group,with no significant difference between the 2 grouvs(t = 1.952,P ＞0.05).The apoptosis rates of SW1990,ASPC-1,Capan-1,PCT-3,MiaPaCa-2 cells were 1.1% ± 0.8%,1.5% ± 0.7%,1.7% ± 1.2%,1.1%±0.7% and 2.2% ± 1.1% in the rAAV1-EGFP group,and 17.6% ± 2.2%,46.9% ± 3.9%,20.0% ±2.8%,12.1% ± 1.6% and 31.1% ±2.5% in the rAAV1-anti EGFR group,respectively,with significant differences between the 2 groups(t = 12.208,19.846,10.405,10.909,18.327,P ＜0.05).Conclusions A rAAV-anti EGFR vector with human anti-EGFR single-chain variable fragment antibody gene was constructed.Anti-EGFR antibody has obvious inhibition effects on pancreatic cancer cell lines.

OBJECTIVETo analyze the characteristics of autopsies in medical dispute.

METHODSThe data of 202 autopsy cases in medical disputes performed by the Department of Pathology of Jiangxi Medical College from January 2001 to December 2010 were retrospectively analyzed.

RESULTSThe number of autopsy in medical disputes increased year by year. Neonatal, infant and 30 ≊ 60y were more common age groups in dispute; the gender ratio of male to female was 2:1 and more cases were from hospitals in rural areas. Most medical disputes came from in departments of pediatric, obstetrics and gynecology and general surgery. Death caused by cardiovascular diseases ranked at the first place.

CONCLUSIONAutopsy is important in medical disputes to define the cause of death and to preserve evidence.

Adolescent ; Adult ; Aged ; Autopsy ; statistics & numerical data ; Cardiovascular Diseases ; mortality ; Cause of Death ; Child ; Child, Preschool ; Dissent and Disputes ; Female ; Hospital Departments ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Malpractice ; Middle Aged ; Retrospective Studies ; Sex Ratio ; Young Adult

OBJECTIVETo study the expression of Toll-like receptor 4 (TLR-4) and caspase-3 in the intestine of neonatal rats with necrotizing enterocolitis (NEC), and explore the protective effects and possible regulatory mechanisms of glutamine (Gln) in NEC.

METHODSSixty premature rats were randomly divided into three groups (n=20 each): control, NEC model and Gln intervention group. NEC model was prepared by formula feeding, hypoxia and cold stress. The Gln intervention group was also subjected to hypoxia and cold stress but was fed with formula containing Gln (0.3 g/kg). Two days later, the rats were sacrificed and the intestine tissues were obtained. The histological changes of ileal tissues were observed by hemetoxylin and eosin staining. The expression of caspase-3 and TLR-4 protein in the jejunum, ileum and colon were detected by inmunohistochemistry. The expression of TLR-4 mRNA in the jejunum, ileum and colon were detected by RT-PCR.

RESULTSCompared with the control group, the histological score of ileal tissues, and the expression of caspase-3, TLR-4 protein and TLR-4 mRNA in the NEC model group increased significantly (P<0.01). Gln intervention decreased significantly the histological score of ileal tissues, and the expression of caspase-3, TLR-4 protein and TLR-4 mRNA compared with the NEC model group (P<0.05).

CONCLUSIONSTLR-4 might be involved in the pathogenesis of NEC. Gln may provide protective effects on intestine possibly through reducing the TLR-4 expression and then decreasing the apoptosis of intestinal epithelial cells.

Animals ; Animals, Newborn ; Caspase 3 ; analysis ; Enterocolitis, Necrotizing ; metabolism ; pathology ; Female ; Glutamine ; pharmacology ; Immunohistochemistry ; Pregnancy ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; analysis ; genetics

Objective: To test the expression of miR-1178 in pancreatic cancer and study its clinicopathological significance and mechanism. Methods: The expression of miR-1178 in 87 paired paraffin pancreatic ductal adenocarcinoma specimens and adjacent non- cancerous pancreatic tissue diagnosed by Pathology Department of Peking Union Medical College Hospital was detected by hybridization in situ. The relationship between the expression of miR-1178 and clinicopathological characters was analyzed.miR-1178 mimics and inhibitor were used to further detect the close relationship among miR-1178 and cancer invasion. Establish a nude mice subcutaneously transplanted tumor model, 4 weeks after vaccination for tumor volume and weight measurement.Student t-test, rank sum test, and χ² test was used respectively to compare the data between two groups. Cox regression was adopted to improve the single factor and multiple factors analysis. Results: The results of hybridization in situ showed the expression of miR-1178 was increased in 72 cases with pancreatic cancer compared to that in paired normal pancreatic tissues (50/72 vs. 11/72, χ²=43.26, P<0.05). miR-1178 expression was positively associated with tumor lymph node stage (χ²=4.189, P=0.041). Univariate and multivariate analysis revealed that miR-1178 was an independent adverse prognostic indicator for patients with pancreatic cancer (HR=2.364, 95%CI: 1.114-5.019, P=0.025). Transwell assay indicated the over-expression of miR-1178 increased the number of AsPC-1 cells that penetrated the ECM-coated membrane (177.0±19.8 vs. 119.7±15.9)(χ²=8.21, P<0.05). For the in vivo experiment, overexpression of miR-1178 significantly promoted tumor growth, compared with control group (tumor volume: (5 122.4±760.2)mm³ vs. (1 976.8±601.8)mm³, t=2.413, P<0.05; tumor weight: (1.55±0.21)g vs. (0.67±0.17)g, t=2.960, P<0.05). Over-expression of miR-1178 down-regulated the expression of Stub1 and elevated the expression of FAK/MMP-9 signal pathway(P<0.05). Conclusions MiR-1178 is overexpressed in pancreatic cancer, and is effective for predicting patients′ prognosis. MiR-1178 regulate Stub1/FAK/MMP-9 signal pathway and promote the invasion of AsPC-1 cells.

Objective: To investigate the expression of KLK7 in pancreatic cancer and its clinical significance. Methods: Immunohistochemistry was used to detect the expression of KLK7 protein in pancreatic cancer tissue microarray with 92 samples. Statistical analysis of the relationship between KLK7 and clinicopathological characteristics was finished. Pancreatic cancer cell lines were infected with lentiviuses in order to get cells with KLK7 stable overexpression.KLK7-siRNA was transfected into pancreatic cancer cells to knock down KLK7.Cell proliferation and chemosensitivity were detected by CCK-8 assay; Cell invasion and migration abilities were detected by Transwell assay. At the same time, subcutaneous xenograft tumor models were established in nude mice to observe the effect of KLK7 on tumor growth in nude mice. Data were statistically analyzed by rank sum test, χ² test and Logistic regression analysis. Results: The expression level of KLK7 in pancreatic cancer tissues was higher than that in paired adjacent tissues (P<0.05). KLK7 expression was correlated with vascular invasion(χ²=7.535, P<0.05). Further univariate and multivariate analysis showed that KLK7 expression was an independent risk factor for vascular invasion of pancreatic cancer(χ²=7.535, P<0.05). The overexpression of KLK7 in pancreatic cancer cell lines BxPC-3 and CFPAC can increase their proliferation abilities, reduce the chemosensitivity and promote their migration and invasion behaviour; The results of in vivo experiments showed that the volume of subcutaneously transplanted tumors in the overexpressing KLK7 group was significantly larger than that in the control group (t=4.479, P<0.05). The group of overexpressing KLK7 showed greater tumor weight than the control group(t=2.831, P<0.05). Conclusions The expression level of KLK7 in pancreatic ductal adenocarcinoma was higher than that in paired adjacent tissues and it is an independent risk factor for vascular invasion of pancreatic cancer.KLK7 can promote the proliferation of pancreatic cancer cells, reduce the chemosensitivity and increase the invasion and migration of pancreatic cancer cells.

Purpose To investigate the feasibility of CT-based feature tracking technology to quantify left ventricular myocardial strain(MS)and its significance in hypertrophic obstructive cardiomyopathy(HOCM).Materials and Methods A total of 35 HOCM patients who underwent cardiac coronary angiography from March 2019 to December 2021 in the First Affiliated Hospital of the Air Force Military Medical University were retrospectively included,and a total of 60 cases who were negative for cardiac coronary angiography among those who visited the hospital with suspected coronary artery disease were randomly enrolled.Conventional cardiac functional parameters and MS parameters were quantified via post-processing software,and differences of parameters between the groups were analyzed.The diagnostic efficacy of MS parameters for HOCM was further evaluated.Results Compared to the control group,the HOCM group exhibited significant increases in various conventional left ventricular functional parameters,including left ventricular wall thickness,mass,mass index,end-diastolic volume and stroke volume(t=2.119 to 24.861,all P<0.05).However,there were no statistically significant differences in end-systolic volume and cardiac output between the two groups(P>0.05).The global longitudinal and radial strain values of HOCM group were significantly lower than those of control group(t=12.857,-6.427,P<0.01),while the endocardial global circumferential strain of HOCM group was significantly higher than that of control group(t=-2.369,P<0.05).Among MS parameters,global longitudinal strain exhibited the best diagnostic efficacy for HOCM,with an area under the curve of 0.997.A cutoff value of≤20.78%for global longitudinal strain showed that the sensitivity and specificity was 100%and 95%,respectively.Conclusion The MS parameters quantified by the CT-based feature tracking technique are superior to left ventricular ejection fraction in quantifying left ventricular function,with the highest sensitivity and specificity for early myocardial function impairment of longitudinal strain.In addition,the technique has good repeatability and is expected to become a new indicator for the assessment of myocardial function in HOCM.