Objective:To explore the indications and effect of surgical treatment of autoimmune pancreatitis.Methods:Clinical data of these 15 patients with autoimmune pancreatitis diagnosed and treated at the Department of General Surgery, the First Hospital of Peking University from 2010 to 2021 were retrospectively analyzed.Results:The main clinical symptoms were obstructive jaundice, abdominal pain, distension and weight loss. The diagnosis of AIP was confirmed by EUS-FNA in 6 patients,among them, 4 did not relapse after oral hormone treatment, 2 did not receive relevant treatment, and 1 developed gastric cancer one year later. Under a suspicion of malignancy, 9 patients underwent surgical laparotomy ,and the diagnosis was established by pathology. There was no recurrence after oral hormone therapy in 1 patient who underwent laparotomy and pancreatic biopsy. One out of the 3 patients with choledochojejunostomy relapsed after 3 years. Of the 5 patients who underwent pancreatectomy, 4 had no obvious recurrence, and 1 had recurrence after 3 years.Conclusions:Untypical autoimmune pancreatitis is likely to be misdiagnosed as pancreatic cancer. For patients with suspicious malignancy, operational management and biopsy may benefit.

Objective:To study on the association between vasoactive-inotropic score(VIS) and mortality of total arch replacement in Stanford type A aortic dissection(TAAD) patients.Methods:Data of TAAD patients admitted from January 2018 to November 2018 were analyzed retrospectively. According to the inclusion and exclusion criteria, 187 patients were finally included in the analysis. 30-day mortality was calculated and the patients were divided into death group(18 cases) and non-death group(169 cases). The VIS at each time point and perioperative indexes of the two groups were compared. The value of VIS in predicting mortality was analyzed.Results:The 30-day mortality was 9.63%(18/187). The operation time, cardiopulmonary bypass time, ventilator assistance time, the incidence of tracheotomy and major postoperative complications in the death group were significantly higher than those in the non-death group( P<0.05). VIS of death group was significantly higher than that of non-death group( P<0.05). At each time point, the area under ROC curve(AUC) of VIS was greater than 0.500( P<0.05), among which AUC of ICU 48 h VIS was the largest(0.817), and the best cut-off point of ICU 48 h VIS was determined to be 9, sensitivity 61.1%, specificity 92.3%. Logistic regression analysis showed that ICU 48 h VIS was an independent risk factor for predicting the death of total arch replacement in TAAD patients( OR=1.465, 95% CI: 1.194-1.796, P<0.001). Conclusion:When ICU 48 h VIS≥9, the risk of death was increased in patients with total arch replacement of TAAD. VIS may be a useful reference index for predicting the mortality of total arch replacement in TAAD patients in the early postoperative period.

Objective To investigate the effects of dexmedetomidine on the proliferation and auto-phagy of human colon cancer cells.Methods In experiment 1,human colon cancer cells LoVo and HCT116 were selected and divided into eight groups:LoVo-1 group(group L0-1),LoVo+dexmedetomi-dine 1 nmol/L-1 group(group L1-1),LoVo+dexmedetomidine 10 nmol/L-1 group(group L10-1),LoVo+dexmedetomidine 100 nmol/L-1 group(group L100-1),HCT116-1 group(group H0-1),HCT116+dexmedetomidine 1 nmol/L-1 group(group H1-1),HCT116+dexmedetomidine 10 nmol/L-1 group(group H10-1)and HCT116+dexmedetomidine 100 nmol/L-1 group(group H100-1).The cell proliferation rate was detected by CCK-8 method 24 and 48 hours after drug treatment.The cells were collected 24 hours after drug treatment,and the contents of microtubule-associated protein 1 light chain 3(LC3)-Ⅱ and autophagy associated protein Beclin-1 were detected by Western blot method.In experiment 2,LoVo and HCT116 were selected and divided into four groups:LoVo-2 group(group L0-2),LoVo+dexmedetomidine 10 nmol/L-2 group(group L10-2),HCT116-2 group(group H0-2)and HCT116+dexmedetomidine 10 nmol/L-2 group(group H10-2).Cells were collected 24 hours after drug treatment,LC3 protein expression was observed by immunofluorescence method,and the positive rate of LC3 site was calculated.The autophagosomes were col-lected and observed by transmission electron microscopy 24 hours after drug treatment.Results In experi-ment 1,the cell proliferation rate in groups L10-1 and L100-1 was significantly lower than that in groups L0-1 and L1-1 24 and 48 hours after drug treatment,the protein content of LC3-Ⅱ and Beclin-1 was signifi-cantly higher than that in groups L0-1 and L1-1 24 hours after drug treatment(P＜0.05).The cell prolifer-ation rate in groups H10-1 and H100-1 was significantly lower than that in groups H0-1 and H1-1 24 and 48 hours after drug treatment,and the protein content of LC3-Ⅱ and Beclin-1 was significantly higher than that in groups H0-1 and H1-1 24 hours after drug treatment(P＜0.05).In experiment 2,compared with group L0-2,the positive rate of LC3 site in group L10-2 was significantly increased 24 hours after drug treatment(P＜0.05).Compared with group H0-2,the positive rate of LC3 site in group H10-2 was significantly in-creased 24 hours after drug treatment(P＜0.05).Groups L0-2 and H0-2 have intact cell membranes and clear nuclei.The cell membrane in groups L10-2 and H10-2 was damaged,the arrangement of organelles was disordered,and a large number of autophagosomes and autophagosomes were visible.Conclusion Dexmedetomidine may inhibit the proliferation of colon cancer cells by inducing autophagy.