Pancreaticoduodenectomy,which is also known as Whipple surgery,is a complex of high-risk surgery,while the majority of patients have postoperative complications.As a serious complication,pancreatic fistula has been prevented and treated by a variety of methods.Currently,the main methods include improved surgical methods,somatostatin analogues,the use of support tube and medical adhesive,and so on.However,prevention and treatment of pancreatic fistula remains to be controversial.Here,the author will review the research progress of pancreatic fistula.

Insulinoma (islet β-cell tumor) is one of the most common pancreatic endocrine tumors. It has a typical clinical manifestation called Whipple's triad. And so far, surgical treatment is the only curative method. But the localization diagnosis of insulinoma is difficult. Recently, with advances in diagnostic tech-niques, the localization diagnosis of insulinoma accuracy has markedly improved. This paper makes a brief overview of the progress in diagnosis and treatment of insulinoma.

NF-κB is a nuclear transcription factor with multiple adjustion. The activation of NF-κB can occur by three different mechanisms. The multiple NF-κB activation pathways are important due to the large number of genes that are regulated by NF-κB and their effects on cancer cells. These gene products can promote growth and tumori-genesis, inhibit apoptosis, allow metastasis and invasion, promote angingenesis, and cause chemoresistance. All of these roles in pancreatic cancer make NF-κB a promising target in treatment. Therefore, inhibiting the activity of NF-κB becomes a hot spot and novel idea of preventing and treating pancreatic cancer.

Objective To summarize the experience in the diagnosis and treatment of adenosquamous carcinoma of the pancreas to better our understanding of this rare exocrine pancreatic neoplasm. Methods The clinical data of five cases of adenosquamous carcinoma of pancreas admitted between July 2002 and June 2008 were analyzed retrospectively, and relevant literature was reviewed and discussed. Results Pancreatic adenosquamous carcinoma was found in 3 men and 2 women with a mean age of 64 ± 18 years old. Tumor was located in the head of pancreas in 2 patients, body and tail in 3 cases. One patient was submitted to pancreaticoduodenectomy, three patients underwent distal pancreatectomy and splenectomy and one had cholecystojejunostomy and gastric bypass surgery, as well as 1251 implantation. The mean size of the tumor was 4.5 cm. One patient had posterior stomach wall, descending duodenum, portal vein involvement; spleen was invaded in 2 cases; neural and vessel invasion was present in 2 cases. Lymph node metastasis was present in 1 case. Pathologically primary tumor and liver metastasis were mixture of adenocarcinoma and squamous cell carcinoma. In all 5 patients with complete follow up, 3 died of tumor recurrence or liver metastasis with a mean postoperative survival time of 11.2 momths (8.5 ~ 13.5 months). The other 2 cases survived for 6 and 56 months , respectively. Conclusions Pancreatic adenosquamous carcinoma was likely to be found in patients in their 60s, and confirmative diagnosis was difficult. The prognosis of this rare tumor appeared to be dismal due to the high degree of malignancy.

Pancreatic resection is the treatment choice for pancreatic malignancy and cer-tain benign pancreatic disorders. Althogh, pancreatic resection requires high techndogy whereas current mortality after a pancreaticoduodenectomy has dropped to below 3 % in expe-rienced high-volume centers and post-operative morbidity is still as high as 50%. At pres-ent, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and proce-dures, and can result in life-threatening complications. Early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating con-sequences; however there is no universally accepted definition of PF that would allow stand-ardized reporting and proper comparison of outcomes between different centers. The present article reviews the conlept evolution of PF and discusses the current preventive strategies.

Objective To sum up the clinical experience of treating thoracolumbar fractures with Scofix system and transpedicular bone graft. Methods 62 consecutive patients with thoracolumbar fracture were treated operatively with reduction and stabilization by Scofix system combined with vertebral fusion via transpedicular bone grafting. Results 62 patients were followed up. Their postoperative radiographs and CT scans showed that more than 90%of the cases gained reduction, the effective diameters of vertebral canal became normal and the mean time of vertebral fusion was about 3 months. Conclusions Scofix system is effective in reduction and fixation for thoracolumbar fractures, and transpedicular bone graft is helpful in restoring the height of vertebral body and increasing vertebral fusion. The procedure also has advantages of preventing vertebral collapse, reducing nerve injury and facilitating functional recovery.

0.05), as well as in the predicted fatality rate based on Ranson score. Conclusion ERCP is safe for the biliary pancreatitis patients, and it does not increase the fatality rate of acute pancreatitis.

MicroRNA (miRNA) plays a regulating function in translation stage of gene expression.MiRNA has been found directly involving in the occurrence and development of pancreatic cancer,and its abnormal expression is closely related to early diagnosis of pancreatic cancer and may provide new therapeutic target for pancreatic cancer patients.MiRNA detection will have good application prospect in on the diagnosis and treatment of pancreatic cancer.

Transient receptor potential (TRP) channels affect several inflammatory and neoplastic conditions.and are widely distributed and activated by multiple stimuli.Mean while,as the sensor to the changes in cellular local environments,TRP channels have multiple functions,including thermal,mechanical and taste sensing,as well as ion homeostasis maintaining.They can regulate muscle contractions,transmitter release,cell multiplication,cell differentiation,genetic transcription,apoptosis and molecular death.TRPM8,a nonselective cation channel,was originally cloned as a prostate-specific protein.Now,TRPM8 is found in carcinoma of colon,lung cancer,mammary cancer,pancreatic cancer and cutaneum carcinoma.The aim of this review is to summarize data reported so far on the expression and functional role of TRPM8 channels in different types of cancers.