The traditional distal pancreatosplenectomy (DPS) has been the standard surgical procedure for the treatment of resectable pancreatic carcinoma of body and tail.With the development of medical technology,however,the results including the rate of R0 resection,number of lymph nodes dissected and postoperative 5-year survival rate were not significantly improved after DPS.According to pancreatic anatomy and phylembryogenesis,combined with renewed tumor treatment concept,the radical antegrade modular pancreatosplenectomy (RAMPS) was put forward after continuous exploration of pancreatic surgeons to improve prognosis of patients with pancreatic carcinoma of body and tail.Compared with DPS,RAMPS has advantages of R0 resection rate and regional lymphadenectomy and might become the standard surgical procedure.

As long non-coding RNA (LncRNA) research boom,Maternally Expressed Gene 3(MEG3) as LncRNA family is also a widespread concern.MEG3 not been studied in benign disease,and malignant disease more and more in-depth research.MEG3 because of the uniqueness of the tumor suppressor much attention in cancer research,but its specific mechanism of action of tumor suppressor and associated pathways have not been yet entirely clear,remains to be further research and clarify.This article will be now anticancer activity MEG3 and related Pathway summarized.

As one of the gastrointestinal malignancies,pancreatic cancer is well known because of high degree of malignancy,low survival rate and very poor prognosis.Lymphatic metastasis,the most important metastasis of pancreatic cancer,has the characteristics of metastasis in an early stage and high occurrence rate.Recently,some studies have suggested that widespread micrometastasis of lymph nodes occurring in the early stage of pancreatic cancer could play an important role in influencing postoperative neoplasm recurrence.Further studies on lymph node micrometastasis of pancreatic cancer are needed to help to understand pancreatic cancer more deeply and to comprehend metastasis rule more clearly.So we can choose more reasonable surgical treatment for every patient,achieving individual treatment,so as to improve the prognosis of the pancreatic cancer patients.

Interferon regulatory factor -4 binding protein ( IBP ) , served as a novel type of microtubule binding protein ,is proven to play an important role in the immune system .New evidence suggests that the protein is associated with the occurrence and development of some malignant tumors through the effects of cytoskeletal re -modeling and cell conduction mechanism .Therefore researchers believe that IBP may become a new target for cancer molecular therapy .Based on the existing experimental data ,this study aims to investigate the structure of IBP,as well as its multiple oncology effects .Furthermore,we provide the theoretical basis for IBP targeted therapy in the treatment of malignant tumors .

Objective:To discuss the approach of treating the patients who suffered from cystic lesions of the pancreas. Methods:According to the retrospective analysis of all the 127 patients who were diagnosed as cystic lesions of the pancreas by the following methods such as ultrasonography ,CT,MRCP,PET,ERCP,EUS and FNA. Results:48 case of cystic lesions of the pancreas (38%) were selected an initial operation,and 79 of them (62%) selected follow-up visit. Nearly 40% of the patients who chose an initial operation were confirmed to suffer a malignant tumor by pathology. 9 patients(11%) of all the patients in the follow-up accept an operation because of their cystic lesions had a variation. According to the result of the pathology after the resection,3 patients of them had a canceration. The patients in the follow-up whose lesion diameter was smaller than 3cm,not existing a solid lesions,and without signs or symptoms,didn't have a risk in the transition to the malignant mutation. The transition rate was less than 4%,which was similar to the death risk of the patients undergoing resection. Conclusion:It is significant to adopt a careful radioactive follow-up to the surrounding parenchyma of all the patients who had not an initial resection.

300 ?m ) damage when the islets are rewarmed to 37 ℃ . These novel findings may help to understand the pathophysiology of early loss of islet tissue after transplantation,and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.

BACKGROUND: Recently,the technique of isolation procedure of viable islets cell from large animals has been mature and used in clinical islet cell transplantation. Some study results indicate that low yields of pig islet cell isolations is probably not due to the presence of higher or more aggressive enzyme activities during the porcine isolation procedure. Therefore, the causative factors resulting in the inconsistent results should be sought for the intrinsic properties of the pancreatic islet and pancreas. The purpose of the study is to get more pancreatic islet cells for diabetic patients.OBJECTIVE: To investigate the effect of single enzymatic solution (SES)and multi-enzymatic solution(MES) on adult porcine pancreatic islet cell isolation,and to provide the theory base for diabetic patients rehabilitation.DESIGN: A completely randomized and controlled experiment based on animals.SETTING: General surgery and gerontology department in a university hospital.MATERIALS: The experiment was conducted in the Second Affiliated Hospital of Harbin Medical University from June 2003 to May 2004. Twenty consecutive random-bred adult pigs, 12 - 24 months old, weighing average 100 kg,were selected for experiment from Hada Slaughterhouse of Harbin.INTERVENTIONS: After slaughtering,the spleentic lobe of the pancreas was excised using sterile surgical gloves and surgical instruments. Each was immediately transported in 500 mL of sterile RPMI1640 solution at 4 ℃ to the laboratory for processing. After removal of fat peritoneum and superficial blood vessel,each pancreas was first immersed in 1:5 000 Liquor chlorhexidine for 3 minutes,then washed three times with cold RPMI1640, next mechanically minced into 1 mm×1 mm×1 mm fragments,weighed,and equally divided into two groups. Adult porcine islets were isolated with two different collagenase solutions(SES and MES).MAIN OUTCOME MEASURES: Islet count was performed with DTZ-staining. The viability was assessed by trypan-blue staining. Porcine islet insulin-secretory function was assessed by insulin content of cultured porcine islets and by insulin release. Islet morphological integrity was finally established by electron microscope examination.RESULTS: Overall islet cell content were statistically different between the two methods[(1 782 ±427) IE/g vs (1 293 ±451) IE/g,P<0.05]. No significant difference was found in viability,function or morphology of islet between MES and SES(P>0. 05).CONCLUSION: An average of isletisolated with MES method represents a uniquely massive yield in comparison with that by SES method. A good viability was also confirmed by static incubation and culture. The transplantation of those pancreatic islet cells can help to control the syndromes of diabetes.

Objective To summarize the surgical skills of the pancreaticoduodenectomy via mesenteric approach for the treatment of duodenal gastrointestinal stromal tumors (GISTs).Methods The clinical data of 1 patient with huge duodenal GIST combined with gastrointestinal hemorrhage and liver metastasis who was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014 were retrospectively analyzed.The patient had continuous bleeding before the operation.The results of computed tomography (CT) showed that there was a solid tumor below the liver and in front of the right kidney,with the size of 12.2 cm × 8.1 cm,inferior vena cava was squeezed by the tumor,a solid tumor was detected in the right lobe of liver,and the colon was suspiciously invaded by the tumor.The patient received pancreaticoduodenectomy,right hemicolectomy and right lobectomy of liver metastases.The patient was followed up by out patient examination and telephone interview up to August 2014.Results The operation time,volume of blood loss and volume of red blood cell (RBC) transfusion were 420 minutes,800 mL and 2 U,respectively,with a full recovery of patients.The duodenal GIST with metastasis tumor and necrosis located at the colon,pancreatis,liver and renal hilum was confirmed by pathological diagnosis.The life quality of the patient was good by follow-up at postoperative month 3.Conclusion In the pancreaticoduodenectomy via mesenteric approach,surgeons perform vigorously the method of mesenteric approach at the first stage of operation,it could maximally reduce the risk of operation and the volume of blood loss.

Radical pancreaticoduodenectomy is the only effective method for the treatment of malignancies in the pancreatic head and the periampulary region.Early determination of the involvement of the superior mesenteric artery (SMA)is important for the selection of the surgical procedure and judgment of the prognosis.The operation should follow the principle of tumor-free and adequate resection range,safe resection margin and complete lymph node resection.For this purpose,we performed the radical pancreaticoduodenectomy via mesenteric approach.The SMA was dissected first,and then the tumor was en-bloc resected.From December 2011 to December 2012,24 patients with tumors in the pancreatic head or the periampullary region received radical pancreaticoduodenectomy via the mesenteric approach at the Second Affiliated Hospital of Harbin Medical University,and the short-term outcome was satisfactory.

Objective To investigate the mechanism of interlekin-6 (IL-6) in wound healing of human biliary epithelial cells ( BECs ).Methods BECs were cultured in IL-6 at different concentrations:0 ng/L(0 ng/L group),10 ng/L (10 ng/L group),50 ng/L (50 ng/L group),100 ng/L (100 ng/L group),1000 ng/L ( 1000 ng/L group).The effects of IL-6 on the phosphorylation of signal transducer and activator of transcription 3( STAT3 ) and the expression of trefoil family factors 3 (TFF3) were detected.BECs were divided into untreated group,STAT3-RNAi group (BECs transfected with STAT3 RNAi adenovirus) and Control-RNAi group (BECs transfected with vacant RNAi adenovirus).The effects of IL-6 on the expression of TFF3 were detected after RNAi of STAT3.In vitro wound models were constructed for the untreated group,STAT3-RNAi group and Control-RNAi group,and the effects of IL-6 and TFF3 on BECs of the 3 groups were detected.All data were analyzed by using the Student's t test,analysis of variance or Sidak test.Results The expressions of phosphorylated STAT3 in the 50 ng/L group,100 ng/L group and 1000 ng/L group were 0.240 ± 0.052,0.714 ± 0.124,0.327 ± 0.069,respectively,which were significantly higher than 0.033 ± 0.011 of the 0 ng/L group (q =5.246,17.260,7.451,P ＜ 0.05 ).The contents of mRNA and protein of TFF3 increased as the increase of IL-6 concentration (q =12.045,9.889,P ＜ 0.05).After RNAi of STAT3 of the BECs,the expression of TFF3 decreased when the concentration of IL-6 was 1000 ng/L.The expression of TFF3 of the STAT3-RNAi group was 0.037 ± 0.005,which was significantly lower than 0.267 ± 0.038 of the Control-RNAi group and 0.301 ± 0.042 in the untreated group ( q =12.135,13.929,P ＜ 0.05 ).In the in vitro wound model,the speed of BECs migration in the STAT3-RNAi group was (9.1 ± 1.5 ) μm/h,which was slower than (25.1 ± 3.8 ) μm/h of the Control-RNAi group after 12 hours of interference with IL-6 (q =7.737,P ＜ 0.05 ).The speed of BECs migration of STAT3-RNAi group was (39.2 ± 4.7) μm/h after adding 1 g/L of recombinant TFF,which was significantly faster than that of the Control-RNAi group (q =14.507,P ＜0.05).Conclusion IL-6 promotes cell migration and wound healing by activating STAT3 and up-regulating TFF3 expression.