In the past,it is always believed that routine drainage after pancreaticoduodenectomy (PD) is one of the most crucial methods to prevent and detect postoperative complications and to reduce mortality.However,in more recent years,with the development of fast track surgery,scholars in pancreatic surgery have investigated the necessity of drainage after PD together with its merits and faults.Therefore,this paper gives a brief review on this topic.

OBJECTIVETo evaluate the performance of vaporized hydrogen peroxide (VHP) for the bio-decontamination of the high efficiency particulate air (HEPA) filter unit.

METHODSSelf-made or commercially available bioindicators were placed at designated locations in the HEPA filter unit under VHP fumigation. The spores on coupons were then extracted by 0.5 h submergence in eluent followed by 200- time violent knocks.

RESULTSDue to the presence of HEPA filter in the box, spore recovery from coupons placed at the bottom of the filter downstream was significantly higher than that from coupons placed at the other locations. The gap of decontamination efficiency between the top and the bottom of the filter downstream became narrower with the exposure time extended. The decontamination efficiency of the bottom of the filter downstream only improved gently with the injection rate of H2O2 increased and the decontamination efficiency decreased instead when the injection rate exceeded 2.5 g/min. The commercially available bioindicators were competent to indicate the disinfection efficiency of VHP for the HEPA filter unit.

CONCLUSIONThis assay developed can detect all 16 β-lactams demanded by the European Union (EU). The whole procedure takes only 45 min and can detect 42 samples and the standards with duplicate analysis.

Air Filters ; Fumigation ; Hydrogen Peroxide ; chemistry

OBJECTIVETo investigate the function of nuclear factor (NF)-κB in the epithelial to mesenchymal transition induced by hypoxia in pancreatic cancer cells.

METHODSFor cultured pancreatic cancer cells (BxPC-3 and Panc-1) under hypoxic and normoxic conditions, the differences in the morphology were observed by optical microscope. The expression of markers of epithelial and mesenchymal phenotypes, E-cadherin, vimentin and N-cadherin, were determined by Western blot. NF-κB P65 activity was measured by electrophoretic mobility shift assay. Invasion and gemcitabine resistance of pancreatic cancer cells were evaluated in matrigel invasion assay and cell counting kit-8 assay. Both molecular and pharmacologic means of inhibiting NF-κB P65 were used in these hypoxic cells and then the above resulting phenotypes were compared with those of the control-treated cells.

RESULTSAfter cultured pancreatic cancer cells under hypoxic conditions for 48 h, normoxic cells exhibited a polygonal shape and formed tight clusters of cells, whereas hypoxic cells took on an elongated, fibroblastoid morphology associated with a more highly invasive character and resistance to gemcitabine; hypoxic cells exhibited an suppression of E-cadherin and increase in vimentin and N-cadherin expression. NF-κB P65 activity was elevated in hypoxic cells. On the contrary, on molecular or pharmacologic inhibition of NF-κB P65, hypoxic cells regained expression of E-cadherin, lost expression of N-cadherin, and reversed their highly invasive and drug resistant phenotype.

CONCLUSIONSPancreatic cancer cells underwent epithelial to mesenchymal transition exposed to hypoxia, exhibited highly invasive and drug resistant phenotype. Inhibition of NF-κB P65 under hypoxic conditions, pancreatic cancer cells regained expression of E-cadherin, lost expression of N-cadherin, and reversed their highly invasive and drug resistant phenotype.

Antigens, CD ; metabolism ; Cadherins ; metabolism ; Cell Hypoxia ; Cell Line, Tumor ; Drug Resistance, Neoplasm ; Epithelial-Mesenchymal Transition ; Humans ; Pancreatic Neoplasms ; metabolism ; pathology ; Transcription Factor RelA ; metabolism ; Vimentin ; metabolism

Translational medicine is a totally new concept which could basically eliminate the barrier between basic medicine and clinical medicine and shorten the process of‘bench to bedside’Throughout the history of the diagnosis and treatment of acute pancreatitis,we found that changes of treatment concept at each historical stage were the results of‘translational medicine’under the technical and cognitive condition at that time.This paper elaborated on the important role of translational medicine based on the diagnosing and treating development of acute pancreatitis as well as discussed the medical teaching and research under the mode of translational medicine.

Objective To analyze the potential factors facilitating post-pyloric placement of spiral naso-jejunum tube in critically ill patients.Methods A retrospective study was carried out in patients requiring enteral nutrition (EN) from Apr 2005 through Dec 2011 in Intensive Care Unit (ICU).Severity of illness was assessed with APACHE Ⅱ score (acute physiology and chronic health evaluation Ⅱ).A selfpropelled spiral naso-jejunum tube was placed and observed for 24 hours.The forward movement and place of the tube tip was checked by bedside X-ray.The APACHE Ⅱ score,therapeutic measures,agents administered within 24 hours after tube insertion were recorded.The patients were divided into the success group and the failure group identified by bedside X-ray whether the tube tip entered into jejunum or not.Univariate analysis and multivariate Logistic regression analysis were used to find out the potential factors impacting on the success or failure in post-pyloric placement of naso-jejunum tube.Results A total of 508 patients composed of 337 male and 171 female,and aged (62.0 ± 19.2) years with APACHE Ⅱ score of (21.9 ± 7.3) were enrolled for study.The placement was successful in 205 (40.4％) of 508 patients.Univariate analysis showed that APACHE Ⅱ score ≥ 20,sedatives and analgesics,catecholamines,prokinetics,artificial airway and mechanical ventilation were potential factors facilitating the post-pyloric placement of naso-jejunum tube.Multivariate logistic regression identified that APACHE Ⅱ score ≥ 20,sedatives and analgesics and prokinetics were independent factors facilitating the post-pyloric placement of naso-jejunum tube.Conclusions The success rate of self-propelled spiral nasojejunal tubes insertion was relatively low.The prokinetics contributed higher success rate of naso-jejunum tube placement than factors of APACHE Ⅱ score ≥ 20,sedative and analgesic,catecholamine drugs,artificial airway and mechanical ventilation.There were no effects of age and gender on the placement of naso-jejunum tube.

BACKGROUNDA satisfied glaucoma model is absent now. The aim of this study was to evaluate the effect of a combination of intracameral injection of silicone oil and electrocoagulation of corneal limbal vessels and episcleral veins in the rats to establish glaucoma model.

METHODSOperation was performed in each of the left eyes of 90 adult male rats. Right eyes were used as controls. Measurement of intraocular pressure (IOP) was performed with an applanation tonometer (Tono-Pen). Retinal ganglion cells (RGCs) were retrogradely labeled by applying FluoroGold onto the bilateral superior colliculus.

RESULTSDuring the follow-up (24 weeks), the IOP of the study eyes was significantly higher (P < 0.05) than the control eyes (at final examination, IOP of control eyes was (13.4 ± 1.0) mmHg and IOP of study eyes was (16.1 ± 1.8) mmHg). Correspondingly, at 24 weeks after operation, the RGCs density of the study eyes (2286.11 ± 290.45/mm(2)) was significantly lower than the control eyes (2626.46 ± 164.85/mm(2), P < 0.01). In the operated eyes, histological examination showed excavation of optic disc and increased neuroglial cells in the optic nerve, reduced thickness of retina and diminution of retinal ganglion cells, and atrophy of ciliary body and iris. Notably, the anterior chamber angle of the operated eye remained open.

CONCLUSIONSA combination of intracameral injection of silicone oil and electrocoagulation of corneal limbal vessels and episcleral veins may establish a reliable glaucoma model for further research.

Animals ; Disease Models, Animal ; Electrocoagulation ; methods ; Glaucoma ; chemically induced ; etiology ; Limbus Corneae ; blood supply ; Male ; Rats ; Rats, Wistar ; Silicone Oils ; administration & dosage ; toxicity

Objective To explore the effects of lactoferrin on T cells ( the levels of CD4 + T and CD8 +T lymphocytes) and the development of intestinal mucous membrane (villus heights, crypt depths, villus circumferences, and villus areas) in neonatal SD rats. Methods Totally 96 neonatal (one week old) SD rats were equally and randomly divided into twelve groups, in which animals were fed with lactoferrin at a dose of 1.0 g/( kg · d) (dose Ⅰ group), 3.0 g/(kg · d) (dose Ⅱ group), or 5.0 g/(kg · d) (dose Ⅲ group) for 2, 3, or4 weeks,with corresponding blank control groups. Rats in the dosage groups were killed at the set time points and the levels of venous blood CD4 + and CD8 + T lymphocytes were detected using immunofluorescence method. Jejunum ( 1 cm)and ileum (1 cm) specimens were obtained for pathological sectioning, and the villus height, crypt depth, villus circumferences, and villus areas were measured through image analysis system. Results The CD4 + T lymphocyte levels at two weeks were significantly different among dose I group, dose Ⅱ group, and control groups ( all P ＜0. 05).The CD8 + T lymphocyte levels at two weeks were significantly different among dose Ⅱ group, dose Ⅲ group,and control groups ( all P ＜ 0. 05 ). The villus heights, crypt depths, villus circumferences, and villus areas of jejunum at two weeks between feeding groups and control groups were not significantly different ( all P ＞ 0. 05 ), while the condition in ileum was on the contrary. The CD4 + T lymphocyte levels at three weeks were significantly different between feeding groups and control groups ( P ＜ 0. 05 ). The CD8 + T lymphocyte levels at three weeks between dose Ⅲ group and control groups were significantly different ( P ＜ 0. 05 ). The villus heights, crypt depths, villus circumferences, and villus areas of jejunum and ileum at three weeks were significantly different between feeding groups and control groups ( all P ＜ 0. 05 ). The CD4 + T lymphocyte levels at four weeks between feeding groups and control groups were significantly different (P ＜0. 05). The CD8 + T lymphocyte levels at four weeks were significantly different among dose Ⅱ group, dose Ⅲ group, and control groups ( all P ＜ 0. 05 ). Except villus areas of ileum, the villus heights, crypt depths, villus circumferences of jejunum and ileum, and villus areas of jejunum at four weeks were significantly different between feeding groups and control groups ( all P ＜ 0.05 ). Conclusions Lactoferrin can promote the levels of CD4 + and CD8 + T lymphocytes in venous blood and facilitate the development of the mucous membranes of jejunum and ileum. However, such effects are affected by the dose and timing of lactoferrin feeding.

BACKGROUND AND OBJECTIVETranscriptional silencing induced by CpG island methylation is believed to be one of the important mechanisms of carcinogenesis. Checkpoint with fork head-associated and ring finger (CHFR) governs the transition from prophase to prometaphase in response to mitotic stress. This study was to analyze the relationship between the methylation of CHFR gene and the clinicopathologic features of gastric cancer, and the difference of results between methylation-specific polymerase chain reaction (MSP) and combined bisulfite restriction analysis (COBRA) in detecting aberrant methylation of CHFR gene in gastric cancer.

METHODSBoth MSP and COBRA methods were used to detect the promoter methylation of CHFR gene in gastric cancer specimens from 64 patients. The relationship between methylation status of CHFR gene and the clinicopathologic features of gastric cancer were analyzed using SPSS16.0.

RESULTSThe methylation rates of CHFR gene promoter were significantly higher in gastric cancer samples than in the corresponding paracancer normal gastric mucosa by MSP (51.6% vs. 18.8%, P < 0.001). However, there was no significant correlation between methylation status of CHFR gene and the clinicopathologic parameters of gastric cancer, including age, gender, tumor size, clinical stage, Borrman type, tumor invasion depth, differentiation, and lymph node metastasis (P > 0.05). Aberrant methylation of the CHFR gene was detected in 27 (42.2%) of the 64 specimens of gastric cancer using COBRA, which did not significantly differ from that using MSP (P > 0.05).

CONCLUSIONSAberrant methylation of the CHFR gene is a frequent event in the carcinogenesis of gastric cancer. Detecting the methylation of CHFR gene in gastric mucosa may conduce to the diagnosis of gastric cancer. No difference was found between MSP and COBRA in detecting promoter methylation of CHFR gene in gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Cell Cycle Proteins ; genetics ; DNA Methylation ; DNA, Neoplasm ; genetics ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Proteins ; genetics ; Neoplasm Staging ; Poly-ADP-Ribose Binding Proteins ; Polymerase Chain Reaction ; methods ; Promoter Regions, Genetic ; genetics ; Stomach Neoplasms ; genetics ; pathology ; Sulfites ; chemistry ; Ubiquitin-Protein Ligases

Humans ; Infection ; etiology ; therapy ; Pancreatitis ; complications ; therapy

Objective To explore the effect of elevated intraocular pressure (IOP) on retina's function of rat. Method Chronic glaucoma rat models were built and IOP were measured persistently. Flash electroretinogram (F ERG) and histological status were measured before and after surgery. ResultsThe maximal IOP in rats without anesthesia is (3.07±1.10) kPa in 1 day after surgery. From 1 w to 6 w after surgery, the model eye IOPs are （2.84±0.90） kPa，（2.86±0.54） kPa，（2.76±0.52） kPa，（2.70±0.51） kPa，（2.39±0.27） kPa and（2.09±0.39） kPa, respectively, which are significant higher than that of the fellow eye. A series of main parameters including the amplitudes of a wave, b wave and oscillatory potentials(OPs) all dramatically decreased in model eyes at 6 weeks and 3 weeks postoperatively . No obvious changes were observed by routine HE staining among the eyes before and after surgery. Conclusions The chronic high intraocular pressure could induce the retinal dysfunction before any morphological change occurred, and what's more, the damage showed itself a progressive one.