Objective To explore the role and mechanism of RNA demethylase fat mass and obesity-associated protein(FTO)in the ferroptosis in testicular interstitial cells induced by di(2-ethylhexyl)phthalate(DEHP).Methods Forty 3-week-old C57BL/6 male mice were randomly divided into a control group(corn oil)and 3 dosed DEHP treatment groups(5,250 and 500 mg/kg),and received an intragastric infusion of corresponding agents for 35 d,respectively.After mouse testicular interstitial TM3 cells was treated with 0,100,200 and 400 μmol/L mono-2-ethylhexyl phthalate(MEHP)for 24 h,corresponding plasmids were transfected to construct Fto overexpressing TM3 cells.Serum testosterone level was detected by ELISA,expression of testicular proteins was detected with immunohistochemical assay,and contents of Fe2+,malondialdehyde(MDA)and lipid peroxides in the testicle were detected by colorimetry.Methylated RNA immunoprecipitation,RT-PCR,and Western blotting were used to detect the level of N6-methyladenosine(m6A)modification.Results In the mice exposed to 250 and 500 mg/kg DEHP,the serum testosterone level was significantly reduced(P＜0.01),contents of Fe2+,MAD and lipid peroxides in testicular tissue were obviously increased(P＜0.01),and protein levels of RNA demethylase FTO,and ferroptosis related molecules ferritin heavy chain 1(FTH1)and glutathione peroxidase 4(GPX4)were significantly down-regulated(P＜0.05),while those of transferrin receptor(TFRC),ferroportin(FPN),cyclooxygenase-2(COX-2),and acyl-CoA synthetase long-chain family member 4(ACSL4)were notably up-regulated(P＜0.05).MEHP treatment for 24 h resulted in remarkably decreased cell viability in the TM3 cells,increased production of intracellular reactive oxygen species(ROS),reduced mitochondrial membrane potential(MMP)(P＜0.01),down-regulated mRNA and protein levels of Fto(P＜0.01),and the changes in other ferroptosis related proteins were consistent with the trend in testicular tissue,indicating ferroptosis in testicular interstitial cells.Intervention with ferroptosis inhibitor Fer-1 or overexpression of Fto significantly inhibited MEHP-induced toxicity and ferroptosis in TM3 cells(P＜0.05),and overexpression of Fto reduced the m6A modification of Gpx4 and Fth1 mRNA(P＜0.05).Conclusion Abnormal m6A modification of Gpx4 and Fth1 caused by inhibiting FTO expression may be the mechanism of ferroptosis in testicular interstitial cells induced by DEHP.

Objective:To investigate the value of machine learning model based on MRI in predicting the abundance of tumor infiltrating CD 8+ T cell and prognosis of pancreatic cancer patients. Methods:The clinical data of 156 patients with pathological confirmed pancreatic cancer who underwent pre-operative MRI within 7 days before surgery in the First Affiliated Hospital of Naval Medical University from January 2017 to April 2018 was retrospectively analyzed. According to the international consensus on the predictive model, a total of 116 patients from January to December 2017 were included in the training set, and a total of 40 patients from January to April 2018 were included in the validation set. With the overall survival of patients as the outcome variable, X-Tile software was used to obtain cut-off values of the percentage of CD 8+ T cells, and all patients were divided into CD 8+ T-high and -low groups. The clinical, pathological and radiological features were compared between two groups. 3D slicer software was used to draw the region of interest in each layer of the primary MR T 1- and T 2-weighted imaging, arterial phase, portal venous phase, and delayed phase images for tumor segmentation. Python package was applied to extract the radiomics features of pancreatic tumors after segmentation and the extracted features were reduced and chosen using the least absolute shrinkage and selection operator (Lasso) logistic regression algorithm. Lasso logistic regression formula was applied to calculate the rad-score. The extreme gradient boosting (XGBoost) were used to construct the machine learning predicted model. The models′ performances were determined by area under the ROC curve (AUC), sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. Results:The cut-off value of the CD 8+ T-cell level was 19.09% as determined by the X-tile program. Patients in the high CD 8+ T cell group had a longer median survival than those in the low CD 8+ T cell group (25.51 month vs 22.92 month, P=0.007). The T stage in the training set and tumor size in the validation set significantly differed between the groups (all P value <0.05). A total of 1 409 radiomics features were obtained, and 19-selected features associated with the level of CD 8+ T cell were determined after being reduced by the Lasso logistic regression algorithm. The rad-score was significantly lower in the CD 8- high group (median: -0.43; range: -1.55 to 0.65) than the CD 8- low group (median: 0.22; range: -0.68 to 2.54, P<0.001). The prediction model combined the radiomics features and tumor size. In the training set, the AUC, sensitivity, specificity, accuracy, and positive and negative predictive value were 0.90 (95% CI 0.85-0.95), 75.47%, 90.48%, 0.84, 0.87, and 0.81. In the validation set, the AUC, sensitivity, specificity, accuracy, and positive and negative predictive value were 0.79 (95% CI 0.63-0.96), 90.00%, 80.00%, 0.85, 0.82, and 0.89. The predictive model can accurately distinguish patients with high and low CD 8+ T cells in pancreatic cancer. Conclusions:The radiomics-based machine learning model is valuable in predicting the CD 8+ T cells infiltrating level in pancreatic cancer patients, which could be useful in identifying potential patients who can benefit from immunotherapies.

Objective:To investigate the effects of case-based learning combined with clinical anatomy in neurosurgery internships.Methods:We included students in grades 2014 and 2015 (test group, n=58) and those in grade 2013 (control group, n=48) doing internships in The first Affiliated Hospital of Shantou University Medical College. The test group adopted case-based learning combined with clinical anatomy in the form of neurosurgery intern learning groups. The group learning consisting of four sessions was held twice a week for a total of four times. The traditional teaching method was used in the control group. All the students filled in the Self-Directed Learning Readiness Scale before and after neurosurgery internships. The test group filled in the Satisfaction Survey on case-based learning combined with clinical anatomy after neurosurgery internships. SPSS 20.0 was used to perform t test. Results:Before neurosurgery internships, there was no difference in self-directed learning ability between the test group and control group ( t=0.25, P=0.807). After the internships, the total score of self-directed learning ability was significantly improved in both the test group ( t=-6.49, P<0.001) and the control group ( t=-4.68, P<0.001). The test group showed improvements in six learning factors, while the control group had no significant changes in love of learning and learning motivation. Compared with the control group, the test group showed a significantly higher total score of self-directed learning ability ( t=2.17, P=0.032) and significantly higher scores of efficient learning ( t=3.81, P=0.001) and learning motivation ( t=4.20, P=0.001). The students in the test group were generally satisfied with the new method combining case-based learning and clinical anatomy. Conclusion:The new method combining case-based learning and clinical anatomy has positive effects on students' self-directed learning ability, especially on learning efficiency and motivation, with a high degree of satisfaction from the students.

Oral bacteria directly affect the disease status of dental caries and periodontal diseases. The dynamic oral microbiota cooperates with the host to reflect the information and status of immunity and metabolism through two-way communication along the oral cavity and the systemic organs. The oral cavity is one of the most important interaction windows between the human body and the environment. The microenvironment at different sites in the oral cavity has different microbial compositions and is regulated by complex signaling, hosts, and external environmental factors. These processes may affect or reflect human health because certain health states seem to be related to the composition of oral bacteria, and the destruction of the microbial community is related to systemic diseases. In this review, we discussed emerging and exciting evidence of complex and important connections between the oral microbes and multiple human systemic diseases, and the possible contribution of the oral microorganisms to systemic diseases. This review aims to enhance the interest to oral microbes on the whole human body, and also improve clinician's understanding of the role of oral microbes in systemic diseases. Microbial research in dentistry potentially enhances our knowledge of the pathogenic mechanisms of oral diseases, and at the same time, continuous advances in this frontier field may lead to a tangible impact on human health.
Bacteria ; Dental Caries/microbiology* ; Humans ; Microbiota ; Mouth/microbiology* ; Mouth Diseases/microbiology* ; Periodontal Diseases/microbiology*

Objective:To investigate the imaging features of pancreatic mucinous cystic tumor (MCN) based on the European evidence-based guidelines on pancreatic cystic neoplasms and risk factors influencing tumor property.Methods:The retrospective case-control study was con-ducted. The clinicopathological data of 109 pancreatic MCN patients who were admitted to the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from March 2011 to April 2021 were collected. There were 5 males and 104 females, aged (49±15)years. There were 97 cases with benign tumors and 12 cases with malignant tumors. Observation indicators: (1) clinical characteristics of MCN patients with different tumor properties; (2) imaging features of MCN patients with different tumor properties; (3) multivariate analysis of factors affecting evaluating tumor pro-perties of MCN. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distri-bution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was performed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Statistically significant indicators in clinical and imaging characteristics were included in multivariate analysis. Multivariate analysis was performed by the Logistic regression model forward method. Results:(1) Clinical characteristics of MCN patients with different tumor properties. Gender(male, female), age, body mass index (BMI), cases with clinical symptoms (asymptomatically physical findings, abdominal pain and distension, emaciation, jaundice, pancreatitis, onset diabetes), cases with CA19-9 (<37 U/mL, ≥37 U/mL), cases with carcinoembryonic antigen (<5.0 μg/L, ≥5.0 μg/L), cases with surgical methods (pancreatoduo-denectomy, pancreatectomy of body and tail, segmental pancreatectomy), cases with tumor location (head of pancreas, tail of pancreas) were 4, 93, (47±14)years, (22±3)kg/m 2, 56, 35, 2, 1, 11, 5, 89, 8, 96, 1, 2, 90, 5, 4, 93 in the 97 cases with benign tumors, versus 1, 11, (59±17)years, (23±3)kg/m 2, 4, 4, 1, 0, 3, 2, 5, 7, 7, 5, 0, 12, 0, 0, 12 in the 12 cases with malignant tumors, showing significant differences in age, CA19-9 and carcinoembryonic antigen ( t=?2.69, χ2=22.57, 26.54, P<0.05) and showing no significant difference in gender, BMI, clinical symptoms, surgical methods and tumor location ( P>0.05) between them. (2) Imaging features of MCN patients with different tumor pro-perties. Of the 109 patients with pancreatic MCN, 85 cases underwent computed tomography (CT) plain and contrast-enhanced scan of pancreas, and 81 cases underwent magnetic resonance imaging (MRI) plain and contrast-enhanced scan of pancreas. There were 57 cases underwent both CT and MRI plain and contrast-enhanced scan of pancreas. Cases with tumor location (head of pancreas, tail of pancreas), cases with cyst morphology (circular, lobulated), cases with cyst diameter (<4 cm, ≥4 cm), diameter of cyst, cases with thickening of capsule wall, cases with calcification of capsule wall, cases with enhancing mural nodule of capsule wall, cases with pancreatic duct dilatation were 4, 93, 69, 28, 32, 65, 4.7(range, 3.3?6.8)cm, 38,20, 4, 13 in the 97 cases with benign tumors, versus 0, 12, 7, 5, 4, 8, 6.8(range, 3.3.?9.6)cm, 10, 2, 6, 4 in the 12 cases with malignant tumors, showing significant differences in thickening of capsule wall and enhancing mural nodule of capsule wall ( χ2=6.75, 21.75, P<0.05) and showing no significant difference in cyst morphology, cyst diameter, diameter of cyst, calcification of capsule wall and pancreatic duct dilatation ( P>0.05) between them. (3) Multivariate analysis of factors affecting evaluating tumor properties of pancreatic MCN. Result of multivariate analysis showed that age, carcinoembryonic antigen and mural nodule of capsule wall were independent factors affecting tumor properties of MCN ( odds Ratio=1.09, 19.67, 63.57, 95% confidence intervals as 1.01?1.18, 1.07?361.49, 4.07?993.49, P<0.05). Conclusions:Thickening of capsule wall and enhancing mural nodule of capsule wall are imaging features of patients with pancreatic MCN. Age, carcinoembryonic antigen and mural nodule of capsule wall are independent factors affecting tumor properties of pancreatic MCN.

Objective:To explore the imaging features of intraductal pancreatic neuro-endocrine tumor (PNET).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 17 patients with intraductal PNET who were admitted to the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from January 2013 to October 2020 were collected. There were 7 males and 10 females, aged (47±13)years. Preoperative contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) of the pancreas was performed on patients. Observation indicators: (1) imaging features of intraductal PNET, including ① imaging features of CT and ② imaging features of MRI; (2) treatment and histopathological examination of intraductal PNET. Measurement data with normal distribution were described as Mean± SD and count data were described as absolute numbers. Results:(1) Imaging features of intraductal PNET. ① Imaging features of CT: 17 patients underwent preoperative contrast-enhanced CT of pancreas. There were 9 cases with tumor located in the head of the pancreas, 5 cases with tumor located in the neck of the pancreas and 3 cases with tumor located in the body and tail of the pancreas. The tumor diameter of the 17 patients was (8.7±2.5)mm, with a range of 5.2?15.5 mm. The tumor shape was round-like in the 17 patients. All the 17 patients showed isodensity on plain CT and markedly enhancement in arterial, venous and portal phases on enhanced CT. The degree of enhancement of tumor was higher than surrounding normal pancreatic parenchyma. All tumors of 17 patients were located at the truncation of main pancreatic duct (MPD) dilation, showing abrupt change in caliber of MPD without the "beak sign". The diameter of dilated MPD was (11.4±5.3)mm, with a range of 4.5?22.5 mm. Other imaging manifestations of the 17 patients included 11 cases with pancreatic parenchymal atrophy, 1 case with retention cyst, 1 case with choledochal dilation, 1 case with calcification, and all cases without cystic degeneration or hemorrhage. ② Imaging features of MRI: preoperative contrast-enhanced MRI was performed in 14 patients. Five cases showed slightly low signal but 9 cases showed unclear on T1-weighted imaging. Five cases showed low signal, 2 cases showed slightly high signal but 7 cases showed unclear on T2-weighted imaging. Of the 14 patients, 9 cases showed diffusion limited on diffusion weighted imaging and 5 cases showed unlimited diffusion. Nine cases showed marked enhancement in tumor higher than in normal pancreatic parenchyma, but 5 cases were unclear on contrast-enhanced MRI. (2) Treatment and histopathological exmination of intraductal PNET: all the 17 patients underwent surgical treatment, including 9 cases with pancreaticoduodenectomy, 4 cases with distal pancreatectomy and splenectomy, 4 cases with pancreatic segmentectomy. Postoperative histopatho-logical examination results showed 10 cases of G1 and 7 cases of G2, including 1 case of G2 with lymph node metastasis, 1 case of G2 with lymph node and liver metastasis. The pathological gross showed that the tumor body was mainly located in the pancreatic duct and blocked the pancreatic duct, with upstream pancreatic dilation. There were pancreatic acinar atrophy and fibrous tissue hyperplasia. The tumor was grayish-yellow or brownish red, solid, medium in texture and well-defined with the surrounding tissues. Microscopically, the tumor of 17 patients was mainly located in the pancreaic duct and invaded into surrounding pancreatic parenchyma. The cells of tumor were polygonal with a central nucleus, but the mitosis was rare. The cytoplasm was eosinophilic or hyaline. The tumor stroma was mainly collagen fiber with abundant capillary network.Conclusions:The imaging features of intraductal PNET are small size, marked enhancement on contrast-enhanced CT and MRI. The tumor obstructs the MPD with distal MPD dilation and pancreatic parenchyma atrophy.

Objective:To develop and verify a predictive model based on CT characteristics for predicting infected walled-off necrosis (IWON) in MSAP and SAP patients.Methods:The clinical and CT data of 1 322 patients diagnosed as MSAP and SAP according to the 2012 Atlanta revised diagnostic criteria in the First Affiliated Hospital of Naval Medical University from January 2015 to December 2020 were continuously collected. Finally, 126 patients who underwent enhanced CT scans within 3 days after admission and percutaneous catheter drainage of WON during hospitalization were enrolled. Among them, there were 63 MSAP and 63 SAP patients. According to the results of the culture from drainage fluid, the patients were divided into sterile walled-off necrosis group (SWON group, n=31) and infected walled-off necrosis group (IWON group, n=95). Patients were divided into training set (18 patients with SWON and 74 patients with IWON from January 2015 to December 2018) and validation set (13 patients with SWON and 21 patients with IWON from January 2019 to December 2020). Univariate and multivariate logistic regression analysis were performed to establish a model for predicting IWON. The model was visualized as a nomogram. The receiver operating characteristic curve (ROC) was drawn. The predictive efficacy of the model was evaluated by the area under the curve (AUC), sensitivity, specificity and accuracy, and the clinical application value was judged by decision curve analysis (DCA). Results:Univariate regression analysis showed that age, etiology, WON with bubble sign and the lowest CT value of WON were significantly associated with IWON. Multivariate logistic regression analysis showed that older age, biliary acute pancreatitis, WON with bubble sign, and the greater minimum CT value of WON were independent predictors for IWON. The formula for the prediction model was 0.12+ 0.01 age-0.75 hyperlipidemia-1.62 alcoholic-2.62 other causes+ 19.18 WON bubble sign+ 0.10 minimum CT value of WON. The AUC, sensitivity, specificity, and accuracy of the model were 0.85 (95% CI 0.76-0.94), 67.57%, 88.89%, and 71.74% in the training set and 0.78(95% CI0.62-0.94), 66.67%, 84.62%, and 73.53% in the validation set, respectively. The decision analysis curve showed that when the nomogram differentiated IWON from SWON at a rate greater than 0.38, using the nomogram could benefit the patients. Conclusions:The prediction model established based on CT characteristics might non-invasively and accurately predict the presence or absence of IWON in MSAP and SAP patients, and provide a basis for guiding treatment and evaluating prognosis.

Objective:To analyze the medical imaging in misdiagnosing serous cystic neoplasm(SCN) of the pancreas with pancreatic duct dilatation as other pancreatic lesions.Methods:Data of 21 patients with SCN and pancreatic duct dilatation who underwent surgical resection from January 2011 to November 2021 at the First Affiliated Hospital of Naval Medical University were retrospectively analyzed. There were 9 males and 12 females with ages ranging from 25 to 74, mean ± s. d. (57.4±13.4) years. The clinical features, surgical treatments, CT and MRI imaging features, and misdiagnosis were analyzed.Results:Of 11 patients who presented with abdominal pain, 1 patient had backache, 1 patient was jaundice, 1 patient had weight loss, 1 patinet had fatigue and 6 patients were asymptomatic. Ten patients were operated using pancreaticoduodenectomy, 8 distal pancreatectomy, 2 segmental pancreatectomy and 1 total pancreatectomy. For 11 patients, the lesion was located in the head of pancreas, and for 10 patients in the body and tail of pancreas. The tumor size was 23.0-92.0 (45.8±17.8) mm. All 21 patients had upstream pancreatic duct dilatation but no downstream pancreatic duct dilatation. The inner diameter of the pancreatic duct was 4.0-11.0(7.1±2.0) mm. Of 13 patients showed a low signal intensity on T 1-weighted imaging, 18 patients showed a markedly high signal intensity on T 2-weighted imaging, 13 patients showed no limitation on diffusion weighted imaging. Among the 11 patients who underwent CT examination, 5 patients were diagnosed to have intraductal papillary mucinous neoplesm (IPMN), 3 SCN, 1 pancreatic neuroendocrine tumor, 1 pancreatic cancer and 1 cyst. The misdiagnotic rate of CT was 72.7% (8/11). Among the 18 patients who underwent MRI examination, 9 patients were diagnosed to have IPMN, 3 mucinous cystic neoplasm, 3 SCN, 2 pancreatic cancer and 1 solid pseudopapillary tumor. The misdiagnosis rate of MRI was 83.3% (15/18). Conclusion:SCN with pancreatic duct dilatation was easily misdiagnosed as IPMN or other pancreatic solid tumors. The difference between SCN with pancreatic duct dilatation and IPMN was that the downstream pancreatic duct of SCN was normal. SCN showed a markedly high signal intensity on T 2-weighted imaging and no limitation on diffusion weighted imaging, which can help to distinguish SCN from other pancreatic solid tumors.

Objective:To compare the numerical rating scales (NRS) and Oswestry disability index (ODI) of denosumab in Chinese postmenopausal osteoporosis patients after 3 months, and analyze the early adverse reactions to provide reference for clinical diagnosis and treatment.Methods:Using a prospective study method, 260 patients with postmenopausal osteoporosis who were outpatients and inpatients in the Second Affiliated Hospital of Soochow University from September 2020 to October 2021 were selected, and general information, including age, height, weight, bone mineral density, history of fragility fractures, and use of anti-osteoporosis drugs. All subjects received denosumab 60 mg subcutaneously, and were given calcium and vitamin D at the same time. Pain was scored by NRS before treatment and 3 months after treatment, and functional improvement was assessed by ODI.Results:After 3 months of denosumab treatment in postmenopausal women with osteoporosis, among patients with different age groups, different degrees of osteoporosis, history of fragility fractures, and history of use of anti-osteoporosis drugs, NRS score and ODI score were lower than those before treatment, and the difference was statistically significant ( P<0.05). In addition, in patients with a history of fragility fractures (mainly vertebral fractures), the NRS scores and the ODI score decreased more significantly, and the difference was statistically significant ( P<0.05); the NRS score and ODI score decreased more significantly in patients with severe osteoporosis than in patients with osteoporosis, and the difference was statistically significant ( P<0.05); the BMD value of lumbar spine was negatively correlated with the reduction of NRS score before and after treatment ( P=0.042). In this study, 260 patients had musculoskeletal pain in 6 (2.3%), fatigue in 5 (1.9%), rash in 4 (1.5%), urinary tract infection in 2 (0.7%), and dizziness in 2 (0.7%), 2 case of fever (0.7%), 1 case of hypocalcemia (0.4%), a total of 22 cases of adverse reactions were reported, and the overall adverse reaction rate was 8.5%. Conclusion:Denosumab can improve pain symptoms and functional disability early in the clinical application of Chinese postmenopausal women with osteoporosis, and the incidence of adverse reactions is low. Especially for postmenopausal female osteoporosis patients with severe osteoporosis, low lumbar spine bone density, and a history of fragility fractures (mainly vertebral fractures), the application effect is more significant.

Objective:To investigate the clinical and imaging features of pancreatic intraductal oncocytic papillary neoplasm (IOPN).Methods:From January 2011 to August 2021, at the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, 12 patients pathologically diagnosed with pancreatic IOPN after surgical resection were enrolled. Before operation, all patients underwent plain and enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The clinical data (general conditions, main complaints, tumor related indicators and past medical history), CT and MRI features, surgical methods and pathologic results of the 12 patients with pancreatic IOPN were retrospectively analyzed. Descriptive method was used for statistical analysis.Results:Among 12 pancreatic IOPN patients, there were 7 males and 5 females, aged (54.0±13.0) years old (ranged from 31 to 75 years old). The symptoms were abdominal pain in 3 cases, jaundice in 1 case and 8 cases were detected during regular health checkups. Serum carbohydrate antigen 19-9 increased in 3 cases and carcinoembryonic antigen increased in 2 cases. One pancreatic IOPN patient with pancreatitis history and 3 pancreatic IOPN patients with diabetes history. Six cases were with the lesions located in the head of pancreas, 5 cases were located in the body and tail of pancreas and 1 case were diffused in the all the pancreas. Five cases were branch duct type, 2 cases were main duct type and 5 cases were mixed duct type. Ten pancreatic IOPN patients presented cystic or cystic-solid tumor, the maximum diameter (range) of the tumor was (50.3±31.1) mm (28 to 127 mm). The cyst walls of 6 patients were thickened and those of 9 patients were found with enhanced mural nodule or solid component, and none of them were growing outside the cystic wall. Two patients presented solid tumor located in the dilated pancreatic duct, and the maximum diameter (range) of the tumor was (25.5±0.5) mm (25 to 26 mm). The solid tumor demonstrated as slightly lower density on plain CT scan, lower signal on T1-weighted MRI imaging, high signal on T2-weighted MRI imaging, and limited diffusion on diffusion weighted imaging, and mild enhancement after CT and MRI enhanced scan. The main pancreatic duct dilated in 11 cases, and the inner diameter (range) was (10.5±8.1) mm (3 to 28 mm). The pancreatic parenchymal of 4 pancreatic IOPN patients was atrophy, 4 patients with calcification and 1 patient with lymphadenopathy. None of the 12 pancreatic IPON patients had peripheral blood vessel and tissue invasion. Six cases were received pancreaticoduodenectomy, 4 cases were underwent distal pancreatectomy, 2 cases underwent total pancreatectomy. The pathological classification of 7 pancreatic IOPN patients was invasive carcinoma, 4 cases were with high-grade dysplasia and 1 case with low-grade dysplasia.Conclusion:The clinical features of pancreatic IOPN are atypical and the imaging findings are mostly solid or cystic-solid tumor, pancreatic duct dilation, solid component of tumor located in the dilated pancreatic duct, and no peripheral tissue invasion.