1.Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients
Jian′ang LI ; Yaolin XU ; Ni DING ; Yuan JI ; Lingxiao LIU ; Shengxiang RAO ; Yiqun ZHANG ; Xiuzhong YAO ; Yue FAN ; Cheng HUANG ; Yuhong ZHOU ; Lili WU ; Yi DONG ; Lei ZHANG ; Yefei RONG ; Tiantao KUANG ; Xuefeng XU ; Liang LIU ; Dansong WANG ; Dayong JIN ; Wenhui LOU ; Wenchuan WU
Chinese Journal of Surgery 2022;60(7):666-673
Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.
2.Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients
Jian′ang LI ; Yaolin XU ; Ni DING ; Yuan JI ; Lingxiao LIU ; Shengxiang RAO ; Yiqun ZHANG ; Xiuzhong YAO ; Yue FAN ; Cheng HUANG ; Yuhong ZHOU ; Lili WU ; Yi DONG ; Lei ZHANG ; Yefei RONG ; Tiantao KUANG ; Xuefeng XU ; Liang LIU ; Dansong WANG ; Dayong JIN ; Wenhui LOU ; Wenchuan WU
Chinese Journal of Surgery 2022;60(7):666-673
Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.
3.Analysis of differential genes and metabolic pathway related to functional male sterility in eggplant.
Zhimin WANG ; Chao YUAN ; Zeqin DING ; Ruolin HU ; Yi NIU ; Qinglin TANG ; Dayong WEI ; Ming SONG ; Yongqing WANG ; Shibing TIAN
Chinese Journal of Biotechnology 2021;37(1):253-265
Based on observing the cytological characteristics of the flower buds of the functional male sterile line (S13) and the fertile line (F142) in eggplant, it was found that the disintegration period of the annular cell clusters in S13 anther was 2 days later than that of F142, and the cells of stomiun tissue and tapetum in F142 disintegrated on the blooming day, while it did not happen in S13. The comparative transcriptomic analysis showed that there were 1 436 differential expression genes (DEGs) (651 up-regulated and 785 down-regulated) in anthers of F142 and S13 at 8, 5 days before flowering and flowering day. The significance analysis of GO enrichment indicated that there were more unigene clusters involved in single cell biological process, metabolism process and cell process, and more catalytic activity and binding function were involved in molecular functions. Through KEGG annotation we found that the common DEGs were mainly enriched in the biosynthesis of secondary metabolites, metabolic pathway, protein processing in endoplasmic reticulum, biosynthesis of amino acids, carbon metabolism and plant hormone signal transduction. The fifteen genes co-expression modules were identified from 16 465 selected genes by weighted gene co-expression network analysis (WGCNA), three of which (Plum2, Royalblue and Bisque4 modules) were highly related to S13 during flower development. KEGG enrichment showed that the specific modules could be enriched in phenylpropanoid biosynthesis, photosynthesis, porphyrin and chlorophyll metabolism, α-linolenic acid metabolism, polysaccharide biosynthesis and metabolism, fatty acid degradation and the mutual transformation of pentose and glucuronic acid. These genes might play important roles during flower development of S13. It provided a reference for further study on the mechanism of anther dehiscence in eggplant.
Flowers/genetics*
;
Gene Expression Profiling
;
Gene Expression Regulation, Plant
;
Humans
;
Infertility, Male
;
Male
;
Metabolic Networks and Pathways/genetics*
;
Solanum melongena/genetics*
;
Transcriptome/genetics*
4.Regulation of plant MYB transcription factors in anther development.
Ruolin HU ; Chao YUAN ; Yi NIU ; Qinglin TANG ; Dayong WEI ; Zhimin WANG
Chinese Journal of Biotechnology 2020;36(11):2277-2286
MYB transcription factor is one of the largest transcription families and involved in plant growth and development, stress response, product metabolism and other processes. It regulates the development of plant flowers, especially anther development, a key role in the reproduction of plant progeny. Here, we discuss the regulatory effects of MYB transcription factors on the development of anther, including tapetum development, anther dehiscence, pollen development, carbohydrates and hormone pathways. We provide a reference for the further study of the regulation mechanism and network of plant anther development.
Arabidopsis/metabolism*
;
Flowers/genetics*
;
Gene Expression Regulation, Plant
;
Humans
;
Pollen/genetics*
;
Reproduction
;
Transcription Factors/metabolism*
5.Advances in research on the mechanism of DNA methylation in plants.
Chao YUAN ; Shaowei ZHANG ; Yi NIU ; Qinglin TANG ; Dayong WEI ; Zhimin WANG
Chinese Journal of Biotechnology 2020;36(5):838-848
DNA methylation is an epigenetic modification that forms an important regulation mechanism of gene expression in organisms across kingdoms. Aberrant patterns of DNA methylation can lead to plant developmental abnormalities. In this article, we briefly discuss DNA methylation in plants and summarize its functions and biological roles in regulating gene expression and maintaining genomic stability, plant development, as well as plant responses to biotic and abiotic stresses. We intended to provide a concise reference for further understanding of the mechanism of DNA methylation and potential applications of epigenetic manipulation for crop improvement.
Crop Production
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trends
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DNA Methylation
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Epigenesis, Genetic
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Gene Expression Regulation, Plant
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Genomic Instability
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Plants
;
genetics
;
Research
;
trends
;
Stress, Physiological
6.Adverse reactions to cosmetics: an analysis of surveillance data from 2005 to 2014 in China
Shuxin HAO ; Benxing HUO ; Yue LIU ; Xiaoyuan YAO ; Qiushui WANG ; Dayong YUAN ; Jie LIU
Chinese Journal of Dermatology 2016;49(1):26-31
Objective To investigate the prevalence and characteristics of adverse reactions to cosmetics in China,and to provide a basis for further supervision.Methods The diagnosis of adverse reactions to cosmetics was according to 7 national standards (GB17149.1-7-1997) including the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Data regarding gender,age,occupation,educational background,disease types,cosmetic types,and so on,were collected from patients with adverse reactions to cosmetics at 13 surveillance sites in China during 2005-2014.A descriptive statistical analysis was carried out.Results During 2005-2014,a total of 13 534 cases of adverse reactions to cosmetics were reported to the monitoring system.Of these cases,95.40% (12 912/13 534) were female,and 80.85% were young or middle-aged (20-44 years).Finally,5 446 cases were confirmed to be adverse reactions to cosmetics,among which,94.66% (5 155/5 466) were contact dermatitis to cosmetics,and 132 were other types that were not included in the A general rule for the diagnosis and management of skin diseases induced by cosmetics.Among these confirmed cases,14 209 cosmetic products were involved,and ordinary skin care products predominated in these products.The proportion of imported cosmetic products (48.79%,6 932/14 209) was slightly higher than that of domestic products (43.21%,6 139/14 209).The number of reported eases increased by 13.16% per year from 2005 to 2009,but decreased by 17.96% per year from 2010 to 2014.Conclusion Adverse reactions to cosmetics are a complicated and important public health issue,and effective measures should be taken based on their characteristics.
7.Diagnosis and treatment of anaplastic carcinoma of the pancreas
Xuefeng XU ; Wenhui LOU ; Yuan JI ; Yebo SHAO ; Chenye SHI ; Wenchuan WU ; Dayong JIN
Chinese Journal of Digestive Surgery 2013;12(8):561-563
Objective To investigate the diagnosis and treatment of anaplastic carcinoma of the pancreas.Methods The clinical data of 10 patients with anaplastic carcinoma of the pancreas who were admitted to the Zhongshan Hospital from January 1999 to June 2010 were retrospectively analyzed.Computed tomography was carried out preoperatively and surgical plan was designed according to the site of tumors.Chemoradiotherapy was applied postoperatively.Patients were followed up till March 2012 by phone call and out-patient examination.The clinical and imaging features,pathological characteristics,treatment and follow-up data were analyzed.The clinical and pathological features were analyzed by descriptive statistics.The continuous data were described as (x) ± s,and categorical data were presented by frequency and precentage.Results The tumors located at the head of the pancreas were observed in 5 patients,tumor located at the neck of the pancreas in 1 patient,and tumors located at the body and tail of the pancreas in 4 patients.Two patients underwent pancreaticoduodenectomy (PD),2 underwent PD + extended lymph node dissection,1 underwent PD + portal vein reconstruction,1 underwent pancreatectomy,4 underwent resection of body and tail of pancreas and splenectomy.The size of the tumors ranged from 2.0 cm × 2.0 cm × 2.0 cm to 14.0 cm × 12.0 cm × 9.0 cm.Duodenal and biliary invasion was observed in 4 patients,superior mesenteric vein-portal vein invasion in 1 patient,splenic artery invasion in 1 patient.Neural invasion was observed in 8 patients,including 4 patients with lymph node metastasis.The results of immunohistochemical staining showed that 10 patients were with positive expression of cytokeratin 7,and 1 patient was with positive expression of vimentin.Nine patients were followed up,2 patients did not receive postoperative chemoradiotherapy,6 received chemotherapy with Gemicitabine and 1 received interventional treatment.The survival time of the 9 patients ranged from 8 to 20 months,and the median survival time was 12 months.Eight patients died of tumor recurrence and metastasis.Conclusions Pancreatic anaplastic carcinoma is a distinct rare variant of pancreatic ductal adenocarcinoma.Pancreatic anaplastic carcinoma has high malignancy,definite diagnosis depends on pathological examination,and the surgical plan should be made according to the result of imaging examination.Conventional radiotherapy and chemotherapy are ineffective for the treatment of this disease.
8.A study on the imaging characteristics of autoimmune pancreatitis
Liang LIANG ; Mengsu ZENG ; Xiuzhong YAO ; Shengxiang RAO ; Weizhong CHENG ; Yuan JI ; Wenhui LOU ; Houyu LIU ; Dayong JIN
Chinese Journal of General Surgery 2012;27(9):721-725
ObjectiveTo investigate the CT and MRI imaging characteristics of autoimmune pancreatitis and its clinical value.MethodsFourteen patients(13males, 1female, mean age 58.3 years) with autoimmune pancreatitis proved histopathologically or clinically were enrolled in the study.Clinical data was studied retrospectively.Among those patients,CT was performed on 12 cases and MR imaging was performed on 8 patients,6 patients underwent both CT and MR imaging.ResultsAll 14 patients had enlargement of the pancreas,which could be divided into three types including diffuse type ( n =7 ),focal type ( n =5 ) and mixed type ( n =2 ).On plain CT the pancreas was of isodensity ( n =5 ) or mild hypodensity ( n =7).In one case there was several small hypodensity cystic lesions within and around the pancreas that was rarely seen in other autoimmune pancreatitis cases.Pancreatic lesions as shown by MRI were all mildly hypointense on T1WI and mildly hyperintense on T2WI,all displayed lesions were detected as high-signal intensity areas on DWI. By medium contrast,autoimmune pancreatitis lesions demonstrated “ snow-like” heterogeneously decreased enhancement on artery phase of dynamic contrast enhanced imaging and then showed gradually delayed enhancement on portal venous phase and later phases.“Capsule-like” rim was present around the autoimmune pancreatitis lesions in 9 cases.Main pancreatic duct was irregular in shape in 4 cases and slightly dilated in 5 patients.Strictures of lower common bile duct and upper bile duct dilatation as well as thickening and enhancement of the bile duct wall were found in 9 cases.Peripheral vascular involvement was seen in 4 cases. Abdominal lymphadenopathy at hepatic portal was observed in 1 patient.Two cases showed tiny decreased enhancement lesions in the kidneys.Steroid therapy was given in 10 cases,all pancreatitis lesions ameliorated as showed by follow-up imaging examinations.ConclusionsAIP specific CT and MRI imaging findings are common in most patients which help establish the diagnosis and differential diagnosis of AIP.
9.Acinar cell carcinoma of the pancreas: an analysis of 10 cases
Xuefeng XU ; Xiaolin NI ; Yuan JI ; Wenhui LOU ; Dasong WANG ; Tiantao KUANG ; Wenchuan WU ; Dayong JIN
Chinese Journal of Pancreatology 2010;10(1):6-8
Objective To investigate the histological features,biological features,clinical treatment and prognosis of pancreatic acinar cell carcinoma.Methods A retrospective review of 10 patients with pancreatic acinar cell carcinoma treated in our hospital from 1999 to 2008 was conducted and the clinical features,imaging changes,pathologic feature,treatment course and follow-up data were collected.Results There were 9 men and 1 woman with a mean age of (62±8) years old.Tumors were located in the uncinate process in 1 patient,head of pancreas in 7,body and tail in 2.The median size of these tumors was 4.5 cm×4.7 cm;common bile duct and intrahepatic bile duct,pancreatic duct dilation was detected in 7 cases,and superior mesenteric vein was invaded in 2 cases.Of the 10 patients,8 received pancreaticoduodenectomy,among these 8 patients,3 had extended lymph node dissection,2 had portal vein resection and replacement;2received resection of pancreatic body and tail as well as splenectomy.Histologically,the size of these tumors were 4.0 cm×3.3 cm×3.4 cm.Macrescopically,duodenum was invaded in 5 patients,superior mesenteric vein was invaded in 2 patients and neural invasion was present in 7 cases.Lymph node metastasis was noted in 6 cases.Follow-up data was available in 9 patients and 1 patient was lost in follow-up.The survival ranged from 3 to 51 months with a median survival 18 months,and 9 patients died of tumor recurrence and metastasis after operation.Conclusions Pancreatic acinar cell carcinoma should be recognized as a distinct tumor entity and it may not be sensitive to radiotherapy or chemotherapy.The biological features of pancreatic acinar cell carcinoma should be investigated further.
10.Diagnostic value of 18F-FDG PET/CT in the preoperative advanced gastric carcinoma comparing with multi-slice spiral computed tomography
Yuan HUANG ; Jinling LIN ; Dayong CHEN ; Zhiming LIU ; Junqiang CHEN
International Journal of Surgery 2010;37(3):161-165,封3
Objective Evaluate the diagnostic value of PET/CT in the preoperative advanced gastric carcinoma comparing with mult;-slice spiral computed tomography. Methods Thirty-nine advanced gastric carcinoma patients taking PET/CT and abstract 40 advanced gastric carcinoma patients performing MSCT before operation,were done the TNM staging, and the Results were compared with the operation histopathology. Results For diagnosing primary lesions, regional lymph nodes, N3 lymph nodes ,PET/CT was accurate in 92.3% , 66.7% and 100.0%.Instead, MSCT was accurate in 82.0% , 50.0% and 62.5%. Conclusions (1) PET/CT and MSCT have high accuracy in diagnosing primary lesions and regional lymph nodes. But for detecting the N3 lymph nodes and distant metastasis, PET/CT has higher accuracy than MSCT. PET/CT combining abdominoscopy may decrease or avoid exploratory laparotomy.

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