Inflammatory diseases (IDs) are a general term of diseases characterized by chronic inflammation as the primary pathogenetic mechanism, which seriously affect the quality of patient′s life and cause significant social and medical burden. Current drugs for IDs include nonsteroidal anti-inflammatory drugs, corticosteroids, immunomodulators, biologics, and antioxidants, but these drugs may cause gastrointestinal side effects, induce or worsen infections, and cause non-response or intolerance. Given the outstanding performance of metal polyphenol network (MPN) in the fields of drug delivery, biomedical imaging, and catalytic therapy, its application in the diagnosis and treatment of IDs has attracted much attention and significant progress has been made. In this paper, we first provide an overview of the types of IDs and their generating mechanisms, then sort out and summarize the different forms of MPN in recent years, and finally discuss in detail the characteristics of MPN and their latest research progress in the diagnosis and treatment of IDs. This research may provide useful references for scientific research and clinical practice in the related fields.

Pancreatic cancer patients often have complaints such as upper abdominal pain and obstructive jaundice when seeking diagnosis and treatment. However, acute pancreatitis as a rare initial clinical manifestation of pancreatic cancer is often overlooked in clinical practice. This oversight often leads to a delayed diagnosis of pancreatic cancer, uncertainty in treatment strategies, and significantly affects patients′ quality of life and prognosis. Therefore, early diagnosis and treatment, and active follow-up are crucial for patients with acute pancreatitis as an initial symptom of pancreatic cancer. Upon admission to such patients, common causes such as gallstones, alcohol abuse, and hyperlipidemia should be initially ruled out. Evaluation with tumor markers, CT and MRI, and endoscopic ultrasound are essential to confirm the diagnosis of pancreatic cancer. For patients with mild pancreatitis, managing peripancreatic inflammation first before radical resection of pancreatic cancer could reduce postoperative complications. Moreover, pancreatitis serves as a high-risk factor for pancreatic cancer, so it is crucial to closely follow up patients with pancreatitis to detect pancreatic cancer early.

Pancreatic cancer patients often have complaints such as upper abdominal pain and obstructive jaundice when seeking diagnosis and treatment. However, acute pancreatitis as a rare initial clinical manifestation of pancreatic cancer is often overlooked in clinical practice. This oversight often leads to a delayed diagnosis of pancreatic cancer, uncertainty in treatment strategies, and significantly affects patients′ quality of life and prognosis. Therefore, early diagnosis and treatment, and active follow-up are crucial for patients with acute pancreatitis as an initial symptom of pancreatic cancer. Upon admission to such patients, common causes such as gallstones, alcohol abuse, and hyperlipidemia should be initially ruled out. Evaluation with tumor markers, CT and MRI, and endoscopic ultrasound are essential to confirm the diagnosis of pancreatic cancer. For patients with mild pancreatitis, managing peripancreatic inflammation first before radical resection of pancreatic cancer could reduce postoperative complications. Moreover, pancreatitis serves as a high-risk factor for pancreatic cancer, so it is crucial to closely follow up patients with pancreatitis to detect pancreatic cancer early.

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.

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.

BACKGROUND: Although de novo stage IV breast cancer is so far incurable, it has entered an era of individualized treatment and chronic disease management. Based on systemic treatment, whether the surgical resection of primary or metastatic foci of de novo stage IV breast cancer can bring survival benefits is currently controversial. We aimed to explore the clinicopathological factors and current status of the management of de novo stage IV breast cancer in China to provide a reference for clinical decisions. METHODS: Based on the assistance of Chinese Society of Breast Surgery, a retrospective study was conducted to analyze the clinical data of patients with de novo stage IV breast cancer in 33 centers from January 2017 to December 2018. The relationship between basic characteristic (age, menstrual status, family history, reproductive history, pathological type, estrogen receptor [ER] status, progesterone receptor [PR] status, human epidermal growth factor receptor 2 [HER2] status, Ki-67 percentage, and molecular subtype), and metastasis sites (lung metastasis, liver metastasis, and bone metastasis) was examined by Pearson Chi-square tests. RESULTS: A total of 468 patients with de novo stage IV breast cancer were enrolled. The median age of the enrolled patients was 51.5 years. The most common pathological type of primary lesion was invasive carcinoma (97.1%). Luminal A, luminal B, HER2 overexpressing, and triple-negative subtypes accounted for 14.3%, 51.8%, 22.1%, and 11.8% of all cases, respectively. Age, PR status, and HER2 status were correlated with lung metastasis (χ2 = 6.576, 4.117, and 8.643 and P = 0.037, 0.043, and 0.003, respectively). Pathological type, ER status, PR status, and molecular subtype were correlated with bone metastasis (χ2 = 5.117, 37.511, 5.224, and 11.603 and P = 0.024, <0.001, 0.022, and 0.009, respectively). Age, PR status, HER2 status, Ki-67 percentage, and molecular subtype were correlated with liver metastasis (χ2 = 11.153, 13.378, 10.692, 21.206, and 17.684 and P = 0.004, <0.001, 0.001, <0.001, and 0.001, respectively). Combined treatment with paclitaxel and anthracycline was the most common first-line chemotherapy regimen for patients with de novo stage IV breast cancer (51.7%). Overall, 91.5% of patients used paclitaxel-containing regimens. Moreover, 59.3% of hormone receptor-positive patients underwent endocrine therapy. CONCLUSIONS In 2018, 1.07% of patients from all studied centers were diagnosed with de novo stage IV breast cancer. This study indicated that 95.1% of patients received systemic therapy and 54.2% of patients underwent surgical removal of the primary lesion in China.
Biomarkers, Tumor ; Breast Neoplasms/surgery* ; China ; Female ; Humans ; Mastectomy ; Middle Aged ; Prognosis ; Receptor, ErbB-2 ; Receptors, Progesterone ; Retrospective Studies

Anesthesia, General ; Coronavirus Infections ; prevention & control ; transmission ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Occupational Exposure ; prevention & control ; Operating Rooms ; Otorhinolaryngologic Surgical Procedures ; Pandemics ; prevention & control ; Personal Protective Equipment ; classification ; Pneumonia, Viral ; prevention & control ; transmission ; Practice Guidelines as Topic

OBJECTIVE：To syst ematically evaluate the effectiveness and safety of ticagrelor versus clopidogrel in the treatment of acute coronary syndrome （ACS）patients in East Asia ，and to provide evidence-based references for clinical drug use. METHODS：Retrieved from Cochrane Library ，PubMed，Embase，CNKI，Wanfang database ，etc.，randomized controlled trials （RCTs）about ticagrelor （trial group ）versus clopidogrel （control group ）in the treatment of ACS patients in east Asia were collected. After literature screening and data extraction ，the quality of included literatures was evaluated by using biasrisk evaluation tool recommended by Co chrane system evaluation manual 5.1.0，and Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 5 RCTs were included ，with a total of 4 511 cases. Meta-analysis showed that the incidence of major adverse cardiovascular events [OR ＝0.85，95％CI（0.68，1.04），P＝0.12]，the incidence of death from cardiovascular causes [OR ＝0.76，95％CI（0.57，1.03），P＝0.08] and the incidence of stroke [OR ＝0.77，95％CI（0.48，1.24），P＝0.28]， without statistical significance. The incidence of major bleeding events [OR ＝1.54，95％CI（1.19，1.99），P＝0.001] and minor bleeding events [OR ＝1.80，95％ CI（1.40，2.32），P＜0.000 01] in trial group were significantly higher than control group. CONCLUSIONS：Ticagrelor is comparable to clopidogrel in reduce the major adverse cardiovascular events，death from cardiovascular causes and stroke in ACS patients in East Asian ，but it can increase the risk of major and minor bleeding events.

Objective: To evaluate the role of multidisciplinary team (MDT) clinic in the diagnosis of pancreatic diseases and patient compliance with MDT advice in the current medical system. Methods: The study included 512 patients that had visited the pancreas-oriented MDT clinic of Zhongshan Hospital between May 2015 and May 2019.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. Compliance was determined according to whether a patient received corresponding therapies or undergoing further checks or follow-ups. Results: Among the 512 patients that had visited the MDT clinic, 121 patients were referred due to undetermined diagnosis. Classified according to the final diagnosis, the rate of undetermined diagnosis in different disease categories from high to low in order was inflammatory diseases of the pancreas (75.0%, 24/32), other lesions of the pancreas (56.1%,23/41), pancreatic cystic lesions (19.1%,17/89), pancreatic carcinomas (18.3%,48/262) and pancreatic neuroendocrine neoplasms (pNEN)(10.2%,9/88). The MDT clinic made diagnosis to 68 patients directly with an accuracy of 89.7%. The rate of compliance in the entire cohort was 63.4%. The rate of compliance of patients from June 2017 to May 2019 (68.4%) was higher than that of patients from May 2015 to May 2017(59.6%). The compliance rate of patients in different disease categories from high to low in order was inflammatory diseases of the pancreas(84.4%, 27/32), pancreatic carcinomas (67.9%, 178/262), pNEN(60.2%,53/88), other lesions of the pancreas (56.1%,23/41), and pancreatic cystic lesions(49.4%, 44/89). The compliance rate of patients with different MDT advice from high to low in order was best supportive care(78.6%,22/28), antitumor approaches beyond surgery(71.6%,159/222), further tests(62.6%, 77/123), surgery(53.7%, 65/121) and follow-up(49.2%, 31/63). In patients suggested for surgery, the compliance rate of patients with carcinomas(67.4%, 33/49) was higher than patients with other kinds of neoplasms. Conclusions MDT clinic could facilitate the diagnosis of pancreatic diseases conveniently and inexpensively. The overall compliance rate of MDT clinic patients is rather low, and patients with carcinomas have a relative high rate of compliance with the suggestion of surgery.

Objective: To explore preoperative predictive markers for invasive malignancy in intraductal papillary mucinous neoplasm(IPMN). Methods: The retrospective case-controlled study was adopted.Seventy-nine patients who underwent surgery and with pathologically confirmed IPMN from January 2005 to December 2014 at Department of Pancreatic Surgery, Zhongshan Hospital Fudan University were enrolled.Forty-six patients were male and 33 were female,with an average age of (62.9±8.9)years (range:37-82 years).Tumor sites:56 tumors were located at the head of the pancreas,22 were located at the body and tail of the pancreas,and 1 was located across the whole pancreas.Surgical procedures: 51 patients underwent pancreaticoduodenectomy, 22 patients underwent distal pancreatectomy, 4 patients underwent segmental pancreatectomy and 2 patients underwent total pancreatectomy.IPMNs were classified into non-invasive lesions and invasive carcinomas according to the histopathological findings of the tumor.Thirty-two tumors were non-invasive lesions and 47 were invasive carcinomas.The preoperative findings were compared between patients with non-invasive IPMN and patients with invasive carcinoma by univariate analysis using t test and χ² test accordingly,and factors with statistically significance were subsequently submitted to multivariate analysis. Results: Univariate analysis showed that tumor size(P=0.022), carcinoembryonic antigen(P=0.012), CA19-9(P=0.011), lymphocytes(P=0.034), neutrophil-to-lymphocyte ratio(P=0.010)and platelet-to-lymphocyte ratio(PLR)(P=0.004)were predictive markers with statistical significance.Multivariate analysis showed that CA19-9(P=0.012)and PLR(P=0.025) were independent predictive markers for invasive malignancy in IPMN.The area under curve of the combination factor of CA19-9 and PLR(0.864) was larger than that of CA19-9(0.806) or PLR(0.685) alone, and all the authentic indicators of the combination factor were better than those of each alone. Conclusions CA19-9 and PLR are independent predictive markers for invasive malignancy in IPMN.The combination of CA19-9 and PLR has improved efficacy than each alone.