The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancreatitis were retrospectively studied. All patients were of Chinese nationality and hospitalized from January 2008 to December 2011. Their ages ranged from 14 to 76 years, with a mean of 43 years. Of 142 patients, there were 72 cases of obstructive chronic pancreatitis (50.70%), 19 cases of alcoholic chronic pancreatitis (13.38%), 14 cases of autoimmune pancreatitis (9.86%) and 37 cases of undetermined etiology (26.06%). Pathologically, the average inflammatory mass diameter was 3.8 ± 3.3 cm, biliary obstruction occurred in 36 cases, gall stones in 70 cases, calcification in 88 cases, ductal dilatation in 61 cases, side branch dilatation in 32 cases, ductal irregularity in 10 cases, lymphocytic inflammation in 23 cases, obliterative phlebitis in 14 cases, extra pancreatic lesion in 19 cases and fibrosis in 142 cases. Location of pancreatic lesion in the region of head (n=97), neck (n=16), body (n=12), tail (n=15) and whole pancreas (n=2) influenced the choice of surgical procedures. Ninety-four patients (66.20%) received surgical treatment and 33.80% received other treatments. After operation, 80.85% of 94 patients experienced decreased pain, and 8.51% of 94 showed recovery of endocrine function but with a complication rate of 12.77%. All the operations were performed successfully. According to the pain scale of European Organization for Research and Treatment of Cancer (QLQ-C30) a decrease from 76 ± 22 to 14 ± 18 was observed. Etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population vary from others.
Adolescent ; Adult ; Aged ; Autoimmune Diseases ; epidemiology ; therapy ; China ; epidemiology ; Cholestasis ; epidemiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis, Alcoholic ; epidemiology ; therapy ; Pancreatitis, Chronic ; etiology ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

The effects of different surgical procedures for late pancreatic head carcinoma without gastric outlet obstruction were explored in order to provide theoretical basis to select a suitable operation for these patients. The clinical data of 441 cases of late pancreatic head carcinoma without gastric outlet obstruction were retrospectively analyzed. All patients were divided into 4 groups based on different surgical procedures: group A (101 cases) subjected to Roux-en-Y cholecystojejunostomy; group B (133 cases) undergoing Roux-en-Y choledochojejunostomy; group C (83 cases) given Roux-en-Y cholecystojejunostomy combined with gastrojejunostomy; group D (124 cases) receiving Roux-en-Y choledochojejunostomy combined with gastrojejunostomy. Therapeutic efficacy in each group was evaluated comparatively. Both groups B and D had a lower rate of postoperative obstructive jaundice than groups A and C separately (P<0.05 for all). The data of mean life span showed that both groups B and D had a lower survival rate than groups A and C separately (P<0.05 for all). The incidence of postoperative gastric outlet obstruction in groups A and B was higher than that in groups C and D separately (P<0.05 for all). The gastrojejunostomy had no impacts on the mean life span, and there was no statistically significant difference in complications, average hospital stay (days) and median survival among four groups (P>0.05). For the late pancreatic head carcinoma without gastric outlet obstruction, Roux-en-Y choledochojejunostomy is effective for the reduction of icteric index and the incidence of recurrent jaundice, also offers an opportunity for prolonged survival. Combined use of prophylactic Roux-en-Y gastrojejunostomy during surgical biliary drainage is safe for advanced pancreatic carcinoma with obstructive jaundice, which can decrease the incidence of postoperative gastric outlet obstruction, and has important implications for improving outcomes.
Aged ; Anastomosis, Roux-en-Y ; Carcinoma ; diagnosis ; surgery ; Case-Control Studies ; Female ; Gastric Outlet Obstruction ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; surgery ; Patient Selection ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the association of diabetes mellitus(DM) with colorectal cancer.

METHODSCase-control study was performed to compare 486 patients with colorectal cancer (study group) and 533 patients without colorectal cancer (control group) in the Affiliated Nanhai Hospital of Southern Medical University between 2006 and 2009.

RESULTSThe incidence of DM was 12.1% in study group and 7.1% in the control group, and the difference was significant(P<0.01). On multivariate analysis, DM was independently associated with colorectal cancer (OR=1.886,95% CI:1.450~3.571). Colorectal cancer risk was increased in DM patients with a duration of 5-20 years(P<0.05), while colorectal cancer risk in those with a duration less than 5 years or more than 20 years did not change(P>0.05). No significant differences in tumor differentiation, invasion depth, lymph node involvement, distant metastasis and lymphovascular invasion were found between colorectal cancer patients with and without DM(all P>0.05).

CONCLUSIONDiabetes mellitus increases the risk of colorectal cancer, however, biological behaviors of colorectal cancer is not associated with diabetes mellitus.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Chi-Square Distribution ; Colorectal Neoplasms ; complications ; pathology ; Diabetes Mellitus ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis

OBJECTIVETo investigate single nucleotide polymorphisms (SNPs) and the distribution of their haplotypes in caspase-8, -10 genes in Zhejiang Han nationality in China.

METHODSPCR, denaturing high-performance liquid chromatography (DHPLC) and DNA sequencing were used to detect the SNPs in the 2nd-5th exons of caspase-10 gene, the 8th-10th exons of caspase-8 and their flanking sequences. Expectation Maximization (EM) algorithm was used for haplotype frequencies analysis and pairwise linkage disequilibrium (LD) test.

RESULTS(1) Two SNPs, A2823G and A12799G, were identified in caspase-10 gene, located in exon 2 and exon 5 respectively. A12799G was newly found with low informativeness. Three SNPs were identified in caspase-8 gene; A43466G, G51484A and G52951A were located in exon 8, exon 9 and intron 9, respectively. They do not change the primary structure of the encoded protein. (2) Linkage equilibrium was observed between A2823G in caspase-10 gene and the three sites in caspase-8 gene. A43466G and G52951A, and G51484A and G52951A in caspase-8 gene were also in linkage equilibrium. Their coefficients of disequilibrium were near 0. Whereas strong linkage disequilibrium was observed between A43466G and G51484A, because its coefficient of disequilibrium was near 1. (3) A total of 11 haplotypes were estimated within A2823G in caspase-10 gene and three sites in caspase-8 gene. A-2823/A-43466/G-51484/G-52951 was the main haplotype with a frequency of 0.3811. A-2823/A-43466/G-51484/A-52951 was the second haplotype with a frequency of 0.2536. The polymorphism information content of their haplotypes was 0.7106.

CONCLUSIONThe SNPs of caspase-8, -10 genes in Han Chinese of Zhejiang could be parsed into at least three different haplotype blocks. The polymorphism information content can be improved by using haplotype analysis of several SNPs.

Alleles ; Base Sequence ; Caspase 10 ; genetics ; Caspase 8 ; genetics ; China ; ethnology ; DNA ; analysis ; Ethnic Groups ; genetics ; Gene Frequency ; Haplotypes ; Humans ; Polymorphism, Single Nucleotide

Adolescent ; Adult ; Female ; Humans ; Male ; Mercury ; urine ; Middle Aged ; Reference Values ; Spectrophotometry, Atomic

OBJECTIVETo study changes of TLR2 signaling pathway expression in Kupffer cells during the process of hepatic ischemia/reperfusion in a mice model and the mechanism of TLR2 signaling pathway participating in hepatic ischemia/reperfusion injury.

METHODSBALB/c mice were divided into 3 groups: sham operation (SH), ischemia/reperfusion (I/R) and GdCl3 treatment (Gd) groups. After 4 h of reperfusion, the expression of TLR2 mRNA and membrane TLR2 protein were analyzed in ischemic lobes of the livers, and in Kupffer cells isolated from ischemic lobes. The expression of NF-kappaB in ischemic lobes was also examined. Levels of endotoxin, ALT and TNFalpha were measured at the same time point.

RESULTSThe expressions of TLR2 mRNA and protein in both ischemic hepatic lobes and Kupffer cells isolated from ischemic lobes were increased in the I/R group compared to those in the SH group, as well as the expression of NF-kappaB in ischemic lobes, which was down regulated by intravenous GdCl3 treatment. Levels of ALT and TNFalpha in the portal vein were higher in the I/R group than in the SH group, which also were decreased with treatment of GdCl3. The level of endotoxin in the three groups remained constant.

CONCLUSIONTLR2 signaling pathway in Kupffer cells is activated during the process of hepatic ischemic/reperfusion injury. The activation of TLR2 signaling pathway in Kupffer cells may play a role in this process.

Animals ; Kupffer Cells ; metabolism ; Liver ; blood supply ; Male ; Mice ; Mice, Inbred BALB C ; Reperfusion Injury ; metabolism ; Signal Transduction ; Toll-Like Receptor 2 ; biosynthesis ; genetics

OBJECTIVETo study the difference in prevalence of dyslipidemia, hypercholesterolemia, hypertriglyceridemia and low blood high-density lipoprotein cholesterol (HDL-C) between the residents of urban and rural areas of varied regions in China.

METHODSFasting plasma levels of total cholesterol, triglyceride and HDL-C were determined with the enzyme methods for 49,252 subjects aged 18 and over during August to December, 2002.

RESULTSPrevalence of dyslipidemia in Chinese adults aged 18 and over was 18.6%, with 17.0%, 22.9% and 23.4% in the groups of 18-44, 45-59 and over 60 years old, respectively, 22.2% and 15.9% in males and females, respectively, and 21.0% and 17.7% in urban and rural areas, respectively. Prevalence of hypercholesterolemia, hypertriglyceridemia and low blood HDL-C in those aged 18 and over was 2.9%, 11.9% and 7.4%, respectively.

CONCLUSIONSDyslipidemia has become one of important risk factors threatening health of Chinese people, with hypertriglyceridemia and low blood HDL-C as two major types in those aged 18 and over. Prevalence of dyslipidemia was nearly the same in the middle-aged and in the elderly people, and not significantly different in those living in urban areas from those in rural areas. It is very important to pay more attention to earlier comprehensive prevention and control of dyslipidemia.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Dyslipidemias ; blood ; epidemiology ; Female ; Humans ; Hypertriglyceridemia ; blood ; epidemiology ; Male ; Middle Aged ; Prevalence ; Rural Population ; statistics & numerical data ; Triglycerides ; blood ; Urban Population ; statistics & numerical data ; Young Adult

OBJECTIVETo investigate the rate of dual rearrangements of lymphocytic antigen receptor genes in non-Hodgkin lymphomas (NHL) and its pathogenesis and pathologic significance.

METHODSPCR analysis of monoclonal, polyclonal and dual rearrangements of IgH and TCR gamma, TCR beta genes was carried out in 125 cases of NHL to evaluate the rate of dual rearrangements, immunohistochemistry was performed for a Ki67 protein expression in 117 cases and the proliferation index was calculated. The relationship between antigen receptor gene rearrangements and proliferation index was analyzed.

RESULTSCombination of the two pairs of IgH gene primers with the multiplex PCR for TCR gamma and TCR beta gene revealed dual rearrangements in 8% (8/96) of B-NHL, 17% (5/29) of T-NHL. In B cell NHL, IgH gene monoclonal, dural and polyclonal rearrangements were identified in 65, 8 and 15 cases respectively, while in T-cell NHL, they were in 15, 5 and 9 cases, respectively. There was no significant difference between proliferation index and monoclonal, dual, polyclonal rearrangements in both B-NHL and T-NHL by One-way test.

CONCLUSIONDual rearrangements in NHL are not rare and have no relationship with proliferation index.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carrier Proteins ; genetics ; Cell Proliferation ; Child ; Female ; Gene Rearrangement ; Genes, T-Cell Receptor gamma ; genetics ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Lymphoma, B-Cell ; genetics ; metabolism ; pathology ; Lymphoma, Non-Hodgkin ; genetics ; metabolism ; pathology ; Lymphoma, T-Cell ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Polymerase Chain Reaction ; Receptors, Antigen ; genetics ; Young Adult

OBJECTIVETo develop a protocol for gene rearrangement study in non-Hodgkin's lymphoma (NHL) by PCR-directed gel-scan method and to set up quantitative criteria for IgH gene rearrangement which can be applied in the follow up of lymphoma patients.

METHODSIgH gene rearrangement studies were carried out in 96 cases of B-cell NHL. The detection rate of clonality was evaluated. Sixty-five cases of IgH gene rearranged cases proven by FR3A-directed PCR and PAGE and 8 cases of benign lymphoid tissues (5 cases of reactive lymphoid hyperplasia, 3 cases of chronic tonsillitis), 5 cases of normal peripheral blood mononuclear cells were analyzed by gel-scan method and the proportion of h1/h2 (heights of peak1 and peak2 of gel-scan) was calculated.

RESULTSThe detection rate of IgH gene clonality was up to 68% using primer FR3A in the 96 B-cell NHL cases. The detection rate was up to 61% using primer FR2A. With a combination of primers FR3A and FR2A, the detection rate increased to 83%. Gel-scan curve showed that the value of h1/h2 was greater than 3 in all the 65 cases with IgH gene rearranged. In the 8 benign lymphoid tissue cases showed h1/h2 < 1.5, 5 cases with normal peripheral blood mononuclear cells showed a bell-shaped curve.

CONCLUSIONSIn the gel-scan curve of gene rearrangement studies in non-Hodgkin's lymphoma samples, the value of h1/h2 greater than 3 represents a true clonal proliferation. The peaks with relative heights less than 1.5 may not be significant and likely represent polyclonal cell population. A value between 1.5 and 3 however requires clinical follow-up. The success rate of rearrangement studies in B-cell NHL can be increased by using a combination of primers FR3A and FR2A.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; DNA Primers ; Electrophoresis, Gel, Two-Dimensional ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Genes, Immunoglobulin ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Lymphoma, B-Cell ; genetics ; immunology ; pathology ; Lymphoma, B-Cell, Marginal Zone ; genetics ; immunology ; pathology ; Lymphoma, Large B-Cell, Diffuse ; genetics ; immunology ; pathology ; Male ; Middle Aged ; Polymerase Chain Reaction