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胰腺囊性肿瘤的诊治策略

临床外科杂志 2024年第7期32卷 680-682页

作者：朱志华刘志强吴河水九江学院附属医院普外科江西九江332000 华中科技大学同济医学院附属协和医院胰腺外科

胰腺囊性肿瘤(PCN)是一类源于胰腺导管上皮和(或)间质组织的囊性肿瘤性病变,主要包括浆液性囊腺瘤(SCN)、黏液性囊性肿瘤(MCN)、导管内乳头状黏液性瘤(IPMN)、实性假乳头状瘤(SPN)和囊性神经内分泌肿瘤(cNET)[1]。PCN的生物学行为各不... 详细信息

胰腺囊性肿瘤(PCN)是一类源于胰腺导管上皮和(或)间质组织的囊性肿瘤性病变,主要包括浆液性囊腺瘤(SCN)、黏液性囊性肿瘤(MCN)、导管内乳头状黏液性瘤(IPMN)、实性假乳头状瘤(SPN)和囊性神经内分泌肿瘤(cNET)[1]。PCN的生物学行为各不相同。

关键词：胰腺囊性肿瘤胰腺导管内乳头状黏液性瘤黏液性囊性肿瘤浆液性囊腺瘤实性假乳头状瘤

Protective effect of N-acetylcysteine against lipopolysaccharide injury in hepatocytes of neonatal mice

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Frontiers of Medicine 2008年第2期2卷 182-185页

作者： Lin WANG Jianbo XU Yuan TIAN heshui wu Yalan LIU Department of Pediatrics Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of General Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

The present study provides supportive evid-ence for the effective prevention and treatment of lipopo-lysaccharide(LPS)-induced hepatocyte injury in neonatal mice by N-acetylcysteine(NAC).Hepatocytes of neonatal mice were obtained through collagenase digestion of the *** hepatocytes were treated either with LPS(10 mg/mL)alone or with NAC(5 mmol/L)for 1 h before the addition of LPS(10 mg/mL).After LPS treatment,12 wells of the cultured hepatocytes and supernatants were harvested at 0,6,and 12 h,*** of alanine aminotransferase(ALT)and nitric oxide(NO)in the supernatant were biochemically quantified and reverse transcription-polymerase chain reaction(RT-PCR)was performed to detect the expression of inducible nitric oxide synthase(iNOS)mRNA after different *** 0 h following the treatment of primary cultured hepa-tocytes with LPS,the levels of ALT,NO and iNOS mRNA in the supernatant were(21.1±4.78)u/L,(1.6±0.31)mmol/L and 0.17±0.023,respectively;at 6 h,(59.8±8.59)u/L,(6.6±0.81)mmol/L,and 0.71±0.091;and at 12 h,(89.6±15.30)u/L,(7.8±1.01)mmol/L,and 0.71±*** levels of ALT,NO and iNOS mRNA at 6 and 12 h increased significantly,compared to those at 0 h(P<0.01).In contrast to LPS treatment alone,pre-treatment with NAC before LPS addition significantly reduced the levels of ALT,NO and iNOS mRNA in the supernatant at 6 h to(40.8±7.30)u/L,(3.2±0.71)mmol/L,and 0.41±0.060;and at 12 h to(55.4±5.48)u/L,(4.0±0.71)mmol/L,and 0.40¡0.067,respectively(P<0.01).However,the levels of ALT,NO and iNOS mRNA at 0 h did not change significantly with both treat-ment *** has protective effects in hepato-cytes of neonatal mice against LPS-induced injury as shown by the reduced levels of ALT,NO and iNOS mRNA when primary hepatocytes were treated with NAC prior to LPS *** postulate that NAC exhibits its protective function by inhibiting LPS-induced transcription of iNOS,resulting in decreased levels of NO.

关键词： N-acetylcysteine endotoxin hepatocytes nitric oxide inducible nitric oxide synthase

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胰腺癌靶向治疗的研究现状和展望

中华实验外科杂志 2023年第1期40卷 5-7页

作者：孙岩吴河水华中科技大学同济医学院附属协和医院胰腺外科武汉430022

胰腺癌是侵袭性和致命性均极高的消化系统恶性肿瘤,近年来,吉西他滨联合白蛋白紫杉醇是不可切除胰腺癌治疗的主要方案,但其改善预后的效果并不显著,因此需要探索新的治疗方案来提升患者的生存率。研究表明,基因突变和细胞信号传导通路... 详细信息

胰腺癌是侵袭性和致命性均极高的消化系统恶性肿瘤,近年来,吉西他滨联合白蛋白紫杉醇是不可切除胰腺癌治疗的主要方案,但其改善预后的效果并不显著,因此需要探索新的治疗方案来提升患者的生存率。研究表明,基因突变和细胞信号传导通路异常是驱动胰腺癌发生发展的重要因素,如果能够识别这些异常的靶点并针对这些靶点设计药物,对于改善胰腺癌预后具有重要意义。同时,不同的胰腺癌患者可能有其特定的基因改变,这为患者的个性化治疗提供了理论基础,有希望进一步延长患者的生存时间。本文阐述了胰腺癌靶向治疗的研究现状,并展望其临床应用前景。

关键词：胰腺癌基因突变细胞信号传导通路靶向治疗耐药

The expression of toll-like receptor 2, 4 of livers in mice with systemic inflammatory response syndrome

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Hepatobiliary & Pancreatic Diseases International 2006年第1期5卷 143-146页

作者： Jing Xiong ZhongHua Zhu JianShe Liu Yang Wang heshui wu Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China.

BACKGROUND: The complicated pathogenesis of systemic inflammatory response syndrome (SIRS) is a hot topic in critical care medicine. In this study we explored the expression of toll-like receptor (TLR) 2, 4 of livers in SIRS mice and evaluated the role of TLR2, 4 in the pathogenesis of SIRS. METHODS: Forty BABL/C mice were randomly divided into 2 groups: control (n=20) and SIRS (n=20). SIRS model was induced by severe acute pancreatitis. Blood routine, blood amylase, glutamic pyruvic transaminase and temperature were measured. Histological changes of pancreases and livers were observed microscopically. The mRNA expressions of TLR2, 4 were detected by real-time polymerase chain reaction (PCR). The protein expressions of TLR2, 4 were examined by Western blot. RESULTS: Marked edema, inflammatory cell infiltration, hemorrhage, and necrosis were observed in the pancreases and livers of SIRS mice. The concentrations of amylase and glutamic pyruvic transaminase were increased significantly. Body temperature and white blood cell count were decreased. The mRNA and protein expressions of TLR2, 4 increased markedly in SIRS mice. Significant difference was observed between SIRS and control mice (P<0.01). CONCLUSION: The expressions of TLR2, 4 of livers were increased markedly in SIRS mice, indicating that TLR might play an important role in the pathogenesis of SIRS.

关键词： toll-like receptor systemic inflammatory response syndrome severe acute pancreatitis

Expression of Toll-like Receptor 2/4 on Alveolar Macrophage in the Model of Total Hepatic Ischemia/Reperfusion Injury in Mice

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The Chinese-German Journal of Clinical Oncology 2006年第4期5卷 298-300页

作者： GU Yuanting wu heshui XU Jianbo WANG Lin TIAN Yuan WANG Chunyou Department of General Surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China Department of Surgery the First Affiliated Hospital Zhengzhou University Zhengzhou 450052 China Department of Pediatrics Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China

客观：在鼠标在全部的肝的局部缺血的进程期间在牙槽的巨噬细胞探索像使用费的受体 2/4 的表达式和意思。方法：BALB/c 老鼠在全部的肝的 ischemia/reperfusion 的一个模型被使用。牙槽的巨噬细胞被 bronchoalveolar 洗室年龄(BAL ) 的... 详细信息

客观：在鼠标在全部的肝的局部缺血的进程期间在牙槽的巨噬细胞探索像使用费的受体 2/4 的表达式和意思。方法：BALB/c 老鼠在全部的肝的 ischemia/reperfusion 的一个模型被使用。牙槽的巨噬细胞被 bronchoalveolar 洗室年龄(BAL ) 的工具在 1h， 6h 和 12h 的时间点收集，并且它的 TLR2/4 mRNA 和蛋白质与流动血细胞计数和实时 PCR 被检测。在 BAL 液体的 TNF 的水平我们 remeasured。军邮局的集中，比率湿 / 干燥并且肺组织学的分数被用来估计肺损害的度。结果：在肝的 ischemiareperfusion 的三个次点， TLR2/4 蛋白质和 mRNA 的表示是起来调整的并且在上升的 TLR2was 的水平不断地。TLR4 在 6 h 的时候到达了山峰价值(P < 0.01 ) 。在 BAL 液体的水平 ofTNF-2 在 6 h 的时候到达了最高的点(P < 0.01 ) 。wet/dryrose 的比率不断地在肝的局部缺血灌注期间。在 1 h 以后，军邮局的水平很快增加了。然后，它在 6 h 的时期期间到达了山峰价值到 12 h。结论：牙槽的巨噬细胞的老鼠上的 TLR2/4 在肝的 ischemia/reperfusion 的过程被激活并且在肺的损害包含了。

关键词：牙槽巨噬细胞肝缺血再灌注损伤受体

The relationship between activation of TLR4 and partial hepatic ischemia/reperfusion injury in mice

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Hepatobiliary & Pancreatic Diseases International 2006年第1期5卷 101-104页

作者： Lin Wang JianBo Xu heshui wu JinXiang Zhang JinHui Zhang Yuan Tian ChunYou Wang Department of Pediatrics Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China. whs1898@***

BACKGROUND: Toil-like receptors (TLRs) are a group of evolutionarily conserved pattern recognition receptors involved in the activation of the immune system in response to various pathogens. In this study, we elucidated the relationship between activation of TLR4 and liver injury in partial hepatic ischemia/reperfusion (I/R) injury in mice. METHODS: BALB/c mice were used in a model of partial hepatic I/R injury, and the changes of TLR4 gene expression in ischemic liver lobes were detected with real-time polymerase chain reaction (RT-PCR). The levels of plasma ALT and endotoxin in the portal vein were measured. TLR4-deficient mice (C3H/Hej) and wild type mice (C3H/Heouj) were used in a model of I/R injury; liver function impairment and the level of serum TNF-α were observed. RESULTS: After one hour ischemia, the expression of TLR4 mRNA increased at the 1st, 3rd hour of reperfusion, indicating the value of △Ct(1st hour: 1.21±0.87vs. 5.85±1.07, t=13.72, P<0.01; 3rd hour: 0.85±0.92vs. 6.11±1.24, t=16.33, P<0.01). No endotoxemia developed in every group of mice. At the 3rd hour of reperfusion, the level of serum TNF-α was significantly higher than that of sham group (Hej: 152±43 pg/ml vs. 18±10pg/ml, t=5.26, P<0.01; Heouj: 249±52pg/ml vs. 25±13 pg/ml, t=7.24, P<0.01). At the 1st, 3rd hour reperfusion, the level of plasmid ALT in Hej mice was lower than that in Heouj mice (1st hour 662±106 U/Lvs. 1216±174 U/L, t=4.21, P<0.01; 3rd hour 1145±132U/L vs. 29584±187 U/L, t=13.72, P<0.01). The level of serum TNF-αwas lower than that in Heouj mice (1524.43 U/L vs. 2494±52 U/L, t=3.94, P<0.01) at the 3rd hour reperfusion. CONCLUSION: TLR4 activation causes partial hepatic I/R injury through release of TNF-α.

关键词： liver reperfusion injury toll-like receptor endotoxin

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铁死亡机制在胰腺癌中的研究现状及未来展望

中国普外基础与临床杂志 2023年第3期30卷 364-368页

作者：周伟吴河水华中科技大学同济医学院附属协和医院胰腺外科武汉430022

目的了解铁死亡的分子机制及它在胰腺癌中的研究进展及未来展望。方法查阅铁死亡分子机制及它与胰腺癌发生及发展相关的基础和临床应用研究方面的文献并进行综述。结果铁死亡是一种依赖铁聚集的非凋亡型细胞死亡形式,其分子生物学特点... 详细信息

目的了解铁死亡的分子机制及它在胰腺癌中的研究进展及未来展望。方法查阅铁死亡分子机制及它与胰腺癌发生及发展相关的基础和临床应用研究方面的文献并进行综述。结果铁死亡是一种依赖铁聚集的非凋亡型细胞死亡形式,其分子生物学特点包括铁离子过载、活性氧堆积、脂质过氧化等。铁死亡与细胞代谢密切相关,胰腺癌在发生、发展过程中也存在因代谢异常引起的铁死亡失衡,进而引发胰腺癌细胞异常增殖而导致其进展。通过对铁死亡的关键分子信号通路进行调控,有望为胰腺癌治疗寻找新的药物治疗靶点及治疗途径,目前已有铁死亡的相关研究结果展现出了未来在胰腺癌治疗领域进行转化研究的潜力。结论铁死亡机制在胰腺癌研究中具有重要的价值。目前对于铁死亡的研究仍有许多未知的领域,对于其中的分子机制仍知之甚少。未来随着对于铁死亡研究的不断深入,有望为胰腺癌治疗提供新思路并发掘新的药物研发靶点。

关键词：胰腺癌程序性细胞死亡铁死亡

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胰腺癌新辅助治疗的适应证的选择与疗效评估

中华医学杂志 2021年第10期101卷 716-721页

作者：勾善淼吴河水华中科技大学同济医学院附属协和医院胰腺外科武汉430022

胰腺癌恶性程度较高、预后较差。虽然手术切除仍是目前唯一能够治愈胰腺癌的方法,但伴随着胰腺癌辅助治疗的进展,其治疗模式已由“手术优先”向“多学科协作”转变。新辅助治疗已被证实可提高交界性可切除和局部进展期胰腺癌的R0切除率... 详细信息

胰腺癌恶性程度较高、预后较差。虽然手术切除仍是目前唯一能够治愈胰腺癌的方法,但伴随着胰腺癌辅助治疗的进展,其治疗模式已由“手术优先”向“多学科协作”转变。新辅助治疗已被证实可提高交界性可切除和局部进展期胰腺癌的R0切除率并改善患者预后,这些患者应给予新辅助治疗已成共识,但胰腺癌新辅助化疗方案的选择、放射治疗的地位、新辅助治疗后影像学与病理学评估等方面仍存较大争议。

关键词：胰腺肿瘤新辅助治疗放射治疗影像学评估病理学评估

Consensus of clinical diagnosis and treatment for non-functional pancreatic neuroendocrine neoplasms with diameter<2 cm

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Journal of Pancreatology 2023年第3期6卷 87-95页

作者： wu Wenming Cai Shouwang Chen Rufu Fu Deliang Ge Chunlin Hao Chunyi Hao Jihui Huang Heguang Jian Zhixiang Jin Gang Li Fei Li Haimin Li Shengping Li Weiqin LiYixiong Liang Tingbo Liu Xubao Lou Wenhui Miao Yi Mou Yiping Peng Chenghong Qin Renyi Shao Chenghao Sun Bei Tan Guang Wang Huaizhi Wang Lei Wang Wei Wang Weilin Wei Junmin wu heshui wu Zheng Yan Changqing Yang Yinmo Yin Xiaoyu Yu Xianjun Yuan Chunhui Zhao Yupei Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Hepatobiliary Surgery PLA General HospitalBeijing 100853China Department of General Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China Department of Hepatobiliary and Pancreatic Surgery Hunnan Division of The First Hospital of China Medical UniversityShenyang 110167China Department of Hepato-Pancreato-Biliary Surgery Peking University Cancer Hospital&InstituteBeijing 100142China Department of Pancreatic Cancer Tianjin Medical University Cancer Institute and HospitalTianjin 300060China Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001China Department of General Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510000China Department of Hepatobiliary Pancreatic Surgery Changhai Hospital Affiliated to Navy Medical University(Second Military Medical University)Shanghai 200433China Department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing 100053China Department of Hepatobiliary Surgery Xijing HospitalFourth Military Medical UniversityXi’an 710032China Department of Hepatobiliary and Pancreatic Surgery Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060China Department of Critical Care Medicine Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China Department of General Surgery Xiangya HospitalCentral South UniversityChangsha 410008China Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department

In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small *** to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat *** response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert *** consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.

关键词： 2 cm Clinical diagnosis Non-functional pancreatic neuroendocrine neoplasms Treatment