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Pancreatic ductal adenocarcinoma chemoresistance:From metabolism reprogramming to novel treatment

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Chinese medical Journal 2024年第4期137卷 408-420页

作者： Jingcheng Zhang Yutong Wang Lejunzi Wang Lei You Taiping Zhang department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China peking union medical college Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China department of Anaesthesia Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Clinical Immunology Centre Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

As pancreatic cancer(PC)is highly malignant,its patients tend to develop metastasis at an early stage and show a poor response to conventional ***-line chemotherapies for PC,according to current guidelines,include fluoropyrimidine-and gemcitabine-based *** research on drug resistance has shown that biochemical metabolic aberrations in PC,especially those involving glycolysis and glutamine metabolism,are highly associated with ***,lipid metabolism is a major factor in ***,emerging compounds that target these key metabolic pathways have the potential to overcome *** review summarizes how PC develops chemoresistance through aberrations in biochemical metabolism and discusses novel critical targets and pathways within cancer metabolism for new drug research.

关键词： Pancreatic cancer Drug resistance Drug development Signal transduction

Diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 393-398页

作者： Mei-Zi Li Tao Guo Yun-Lu Feng Sheng-Yu Zhang Xiao-Yin Bai Xi Wu Kai Xu Ai-Ming Yang department of Gastroenterology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China department of Radiology Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China

Background:A high prevalence of diabetes mellitus(DM)coexisting with autoimmune pancreatitis(AIP)is ***,evidence on the circumstances under which corticosteroid therapy(CST)for AIP improves or worsens DM is *** study aimed to demonstrate and identify predictors of DM control under the influence of ***:Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed:pre-existing DM(pDM),concurrent DM(cDM),and non-DM(nDM).The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as‘improvement’and‘non-improvement’(including‘no change’and‘exacerbation’).Results:Among 101 patients with type 1 AIP,52(51.5%)patients were complicated with DM at the time of AIP diagnosis,with 36 patients in the cDM group and 16 patients in the pDM *** incidences of diffuse pancreatic swelling(72.2%)and pancreatic body/tail involvement(91.7%)were significantly higher in the cDM group than in both the pDM and nDM *** the 52 patients with DM,CST was administered in 48 *** logistic analysis identified that elevated serum gamma-glutamyl transferase(GGT)level at AIP diagnosis[odds ratio(OR)=0.032,95%confidence interval(CI):0.003-0.412,P=0.008]and pancreatic atrophy after CST(OR=0.027,95%CI:0.003-0.295,P=0.003)were negatively associated with DM control ***:Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP *** exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis,particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST.

关键词： Type 1 autoimmune pancreatitis Diabetes mellitus Corticosteroid therapy Predictive factor Pancreatic atrophy

Assessment of cheese sign and its association with vascular risk factors:Data from PUMCH dementia cohort

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Chinese medical Journal 2024年第7期137卷 830-836页

作者： Xinying Huang Bo Hou Jie Wang Jie Li Li Shang Chenhui Mao Liling Dong Caiyan Liu Feng Feng Jing Gao Bin Peng department of Neurology State Key Laboratory of Complex Severe and Rare DiseasePeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China department of Radiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Background:In the clinic,practitioners encounter many patients with an abnormal pattern of dense punctate magnetic resonance imaging(MRI)signal in the basal ganglia,a phenomenon known as"cheese sign".This sign is reported as common in cerebrovascular diseases,dementia,and old ***,cheese sign has been speculated to consist of dense perivascular space(PVS).This study aimed to assess the lesion types of cheese sign and analyze the correlation between this sign and vascular disease risk ***:A total of 812 patients from peking union medical college hospital(PUMCH)dementia cohort were *** analyzed the relationship between cheese sign and vascular *** assessing cheese sign and defining its degree,the abnormal punctate signals were classified into basal ganglia hyperintensity(BGH),PVS,lacunae/infarctions and microbleeds,and counted *** type of lesion was rated on a four-level scale,and then the sum was calculated;this total was defined as the cheese sign *** and Age-Related White Matter Changes(ARWMC)scores were used to evaluate the paraventricular,deep,and subcortical gray/white matter ***:A total of 118 patients(14.5%)in this dementia cohort were found to have cheese ***(odds ratio[OR]:1.090,95%confidence interval[CI]:1.064-1.120,P<0.001),hypertension(OR:1.828,95%CI:1.123-2.983,P=0.014),and stroke(OR:1.901,95%CI:1.092-3.259,P=0.025)were risk factors for cheese *** was no significant relationship between diabetes,hyperlipidemia,and cheese *** main components of cheese sign were BGH,PVS,and lacunae/*** proportion of PVS increased with cheese sign ***:The risk factors for cheese sign were hypertension,age,and *** sign consists of BGH,PVS,and lacunae/infarction.

关键词： Dementia Cerebrovascular disease Cheese sign Dense punctate lesions Basal ganglia Risk factor White matter

Targeted metabolomics reveals the aberrant energy status in diabetic peripheral neuropathy and the neuroprotective mechanism of traditional Chinese medicine JinMaiTong

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Journal of Pharmaceutical Analysis 2024年第2期14卷 225-243页

作者： Bingjia Zhao Qian Zhang Yiqian He Weifang Cao Wei Song Xiaochun Liang department of Traditional Chinese Medicine Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing100730China Institute of Basic Medicine Sciences Chinese Academy of Medical SciencesBeijing100005China medical Research Center Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing100730China

Diabetic peripheral neuropathy (DPN) is a common and devastating complication of diabetes, for which effective therapies are currently lacking. Disturbed energy status plays a crucial role in DPN pathogenesis. However, the integrated profile of energy metabolism, especially the central carbohydrate metabolism, remains unclear in DPN. Here, we developed a metabolomics approach by targeting 56 metabolites using high-performance ion chromatography-tandem mass spectrometry (HPIC-MS/MS) to illustrate the integrative characteristics of central carbohydrate metabolism in patients with DPN and streptozotocin-induced DPN rats. Furthermore, JinMaiTong (JMT), a traditional Chinese medicine (TCM) formula, was found to be effective for DPN, improving the peripheral neurological function and alleviating the neuropathology of DPN rats even after demyelination and axonal degeneration. JMT ameliorated DPN by regulating the aberrant energy balance and mitochondrial functions, including excessive glycolysis restoration, tricarboxylic acid cycle improvement, and increased adenosine triphosphate (ATP) generation. Bioenergetic profile was aberrant in cultured rat Schwann cells under high-glucose conditions, which was remarkably corrected by JMT treatment. In-vivo and in-vitro studies revealed that these effects of JMT were mainly attributed to the activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) and downstream peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α). Our results expand the therapeutic framework for DPN and suggest the integrative modulation of energy metabolism using TCMs, such as JMT, as an effective strategy for its treatment.

关键词： Diabetic peripheral neuropathy JinMaiTong Energy metabolism Targeted metabolomics Adenosine monophosphate-activated protein kinase

Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery:A propensityscore-matching analysis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1259-1270页

作者： Gan-Bin Li Chen-Tong Wang Xiao Zhang Xiao-Yuan Qiu Wei-Jie Chen Jun-Yang Lu Lai Xu Bin Wu YiXiao Guo-Le Lin department of General Surgery Peking Union Medical College HospitalPeking Union Medical CollegeBeijing 100730China

BACKGROUND Intestinal flora disorder(IFD)poses a significant challenge after laparoscopic colonic surgery,and no standard criteria exists for its diagnosis and *** To analyze the clinical features and risk factors of *** Patients with colon cancer receiving laparoscopic surgery were included using propensity-score-matching(PSM)*** on the occurrence of IFD,patients were categorized into IFD and non-IFD *** clinical characteristics and treatment approaches for patients with IFD were *** regression analysis was performed to identify the risk factors of *** The IFD incidence after laparoscopic surgery was 9.0%(97 of 1073 patients).After PSM,97 and 194 patients were identified in the IFD and non-IFD groups,*** most common symptoms of IFD were diarrhea and abdominal,typically occurring on post-operative days 3 and *** patients were managed conservatively,including modulation of the intestinal flora(90.7%),oral/intravenous application of vancomycin(74.2%),and insertion of a gastric/ileus tube for decompression(23.7%).Multivariate regression analysis identified that preoperative intestinal obstruction[odds ratio(OR)=2.79,95%CI:1.04–7.47,P=0.041]and post-operative antibiotics(OR=8.57,95%CI:3.31–23.49,P<0.001)were independent risk factors for IFD,whereas pre-operative parenteral nutrition(OR=0.12,95%CI:0.06–0.26,P<0.001)emerged as a protective *** A stepwise approach of probiotics,vancomycin,and decompression could be an alternative treatment for *** attention is warranted post-operatively for patients with pre-operative obstruction or early use of antibiotics.

关键词： Colon cancer,Laparoscopy Intestinal flora disorder Clinical characteristics Risk factors

Percutaneous transhepatic stenting for acute superior mesenteric vein stenosis after pancreaticoduodenectomy with portal vein reconstruction:A case report

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1195-1202页

作者： Chen Lin Zi-Yan Wang Liang-Bo Dong Zhi-Wei Wang Ze-Hui Li Wei-Bin Wang department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China department of General Surgery Peking Union Medical College HospitalBeijing 100730China Interventional Section Department of RadiologyPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China

BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/*** has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are *** SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic *** patient was successfully treated using stent *** the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly *** use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of *** careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV *** Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.

关键词： Pancreaticoduodenectomy Portal vein reconstruction Portal vein stenosis Portal vein stent Case report

Epidemiological research,burden,and clinical advances of inflammatory bowel disease in China

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Chinese medical Journal 2024年第9期137卷 1009-1011页

作者： Hong Yang Jiaming Qian department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Inammatory bowel disease(IBD),which includes Crohn’s disease(CD)and ulcerative colitis(UC),is a chronic,progressive illness thatuctuates in severity and involves recurring periods of relapse and *** has emerged as a global public health ***,IBD has been predominantly found in Western countries,with North America and Europe exhibiting the highest rates of prevalence and ***cally,the prevalence and incidence rates for UC were 505/100,000 and 249/100,000,respectively,while for CD they were 322/100,000 and 319/100,000,respectively.[1]However,there has been a recent stabilization of IBD incidence in countries with high prevalence rates.

关键词： prevalence bowel stabilization

Long-term prognosis and its associated predictive factors in patients with eosinophilic gastroenteritis

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World Journal of Gastroenterology 2024年第2期30卷 146-157页

作者： Kai-Wen Li Ge-Chong Ruan Shuang Liu Tian-Ming Xu Ye Ma Wei-Xun Zhou Wei Liu Peng-Yu Zhao Zhi-Rong Du Ji Li Jing-Nan Li department of Gastroenterology Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China department of Allergy Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China department of Pathology Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China department of Radiology Chinese Academy of Medical Sciences and Peking Union Medical College HospitalBeijing 100730China Affairs Office Chinese Academy of Medical Sciences and Peking Union Medical College Hospital(West campus)Beijing 100032China

BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal *** remain the most common treatment ***,disease relapse and glucocorticoid dependence remain notable *** date,few studies have illuminated the prognosis of EGE and risk factors for disease *** To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term *** This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and *** records were collected and ***-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at *** a median follow-up of 67 mo,all patients survived,and 56.4%had at least one *** variables at baseline might have been associated with the overall RFS rate,including age at diagnosis24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease c

关键词： Eosinophilic gastroenteritis Prognosis Relapse Glucocorticoid Glucocorticoid dependence

Efficacy and safety of transvaginal mesh repair in a cohort with a minimum of 10-year follow-up

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Science China(Life Sciences) 2024年第5期67卷 1061-1068页

作者： Zhibo Zhang Jianbin Guo Weijie Tian Ye Zhang Yuelun Zhang Tianshu Sun Jiali Duan Xinmiao Bao Yuan Wang Yang Ye Qianqian Gao Honghui Shi Abraham Nick Morse Juan Chen Lan Zhu departmentof Obstetrics and Gynecology Peking Union MedicalCollege HospitalChinese Academyof Medical Sciences&Peking Union MedicalCollegeNational Clinical Research Center for Obstetricand Gynecologic DiseasesBeijing 100730China department of Gynecology Guizhou Provincial People’s HospitalMedical College of Guizhou UniversityGuiyang 550002China department of Obstetrics and Gynecology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000China medical Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China medical Doctor Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China department of Pathology Peking Union Medical College HospitalBeijing 100730China Tufts University School of Medicine Boston MA 02111USA

Although transvaginal mesh(TVM)repair is no longer used in some countries,long-term outcomes after TVM surgery are of great importance ***,reports with follow-up>10 years are ***,this study aimed to report outcomes in a prospective cohort with at least 10 years of *** with stageⅢ–Ⅳsymptomatic prolapse were approached consecutively from 2008 to 2013 at one tertiary *** main outcome measure was symptomatic *** outcomes included anatomic failure,recurrence,patient satisfaction,complications,and *** Kaplan-Meier curve was used to estimate the cumulative failure *** the 121 patients enrolled in the study,103(85.1%)completed a median follow-up of 11 *** estimated probability rates of symptomatic and anatomic failure were 17.6%and 8.8%in 11 years,*** estimated incidence of symptomatic failure increased by 8.2%between 5 and 11 years;however,the corresponding rate for anatomic failure was 3.7%.The most common complication was vaginal mesh exposure,and its estimated probability increased from 19.3%to 28.4%from 5 to 11 years,*** trimming resolved 80.0%of vaginal *** patients did not report decreased overall *** with vaginal mesh exposure requiring>3 office procedures or mesh removal in the operating room(5.8%by 11 years)had lower satisfaction rates(P<0.01)and were defined as having severe mesh *** rates of postoperative pain,reoperation,and Patient Global Impression of Improvement≥2 were 2.5%,3.3%,and 94.2%,*** results of this study implied that TVM treatment gradually increased the symptomatic failure rate but provided durable anatomical support of the vaginal *** mesh exposure was common in women who were largely not sexually active;however,80%of the cases could be managed in the outpatient clinic,which did not affect patient satisfaction.

关键词： complication efficacy long-term follow-up pelvic organ prolapse safety transvaginal mesh

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