[Interpretation of the guidelines for neoadjuvant therapy of pancreatic cancer in China(2020 edition)]

Pancreatic cancer is a highly malignant tumor in the digestive system.The role of neoadjuvant therapy in pancreatic cancer has been highlighted with the understanding of pancreatic cancer biological behavior and popularization of comprehensive treatment.Therefore,Study group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association has formulated the guidelines for neoadjuvant therapy of pancreatic cancer in China(2020 edition).This guidelines elaborated key issues of the neoadjuvant therapy of pancreatic cancer,and provided reference for clinical practice.This article aims to interpret the guidelines about the preparation before neoadjuvant therapy, indication, regimen selection, therapeutic effect evaluation and surgery strategy, with further discussion about controversial issues of neoadjuvant therapy in pancreatic cancer.

[Research status of risk prediction and management of postoperative pancreatic fistula]

Pancreatic fistula is a common complication of pancreatic surgery and also a leading cause of postoperative death. The 2016 International Study Group on Pancreatic Surgery definition and grading criterion of postoperative pancreatic fistula (POPF) is instructive to clinical practice and scientific research. Although the criterion is widely applied, further optimization is required. It has established a variety of risk prediction models, which forwards the early diagnosis of POPF. However, the inconsistency of the criteria and the potential mutual influence of multiple factors hindered the model extrapolation. Moreover, it remains controversial in specific strategies of perioperative nutritional support, surgical methods, postoperative drainage, and somatostatin application in the prevention and treatment of POPF. Thus, more prospective studies are needed to explore safer, more effective and economical POPF prediction and intervention methods.

Serum Proteomics Analysis in Rats of Immunosuppression Induced by Chronic Stress

The immune system can be damaged by chronic stress. However, for this process, the involved molecular alterations and their regulatory roles played in immunosuppression still remain unclear. This study was aimed to identify the differences in serum protein expressions that are closely associated with the effect of chronic stress on immune function. Serum protein levels of rats in control group and chronic stress group were measured by iTRAQ analysis. Subsequently, among the 121 differentially expressed proteins screened between the two groups, 46 proteins were upregulated (>1.5-fold, P < 0.05), while 75 proteins were downregulated (<0.67-fold, P < 0.05). Bioinformatics analysis revealed that most of the differentially expressed proteins were in relation with the metabolic, cellular, response stimulus and immune system processes. The significantly differential expression of ceruloplasmin, haptoglobin, catalase and peroxiredoxin-1 were picked out for reconfirmation by ELISA analysis. The results were consistent with those obtained by iTRAQ. What is more, the roles of above-mentioned four proteins, apolipoprotein B-100 and heat-shock protein 90 in immunosuppression induced by chronic stress were discussed. Taken together, these findings may provide a new insight into better understanding the molecular mechanisms of immunosuppression induced by chronic stress.

Effects of recombinant human basic fibroblast growth factor on restenosis after arterial endothelial injury in rats

AIM

To study the preventive effect of recombinant human basic fibroblast growth factor (rh-bFGF) on restenosis after percutaneous transluminal coronary angioplasty (PTCA).

METHODS

Sixty male Wistar rats were randomly divided into sham operation group, intima injured group, and intima injured plus rh-bFGF treated group. Rat carotid arteries were injured using a balloon catheter except sham operation group. The rats of rh-bFGF treated group were injected im rh-bFGF 10 kU . kg-1 . d-1 after intima was injured. Ten rats in each group were killed on d 7 and d 14 after injury, respectively. [3H]Thymidine incorporation assay and pathological examination were carried out to each vessel.

RESULTS

(1) Seven days after injury, the average intimal thickness in sham operation group, intima injured group, and rh-bFGF treated group was (7 +/- 1), (32 +/- 11), and (17 +/- 3) micron; average intimal area was (384 +/- 145), (1530 +/- 817), and (586 +/- 185) micron2; the numbers of smooth muscle cells in neointima per transect were 0 +/- 0, 146 +/- 18, and 105 +/- 26; the ratio of the collagen area to intimal area plus medial area were 0.29 +/- 0.09, 0.7 +/- 0.3, and 0.30 +/- 0.14; [3H]thymidine incorporation were (17 +/- 6), (62 +/- 23), (20 +/- 8) kBq/g tissue, respectively. (2) Fourteen days after injury, the average intimal thickness of sham operation group, intima injured group, and rh-bFGF treated group was (8 +/- 1), (41 +/- 9), and (20 +/- 3) micron; average intimal area was (391 +/- 134), (1761 +/- 337), and (731 +/- 124) micron2; the numbers of smooth muscle cells in neointima per transect were 0 +/- 0, 145 +/- 9, and 102 +/- 6; the ratio of collagen area to intimal area plus medial area were 0.28 +/- 0.14, 0.59 +/- 0.21, and 0.38 +/- 0.03; [3H]thymidine incorporation was (15 +/- 4), (57 +/- 11), and (22 +/- 6) kBq/g tissue, respectively.

CONCLUSION

Large dosage of rh-bFGF inhibits neointimal hyperplasia and reduces restenosis after balloon injury.