Treatment of acute pancreatitis with early pancreatic stenting: a case series of 336 patients

Background

Pancreatic duct (PD) obstruction and hypertension may play a central role in the onset and progression of acute pancreatitis (AP). However, only a few studies have reported using pancreatic stenting to relieve PD obstruction in the early phase of AP, with conflicting results. Whether pancreatic stenting is effective in the early phase of AP remains unknown. We conducted this experiment in order to study the therapeutic efficacy and safety of pancreatic stenting in the early stage of AP.

Methods

We conducted a retrospective analysis of 336 AP patients from 2011 to 2018 who underwent pancreatic stenting within 48 hours of admission.

Results

A total of 330 (98.2%) patients underwent successful pancreatic stenting, of whom 23 (7.0%) had severe AP, 178 (53.9%) had moderately severe AP, and 129 (39.1%) had mild AP. Visible PD obstructive material was observed in 94 (28.5%) patients. The mean oral refeeding time since admission and length of hospital stay were 3.5±2.7 and 7.4±6.7 days, respectively. Procedure-related adverse events, in-hospital mortality, and local complication rates were 0.3%, 0.3%, and 7.6%, respectively.

Conclusions

Early endoscopic pancreatic stenting in AP patients effectively shortened the fasting time and length of hospital stay and did not increase the risk of adverse events, death, or local complications. A further prospective randomized controlled clinical trial is currently underway to validate the safety and efficacy of this procedure.

Satb1 promotes Schwann cell viability and migration via activation of PI3K/AKT pathway

OBJECTIVE

Satb1 regulates chromatin structure and gene expression, and is aberrantly expressed in many tumors. However, there is still no report about Satb1 functions in peripheral nerve injury until now. In this study, we explored the regulatory effect of Satb1 on Schwann cells.

MATERIALS AND METHODS

MTT assay, transwell assay, and flow cytometry assay were respectively used to determine Schwann cell viability, migration, and apoptosis. The mRNA and phosphorylation levels of Satb1 and SHIP1 were assessed by RT-PCR and Western blotting analysis, respectively. The correlation between Satb1 and SHIP1 was examined by ChIP assay. The expressions of PI3K/AKT pathway related factors were detected by Western blotting.

RESULTS

In the present study, we found that knock-out of Satb1 significantly inhibited cell viability and migration, and promoted Schwann cells apoptosis. Conversely, over-expression of Satb1 promoted cell viability, migration, and inhibited apoptosis. Satb1 inhibited SHIP1 expression by recruiting HDAC1. Furthermore, results showed that Satb1 activated the PI3K/AKT signaling pathway by inhibiting the expression of SHIP1. SHIP1 showed significant reversal effects on the regulatory roles of Satb1 in Schwann cells. Over-expression of Satb1 and SHIP1 inhibited cell viability, migration, and promoted apoptosis.

CONCLUSIONS

Our study demonstrated that the Satb1 knock-out could inhibit the activation of PI3K/AKT pathway by up-regulating SHIP1, thus inhibiting cell viability and migration, and promoting Schwann cell apoptosis.

LncRNA DANCR promotes proliferation and metastasis in pancreatic cancer by regulating miRNA-33b

Increasing evidence indicates that long noncoding RNAs (lncRNAs) function as important regulators in biological processes and are dysregulated in various tumors. The lncRNA DANCR functions as an oncogene in various cancers, but elucidation of its role in pancreatic cancer (PC) requires further investigation. In the current study, we demonstrate that DANCR was increased in PC tissues and cell lines. Knockdown of DANCR significantly suppressed cell proliferation, migration, and invasion and influenced the levels of epithelial‐to‐mesenchymal transition‐associated proteins, as demonstrated by the observation of enhanced E‐cadherin levels and reduced N‐cadherin levels in PC cells. In addition, we identified direct binding to the predicted miR‐33b binding site on DANCR. We also showed that there is reciprocal repression between DANCR and miR‐33b. Furthermore, a miR‐33b inhibitor partially abrogated knockdown of DANCR and caused inhibitory effects. We also demonstrated that DANCR functions as a miR‐33b sponge to positively regulate MMP16 expression in PC cells. Collectively, the data reveal that DANCR exerts its function by regulating miR‐33b/MMP16 expression, implying an important role for a lncRNA–miRNA–mRNA functional network and suggesting a novel potential therapeutic target for PC.

Mating compatibility between Bactrocera invadens and Bactrocera dorsalis (Diptera: Tephritidae)

The invasive fruit fly, Bactrocera invadens Drew, Tsuruta & White, is a highly polyphagous fruit pest that occurs predominantly in Africa yet has its origins in the Indian subcontinent. It is extremely morphologically and genetically similar to the Oriental fruit fly, Bactrocera dorsalis (Hendel); as such the specific relationship between these two species is unresolved. We assessed prezygotic compatibility between B. dorsalis and B. invadens using standardized field cage mating tests, which have proven effectiveness in tephritid cryptic species studies. These tests were followed by an assessment of postzygotic compatibility by examining egg viability, larval and pupal survival, and sex ratios of offspring produced from parental and subsequent F1 crosses to examine for hybrid breakdown as predicted under a two-species hypothesis. B. dorsalis was sourced from two countries (Pakistan and China), and each population was compared with B. invadens from its type locality of Kenya. B. invadens mated randomly with B. dorsalis from both localities, and there were generally high levels of hybrid viability and survival resulting from parental and F1 crosses. Furthermore, all but one hybrid cross resulted in equal sex ratios, with the single deviation in favor of males and contrary to expectations under Haldane's rule. These data support the hypothesis that B. dorsalis and B. invadens represent the same biological species, an outcome that poses significant implications for pest management and international trade for sub-Saharan Africa.

Mapping shape quantitative trait loci using a radius-centroid-contour model

As the consequence of complex interactions between different parts of an organ, shape can be used as a predictor of structural-functional relationships implicated in changing environments. Despite such importance, however, it is no surprise that little is known about the genetic detail involved in shape variation, because no approach is currently available for mapping quantitative trait loci (QTLs) that control shape. Here, we address this problem by developing a statistical model that integrates the principle of shape analysis into a mixture-model-based likelihood formulated for QTL mapping. One state-of-the-art approach for shape analysis is to identify and analyze the polar coordinates of anatomical landmarks on a shape measured in terms of radii from the centroid to the contour at regular intervals. A procrustes analysis is used to align shapes to filter out position, scale and rotation effects on shape variation. To the end, the accurate and quantitative representation of a shape is produced with aligned radius-centroid-contour (RCC) curves, that is, a function of radial angle at the centroid. The high dimensionality of the RCC data, crucial for a comprehensive description of the geometric feature of a shape, is reduced by principal component (PC) analysis, and the resulting PC axes are treated as phenotypic traits, allowing specific QTLs for global and local shape variability to be mapped, respectively. The usefulness and utilization of the new model for shape mapping in practice are validated by analyzing a mapping data collected from a natural population of poplar, Populus szechuanica var tibetica, and identifying several QTLs for leaf shape in this species. The model provides a powerful tool to compute which genes determine biological shape in plants, animals and humans.

Newly defined clinical features and treatment experience of seventh day syndrome following living donor liver transplantation

AIM

The aim of this study was to describe a unique Seventh-Day Syndrome (7DS) in our liver transplantation center.

METHODS

We performed a retrospective analysis of 244 cases of adult living donor liver transplantations (LDLT) performed in our liver transplantation center from January 1995 to January 2009.

RESULTS

Since 2005, we identified 8 cases of 7DS. Previously reported features for 7DS include a rapid deterioration of liver function followed by renal failure and a sudden peak in liver enzyme levels around day 7. In addition, the following attributes have been observed in our patients: (1) all recipients were males while the donors included both genders; (2) most patients showed increased levels of irritability; (3) color Doppler revealed reduced blood flow or bidirectional blood flow in the portal vein; (4) coagulation necrosis was observed with disruption of lobular architecture and increased expression of death receptor Fas in all examined patients; (5) after onset, a steroid pulse with or without OKT3 therapy showed minimal effect; (6) a abrupt increase in liver enzymes was noted 1-2 days after intravenous (IV) methylprednisolone was switched to oral immunosuppressants; and (7) extension of IV methylprednisolone treatment delayed the occurrence from 8 to 11 days postoperatively.

CONCLUSIONS

7DS is a distinct entity associated with early graft dysfunction, which is associated with a high rate of mortality and need for retransplantation. Coagulation necrosis and Fas receptor activation may be implicated in the occurrence of 7DS. Our study supported the hypothesis that 7DS may be associated with an undefined immune response. Our experience extending IV methylprednisolone treatment seeking to delay occurrence and reduce mortality provided a possible therapeutic approach for 7DS.

Superiority of visipaque (iodixanol)-controlled density gradient over Ficoll-400 in adult porcine islet purification

OBJECTIVE

Sufficient and favorable biological functions of islets are major problems hindering xenotransplantation. The aim of the present study was to evaluate the effects on harvesting, purity, viability, and function of using improved Visipaque (iodixanol) and Ficoll-400 for adult porcine islet purification.

METHODS

Twelve adult porcine pancreata were randomly divided into an Iodixanol-University of Wisconsin (UW) group and a Ficoll-400-UW group according to the purification method. Porcine pancreata were isolated by collagenase digestion. After isolation and purification, the islet yield and purity were evaluated by dithizone staining, and islet function assessed by in vitro insulin release assays and in vivo islet xenotransplantation.

RESULTS

There were no marked differences in the islet yield before purification (5254.67 +/- 189.44 IEQ/g vs 5092.67 +/- 178.94 IEQ/g, P > .05). After purification, there were significantly more islets harvested in Iodixanol-UW group than in the Ficoll-400-UW group: 4222.00 +/- 228.84 IEQ/g vs 3036.83 +/- 79.60 IEQ/g (P < .05). Islets from the two groups showed satisfactory insulin secretory ability. There were no significant differences in islet survival times between the two groups in diabetic rats: 8.2 +/- 1.619 days vs 6.9 +/- 1.197 days (P > .05).

CONCLUSION

The improved iodixanol-UW density gradient method was superior to Ficoll-400 method to improve the number, viability, and insulin secret of purified adult porcine islets although the benefits did not improve in vivo survival.

Defining new pathogens and nonculturable infectious agents associated with inflammatory bowel disease

The causes of inflammatory bowel disease remain uncertain, but increasing evidence supports roles for two pathogenic processes: genetic susceptibility in the host and an aberrant host response to enteric bacteria. Here, we review studies showing that the pathogenesis of inflammatory bowel disease involves both bacterial agents and genetic susceptibilities. We discuss the roles of known and novel commensal intestinal bacteria in the pathogenesis of inflammatory bowel disease and the various recombinant approaches used to identify these pathogens.

Transcranial Doppler characteristics in persistent vegetative status, locked-in syndrome and brain death

AIM

Comparison of the transcranial Doppler (TCD) characteristics of cerebral circulation in persistent vegetative status (PVS), locked-in syndrome and brain death patients.

METHODS

Using TCD ultrasound to detect the flow velocity and waveform patterns of middle cerebral artery (MCA) and basilar artery (BA) in patients with PVS, locked-in syndrome and brain death.

RESULTS

The mean velocities of middle cerebral artery (Vmca) and basilar artery (Vba) were 30.0 cm/s and 24.3 cm/s in PVS patients respectively, which decreased 45.0% and 14.4% in comparing with normal value. For patients with locked-in syndrome, Vmca and Vba were 49.7 cm/s and 9.8 cm/s, which decreased 5.0% and 61.7% than the normal value respectively. These results showed that the decrease of anterior circulation was predominant in PVS, and the decrease of posterior circulation was predominant in locked-in syndrome. A unique diastolic reverse flow, short peak systolic wave or undetectable flow signal in middle cerebral artery were predominant in brain death patients, which was completely different from that of either PVS or locked-in syndrome.

CONCLUSION

TCD was a valuable tool in distinguishing PVS, locked-in syndrome and brain death patients according to the differences in velocities and patterns of anterior and posterior cerebral arteries.

Expression of HIS50 Ag: a rat homologue of mouse heat-stable antigen and human CD24 on B lymphoid cells in the rat

Recently, a cDNA encoding a newly identified rat antigen (HIS50 Ag) that binds to monoclonal antibody (mAb) HIS50 was cloned and shown to be homologous to cDNA encoding murine heat-stable antigen (HSA) and human CD24. Here we show that, like CD24 and HSA, at least part of HIS50 Ag is inserted into the plasma membrane by a glycosylphosphatidylinosito: (GPI)-lipid linkage and we describe its expression in rat haemolymphopoietic tissues. HIS50 Ag expression was almost exclusively confined to B lymphoid cells, the vast majority of T lymphoid cells, erythroid and myeloid cells were HIS50+. Cell suspension analysis indicated that in bone marrow (BM) almost all Thy-1+ cells, HIS24+ cells [HIS24 recognizes the B-cell form of leucocyte common antigen (LCA)], terminal deoxynucleotidyl transferase-positive (TdT+) cells and (c + s)kappa cells expressed HIS50 Ag, and all (c + s)mu 1 cells. A presumably early population of B lymphoid cells, expressing HIS24 Ag without HIS50 Ag, TdT or immunoglobulin HIS24+HIS50+ TdT Ig+), constituted 1.6% of BM nucleated cells. In blood, one-fifth of mononuclear cells were HIS50+, and about 85% of these expressed mu and/or kappa chains. In spleen, flow cytometry analysis and immunohistology demonstrated heterogeneous expression of HIS50 Ag: immunoglobulin M (IgM)bright cells (as found largely in red pulp and marginal zone) were HIS50bright, while IgMdull cells expressed low or undetectable levels of HIS50 Ag. Germinal centre B cells expressed high levels of HIS50 Ag. Germinal centres of lymph nodes and tonsil of man also bound HIS50. We conclude that HIS50 Ag expression in the haemolymphopoietic system of rat is virtually restricted to the B lineage.