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" State-target-cause-result" is a new clinical theory combining macroscopic and microscopic syndrome differentiation based on the holistic view of traditional Chinese medicine combined with Western medical research. The "inflammation-cancer transformation " of chronic pancreatitis is a complex pathological process that is associated with the interaction between the pancreas and various pathological factors and multiple objects, involving the imbalance of multiple homeostasis. The microscopic process of " inflammation-cancer transformation" in chronic pancreatitis is the " target," whereas various factors that could induce its occurrence under chronic inflammatory conditions are the " state. " The " inflammationcancer transformation" of chronic pancreatitis is summarized as yin and yang imbalance, qi movement disorder, endogenous dampness, heat, blood stasis, and turbid phlegm stagnation, unresolved congestion resulting in deficiency caused by stagnation, intermingled deficiency and excess, and internal cancer toxin generation. This paper elucidates the pathogenesis and intervention strategies of the " inflammation-cancer transformation " of chronic pancreatitis from a macro perspective of "state," focusing on reducing the impact of " state" imbalance on the " target" to establish a balanced pancreas-immune-microbiota state. The aim is to broaden the theory for exploring the mechanism and drug development related to chronic pancreatitis " inflammation-cancer transformation " in both traditional Chinese and Western medicine. [ABSTRACT FROM AUTHOR]

Chronic pancreatitis (CP) is a progressive fibroinflammatory disease characterized by destruction of pancreatic acinar cells, infiltration of inflammatory cells, activation of pancreatic stellate cell (PSC), and pancreatic fibrosis. Autophagy participates in the maintenance of cell homeostasis. Recent studies have shown that autophagy closely related to the occurrence and development of CP. However, several autophagy types in the pancreatic microenvironment play different roles in the progression of CP. The autophagy of acinar cells has a "double-edged sword" effect. PSC autophagy is positively correlated with its activation, while the role of autophagy of inflammatory cells is still unclear. This study focused on some key cells in the CP microenvironment and explored the role and mechanism of autophagy in the progression of CP. [ABSTRACT FROM AUTHOR]

Chronic pancreatitis (CP) is a progressive fibrotic pancreatic disease influenced by multiple factors such as genetic and environmental factors. Currently, the genetic pathogenic mechanisms of CP are mainly divided into three pathways: the trypsin-dependent pathway, the protein misfolding pathway, and the ductal pathway. Pancreatic ductal epithelial cells, as an important cell type in the exocrine pancreas, are capable of producing H2O and HCO-3, and are responsible for the alkalization, dilution, and transportation of digestive enzymes. When genes related to the ductal pathway are functionally impaired, it will lead to an imbalance in the ion concentration within the duct and a disturbance in the transport of digestive enzymes, promoting the occurrence and development of CP. In the past, genes related to the ductal pathway were relatively rare, but in recent years, our understanding of the ductal pathway has gradually deepened, and new susceptibility genes have been continuously discovered. This article mainly discusses the genes related to the ductal pathway and their main pathogenic mechanisms to deepen our understanding of the pathogenesis of CP.

Chronic pancreatitis (CP) is a chronic progressive disease that causes varying degrees of functional damage on pancreatic endocrine and exocrine, seriously affecting the quality of life of the patients. Endoscopic retrograde cholangio-pancreatography (ERCP) with minimal trauma, high safety, and good efficacy has become a first-line treatment method for CP. ERCP is a first-line treatment method for pancreatic duct stones and pancreatic duct stricture, and complications of CP.

Objective To explore the difference between duodenum-preserving pancreatic head resection (DPPHR) and pancreatic-preserving pancreatic duct jejunostomy (Partington operation) in the treatment of pancreatic head calculus, and evaluate the advantages and disadvantages of the two operations, and optimize and improve them. Methods From January 1, 2017 to October 1, 2022, the clinical, imaging and pathological data of 139 patients with pancreatic head stones requiring surgical treatment admitted to the Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed. According to the different surgical methods, the patients were divided into DPPHR group and Partington group. The clinical characteristics of patients in the two groups and the short-term and long-term outcomes of surgical treatment were analyzed. Results There was no significant difference in preoperative general data (P > 0.05). Type Ⅰ stones were predominant in DPPHR group (80.2%), while type Ⅰ and Ⅲ stones were predominant in Partington group (45.3%, 47.2%), and the difference was statistically significant (P < 0.001). In terms of shortterm efficacy, DPPHR group had advantages over Partington group in terms of operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rate (P < 0.05) . In the long-term efficacy, the DPPHR group was better than the Partington group in stone recurrence reoperation and postoperative pancreatic function (P < 0.05). Logistic multivariate analysis showed that CP≥5 a (95%CI 1.057-3.884, P = 0.012) and long postoperative drinking history (95%CI 0.987-3.128, P = 0.025) . CP≥5 a and a long history of postoperative alcohol consumption were independent risk factors for survival without pain recurrence after pancreatic head calculi surgery Conclusions Based on the analysis of the short-term efficacy (operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rate) and long-term efficacy (stone recurrence and reoperation, postoperative pancreatic function) of patients with pancreatic head calculi in this study, DPPHR surgery was superior to Partington surgery, suggesting that DPPHR surgery has become an effective treatment for PDS at present. However, it is also necessary to develop an individualized surgical strategy for the patient, with emphasis on postoperative care and follow-up to provide the best outcome for the patient. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To analyze the correlation between serum procalcitonin (PCT), neutrophil extracellular trapping nets (NETS), milk fat globule-epidermal growth factor 8 (MFG-E8), toll like receptor 9 (TLR 9) and intestinal mucosal barrier function in patients with severe acute pancreatitis (SAP), and to observe their effects on the prognosis. Methods: The clinical data of 174 patients with SAP (SAP group) who were treated in our hospital from March 2019 to January 2022 were retrospectively analyzed. In addition, the clinical data of 90 volunteers (control group) who came to our hospital for physical examination in the same period were collected and analyzed. The levels of serum PCT, NETs, MFG-E8, TLR 9, endotoxin (LPS), D-lactic acid and diamine oxidase (DAO) in the control group and SAP group were compared, and the correlation between PCT, NETS, MFG-E8, TLR 9 and intestinal mucosal barrier function indexes was analyzed. Among the 174 patients, 39 patients died within 28 days after admission and 135 patients survived. According to prognosis within 28 d, they were divided into death group (n=39) and survival group (n=135). Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of prognosis. Results: The levels of serum PCT, NETS and TLR 9 in SAP group were higher than those in the control group, and the MFG-E8 level was lower than that in the control group (P<0.05). The levels of serum LPS, D-lactic acid and DAO in the SAP group were higher than those in the control group (P<0.05). Pearson correlation analysis confirmed that LPS, D-lactic acid and DAO were positively correlated with PCT, NETS and TLR 9, and negatively correlated with MFG-E8 (P<0.05). Univariate analysis showed that: the prognosis of patients with SAP was related to age, diabetes mellitus, blood amylase, acute physiological function and chronic health score System Ⅱ (APACHE Ⅱ) score, acute pancreatitis severity bedside index (BISAP) score, LPS, D-lactic acid, DAO, PCT, NETs, MFG-E8, TLR 9, reducing alcohol consumption, low fat diet (P<0.05). Multivariate Logistic regression analysis showed that: high BISAP score, high APACHE Ⅱ score, high LPS, high PCT, high blood amylase, high D-lactic acid, high DAO, high NETs, low MFG-E8 and high TLR 9 were risk factors for the prognosis of patients with SAP. Reducing alcohol consumption and low fat diet were the protective factors for the prognosis of patients with SAP (P<0.05). Conclusion: The levels of serum PCT, NETs, MFG-E8 and TLR 9 in patients with SAP are abnormal and correlated with intestinal mucosal barrier function. Meanwhile, blood amylase, APACHEⅡ score, BISAP score, LPS, PCT, D-lactic acid, DAO, NETs, MFG-E8 and TLR 9 are risk factors for the prognosis of patients with SAP, while reducing alcohol consumption and low fat diet are protective factors for the prognosis of patients with SAP. Early clinical evaluation should be paid attention to to improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To studyExpression of serum Soluble Differentiation antigen 14 (sCD14), C-reactive protein (CRP), procalcitonin (PCT) in acute pancreatitis and their correlation with Acute physiological function and chronic health status scoring system Ⅱ (APACHEII), bedside acute pancreatitis severity index (BISAP). Methods: 150 patients with acute pancreatitis who were treated in our hospital from January 2019 to January 2021 were selected as the case group, and 50 healthy patients who were examined in our hospital during the same period were selected as the control group. The changes of serum sCD14, CRP and PCT levels and their correlation with APACHE Ⅱ and BISAP were analyzed. Results: The serum levels of sCD14, CRP, PCT, APACHE Ⅱ and BISAP in case group were significantly higher than those in control group, with significant differences (P<0.05); The serum levels of sCD14, CRP, PCT, APACHE Ⅱ and BISAP in mild patients were significantly lower than those in moderate and severe patients, and the serum levels of sCD14, CRP, PCT, APACHE Ⅱ and BISAP in moderate patients were significantly lower than those in severe patients, with significant differences (P<0.05). Correlation analysis results showed that serum sCD14, CRP and PCT and APACHE Ⅱ, there was a positive correlation between BISAP (r=0.449, 0.649, 0.584, 0.488, 0.674, 0.663, P<0.05). Conclusions: Serum sCD14, CRP and PCT were highly expressed in patients with acute pancreatitis, and were closely related to APACHE Ⅱ and BISAP. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinical features and the nutrition status in elderly chronic pancreatitis (CP) patients. Methods A total of 341 patients with CP were divided into two groups by age: elderly group (≥65 years old) and non-elderly group (<65 years old). Sex, etiology, symptoms, complications, and imaging were analyzed retrospectively in the two groups. The nutrition status of elderly patients with CP were further evaluated by NRS2002. Results The sex ratio was 1.88∶1 in elderly group. Idiopathic CP was the primary etiology among elderly patients, followed by alcoholic CP. The proportions of idiopathic and autoimmune CP in the elderly group increased, while the proportion of alcoholic CP decreased, the differences were statistically significant (P <0.05). The proportion of abdominal pain in the elderly group was lower than that in the non-elderly group, while the proportion of abdominal distension was higher than that in the non-elderly group, the differences were statistically significant (P <0.05). In terms of imaging features, the proportion of pancreatic atrophy in the elderly group was significantly higher than that in the non-elderly group, and the pancreatic duct, calculi appear as a pancreatic mass were lower than those in the non-elderly group, with statistical significance (P <0.05). The proportion of CP nutritional risk in the elderly was 79.13%. Conclusion CP in elderly patients has its own unique clinical features that different from those of non-elderly patients. This can lead to increased risk of malnutrition in elderly patients, which require early recognition and prompt treatment. [ABSTRACT FROM AUTHOR]

Chronic pancreatitis (CP) is a progressive inflammatory disease of the pancreas in individualswith genetic, environmental, and/or other risk factors. In recent years, CP has aroused extensive attentions of theresearchers worldwide and several high qualified clinical guidelines and studies were published. CP is characterized by increasing incidence, complex etiology and pathogenesis, variable clinical courses, difficult early diagnosis, and low life quality of patients. A plenty of issues in basic and clinical researches of CP need to be explainedand solved. This review outlined the important basic and clinical researches of CP currently, to provide some references for this field.

Objective: To study Analysis of the Changes and significance of serum Proalbumin (PAB), high mobility group protein B1 (HMGB1), soluble interleukin-2 receptor (sIL-2R), tensin converting enzyme 2 (ACE2) levels in patients with acute pancreatitis. Methods: 83 patients with acute pancreatitis who were treated in our hospital from July 2018 to July 2020 were selected as the case group, and 70 healthy people in our hospital during the same period were selected as the control group. The changes of serum PAB, HMGB1, sIL-2R, ACE2 and acute physiology and chronic health scoring system II (APACHE II) score levels and their correlation were analyzed The diagnostic value of serum PAB, HMGB1, sIL-2R and ACE2 was analyzed by receiver operating characteristic curve. Results: Serum PAB and ACE2 levels in case group were significantly lower than control group, and HMGB1, sIL-2R and ApacheII scores were significantly higher than control group, the differences were significant (P < 0.05). Serum PAB and ACE2 levels in mild disease group were significantly higher than those in severe disease group, and the levels of HMGB1, sIL-2R and ApacheII scores were significantly lower than those in severe disease group, with significant differences (P < 0.05). Pearson correlation analysis, according to the results of serum PAB, ACE2 with APACHE Ⅱ between negatively correlated (P < 0.05), serum HMGB1, SIL - 2 r and APACHE Ⅱ between positively correlated (P < 0.05); Serum PAB predict the critical value of acute pancreatitis is 147.09 mg/L, the sensitivity was 80.54%, 85.68%, AUC is 0. 845, serum HMGB1 predict the critical value of 85.34 ng/L of acute pancreatitis, the sensitivity was 81.65%, 86.69%, AUC is 0. 998, serum SIL - 2 r to predict the critical value of acute pancreatitis is 25.47 pg/mL, the sensitivity was 81.59%, 87.57%, AUC is 0. 978, The cut-off value of serum ACE2 for predicting acute pancreatitis was 298.57 pg/mL, the sensitivity was 80.19%, the specificity was 83.58%, and the AUC was 0. 867. Conclusion: The expression of PAB, HMGB1, sIL-2R and ACE2 in serum was closely correlated with ApacheII score, which had a high predictive value for acute pancreatitis. [ABSTRACT FROM AUTHOR]

Objective: To compare the computed tomography (CT), magnetic resonance imaging (MRI) image findings of patients with acute pancreatitis and their diagnostic value. Methods: 124 patients who were admitted to our hospital and initially diagnosed as acute pancreatitis from January 2018 to December 2019 were selected. All patients were examined with CT and MRI examination at the same time. The image findings of the two examination methods of diagnosis of acute pancreatitis, were compared. With the clinical final diagnosis results as a reference, the value of the two examination methods in the diagnosis of acute pancreatitis were compared. Results: Of the 124 patients, 96 were diagnosed as acute pancreatitis, and 28 were non-acute pancreatitis. Take the final clinical diagnosis result as the "gold standard", the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in the diagnosis of acute pancreatitis were 84.38%, 75.00%, 92.05%, 58.33% and 82.26% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI in the diagnosis of acute pancreatitis were 95.83%, 78.57%, 93.88%, 84.62% and 91.94%, respectively. The sensitivity, negative predictive value and accuracy of MRI in the diagnosis of acute pancreatitis were significantly higher than those of CT in the diagnosis of acute pancreatitis(P<0.05). There were no significant differences between the two examination methods in specificity and positive predictive value (P>0.05). Conclusion: CT and MRI image findings are helpful for the diagnosis of acute pancreatitis. Both of them have high sensitivity, specificity and accuracy. However, the sensitivity and accuracy of MRI in the diagnosis of acute pancreatitis are better than that of CT. [ABSTRACT FROM AUTHOR]

Objective　 To investigate the clinical application value of modified Beger operation. Methods　 The clinical data of 59 patients with chronic pancreatitis, benign and low-grade malignant tumor of pancreatic head treated by surgery from January 2014 to January 2020 were retrospectively analyzed, Among them, there were 49 cases of mass type chronic pancreatitis in the head of pancreas, 3 cases of cyst with pancreatic duct stones, 2 cases of solid pseudopapillary tumor, 2 cases of intraductal papillary mucinous tumor, 2 cases of serous cystadenoma and 1 case of mucinous cystadenoma. They were randomly divided into modified beger operation group and pancreatoduodenectomy (PD) group. Among them, 31 cases underwent modified beger operation and 28 cases underwent pancreaticoduodenectomy (PD). Results　 For patients in the modified beger operation group and PD group, the operation time, intraoperative bleeding, postoperative hospital stay, incidence of postoperative complications and pain relief efficiency were(231.4 ± 42.3/268.1 ± 52.5)min, (405.5 ± 64.1 / 449.9 ± 61.2)mL, (17.1 ± 3.4 / 28.5 ± 4.1)d, (12.9 / 42.9)% and (89.7 / 88.9)%, respectively. 56 cases (29 cases in Beger group and 27 cases in PD group) were followed up for 6 months to 5 years without recurrence of tumor or stone. Conclusion　 The modified Beger operation has the advantages of less pancreatic tissue resection, less surgical trauma, safer operation, faster recovery, more accurate relief of intractable abdominal pain, and significant improvement of postoperative quality of life and nutritional status of patients. [ABSTRACT FROM AUTHOR]

Objective To explore the correlation between vitamin D and K levels and osteoporosis in patients with chronic pancreatitis (CP). Methods Bone mineral density was determined using dual-energy X-ray absorptiometry. Faecal elastase was detected to evaluate pancreatic function. Nutritional evaluation included vitamin D and vitamin K. The association between investigated variables and bone mineral density were analyzed with logistic regression analysis. Results A total of 211 CP patients were enrolled (67% men； mean age 60 years old). In total, 18% of the patients had advanced CP, 56% suffered from pancreatic exocrine insufficiency, and 43% had alcoholic etiology. Vitamin D and K were deficient in 56% and 32% , respectively. Osteopenia was diagnosed in 42% and osteoporosis in 22%. In the multivariate analysis, female sex (2. 78)，age (£>/?= 1. 07 per year), and higher BMI ((9/? = 0. 84) were associated with the presence of osteoporosis. In male patients, the only factor associated with osteoporosis was vitamin K deficiency (= 4. 23). Conclusion The present data confirm a high rate of osteopathy in CP patients and highlight the relevance of vitamin K deficiency as the only factor associated with osteoporosis in male patients. [ABSTRACT FROM AUTHOR]

Objective: To study the value of bedside index of acute pancreatitis (BISAP), Ranson and acute physiology and chronic health evaluation (APACHE II) scoring system in evaluating the condition and prognosis of patients with hyperlipidemic acute pancreatitis (HLAP). Methods: The clinical data of 160 patients with HLAP admitted to our hospital from March 2015 to March 2019 were retrospectively analyzed. Among them, 113 cases were light, 26 cases were moderate, 21 cases were severe, 14 cases were complications and 5 cases were dead. Pearson correlation test was used to examine the correlation between the three scoring systems and condition. The relationship between the three scoring systems and patients with moderate to severe, complications and deaths were analyzed. Value of three scoring systems in evaluating the condition and prognosis of HLAP patients by receiver operating characteristic (ROC) curve analysis. Results: The scores of BISAP, Ranson, APACHE II increased with the aggravation of the disease, and there were significant positive correlation between them (P<0.05). The three scoring systems had high value in evaluating the severity of HLAP, the area under curve (AUC) were above 0.76, and the sensitivity and specificity were higher than 0.7. The proportion of moderate to severe patients, complications patients, deaths with BISAP more than 3 scores, Ranson more than 3 scores, APACHE II more than 8 scores were higher than those with BISAP less than 3 scores, Ranson less than 3 scores, APACHE II less than 8 scores (P<0.05). The three scoring systems had high value in excluding complications and predicting death, and their specificity were above 0.9. Conclusion: The application of BISAP, Ranson, APACHE II scoring system in evaluating the condition and prognosis of HLAP patients has certain value, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective: To investigate the changes of serum carcinoembryonic antigen(CEA), carbohydrate antigen 242(CA242)and carbohydrate antigen 199(CA199) levels in patients with pancreatic cancer, and to analyze the combined diagnostic value of the above indicators for pancreatic cancer, so as to provide reference for clinical diagnosis of pancreatic cancer. Methods: 186 patients with pancreatic cancer(pancreatic cancer group) and 89 patients with pancreatitis(pancreatitis group) admitted to our hospital from February 2014 to February 2018 were selected as the study subjects, and 268 healthy persons who came to our hospital for examination during the same period were selected as the control group. The changes of serum CEA, CA242 and CA199 levels were compared among the three groups. The accuracy, specificity and sensitivity of single and combined diagnosis of serum CEA, CA242 and CA199 were compared and analyzed. The ROC curve was drawn to analyze the diagnostic value of the above indicators. Results: There were significant differences in serum CEA, CA242 and CA199 levels among the three groups(P<0.05). The levels of serum CEA, CA242 and CA199 in pancreatitis group and pancreatic cancer group were significantly higher than those in control group. The levels of serum CEA, CA242 and CA199 in pancreatic cancer group were significantly higher than those in pancreatitis group(P<0.05). ROC curve showed that CEA had the greatest diagnostic value and CA199 had the smallest diagnostic value. CEA was the most sensitive single tumor marker for pancreatic cancer(85.48%), CA242 (96.72%) had the highest specificity; the accuracy of combined diagnosis of three tumor markers increased to 92.27%,the sensitivity increased to 95.16%, and the specificity decreased slightly. Conclusion: Compared with single tumor marker in the diagnosis of pancreatic cancer, the sensitivity and accuracy of CEA, CA242 and CA199 combined diagnosis were significantly increased,which could significantly improve the missed diagnosis rate of pancreatic cancer, improve the survival rate of patients, and have better clinical application value. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To evaluate the clinical efficacy of total pancreatectomy-islet autotransplantation (TP-IAT) in the treatment of chronic pancreatitis. Methods One patient diagnosed with refractory chronic pancreatitis complicated with multiple pseudocysts and pancreatic stones underwent TP-IAT in the First People's Hospital of Foshan. Clinical data were collected and analyzed during postoperative 3 months follow-up. Results The patient was well recovered after TPIAT without complications, such as bleeding and severe hypoglycemia. Abdominal pain was completely relieved without taking analgesic drugs. During postoperative follow-up, the patient was treated with exogenous insulin, the fasting blood glucose was properly controlled and the function of islet cells was partially restored. Conclusions TP-IAT can not only relieve the clinical symptoms of chronic pancreatitis, but also prevent postoperative diabetes mellitus, which is an efficacious treatment of refractory chronic pancreatitis. [ABSTRACT FROM AUTHOR]

Objective To analyze the mutation of chymotrypsin C (CTRC) gene in patients with chronic pancreatitis (CP) in southwestern Han population and to explore the mechanism of CP pathogenesis in southwestern Han population from the genetic level. Methods Peripheral blood samples were collected from 108 patients with CP in the southwestern Han (CP group) and 150 healthy controls (control group). The nuclear DNA of white blood cells was extracted for CTRC gene exon sequencing. The sequencing results were compared online and CTRC gene mutation was analyzed. Further, a dominant genetic model was established and the correlation between two genetics and environment was statistically analyzed based on the clinical data. Results One case of c.611C > A heterozygous missense mutation, one case of c.703G >T heterozygous missense mutation and one case of c.736C >T heterozygous missense mutation were detected in the CTRC gene exon region of CP group, while no CTRC gene mutation was detected in the exon region of the control group. In addition, live single nucleotide polymorphism (SNP) loci were found: c. 40 + 133C > A, c. 40 + 92T > A, c. 493 + 49C > C, c. 493 + 51C > A, and c. 793-137A > C, which were located in the intron region. The frequencies of the above sites in the CP group were 0, 12.96% , 19.44% , 7. 41% , and 16.67% , respectively ; the frequencies of the above sites in the control group were 2.67% , 5.33% , 7. 33% , 6.67% , and 16.00%. The frequencies of c. 40 + 133G > A, c. 493 +49G > C sites in the CP group were higher than those in the control group (all P < 0.05). The genotype frequency and allele frequency of c.40 + 133 G > A locus and c. 493 + 49G > C locus in the CP group were both higher as compared with those of the control group (P < 0.05 or P <0.01). Under the dominant model, the CP group and the control group showed an increased risk of CP for the population with e.40 + 133G > A site or e.493 +49G >C site changes (all P<0.05). In the presence of smoking factors, there was a statistically significant difference in the distribution of c.493 +49G >C sites (OR = 4.667 , 95% CP. 1.341-16.239, P <0.05). Conclusion The e.611G>A, c.703G>T, and c.736C >T heterozygous missense mutations may lie related to the pathogenesis of CP in the southwestern Han population, SNP loci c.40 + 133G > A and c.493 + 49G >C may he the CP susceptibility sites, and the smokers with a loci c.493 +49G >C change are prone to CP. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation of disease severity with pleural effusion in patients with acute pancreatitis (AP). Methods: A retrospective analysis was conducted on a prospectively collected database. The demographic, clinical, and laboratory data of 492 consecutive cases of AP in patients admitted to the Yunnan Third Peoples' Hospital from January 2008 to December 2014 were reviewed. Acute physiology and chronic health evaluation I (APACHE I) score and computed tomography severity index (CTSI) were used to evaluate the disease severity of AP. The relationship between the severity and pleural effusion was analyzed. Receiver operator characteristic (ROC) curve was used to compare the values of APACHE I score and CTSI in predicting the prognosis of AP patients with pleural effusion. Results: Among the 492 patients, there were 368 patients with pleural effusion and 124 patients without pleural effusion. The incidence of pleural effusion in AP was 74.8%. Further study showed that the difference in the incidences of pleural effusion between the severe group and the mild group was significant (P<0.01). There was a trend that the more serious the patients' condition, the more the pleural effusion. Moreover, the level of pleural effusion was significantly and positively correlated with the APACHE I score (r=0.775, P<0.01) and CTSI (r=0.525, P<0.05). Logistic regression analysis showed that high APACHE I score and high CTSI were significantly associated with pleural effusion formation. Areas under the ROC curve of the APACHE I score, CTSI and combined assessment were 0.798, 1.687 and 0.812 for predicting mortality of AP patients with pleural effusion. There were significant differences between the APACHE I score and CTSI as well as combined assessment and CTSI (P<0.05). Conclusion: The disease severity was closely related to pleural effusion in patients with AP. Combining the two scoring systems to evaluate the disease severity and providing active treatment were important to improve the prognosis of APC patients with pleural effusion. [ABSTRACT FROM AUTHOR]

Objective To investigate the association between PRSS1 single nucleotide polymorphism (SNP) and chronic pancreatitis (CP) in southwestern Chinese Han population. Methods Genomic DNA was prepared from 384 individuals with CP (CP group) and 480 healthy controls (control group). Three SNPs in the PRSS1 gene (rsl0273639, rs6667 and rs2011216) were selected by ease-control study. The SNPs were detected by single-base extension method and their correlation with CP was analyzed. Results All throe SNPs conformed to Hardy-Weinberg equilibrium (all P >0. 05). The G allele frequencies of rs6667 and rs2011216 were 37.8%, 33.2%, 29.8% and 26.5% in the CP group and control group, respectively. The GG genotype frequencies were 14.1 %, 10.4%, 7.5% and 6.0% (all P < 0.05). The allele and genotype of rsl0273639 had no significant difference between the CP group and control group (all P>0.05). Binarv logistic regression analysis showed that the risk of CP in rs6667 G allele was 1. 18 times more than that in A allele, while in the dominant model (AG + GG) vs AA and recessive model GG vs (AG + AA) it was 1. 18-fold and 1. 76-fold higher in CP group than that of the control group, respectively. In the risk of developing CP. rs2011216 G allele carriers wend. 16 times as high as the A allele carriers. In the dominant model (AG + GG) vs AA and recessive model GG vs (AG + AA), the risk of CP group was 1.17 times and 1. 34 times higher than that of the control group, respectively. In addition, rsl0273639 was not associated with CP susceptibility (P>0. 05). Conclusion The rs6667 and rs2011216 loci of the PRSS1 gene may be associated with chronic pancreatitis among southwestern Chinese Han population. [ABSTRACT FROM AUTHOR]

Objective: Interleukin (IL)-17A palys an vital role in various in ammatory diseases such as chronic inflammation and autoimmune diseases including autoimmune pancreatitis, but the role of IL-17A in chronic pancreatitis has not been clarified. This study aimed to study the role of IL-17A in experimental chronic pancreatitis (CP) induced by caerulein in mice. Methods: We firstly examined the expression levels of IL-17A during caerulein-induced CP in vivo in mice by qRT-PCR, Western blotting, ELISA, and immunoreactivity by immunohistochemistry. The effects of IL-17A on pancreatic stellate cells (PSCs) were further investigated in vitro using recombinant IL-17A (rIL-17A). Results: Expression of IL-17RA and IL-17RC mRNAs were remarkably upregulated during CP, IL-17A protein level in pancreatic tissues was increased aftrer stimulation with caerulein, the serum concentration of IL-17A was also significantly elevated in CP mice (56.40± 10.50 pg/L) compared with NC group (27.88± 5.74pg/L). Immunoreactivity of IL-17A was rarely examined in normal pancreatic tissue (8.9± 2.72%), but the positive cells were remarkebly increased in CP mice (55.84± 5.71%), which were mainly localized in interstitial inflammatory cells and tubular complexes. Futhermore, rIL-17A promoted activation of pancreatic stellate cell in vitro, and directly stimulated expression of several profibrotic genes, including IL-6, IL-1茁and TGF-茁in PSCs. Conclusion: IL-17A plays a role in activating PSCs by inducing the expression of Chronic pancreatitis mediators, and probably promote pancreatic fibrosis during experimental chronic pancreatitis. [ABSTRACT FROM AUTHOR]

Objective To investigate the role of purinergic 2X7 receptor (P2X7R) and its downstream target-NLRP3 inflammasome activation in the process of pancreatic fibrosis in a mouse model of chronic pancreatitis (CP). Methods Forty C57BL/6 mice were randomly divided into normal control group, CP group, P2X7R antagonist oxidized ATP (OxATP) group and brilliant blue G (BBG) group. The chronic pancreatitis model was induced by repeated intraperitoneal injection of the cholecystokinin analogue caerulein with the dose of 50 μg/kg for six weeks. Normal saline, OxATP (20 μL, 300 μmol/L) or BBG (20 μL, 10 μmol/L) were administered for CP group, OxATP group and BBG group for two weeks after the last caerulein injection. Then all mice were sacrificed and the histopathological changes of the pancreas, especially the fibrotic degrees were evaluated by HE stain, fibrosis score, Sirius red staining and α-SMA immunohistochemical stain. The pancreatic P2X7R, NLRP3 and Caspase-1 expressions were detected by immunohistochemistry respectively to compare the changes between the groups, and explore the role of P2X7R-NLRP3 signaling pathway in pancreatic fibrosis. Results Compared with the normal control group, the scores of pancreatic fibrosis and the expressions of P2X7R, NLRP3 and Caspase- 1 in pancreas were significantly increased in CP model group (P＜0.05). Compare to CP group, the pancreatic chronic inflammation and the fibrosis indices such as HE fibrosis score, Sirius red staining and α- SMA immunohistochemical stain were ameliorated obviously in OxATP and BBG groups (P＜0.05). And expressions of P2X7R, NLRP3 and Caspase-1 in the pancreas were all reduced greatly in both OxATP and BBG groups (P<0.05). Conclusion P2X7R antagonist OxATP and BBG can significantly decrease pancreatic chronic inflammation and fibrosis in the mouse model of CP, which suggests that the blockade of P2X7R - NLRP3 inflammasome signaling pathway may represent a novel therapeutic strategy for CP and its fibrotic process. [ABSTRACT FROM AUTHOR]

Objective To explore the way for clinical pharmacists to involve in anti-inflammatory treatment of pancreatitis. Methods Pharmaceutical recommendations were put forward through the literature and related guideline review and pharmaceutical care was conducted by clinical pharmacists in this case of anti-infective treatment of severe acute pancreatitis. Results The suggestions provided by pharmacists were adopted, the patient got better and discharged from the hospital. Conclusion Clinical pharmacists could assist doctors to make drug treatment safer and more effective for patients. [ABSTRACT FROM AUTHOR]

Chronic pancreatitis, a chronic progressive inflammatory disease, can cause irreversible damage to pancreatic tissue and pancreatic function. The epidemiology studies show that there is a high prevalence of osteoporosis and fractures in patients with chronic pancreatitis. The pathogenesis of chronic pancreatitis-related osteoporosis may relate to the damage of pancreatic exocrine and endocrine function. Meanwhile, a variety of factors such as smoking, disease severity, duration of disease, etiology, body mass index (BMI), age, and gender can affect the incidence of chronic pancreatitis-related osteoporosis. This paper mainly reviews the correlation between chronic pancreatitis and osteoporosis through epidemiology studies, pathogenesis, and affecting factors, expecting to provide a reference for clinicians. [ABSTRACT FROM AUTHOR]

Objective: To explore the individualized surgical strategies and surgical methods which can greatly improve the efficacy and safety of laparoscopic pancreaticoduodenectomy in difficult and complicated situations, such as pancreatic head malignant tumors invade the major vascular and chronic pancreatitis with severe abdominal adhesions., Methods: Case 1：A 65-year-old man with jaundice was diagnosed preoperatively with a pancreatic acinus process with superior mesenteric vein (SMV) invasion. In order to ensure R0 resection, the patient underwent laparoscopic pancreaticoduodenectomy combined with SMV resection and reconstruction, taking the way of the superior mesenteric artery (SMA)-first approach. The length of SMV removed was 2 cm (see the Video 1 in Supplemental Contents, http://ykxb.scu.edu.cn/article/doi/10.12182/20200760501). The portal vein (PV)-SMV occlusion time was 26 min, the reconstruction time was 17 min. The duration of the surgery was 340 min, with 200 mL of blood loss and no transfusion. Case 2: A 47-year-old man with abdominal pain was admitted with preoperative diagnosis of pancreatic head mass with obstructive jaundice. His past medical history included small bowel resection and bowel anastomosis for abdominal trauma, open Roux-en-Y choledochojejunostomy for acute pancreatitis and obstructive jaundice. In the operation, we used ultracision harmonic scalpel, hook electrode, laparoscopic scissors, and other means to separate the adhesion of different parts of the abdominal, adjusted traditional modular surgical procedure for laparoscopic pancreaticoduodenectomy with Easy First strategy to perform surgical resection (see the Video 2 in Supplemental Contents, http://ykxb.scu.edu.cn/article/doi/10.12182/20200760501). Emergencies such as mass bleeding，used Two Chief Surgeons Model to control bleeding and suture the bleeding site. The duration of the surgery was 400 min, with 500 mL of blood loss and no transfusion., Results: Case 1: The patient's postoperative course was uneventful, with a hospital stay of 9 d. Histology confirmed the diagnosis of a 3.6 cm×2.4 cm×1.8 cm pancreatic ductal adenocarcinoma tumor (R0 and lymph nodes 1/26, AJCC 8th T 2 N 1 M 0 , stage ⅡA). The removed SMV layer was invased and the cut edges were negative. The patient underwent 6 cycles of GS (gemcitabine+tegio) chemotherapy. The patient was asymptomatic 1 year later, with no tumor recurrence and no pancreatic insufficiency. Case 2: The patient's postoperative course was uneventful, with a hospital stay of 11 d. Histology confirmed the diagnosis of a 6 cm pancreatic inflammatory mass. The patient was asymptomatic 20 months later, with no recurrence of acute pancreatitis again., Conclusion: With different surgical methods and individualized surgical strategies, laparoscopic pancreaticoduodenectomy in difficult and complicated situations is safe and feasible in the experienced pancreas minimally invasive center., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)