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To study the effect of low molecular weight heparin (LMWH) in the treatment of severe acute pancreatitis (SAP). Methods: A total of 265 SAP patients were randomly divided into two groups: firstly, the conventional treatment group (C group, n = 130; and secondly the conventional treatment plus the LMWH treatment group (LT group, n = 135). The clinical parameters, laboratory parameters and computed tomography (CT) score of pancreatic necrosis (CTSPN) in the two groups were compared. Results: On admission, all the clinical parameters, laboratory parameters and CTSPN in the two groups were not significantly different (p > 0.05). However, after treatment, in LT group, the clinical presentation improvement rate and laboratory parameters improvement were significantly higher than those in C group (p < 0.05–0.01), and the acute physiology and chronic health evaluation (APACHE) II score, complication rate, mortality and mean hospital stay in LT group were obviously lower than those in C group (p < 0.05–0.01). The CT score in LT group was much lower than that in C group (p < 0.05). Two weeks after treatment FBI decreased obviously in C group, but not in LT group, and no haemorrhagic complications occurred. Conclusions: LMWH can enhance the effect of conventional treatment for SAP, and can markedly decrease the mortality of SAP. LMWH is a simple, safe, economic and effective method for treatment of SAP. It is can be used in every hospital.

Nowadays, pancreatic cancer (PC) remains the most lethal tumor, partially due to the invasive and treatment‐resistant phenotype induced by the extent of hypoxic stress within the tumor tissue. According to previous studies, miR‐142/HIF‐1α and miR‐133a/EGFR could modulate PC cell proliferation under hypoxic and normoxic conditions, respectively. In the present study, FEZF1‐AS1, a recently described oncogenic long noncoding RNA, was predicted to target both miR‐142 and miR‐133a; thus, we hypothesized that FEZF1‐AS1 might affect PC cell proliferation through these two axes under hypoxic or normoxic conditions. In PC cell lines, FEZF1‐AS1 acted as an oncogene via promoting PC cell proliferation and invasion through miR‐142/HIF‐1α axis under hypoxic condition; however, FEZF1‐AS1 failed to affect the protein levels of HIF‐1α and VEGF under the normoxic condition, suggesting the existence of another signaling pathway under normoxic condition. As predicted by an online tool, FEZF1‐AS1 could target miR‐133a to inhibit its expression; under the normoxic condition, FEZF1‐AS1 exerted its effect on PC cell lines through miR‐133a/EGFR axis. Taken together, FEZF1‐AS1 might be a promising target in controlling the aberrant proliferation and invasion of PC cell lines. [ABSTRACT FROM AUTHOR]

MicroRNAs (miRNAs) represent a class of small non‑coding RNAs regulating gene expression by inducing the degradation of RNA or interfering with translation. Aberrant miRNA expression has been described in several types of cancer in humans. In the present study, it was demonstrated that miR‑145 is downregulated in pancreatic cancer tissues and the Panc‑1 cell line. Restoration of miR‑145 inhibited cell proliferation, invasion and migration in Panc‑1 cells. Neural precursor cell expressed, developmentally down‑regulated 9 (NEDD9) has been identified as a novel potential miR‑145 target using bioinformatics. Using luciferase reporter constructs, it was observed that the NEDD9 3'‑untranslated region is the location of the direct binding site for miR‑145. Additionally, it was identified that miR‑145 is inversely correlated with NEDD9 expression in pancreatic cancer tissues and that restoration of miR‑145 in Panc‑1 cells reduced NEDD9 mRNA and protein expression accompanied by inhibition of cell proliferation, invasion and migration. In conclusion, these findings indicate that miR‑145 may be an effective target for pancreatic cancer therapy.

The majority of patients with pancreatic cancer are resistant to gemcitabine. One of the mechanisms involved is the anti-apoptotic ability of these cells. The median lethal dose (LD50) of gemcitabine for PANC-1 cells was higher than that for Mia PaCa-2 cells and the former had higher nuclear factor-κB (NF-κB) and X-linked inhibitor of apoptosis protein (XIAP) levels. NF-κB contributes to the inhibition of apoptosis by the downregulation of downstream genes, such as XIAP and Bcl-2 and it confers chemoresistance. The two cell lines were infected with NF-κB p65 small interfering RNA (siRNA). p65 protein was effectively downregulated accompanied by the downregulation of XIAP protein. The combination treatment with gemcitabine and p65 siRNA increased the apoptotic rates in both cell lines; however, this was not sufficient. XIAP is involved in apoptosis to a greater extent compated to Bcl-2. XIAP may serve as another factor affecting the sufficiency of chemotherapy. XIAP siRNA was designed to knockdown XIAP. Mia PaCa-2 and PANC-1 cells were co-infected with XIAP siRNA and p65 siRNA. XIAP and p65 proteins were effectively downregulated and the gemcitabine-induced apoptotic rates were significantly increased. These results suggest that XIAP and NF-κB are two important factors conferring the chemoresistance of pancreatic cancer cells, and that their downregulation via RNAi effectively enhances the chemosensitivity of pancreatic cancer cells to gemcitabine.

Aim: To determine whether lentivirus-mediated shRNA targeting the X-linked inhibitor of apoptosis protein (XIAP) gene could be exploited in the treatment of pancreatic cancer., Methods: Human pancreatic cancer cells Panc-1, Mia-paca2, Bxpc-3 and SW1990, infected with lentivirus, were analyzed by real-time polymerase chain reaction (PCR). Western blotting was used to examine XIAP protein levels, survivin and p-Akt to confirm the result of real-time PCR and determine the possible mechanism. The 3-(4,5-cimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to measure IC₅₀ to determine chemosensitivity to the chemotherapeutic drugs 5-fluorouracil (5-FU) and gemcitabine. A colony assay, MTT assay and a tumorigenicity experiment were used to study cell proliferation in vitro and in vivo. Caspase-3/7 activity, 4',6-diamidino-2-phenylindole-staining and flow cytometric measurements were used to study apoptosis in SW1990 cells., Results: XIAP proteins were found to be differentially expressed among pancreatic cancer cell lines Panc-1, Mia-paca2, Bxpc-3 and SW1990. Data of real-time PCR and Western blotting showed that XIAP was reduced persistently and markedly by lentivirus-mediated shRNA. Downregulation of XIAP by transfection with XIAP shRNA resulted in decreased p-Akt expression. XIAP shRNA also inhibited the growth of pancreatic cancer cells in vitro and in vivo, enhanced drug-induced apoptosis and increased chemosensitivity to 5-FU and gemcitabine. Results also suggest that inhibition of XIAP and subsequent p-Akt depletion may have an anti-tumor effect through attenuating the ability of cancer cells to survive., Conclusion: Lentivirus-mediated gene therapy is an attractive strategy in the treatment of pancreatic cancer and justifies the use of lentivirus in pancreatic cancer gene therapy studies.

A review of the literature indicates a higher prevalence of depression and anxiety in patients with pancreatic carcinoma compared with nonclinical populations. The aims of this study were to evaluate the tripartite model for assessing symptoms of depression and anxiety and develop a Chinese version of the Mood and Anxiety Symptoms Questionnaire-Short Form (MASQ-SF) in patients with pancreatic cancer. The final sample consisted of 1,029 patients with pancreatic cancer. In line with our hypothesis, results of confirmatory factor analysis suggest that the three factors identified fit the hypothesized tripartite model well. The Chinese version of the MASQ-SF also exhibited high internal consistency. Reliability of the three scales was excellent with all scores greater than .79. Cronbach's alpha for the total MASQ-SF was .88. The 1-month test-retest reliability was .80. Correlation coefficients among the three subscales ranged from .36 to .75. Thus, the Chinese version of the MASQ-SF exhibited high levels of reliability and validity, indicating that the Chinese version of the MASQ-SF is appropriate for assessing symptoms of depression and anxiety in patients with pancreatic cancer. The use of this instrument may help researchers to better measure depression and anxiety in patients with pancreatic cancer and consequently develop appropriate prevention and treatment interventions.

The aim of this study was to investigate the inhibitor of apoptosis proteins survivin and XIAP in pancreatic cancer by determining their biological characteristics and expression. XIAP and survivin are potential therapeutic targets for pancreatic cancer, and elucidating their association with cell proliferation and apoptosis may lead to the development of novel treatments for this disease. The human pancreatic cancer SW1990 cell line was infected with lentivirus and then analyzed by real-time PCR, and the results were confirmed by Western blotting. The MTT assay and the determination of caspase-3/-7 activity, DAPI-staining and tumorigenicity were used to measure cell proliferation and apoptosis in the human pancreatic cancer SW1990 cell line and in an experimental pancreatic cancer mouse xenograft model inoculated with the lentivirus-transfected SW1990 cells. The results revealed that the XIAP and survivin proteins were differentially expressed among the pancreatic cancer cell lines, and their decreased expression resulted in the inhibition of cell proliferation in vitro as well as in vivo. These findings suggest that lentivirus-mediated gene therapy targeting XIAP and survivin is a potential and attractive strategy for the treatment of pancreatic cancer.

Aim: To study the diagnosis of hepatocellular carcinoma (HCC) presenting as bile duct tumor thrombus with no detectable intrahepatic mass., Methods: Six patients with pathologically proven bile duct HCC thrombi but no intrahepatic mass demonstrated on the preoperative imaging or palpated intrahepatic mass during operative exploration, were collected. Their clinical and imaging data were retrospectively analyzed. The major findings or signs on comprehensive imaging were correlated with the surgical and pathologic findings., Results: Jaundice was the major clinical symptom of the patients. The elevated serum total bilirubin, direct bilirubin and alanine aminotransferase levels were in concordance with obstructive jaundice and the underlying liver disease. Of the 6 patients showing evidence of viral hepatitis, 5 were positive for serum alpha fetoprotein and carbohydrate antigen 19-9, and 1 was positive for serum carcinoembryonic antigen. No patient was correctly diagnosed by ultrasound. The main features of patients on comprehensive imaging were filling defects with cup-shaped ends of the bile duct, with large filling defects presenting as casting moulds in the expanded bile duct, hypervascular intraluminal nodules, debris or blood clots in the bile duct. No obvious circular thickening of the bile duct walls was observed., Conclusion: Even with no detectable intrahepatic tumor, bile duct HCC thrombus should be considered in patients predisposed to HCC, and some imaging signs are indicative of its diagnosis.