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The World Health Organization (WHO) 2017 classifications for neuroendocrine neoplasms (NENs) subdivided grade 3 pancreatic neuroendocrine neoplasms (pNENs) into G3 well-differentiated pancreatic neuroendocrine tumors (G3 pNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (pNECs), according to the mitotic count, Ki-67 index, and cell differentiation. As a new category, G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical practice. Therefore, the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.

The diagnosis of solid pseudopapillary neoplasm of the pancreas (SPN) can be challenging due to potential confusion with other pancreatic neoplasms, particularly pancreatic neuroendocrine tumors (NETs), using current pathological diagnostic markers. We conducted a comprehensive analysis of bulk RNA sequencing data from SPNs, NETs, and normal pancreas, followed by experimental validation. This analysis revealed an increased accumulation of peroxisomes in SPNs. Moreover, we observed significant upregulation of the peroxisome marker ABCD1 in both primary and metastatic SPN samples compared with normal pancreas and NETs. To further investigate the potential utility of ABCD1 as a diagnostic marker for SPN via immunohistochemistry staining, we conducted verification in a large-scale patient cohort with pancreatic tumors, including 127 SPN (111 primary, 16 metastatic samples), 108 NET (98 nonfunctional pancreatic neuroendocrine tumor, NF-NET, and 10 functional pancreatic neuroendocrine tumor, F-NET), 9 acinar cell carcinoma (ACC), 3 pancreatoblastoma (PB), 54 pancreatic ductal adenocarcinoma (PDAC), 20 pancreatic serous cystadenoma (SCA), 19 pancreatic mucinous cystadenoma (MCA), 12 pancreatic ductal intraepithelial neoplasia (PanIN) and 5 intraductal papillary mucinous neoplasm (IPMN) samples. Our results indicate that ABCD1 holds promise as an easily applicable diagnostic marker with exceptional efficacy (AUC=0.999, sensitivity=99.10%, specificity=100%) for differentiating SPN from NET and other pancreatic neoplasms through immunohistochemical staining.

The Howland current source is widely recognized as a high-efficiency voltage-controlled current source (VCCS) because it delivers a precise and stable current with a high output impedance over a wide frequency bandwidth. The dual Howland (DH) is distinguished by a relatively high output impedance in comparison to the enhanced Howland circuit (EH) has therefore the ability to supply higher loads. Nevertheless, at high frequencies, stray capacitances occurring mainly at the input of the operational amplifier and the circuit’s output strongly affect its behavior. The output impedance strongly decreases, especially at frequencies higher than 100 kHz, and the flatness of the output current in dependence on the load is strongly affected. To overcome these challenges, we propose a novel DH current source with load in the loop (DH-LL) completely isolating the load from the ground and maintaining the simplicity of the circuit. A simulation study shows that the output impedance ( $Z_{\mathrm{ out}}$ ) of the DH-LL remains constant independent of the input stray capacitances. The influence of the output stray capacitance on the relative deviation of the output current decreases from 92% in the case of DH to 2.7% in the case of DH-LL. Experimental results show that the DH-LL reaches a frequency bandwidth of up to 5 MHz with a deviation of only 2.32% for a varying load of up to 10 $\text{k}\Omega $ . Thereby, the relative deviation of the current amplitude, e.g., at 1 MHz, decreases from 6.98% for DH to 1.44% for DH-LL.

Various types of minimally invasive pancreatic surgery have been carried out in the last decades with promising outcomes reported by early explorers. Nevertheless, there are still controversies on oncologic outcomes and safety in the use of minimally invasive radical surgery for pancreatic ductal adenocarcinoma (PDAC). This consensus, referring to Chinese expert opinions and worldwide researches, aimed to discuss the related issues on minimally invasive radical surgery for PDAC to ensure the perioperative and oncological outcomes. Quality of evidence and strength of recommendations were evaluated based on the GRADE approach. The 15 recommendations covered 5 topics: oncological outcomes and patient safety of laparoscopic and robotic pancreatoduodenectomy, left-side pancreatectomy for PDAC, learning curve, safety of neoadjuvant therapy, and vascular resection in minimally invasive radical surgery for PDAC. This consensus gives reference and guidance to surgeons on the use of minimally invasive radical surgery for PDAC. Although this consensus is not sufficient to answer all the questions about minimally invasive radical surgery for PDAC, it represents the current consensus on the application of the techniques in the treatment of PDAC on the Chinese mainland.

AbstractFootball in China is undergoing an unprecedented expansion, the result of targeted industrial policy, private sector investment, and the increased popularity of the world’s most popular game in the world’s most populous nation. Yet, as China’s own football infrastructure matures and foreign clubs seek to establish new fanbases there, little is known about Chinese football fans themselves, the ways in which they express their fandom, or the methods by which they consume football. This study aims to take a first step in identifying and exploring football fandom in the People’s Republic of China, with a view to critically understanding the context out of which it has emerged, and its likely trajectory of development in the short-to-medium term. Adopting an inductive approach to survey research to explore the attitudes, behaviours and activities of Chinese football fans, an online survey resulting in 710 usable responses was conducted on a Chinese online survey platform Wenjuanxing(问卷星) for three weeks in March 2018. Our research identifies similarities with fandom found elsewhere in the world, yet with key differences generally characteristic of Chinese football fans resulting from the geography, distance and league structures of China’s domestic football infrastructure. A tendency to support more than one club, often one domestic and one foreign club, is also noted, with distinct methods of consumption which eschew traditional forms such as match attendance.

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Introduction: Radical antegrade modular pancreatosplenectomy (RAMPS) was proposed a decade ago with the aim to achieve higher R0 tangential margin and radical N1 lymph node resection for left-sided pancreatic adenocarcinoma (PDAC), which has been widely accepted worldwide at present. Laparoscopic RAMPS (Lap-RAMPS) has been attempted for PDAC during last several years, however, no outcomes evaluation by comparison between laparoscopic vs open RAMPS has been reported yet. Materials and methods: From August, 2012 to March, 2018, patients undergoing open or lap-RAMPS for the diagnosis of left-sided PDAC were reviewed from a prospective database. Patients excluded if they were related with combined organs or vessels resection, systematic metastasis as well as conversion from open RAMPS to lap RAMPS. The surgical and oncologic outcomes were compared. Results: A total of 48 PDAC patients were enrolled (25 underwent lap-RAMPS and 23 underwent open-RAMPS). There were no significant differences in demographic or perioperative morbidity. In the lap-RAMPS group, R0 transection margin and retroperitoneal margin were both achieved in 23 of 25 patients (92%). In the open RAMPS group, R0 transection margin was achieved in 21 of 23 patients (91.3%), R0 retroperitoneal margin was 22 of 23 patients (95.65%). There were no differences in pathological examinations. The number of lymph node (LN) retrieved between lap-RAMPS and open- RAMPS group was not significant difference (15.84 vs 18.22; P= 0.268). Median disease-free survival (DFS) was analogous in two groups (18.11 m vs 20.00 m, P= 0.999). Median overall survival (OS) was 24.53 m in lap-RAMPS group and 28.73 m in the open-RAMPS group (P= 0.633). Conclusions: Lap-RAMPS is technically feasible, and has comparable long-term oncological outcome with open-RMAPS.

Pancreatic ductal adenocarcinoma (PDAC) has poor prognosis due to limited therapeutic options. This study examines the roles of genome-wide association study identified PDAC-associated genes as therapeutic targets. We have identified HNF4Ggene whose silencing most effectively repressed PDAC cell invasiveness. HNF4Goverexpression is induced by the deficiency of transcriptional factor and tumor suppressor SMAD4. Increased HNF4G are correlated with SMAD4 deficiency in PDAC tumor samples and associated with metastasis and poor survival time in xenograft animal model and in patients with PDAC (log-rank P= 0.036; HR = 1.60, 95% CI = 1.03–2.47). We have found that Metformin suppresses HNF4G activity via AMPK-mediated phosphorylation-coupled ubiquitination degradation and inhibits in vitroinvasion and in vivometastasis of PDAC cells with SMAD4 deficiency. Furthermore, Metformin treatment significantly improve clinical outcomes and survival in patients with SMAD4-deficient PDAC (log-rank P= 0.022; HR = 0.31, 95% CI = 0.14–0.68) but not in patients with SMAD4-normal PDAC. Pathway analysis shows that HNF4G may act in PDAC through the cell-cell junction pathway. These results indicate that SMAD4 deficiency-induced overexpression of HNF4G plays a critical oncogenic role in PDAC progression and metastasis but may form a druggable target for Metformin treatment.

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Different evidence has indicated metabolic rewiring as a necessity for pancreatic cancer (PC) growth, invasion, and chemotherapy resistance. A relevant role has been assigned to glucose metabolism. In particular, an enhanced flux through the Hexosamine Biosynthetic Pathway (HBP) has been tightly linked to PC development. Here, we show that enhancement of the HBP, through the upregulation of the enzyme Phosphoacetylglucosamine Mutase 3 (PGM3), is associated with the onset of gemcitabine (GEM) resistance in PC. Indeed, mRNA profiles of GEM sensitive and resistant patient-derived tumor xenografts (PDXs) indicate that PGM3 expression is specifically increased in GEM-resistant PDXs. Of note, PGM3 results also overexpressed in human PC tissues as compared to paired adjacent normal tissues and its higher expression in PC patients is associated with worse median overall survival (OS). Strikingly, genetic or pharmacological PGM3 inhibition reduces PC cell growth, migration, invasion, in vivo tumor growth and enhances GEM sensitivity. Thus, combined treatment between a specific inhibitor of PGM3, named FR054, and GEM results in a potent reduction of xenograft tumor growth without any obvious side effects in normal tissues. Mechanistically, PGM3 inhibition, reducing protein glycosylation, causes a sustained Unfolded Protein Response (UPR), a significant attenuation of the pro-tumorigenic Epidermal Growth Factor Receptor (EGFR)-Akt axis, and finally cell death. In conclusion this study identifies the HBP as a metabolic pathway involved in GEM resistance and provides a strong rationale for a PC therapy addressing the combined treatment with the PGM3 inhibitor and GEM.

The emergence and convergence of social, mobile and locative technologies have inspired scholars to develop the concept of ‘SoMoLo’ to study the changing forms of journalism and activism in this new context. This study therefore attempts to further develop this concept, rejuvenating the older ‘media and movement’ tradition and especially the ‘journalism and activism’ relationship to explore how and why SoMoLo journalism coexists interdependentlywith SoMoLo activism. Based on the research methods of virtual ethnography and interviews, we used Macau netizens’ digital practices as case studies to explain how SoMoLo journalism led to SoMoLo activism and its implications for Macau. We believe that this type of ‘local knowledge’ for Macau may reveal possible particularities and diversities of journalism and activism that may be valuable in a global context.

FDG PET/CT and PET/MRI were performed to evaluate a cystic lesion in the body of the pancreas in a 65-year-old man. Neither studies showed abnormally increased activity in the cystic lesion in the body of the pancreas. However, both studies revealed abnormal activity in the neck of the pancreas, which did not show anatomical abnormality and was not suspected prior to the PET imaging. Pathological examination demonstrated that the lesion in the body of the pancreas was a benign duct dilation, whereas the abnormal FDG activity in the neck of the pancreas was due to pancreatic adenocarcinoma.

ABSTRACTCircular RNAs (circRNAs) are a recently identified class of non-coding RNAs that participate in multiple biological processes and tumour progression. However, circRNA expression pattern in parathyroid neoplasms remains unknown. The circRNA profile of 6 parathyroid carcinomas (PCs), 6 parathyroid adenomas (PAs) and 4 normal parathyroid tissues was assessed by a microarray. Bioinformatic analyses were performed to investigate potential core circRNAs via co-expression network. CircRNA and corresponding mRNA expression were validated in a cohort of parathyroid neoplasms by RT-qPCR and fluorescence in situ hybridization (FISH). Compared to normal parathyroid, 5310 and 1055 circRNAs were differentially expressed in PC and PA tissues, respectively. The differential expression of 4 circRNAs (hsa_circRNA_0035563 (p = 0.006), hsa_circRNA_0017545 (p = 0.009), hsa_circRNA_0001687 (p = 0.005) and hsa_circRNA_0075005 (p = 0.001)) and 4 mRNAs (MYC, FSCN1, ANXA2 and AKR1C3) between PC and PA tissues were confirmed by RT-qPCR. In addition, high expression of hsa_circ_0035563 was related to CDC73mutations (p = 0.022) and recurrence in PC patients (p = 0.042). Furthermore, hsa_circ_0075005 helped distinguish PCs from benign lesions using FISH, and the area under the curve was 0.779 (p = 0.013). Our findings describe the circRNA profile of PC for the first time and suggest that circRNAs and mRNAs interact in parathyroid tumourigenesis. This study demonstrates that hsa_circ_0075005 and MYC mRNA may be used for the differential diagnosis of PC and PA. The expression levels of hsa_circ_0035563 are related to CDC73mutations and recurrence in malignancy, highlighting the significance of this parameter in prognosis of PC patients.

Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer featured with high intra-tumoral heterogeneity and poor prognosis. To comprehensively delineate the PDAC intra-tumoral heterogeneity and the underlying mechanism for PDAC progression, we employed single-cell RNA-seq (scRNA-seq) to acquire the transcriptomic atlas of 57,530 individual pancreatic cells from primary PDAC tumors and control pancreases, and identified diverse malignant and stromal cell types, including two ductal subtypes with abnormal and malignant gene expression profiles respectively, in PDAC. We found that the heterogenous malignant subtype was composed of several subpopulations with differential proliferative and migratory potentials. Cell trajectory analysis revealed that components of multiple tumor-related pathways and transcription factors (TFs) were differentially expressed along PDAC progression. Furthermore, we found a subset of ductal cells with unique proliferative features were associated with an inactivation state in tumor-infiltrating T cells, providing novel markers for the prediction of antitumor immune response. Together, our findings provide a valuable resource for deciphering the intra-tumoral heterogeneity in PDAC and uncover a connection between tumor intrinsic transcriptional state and T cell activation, suggesting potential biomarkers for anticancer treatment such as targeted therapy and immunotherapy.

Long-standing hypoglycemia can cause cognitive impairment, and whether recurrent severe hypoglycemia impacts cognitive function in patients with insulinoma has not been studied. This study focused on exploring the cognitive function in patients with insulinoma. A prospective study was conducted to assess cognitive function in patients with insulinoma by administering the Montreal Cognitive Assessment (MoCA) questionnaire between January 2016 and July 2017, and patients with cognitive impairment were followed up to undergo the MoCA test 1 year after surgery. The MoCA scores after surgery were compared with the scores before surgery, and the associations between cognitive impairment and relevant factors were further evaluated by multiple linear regression analysis. Eighteen out of thirty-four patients (53%) with insulinoma were screened positive for cognitive impairment as defined by a MoCA score <26. Performance in certain cognitive domains, including visuospatial and executive functions, delayed memory, attention, language, and abstraction, was significantly worse in patients with cognitive impairment. Multivariate analysis indicated that MoCA scores correlated significantly with tumor grade and years of education. Eight patients with cognitive impairment were lost to follow-up. The remaining ten patients with cognitive impairment showed improvements 1 year postoperatively, and seven patients recovered to normal cognitive function. Cognitive impairment was found in patients with insulinoma and was reversible in some patients 1 year after surgery. More studies are needed to explore the underlying mechanisms of the existence and reversibility of cognitive impairment in patients with insulinoma.

Pancreatic cancer is one of the most lethal human malignancies, partly because of its propensity for metastasis. However, highly metastatic human pancreatic cancer cell lines suitable for studies of metastasis are currently lacking. Here we established two highly metastatic human pancreatic cancer cell lines, MIA PaCa-2 In8 and Panc-1 In8, by Matrigel induction assay. The cell lines were further characterized both in vitroand in vivo. MIA PaCa-2 In8 and Panc-1 In8 cells demonstrated increased migration and invasion compared with their respective parental cells. Following injection into nude mice, MIA PaCa-2 In8 and Panc-1 In8 cells resulted in more pulmonary metastases compared with the parental cells. Furthermore, analyses of mRNA, long non-coding RNA, micro RNA, and methylation profiling revealed that these factors were aberrantly regulated in the highly metastatic cells, indicating that they probably affected metastasis. We thus established and characterized two highly metastatic human pancreatic cell lines that could be used as valuable tools for future investigations into the pathogenesis, metastasis, and potential treatment of human pancreatic cancer.

The high-throughput sequencing at single-cell resolution requires high-quality samples of inputted 100–10,000 cells with at least 80%–90% viability according to the applied platform. Here, we present a protocol for single-cell isolation from normal and neoplastic human pancreas. We describe steps for sample harvesting, procurement, tissue digestion, and cell purification. Subsequently, isolated cells can be further applied to single-cell profiling, for example, single-cell RNA sequencing and single-cell ATAC-seq using 10× Genomics platform.

Objective Intraductal papillary neoplasm of the bile duct (IPNB) has been increasingly recognized and reported. However, its clinical features are still controversial because of its low incidence. In the present study, we investigated the characteristics of IPNB.Methods In total, 28 patients with IPNB were treated at our institution from January 2000 to December 2016. Clinical data were collected and a retrospective accurate database was constructed. Demographic characteristics, perioperative management, and prognosis were retrospectively analyzed.Results Abdominal discomfort was the most common symptom. Preoperative imaging revealed biliary tract dilatation in 23 patients. Left lateral or left hepatic lobectomy was the most frequently performed surgical procedure. Histological analysis revealed malignancy in 17 patients. Eighty-eight lymph nodes were swept from the patients with malignant disease, but only three were metastatic. Twenty-one patients were followed up for 3 to 60 months (mean, 29.4 ± 18.2 months). Seven patients died during the follow-up period. Patients with benign tumors had significantly greater disease-free survival.Conclusions IPNB is a rare biliary disease that occurs mainly in patients of advanced age. The most common symptom is abdominal discomfort. Lymphatic metastasis is uncommon. Patients with benign tumors may have a better prognosis than those with malignant tumors.

Parathyroid carcinoma (PCa) is a rare endocrine malignancy with poor prognosis and is often difficult to accurately diagnose both before and after surgery. Dysregulated microRNA (miRNA) levels have been identified in PCa using a limited number of samples. The aim of the present study was to verify a group of miRNA markers in a new series of samples to explore their potential significance in PCa diagnosis. A total of 58 tissue samples, including 17 PCa lesions and 41 sporadic parathyroid adenomas (PAds), were obtained from 56 primary hyperparathyroidism (pHPT) patients. Candidate miRNAs (miR-139-5p, miR-155-5p, miR-222-3p, miR-26b-5p, miR-296-5p, miR-30b-5p, miR-372-3p, miR-503-5p, miR-517c-3p, miR-7-5p, and miR-126-5p) were quantified by TaqMan real-time quantitative PCR assays. Up-regulated miR-222 (p= 0.041) levels and down-regulated miR-139 (p= 0.003), miR-30b (p< 0.001), miR-517c (p= 0.038), and miR-126* (p= 0.002) levels were found in PCa relative to PAd. Binary logistic regression analysis showed that miR-139 and miR-30b were the best diagnostic markers. The combination of miR-139 and miR-30b yielded an area under the receiver operating characteristic curve of 0.888. Additionally, serum calcium (rs= −0.518, p< 0.001), intact parathyroid hormone (iPTH) (rs= −0.495, p< 0.001), and alkaline phosphatase (ALP) (rs= −0.523, p< 0.001) levels were negatively correlated with miR-30b levels. miR-139, miR-222, miR-30b, miR-517c, and miR-126* were differentially expressed between PCa and PAd. The combined analysis of miR-139 and miR-30b may be used as a potential diagnostic strategy for distinguishing PCa from PAd.

DNA modifications such as 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) are epigenetic marks known to affect global gene expression in mammals. Given their prevalence in the human genome, close correlation with gene expression and high chemical stability, these DNA epigenetic marks could serve as ideal biomarkers for cancer diagnosis. Taking advantage of a highly sensitive and selective chemical labeling technology, we report here the genome-wide profiling of 5hmC in circulating cell-free DNA (cfDNA) and in genomic DNA (gDNA) of paired tumor and adjacent tissues collected from a cohort of 260 patients recently diagnosed with colorectal, gastric, pancreatic, liver or thyroid cancer and normal tissues from 90 healthy individuals. 5hmC was mainly distributed in transcriptionally active regions coincident with open chromatin and permissive histone modifications. Robust cancer-associated 5hmC signatures were identified in cfDNA that were characteristic for specific cancer types. 5hmC-based biomarkers of circulating cfDNA were highly predictive of colorectal and gastric cancers and were superior to conventional biomarkers and comparable to 5hmC biomarkers from tissue biopsies. Thus, this new strategy could lead to the development of effective, minimally invasive methods for diagnosis and prognosis of cancer from the analyses of blood samples.

It is a challenge to distinguish parathyroid carcinoma (PTCA) from benign parathyroid lesions without recurrence or metastasis. Parafibromin immunohistochemical (IHC) staining had been described for the diagnosis of PTCA. But great variations existed in the reported sensitivity and specificity among different studies. We conducted a meta-analysis to summarize the diagnostic accuracy of parafibromin staining for PTCA. Published studies from Pubmed, Embase, and Cochrane Library were searched using the combination of terms “parafibromin,” “CDC73,” “HRPT2,” and “parathyroid.” Pooled sensitivity and specificity with 95 % confidence interval (CI) were calculated and the summary receiver operator characteristic (SROC) curves were constructed. The heterogeneity among included studies was evaluated and possible reasons were explored by meta-regression. A total of 10 studies including 202 patients with PTCA were finally enrolled in this meta-analysis. For parafibromin staining, sensitivity varied from 29 to 100 % (pooled estimate of 68 %; 95 % CI 49–82 %) and specificity ranged from 61 to 100 % (pooled estimate of 95 %; 95 % CI 85–98 %). The AUC for parafibromin staining was 0.91 (95 % CI 0.88–0.93). A significant heterogeneity was observed among included studies. According to meta-regression analysis, the scoring criteria and parafibromin antibody used in IHC were the covariates influencing the sensitivity. And the specificity decreased if atypical parathyroid adenomas were included in the control groups. The specificity of parafibromin staining was satisfactory for diagnosis of PTCA, while the sensitivity was limited. We suggested that a standardized IHC protocol and scoring system criteria should be applied in future studies to improve the diagnostic performance of parafibromin staining.

We report an enantio- and diastereodivergent synthesis of enantioenriched fluorenes bearing bis-1,3-nonadjacent stereocenters with broad substrate scope and high enantioselectivity (up to 99% ee) under low catalyst loading (0.1 mol %). The key to the success of this method is the pseudo-diastereodivergent desymmetrization of stereoisomers of meso-epoxides enabled by the same organocatalyst. Furthermore, some of the chiral fluorenes obtained exhibit high fluorescence quantum yields (up to 76.6%), as evidenced by photophysical properties studies.

A strong solid acid, tungstated zirconia (WZ), has been prepared first using tungstate immobilized UiO-66 as precursors through a “double-solvent” impregnation method under mild calcination temperature. With moderate W contents, the as-synthesized WZ catalysts possess a high density of acid sites, and the proper heat treatment also has facilely led to a bunch of oligomeric tungsten clusters on stabilized tetragonal ZrO2. The resultant solid acids show an improved catalytic performance toward the benzaldehyde’s acetalization in comparison with traditional zirconium hydroxide-prepared WZ. Notably, due to large surface area and additionally introduced strong acid sites, the MOF-derived WZ catalysts afforded conversion up to 86.0%. The facile method endows the WZ catalysts with superior catalytic activities and excellent recyclability, thus opening a new avenue for preparation of metal oxide-based solid superacids and superbases.

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Oncolytic virotherapy is an attractive approach that uses live viruses to selectively kill cancer cells. Oncolytic viruses can be genetically engineered to induce cell lyses through virus replication and cytotoxic protein expression. Herpes simplex virus (HSV) has become one of the most widely clinically used oncolytic agent. Various types of HSV have been studied in basic or clinical research. Combining oncolytic virotherapy with chemotherapy or radiotherapy generally produces synergic action with unclear molecular mechanisms. Arming HSV with therapeutic transgenes is a promising strategy and can be used to complement conventional therapies. As an efficient gene delivery system, HSV has been successfully used to deliver various immunomodulatory molecules. Arming HSV with therapeutic genes merits further investigation for potential clinical application.

Catechol-O-methyl transferase (COMT) is an enzyme involved in estrogen metabolism. Proteomic and immunoproteomic screens suggested COMT might be an immunogenic membrane antigen in human pancreatic cancer. The aim of this study was to investigate the dynamic expression of COMT in pancreatic ductal adenocarcinoma (PDAC) and noncancerous pancreatic tissue, and to determine the relationship between COMT expression and clinicopathologic parameters. COMT expression was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) and western blot in five pancreatic cell lines and five pairs of PDAC and noncancerous pancreatic tissue. Immunohistochemistry was used to evaluate COMT expression in tissue microarrays and 20 cases of paraffin-embedded clinical specimens. The results indicated that COMT expression was detected in AsPC-1, BxPC-3, MIA PaCa-2, Capan-1 and SW1990 pancreatic cell lines, and in five pairs of PDAC and noncancerous pancreatic tissue, at the mRNA and protein levels. Immunohistochemistry analysis revealed that COMT expression was significantly higher in PDAC than in nonmalignant pancreatic tissue. High expression of COMT significantly correlated to early T stages. Therefore, we conclude that COMT might serve as a potential biomarker for applied clinical pathology in PDAC.

To investigate the clinical feature and treatment strategy of primary pancreatic lymphoma.

Abstract: Objective: To investigate the diagnosis and treatment of gastric stromal tumors (GSTs). Methods: The clinical data from 70 cases with GSTs were analyzed retrospectively. Results: Wedge resections were performed on 32 patients and major gastrectomies on 38 patients. The median tumor size was 5.4cm in diameter and 2 out of 70 cases (2.9% ) indicated positive lymph node metastasis. Immunohistochemical staining showed 66 out of 70 (94.3%) were positive for CD117, 53 (75.7%) positive for CD34, 24 positive for SMA and 8 positive for Desmin and S100. Ten out of 70 cases recurred or metastasized. The 5-year survival rate in this series was 71.3%. The 5-year survival rate of benign and malignant GSTs were 92.3% and 61.8% (P<0.05) respectively. The 5-year survival rate for tumors of size <5 cm and ≥5 cm were 95.0% and 48.4% (P< 0.05), respectively. Conclusion: The primary treatment for gastric stromal tumors is surgery. Tumor size and mitotic counts were observed to be important prognostic indicators.

Objective Postpancreatectomy hemorrhage is a life-threatening complication. Hemorrhage occurring >24 hours after the index operation is defined as late hemorrhage. This study was performed to analyze the therapeutic management and prognostic factors of late hemorrhage after pancreatectomy.Methods We identified 87 patients with late hemorrhage among 2031 patients who underwent pancreatic surgery from January 2013 to December 2017. The patients’ demographic characteristics, perioperative treatment, hemorrhage details, and prognosis were retrospectively analyzed.Results Of the 87 patients, 53 were men. Bleeding occurred at a mean of 8.9 ± 6.0 days postoperatively. Extraluminal and intraluminal hemorrhage occurred in 58 and 29 patients, respectively. The primary intervention was successful in 66 patients, and 16 patients required a secondary intervention. The primary and total recovery rates were 72.4% and 89.7%, respectively. Of the 87 patients, 9 died. Male sex, hemorrhage on a later postoperative day, a significantly decreased hemoglobin level, and pancreatic fistula showed statistical significance as possible risk factors for mortality.Conclusions Male sex, hemorrhage on a later postoperative day, a significantly decreased hemoglobin level, and pancreatic fistula are possible risk factors for mortality in patients with late hemorrhage after pancreatectomy. Hemorrhage is a dynamic process, and a secondary intervention may be necessary.

The novel coronavirus SARS-CoV-2 and the disease caused by it, COVID-19, have spread to virtually all countries worldwide within just a few months. The economic and sanitary impact has been enormous. In March 2020, the World Health Organization declared COVID-19 a pandemic. How to effectively prevent and control SARS-CoV-2 transmission while providing care to surgical patients during the pandemic is a crucial topic. In order to minimize the risk of cross-infection between patients and physicians, many hospitals have taken measures to limit outpatient services, elective hospitalizations, and the number of operations. Based on the prevention and control measures stipulated by major medical institutions in China, this overview provides recommendations for surgeons from three aspects: outpatient treatment, ward management and perioperative protection. Telemedicine should be encouraged as a means of social distancing. Outpatient examination should be selected. Reasonable spatial arrangement and effective environmental disinfection are important for ward management. Patient selection for surgery and timing of operations should be carefully discussed within multi-disciplinary teams. Appropriate personal protective equipment should be worn adapted to the situational risk.

A 57-year-old man underwent FDG PET/CT to evaluate a mass in the head of the pancreas. The imaged revealed mildly, nonuniformly increased activity in the mass, but the exact location of the activity could not be determined on the low-dose noncontrast CT portion of the study. On subsequent PET/MRI images acquired 60 minutes after the FDG PET/CT study, the increased activity was clearly localized on the cystic wall. The pathological examination showed that the lesion was intraductal papillary mucinous neoplasm of the pancreas with high degree of dysplasia.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

In the initial published version of this article, there was a mistake in the Pvalue for the correlation between gene-expression changes and 5 hmC changes in tumors. The correct Pvalue should be same as the Pvalue shown in Fig. S6A: 9.8?×?10-6(mistakenly shown as “9.8?×?106” in the main text). This correction does not affect the description of results or the conclusions of this study, since the range of Pvalue is between 0 and 1.