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Increased postoperative serum amylase has been recently reported to be associated with increased postoperative morbidity, but studies on postoperative serum lipase are limited. The aim of this study was to evaluate the value of postoperative serum lipase in predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD).A retrospective analysis was performed on 212 patients who underwent PD from September 2018 and March 2021, focusing on the association between postoperative day (POD) 1 serum lipase and CR-POPF.Overall, 108 (50.9%) patients had elevated serum lipase levels (68 U/L) on POD 1. Patients with elevated serum lipase exhibited a significantly higher incidence of CR-POPF (37.0% vs. 6.7%, p 0.001). Receiver operating characteristic (ROC) analyses showed improved diagnostic accuracy for POD 1 serum lipase compared with POD 1 serum amylase in predicting CR-POPF (AUC: 0.801 vs. 0.745, p = 0.029). Elevated serum lipase on POD 1 and elevated serum CRP on POD 3 were identified as independent predictors of CR-POPF. A simple early postoperative model, consisting of POD 1 serum lipase levels and POD 3 serum CRP levels, showed good discrimination (AUC 0.76, 95% CI 0.69-0.83) to identify the onset of CR-POPF.Serum lipase on POD 1 outperformed serum amylase on POD 1 in predicting CR-POPF after PD. The combination of POD 1 serum lipase and POD 3 serum CRP provides a reliable predicting model for CR-POPF.

Despite progress in the diagnostics and treatment of hepatocellular carcinoma (HCC), its prognosis remains poor. In this study, we globally assessed long noncoding RNAs (lncRNA) for contributions to HCC using publicly available microarray data, in vitro and in vivo assays. Here, we report that ZFAS1, encoding a lncRNA that is frequently amplified in HCC, is associated with intrahepatic and extrahepatic metastasis and poor prognosis of HCC. ZFAS1 functions as an oncogene in HCC progression by binding miR-150 and abrogating its tumor-suppressive function in this setting. miR-150 repressed HCC cell invasion by inhibiting ZEB1 and the matrix metalloproteinases MMP14 and MMP16. Conversely, ZFAS1 activated ZEB1, MMP14, and MMP16 expression, inhibiting these effects of miR-150. Our results establish a function for ZFAS1 in metastatic progression and suggest its candidacy as a new prognostic biomarker and target for clinical management of HCC. Cancer Res; 75(15); 3181–91. ©2015 AACR.

Supplementary Figure S1. Differentially expressed lncRNAs between HCC tissues and pair non-tumor tissues. Supplementary Figure S2. Co-expression network analysis. Supplementary Figure S3. qPCR analysis of lncRNAs. Supplementary Figure S4. qPCR analysis of miR-150 in HCC. Supplementary Figure S5. qPCR analysis of miR-150. Supplementary Figure S6. ZFAS1 positively regulates ZEB1, MMP14 and MMP16 expression in vivo. Supplementary Table S1. qPCR primers and siRNA sequences used in the study. Supplementary Table S2. Consistently upregulated or downregulated lncRNAs in GSE55191 and GSE58043 (Fold change>4.0, p

In previous studies, it's recommended that the lymph node involvement should be evaluated with enough examined lymph nodes (eLNs) in the 8th American Joint Committee on Cancer (AJCC) staging system for pancreatic cancer. This study aims to put forward a rescue staging system for pancreatic ductal adenocarcinoma (PDAC) patients with inadequate eLNs after pancreatoduodenectomy (PD).11,224 PDAC patients undergoing PD in The Surveillance, Epidemiology, and End Results (SEER) database were included. Another Ruijin Pancreatic Disease Center (RJPDC) database consisted of 821 patients was utilized for external validation.The proportions of patients with eLNs≥15 were 44.7% and 32.8% in SEER and RJPDC database separately. The rescue staging system was put forward relying on LNR (HR = 1.83, 95% CI 1.74-1.92, P 0.001) for N staging of eLNs15 population and pLNs for the rest. The TNM modalities were also rearranged in the rescue system for better survival coordination. The C-index of rescue staging system was 0.638 while that of AJCC 8th staging system was 0.613 in SEER database. Similar phenomena were observed in RJPDC database. Kaplan-Meier analyses revealed reliable internal coherences (SEER: Ib: P = 0.26; IIa: P = 0.063; IIb: P = 0.53; IIIa: P = 0.11.Ib: P = 0.32; IIa: P = 0.66; IIb: P = 0.76; IIIa: P = 0.66) and significant staging efficiency (SEER: P 0.001; RJPDC: P = 0.002).A rescue staging system was put forward regardless of the eLNs number. And the novel system manifested better predictive capacity than 8th AJCC staging system.

Objective Our study examined the association between molecular features and clinical results of pancreatic ductal adenocarcinoma (PDAC) patients, aiming to explore the genomic determinants of the recurrence and prognosis of PDAC after surgical removal. Methods This retrospective study analyzed 181 PDAC patients who received pancreatectomy and adjuvant chemotherapy, with 67 patients in the training set. An internal validation set of 48 patients and an external validation set of 66 patients were used to validate the result. Comprehensive genomic profiling was performed on formalin‐fixed paraffin‐embedded (FFPE) tumor specimens to determine genomic features using the designed cancer‐related gene panel based on next‐generation sequencing (NGS). Results Significant differences were identified between the late recurrence (LR) group and early recurrence (ER) group in tumor copy number instability (CNI) levels. Next, the utility of low CNI (the middle and lowest tertile) with regard to predicting LR was confirmed in the training, internal, and external validation sets. Further univariate and multivariate analyses revealed that CNI was an independent predictive and prognostic biomarker, and had higher predictive accuracy for LR than CA19‐9 level, pathological stage, tumor size, and age. In addition, CNI combined with lymph node (LN) metastasis status could provide a more accurate model for predicting LR of PDAC. Conclusion We discovered and validated the association between CNI and clinical outcome in 181 patients with resectable PDAC, demonstrating the utility of lower tumor CNI levels as biomarkers of postoperative LR and favorable prognosis. Moreover, the combination of CNI and LN metastasis status elevated the predictive accuracy and illuminated strategies for patient stratification., We discovered and validated the association between copy number instability (CNI) and clinical outcome in 181 patients with resectable pancreatic ductal adenocarcinoma (PDAC), demonstrating the utility of lower tumor CNI levels as biomarkers of postoperative late recurrence and favorable prognosis. Moreover, the combination of CNI and lymph node metastasis status elevated the predictive accuracy and illuminated strategies for patient stratification.

Objective: To explore the ultrasonic(US)features of calcified epithelioma Malherbe (CEM) and epidermoid cyst(EC) in differential diagnosis and improve the accuracy of US diagnosis of CEM.Materials and Methods: We retrospectively analyzed 309 subjects, who underwent US examination before operation and pathological diagnosis for CEM or EC post-operation. The subjects were categorized into the training and validation sets according to different inspection times. The US and clinical features of CEM were evaluated through univariate analysis. A multivariate logistic regression model was used to establish the diagnostic model. Results: Statistically significant variables in univariate analysis(PConclusions: The diagnostic accuracy for CEM is higher compared to EC when the nodule is characterized by posterior echo attenuation, hypoechoic halos, smaller thickness, and younger age. US diagnostic model can guide the diagnosis of CEM.

Purpose This study aimed to determine the outcome of pancreatic metastatic renal cell carcinoma (PmRCC) after treatment and share the relevent results. Methods In total, 13 patients with PmRCC were diagnosed and treated in our institution from December 2013 to October 2017. We retrospectively reviewed the records and analyzed the patient demographics, perioperative outcomes, and overall survival. Simultaneously, our experience including treatment and misdiagnosis was shared. Results The median time between nephrectomy and reoperation for pancreatic recurrence was 11 years (range 1–20 years). Four patients had multiple tumors and nine patients had solitary tumor. Five patients accepted distal pancreatectomy, and five patients underwent pancreaticoduodenectomy. One patient underwent total pancreatectomy, one patient underwent duodenum-preserving pancreatic head resection plus distal pancreatectomy, and one patient underwent exploratory laparotomy and gastrointestinal bypass due to widespread metastasis with clear obstructive symptoms. The misdiagnosis rate of preoperative diagnosis at our center was 69.2% (9/13). The median follow-up duration was 26 months (range 7–53 months, until June 2018). By the end of follow-up, 12 patients were alive and one patient died of gastrointestinal bleeding within 1 month after surgery. Conclusions PmRCCs are uncommon, but pancreatic metastasectomy has a relatively good prognosis and may, therefore, be a good therapeutic choice for patients with PmRCCs. Because PmRCC occurs long after the primary tumor resection, long-term follow-up is necessary. Besides, detailed medical history and specific manifestation in imaging features could contribute to avoiding misdiagnosis.

SiC particulate reinforced aluminum metal matrix composites (SiCp/Al MMCs) are characterized by controllable thermal expansion, high thermal conductivity and lightness. These properties, in fact, define the new promotional material in areas and industries such as the aerospace, automotive and electrocommunication industries. However, the poor weldability of this material becomes its key problem for large-scale applications. Sintering bonding technology was developed to join SiCp/Al MMCs. Cu nanoparticles and liquid Ga were employed as self-fluxing filler metal in air under joining temperatures ranging from 400 °C to 500 °C, with soaking time of 2 h and pressure of 3 MPa. The mechanical properties, microstructure and gas tightness of the joint were investigated. The microstructure analysis demonstrated that the joint was achieved by metallurgical bonding at contact interface, and the sintered layer was composed of polycrystals. The distribution of Ga was quite homogenous in both of sintered layer and joint area. The maximum level of joint shear strength of 56.2 MPa has been obtained at bonding temperature of 450 °C. The specimens sintering bonded in temperature range of 440 °C to 460 °C had qualified gas tightness during the service, which can remain 10−10 Pa·m3/s.

Pancreatic adenocarcinoma (PAAD) is one of the most lethal carcinomas all over the world. The current histopathological classifications for PAAD are of limited use to guide clinical decision-making, and there is an unmet need to identify new biomarkers for molecular subtyping. We profiled a comprehensive landscape of genomic alterations for 608 PAAD patients in a Chinese cohort, including somatic mutations, pathogenic germline variants and copy number variations (CNV). Our data provided no evidence of associations with prognosis based on the information of point mutations in either highly mutated genes (such as KRAS, TP53, CDKN2A and SMAD4) or homologous recombination repair genes. Instead, associated with worse prognosis were amplified genes involved in DNA repair and receptor tyrosine kinase related signaling pathways. Motivated by this observation, we categorized patients into four molecular subtypes (namely repair-deficient, proliferation-active, repair-proficient and repair-enhanced) that differed in prognosis. Together with the evidence from genomic footprint analysis, we suggested that repair-deficient and proliferation-active subtypes were better suited for DNA damage therapies, while immunotherapy was highly recommended for repair-proficient and repair-enhanced subtypes. Collectively, our findings represent a significant step in improving diagnosis and management for PAAD patients. Funding Statement: This work was supported by the National Natural Science Foundation of China (grant numbers 81470894, 81502695, 81672325, 81871906, 82073326) and the Shanghai Sailing Program (grant number 20YF1426900). Declaration of Interests: The authors declare no potential conflicts of interest. Ethics Approval Statement: The overall study protocol was approved by the Medical Ethical Committee of Ruijin Hospital and the research was conducted in accordance with relevant ethical guidelines.

Aluminum metal matrix composites with high SiC particle content (SiCp/Al MMCs) was surface metalized with Ti layer by magnetron sputtering technology, and reaction brazing was performed on ...

Metastasis is a key component of cancer progression and is strongly associated with poor prognosis. Perineural invasion is thought to be related to pain, tumor recurrence, and other conditions. However, the exact molecular mechanism is unclear. This study was conducted to identify the key components and signaling pathways involved in the perineural invasion of pancreatic cancer and alterations in the phenotype after the interaction between the dorsal root ganglion (DRG) and pancreatic cancer cells. The results indicated that the p38 mitogen-activated protein kinase signaling pathway was activated after coculture of the DRG and pancreatic cancer cells and lead to the promotion of cell growth and chemoresistance.

BACKGROUND: The significance of surgical resection in the treatment of metastatic pancreatic ductal adenocarcinoma (PDAC) is currently unclear. This study aimed to summarize and clarify the experience of surgical treatment of M1 PDAC in our center and evaluate whether it may offer benefits to some metastatic PDAC patients. METHODS: We analyzed the data of the patients with M1 PDAC who underwent synchronous tumor resection between 2003 and 2014 at Ruijin Hospital. Simultaneously, clinical data for M1 PDAC patients who underwent palliative bypass or exploratory laparotomy only was also collected during the same period as control. Every patient was followed up at least 3 years after hospitalization. The follow-up endpoint was December 31, 2017. RESULTS: A total of 36 patients underwent synchronous tumor resection; of them, 7 received postoperative adjuvant chemotherapy. Their 1-, 2-, and 3-year survival rates were 27.3%, 21.2%, and 7.1%, respectively, and the overall survival was 7.9 months. The overall survival of the palliative bypass and exploratory laparotomy groups was only 4 and 3.7 months, respectively (P

The study aims to verify the hypothesis that up-regulation of microRNA-300 (miR-300) targeting CUL4B promotes apoptosis and suppresses proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of pancreatic cancer cells by regulating the Wnt/β-catenin signaling pathway. Pancreatic cancer tissues and adjacent tissues were collected from 110 pancreatic cancer patients. Expression of miR-300, CUL4B, Wnt, β-catenin, E-cadherin, N-cadherin, Snail, GSK-3β, and CyclinD1 were detected using qRT-PCR and Western blot. CFPAC-1, Capan-1 and PANC-1 were classified into blank, negative control (NC), miR-300 mimics, miR-300 inhibitors, siRNA-CUL4B and miR-300 inhibitors + siRNA-CUL4B groups. The proliferation, migration, invasion abilities, the cell cycle distribution and apoptosis rates were measured in CCK-8 and Transwell assays. Pancreatic cancer tissues showed increased CUL4B expression but decreased miR-300 expression. When miR-300 was lowly expressed, CUL4B was upregulated which in-turn activated the Wnt/β-catenin pathway to protect the β-catenin expression and thus induce EMT. When miR-300 was highly expressed, CUL4B was downregulated which in-turn inhibited the Wnt/β-catenin pathway to prevent EMT. Weakened cell migration and invasion abilities and enhanced apoptosis were observed in the CUL4B group. The miR-300 inhibitors group exhibited an evident increase in growth rate accompanied the largest tumor volume. Smaller tumor volume and slower growth rate were observed in the miR-300 mimics and siRNA-CUL4B group. Our study concludes that lowly expressed miR-300 may contribute to highly expressed CUL4B activating the Wnt/β-catenin signaling pathway and further promoting EMT, thus suppressing proliferation and migration but promoting apoptosis of pancreatic cancer cells. This article is protected by copyright. All rights reserved

// Jiaqiang Zhang 1,2,* , Jiabin Jin 1,* , Shi Chen 1,2,* , Jiangning Gu 1,2 , Yi Zhu 1 , Kai Qin 1 , Qian Zhan 1,2 , Dongfeng Cheng 1 , Hao Chen 1,2 , Xiaxing Deng 1,2 , Baiyong Shen 1,2 and Chenghong Peng 1,2 1 Department of Pancreatic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China 2 Research Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China * These authors have contributed equally to this work Correspondence to: Baiyong Shen, email: // Chenghong Peng, email: // Keywords : PNETs, distal pancreatectomy, robotic surgery, laparoscopic surgery Received : October 20, 2016 Accepted : April 18, 2017 Published : April 28, 2017 Abstract Background: The most effective and radical treatment for pancreatic neuroendocrine tumors (PNETs) is surgical resection. Minimally invasive surgery has been increasingly used in pancreatectomy. Initial results in robotic distal pancreatectomy (RDP) have been encouraging. Nonetheless, data comparing outcomes of RDP with those of laparoscopic distal pancreatectomy (LDP) in treating PNETs are rare. The aim of this study was to compare the safety and efficacy of RDP and LDP for PNETs. Methods: From September 2010 to January 2017, operative parameters and perioperative outcomes in an initial experience with 43 consecutive patients undergoing RDP were collected and compared with those in 31 patients undergoing LDP. Results: Patients undergoing RDP and LDP demonstrated equivalent age, sex, ASA score, tumor location and tumor size. Operating time, length of resected pancreas, postoperative length of hospital stay and rates of conversion to open, pancreatic fistula, transfusion and reoperation were not statistically different. Patients in the RDP group were associated with significantly higher overall (79.1 vs. 48.4 %, P = 0.006) and Kimura spleen preservation rates (72.1 vs. 16.1%, P < 0.001) and had reduced risk of excessive blood loss (50 vs. 200mL, P < 0.001). Oncological outcomes in this series were superior for the RDP group with more lymph node harvest for G2 and G3 PNETs (3.5 vs. 2, P = 0.034). Conclusions: Both RDP and LDP are efficacious and safe methods in treating PNETs located in the body or tail of pancreas. Robotic approach offers advantages with less intraoperative blood loss, higher spleen preservation rate and more lymph node harvest. It may be sensible to choose RDP for patients who fit indications for scheduled spleen preservation.

Background Postoperative acute pancreatitis (POAP) after pancreaticoduodenectomy (PD) has been recently recognized as an independent complication that is associated with undesirable postoperative outcomes and often precedes other complications, yet predictive factors attributable to POAP after PD remain elusive. Methods The data from 1465 consecutive patients who underwent laparotomy or minimally invasive robotic PD from March 2010 to December 2018 were retrospectively reviewed. POAP was defined as an elevation of the serum amylase levels above the institution’s normal upper limit (100 U/L) on postoperative day (POD) 1. Univariate and multivariate analyses were performed to investigate the predictive factors for POAP after PD and the association between POAP and clinically relevant postoperative pancreatic fistulas (CR-POPFs). Results Among the 1465 patients, 411 (28%) underwent minimally invasive robotic surgeries, and the overall POAP and CR-POPFs rates were 770 (53%) and 277 (19%), respectively. The female sex (OR 1.76), a normal bilirubin level (OR 1.55), the robotic surgery (OR 1.36), a main pancreatic duct (MPD) ≤3 mm (OR 5.69) and a high-risk nonadenocarcinoma pathology (cystic disease: OR 4.33; pNETs: OR 4.34; others: OR 2.74) were considered independent risk factors for POAP. A nondilated MPD was a predominant predictor for POAP, with 72.2% sensitivity and 71.8% specificity. POAP was also an independent predictive factor for CR-POPFs (OR 3.48). Conclusion A nondilated MPD, a high-risk pathology, the female sex, a normal bilirubin level and the robotic surgery were independent predictive factors for POAP after PD. Prevention and early treatment strategy changes can be made based on these preoperative predictive factors.

Summary: Background: Robotic surgery is the most advanced minimally invasive technique for the treatment of complicated solid pseudopapillary tumors (SPT). The aim of this study is to evaluate feasibility of robotic surgery for the treatment of SPTs in the pancreatic head. Methods: A retrospective analysis of the clinical data of 83 SPTs in pancreatic head was conducted. Clinical characteristics were extracted and propensity score matching (PSM) was used to compare and evaluate mid-term outcomes of the two techniques. Results: Pancreaticoduodenectomy (PD), duodenum-preserving partial pancreatic head resection (DPPHR-P) and tumor enucleation (En) were performed in 51, 24, and 8 patients, respectively. The robotic approach was associated with a significantly lower volume of blood loss, lower need for transfusion, and faster time to post-surgery recovery. Major complications and costs were comparable for both techniques. Conclusion: A robotic approach provides an alternative to open surgery for SPTs in the pancreatic head without increasing the incidence of clinically relevant pancreatic fistula (CRPF) or other major complications and with good patient outcomes. Keywords: Solid pseudopapillary tumor, Pancreatectomy, Procedure selection, Robotic surgery

This first prospective randomized controlled trial was performed to compare short-term outcomes of robot-assisted laparoscopic middle pancreatectomy (RA-MP) with open middle pancreatectomy (OMP). RA-MP is a novel minimally invasive surgical technique for benign or borderline tumors in the pancreatic neck or body. Its short-term effectiveness and safety remain unknown, compared to OMP. Patients eligible for MP from August 2011 to November 2015 were randomized into the RA-MP or OMP group. The primary endpoint was length of hospital stay (LOS). Secondary endpoints were intraoperative parameters, and postoperative and recovery variables. A total of 100 patients were included into the study to analyze primary and secondary endpoints. Demographic characteristics and pathological parameters were similar in both groups. Furthermore, LOS was significantly shorter (15.6 vs. 21.7 days, P = 0.002), median operative time was reduced (160 vs. 193 min, P = 0.002), median blood loss was lower (50 vs. 200 mL, P

Objectives This study aimed to use a retrospective data base to investigate whether a standard lymphadenectomy during distal pancreatectomy should include the No. 9 lymph nodes (LNs) for resectable pancreatic ductal adenocarcinoma (PDAC) located in the body and tail of the pancreas. Methods Data from 169 patients undergoing curative distal pancreatectomy for PDAC between Jan 1, 2013 and Dec 31, 2016 were collected. According to the tumor location, patients were divided into three groups: pancreatic neck tumor, pancreatic body and tail tumor with margin-to-bifurcation-distance (MTBD) ≤ 2.5 cm and pancreatic body and tail tumor with MTBD > 2.5 cm. The metastatic rate of the No. 9 LNs was compared among the 3 groups. The survival outcomes were analyzed. Results The involvement rate for No. 9 LNs was 20.7% (6/29) for pancreatic neck tumors, 17.6% (15/85) for body and tail tumors with MTBD ≤ 2.5 cm and 1.8% (1/55) for MTBD > 2.5 cm. The No. 9 LNs were significantly more frequently involved in neck or body and tail tumors with MTBD ≤2.5 cm than with the cases with MTBD >2.5 cm (OR 0.082, P = 0.016). No. 9 LN involvement was not associated with worse survival compared with survival associated with involvement of other LNs (P = 0.780). Conclusions For PDAC located in the neck or in the body and tail of the pancreas with MTBD ≤ 2.5 cm, the involvement rate for No. 9 LNs is high. Standard lymphadenectomy should include the No. 9 LNs.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. Despite progress in diagnostics and treatment of HCC, its prognosis remains poor. Emerging studies showed that long noncoding RNAs (lncRNAs) have crucial regulatory roles in cancer biology. In the current study, differentially expressed lncRNAs between HCC and paired non-tumor tissues were identified using microarrays. The effects of a specific differentially expressed lncRNA (termed ZEB1-AS1) on tumor progression were investigated in vitro and in vivo. We found that ZEB1-AS1 is frequently upregulated in HCC samples, especially in metastatic tumor tissues. DNA methylation analysis shows a tumor-specific ZEB1-AS1 promoter hypomethylation. Aberrant methylation is tightly correlated with overexpression of ZEB1-AS1 in HCC. Patients with ZEB1-AS1 hypomethylation or with high ZEB1-AS1 expression have poor recurrence-free survival. Functionally, ZEB1-AS1 promotes tumor growth and metastasis, acts as an oncogene in HCC. The ZEB1-AS1 gene is located in physical contiguity with ZEB1 and positively regulates the ZEB1 expression. ZEB1 inhibition partially abrogates ZEB1-AS1-induced epithelial to mesenchymal transition (EMT) and cancer metastasis. Our results provide novel insights into the function of lncRNA-driven hepatocarcinogenesis, highlight the important role of ZEB1-AS1 and ZEB1 in HCC progression, and indicate that ZEB1-AS1 may be served as a valuable prognostic biomarker for HCC.

Background Pancreatic cancer, one of the top two most fatal cancers, is characterized by a desmoplastic reaction that creates a dense microenvironment, promoting hypoxia and inducing the epithelial-to-mesenchymal transition (EMT) to facilitate invasion and metastasis. Recent evidence indicates that the long noncoding RNA NORAD may be a potential oncogenic gene and that this lncRNA is significantly upregulated during hypoxia. However, the overall biological role and clinical significance of NORAD remains largely unknown. Methods NORAD expression was measured in 33 paired cancerous and noncancerous tissue samples by real-time PCR. The effects of NORAD on pancreatic cancer cells were studied by overexpression and knockdown in vitro. Insights into the mechanism of competitive endogenous RNAs (ceRNAs) were gained from bioinformatics analyses and luciferase assays. In vivo, metastatic potential was identified using an orthotopic model of PDAC and quantified using bioluminescent signals. Alterations in RhoA expression and EMT levels were identified and verified by immunohistochemistry and Western blotting. Results NORAD is highly expressed in pancreatic cancer tissues and upregulated in hypoxic conditions. NORAD upregulation is correlated with shorter overall survival in pancreatic cancer patients. Furthermore, NORAD overexpression promoted the migration and invasion of pancreatic carcinoma cells, while NORAD depletion inhibited EMT and metastasis in vitro and in vivo. In particular, NORAD may function as a ceRNA to regulate the expression of the small GTP binding protein RhoA through competition for hsa-miR-125a-3p, thereby promoting EMT. Conclusions Elevated expression of NORAD in pancreatic cancer tissues is linked to poor prognosis and may confer a malignant phenotype upon tumor cells. NORAD may function as a ceRNA to regulate the expression of the small GTP binding protein RhoA through competition for hsa-miR-125a-3p. This finding may contribute to a better understanding of the role played by lncRNAs in hypoxia-induced EMT and provide a potential novel diagnostic and therapeutic target for pancreatic cancer. Electronic supplementary material The online version of this article (10.1186/s12943-017-0738-0) contains supplementary material, which is available to authorized users.

This experiment chooses 6063 aluminum matrix composites containing 55~75% SiC particle reinforcing phase as the parent metal and Al75Cu20Ti5 foil as the interlayer. The laser power, defocusing amounts and welding speed are discussed using three important parameters for the joint forming, microstructure and shear strength. The result shows that the weld width is mainly affected by laser power, and the weld penetration is almost determined by the defocusing amount. The welding speed has a certain influence on both weld width and weld penetration. When suitable laser heat input is adopted, superior weld appearance and satisfied shear strength could be obtained. The highest shear strength is 217MPa, with the laser power of 520W, the defocusing amounts of -1mm, and the welding speed of 1.5cm/s.

The high-mobility group box 1 (HMGB1) signaling pathway plays a crucial role in tumorigenesis and progression of many malignant cancers. The present study aimed to investigate the expression and clinical significance of HMGB1 in human primary liver cancer, and further explore the molecular mechanisms of HMGB1 in tumor growth and metastasis. Forty cases of human liver cancer and normal liver tissues were collected. The expression of HMGB1 was assessed using RT-PCR and western blot assays in biopsy samples. The HMGB1 pathway in vitro was blocked using transfection of the recombinant small hairpin RNA adenovirus vector rAd5-HMGB1 into the human liver cancer cell line SMMC-7721. The expression of HMGB1, phosphorylated AKT (p-AKT), Ki-67 and matrix metallopeptidase-2 (MMP-2) was detected by Real-PCR and western blot assays. Cell proliferative activities and metastatic capability were determined by MTT and Transwell assays. Cell cycle distribution and apoptosis were detected by flow cytometry. A subcutaneous xenograft tumor model was established, validating the effects of rAd5-HMGB1 on tumor growth in vivo. As a consequence, HMGB1 was found to be highly expressed in liver cancer compared with normal tissues, and was positively associated with pathological grade and distant metastases of liver cancer. Knockdown of HMGB1 downregulated the expression of p-AKT, Ki-67 and MMP-2, inhibited the proliferative activities and metastatic potential of SMMC-7721 cells, induced cell cycle arrest and apoptosis, and slowed the growth of xenograft tumors. Altogether, the expression of HMGB1 is closely correlated with pathological grade and distant metastases of liver cancer, and knockdown of HMGB1 inhibits liver cancer growth and metastasis, suggesting that HMGB1 may be involved in liver cancer development and progression through AKT-mediated regulation of Ki-67 and MMP-2 expression, and represent a potential therapeutic target for this aggressive malignancy.

Objectve To study clinically pathological features and origin of solid-pseudopapillary tumor of pancreas (SPT). Patients and Methods Clinical and pathological data of 82 cases with SPT were retrospectively studied. SAS6.12 statistics package was used for analysis. P

Few comparison studies have been carried out on patients with distal pancreatectomy (DP) combined with celiac axis (CA) resection. The aim of this study was to assess the safety and efficacy of this extended procedure in treatment of advanced carcinoma of the body/tail of the pancreas.This was a retrospective analysis of 206 patients with carcinoma of the body/tail of the pancreas from January 2003 through June 2008. Patients were divided into three groups based on the relationship of tumor and CA/common hepatic artery (CHA) as well as different treatment strategies. Data for operation time, blood loss, complications, and survival time were collected and statistically analyzed.Sixty-five patients (31.6%) received radical distal pancreatectomy (DP), including 11 patients who underwent DP combined with celiac axis resection (group A) and 54 patients who received conventional DP (group B). Twenty patients did not undergo DP because of CA and/or CHA invasion only (group C). Group A had longer mean operative time than group B (323 versus 225 min, P = 0.000); there was no difference in mean estimated blood loss, percentage of pancreatic fistula or median survival time (14 versus 15 months, P = 0.197). However, group A had significantly prolonged median survival time compared with the 20 patients in group C (14 versus 5 months, P = 0.013), and quality of life was also dramatically improved.DP combined with CA resection can be safely performed in certain patients with carcinoma of body/tail of the pancreas and significantly improves patient survival and quality of life.

The differential diagnosis of benign and malignant tongue tumors is crucial to treatment and prognosis. Magnetic resonance imaging (MRI) is the preferred modality for the evaluation of tongue carcinomas. Dynamic contrast-enhanced (DCE)-MRI can reflect the density, integrity, and leakiness of tumor vasculature, and the time-intensity curve (TIC) patterns derived from DCE-MRI results can differentiate benign from malignant tumors based on differences in vascular structure. Diffusion-weighted (DW)-MRI is based on the random thermal motion of water molecules and can provide information on the cellular and tissue microstructure of the tumor. A low apparent diffusion coefficient (ADC) derived from DW-MRIs may indicate a malignant tumor. Thus, ADC values and TIC parameters yield complementary information on tumors that may improve diagnostic accuracy. Indeed, the combination of DCE-MRI and DW-MRI is a comprehensive reflection of the pathological status of the tongue tumor, so utilization of these MRI modalities may facilitate the diagnostic differentiation of benign from malignant tumors of the tongue.

In this research, 6063 aluminum matrix composites containing 55-75% SiC particle reinforcing phase was selected as the parent metal and Al-Cu24-Si5-Zn2-Ti1 alloy metal was selected as the filler metal. After nickel plating of the parent metal, the brazing process is carried out on vacuum brazing furnace under the temperature of 565℃, 570℃ and 575℃ and holding for 10 minutes, 20 minutes and 30 minutes. The interfacial microstructure is investigated by light optical microscopy (LOM), scanning electron microscopy (SEM), and the element diffusion is analyzed by energy spectrum analysis (EDS). The result shows that the nickel plating layer on the surface of parent metal not only metalizes the SiC particle, but also participates in the diffusion process. The element distribution in the brazing seam is described exactly. Finally, the reason why finest crystalline grains and evenest distribution could be achieved under brazing temperature of 575℃ and holding for 30 minutes is analyzed.

Compared without electroless Ni–P alloy coating on the SiCp/Al composites, the paper describes the effect of Ni–P deposited layer on the microstructure evolution, shear strength, airtightness and fracture behavior of vacuum brazed joints. Void free and compact reaction layers along the 6063Al/Ni–P deposited layer/filler metal interfaces indicated that the joints exhibit high airtightness with He-leakage less than [Formula: see text] [Formula: see text]. Energy Dispersive X-ray Spectroscopy (EDS) analysis showed that the reaction layers mainly included brittle Al–Ni and Al–Cu–Ni intermetallics, where fracture occurred in priority and the shear strength was less than 90 MPa. However, without Ni–P alloy coating, sound joints with high shear strength of 100.1 MPa but low airtightness with He-leakage higher than [Formula: see text] were also obtained at 590[Formula: see text]C for soaking time of 30 min. In this case, a few holes that occurred along the filler metal/SiC particle interface significantly decreased the compactness of the joints. Therefore, according to the requirements in practical applications, suitable choice was provided in this research.

We report a case of a 64-year-old man who presented with liquefying panniculitis associated with intraductal papillary mucinous neoplasm (IPMN) after the Whipple operation.

The present case report describes a case of infantile myofibromatosis (IM) with a pseudo-ulcerated plaque on the right side of the back of a fetus, detected in the 38th week of gestation using prenatal ultrasound. The fetus was examined weekly by ultrasound to measure the size of the mass. At birth, the scarlet mass was slightly elevated compared with the skin around it, with a cavity in the center. It appeared similar to an ulcerated plaque, but the surface of the mass was intact and smooth with a stratum lucidum. Thus, the mass was indicated to be a pseudo-ulcerated plaque. Three months later, the mass had grown larger and so was removed by surgery. The pathology of the mass was confirmed as IM. It is suggested that IM should be considered when a soft tissue tumor is presented by prenatal ultrasound.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. Despite progress in diagnostics and treatment of HCC, its prognosis remains poor because the molecular mechanisms underlying hepatocarcinogenesis are not well understood. In the study, we focused on identifying the role of miRNAs in HCC progression. miRNA microarray was used to analyze the differentially expressed miRNAs, and the results were validated by qPCR. We found that the miR-150-5p expression is down-regulated in HCC tissues compared with pair non-tumor tissues. miR-150-5p expression is also decreased in metastatic cancer tissues compared with pair primary tissues, indicating that miR-150-5p may be involved in HCC metastasis. Functionally, miR-150-5p inhibition significantly promotes hepatoma cell migration and invasion, whereas miR-150-5p overexpression suppresses cancer cell migration and invasion in vitro. The matrix metalloproteinase 14 (MMP14) is identified as a new target gene of miR-150-5p. miR-150-5p markedly inhibits MMP14 expression in hepatoma cells, and miR-150-5p expression is negative correlation with MMP14 expression in vivo. More important, re-expression of MMP14 in hepatoma cells partially reverses the effect of miR-150-5p in inhibiting cell invasion.

Background The prevalence of osteoarthritis of the atlanto-odontoid joint has been reported by radiology, autopsy, and conventional computed tomography (CT), but the prevalence has not yet been assessed by multidetector computed tomography (MDCT). Purpose To reveal the prevalence of osteoarthritis of the atlanto-odontoid joint and to analyze the inter-relationships among gender, age, and osteoarthritis with MDCT in adults. Material and Methods First, a series of 700 selected domestic patients aged >18 years undergoing an upper cervical MDCT scan were divided equally into seven age groups. Second, using the postprocessing technique of multiplanar reconstruction, osteoarthritis of the atlanto-odontoid joint was viewed from any direction and classified into four grades, which were normal, mild, moderate, and severe. Lastly, the incidence of the different grades of osteoarthritis was assessed, and the reproducibility was tested. Results There was no significant difference between gender and osteoarthritis of atlanto-odontoid joint ( P > 0.05). The rate of osteoarthritis was 16% in the age group 18–25 years, 23% in the age group 25–30 years, 33% in the age group 30–40 years, 54% in the age group 40–50 years, 70% in the age group 50–60 years, 87% in the age group 60–70 years, and 93% in the age group >70 years. Mild osteoarthritis appeared at the earliest at age 19.6 years, moderate osteoarthritis in at earliest at age 24.2 years, and severe osteoarthritis at the earliest at age 48.5 years. The inter-observer reliability was excellent (k = 0.86). Conclusion Osteoarthritis of the atlanto-odontoid joint could be detected by MDCT in a young adult. It increased rapidly with increasing age on MDCT.

Background Middle-preserving pancreatectomy (MPP) is a parenchyma-sparing surgical procedure which has recently been sporadically reported for the treatment of multicentric periampullary-pancreatic lesions. However, a comprehensive recognition of this procedure has not been clearly elucidated. Case presentation We herein report two patients undergoing MPP due to synchronous multicentric pancreatic neoplasm. Patient one was a 24-year-old woman with a multicentric solid pseudopapillary neoplasm (SPN) and patient two was a 36-year-old woman with a multicentric serous cystic neoplasm (SCN). Simultaneous atypical pancreaticoduodenectomy and atypical left pancreatectomy were performed in patient one; simultaneous standard pancreaticoduodenectomy and atypical left pancreatectomy with spleen preservation were performed in patient two. Approximately 6 cm and 5 cm segments of the middle portion of the pancreas were preserved, respectively. At follow-up at 36 months and 6 months respectively, patient one had developed diabetes and malabsorption requiring dietary control, exercise and pancreatic enzyme supplement whereas patient two showed normal fasting blood glucose without diarrhea. Both patients were disease-free and in good nutritional condition. We reviewed twenty cases of MPP that were previously reported in the literature. Patient characteristics, surgical techniques and short- and long-term outcomes were analyzed. Conclusion MPP is mainly beneficial for multicentric noninvasive periampullary-pancreatic lesions. However, for multicentric periampullary-pancreatic lesions involving even primary invasive cancers, as long as the invasive cancers affect only one side of the pancreas (proximal or distal), MPP could serve as a rational choice in well-selected patients.

[corrected] To study clinically pathological features and origin of solid-pseudopapillary tumor of pancreas (SPT).Clinical and pathological data of 82 cases with SPT were retrospectively studied. SAS6.12 statistics package was used for analysis. P0.05 was regarded as statistically significant difference.The SPT patients included 70 females and 12 males, with a median age of 31 years old. The mean tumor size was 6.71 ± 4.42 cm. Vascular or organs was invaded in nine cases. The clinical and pathological characteristics show no significant difference between male and female patients. In the non-encapsulate group (22 cases), the tumor was larger (P = 0.0015), exogenous growth pattern (P = 0.0194), and would probably involve major vascular or organs (P = 1.697E-06). The typical features of SPT include pseudopapillary pattern with fibro vascular stalks by uniform poorly cohesive polygonal cells. The tumor cell expresses a variety of immune markers in heterogeneity. Under electron microscope, there are some electron dense granules, about 8-1.2 µm in diameter, with membrane similar to the zymogen granules in SPT cell cytoplasm.SPT with incomplete capsule often presents malignant behaviors. SPT shows multi-heterogeneity, which is caused by the disorder in the development of pancreatic stem cell.