Midtgaardfiltenborg7011

Kaplan-Meier survival curve was used to assessed the influence of dyslipidemia on prognosis of pancreatic cancer patients. Results In 265 pancreatic cancer patients,115(43.4%)of them had dyslipidemias,and the most common form was increase of triglyceride(TG)(72.2%). Genipin order In pancreatic cancer with dyslipidemias group,patients with body mass index ≥25 kg/m2 had higher proportion than normal lipid group(36.1%(26/72) vs. 21.2%(21/99),χ²=4.643,P=0.031); The proportion of carcinoma located at head of pancreas(83.5%(96/115) vs. 40.7%(61/150),χ²=49.412,P0.05). Conclusions In pancreatic cancer patients,TG disorder was the most common type of dyslipidemia. Dyslipidemia has closely association with clinicopathologic features,including tumor location,body mass index,tumor stage. However,dyslipidemia had little effect on prognosis of pancreatic cancer patients.Objective To investigate the safety and feasibility of minimally invasive pancreatic tumor enucleation. Methods The clinicopathological data of 60 patients with minimally invasive pancreatic tumor enucleation admitted to the Department of Pancreatic Surgery of Fudan University Cancer Center from November 2019 to August 2021 were retrospectively analyzed. There were 17 males and 43 females,with age of (50.0±13.2)years(range 23 to 73 years). Tumors were located in the head of pancreas in 40 cases(66.7%),neck and tail of pancreas in 20 cases(33.3%). Patients were divided into robotic group(n=25) and laparoscopic group(n=35) according to surgical methods. The measurement data were compared by t-test or Mann-Whitney U test, and the categorical data were compared by χ2 test or Fisher exact probability method. The influencing factors of postoperative pancreatic fistula were analyzed by univariate and multivariate Logistic regression. Results All patients successfully completed tumor enucleation without conversion toperative pancreatic duct repair(OR=7.889,95%CI1.471 to 42.296,P=0.016) were independent risk factors,whereas robotic surgery(OR=0.168,95%CI0.036 to 0.796,P=0.025) was a protective factor. No case of pancreatin dependent dyspepsia and new onset diabetes mellitus was observed. Conclusions Minimally invasive tumor enucleation is feasible in the treatment of benign and low-grade pancreatic tumors. The incidence of pancreatic fistula is high in the short term after operation,but serious complications are rare. The robot assisted system can reduce the risk of postoperative pancreatic fistula and has more advantages in dealing with larger diameter tumors because of clearer surgical vision and more accurate operation.Objectives To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer. Methods The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univoward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months,P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%,P0.05). Conclusions The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients' compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.Infected pancreatic necrosis (IPN) is a crucial reason for the poor prognosis of patients with acute pancreatitis,which is complicated and difficult to predict the outcomes. Surgery is an important way to cure IPN,and "step-up approach" is the mainstream mode of IPN treatment. In the era of minimally invasive surgery,the full course endoscopic treatment of IPN has been gradually hot and achieved good outcomes as endoscopic technology' improvement. However,it is controversial that whether technique is better for IPN by surgery debridement or endoscopy drainage,and there is no consensus on the scope of applicability and the timing of intervention. The paper aims to explore the intervention methods,indications and timing of endoscopic and surgical treatment of IPN and elaborate the selection strategies of them in clinical practice,so as to develop individualized treatment options,accurately implement minimally invasive intervention and improve the prognosis.Recently,with growing numbers of pancreatectomy and continuous improvement of comprehensive treatment,more patients have survived surgery of benign or malignant pancreatic tumors. As a result, pancreatic surgeons meet more long-term complications after pancreatic surgery. For many years,there is no uniform definition, diagnosis or therapeutic standard for long-term complications after pancreatic surgery. Such unsatisfactory situation has an indirectly negative impact on the life quality of patients as well as development of clinical research. By reviewing literature,the definition,diagnostic criteria and treatment strategies of some common long-term complications after pancreatic surgery were analyzed, including bilioenteric anastomotic stricture, pancreatic exocrine or endocrine insufficiency,and pancreatico-digestive tract anastomotic stricture,in order to improve the treatment effect of long-term complications and life quality of these patients.With the gradual spread of laparoscopic and robotic technology, pancreatic surgery is developing toward reducing complications and preserving more pancreatic functions. The main pancreatic duct is an important outflow channel for pancreatic exocrine fluid, and precise management of the main pancreatic duct can effectively reduce the occurrence of postoperative pancreatic complications. This paper focuses on the difficulties of pancreatic-intestinal anastomosis, distal pancreatic resection, the relationship between the pancreatic pseudocyst and main pancreatic duct, and partial pancreatic resection, and introduces how to properly manage the main pancreatic duct in common pancreatic procedures under laparoscopic and robotic techniques. Besides, the "mucosa-to-mucosa six-stitch method" for mid-pancreatic resection and end-to-end anastomosis has been proposed, which can achieve the best surgical results with minimally invasive technology and benefit more patients.With the progress of imaging technology and the popularization of healthy examination, the detection rate of pancreatic cystic neoplasm(PCN) has increased significantly. PCN has complex disease spectrum, strong heterogeneity, and diverse surgical treatment strategies. Surgical timing and methods directly affect patients' prognosis. Therefore, how to identify malignant tumors and formulate reasonable treatment strategies are the keys to treat PCN. Many guidelines for clinical diagnosis and treatment of PCN have been released, but there are still many disputes about its surgical indications. Hence, fully assessing the surgical indications is of great significance to improve the PCN patients' prognosis. This paper deeply discusses on the surgical indications of PCN by reviewing the current clinical diagnosis, treatment and research progress of PCN, in order to standardize the diagnosis and treatment of PCN.Anatomical resectability criteria based on radiologic findings for pancreatic ductal adenocarcinoma has been the main or even the only criterion in practice for a long time. The anatomical criteria has played a very positive role in standardizing surgical indication and restricting medical behavior. However,in the current era of systematic treatment,the limitations of anatomical criteria are becoming increasingly prominent. Although the biological criteria which can be used to evaluate the resectability of pancreatic cancer is still very limited,the comprehensive benefit of CA19-9,PET-CT,neoadjuvant therapy,gene detection and so on can still provide a reference for the evaluation of the resectability of pancreatic cancer. At present,the evaluation of resectability of pancreatic cancer should still adhere to the basic principle of taking anatomical criteria as the basis,biological criteria as the guide,and improving the prognosis of patients as the goal.Objective To understand the actual situation of the implementation of "Diagnosis and therapy guideline of preterm birth（2014）", "Guideline" for short, by front-line obstetricians, and to provide reference for the further update and supplement of the "Guideline". Methods This study designed a structured questionnaire for the prominent problems in the prevention and treatment of preterm birth, which was determined by the expert team drafting the "Guideline". In October to November 2021, a cross-sectional survey was conducted among obstetricians, including members of the Perinatal Medicine Branch of Jiangsu Medical Association and the Obstetrics Subgroup,Chinese society of Obstetrics and Gynecology, Chinese Medical Association, on the implementation status of the "Guideline". The recommendations of the "Guideline" were used as standard answers to determine the implementation rate. A total of 328 valid questionnaires were collected. The total score of the questionnaire was 12 points. The questionnaire was dividedertiary hospitals (OR=0.42, 95%CI 0.23-0.77; P=0.005). Senior titles had higher scores and better execution than junior titles (OR=5.33, 95%CI 2.35-12.07; P less then 0.001). When answering the question "gestational week at which premature infants could survive in your hospital", only 3.4% (11/328) answered 22 weeks, and 44.5% (146/328) answered 28 weeks, accounted for the highest proportion. The gestational week of surviving premature infants in tertiary hospitals was earlier than that in secondary hospitals (P less then 0.05). The gestational week of surviving premature infants answered by senior titles was earlier than that of junior titles (P less then 0.05). Conclusions Obstetricians generally have a good implementation of the "Guideline", and their understanding of some recommended clauses in the guidelines needs to be improved. In the future, training of primary hospitals and physicians with junior titles should be strengthened.Objective To investigate the role of adenosine diphosphate ribosylation factor 6 (Arf6) in the pathogenesis of endometriosis. Methods Endometrial tissues were sampled from women who were hospitalized in the Affiliated Hospital of Medical School of Ningbo University and Ningbo Women and Children's Hospital from November 2020 to May 2021 with endometriosis (n=44, endometriosis group) and without endometriosis (n=17, control group). The expression of Arf6 protein in the endometrial tissues was detected by western blot. Endometrial epithelial cells from both groups were primary cultured and the distribution of intracellular mitochondria was detected by immunofluorescence. The expression of Arf6 protein was down-regulated by small interference RNA (siRNA), the distribution of mitochondria in cells with decreased Arf6 protein expression was observed, and the expression of mitochondria-related proteins development and differentiation enhancing factor 1 (DDEF1, also called AMAP1), reactive oxygen species 1 (ROS1) and epithelial-mesenchymal transition (EMT)-related proteins E-cadherin, vimentin were detected.