Pancreatic cancer (PC) is a highly malignant tumor of the digestive system and has a concealed onset with rapid progression. The majority of PC patients are diagnosed in the middle to late stages, and the effectiveness of traditional treatment methods for advanced pancreatic cancer is limited, which results in a poor prognosis. Immunotherapy, as a novel treatment strategy, aims to suppress tumor growth and metastasis by modulating and enhancing the human immune system. It has become a hot point in current cancer prevention and treatment. This article will elaborate on the newest advancements in immunotherapy for PC. Furthermore, we point out the major challenges of PC immunotherapy.
Objective To investigate the expression of cyclooxygenase-2 (COX-2) in liver tissue of severe acute pancreatitis (SAP) rats. Methods A rat model of SAP was induced by retrograde infusion of 3.5% sodium taurocholate into the biliary-pancreatic duct. Eighty rats were randomly divided into SAP group and control group. The levels of serum amylase (AMY), alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor (TNF) -α and ascites AMY were detected dynamically at 4 h, 8 h, 16 h and 24 h after operation. The pancreatic and liver injuries were observed by light microscope. The expression of COX-2 in liver tissue was measured by immunohistochemistry. Results Compared with the control group, the levels of serum AMY, ALT, AST, TNF-α and ascites AMY increased significantly at the time point of 4 h, 8 h, 16 h and 24 h (Plt;0.05). These changes were paralleled with the histopathological changes of pancreatic and liver tissue. The expression positive rates of COX-2 at the different time in the SAP group were higer than those of the control group (Plt;0.05). There was a significantly positive correlation between the expression of COX-2 and ALT (rs=0.949, P=0.039), AST (rs=0.972, P=0.016) and serum AMY (rs=0.944, P=0.041), respectively. Conclusion Overexpression of COX-2 may play an important role in liver injury during SAP.
ObjectiveTo explore the effectiveness of liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty.MethodsBetween March 2014 and March 2019, 65 patients (127 sides) with breast hypertrophy had undergone breast reduction by using liposuction technique assisted superomedial pedicle with a vertical incision. The patients were 21 to 58 years old, with an average of 42.2 years. Body mass index ranged from 18.8 to 26.5 kg/m2, with an average of 21.3 kg/m2. Among them, 62 cases were bilateral operations and 3 cases were unilateral operation. The degree of mastoptosis was rated as degreeⅡ in 73 sides and degree Ⅲ in 54 sides according to the Regnault criteria.ResultsThe unilateral breast removed 432 g on average (range, 228-932 g); the distance of nipple upward was 4.5-9.5 cm (mean, 6.5 cm); the volume of unilateral liposuction was 50-380 mL (mean, 148 mL). There were 2 sides (1.58%) of unilateral intramammary hematomas after operation, 4 sides (3.15%) of bilateral breast vertical incisions slightly split, and 1 side (0.79%) of the nipple-areola epidermis necrosis. All patients were followed up 6 months to 5 years, with an average of 18 months. During the follow-up, there was no evident re-dropping of the breast and no enlargement of the areola. No patient underwent scar excision. At last follow-up, the effectiveness was evaluated by the surgeons. There were 52 cases with very satisfactory, 10 cases with satisfactory, and 3 cases with unsatisfactory for the breast shape and symmetry. There were 51 cases with very satisfactory, 11 cases with satisfactory, and 3 cases with unsatisfactory for the nipple position and areola diameter. The incision scar was obvious in 25 cases and was not obvious in 40 cases. The results of self-assessment showed very satisfactory for the breast shape in 48 cases, satisfactory in 12 cases, and unsatisfactory in 5 cases; very satisfactory for the incision scar in 40 cases, satisfactory in 17 cases, and unsatisfactory in 8 cases. Overall evaluation of the patient was very satisfactory in 52 cases, satisfactory in 7 cases, and unsatisfactory in 6 cases.ConclusionThe liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty is a safe and reliable surgical method with a satisfactory result.
Objective To explore the pain after discharged in patients with radical total gastrectomy under painless ward management, and to analyze the causes of pain in order to guide the treatment strategy after discharge. Methods Retrospective analysis was performed on the pain data of 82 patients who underwent radical total gastrectomy in The First Affiliated Hospital of Air Force Military Medical University from December 2015 to April 2017, and the situation of pain was followed-up at 2 weeks, 1 month, 2 months, and 3 months after discharged. Results Mild pain occurred in 25 patients at the 2 weeks after discharged; mild pain occurred in 38 patients and moderate pain occurred in7 patients at the first month after discharged; mild pain occurred in 31 patients and moderate pain occurred in 4 patients at the second month after discharged; 19 patients had mild pain at the third month after discharged. There was no significant difference in pain scores between male patients and female patients, <60 years old patients and ≥60 years old patients, patients’ operative time<180 min and patients’ operative time ≥180 min, patients’ intraoperative blood loss<200 mL and patients’ intraoperative blood loss ≥200 mL at the all time points, including the second week, the first, the second, and the third month after discharge ( P>0.05). Conclusion Painless ward management can effectively control the degree of pain in discharged patients who underwent radical total gastrectomy.