ObjectiveTo analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP). MethodsEight patients with SPTP received triple phasic contrast-enhanced CT, and its consistency with pathological findings was analyzed. ResultsSPTP manifested as a solitary and exogenous mass, with a heterogeneous pattern composed of solid and polycystic parts. The shape of SPTP was spherical in four patients, oval in two patients, and shallow lobulation in another two patients. In contrast-enhanced phase images, the solid parts showed mild to moderate enhancement in both arterial and portal phases. Complete capsule was showed in seven patients, and nodules were found in the wall of mass in five patients. Hemorrhage was seen in two patients and calcification was showed in five patients. The dilation of pancreatic duct was found in one patient, liver metastases was showed in one patient, and the invasion of tumor to posterior gastric wall was found in one patient. Pseudopapillary structure, hemorrhage, necrosis, and cystic degeneration were showed in all patients by histological study. ConclusionSPTP has certain characteristic CT imaging manifestations consistent with histological features, which is helpful for the diagnosis and differential diagnosis of SPTP.
Objective To summarize the advancement of immune tolerance in pancreas transplantation.Methods Relevant literatures about immune tolerance in pancreas transplantation, which were published recently domestic and abroad were collected and reviewed. Results The main methods to induce immune tolerance are peripheral tolerance and central tolerance. The induction of chimerism by infusion of donor-specific bone marrow cells is the research hot spot recently. Conclusion The infusion of donor-specific bone marrow cells in combination with one or more peripheral tolerance maybe can induce immune tolerance successfully. However, it should be researched further.
Objective To investigate the roles of cell apoptosis and the gene expressions of Fas, FasL, bcl-2 and bax in acute rejection of pancreaticoduodenal transplantation and to evaluate the function of duodenum biopsy for early detection of rejection in rats. Methods Wistar and SD rats were divided into two groups: ①Wistar rats that underwent allogenic pancreaticoduodenal transplantation from the organs of SD rats; ②Wistar rats that received homogenic transplantation. The grafts were then harvested on day 3, 5 and 7 after the transplantation, and all graft samples were observed with HE staining and TUNEL was also used to detect apoptotic cells. The expressions of Fas, FasL, bcl-2 and bax were measured by immunochemical method. According to Nakhleh’s score, pathologic features of transplanted pancreas and duodenum were ranged from one to three scores in order. Results The percentage of same or different scores between the pathological scores of pancreas and duodenum in allogenic pancreaticoduodenal transplantation group were 61.1% (11/18) and 38.9% (7/18) respectively, and there were 6 specimens of pancreatic tissue got higher scores with only one higher score for duodenum. There were significant differences of histopathologic rejection scores and apoptotic indices between the two groups, respectively (P＜0.05， P＜0.01). Apoptotic indices of pancreas and duodenum both showed positive correlations with histopathologic rejection scores (r=0.965， P＜0.01; r=0.942, P＜0.01). The rejection score and apoptotic index elevated, the expression of FasL increased, bcl-2 decreased, and Fas and bax changed over time after operation. Conclusion Apoptosis maybe significantly positive correlated with the degrees of damage of the acute pancreaticoduodenal allograft rejection, and the apoptotic index maybe valuable to estimate the damage. FasL and bcl-2 were significantly related to the impairment of acute pancreatic allograft rejection as well. Duodenum biopsy may contribute to the early diagnosis of the rejecting transplanted tissues.
Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes （one had chronic cholangitis with choledochal lithiasis）， another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.
【Abstract】Objective To explore Toll-like receptor 4 (TLR4) expression and distribution in rat pancreas.Methods Reverse transcriptase-polymerase chain reaction (RTPCR) and immunohistochemistry (IHC) were applied to detect expression of TLR4-mRNA and TLR4 protein respectively. Results RT-PCR of RNA isolated from rat pancreatic tissue yielded the predicted amplicon for the TLR4. IHC/immunofluorescence revealed TLR4 protein mainly distributed in the epithelium of the pancreatic duct, vascular endothelium of the exocrine section, endocrine islet also had some signs of distribution. No TLR4 protein signal could be detected in the acinar cells. Conclusion TLR4 could be detected in rat pancreas. Its distribution is consistent with its roles in immune surveillance, mainly in tissues exposed to the external environment such as pancreatic duct as well as in immunologically important settings such as pancreatic vascular endothelium. Islet also has some signs of distribution. No TLR4 expression in acinar cells, suggesting TLR4 immunological involvement in the pathophysiology of pancreas.
ObjectiveTo investigate the clinical significance of abnormal confluence of common bile duct (CBD) and pancreatic duct. MethodsFortyfive cases of biliary pancreatic confluence portion of cadavers were dissected and observed with microscope. ResultsThe lower end of CBD inserted normally into the medial posterior portion of descending duodenum with oblique angle (41.4±5.3)° and safeguarded by the sidelong wrinkle formed by mucous membrane of duodenum. In common, pancreatic duct ampulla inserted into CBD with oblique angle (28.5±7.9)° and jointed CBD in the medial wall of dudenum. The length ampulla of Vater was about 0.5-1.5 cm. The Vater’s ampulla was dilated obviously. ConclusionThe result indicates that pancreatic duct and CBD joint with a sharp angle. A number of abnormal anatomic factors may change the relation of oblique angle, and lead to the pancreatitis.
ObjectiveTo explore apoptosis of acinar cells during pancreatic allograft rejection in rats.MethodsGroups of Wistar rats underwent heterotopic pancreaticoduodenal transplantation from syngenic Wistar of allogenic SD rats. The grafts were harvested on postoperative day 3, 5 and 7. All graft samples were subjected to histological examination and apoptotic cells of graft acinar cells using in situ terminal deoxynucleotidy1 transferasemediated dUTP nickend labeling (TUNEL). Histopathological rejection score and apoptotic index (AI) were analyzed. ResultsThe incidence of apoptotic cells was increased steadily over time in allografts, in contrast with syngenic grafts. The apoptotic cells in allografts were mainly acinar cells and few infiltrating lymphocytes. A significant correlation between apoptotic index and histopathological rejection score was noted.ConclusionTUNEL can display apoptosis of single cell in situ. Apoptosis is an important mechanism of tissue injury in acute pancreatic allograft rejection in rats. Acinar cell apoptosis can be used as a valuble index to estimate the injury of grafts and to monitor the acute rejection.
ObjectiveTo explore the effect of endotoxin on insulin secretion from islet βcell of rat pancreas.MethodsAfter the model of endotoxemia was established in rats with intraperitoneal injection of LPS (2 mg/kg),the changes of insulin level in the serum and pancreas were dynamically determined, the expression of inducible nitric oxide synthase (iNOS) by situ hybridization and DNA damage in islet cells were also observed, the effect of sodium nitroprusside (exogenous NO) on synthesis and secretion of insulin from isolated islet βcell of normal rat pancreas under high glucose stimulation was also evaluated.ResultsThe level of glucose and insulin in plasma were significantly increased at 12th and 6th h, respectively and kept on 3 d after injection of LPS,but the insulin level in pancreas was not remarkably altered.The expression of iNOS and DNA damaged significantly enhanced at 6 d after endotoxemia. The high glucosestimulated insulin synthesis and secretion were bly inhibited by exogenous NO.ConclusionThese findings suggest that LPS be stimulate the expression of iNOS and NO product,which inhibites synthesis and secretion of insulin in islet βcells,but it stimulates insulin secretion by another mechanism,and results in dysfunction and destruction of the rat pancreas.
ObjectiveTo construct DPC4 gene recombinant expression vector and to study the inhibitory effect of DPC4 on the growth of human pancreatic adenocarcinoma cell line (PC3) cells.MethodsDPC4 cDNA was amplified from K562 cell line using RTPCR, and was cloned into the pcDNA3.1 vector to construct a recombinant expression vector plasmid pcDNA3.1DPC4. The recombinant expression plasmid was transferred into PC3 cells by liposome method. After G418 selection, cell cycle and apoptosis were assessed by flow cytometry, then the cell growth rate was estimated by cell count. The cells being not transferred plasmid and transferred pcDNA3.1 plasmid were used as controls.ResultsThe DPC4 gene recombinant expression vector was constructed. Wildtype DPC4 gene attributed to the increase of G1 phase cells and the decrease of S phase cells in PC3 cells,and could inhibit the growth of PC3 cells, the cell growth rates was reduced to 34.3%-41.1% of that of the controls, but cell apoptosis was not observed on all groups. ConclusionWildtype DPC4 gene could inhibit the proliferation of human pancreatic adenocarcinoma cells and could become one of the target genes of pancreas adenocarcinoma gene therapy
【Abstract】Objective To investigate the effect of ischemia on the treatment of advanced body and tail carcinoma of pancreas. Methods In operation the proximal spleen artery was ligated, a chemotherapy pump was installed to connect the distal spleenic artery and urea solution (40%) was injected through the device during and after operation. The pathology and pathophysiology change in dogs were observed. Results All the eight dogs studied were alive after operation, no serious complication appeared, pancreatic cells were replaced by fibrosis. Conclusion Infusion of 40% urea solution is a safe and effective ischemic method, it can lead to all sorts of pancreatic cell necrosis and fibrosis. It may be a good madality in the treatment of advanced pancreatic carcinoma.