Clinical analysis of autoimmune pancreatitis: a single center study of 14 consecutive cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristic findings of autoimmune pancreatitis (AIP) to increase the recognition of AIP.</p><p><b>METHODS</b>From February 2002 to April 2008, a total of 14 cases of AIP were reviewed by clinical, imaging, serologic, histopathologic features and treatment response. There were 13 male and 1 female, with a mean age of 53 years. The main clinical manifestations included progressive obstructive jaundice in 11 cases, upper abdomen pain in 3 cases.</p><p><b>RESULTS</b>Diffuse enlargement of pancreas and diffuse narrowing of the main pancreatic duct (MPD) were observed in 11 cases, while 3 patients showed localized pancreatic head enlargement and focal narrowing of the MPD. Distal common bile duct stenosis was found in all cases. Increased expression of serum immunoglobulin G was found in 7 patients. Autoantibody test was positive in 5 of 12 patients. Nine of 14 patients with AIP had extrapancreatic organ involvement. Massive lymphocytes and plasma cells infiltration in pancreatic tissues were showed on pathology, as well as parenchymal fibrosis. Seven earlier patients were treated initially with surgical laparotomy or resection for suspected malignancy. Steroid therapy was given to the other patients and was responsive. There were 4 recurrences after initial treatment.</p><p><b>CONCLUSION</b>AIP should be a differential diagnosis in pancreatic head mass in order to avoid unnecessary resection.</p>

The effect of iNOS gene expression inhibited by RNA inference on the pancreas islet apoptosis and function in rats / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of iNOS gene on cell apoptosis and insulin secretion of pancreas islet in rats by RNA inference (RNAi).</p><p><b>METHODS</b>Islets obtained from thirty Wistar rats were randomly divided into five groups, and siRNA oligo was purchased from Genepharma in Shanghai. The cultured islets were transfected with iNOS siRNA, and then were divided into five groups. Islet cultured only was taken as blank control group, and cultured with TNF-alpha + IL-1 beta as cytokine group. Islet transfected with negative or iNOS siRNA were taken as negative transfection control group or RNAi group, while that transfected with iNOS siRNA and cultured with TNF-alpha + IL-1 beta as RNAi + cytokine group. Expression of iNOS mRNA was evaluated by RT-PCR and iNOS protein was evaluated by Western blot to detect the effect of RNAi. The expression of apoptosis correlated gene, Bax, Fas were analyzed, and the apoptotic cells were identified by TUNEL method meanwhile. Insulin secretion index assay the function of the islets.</p><p><b>RESULTS</b>500 - 600 IEQ islets could be extracted from every rat. RNAi attenuated the expression of iNOS and restrained the synthesis of iNOS protein.With treatment of cytokines IL-1 beta and TNF-alpha, the level of iNOS increased remarkably, the expression of Bax and Fas ascended distinctly, and insulin secretion index decreased strikingly. While, the expression of apoptosis gene and amount of apoptotic cells descended in group of RNAi + cytokine, and insulin secretion index were satisfying.</p><p><b>CONCLUSION</b>The apoptosis from cytokines to islets mediated by iNOS could be suppressed by RNAi, which leaded to favorable function and survival of islets.</p>