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Objective To detect and analyze the value of adipokines in the diagnosis and prognosis of patients with pancreatic cancer complicated with diabetes.Methods From July 2012 to June 2013,24 pancreatic ductal adenocarcinoma (PDAC) complicated with diabetes mellitus (DM) (study group),30 PDAC (control group A) and 31 DM (control group B) cases were collected.Serum levels of adiponectin,resistin,leptin and visfatin were tested and the differences were compared among different groups.Receiver operator characteristic (ROC) curves were used to analyze the diagnostic value of the above cytokines.The patients were followed up for two to 58 months.Kaplan-Meier survival curve was performed to analyze the prediction value of above cytokines in recurrence-free survivals (RFS) in patients with PDAC complicated with DM.Chi square test,t test and Mann-Whitney U test were used for statistical analysis.Results The median levels of serum adiponectin and resistin of study group were both higher than those of control group B (36.92 mg/L,15.80 mg/L to 101.57 mg/L vs 12.84 mg/L,5.64 mg/L to 21.39 mg/L;9.07 μg/L,6.39 μg/L to 12.19 μg/L vs 5.93 μg/L,4.22 μg/L to 7.68 μg/L,respectively),and the differences were statistically significant (Z=-3.462 and-2.868,P=0.001 and 0.004,respectively).However the serum levels of leptin and visfatin of study group were both lower than those of control group B (1.02 μg/L,0.11 μg/L to 2.06 μg/L vs 1.92 μg/L,0.96 μg/L to 2.72 μg/L;2.43 μg/L,0.48 μg/L to 4.28 μg/L vs 4.18 μg/L,2.43 μg/L to 7.28 μg/L),and the differences were statistically significant (Z=-1.986 and-2.336,both P＜0.05).The results of ROC curve analysis of adipokines in differential diagnosis of pancreatic cancer from diabetes indicated that the areas under the curve (95 ％ confidence interval) of serum adiponectin,resistin,leptin and visfatin in the diagnosis of PDAC were 0.774 (0.645,0.903),0.727 (0.593,0.861),0.657 (0.504,0.810) and 0.685 (0.543,0.826),respectively,with statistical significance (P=0.001,0.004,0.047 and 0.020,respectively).The sensitivity of combination of CA19-9 and adiponeetin in the diagnosis of PDAC complicated with DM was 0.917 and the negative predictive value was 0.940.The leptin level in advanced PDAC patients was lower than that in non advanced PDAC patients (0.61 μg/L,0.11 μg/L to 2.28 μg/L vs 1.86 μg/L,0.79 μg/L to 4.14 μg /L);and the difference was statistically significant (Z=-2.210,P=0.027).Higher serum adiponectin level was correlated with early recurrence after operation in PDAC patients complicated with DM (P=0.035).Conclusions Serum adipokines may be valuable in screening PDAC in patients with DM.And adipokines may be valuable in the prediction of recurrence after operation in PDAC patients complicated with DM.
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Objective To explore the role of pancreatic cancer-derived microvesicles (MV) and their enclosed microRNAs (miRNA) in the pathogenesis of pancreatic cancer induced diabetes mellitus (DM).Methods The supernatants of three pancreatic cancer cell lines SW1990, BxPC3 and PANC1 were collected, and MV were isolated with gradient centrifugation.The entrance of MV into pancreatic islet cell line MIN6 was proved by Western blot assay and fluorescence-label method.The miRNA-19a levels were measured in MV and MV-free supernatants of three pancreatic cancer cells lines.The three experimental groups were MIN6 cells separately treated by MV derive from SW1990, BxPC3 and PANC1, and untreated MIN6 cells were assigned to the control group.The miRNA-19a levels as well as changes of glucose stimulated insulin secretion (GSIS) were measured.Afterward, pre-miRNA-19a and anti-miRNA-19a were transfected into MIN6 cells by liposome, and the effects of them on GSIS were observed.Results CD63 and AGO2 as the protein markers of MV and the entrance of MV from pancreatic cancer into pancreatic islet cell line MIN6 were detected by Western blotting.The miRNA-19a levels in MV and MV-free supernatants of SW1990, BxPC3 and PANC1 were (132.7±16.0), (32.8±4.3), (78.4±8.9),(22.6±3.3), (63.3±12.0) and (23.3±3.3) pmol/L, respectively, and the differences were statistically significant (t=10.44, 10.12 and 5.56,all P＜0.01).Compared to the MIN6 control group, the miRNA-19a levels of MIN6 treated by MV from SW1990, BxPC3 and PANC1 significantly increased, and the 2-△△Ctvalue was 2.02 ± 0.50, 1.80 ± 0.41 and 2.11 ± 0.59, respectively, and the differences were statistically significant (t=2.97, 2.77, 2.84;all P＜0.05).Stimulated with high glucose, the GSIS of pancreatic islet cells treated by SW1990, BxPC3 and PANC1 in three groups decreased, which were (103.73±16.49), (141.17±11.26), and (138.24±13.97) ng · mg protein-1 · h-1 MV, respectively, and that of control group was (256.24 ± 33.05) ng · mg protein-1 · h-1.The differences were statistically significant (t=4.13, 3.30 and 3.29, all P＜0.05).Compared with control group, GSIS of pre-miRNA-19a treated MIN6 remarkably decreased, which was (126.17± 62.87) ng · mg protein-1 ·h-1 and (316.72±91.87) ng · mg protein-1 · h-1 , and the difference was statistically significant (t=2.97, P＜0.05).GSIS of MIN6 cells transfected with anti-miRNA-19a was higher than that of control group, which was (697.47±77.62) ng · mg protein 1 · h-1 and (355.33 ±84.77) ng · mg protein-1 ·h-1 , and the difference was statistically significant (t=-2.97,P＜0.05).Conclusion The entrance of MV derived from pancreatic cancer into pancreatic islet cell line MIN6 may cause the dysfunction of insulin secretion an important signaling molecules, miRNA-19a.
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Objective To provide effective reference for quality analysis of the chemical composition and extraction of astragalus separation process by comparing the extract of astragalus and it’s IR spectra. Methods The saponins and flavonoids in astragalus were firstly extracted by the method of circumfluence with ethanol as solvent and the residue of ethanol-extraction was then used to extract polysaccharides by distilled water. Fourier transform infrared spectroscopy (IR) combined with second derivative infrared spectroscopy was applied to quickly identify astragalus herbs powder, water extraction of astragalus, astragalus alcohol extraction and water extraction of the residue of ethanol-extraction. Results The powder and 70% ethanol extract, 80% ethanol extract were around at 1 735 cm-1 (carbonyl stretching vibration absorption peak) has a weak, broad absorption, while the absorption peak was less obvious in boiling water extraction. So the maln components of astragalus water extraction are polysaccharides and also contaln a small amount of water-insoluble flavonoids. Alcohol extraction malnly contalns saponins and flavonoids, and flavonoid extract volume increases with increasing alcohol concentration in a certaln range.Conclusion This method can be a quick and easy identification for astragalus and it’s extraction for its chemical composition class, and provide the basis for further research quality.
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Objective To investigate the diagnosis of Crohn's disease(CD)in Ruijin hospital of School of Medicine of Shanghai Jiaotong University according to the criteria made by World Health Organization(WHO)and Chinese Medical Association.Methods The consecutive patients with CD diagnosed in Ruijin hospital between 1998 and 2007 were retrospectively analyzed.The clinical manifestation.endoscopic,radiologic and pathologic findings of all patients were re-evaluated accordingto the diagnostic criteria of CD proposed by WHO and Chinese Medical Association in 2007.The diagnostic level of CD was assessed.Results Only 5 and 10 patients were confirmed to be well consistent with the criteria of WHO and Chinese Medical Association,respectively.Two hundred and thirty-six patients were confirmed as suspected diagnosis to the criteria of Chinese Medical Association and 20 patients to WHO.The level of endoscopic diagnosis was raised,wherease the level ofpathologic diagnosis was decreased in recent years compared with that before 2004.Conclusion The pathologic diagnosis rate of CD is still at a low level.The current diagnostic level of CD is lagging behind the demand of the guidelines.