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Pancreatic cystic neoplasm (PCN) is characterized by cystic degeneration with a low incidence. With the development of imaging technology and the popularization of screening, the detection rate of this disease has been increasing in recent years, especially in the elderly population. Due to the multiple subtypes of PCN, difficult differential diagnosis, and the potential risk of malig-nant transformation, the formulation of reasonable diagnosis and treatment strategy is the key to treat PCN. Although many clinical guidelines have been released, the diagnosis and treatment strategies of PCN are still controversial. Elderly patients are generally weak, some with serious comorbidities, and have poor tolerance to surgery. In the process of diagnosis and treatment, clinicians need to pay special attention, carefully evaluate and weigh the advantages and disadvantages, so as to make the best plan for treatment. Based on the current guidelines and clinical experience, the authors summarize the diagnosis, surgical indications, and the whole-course management strategies of elderly patients with PCN, in order to provide suggestions for the diagnosis and treatment of this disease.
ABSTRACT
Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare low-grade malignant tumor. In recent years, with the improvement of national health check-up awareness and the advancement of imaging diagnostic technology, the detection rate of SPN has continued to rise. With the release of guidelines for many pancreatic cystic tumors at home and abroad, the diagnosis and treatment of SPN has gradually become standardized. However, its diagnostic and treatment strategies are still difficult and controversial. Therefore, the author summarizes the current status of diagnosis and treatment of SPN by referring to the literature and combining clinical experience, in order to deepen the understanding of rare pancreatic tumor by clinicians and further promote the standardized diagnosis and treatment of SPN in China.
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Objective:To investigate the effects of mitochondrial arginyl-tRNA synthase (RARS2) on cell proliferation, invasion, migration and chemotherapy resistance of pancreatic cancer.Methods:Human pancreatic cancer cell lines AsPC-1 and PANC-1 were divided into negative control group, RARS2 interference group-1, RARS2 interference group-2, RARS2 overexpression control group and RARS2 overexpression group. Cell proliferation and sensitivity to gemcitabine were detected by CCK-8 assay, and cell invasion and migration were detected by Transwell assay. Western blot was used to detect the expression of RARS2 under different concentrations and different times of gemcitabine treatment. Western blot and PCR were used to detect the expression of RARS2 in gemcitabine-resistant AsPC cell.Results:Inhibition of RARS2 expression in AsPC-1 and PANC-1 cells significantly inhibited cell proliferation and enhanced sensitivity of gemcitabine to chemotherapy. Overexpression of RARS2 enhanced cell proliferation and decreased sensitivity to gemcitabine. In AsPC-1 cells, the number of migrated cells (100×) in negative control group, RARS2 interference group-1, RARS2 interference group-2, RARS2 overexpression control group and RARS2 overexpression group were (586.7±37.4) cells/field, (195.7±18.6) cells/field, (237.0±17.1) cells/field, (157.7±19.1) cells/field, (456.0±23.1) cells/field, the number of invasive cells were (87.7±13.2) cells/field, (24.7±6.5) cells/field, (31.7±6.1) cells/field, (29.3±4.5) cells/field, (94.3±9.3) cells/field, respectively. The migration and invasion ability of cells were decreased after the expression of RARS2 was decreased, and the migration and invasion ability of cells were enhanced after the expression of RARS2 was increased. PCR and Western blot assay showed that RARS2 expression in the gemcitabine-resistant AsPC-1 was higher than that in the common cell line. In AsPC-1 cells, the expression of RARS2 increased with increasing gemcitabine concentration and treatment time.Conclusion:RARS2 promotes cell proliferation, invasion, migration and chemoresistance of pancreatic cancer, and expression of RARS2 is positively correlated with gemcitabine concentration and treatment time.
ABSTRACT
With the development of neoadjuvant therapy, the treatment of pancreatic cancer has entered the era of comprehensive diagnosis and treatment consisting of surgery, chemo-therapy and radiotherapy. In recent years, the concept of 'total neoadjuvant therapy' has become one of the important treatment methods for locally advanced rectal cancer. The authors focus on pancrea-tic cancer, introduce the development status of total neoadjuvant therapy in pancreatic cancer and summarize the current controversies and challenges in the application of total neoadjuvant therapy in pancreatic cancer, in order to further standardize the diagnosis and treatment of pancreatic cancer and improve the overall level of pancreatic cancer treatment in China.
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Artificial intelligence is a branch of computer science. As a new science and technology, it is more and more extensive used in the medical and health field recent years and shows outstanding ability in the diagnosis and treatment of complex diseases. Pancreatic cancer has the characteristics of high degree of malignancy, high concealment, difficult diagnosis and treatment, poor prognosis and so on. Therefore, clear diagnosis and early treatment are significant to improve patient prognosis. This paper summarizes the development and application of artificial intelligence and radiomics in the field of pancreatic cancer.
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Pancreatic cancer is extremely malignant and has poor prognosis. Surgery is the only way for the therapy. In recent years, minimally invasive surgery has been developed rapidly in pancreatic surgery. However, pancreatic cancer is often accompanied with vascular aggression and inflammation, which greatly increasing the difficulty of minimally invasive surgery procedure. Its feasibility, safety and radical tumor cure are still controversial. In this article, combined with the existing guidelines and the latest clinical researches, we compared the application of minimally invasive and open surgery in pancreatic cancer and summarized the development status and controversy of minimally invasive treatment of pancreatic cancer. Surgeons should strictly grasp the minimally invasive surgical adaptation certificate, and further carry out clinical research on minimally invasive treatment of pancreatic cancer, so as to standardize and enhance the development of minimally invasive pancreatic surgery in China.
ABSTRACT
With the development of modern imaging technology and improvement of physical examination consciousness of people, the incidence of pancreatic cystic neoplasm (PCN) has increased significantly. The overall prognosis of PCN is good, and great progress in surgical techniques and multidisciplinary teamwork has been made in pancreatic surgery. Although many guidelines have been released at home and abroad, there are controversies in the differential diagnosis, operative indications, surgical procedure, and the follow-up strategies toward patients with PCN. There are also significant differences in the level of diagnosis and treatment of medical centers, which brings certain challenges to the standardized diagnosis and treatment of PCN. Based on the latest clinical guidelines and new developments in clinical researches, the authors summarize the controversies of different guidelines in the diagnosis, treatment and follow-up of PCN in order to further improve the standardization of the diagnosis and treatment.
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Objective To learn the awareness rate of patients for dual referral and analyze factors affecting their intent, in order to provide references for healthcare decision making. Method Data were collected with questionnaires, and analyzed with logistic regress model. Results (1) Factors for patients' awareness rate: Patients' attitude toward first treatment in community) accessibility to community healthcare centers in their vicinity. (2) Factors affecting patients' intention for dual referral: Patients' attitude toward dual referral feasibility; patients' attitude toward rehabilitation back to community if the community joins hands with a hospital; whether patients would choose the community for treatment if the community offers benefits. Conclusion Greater efforts are expected to encourage the people to embrace the practices of dual referral and first treatment in community, and to support community healthcare centers, in addition to expanding the cooperation between such centers and hospitals.
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Objective To find out the usage of community healthcare service by citizens in Taiyuan and its influential factors,for the purpose of offering references for sustainable development of community healthcare services.Methods By means of multiphase sampling,in-home surveys were made to 800 residents in Taiyuan,recovering 768 valid questionnaires.The single factorx2 test and unconditional logistic regression analysis using SPSS13.0 software.Results The two-week visit rate is 13.28%,and two- week non-visit rate is 45.16%.Ratio of community healthcare service usage by residents surveyed was 36.72%.Factors affecting utilization of such service for residents are education level,monthly average income,and knowledge of community healthcare services.Conclusion Usage of community healthcare service is low in Taiyuan.It is recommended to improve the system of community healthcare services in Taiyuan in view of the influential factors,in order to maximize efficient usage of the service.
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Because of its special features of cell differentiation, regeneration, and even passible re-growth of organs, stem cell research, which started at the end of the last century and has been making progress up to now, has triggered another biomedical revolution and has been hailed as the most important biomedical achievement towards the end of the 20th century. But at the same time because embryonic stem cells involve embryonic lives of human beings and tissue and organ re-growth, stem cell research has from the date of its birth prompted widespread ethical debate among biomedical and law specialists, philosophers and politicians. The paper briefly reviews the achievements that have been made in stem cell research and relevant ethical debate. It also puts forward the authors' viewpoints on the ethical issues involved and their effect on the future development of medical treatment.