胃癌是全球第三大癌症相关死因[1],已成为一种全球性的公共卫生负担.全世界每年新增胃癌病例近100万例,其中约75％的患者最终因此死亡[2].中国、日本和韩国是胃癌高发的三大东亚国家,至2012年,患者病例数已接近全球胃癌总病例数的一半[3].胃癌发生的风险因素较多,而东亚国家除遗传因素外,较高的幽门螺杆菌(Helicobacter pylori,H.pylori)感染率,很可能也是胃癌高发的重要原因之一[4].

目的 探究胰蛋白酶制剂卡莫司他对雨蛙素诱导的急性胰腺炎的作用.方法 用雨蛙素腹腔注射法诱导C57BL/6J小鼠建立急性胰腺炎模型,以卡莫司他灌胃法为治疗组,生理盐水灌胃法为对照组.通过观察小鼠行为学的变化和检测各组小鼠血清淀粉酶水平,比较胰腺质量/体质量、胰腺组织病理变化等指标,分析炎症的不同损伤程度及变化.结果 治疗组小鼠的胰腺质量/体质量和血清淀粉酶水平均低于非治疗组;非治疗组C57BL/6J小鼠注射雨蛙素后有急性胰腺炎的典型病理组织学改变,而治疗组小鼠则炎症明显改善,水肿及坏死均减轻,炎症细胞浸润减少.治疗组和对照组之间的胰腺质量/体质量和血清淀粉酶水平比较差异均没有统计学意义.结论 卡莫司他可通过抑制胰腺蛋白酶活性减轻急性胰腺炎的炎症严重程度.

Objective To explore the effects of ApoC3 gene on the severity of hypertriglyceridemiainduced acute pancreatitis (AP).Methods ApoC3 transgenetic mice and C57BL/6J mice AP model was induced by cerulein intraperitoneal injection,and ApoC3 transgenetic mice and C57BL/6J mice injected by normal saline solution in equal volume served as control group.Serum triglyceride and cholesterol were detected,and the pathological changes of the pancreas were observed.RT PCR method was used to examine the changes of the inflammatory factor including IL-1β,IL-6,α-SMA and TNF-α mRNA levels,which reflected the severity of the inflammation.Results Serum triglyceride and cholesterol were higher in ApoC3 transgenetic mice than in C57BL/6J mice [(3.434 ± 0.931) mmol/L vs (0.766 ± 0.120) mmol/L,(2.553 ±0.178) mmol/L vs (1.996 ± 0.080) mmol/L],and the differences were statistically different (P ＜ 0.05).The pathological changes of the pancreas were more severe in ApoC3 transgenetic AP mice than in C57BL/6J AP mice,and the IL-1β,IL-6 and α-SMA mRNA levels in the pancreatic tissue were obviously higher in ApoC3 transgenetic AP mice than in C57BL/6J mice (1.72 ± 0.07vs 0.78 ± 0.09,1.58 ± 0.09vs 0.87 ±0.04,0.83 ± 0.05vs 0.44 ± 0.04),and the differences were statistically significant (P ＜ 0.05),while there was no statistical difference on TNF-αmRNA level (0.70 ± 0.09vs 0.65 ± 0.08,P ＞ 0.05).Conclusions ApoC3 gene could aggravate the severity of the inflammation in hypertriglyceridemia-induced AP.

目的 探究超声内镜引导下无水乙醇灌洗术(EUS-EL)治疗胰腺浆液性囊性肿瘤的临床疗效及安全性.方法 回顾性分析第二军医大学长海医院消化内科2012年5月至2014年11月期间收治的13例胰腺浆液性囊性肿瘤患者的临床资料,其中6例接受超声内镜引导下无水乙醇灌洗术治疗及术后随访,另7例仅接受超声内镜引导下囊液抽吸术,进行为期7～36个月的随访.对两组患者临床症状、病灶大小的变化及复发率进行了比较,统计手术相关并发症的情况.结果 EUS-EL治疗组在治疗前后囊肿最大直径分别为(24.8±14.2)mm及(9.0±4.8)mm(P=0.004).对照组在治疗前后囊肿最大直径分别为(21.3±11.6)mm及(18.6±14.0)mm(P=0.203).EUS-EL治疗组和对照组的囊肿最大直径的变化分别为-15.8±3.1mm和-2.7±1.9mm(P=0.003).EUS-EL治疗组无相关并发症发生,也无复发病例.治疗组囊肿完全消除4例,对照组完全消除1例.治疗组5例患者腹痛症状缓解,腹痛缓解1例(P=0.11).结论 接受EUS-EL治疗胰腺浆液性囊性肿瘤可有效缓解临床症状、减小病灶大小,并发症少,安全性较高.

Objective To investigate the effect of Gsh2 silencing on the sonic hedgehog (Shh) and GLI1 gene expression,which are the key factors of hedgehog pathway in human pancreatic cancer cell SW1990.Methods Three shRNAs tagerting Gsh2 (Gsh2-shRNA) were constructed and were inserted into pLKO.1 puro vector by double digestion with restriction enzyme,the empty vector without shRNA was used as a negative control.After plasmid amplification,plasmids DNA was extracted,and underwent electrophoretic separation and sequencing by double digestion.After confirmation by gene sequencing,plasmid was transfected into the human pancreatic cancer cell line SW1990,then real time PCR was used to detect the Gsh2 mRNA expression,and the plasmid with best silencing effect was selected to transfect the SW1990 cells,real time PCR and Western blot were respectively used to detect the mRNA and protein expression of the key factor in hedgehog pathway(Gsh2,Shh,Gli1).Results The gene sequencing of the 3 recombinant plasmids showed that Gsh2-shRNA were correctly constructed.If the mRNA expression of empty vector transfection cells was 1,the Gsh 2 mRNA expressions of SW1990 cells which were transfected by recombinant Gsh2-shRNA-1,Gsh2shRNA-2,Gsh2-shRNA-3 were 0.41 ± 0.02,0.22 ± 0.043,0.53 ± 0.03,and Gsh2-shRNA-2 had the best silencing effect.If the mRNA or protein expression of empty vector transfection cells was 1,the Gsh2,Shh,Gli1 mRNA expressions of cells with Gsh2-shRNA-2 transfection were 0.12 ±0.02,0.97± 0.13,0.19± 0.03,and the protein expressions were 0.55 ± 0.12,0.74 ± 0.06,0.53 ± 0.09.The Gsh2,Glil mRNA and protein expressions with Gsh2-shRNA-2 transfection were significantly down-regulated when compared with those of empty vector transfection cells,and the difference between the two groups was statistically significant (P＜0.01 or ＜0.05).Conclusions Gsh2 gene silence in pancreatic cancer cell line SW1990 can repress the expression of GLI1 in hedgehog pathway without affecting Shh expression.