Locally advanced pancreatic cancer often invades the surrounding blood vessels. Currently,pancreatectomy combined with venous resection for the treatment of patients with venous involvement is accepted worldwide,but pancreatectomy combined with arterial resection for arterial involvement is still controversial. With reference to the latest research advances at home and abroad and the experience in our center,this article investigates the value of arterial resection in pancreatic cancer surgery,in order to provide a reference for clinical studies.

Due to the limitations of laparoscopic surgery,the lack of special instrument,and the particular location,structure,and function of the pancreas,laparoscopic pancreatic surgery develops slowly and is used only for diagnosis. With the innovation of laparoscopic instruments,the increases in operative experience,and the improvement in laparoscopic technology,laparoscopic distal pancreatectomy is safe and effective for the appropriate cases. In order to avoid the splenectomy- associated complications,laparoscopic spleen- preserving distal pancreatectomy is preferable. There are mainly two methods to preserve the spleen: Kimura' s method and Warshaw' s method. The Kimura' s method is a difficult technology and has a high risk,but it can preserve all functions of the spleen and has few complications. The Warshaw's method has a narrow indication,a low risk of bleeding,and a short operation time,but it has a high incidence of complications and can hardly preserve all functions of the spleen. Therefore,the Kimura' s method is the first choice to preserve the spleen and the Warshaw' s method is a replacement technology.

Objective To investigate the efficacy and toxic and adverse effects of high- dose hypofractionated radiotherapy in elderly patients with stage Ⅳ pancreatic cancer. Methods The clinical data of the patients with pancreatic cancer and distant metastasis who were admitted to our hospital from September 2011 to May 2015 were collected,and all the patients underwent high- dose hypofractionated helical tomotherapy. The data on efficacy and toxic and adverse effects were obtained through follow- up,and the evaluation of adverse effects was performed according to National Cancer Institute- Common Terminology Criteria for Adverse Events version 4. 02. The Kaplan- Meier method was used for survival analysis. Results A total of 33 patients older than 65 years received the high- dose hypofractionated radiotherapy.Of all the patients,30 received follow- up visits,and the follow- up rate was 91. 0%. The median survival time was 9 months,the 1- year overall survival rate was 24. 0%,and the rate of pain relief was 80. 0%( 20 /25). The treatment outcome of pancreatic lesions could be evaluated in 17 patients,among whom 4( 23. 5%) achieved partial remission,12( 70. 6%) achieved stable disease,and 1( 5. 9%) experienced progression. As for toxic and adverse effects,the incidence rate of grade 3 hematologic toxicity was 6. 7%( 2 /30),and no patients experienced grade > 2 upper gastrointestinal reactions. Conclusion In elderly patients with stage IV pancreatic cancer,high- dose hypofractionated radiotherapy has tolerable toxic and adverse effects and can relieve cancer pain and prolong survival time.

Objective To investigate the expression of Axin2 in pancreatic cancer cells,and to observe the influence of Axin2 on the proliferation,invasion,and migration of human pancreatic cancer cells( PANC- 1). Methods Quantitative real- time PCR was used to measure the expression of Axin2 in pancreatic cancer cell lines with different invasive abilities( PANC- 1,Mia Pa Ca- 2,and Bx PC- 3) and immortalized normal pancreatic cells( H6C7). PANC- 1 cells with low expression were transfected with over- expressed Axin2 plasmid by transient transfection. MTT assay,Transwell assay,and scratch assay were used to determine the proliferation,invasion,and migration of cells transfected with over- expressed Axin2. One- way analysis of variance was used for comparison between multiple groups,and SNK- q test was used for comparison between any two groups. Results The relative expression levels of Axin2 in PANC- 1,Bx PC- 3,Mia Pa Ca- 2,and H6C7 cells were 0. 13 ± 0. 01,0. 42 ± 0. 05,0. 24 ± 0. 011,and 1. 00 ± 0. 00,respectively,and PANC- 1 cells had the lowest expression level of Axin2,with significant differences compared with the other cells( all P < 0. 05). When PANC- 1 cells were transfected with over- expressed Axin2 plasmid,the cells in the over- expression group had a significant increase in the expression level of Axin2 compared with those in the blank group and the negative control group( both P < 0. 05). Compared with those in the non- transfection group and the blank group,PANC- 1 cells in the over- expression group showed significant reductions in the proliferation,invasion,and migration abilities. Conclusion The expression of Axin2 is down- regulated in pancreatic cancer cell lines and decreases with the increasing invasion ability,suggesting the role of tumor suppressor gene. High expression of Axin2 can reduce the proliferation,invasion,and migration abilities of PANC- 1 cells.

Objective To investigate the specific antitumor immune response induced by the infusion of Capan- 2 pancreatic cancer cells and dendritic cells( DC). Methods DC were isolated from the peripheral blood mononuclear cells( PBMC) derived from 6 patients with pancreatic cancer and cultured. The DC obtained were divided into three groups. In group 1,PEG- DMSO was used for induction,and DC and Capan- 2 cells were fused to bear tumor antigens. In group 2,DC were cultured with Capan- 2 cells. In group 3,DC were cultured alone. Flow cytometry was used to detect PE- MUC4 / FITC- CD86 double- labeled cells and assess the fusion rate,and MTT assay was used to determine the changes in viability of DCs in each group. IFNγ enzyme- linked immunosorbent assay was used to detect the activation reactions of cytotoxic T lymphocytes( CTLs) induced by DCs. The 51 Cr standard cytotoxicity test was used to determine the killing effect of antigen- specific CTLs induced by DCs on in vitro pancreatic cancer cells. An analysis of variance was used for comparison between multiple groups. The LSD- t test was used for comparision between any two groups. Results The DC- Capan- 2 fused cells expressed DC phenotype( CD86) and MUC4 molecules and had a significantly higher double- positive rate for CD86 and MUC4 than the co- cultured group( 38. 30% ±7. 30% vs 7. 21% ± 1. 06%). In the fusion group,the viability of DCs decreased in a time- dependent manner and reached62. 81% at 96 hours after transfection,while in the co- cultured group,the viability of DCs was maintained above 80%. The viability of DC showed a significant difference between these two groups( P < 0. 05). The release of IFNγ showed a significant difference between CTLs induced by DC- Capan- 2 fused cells and those induced by DCs in the co- cultured group( 85. 34 ± 2. 97 U / ml vs 19. 07 ± 4. 25 U / ml,P<0. 05). The specific CTLs induced by DC- Capan- 2 fused cells could effectively identify identified and killed the HLA- A2~+/ MUC4~+Capan- 2 cells and the HLA- A2~+/ MUC4-PANC- 1 cells,but did not effectively identify and kill the HLA- A2-/ MUC4-Mia Pa Ca- 2 cells and the HLA- A2-/ MUC4~+As PC- 1 cells. Conclusion The fusion of pancreatic cells and DCs can induce a pronounced CTL anti- tumor immune response in CTLs,which is limited by which was restricted by MHC class I antigen presentedpresentation.

Objective To investigate the risk factors for recurrence after drug withdrawal in HBeAg- positive chronic hepatitis B( CHB)patients completing the treatment with nucleos( t) ide analogues( NAs). Methods A total of 60 HBeAg- positive CHB patients who visited and were treated in The First Hospital Affiliated to Guangxi Medical University from May 2004 to December 2014 were enrolled. The drugs were withdrawn after the patients reached the criteria for drug withdrawal in related guidelines. The univariate and multivariate Cox proportional hazards regression model analyses were performed for 15 factors which might influence recurrence,i. e.,sex,age,a family history of HBV infection,baseline HBV DNA load,baseline total bilirubin( TBil) level,baseline alanine aminotransferase( ALT) level,baseline aspartate aminotransferase( AST) level,duration of virologic response,time to disappearance of HBeAg,time from the start of medication to the development of HBeAg seroconversion,duration of consolidation therapy after HBeAg seroconversion,total course of the treatment,prolonged course of the treatment,HBs Ag level at drug withdrawal,and drug type. The Kaplan- Meier method was used for calculating the cumulative recurrence rate. Results The mean course of the treatment was 37. 36 ± 12. 67 months,the prolonged course of the treatment was 7. 0( 2. 0 ~ 13. 0) months,and 56. 7% of all patients experienced recurrence. Sex,age,baseline HBV DNA load,baseline TBil level,baseline ALT level,baseline AST level,duration of virologic response,duration of consolidation therapy,total course of the treatment,prolonged course of the treatment,and drug type were not significantly associated with recurrence after drug withdrawal in patients who met the criteria for drug withdrawal( all P > 0. 05). A family history of HBV infection( RR = 1. 583,P = 0. 047),time to HBeAg seroconversion( RR = 1. 205,P = 0. 015),and HBs Ag level at drug withdrawal were independent risk factors for recurrence after drug withdrawal. The patients with time to HBeAg seroconversion > 12 months had a significantly higher recurrence rate than those with time to HBeAg seroconversion < 12 months( 80. 0% vs 48. 9%,P < 0. 001). Conclusion A family history of HBV infection,delayed HBeAg seroconversion,and high HBs Ag level at drug withdrawal are major risk factors for recurrence after drug withdrawal in HBeAg- positive CHB patients who have met the criteria for drug withdrawal in the treatment with NAs. If HBeAg- positive CHB patients can acquire immune control,recurrence after withdrawal of NAs will be reduced.

Objective To investigate the correlation between serum interleukin- 1 receptor antagonist( IL- 1Ra) level and disease severity in patients with acute- on- chronic hepatitis B liver failure( HBV- ACLF). Methods A total of 31 patients with HBV- ACLF who visited Fuzhou Infectious Disease Hospital from October 2013 to January 2015 were enrolled as study subjects. Another 28 patients with acute hepatitis B( AHB) and 30 patients with chronic hepatitis B( CHB) were enrolled as controls. The Q- Plex was used to measure the peripheral blood concentrations of cytokines including IL- 1Ra,interleukin- 1β( IL- 1β),interleukin- 6( IL- 6),interleukin- 4,interleukin- 10,tumor necrosis factorα( TNFα),and interferonγ. Liver function and coagulation function were examined for each group,and the correlations of concentrations of serum cytokines including IL- 1Ra with Model for End- Stage Liver Disease( MELD) score and HBV DNA were analyzed. The Kruskal- Wallis H test was used for comparison of continuous data between multiple groups,and the Mann- Whitney U test was used for comparison between any two groups; the chi- square test was used for comparison of categorical data between groups. The Spearman rank correlation was used for correlation analysis. Results The IL- 1Ra level and IL- 1Ra / IL- 1β ratio showed significant differences between the three groups( all P < 0. 05),and the HBV- ACLF group had a significantly higher IL- 1Ra level than the CHB group and the AHB group [186. 46( 162. 68-512. 90) pg/ml vs 70. 47( 47. 07-92. 47) pg/ml,Z =6. 300,P <0. 001; 186. 46( 162. 68-512. 90) pg/ml vs 143. 69( 117. 75-208. 54) pg / ml,Z = 2. 505,P = 0. 012]. The HBV- ACLF group had a significantly lower IL- 1Ra / IL- 1β ratio than the AHB group[2. 92( 2. 20- 4. 74) vs 4. 54( 2. 75- 6. 05),Z = 1. 966,P = 0. 048],but a significantly higher IL- 1Ra/IL- 1β ratio than the CHB group [2. 92( 2. 20- 4. 74) vs 2. 49( 1. 50- 2. 50),Z = 2. 682,P < 0. 001]. The HBV- ACLF group had significantly higher IL- 1β,IL- 6,and TNFα levels than the other two groups( all P < 0. 01). Serum IL- 1Ra level was negatively correlated with total bilirubin( TBil) and MELD score( r =- 0. 506 and- 0. 818,both P < 0. 01) but was positively correlated with prothrombin activity( PTA)( r =0. 475,P = 0. 007). Conclusion IL- 1Ra is negatively correlated with TBil and MELD score and positively correlated with PTA,which are the indicators for the severity of HBV- ACLF. IL- 1Ra may play an important role in the pathogenesis of HBV- ACLF.

Objective To investigate the effects of hepatitis B virus( HBV) on the expression of Toll- like receptor 9( TLR9),interferon regulatory factor- 7( IRF- 7),and interferonα( IFNα) in plasmacytoid dendritic cells( pDCs) cultured in vitro in the umbilical cord blood of healthy parturients. Methods Hep G 2. 2. 15 cells were cultured in vitro,and the culture supernatants of Hep G 2. 2. 15 in each well were collected. HBV particles were obtained by ultracentrifugation,and HBV DNA concentration was measured by fluorescent- probe PCR. pDCs( on day 7 of culture) and HBV( 1 × 105 copies / ml,1 × 106 copies / ml,1 × 107 copies / ml,and blank control) were co- cultured for 24 hours,and then cultured continuously for another 24 hours with Cp G ODN 2216 at a final concentration of 2 μg / ml. The mRNA expression of TLR9 and IRF- 7 in pDCs was measured by real- time PCR,the protein expression of TLR9 and IRF- 7 in pDCs was measured by Western blot,and the level of IFNα was measured by ELISA. The analysis of variance was used for comparison of continuous data between multiple groups,and the SNK- q test was used for comparison between any two groups; the common logarithms of HBV DNA copies were obtained,and the linear regression analysis was performed to investigate the correlation between related indicators and the common logarithms of HBV DNA copies. Results Compared with the blank control group and the HBV 1 × 105 copies / ml group,the HBV 1 × 106 copies / ml and HBV 1 × 107 copies / ml groups had significantly lower mRNA expression of TLR9 and IRF- 7,significantly lower protein expression of TLR9 and IRF- 7,and significantly lower expression of IFNα( all P < 0. 05). The inhibitory effects of HBV on the mRNA expression of TLR9 and IRF- 7,the protein expression of TLR9 and IRF- 7,and the expression of IFNα in the culture supernatants of pDCs rose with the increasing HBV DNA load( r =- 0. 729,- 0. 761,- 0. 657,- 0. 703,and- 0. 803,all P < 0. 05). Conclusion After in vitro treatment with HBV,the mRNA and protein expression of TLR9 and IRF- 7 in normal pDCs is reduced,leading to reduced secretion of downstream IFNα. HBV can inhibit the function of normal pDCs and cause persistent HBV infection.

Objective To investigate the therapeutic effect and adverse effects of transcatheter arterial chemoembolization( TACE) combined with thalidomide or sorafenib in the treatment of unresectable primary liver cancer. Methods A total of 102 patients who underwent TACE combined with thalidomide or sorafenib in 215 Hospital of Nuclear Industry of Shaanxi Province from January 2012 to August 2013 were enrolled and divided into TACE- thalidomide group( 49 patients) and TACE- sorafenib group( 53 patients). The short- term outcome,long- term outcome,changes in related indices,and adverse events were evaluated. The independent- samples t- test was applied for comparison of continuous data between groups,and the paired t- test was applied for comparison of continuous data within one group; the chi- square test was applied for comparison of categorical data between groups; the survival curve was used for survival analysis,and the log-rank test was applied for survival comparison. Results The indices of short- term outcome,objective response rate and disease control rate,showed no significant differences between the two groups. The 2- year survival showed a significant difference between the two groups( χ2=4. 692,P = 0. 03). The log- rank test showed that overall survival time and median progression- free survival time showed significant differences between the two groups( χ2= 8. 267 and 6. 896,P = 0. 004 and 0. 009). After treatment,alpha- fetoprotein( AFP) and gamma- glutamyl transpeptidase( GGT) showed significant differences between the two groups( t = 2. 035 and 2. 843,P = 0. 038 and 0. 025). The incidence rates of nausea / vomiting,dizziness / headache,rash / desquamation,and increased blood pressure showed significant differences between the two groups( all P < 0. 05). Conclusion TACE combined with thalidomide has the same short- term therapeutic effect as TACE combined with sorafenib and can improve the patient's long- term outcome and significantly reduce the levels of AFP and GGT,but it has high incidence of nausea / vomiting and dizziness / headache.

Objective To investigate the association between the single nucleotide polymorphism( SNP) of miRNA- 146 a rs2910164 and recurrence after liver cancer surgery. Methods A total of 89 patients with primary liver cancer who underwent radical resection for liver cancer in Maojian Hospital of Dongfeng Medical Group were enrolled,and according to the presence or absence of postoperative recurrence,they were divided into recurrence group and non- recurrence group. The Taq Man probe method was used to determine the genotypes( G / C)of miRNA- 146 a rs2910164. The frequency of each genotype was compared between the two groups to investigate the association between the SNP of MicroRNA- 146 a and recurrence after liver cancer surgery. The independent- samples t test was used for comparison of continuous data between the two groups,the chi- square test was used for comparison of categorical data between the two groups,and multivariate logistic regression analysis was used to determine the factors associated with the recurrence of liver cancer. Results The three genotypes of miRNA- 146 a G / C in non- recurrence group conformed to the Hardy- Weinberg equilibrium law( P > 0. 05). After the surgery for liver cancer,the frequency of miRNA- 146 a G / C genotype showed a significant difference between the recurrence group and the non- recurrence group( χ2= 9. 115,P = 0. 010),and compared with the non- recurrence group,the recurrence group had a significantly higher frequency of miRNA- 146a( rs2910164) CG genotype( χ2= 4. 013,P = 0. 039) and a significantly lower frequency of GG genotype( χ2= 9. 046,P = 0. 003). The multivariate logistic regression analysis showed that tumor diameter( OR = 1. 075,P = 0. 003 9) and miRNA- 146a( rs2910164) CG genotype( OR = 6. 215,P = 0. 001 4) were the risk factors for recurrence after the surgery for liver cancer,and that miRNA146a( rs2910164) GG genotype was the protective factor against recurrence after the surgery for liver cancer( OR = 0. 382,P = 0. 002 5).Conclusion The SNP of MiRNA- 146a( rs2910164 C / G) is associated with recurrence after the radical surgery for liver cancer,and the CG genotype of rs2910164 may be the risk factor for postoperative recurrence after the surgery for liver cancer.

Objective To investigate the effect of sorafenib and / or thalidomide on angiogenesis in chick chorioallantoic membrane( CAM).Methods White eggs incubated for 7 days were used to establish a CAM model. The model eggs were randomly divided blank control group,sorafenib group,thalidomide group,and sorafenib / thalidomide group. After treatment,each egg was incubated for another 2 days.The CAM samples were collected and fixed to take their pictures under a microscope,and the vascular coverage of each sample was calculated.Comparison between these groups was made by analysis of variance,and comparison between each two groups was made by SNK- q test.Results The thalidomide group or sorafenib group had significantly lower vascular coverage than the blank control group( 30. 2% ± 2. 9%or 26. 5% ± 2. 1% vs 38. 3% ± 2. 7%,P < 0. 05). The sorafenib / thalidomide group had significantly lower vascular coverage than the thalidomide group or sorafenib group( 12. 6% ± 1. 5% vs 30. 2% ± 2. 9% or 26. 5% ± 2. 1%,P < 0. 05). Conclusion Both sorafenib and thalidomide have a good anti- angiogenic effect on CAM,but a combination of the two drugs shows better efficacy.

Objective To investigate the effect and safety of endoscopic injection of cyanoacrylate in the treatment of esophageal and gastric variceal bleeding( EGVB) in children. Methods The clinical data of 35 children with acute EGVB who were treated with endoscopic injection of cyanoacrylate in Children's Hospital of Baoji Maternal and Child Health Care Hospital from August 2010 to August 2015 were analyzed retrospectively. The emergency response rate,rebleeding rate,and incidence of complications after the treatment were analyzed statistically. Results Thirty- five patients received 46 times of endoscopic injection of cyanoacrylate in total. The response rate to the initial injection was 95. 6%( 44 /46). The volume of cyanoacrylate injected was 0. 2- 0. 6 ml,with a mean volume of 0. 4 ± 0. 2 ml. The emergency hemostasis rate was 93. 4%( 43 /46),the rebleeding rate was 11. 4%( 4 /35),and the cycle for 4 patients with the recurrence of bleeding to be cured was 1. 2- 23. 0 months( mean 12. 1 ± 10. 9 months). One patient experienced abdominal pain,and no patients experienced ectopic embolism. Two patients died after injection. Conclusion Frequent,small- volume endoscopic injection of cyanoacrylate is an effective and convenient therapeutic method for EGVB in children,has few complications,and holds promise for clinical application.

Objective To investigate the methods for establishing a rat model of early- stage liver failure and the changes in Th17,Treg,and Th17 / Treg after dexamethasone and thymosin interventions. Methods A total of 64 rats were randomly divided into carbon tetrachloride( CCl4) group and endotoxin [lipopolysaccharide( LPS) ]/D- galactosamine( D- Gal N) combination group to establish the rat model of early- stage liver failure. The activities of the rats and changes in liver function and whole blood Th17 and Treg were observed to evaluate the effectiveness of the rat model. Dexamethasone and thymosin were used for intervention and related effects were observed. The t- test was used for comparison of continuous data between groups,and the paired t- test was used for comparison of continuous data within one group.Results The serum levels of alanine aminotransferase,aspartate aminotransferase,and total bilirubin showed significant increases in the model groups and were significantly different from those in the control group( CCl4group: t =- 3. 95,- 3. 60,and- 3. 57,P = 0. 006,0. 009,and 0. 009; LPS / D- Gal N combination group: t =- 10. 56,- 9. 63,and- 11. 82,all P < 0. 001). After the model was established,the rats showed an increase in Th17,a reduction in Treg,and Th17 / Treg imbalance. The liver pathology in the rats in the model groups was consistent with the changes in early- stage liver failure. After dexamethasone intervention,the rats showed a reduction in Th17( CCl4group: 0. 830 ± 0. 224 vs 0. 580 ± 0. 105,t = 3. 25,P = 0. 014; LPS / D- Gal N combination group: 1. 301 ± 0. 163 vs 0. 921 ±0. 141,t = 4. 12,P = 0. 004),an increase in Treg( CCl4group: 0. 317 ± 0. 076 vs 0. 385 ± 0. 083,t =- 11. 13,P < 0. 001; LPS / D-Gal N combination group: 0. 351 ± 0. 110 vs 0. 570 ± 0. 119,t =- 4. 06,P = 0. 005),and Th17 / Treg rebalance( CCl4group: 2. 201 ±0. 556 vs 1. 511 ± 0. 534,t = 3. 56,P = 0. 09; LPS / D- Gal N combination group: 3. 699 ± 0. 976 vs 1. 619 ± 0. 423,t = 3. 82,P = 0. 07).After thymosin intervention,the rats showed an increase in Th17( CCl4group: 1. 161 ± 0. 219 vs 1. 270 ± 0. 230,t =- 5. 74,P = 0. 001;LPS / D- Gal N combination group: 0. 451 ± 0. 095 vs 0. 929 ± 0. 130,t =- 8. 61,P < 0. 001),a reduction in Treg( CCl4group: 0. 643 ±0. 100 vs 0. 615 ± 0. 092,t = 2. 66,P = 0. 032; LPS / D- Gal N combination group: 0. 200 ± 0. 085 vs 0. 161 ± 0. 095,t = 3. 15,P =0. 016),and aggravation of Th17 / Treg imbalance( CCl4group: 1. 799 ± 0. 625 vs 2. 071 ± 0. 587,t =- 6. 47,P < 0. 001; LPS / D- Gal N combination group: 2. 244 ± 0. 634 vs 5. 770 ± 1. 455,t =- 11. 72,P < 0. 001). Conclusion The two methods of CCl4 and LPS / D-Gal N combination can successfully establish the rat model of early- stage liver failure with no deaths,and liver histological results and serum biochemical changes are in consistence with the changes in early- stage liver failure. Dexamethasone intervention helps to improve Th17 /Treg imbalance,while thymosin intervention causes aggravation of Th17 / Treg imbalance.

Objective To investigate the mechanism of α- naphthyl isothiocyanate( ANIT) inducing cholestatic hepatitis. Methods A total of 60 healthy male Sprague- Dawley rats were randomly divided into normal control group( N group with 30 rats) and model group( ANIT group with 30 rats),and each group was further divided into three subgroups according to different time phases after gavage( at 24,48,and 72 hours after gavage),with 10 rats in each group. The serum levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),gamma- glutamyl transpeptidase( GGT),and total bilirubin( TBil) were measured,and the level of malondialdehyde( MDA) in the liver was measured. A light microscope was used to observe the pathological changes in the liver,and a transmission electron microscope was used to observe the changes in the ultrastructure of the bile canaliculus. A confocal laser scanning microscope was used to analyze the mean fluorescence intensity of phalloidine labeled by fluorescein isothiocyanate in order to determine the change in the level of fibrous actin( F- actin). Results After the administration of ANIT by gavage,the model group showed significant increases in the serum levels of ALT,AST,GGT,and TBil and the level of MDA in liver tissue compared with the normal control group. The model group also showed damage in the structure of the hepatic lobules,hyaline degeneration of hepatocytes,spotted,patchy,and focal necrotic lesions,and neutrophil infiltration mostly confined to the hepatocytes around the bile duct,proliferation of biliary epithelial and fibrous tissues,widened perisinusoidal spaces,dilation of the bile canaliculi,extensive shedding of microvilli,and formation of bile thrombi in the bile capillaries,as well as a low fluorescence intensity of F- actin. The above changes were the most obvious at 48 hours; recovery began at 72 hours,but significant differences were still seen between the two groups. Conclusion ANIT can cause lipid peroxidation in liver tissue and lead to degeneration and necrosis of liver cells,damage of microvilli of the bile canaliculi,and formation of bile thrombi,as well as reduction in the expression of F- actin in the bile canaliculi. Therefore,it affects the function of the liver to secrete bile and causes cholestatic hepatitis.

Besides regulating lipid,statins can inhibit inflammatory response,improve the function of endothelial cells,and protect intestinal mucosal barrier. Therefore,it can be used to relieve the clinical symptoms of acute pancreatitis,shorten the course of treatment,and improve the prognosis,and can play an important role in treatment. With the wide application of statins,their adverse effects are gradually being recognized,including acute pancreatitis. The World Health Organization database lists a variety of statins that can cause acute pancreatitis,but related mechanisms remain unknown. In view of the contradictory results mentioned above,this article reviews the current status,mechanisms of action,and roles of statins in acute pancreatitis and points out that further double- blind trials are needed to investigate the association between statins and acute pancreatitis.