Objective To assess the risk factors of adrenal incidentalomas during follow up. Methods In 43 patients with adrenal incidentalomas, the significant risk factors were screened by univariate analysis, and the multivariate analysis was evaluated by logistic regression. Results After an average of (4.0?1.2)years of follow up,4 out of in 21 patients with adrenalectomy were verified to be malignant. By means of multivariate analysis, tumor size ( P =0.018)and abnormal level of hormonal or its metabolic products ( P =0.039)were the risk factors for adrenal incidentalomas and adrenalectomy should be considered when indicated. Conclusions The gains and losses of open surgery for adrenal incidentalomas should be weighed up.If the evaluation of risk factors reveals a possibility of malignancy,adrenalectomy should be undertaken.

Objective:To investigate and analysis the distribution situations of Rh blood group system from voluntary blood donors in Foshan area.Methods:Anti-D,anti-C,anti-c,anti-E and anti-e reagents were used to identify Rh blood group system and the RhD(-) was confirmed.The phenotypes,haplotypes and corresponding genotypes frequencies were calculated and the datas were analyzed based on Hardy-Weinberg law.Results:The characteristics of phenotype frequencies in the voluntary blood donors in Foshan area was CCDee＞CcDEe＞CcDee＞ccDEE＞ccDEe＞CCDEe＞CcDEE＞ccdee＞ccDee,Ccdee＞CCdee,ccdEe＞CCDEE,CCdEE,CCdEe,CcdEE,CcdEe and ccdEE.The characteristics of haplotypes frequencies was CDe＞cDE＞cDe＞CDE,de＞Cde＞cdE＞CdE.The characteristics of genes frequencies was D＞d,C＞c,e＞E.The frequency of RhD(-)phenotype was 0.379%.The gene frequency of d was 0.061.The observed value and desired value of the haplotypes and corresponding genotypes were not statistically significant(P>0.05).The data were analyzed well based on Hardy-Weinberg law.Conclusion:The result is reliable according to Hardy-Weinberg law.The distribution of Rh blood group system from voluntary blood donors in Foshan area has geographic and general characteristics.The result is important in guiding the recruitment of voluntary blood donors and banking blood reasonably and enhancing the abilitiy of offering blood for the recipients of rare blood group.

Objective To design a nailing guiding device to improve individual atlas pedicle screw implantation, avoiding the damage of adjacent tissues and reducing the risk of operation. Methods Three-dimensional data of CT scan of 30 adult atlas were collected and analyzed by SPSS 21.0 software with 95 % reference value range. The height of the posterior arch in starting point, the horizontal distance between starting point and the center of posterior tubercle, and the longitudinal distance from starting point to cortical bone of anterior arch through the center of lateral mass were determined for designing the guiding device. The designing steps included; (1) the fixing device of guider was designed with posterior tubercle of atlas as the anchor point; (2) based on the anchor point, vertical lifting rod and lateral vernier stents were installed to resist the external force of nailing and to preliminarily locate the starting point refering to the preoperative imaging data, repectively; (3) a needle sleeve was installed on the transverse stents, and the position of starting point and the direction of screw were determined; and (4) other parts included 2 mm diameter needle, screw nut, screw driver, etc. Clinical study: the designed guider was used in patients with atlanto-axial dislocation or instability, and patients receiving tranditional therapy were taken controls. The efficay of designed guider was evaluated by comparing the success rates and operation time of the two methods. Results The nailing success rate of the designed guider was significantly higher than that of the control group (96. 15% [25/26] vs 84. 61% [22/26], P=0. 025). The Operation time of the guider group was significantly shorter than that of control group ([123. 38 ± 5. 59] vs [137. 62 ± 4. 15] min, P<0. 05). Conclusion We have successfully designed an individual guiding device for atlas pedicle screw implantation, which can help to improve the operation efficiency.

Objective To develop a percutaneous technique with expandable balloon catheter for establishing a sheep model of acute cervical spinal cord compression injury. Methods Twelve adult male sheep were randomized into 3 groups: control (A, n = 4), 0. 6 mL compression (B, n = 4) and 1 mL compression (C, n = 4) groups. All animals received epidural balloon catheter (3Fr) insertion using a percutaneous trans-lumbosacral interlaminar space technique similar to the method used in vascular access for angiography. The balloon catheter was advanced under fluoroscopic guidance until its distal tip reached the C6/7 level. One week later, the balloons of group B and C were inflated by 0. 6 mL and 1 mL half-strength contrast material; the balloons were left inflated for 1-hour and then deflated. Animals in group A received no treatment. CT and MR images were taken before and after surgical procedures. Quantitative assessment of spine canal occupying rate was accomplished by using a software program based on CT results. Motor functions of animals were assessed by modified Tarlov scale. Two animals were sacrificed each time at 24 h and 48 h after inflation in each group. Spinal segments of the injured level were then obtained for pathologic examination. Results Balloon catheters were successfully inserted in all animals, and the spinal-canal-occupying rates were (9. 1±0. 2)% in group A, (9. 1±0. 2)% in group B, and (8. 9±0. 2)% in group C after insertion. After inflation, the rates increased to (45. 5 ± 2. 5)% in group B and (78. 3±2. 3) % in group C, and MRI findings indicated ventral compression of the cervical spinal cord. Hind limb movement remained normal after catheter insertion in all groups. Animals in group B and C became paraplegic after inflation, and a positive correlation between injection volume and Tarlov score was observed. Pathological results demonstrated neuron atrophy, increased gap around the neurons, mild demyelinated and vacuolar degeneration in both group B and C at C6/7 level 24 h after injury. Pathological changes deteriorated at 48 h after injury. Conclusion Percutaneous epidural balloon catheter insertion can avoid surgical exposure of normal tissues around the spinal cord, and it may serve as a method for establishing acute cervical spinal cord injury model simulating the clinical condition.

OBJECTIVETo explore the effects and possible mechanisms of decitabine on Molt4 in vitro.

METHODSEffects of decitabine on cells proliferation were detected by using CCK-8, the apoptosis by Annexin V-FITC, cell cycles by propidium iodide-FACS. Discrepancy genes were screened by RNA-seq technique. The CpG methylation of lactoferrin (LTF) gene in Molt4 cells were identified by Bisulfite sequencing PCR (BSP). The expression of LTF mRNA in Molt4 by RT-PCR and LTF protein expression were analyzed by Western blot.

RESULTSDecitabine effectively inhibited proliferation and induced apoptosis for Molt4 cells by an time- and dose-dependent manners. Cell cycles were arrested at the G₀/G₁ phase. The promoter methylation degree of LTF gene in Molt4 cells was 72.3% before decitabine treatment and decreased to 45.0% after treatment with 0.50 μmol/L decitabine for 72 h. After the reduction of methylation, expression of its mRNA and protein increased, meanwhile caspase 3 and caspase 9 protein expression levels increased.

CONCLUSIONThe demethylating drug decitabine can induce apoptosis, detain cell cycle at phase G₀/G₁, inhibit proliferation and up-regulate LTF gene expression in Molt4 cells. LTF may become a new target for acute T lymphoblastic leukemia.

Antimetabolites, Antineoplastic ; Apoptosis ; Azacitidine ; analogs & derivatives ; Caspase 3 ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; DNA Methylation ; Humans ; Lactoferrin ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; Promoter Regions, Genetic

Angiomyolipoma/diagnosis ; Angiomyolipoma/*pathology ; Biopsy, Needle ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/*pathology ; Diagnosis, Differential ; Liver Neoplasms/diagnosis ; Liver Neoplasms/*pathology

AIMTo study the mechanisms of sodium ferulate (SF) on inhibition of collagen synthesis in hepatic stellate cells.

METHODSCollagen synthesis was analyzed by measuring 3H-proline incorporation. ELISA method was used to study the effect of SF on transforming growth factor beta1 (TGFbeta1) level in cultured HSC-T6 cell. The effect of SFon the TGFbeta1 activity in the supernatant of culture was analyzed by mink lung epithelial cell (Mv1Lu) proliferation inhibition by MTT assay.

RESULTSSF inhibited collagen synthesis in hepatic stellate cells stimulated with TGFbeta1. SF was shown to decrease TGFbeta1 level in the supernatant of HSC-T6 increased by oxidative stress. TGFbeta1 activity was intervened by SF.

CONCLUSIONSF could decrease collagen synthesis, with mechanism may be associated with that SF intervened TGFbeta1 activity, and reduced the level of TGFbeta1 increased by oxidative stress.

Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Collagen ; biosynthesis ; Coumaric Acids ; pharmacology ; Epithelial Cells ; cytology ; Hepatocytes ; cytology ; metabolism ; Lung ; cytology ; Mink ; Oxidative Stress ; Rats ; Transforming Growth Factor beta ; metabolism ; Transforming Growth Factor beta1

Irisin is a newly discovered myogenic glycosylation of peptide which can promote expression of uncoupling protein in white fat cells, facilitate lipid droplet formation, increase mitochondrial density and oxygen consumption of fat cells, and results in the shift from white fat cells to brown fat cells and promotion of β cells regeneration, thus inhibiting the occurrence of obesity and insulin resistance. Meanwhile, Irisin can also increase brain-derived neurotrophic factor, activate genes involved in learning and memorizing, so as to improve cognition function. Furthermore, Irisin is also reported to mitigate aging by extending the length of telomeres. This paper reviewed the relationship between Irisin and type 2 diabetes in the elderly, hoping to provide reference for prevention and treatment of type 2 diabetes in the elderly.

Objective To compare the clinical efficacies between open resection and laparoscopic resection for gastrointestinal stromal tumors (GISTs) of stomach, and to discuss the indications of laparoscopic resection for GISTs. Methods A retrospective analysis was conducted in 174 patients with GISTs undergoing either open (open resection group [ORG], n = 76) or laparoscopic resection (laparoscopic resection group [LRG], n=98) from July 2008 to April 2014 at Changhai Hospital. The patients, according to tumor size (max diameter), were divided into two subgroups: <5 cm (113 cases: 35 cases for ORG and 78 cases for LRG), ≥5 cm and ≤10 cm (61 cases: 41 cases for ORG and 20 cases for LRG). The data for analysis included gender, age, tumor size, risk grading, mitotic rate, surgical type, operative time, intraoperation blood loss, postoperative hospital stay, postoperative feeding time, and 5-year tumor-free survival time, etc. Results The gender, age, tumor size, risk grading, mitotic rate and surgical type of patients had no significant differences between the laparoscopic and open resection groups for the two tumor size groups. When the tumor size <5 cm, the operation time was similar for the two surgical approaches, but the blood loss, postoperative hospital stay and postoperative feeding time were significantly reduced in LRG compared with ORG (P<0. 01). When the tumor size ≥5 cm and ≤10 cm, the operation time and postoperative hospital stay were similar between ORG and LRG, but the blood loss and postoperative feeding time of LRG were significantly less than those of ORG (P<0. 05). The 5-year tumor-free survival time was not significantly different between LRG and ORG for the two tumor size groups. Conclusion When the tumor size is <5 cm, laparoscopic resection is more safe and reliable than open resection for the gastrointestinal stromal tumor of stomach; when the tumor size is ≥5 cm and ≤10 cm, laparoscopic resection is safe and feasible after appropriate preoperative evaluation and patient selection.

To investigate the prevalence of thyroid nodules in elderly patients (age≥80 years) with type 2 diabetes mellitus (T2DM), and to analyze the correlation between thyroid nodules and type 2 diabetes mellitus. Methods The study included two groups: one group included 103 patients with T2DM (diabetic group) and the other group included 103 patients without T2DM (control group). Information including clinical history, fasting plasma glucose(FPG), thyroid hormone, and ultrasonic finding of thyroid glands was collected for both groups. The clinical features of thyroid nodules were compared between the two groups and their relationship with other indices was analyzed. Results (1)The prevalence rate of thyroid nodules in diabetic group was greatly higher than that of the control group (84.47% vs 70.59%). The proportion of patients with multiple nodules was as high as 80.46% in the diabetic group. Presence of thyroid nodule was significantly associated with patient ages (χ2=7.060, P<0.05), but not with gender, body mass index (BMI), or serum glucose level. (2) The positive rate of thyroid dysfunction in the diabetic group was significantly higher than that in the control group (15.53% vs 6.80%, P<0.05). The prevalence rates of sub-clinical hypothyroidism were similar between the two groups. T3 and T4 levels of thyroid function in the diabetic group were significantly lower than those in the control group (P<0.05), and the thyroid stimulating hormone (TSH) levels were similar between the two groups. Conclusion Elderly patients (age≥80 years) have a higher liability for thyroid disease, which may affect the control and prognosis of diabetes. It is recommended for those patients to receive regular check-up for thyroid function and morphology changes.