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 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.

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.

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

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

[Abstract] Objective To investigate the clinical value of plasma (1-3)-β-D-glucan test (G test) for diagnosis of fungal bloodstream infection. Methods The blood samples for fungal culturing and G test were collected in Changhai Hospital of Naval Medical University (Second Military Medical University) from Jan. 2015 to Dec. 2017. The department distribution and strain distribution of 264 positive specimens detected by fungal blood culture were analyzed. A total of 1 678 samples were collected during this period for fungal blood culture and plasma G test. Taking fungal blood culture as the criterion, with a cut-off of 100.5 pg/mL for G test, we analyzed the sensitivity, specificity, positive forecast value, and negative forecast value of G test for diagnosis of fungal bloodstream infection. Statistical analysis was performed using SPSS 19.0 software, and the diagnostic value of G test for bloodstream infection was judged by the receiver operating characteristic (ROC) curve. Results A total of 264 strains of fungal blood culture were positive from 2015 to 2017, mainly from the departments of hepatobiliary surgery (81 strains), cardiac surgery (57 strains), emergency (24 strains), thoracic surgery (22 strains), and hematology (16 strains). Candida is the main genus, of which Candida parapsilosis is the most common one, with 142 strains (53.8%), followed by Candida corneum (36 stains, 13.6%), Candida albicans (20 strains, 7.6%) and Candida tropical (18 strains, 6.8%). Taking fungal blood culture as the criterion, we found that the sensitivity, specificity, positive forecast value, and negative forecast value of G test for diagnosis of fungal infection were 61.3%, 87.9%, 31.1%, and 96.2%, respectively. ROC curve analysis showed that G test was valuable for diagnosis of fungal bloodstream infection, with the area under the curve being 0.771 (95% confidence interval: 0.723-0.819). Among 137 cases of bloodstream infection, 102 cases (69.6%) were tested for G test 2-5 d before blood culture, and 71 cases were positive. Conclusion Plasma G test kit is still ideal in terms of specificity and has a certain clinical value for the early diagnosis of fungal bloodstream infection.

Objective: To investigate the effect of calcitonin (CT) on promoting collagen synthesis and osteogenesis of human periodontal ligament stem cells (hPDLSCs). Methods: Fifty adult participants were divided into chronic periodontitis (CP) group (n=25) and control group (n=25). In the CP group, the anterior maxilla with probing depth ≥5 mm and the sites with imaging evidence of bone loss were selected. The gingival crevicular fluid (GCF) samples were collected from 6 maxillary sites in each patient. In the control group, multiple sites without inflammation (10 to 12 per subject) were sampled to ensure that a sufficient amount of GCF was collected. The expression of CT, transforming growth factor β1 (TGF-β1) and bone morphogenetic protein (BMP) 2/4/7 in GCF was detected by enzyme linked immunosorbent assay (ELISA), and the correlation between CT expression and clinical parameters such as periodontal pocket probing depth (PD), clinical attachment loss (CAL) and gingival index (GI), and the above-mentioned indicators was investigated with Spearman correlation analysis. hPDLSCs were infected with the adenoviruses carrying CT gene (Ad.CT) and the expression of mRNA and protein of TGF-β1, BMP2/4/7, alkaline phosphatase (ALP), osteocalcin (OCN) and collagen type I/III (Col I/III) were detected by quantitative real-time PCR and Western blotting. Results: The expression level of CT in GCF of the CP group was significantly higher than that of the control group ([32.62±1.46] ng/mL vs [17.70 ± 0.76] ng/mL, P<0.01). The expression of CT was positively correlated with clinical parameters such as PD, CAL and GI (P<0.01, P<0.05). The expression levels of BMP2/4/7 and TGF-β1 in GCF of the CP group were significantly higher than those of the control group (BMP2: [138.67 ± 4.04] ng/mL vs [103.96 ± 2.78] ng/mL, BMP4: [155.53 ± 3.55] ng/mL vs [133.15 ± 2.92] ng/mL; BMP7: [106.59 ± 2.85] ng/mL vs [90.22±1.56] ng/mL; TGF-β1: [105.92 ± 3.40] ng/mL vs [89.85 ± 2.42] ng/mL; all P<0.01). The expression of BMP2/4/7 and TGF-β1 was negatively correlated with CT expression (P<0.01, P<0.05). The overexpression of CT significantly increased the expression of TGF-β1, Col I/III and osteoblast markers BMP2/4, ALP and OCN in GCF (all P<0.01). Compared with the cells co-infected with Ad.CT and Ad.Null, the cells co-infected with Ad.CT and small interfering RNA specifically blocking TGF-β1 (Ad.TGF-β1 siRNA) had significantly lower collagen expression (Col I: 0.16 ± 0.02 vs 0.22 ± 0.03; Col III: 0.11±0.01 vs 0.15 ± 0.02; both P<0.01). Compared with Ad.CT infected cells, the protein expression levels of ALP and OCN were significantly decreased in Ad.CT and noggin co-treated cells (ALP: 0.19 ± 0.02 vs 0.25 ± 0.03; OCN: 0.13 ± 0.01 vs 0.19 ± 0.02; both P<0.01). Conclusion: CT can promote collagen synthesis and osteogenesis in hPDLSCs through TGF-β1 and BMP signaling transduction pathways.

Objective To investigate the related factors and clinical features of unexplained early neurological deterioration (END) of acute ischemic stroke (AIS) patients after intravenous thrombolysis. Methods A total of 258 AIS patients, who underwent intravenous thrombolysis treatment within 4.5 h of onset and were registered continuously in Stroke Center of our hospital between Jan. 2016 and Feb. 2018, were included in this study. The unexplained END was defined as the National Institutes of Health stroke scale (NIHSS) score increasing by more than 4 within 24 h of onset compared with that before thrombolysis, with no definite mechanism by imaging examination. The baseline and clinical data were compared between the unexplained END and non-END patients. The clinical features of the AIS patients with unexplained END were analyzed. Results Among the 258 patients enrolled in this study, 243 (94.2%) had no END and 15 (5.8%) had unexplained END. Compared with the patients without END, the proportion of diabetes mellitus in the patients with unexplained END was significantly higher and the door-to-needle time (DNT) was significantly longer (χ2＝6.093, P＝0.048; Z＝2.055, P＝0.040). The NIHSS score of 15 patients with unexplained END before thrombolysis was low (5 [4, 9]). The most common type of trial of Org 10172 in Acute Stroke Treatment (TOAST) classification was small artery occlusion (11 cases, 73.3%). The most common infarction sites were posterior limb of internal capsule (6 cases, 40.0%) and ventromedial pons (6 cases, 40.0%). Conclusion Diabetes mellitus and long DNT may be the risk factors of unexplained END in the patients with AIS after intravenous thrombolysis. Unexplained END usually occurs in the AIS patinets with small artery occlusion and has lower NIHSS score; the common sites of infarction are posterior limb of the internal capsule and ventromedial pons.

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.