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 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 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.

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

Objective To study the choice of diagnostic and therapeutic strategy for young patients with acute myocardial infarction (AMI) according to the onset characteristics. Methods We retrospectively analyzed the clinical data of 36 young and 1 283 elderly patients with AMI, who were treated between Dec. 2006 and Jan. 2012 in our hospital. The risk factors, clinical characteristics and diagnosis/treatment strategies were analyzed. Results (1) The young patients accounted for 2.7% of all the AMI patients in our study, with most of them being male (97.2%). AMI with ST-segment elevation accounted for 94.4% (34/36) among the young AMI patients, often with risk factors like smoking and dyslipidemia, scarcely with hypertension or diabetes. In the young patients the incidence rates of cardiogenic shock, heart failure and arrhythmia were 5.6% (2/36), 16.7% (6/36), and 5.6% (2/36, respectively, and there was no death during treatment or follow-up. (2) Among the 33 young patients receiving coronary angiography, 21 (63.6%) had single vessel lesions, mostly involving the left anterior descending artery and resulting in anterior myocardial infarction. Among the 15 young AMI patients who received emergent coronary angiograpy, 6 (40%) had heavy thrombus burdern but had slighter coronary stenosis, and they did not receive stent treatment. Conclusion AMI should be considered when young male patients with smoking history, dyslipidemia and chest pain. Young AMI patients often have single vessel lesions and better prognosis, and they need timely revascularization.

Objective To explore the feasibility and effectiveness of establishing an aortic valve regurgitation canine model by minimally invasive peripheral vascular catheter method. Methods A total of 10 healthy canines were selected in this study. An aortic insufficiency animal model was established by percutaneous femoral artery puncture and aortic dilatation. Aortic angiography and transthoracic echocardiography were used to evaluate aortic valve regurgitation immediately after operation. Results Aortic valve regurgitation animal models were successfully established in all the 10 canines. Two canines died of acute left ventricular failure due to the large aortic regurgitation after the operation. Six surviving canines had moderate aortic regurgitation and two had slight aortic regurgitation; they survived for more than 1 month. Conclusion It is feasible to establish an aortic regurgitation canine model by minimally invasive peripheral vascular catheter method.

Objective To investigate the relationship between autonomic nervous reflex and early recurrence of atrial fibrillation after radiofrequency catheter ablation (RFCA) using diving reflex test and cold pressor test. Methods A total of 102 patients with paroxysmal atrial fibrillation were recruited in the present study. All patients underwent diving reflex test and cold pressor test before and after RFCA. The relationship between mean heart rate and early recurrence of atrial fibrillation was observed. Results Circumferential pulmonary vein isolation was successfully achieved in all the 102 patients. The mean heart rate was decreased by diving reflex test and increased by cold pressor test. The diving reflex of the participants was significantly decreased after RFCA (P<0.05), and the cold pressor test results had no noticeable change. The diving reflex in patients with early recurrence of atrial fibrillation was more intensive than those without (P<0.05). Conclusion The parasympathetic activity is decreased in atrial fibrillation patients after RFCA, and the decrease may be related to the early recurrence of atrial fibrillation after RECA.

Objective To observe the expression of YKL-40 protein in the pulmonary tissues of rats with bleomycin-induced pulmonary fibrosis (PF). Methods The PF model group was induced with intratracheal instillation of bleomycin solution (7. 5 mg/kg) and the control group was treated with normal saline. On day 7, 14, 21 after bleomycin challenge, rats were sacrificed and the pulmonary tissues were harvested. H-E staining, Masson staining and Szapiel score were employed to determine alveolitis and pulmonary fibrosis. Expressions of YKL-40 in lung tissues were detected by real-time RT-PCR, Western blotting analysis and immunohistochemistry method. Results Bleomycin instillation induced alveolitis in the lung of rats, with inflammation score being significantly higher on day 7 (2. 8 ± 0. 45, P<0. 01) and on day 21 (1. 8 ± 0. 84, P<0. 05) compared with that of control group (0. 42± 0. 25). Pulmonary fibrosis degrees in model group was significantly higher on day 14 (1.7 ± 0.73, P<0.05) and on day 21 (2.9± 0.56, P<0. 01) compared with that of control group (0.2 ± 0.45). YKL-40 mRNA (YKL-40/p-actin) expression was significantly increased on day 7 (3. 71 ± 0. 25) after bleomycin treatment compared with the control group (P<0. 05). Western blotting analysis showed that YKL-40 protein expression was significantly increased on day 14(0. 56 ±+ 0. 24,P<0. 05) and on day 21(1. 15 ± 0. 19, P<0. 01) after bleomycin treatment compared with the control group (0. 23 ± 0. 07). The results of immunohistochemistry showed that bleomycin up-regulated YKL-40 expression in a time-dependent manner, and YKL-40 expression was mainly located in the smooth muscle cells, alveolar macrophages, alveolar epithelium and fibroblasts. Conclusion YKL-40 expression may contribute to the pulmonary fibrosis, and may participate in the pathogenesis of pulmonary fibrosis.