Oncolytic adenoviruses are genetically altered to replicate within tumor cella while exhibiting a high degree of infectivity,good safety and specificity.The use of oncolytic adenoviruses to treat malignant brain tumors has been proved to be a promising mode of cancer therapy.Local injection of adenoviral vectors fails to reach scattered infiltrative tumor cells within the brain parenchyma and the therapeutic effect of intracereberal injections of oncolytic adenoviruses is only seen in the vicinity of the injection site.To remedy this and prevent possible tumor recurrence,stem cells have been explored as vehicles for gene therapy in brain tumors given that they possess an intrinsic tropism for brain glioma.

Oncolytic adenoviruses have been used in cancer gene therapy because of their ability to selectively transfect and repli-cate in tumor cells. However, systemically administering oncolytic adenoviruses is often inefficient because the host's immunity also at-tacks the viruses. Delivering oncolytic adenoviruses by loading them into mesenchymal stem cells effectively solves this problem. Mes-enchymal stem cells have been described to possess a tumor-homing ability, as well as the capacity to deliver oncolytic adenoviruses. This review discusses the current challenges faced by oncolytic adenovirus delivery via mesenchymal stem cells.

Objective To evaluate the clinical effect in prevention of intravenous catheter-related infection(CRI) using antiseptic impregnated central venous catheter.Methods Intravenous catheter-related infection was retrospectively analyzed between 440 cases performed with general centrol venous catheter and 420 cases performed with antiseptic impregnated central venous catheter in ICU.Results There were 34 cases of CRI in 860 cases,28 cases were inserted general central venous catheter and 6 cases inserted antiseptic impregnated central venous catheter,the group of antiseptic impregnated was lower singificantly than the group of general in infection rate(P=0.0002).Conclusion Using antiseptic impregnated central venous catheter can reduce CRI,which has clinical effect in prevention of CRI.

Objective To evaluate the application of inguinal incision in retroperitoneal laparoscopic nephroureterectomy(LNU)in the treatment of upper urinary urothelial carcinoma(UUUC).Methods From Mar.2007 to Jan.2012,186 retroperitoneal LNU procedures on 115 males and 71 females for the treatment of UUUC were performed in our institute.All cases were grouped as inguinal incision group(n =112)and lumbar incision group(n =74)according to specimen retrieval incision.Operative time,estimated blood loss,postoperative analgesia,hospital stay,incision complications,cosmetic satisfaction and tumor recurrence were compared between the 2 groups.Results All the 186 cases of operation were successfully accomplished.There were no differences in tumor stage,tumor grade,mean operative time,blood loss between the 2 groups.In inguinal incision group,the incidence of incision fat liquefaction,incision hernia,incision bulging,lumboabdominal unsymmetry and postoperative analgesia was less than that of lumbar incision group.In inguinal incision group,the mean hospital stay was shorter,cosmetic satisfaction(Ⅰ/Ⅱ/Ⅲ)was better(7/24/81 versus 22/18/34,P ＜ 0.01).Recurrence rate of UUUC in middle and inferior segment of ureter was fewer than that of lumbar incision group(5.3％ versus 35.0％,P ＜0.01).Conclusion Retroperitoneal LNU for UUUC combined with inguinal incision offers advantage of less trauma,less complications,higher cosmetic satisfaction and lower tumor recurrence.

Objective To evaluate the antitumor effect of oncolytic adenovirus expressing human IL-18 gene on malignant melanoma implanted in nude mice.Methods BALB/c nude mice were subcutaneously inoculated with A375 cells to establish a model of malignant melanoma.When the volume of implanted tumor reached 100-150 mm3,murine models were randomly divided into three groups to receive a 3-day intratumoral injection of IL-18 gene-expressing human oncolytic adenovirus named ZD55-IL-18,IL-18 gene-expressing adenovirus named Ad-IL-18,phosphate buffer saline(PBS),respectively.The tumor size was measured at an interval of 4 days for 9 weeks.Hematoxylin and eosin (HE)staining was performed to observe the morphological changes of tumor cells.The protein expression of IL-18 and E1A.microvessel density in tumor tissue,and apoptosis of tumor xenografts were detected by immuno fluorescence assay,immunohistochemistry and in situ end labeling technique (TUNEL).respectively.Results The treatment with ZD55-IL-18 significantly inhibited the growth of tumor.Forty-four days after the treatment,the mean tumor volume was 1039.378±29.67 mm3 in ZD55-IL-18-treated mice.significantly smaller than that in Ad-IL-18 treated mice(2900.46±62.65 mm3)and PBS-treated mice(3980.24±63.78 mm3).HE staining showed that the nuclei of tumor cells were heavily stained with few nucleoli in ZD55-IL-18-treated mice.Increased positivity rate of IL-18 was noticed in ZD55-IL-18-treated mice vs.AD55-IL-18-treated mice(83.4%±3.2%vs 24.4%±2.1%.P＜0.01).Moreover,immunofluorescence assay revealed the presence of E1A protein in tumor tissue.A decrease was found in the microvessel density in ZD55-IL-18-treated mice compared with the PBS-treated mice(P＜0.01).The apoptosis rate in tumor cells from high to low was 86.28%±3.25%in ZD55-IL-18-treated mice,43.67%±3.46%in Ad-IL-18-treated mice,and 10.73%±2.48%in PBS-treated mice;there was a significant difference between the three groups(all P＜0.05).Conclusion The oncolytic adenovirus expressing human IL-18 gene,ZD55-IL-18,has a significant inhibitory effect on the growth and metastasis of malignant melanoma implanted in nude mice.

Objective To explore the feasibility and reasonable of low-dose scan on abdominal angiography in 64-slice spiral helical CT. Methods Phantom test: at 120 KV and from 200 mAs to 30 mAs at an interval of 10 mAs in each image acquisition, it was measured standard deviation (SD) of CT number, high contrast resolution and low contrast resolution, and then analyzed the relationship between the three parameters and the mAs values. Three mAs values were chosen to undertake clinical analysis.Clinical analysis: 90 randomly selected objects with abdominal angiography were divided into three groups,scanning with above three mAs values.Measurement of the SD value at the plain scan images was performed and the enhanced low-dose scan images were used post-processing with three-dimensional volume reconstruction (VR). The VR images were classified into three grades (excellent, moderate, bad) with the blind evaluation of three CT radiologists. The quality-correlation analysis was used between the standard deviation (SD) values of plain scan image and abdominal angiography VR image. Results According to the quality-correlation analysis between the standard deviation (SD) value of plain scan image and abdominal angiography VR image, the area under curve in receiver-operated characteristic (ROC) analysis was 0.921, 0.906 and 0.893 in each three group, respectively. Conclusions The low-dose scan of abdominal angiography is feasible. 80mAs can ensure better image quality. The enhanced scan probably can use 60mAs when the SD value is less than 5.78 in the plain scan; but when the SD value of plain scan is greater than 11.8, the enhanced scan is used best 100 mAs or higher.

Objective To analyze the change trends of death situation caused by cerebral apoplexy and myocardial infarction in Chongqing from 2006 to 2010 .Methods All death cases of cerebral apoplexy and myocardial infarction from the five years of 2006 to 2010 were extracted from the direct network report system covering the whole crowd death causes in Chongqing and performed the statistical analysis .Results The constituent ratio of cerebral apoplexy death was increased from 13 .94% to 16 .71% in these five years ,while which of myocardial infarction death in all death causes was stabilized around 4% .The sex ratio of male to female for cerebral apoplexy was descended from 1 .76∶1 .00 to 1 .43∶1 .00 in these five years ,while which for myocardial infarction was dropped from 1 .44∶1 .00 to 1 .30∶1 .00 ;which of cerebral apoplexy and myocardial infarction below 75 years old tended to de-cline ,while which above 75 years old tended to rise .Conclusion The cerebral apoplexy harm to Chongqing people′s life is increas-ing ,while the harm caused by myocardial infarction changes little ;the constituent ratio of female death caused by cerebral apoplexy and myocardial infarction is rising ;the cerebral apoplexy and myocardial infarction damage to old people above 75 years old is grea-ter ,and this damage still continues to grow .

Objective To understand the prevalence of diabetes and its influencing factors among rural residents in Fengdu coun-ty of Chongqing and to provide the suggestion for diabetes prevention and control.Methods Rural residents aged above 18 years old were sampled by stratified clustered random sampling.The data was entered by software Epi data3.02 and analyzed by SPSS 16.0.The rate was compared by Chi-square test.The influencing factors of diabetes was identified by multivariate logistic regres-sion.Results A total of 623 rural residents was investigated.The average age was (51.3±1.4)years old.The rate of smoking at present was 20.2% and the rate of smoking at present among male rural residents was 53.0%.The rate of passive smoking was 38.2%.The rate of drinking alcohol in the past 12 months was 22.8%.And its rate of male residents was 41.7%.The awareness rate of height,body weight,waist circumference,blood pressure and blood glucose was 9.5%,13.6%,1.9%,50.1% and 12.4%respectively.The crude and adjusted prevalence of obesity,hypertension and diabetes was 11.4% and 8.3%,52.5% and 28.4%, 12.0% and 9.3%.The result of multivariate logistic regression indicated that whether parents had diabetes(OR=0.20,95%CI :0. 04-0.94)and whether participants was diagnosed to be hypertension (OR=2.31,95%CI :1.19-4.49)was the independent fac-tor of diabetes.Conclusion The prevalence of diabetes among rural residents in Fengdu county of Chongqing was high.The risk factors such as smoking,alcohol use and unbalance diet was common.It should be strengthened to conduct the comprehensive ine-trevention for diabetes in rural area.

Objective Toinvestigatetheapplicativevalueof3D-DSAandheadMRIorCTfusion technology for guiding the individualized treatment of intracranial arteriovenous malformation (AVM ). Methods Twenty-onepatientswithAVMdiagnosedwithDSAattheDepartmentofNeurosurgery,Nanjing General Hospital of Nanjing Military Command from January 2015 to May 2015 were analyzed retrospectively. All patients performed DSA,MRI,and CT scan respectively before procedure,and they also performed 3 D-DSA and MRI or CT fusion. Of the 21 patients,15 performed MRI and 3D-DSA fusion,6 performed CT and 3D-DSA fusion. According to the image fusion results of the patients,the individualized treatment regimens were further developed,including microsurgical resection,endovascular embolization,and stereotactic radiotherapy (alone or combined treatment). The patients were followed up and observed for 2 to 6 months after procedure.Results Fromthe3D-DSAwithheadMRIorCTfusionimagesofthepatientsbeforetheprocedure not only could observe the vascular architecture of AVM,the relationship between the niduses and the surrounding nerve structures,but also could precisely locate the positions of AVM with small aneurysms or tiny AVMs. According to the results of image fusion,17 patients with AVM were treated with microsurgical resection,2 were treated with interventional embolization and stereotactic radiotherapy,and 2 were treated with stereotactic radiotherapy only. Of the 17 patients with AVM underwent microsurgical resection, none experienced intracranial rebleeding during the follow-up period. The last Glasgow outcome scale (GOS)score was 5 in 13 cases,and 4 in 4 cases. One patient with AVM underwent combined stereotactic radiotherapy had intracranial rebleeding during the follow-up period,and their last GOS score was 4. The other remaining 3 patients did not have new neurological deficits or rebleeding during the follow-up period,and theirGOSscorewas5.Conclusions 3D-DSA,headMRI,andCTfusiontechnologyarenovel, the operative method is simple,and the fusion image is accurate. They can effectively develop the individualized treatment regimens for patients with AVM.

Objective To investigate the clinical risk factors of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods From January 2015 to April 2016,106 consecutive patients with aSAH treated with endovascular embolization at the Department of Neurosurgery,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.The patients were divided into either a DCI group (n =34) or a non-DCI group (n =72) according to whether the occurrence of DCI.The general information of patients were collected,including sex,age,Hunt-Hess grade,modified Fisher grade,world federation of neurosurgical societies (WFNS) grade,acute cerebral edema,early (bleeding 1-3 d) hypoalbuminemia,and hypohemoglobinemia.Univariate and multivariate Logistic regression analyses were used to analyze the risk factors for occurrence of DCI.Results The incidence of DCI was 32.1％ (34/106).The Hunt-Hess grade ≥ Ⅲ,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ,acute cerebral edema,the incidences of hypoalbuminemia and hypohemoglobinemia in the DCI group were higher than those in the non-DCI group.There were significant differences between the 2 groups (all P ＜ 0.05).There were no significant differences in the ratios of sex,age ≥ 55 years,hypertension,diabetes and hyponatremia between the 2 groups (all P ＞ 0.05).In univariate analysis,the Hunt-Hess grade ≥ Ⅲ grade,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ on admission,and hypoalbuminemia were used as the independent variables for multivariate analysis,the results showed that WFNS grade ≥ Ⅳ (OR,8.02;95 ％ CI 2.41-26.70),modified Fisher grades ≥ Ⅲ (OR,4.44;95％ CI 1.38-14.32),and hypoalbuminemia at day 1-3 (OR,5.42;95％ CI 1.40-20.76) were the independent risk factors for occurring DCI in patients with aSAH (all P ＜ 0.05),and the Hunt-Hess grade ≥ Ⅲ was not the risk factor for occurring DCI in patients with aSAH (OR,1.86;95％ CI 0.39-8.88,P ＞ 0.05).Conclusion The patients with hypoalbuminemia,WFNS grade≥Ⅳ on adrnission,and modified Fisher grade ≥ Ⅲ may were the independent risk factors DCI after aSAH,and the clinical diagnosis and treatment should attach great importance to.