Although the mutations in RET,VHL,NF1,SDHB,and SDHD genes have been identified to be　responsible for familial pheochromocytomas, the pathogenesis of most pheochromocytomas remains unknown.Inadequate methods to distinguish malignant from benign tumors and a lack of effective treatments for the malignancy　are critical problems that require further resolution.Indeed,epigenetic changes are now recognized to be at least as　common as genetic changes in cancer.In recent years,research has been initiated to shed light on epigenetic aspects　such as DNA methylation and microRNA in pheochromocytomas,to explore the molecular mechanism,and might　provide a diagnostic tool and a target for future therapies.

The smooth conversion of scientific achievements in Chinese medicine to standards acts as a bridge in the industrialization process of scientific achievements. By combining scientific researches and standards development of Chinese medicine, this paper analyzed how to establish a mechanism for mutual supports of scientific research and standards development. Based on different categories of scientific achievements in Chinese medicine, this paper ex-plored models for converting fundamental achievements for public wealth and technical achievements for products in-to standards.

Objective To investigate the positive detective rate of interlobar node in the operation of non-small cell lung cancer (NSCLC), and to compare the effect of interlobar node dissection by video-assisted thoracoscopic surgery (VATS) with thoracotomy in treatment of lung cancer. Methods 108 patients with NSCLC who received the surgery by the same group of thoracic surgeons were collected from Aug 2012 to Mar 2016 in Guangdong Medical University Affiliated Kaiping Central Hospital. The positive transfer and detective rates of interlobar node in patients with different clinical and pathological stage were analyzed. Then the patients were divided into traditional open thoracotomy group and VATS group according to the operation mode, meanwhile, the number of interlobar nodes dissection in the two groups were compared. Results The positive transfer rates of the interlober nodes in patients with different clinical stage were ⅠA 5.7 % (2/35),ⅠB 5.0 % (1/20), ⅡA 14.3 % (3/21), ⅡB 13.3 % (2/15), ⅢA 29.4 % (5/17); For patients with different pathological T stage were T1A 8.3 % (2/24), T1B 9.1 % (2/22), T2A 12.9 % (4/31), T2B 14.3 % (2/14), T3 21.4 %(3/14), T4 33.3 % (1/3), and over-all transfer rate was 13.0 % (14/108). In pathology stage and pathology T stage, the number of interlober nodes had no statistical difference in traditional open thoracotomy group and VATS group (all P>0.05). Conclusions Even in the early clinical stage, the transfer of interlobar node may be positive. The transfer rate of interlobar node is correlated positively with pathology T stage. VATS can achieve the same effect in interlobar node dissection compared with the traditional approach.

Objective To compare the effect of mediastinal lymph node dissection by video -assisted thora-coscopic surgery (VATS)with thoracotomy in the treatment of lung cancer.Methods 96 patients with non -small cell lung cancer were collected.Patients undergoing VATS were matched with those undergoing thoracotomy in terms of gender,age,clinical tumor stage,tumor location and surgical procedure.Results After matching,48 patients in VATS group and 48 patients in open group were eligible for analysis.In the VATS and open groups,the mean total numbers of dissected lymph nodes were (27.2 ±7.4)and (28.8 ±10.6)(P =0.507),the numbers of N1 nodes were (9.4 ±4.0)and (8.3 ±4.6)(P =0.323).And the number of N2 nodes was similar between the VATS and open group [(18.5 ±6.9)vs (21.3 ±9.9),P =0.201].No significant differences were observed between the two groups(all P >0.05 ).But the days of the postoperation and the chest tube indwelling in thoracotomy group were (8.1 ±3.9)and (7.3 ±4.4)days,which in the VATS group were (6.8 ±3.5)and (5.6 ±3.5),the VATS group had more advantages than the thoracotomy group(P <0.05).The intraoperative blood loss more than 400mL and peri-operative blood transfusion rate of the thoracotomy group were 27.38% and 25.00%,those of the VATS group were 7.03% and 8.60% respectively,which in thoracotomy group were higher than the VATS group.Conclusion Under-go our retrospective study,after mature VATS to treat lung cancer,with regard to the number of the dissected lymph nodes,VATS lobectomy can achieve complete mediastinal lymph node dissection compared with the traditional approach.There are more advantages by VATS in the complications.

Objective:To explore the influence of RNAi mediated Slug silencing on the growth and metastasis of colon cancer in nude mice.Methods: HCT116 colon cancer cells use for 24 five-week-old nude mice implanted subcutaneously , established colon cancer xenograft model in nude mice ,all divided into blank control group ,negative control group and the experimental group ,each group had eight nude mices.All group were injected with saline , negative plasmid and lentivirus vectors respectively.Tumor growth was observed and draw tumor curved growth ,changes in tumor growth and lymph node metastasis between the groups were observed ,Slug gene and protein expression were detected by immunohistochemistry ,qRT-PCR and Western blot analysis.Results: Slug gene shRNA intervention group compared with the control group and negative control group ,tumor grew slower ,tumor mass was significantly reduced (3.08±0.31 vs 7.37±1.18,7.46±1.16,P＜0.01),experimental group of lymph node-positive rate was 36.3%( 4 /11 ) ,compared to the negative control group 77.8% ( 14/18 ) and the control group was 68.4% ( 13/19 ) ( P＜0.01 ).Conclusion: Targeted Slug RNA interference can significantly inhibit the growth of colon cancer in nude mice ,lymph node metastasis and the expression of the gene protein in cancer tissue ,Slug may be a potential molecular target for colon cancer gene therapy.

Objective To discuss the clinical features of trachea and bronchial tuberculosis and estimate the efficacy of the diagnosis of trachea and bronchial tuberculosis by fiberoptic bronchoscopy. Methods Clinical presentations and examination of fiberoptic bronchoscopy findings of 216 patients diagnosed by Olympus electric or fiberoptic bronchoscopy were retrospectively investigated. Results Male of the 216 patients were 95, female were 121, with 1.27 times higher incidence noted in female than in male subjects. An activator dry cough was the most complain in 72.7% , intermittent hemoptysis was in 34.7% , absenting of typical clinical poisoning symptoms of tuberculosis. Atelectasis and shape in lung were the most common chest roentgenographic presentations respectively in 31.0 % and 24.1 %. Chest roentgenographic presentations of 16.7% were normal. Bronchoscopic findings showed that main pathologic changes included 36.1% granulation, 31.0% mucosa inflammation, 24.1% ulceration (or necrosis) and 8. 8% cicatricial stenosis, left lung (56. 2%) was more often affected than right lung (37.6%), left bronchi (26.9% ) was in the first. The pathologic changes affected all of leaf, segment bronchi. One hundred and seventy-eight cases (82.4%) were diagnosed by bronchoscopic biopsy, 68 cases (31.5%) were diagnosed by bronchoscopic brushing examination for acid - fast bacillus. Conclusion The clinical features of trachea and bronchial tuberculosis are non - specific and easy to be misdiag-nosed. It is the main reason to be misdiagnosed that bronchial biopsy is neglected by clinical doctors. Bronchial biopsy should be the most reliable and accurate step to get the definite diagnosis.

ObjectiveTo detect mRNA and protein expression of steroidogenic factor-1 ( SF-1 ) and DAX-1 in human adrenocortical tumors and normal adrenal cortex,and to investigate the effect of SF-1 and DAX-1 on the steroidogenesis and development of adrenocortical tumors.Methods Total RNA and protein was extracted from angiotensin Ⅱ unresponsive aldoterone-producing adenomas ( A Ⅱ -U-APA,n =12 ),angiotensin Ⅱ responsive aldoterone-producing adenomas ( AⅡ -R-APA,n =5 ),cortisol-producing adenomas ( CPA,n =10 ),adrenal nonfunctional adenomas ( NFA,n =10 ),aldosterone-producing carcinoma ( APC,n =2 ) and normal adrenal cortex ( NAC,n =8).To analyze gene expression of SF-1,DAX-1,ACTH receptor(ACTHR),and β-actin by real-time quantitative PCR in different tissues.The protein expression of SF-1,DAX-1,and β-actin in the same tissues by Western blot.To study the relationship of ACTHR,SF-1,and DAX-1 with clinical data in adrenocortical tumors.ResultsThe expression of SF-1,DAX-1 mRNA and protein was different in NAC,AⅡ -U-APA,A Ⅱ -R- APA,APC,CPA,and NFA tissues [ relative expression of SF-1 mRNA:24.58±2.45,23.89±3.17,21.59±3.00,(38.75,44.16),14.17±2.80,and 36.38±3.50; DAX-1 mRNA:0.57±0.06,0.37±0.05,0.43±0.05,( 1.52,1.21 ),0.39 ±0.04,and 0.83 ±0.08 ; SF-1 protein:0.76 ±0.11,0.76 ±0.10,0.73 ±0.07,(1.24,1.40),0.55±0.04,and0.98±0.10; DAX-1 protein:0.65±0.14,0.39±0.13,0.43±0.14,(1.18,1.02),0.56±0.04,and 1.03±0.13 ; all P＜0.05 or P＜0.01 ].There was negative correlation by higher SF-1/DAX-1 ratio and tumor size in AⅡ -U-APA tissues.The mRNA and protein expression of SF-1 was lower in CPA and there was the positive correlation with tumor size.Conclusion SF-1 and DAX-1 might play a key role in the development of the adrenocortical tumorigenesis and steroidogenic tissues.

Objective To measure the financial burden incurred by hypertension to urban patients in Beijing, Nanjing and Hangzhou cities. Methods Two communities were sampled from the three cities randomly, and 300 hypertension patients were sampled randomly from hypertension control files in each community for questionnaire survey. Results Health expenditure of the families with hypertension patients accounts for 14. 4% of the family's income, and 18. 2% of the family's expenditure, a ratio far beyond the national average (10.6 %). However, the majority of them report the burden as affordable.The basic medical insurance for urban residents helps alleviate the financial burden of hypertension patients and the extent of such burden has a close bearing on the outcome of hypertension treatment and prevention. Conclusion Effective community-based blood-pressure monitoring and control system is key to reducing the financial burden of hypertension. The reimbursement policy for hypertensive patients within the basic medical insurance is expected to be further improved.

Objective To study on the difference of plasma renin activity ( PRA),angiotensin Ⅱ (Ang Ⅱ ),and aldosterone levels in patients with essential hypertension (EH) or primary aldosteronism (PA) or pheochromocytoma (PHEO),and to analyze the sensitivity and specificity on the diagnosis of PA among patients with hypertension with aldosterone/PRA ratio (ARR).Methods The plasma aldosterone,Ang Ⅱ and PRA concentrations in supine and upright positions were measured by radioimmunoassay from 413 patients including idiopathic hyperaldosteronism (IHA,n =111 ),aldosterone-producing adenoma (APA,n=l18),PHEO (n=98) and EH (n=86).ARR was calculated.Results Plasma aldosterone concentrations in both of supine and upright positions in PHEO group [ 374 (294,465 ) pmol/L and 629 (449,997) pmol/L] and PA group [471 (346,632) pmol/L and 673(499,825) pmol/L] were higher than those in EH group [ 277 (224,332) pmol/L and 427 (341,501 ) pmol/L ] (P ＜ 0.01 ).They were also higher in APA group [576 (416,731 ) pmol/L and 726 (554,906 )pmol/L ] than those in IHA group [399(313,504) pmol/L and 609(485,776)pmol/L ] (P ＜0.01).Ang Ⅱ levels in both positions were lower in PA group [43.2(26.4,74.4) ng/L and 60.1(38.5,103.6) ng/L] than in EH group [56.7 (43.3,78.9) ng/L and 84.3(61.3,108.4) ng/L] or PHEO group [54.3(29.9,101.5) ng/L and 102.8 (49.9,167.0) ng/L] (all P values ＜ 0.01 ),and there was no difference between IHA and APA group (P ＞ 0.05 ).The PRA level in both positions of each group were PHEO group [ 0.3 (0.2,1.0) μg ·L-1 · h-1 and 1.4(0.6,3.4) μg · L-1 · h-1] ＞EH group [0.2(0.1,0.4)μg · L-1 · h-1 and 0.6(0.4,1.0)μg· L-1 ·h-1] (P＜0.01) ＞PAgroup [0.1(0.1,0.1)μg· L-1 · h-1 and 0.2(0.1,0.3)μg·L-1 · h-1] (P＜0.01),and APA group [0.1(0.1,0.1)μg · L-1 · h-1 and0.1(0.1,0.3)μg · L-1 ·h - 1 ] ＜ IHA group [ 0.1 ( 0.1,0.2 ) μg · L - 1 · h - 1 and 0.2 (0.1,0.3 ) μg · L-1 · h - 1 ] ( supine P ＜0.01 ; upright P ＜ 0.05 ).APA was divided into 2 types with renin-Ang Ⅱ -responsive APA ( n =26) and unresponsive APA (n =92).The plasma aldosterone concentration was lower in supine position but higher in upright position in renin-Ang Ⅱ-responsive APA than in unresponsive APA patients.ARR in upright was higher in PA group ( P ＜ 0.01 ) but lower in PHEO group ( P ＜ 0.05 ) compared with EH.ARR was higher in APA than in IHA (P ＜0.01 ).The sensitivity and specificity of ARR as 40 (aldosterone unit:ng/dl;PRA unit:μg · L-1 · h-1; its value should multiply 27.7 when transferred to pmol/L,simili) were 93％ and 76％,respectively.Conclusion The levels of PRA,Ang Ⅱ and aldosterone from patients with EH,PA and PHEO are significant different.ARR as 40 in upright position could be used for PA screening cutoff point.

OBJECTIVE: To assess the toxicity of delivering extended field intensity-modulated radiotherapy (EF-IMRT) and concurrent cisplatin chemotherapy for locally advanced cervical carcinoma. METHODS: Forty-five patients who underwent EF-IMRT and concurrent cisplatin chemotherapy for the treatment of stage IB2 to IIIB cervical cancer were retrospectively reviewed. The clinical target volume included all areas of gross and potentially microscopic disease and regional lymph node regions. All patients underwent high-dose-rate brachytherapy. The acute and late toxicity were scored using the Common Terminology Criteria for Adverse Events and the Radiation Therapy Oncology Group late radiation morbidity scoring criteria, respectively. RESULTS: The median follow-up was 28 months (range, 5 to 62 months). Forty-two patients had a complete response, and three had a persistent disease. Of those 42 patients, 15 patients (35.7%) had recurrence. The regions of recurrence were in-field in 2 patients and out-field in 13 patients. Acute grade > or =3 gastrointestinal, genitourinary and hematologic toxicity occurred in 3, 1, and 9 patients, respectively. Three patients (6.7%) suffered from late grade 3 toxicities. Seven patients experienced ovarian transposition, 5 of those patients (71%) maintained ovarian function. Thirty-eight patients (84.4%) were alive at the last follow-up. CONCLUSION: Concurrent cisplatin chemotherapy with EF-IMRT was safe. The acute and late toxicities are acceptable. EF-IMRT provides an opportunity to preserve endocrine function for patients with ovarian transposition.
Brachytherapy ; Cisplatin* ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Radiotherapy, Intensity-Modulated* ; Recurrence ; Retrospective Studies ; Uterine Cervical Neoplasms*