Management of adrenocortical tumor are developing vigorously,from diagnostic treatment to precisely therapy with endocrine lab test and radiology examination improving.The prevalence rate of incidental adrenal mass is 7％.Update researches show that surgical treatment is beneficial in subclinical hypercorisolism patients combined with adrenal incidentaloma.Histopathology improves the evaluation of prognosis in primary aldosteronism patients.For adrenocortical cancer patients,mitotane with combination of etoposide,doxorubicin and cisplatin after surgical treatment was recommended,while adjuvant radiotherapy needs more study to conform the efficacy.

Objective To observe the effectiveness of lactobacillus acidophilus combined with electroacupuncture on gastrointestinal function in patients with traumatic brain injury. Methods A total of 167 patients with traumatic brain injury treated in our hospital from June 2013 to December 2016 were randomly divided into combining treatment group (n=84) and lactobacillus acidophilus group (n=83). The lactobacillus acidophilus group was given routine treatment and lactobacillus acidophilus. The combining group was given the routine treatment, electroacupuncture treatment and lactobacillus acidophilus. Data of gastronintestinal function, infection, pH of gastric juice, serum two amine oxidase (DAO) and D-lacticacid level were compared between two groups. Results Compared with lactobacillus acidophilus group, the incidence rates of reflux (χ2=7.948), vomit (χ2=7.514), diarrhea (χ2=4.521), abdominal distension (χ2=5.968), pulmonary infection (χ2=4.521) and enterogenic infection (χ2=4.531) were significantly decreased in the combining treatment group (P<0.05). After 20-day treatment, pH value of gastric juice (t=8.125) was significantly increased, the serum DAO value (t=6.383) and D-lacticacid level (t=6.745) were decreased, in combining treatment group than those of lactobacillus acidophilus group (P<0.05). Conclusion Lactobacillus acidophilus combined with electroacupuncture can improve the gastrointestinal function, stimulate gastric acid secretion and decrease serum levels of DAO and D-lacticacid.

With the emergence of new technologies such as brain imaging, bio-sensing, human-computer interaction, cloud computing and large data, the treatment of traumatic brain injury has entered a new era. However, it must be clearly recognized that the central nervous system (CNS) trauma remains a worldwide medical problem. Based on the existing medical knowledge, it is important for promoting CNS trauma treatment levels including nerve trauma standardized treatment, professional management team, multi modal monitoring and data analysis, actively participating in domestic and international multi-center clinical research. Medical workers should dare to explore and innovate, keep up with the pace of the times, and truly achieve the overall improvement of nerve trauma.

BACKGROUND: The ulcer wound is hard to heal in diabetic patients,and it is believed to be caused by the microcirculatory disorder of wound and decreased contents of endogenous growth factors in patients with diabetes mellitus.OBJECTIVE: To observe the biological effects of adeno-associated virus (AAV) mediated transforming growth factor beta1 (AAV-TGFβ1) and vascular endothelial growth factor (AAV-VEGF) in promoting the dermal ulcer healing of diabetic rabbits.DESIGN: A randomized controlled animal experiment.SETTINGS: Medical College, Qingdao University; Affiliated Hospital of Medical College, Qingdao University.MATERIALS: The experiments were carried out in the gynecological laboratory, Affiliated Hospital of Medical College, Qingdao University from July 2004 to January 2006. Twenty-four healthy adult New Zealand rabbits were randomly divided into co-transfection group (n=12) and control group (n=12).METHODS: ① The dermal ulcer models of diabetic rabbits was established by injecting alloxan (130 mg/kg) via ear vein, and the ulcer wound was made by operation. ② In the co-transfection group, the wound was locally infiltrated, and injected with AAV-TGFβ1 virus and AAV-VEGF virus (the concentration was 9×106 virus granules/mL respectively). The rabbits in the control group were treated with injection of saline.MAIN OUTCOME MEASURES: ① The levels of TGFβ1 and VEGF gene transcription in the healing tissue were detected with polymerase chain reaction (PCR) at 1 month postoperatively. ② The capillary density in the wound margin was counted with microcirculation microscope at 3 weeks postoperatively. ③ The collagen Ⅰ and Ⅲ were isolated and detected with Western blotting by protein gel electrophoresis and semi-dry electrophoretic transfer. ④ The content of collagen in the ulcer healing issue was detected at 1 day, 1, 2 and 3 weeks, 1, 2, 3, 4, 5 and 6 months postoperatively. ⑤ The thickness, color and quality of the wound healing were observed postoperatively.RESULTS: All the 24 rabbits were involved in the analysis of results. ① The expressions of TGFβ1 and VEGF gene transcription in the co-transfection group were increased as compared with those in the control group. ② The capillary density at the wound margin in the co-translection group was higher than that in the control group [(19.18±3.56), (6.43±1.52)/mm2,t=3.21, P ＜ 0.05]. ③ The content of collagen Ⅰ in the ulcer healing tissue in the co-transfection group was obviously increased, and the proportion of collagen Ⅰ in the constituent ratio of collagen Ⅱ and Ⅲ was increased.④ The contents of collagen in the ulcer healing tissue at 1 day after transfection were close without significant difference between the two groups (t=1.55, P ＞ 0.05). After that, the contents of collagen in the cotransfection group were all significantly higher than those in the control group (P ＜ 0.05). ⑤ The ulcer healing in the control group was obviously lagged with bad quality.CONCLUSION: The combination of AAV-TGFβ1 and AAV-VEGF can efficiently transfect the dermal ulcer wound in diabetic rabbits, obviously increase the capillary density in ulcer tissue, markedly improve the proportion of collagen I in the constituent ratio of collagen Ⅰ and Ⅲ in healing tissue, and obviously ameliorate the condition of ulcer healing.

Objective To analyze the clinical treatment effect of non-gland-derived mass on the neck,and discuss the distribution types and the best treatment options.Methods A total of 76 cases with non-gland-derived mass on the neck were analyzed retrospectively,and the treatment effect was analyzed.Results In the 76 cases,25 cases were benign tumors,19 cases were malignant tumors,32 cases were non-rumors.Surgical treatment was preferred to tumors.According to the nature of the lesions,non-tumors mass shoud choose surgical treatment or medication.Conclusion Non-gland-derived mass on the neck with multiple presentations,it is necessary to choose personal therapies according to the characteristics of masses.

ObjectiveTo explore the relation between personality and depression in elderly,particularly to investigate mediating effect of positive psychological resource.MethodsThe eysenck personality questionaire-revised short scale for Chinese(EPQ-RSC),self-rating depression scale(SDS) and scales for positive psychological resource were performed by 270 elderly in community of Tianjin.Then correlation analysis,regression analysis and path analysis were accomplished to explore association between those variables.Results Neuroticism and Psychoticism personality correlate positively with depression ( r=0.45,0.48) and contribute about 30％ variance of it (F=49.95 ).Positive psychological resource such as optimism,resilience and self-efficacy correlated negatively with depression ( r =- 0.41,- 0.39,- 0.20 ) and contributed 19％ variance of it (F =30.02 ).The results of path analysis showed positive psychological resource mediated the relation between personality and depression also.ConclusionNeuroticism and Psychoticism are important risk factors of depression in elderly.Positive psychological resource such as optimism,resilience and self-efficacy are key protecting factors for depression and they mediate the relation between vulnerable personality and depression.

Mesenchymal stem cells (MSCs), which are regarded as the promising option of cell replacement therapy, are able to regulate immune response after tissue damage caused by traumatic brain injury (TBI). Secondary neuroinflammation following the mechanical injury is the essential factor of neural cell necrosis and apoptosis, even after the intracranial pressure has returned to normal. Their immune environments caused by neuroinflammtary response determine the outcome and long-term behavior function of TBI in survivors directly. MSCs modulate macrophage/microglia, drive them to polarize into alternative M2-like cells through releasing soluble cytokines, such as prostaglandin E2 (PGE2), tumor necrosis factor-stimulated gene 6 protein (TSG-6), IL-1 and TGF-β, which limits the progression of inflammation and maintain micro-environment stable. Meanwhile, macrophage/microglia exerts significant effects in MSCs survival, proliferation, differentiation and activation. It provides a novel approach as a practical anti-inflammatory therapy in clinical treatment.

In recent decades, the development of the neurosurgery has changed from the traditional anatomical model to the modern anatomical-functional model. The nerve functions are maximally protected while lesions are removed as far as possible. Neurophysiological monitoring especially somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) can directly reflect the integrity of the sensory and motor nerve conduction pathways of the nervous system. At present, it has been widely used in the neurosurgery, spinal surgery, vascular surgery and other surgical fields. In recent years, more and more clinical surgeries involved spinal surgery, intraoperative neurophysiological monitoring could timely find any reversible spinal cord damage such as mechanical stretch, ischemia, and anesthetic drugs, which not only improve the quality of surgery, reduce iatrogenic spinal cord injury, but also greatly improve the prognosis of patients and reduce postoperative neurological dysfunction and complications. In this paper, the research progress of neural electrophysiological monitoring techniques in spinal cord surgery is reviewed.

Objective To investigate the clinical efficacy and safety of Jianwei xiaoshi oral liquid combined with mosapride on treating postprandial distress syndrome( PDS ). Methods Eighty cases patients with PDS diagnosed according to Rome-Ⅲ PDS diagnostic criteria were randomly assigned into treatment group and control group. Patients in treatment group were treated with jianwei xiaoshi oral liquid( 1 bottle/times,3 tiems/d,after meals)and mosapride,and in the control group were taken mosapride(5 mg/times,3 times/d, before meals)only for 4 weeks. After the end of treatment,the improvement of the symptoms,the total symptoms score,the total effective rate and adverse drug reaction were recorded. Results After the treatment,symptoms were relieved in both groups. The total symptoms score of the treatment group was(2. 90 ± 1. 39)scores,lower than that in before((11. 14 ± 1. 86)scores),and the difference was significant(t=22. 328,P﹤0. 01). The total symptoms score in treatment group was(2. 90 ± 1. 39)scores,significantly lower than the control group((4. 94 ±2. 03)scores;t =5. 217,P ﹤0. 01). The total effective rate was 87. 80%(36/41),66. 67%(26/39)in treatment and control group,and the difference was significant( t=5. 122,P﹤0. 05). There was no significant in terms of adverse drug reaction in two groups during the treatment. Conclusion Jianwei xiaoshi oral liquid combined with mosapride is a safe and effective treatment of PDS patients,which is better than using mosapride alone.

Stem cells transplantation had been proved to be effective in many clinical diseases. However, microenvi-ronment can influence their growth, migration and differentiation. Under chemical microenvironment, such as hypoxia, neu-ral growing factors and different kinds of ions, stem cells had been intensively studied while little is known about their perfor-mance under physical microenvironment. The effects of mechanical forces, elasticity and rigidity of the matrix of stem cells are still to be further investigated. This article is to summarize how microenvironment controls the fate of stem cells and to re-view the measurement of the mechanical properties.