Exosomes contain many components including variety kinds of lipids,proteins,microRNAs (miRNAs) and so on.They can transport their loaded substances to the recipient cells and play a role of biology.Exosomal miRNAs play important roles in the occurrence and development of tumors,and they are closely related to the tumor growth,metastasis,drug resistance and immune regulation.Exosomes and exosomal miRNAs can be served as reference indexes for tumor metastasis and prognosis,which provide new targets for tumor therapy.

Objective:To observe the effect and its mechanism of hemoperfusion on injured myocardium under acute toxication of methomyl in rabbits. Methods:Twenty-four rabbits were randomly divided into three groups:control group ( N group) , acute metho-myl intoxication group ( P group) , hemoperfusion group ( HP group) . P group and HP group was treated by methomyl intoxication, and with 2-hour sham-hemoperfusion and hempoperfusion respectively. Then the pathological changes of myocardium were observed under optical microscope. The activity of SOD and content of MDA in myocardium were measured by colorimetry. The experimental data were analyzed by SPSS 16. 0 package. Results:There were congestion, edema and other pathological changes in group P, while no obvious changes in N group and HP group. The activity of SOD decreased while MDA content increased in P group versus N and HP group ( P< 0. 05). Conclusion:Hemoperfusion can alleviate the myocardial injury induced by methomyl poisoning through the mechanism of the resistance to oxidative damage.

Objective By analyzing the clinical and radiographic manifestations of calcium pyrophosphate deposition disease (CPDD) to improve the recognization of the disease.Methods Clinical features,diagnosis and treatment of an old female patient with CPDD was reported with literature review.Results An old female patient presented with swollen and pain on the right knee without obvious causes eight years ago,which was characterized by slightly reddness of joint surface,warm of local skin.Thcn she gradually developed swollen and pain in left knee,right ankle,both wrists,bilateral meta-carpophalangeal (MCPJ) and right elbow joints with few joint symptoms and the joints swollen and pain could relieved spontaneouslyitself in about one week.X-ray showed the thin strip of cartilage calcifications in wrist triangular fibrocartilage disc,meniscus of knee and the pubic symphysis were parallel to the surface of cartilage.Examination of microscopy with refractive filter demonstrated that short rod crystals refraction in joint fluid.CPDD was diagnosed and treated with flushing of joint cavity and injections of betamethasone as well as nonsteroidal anti-inflammatory drug orally.Symptoms relieved after therapy.Conclusion Understanding the disease characteristics of CPDD is beneficial to for accurate diagnosis and treatment.

Objective To investigate the clinical features of connective tissue diseases (CTD) related organizing pneumonia (OP). Methods The clinical and radiological features, therapy and outcome of 57 CTD-OP patients diagnosed by biopsy were retrospectively analyzed. T test, x2 test, Pearson/Spearmanˊs correla-tion analysis were used for statistical analysis with software version 15.0. Results CTD-OP accounted for 44% of all the OP. There were 36 cases (63%) with the initial clinical manifestation of OP in CTD-OP patients. The underling primary disease of CTDs included Sj?grenˊs syndrome (22, 38%), polymyositis/dermatomyositis (13, 23%), RA (13, 23%) and undifferentiated connective tissue diseases (9, 16%). At baseline, the clinical symptoms of cough and malaise [54% vs 83%, x2=7.749, P=0.005; 49% vs 71%, x2=4.007, P=0.045] were significantly lower in the CTD-OP patients than in the COP patients. The signs of moist rales and crackles (54% vs 32%, x2=4.160, P=0.041; 49% vs 27%, x2=4.529, P=0.033) were more common in the CTD-OP patients than in the COP patients. The TLC%, FVC% of the lung function reduced significantly in CTD-OP patients than in COP patients [(72 ±18)% vs (97 ±29)%, t=-2.475, P=0.027;(75 ±26)% vs (96 ±23)%, t=-2.174, P=0.039). The dosage of corticosteroids [(44 ±14) mg/d vs (37 ±10) mg/d, t=2.541, P=0.013] were significantly higher in the CTD-OP patients than in the COP patients. The complete recovery rate was slightly lower in CTD-OP than in COP (22% vs 29%, x2=0.384, P=0.483) with a tendency towards higher recurrence rate in CTD-OP (33% vs 14%, x2=4.007, P=3.958). Conclusion CTD-OP is probably the common cause of OP. OP can be the initial manifestation of CTD. The primary disease of the CTD-OP includes Sjogrenˊs syndrome, polymyositis/dermatomyositis, rheumatoid arthritis and undifferentiated connective tissue diseases. Compared with COP, CTD-OP patients may have milder clinical symptoms, but the more severe damage of the lung, the higher the recurrence rate, therefore, CTD-OP is worthy of more attention from rheumatologists.

Horseradish peroxidase (HRP) was injected unilaterally or bilaterally into the cerebellum of 11 rabbits in order to trace the distribution of labeled neurons in the whole length of the spinal cord. To investigate the ascending side of the axons, hemisections were made unilaterally in the lower thoracic cord of 4 rabbits before injection. The distribution of labeled spinocerebellar tract neurons was rather wide. Neurons in the cervical segments were located in (1) the central cervical nucleus (CCN) in Q_(1-4), (2) the medial part of lamina VI in C_2-T_1, (3) the central part of lamina VII in C_(4-8) and (4) lamina IV-V in C_(5-8). The labeled neurons located in segments caudal to thoracic cord could be divided into two groups. Neurons of the uncrossed tract were located in (1) Clarke's column in T_2-L_4, (2) laminae IV-VI in T_2-L_6. Neurons of the crossed tract were found in (1) the spinal border cells (SBC)in L_(3-6), (2) the medial part of the lamina VII in segments caudal to L_6, (3) lamina V in the sacrococcygeal cord and (4) laminae VII-VIII in the sacrococcygeal cord. The present study suggests that the location and fiber course of the spinocerebellar neurons in the rabbit are quite the same as those in the cat. These results should form a basis for further anatomical and physiological studies of spinocerebellar system in the rabbit.

ObjectiveTo explore the influence of the CT scanning mode on the gross tumor volume (GTV) delineation of solitary pulmonary lesion (SPL),and to evaluate the feasibility of the spiral CT scan in CT simulation.Methods Sixteen patients with SPL underwent axial scan,spiral scan during free breathing.Compare the target position,volume between GTVS and GTVA (paired t-test).The matching index (MI) between GTVS and GTVA and correlations between MI and the tumor volume were calculated ( bivariate correlation analysis).ResultsGTVS and GTVA volume was 8.95 cm3 and 9.38 cm3 ( t =0.43,P =0.667),respectively.The centroid position for GTVS and GTVA in x,y and z axises were 6.80 cm and 6.81 cm (t =0.27,P =0.794),36.19 cm and 36.05 cm (t =0.37,P =0.717),and 4.99 cm and 4.96cm (t =0.65,P =0.526),respectively.There were also no statistically significant difference in the distance between the centroidal position and origin of coordinates for GTVS and GTVA (38.31 cm∶ 38.23 cm,t =0.47,P =0.646 ).MI between GTVS and GTVA was 0.36 ( range 0-0.77 ),correlated with the tumor volume (r =0.587,P =0.017).ConclusionsThere was no significant difference between the axial scan and spiral scan in the GTV volume and position for SPL,but MI between GTVS and GTVA were small.A correlation was found for the MI between GTVS and GTVA with the tumor volume.Spiral CT scan was more timesaving,and was feasible in CT simulation scan.

Objective To synthesize 2-(5-[18 F] fluoro-pentyl)-2-methyl-malonic acid (18 F-ML-10) and to investigate the biodistribution in mice and the primary clinical application.Methods 18F-ML-10 was synthesized by domestic synthesis module MF-2V-IT-1.Quality control of the probe was performed after automated synthesis.The biological characteristics of 18F-ML-10 were assessed by biodistribution assay on male Kunming mice and microPET imaging on a male SD rat.Six patients with brain metastasis (4males,2 females,and age 21-68 years) were enrolled in this study.18F-ML-10 PET images were acquired before and at 48 h after radiotherapy.SUVmean and SUVmax of ROI were calculated.GTV changes were measured by MRI before and 3 months after radiotherapy.Response of brain metastasis to radiotherapy was assessed by PET imaging with 18F-ML-10.Two-sample t test was used.Results The non-corrected radiochemical yield of 18F-ML-10 was (26.5±7.3)％ with acceptable quality.The radiochemical purity exceeded 99％.18F-ML-10 was excreted through the kidneys,and the radiouptake in the blood was declined rapidly.The radiotracer accumulation was low in most of other organs.The testis showed a significant uptake.The SUVmean and SUVmax after radiotherapy (5.54±2.72 and 7.29±3.09) were significantly higher than the baseline values(3.81±1.13 and 4.97±1.05;t=2.670,2.663,both P＜0.05).The GTV after radiotherapy was significantly lower than the baseline value:(13.14±9.39) cm3 vs (23.34± 18.13) cm3;t =3.002,P＜0.05.Conclusions 18F-ML-10 could be synthesized reliably and repeatedly by domestic synthesis module.It has satisfactory properties in vivo and is probably suitable for early assessment of the response to radiotherapy in patients with brain metastasis.

Objective To evaluate the effect of video- assisted thoracoscopic pulmonary segmentectomy in patients with isolated pulmonary arteriovenous fistula (PAVF). Methods A retrospective analysis was performed on 10 patients with PAVF in the department of thoracic surgery of the first affiliated hospital of Nanjing Medical University between January 2010 and December 2016. Computed tomography angiography (CTA) and three-dimensional reconstruction were performed before operation, and all patients accepted video-assisted thoracoscopic pulmonary segmentectomy. Results The diagnosis of PAVF was identified by CTA, with maximum diameter of tumor of 3.0- 5.0 cm. No perioperative mortality or postoperative complications were observed including bleeding, hemoptysis, serious air leakage, and bronchopleural fistula. The lesions were completely removed in all 10 patients, and no patients converted to open surgery intraoperatively. Blood gas analysis showed that oxygen partial pressure before operation, in the first day after operation and the third month after operation was (62.5 ± 6.7), (70.2 ± 4.8) and (75.4 ± 4.8) mmHg (1 mmHg = 0.133kPa) respectively; which was significantly increased successively (P<0.05). After a follow-up time of 3-30 months, no recurrences were observed. Conclusions Video- assisted thoracoscopic pulmonary segmentectomy guided by preoperative CTA and three-dimensional reconstruction is a very effective method for the treatment of isolated PAVF.

Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.

With the development of fine anatomy,the concept of mesopancreas has been proposed,and total mesopancreatic excision continues to be used in clinical practice.This method has become the best surgical method of pancreatic head cancer.But due to deep position of pancreas and mesopancreas,the surrounding adjacent organs and complexs tructure and other factors,experts are concerned about at the presence or absence of the mesopancreas.So the scope of clinical surgical resection structural reservations are also controversial.This article reviewed the development of embryonic development of the pancreas and the research progress in order to provide theoretical support for the study of the fine anatomy of the pancreas and the precise operation of pancreatic diseases.