Objective To improve the diagnosis and treatment for malignant adrenal tumors. Methods Clinical data of 50 cases of malignant adrenal tumors were retrospectively analyzed.Of them 7 cases of corticoadrenal carcinoma with endocrine function presented with relevant symptoms and endocrine abnormality.Among 23 cases of malignant pheochromocytoma high blood pressure existed in 19 and 18 had a high level of urinary catecholamine.Fifteen cases had corticoadrenal carcinoma without endocrine function and 5 cases developed adrenal metastic carcinoma.All of the patients underwent endocrinological and image examination before operation. Results Among the 27 cases of corticoadrenal carcinoma or metastasis,25 were confirmed by pathology and 2 were confirmed during follow-up.Of the 23 patients who were diagnosed as malignant pheochromocytoma,11 were confirmed to have extensive tumorous infiltration or metastasis by imaging procedures and operations and 12 were detected by follow-up to have metastasis.Tumors were resected in 14 cases of corticoadrenal carcinoma,8 of whom survived for 1～5 years.Twelve cases of malignant pheochromocytoma underwent radical operations with a survival of 1～14 years. Conclusions Most cases of corticoadrenal carcinoma can be diagnosed by pathology or image findings of metastasis.Pheochromocytoma is more likely to be malignant when it recurs,expecially for the extro-adrenal pheochromocytoma.The diagnosis of malignant pheochromocytoma must depend on the evidence of tumorous infiltration or invasion of the tissue without para ganglions found by imaging procedures or pathology.The prognosis of the late-stage corticoadrenal carcinoma is poor.For the cases of late-stage malignant pheochromocytoma dibenzyline or 131 I-MIBG treatment can extend their lives.

BACKGROUND:As a kind of stressor, exercise-induced fatigue surely can lead to the material and functional changes of certain nerve nucleus within brain.It is still uncertain on what kind of nucleus closely relate to exer-cise-induced fatigue and what materials induce the functional or/and structural changes of tired central nerve.OBJECTIVE:To study the relationship between nitric oxide synthase (NOS) in ventromedial hypothalamic nucleus(VMH),dorsomedial hypothalamic nucleus(DMH) and exercise-induced fatigue.DESIGN:Randomized controlled study.MATERIALS:The experiment was completed in the Department of Human Anatomy of North University of China and Shanxi Medical University during October 2003 to January 2004.Twenty male Wister rats of clean class were selected.INTERVENTIONS:The rats were randomly divided into experimental group and control group with each of 10 rats.The rats in experimental group were made exercise-induced fatigue animal model by doing heavy load swimming until they were exhausted for 4 consecutive weeks. After the model was built,ABC immunohistochemical method was used to observe the expression of neuronal NOS (nNOS) in neurons of VMH ,and DMH and image analysis and statistic process were conducted.MAIN OUTCOME MEASURES:Number of nNOS positive cells in per unit visual field; Area and gray of positive substance.RESULTS:The number of nNOS positive cells in VMH of fatigue group was (25.25±7.35)/visual field which was much greater than that of control group (9.70±3.20)/visual field(P＜ 0.001).The area of nNOS positive substance was (3 867.75±1 940.41)μm2/visual field which was greater than that of control group(750.13±579.88)μm2/visual field(P ＜ 0.001). The number of nNOS positive cells in DMH of fatigue group was (30.25±7.87) /visual field which was much greater than that of control group (14.00±4.99) /visual field. And the area of nNOS positive substance was (4 512.06±1 243.93) μm2/visual field that was much greater than that of control group(782.46±711.46)μm2/visual field(P ＜ 0.001).CONCLUSION:The nNOS positive neurons in VMH and DMH neurons are closely related to the occurrence of central exercise-induced fatigue.Nitric oxide may play an important role in regulation of VMH and DMH to stress caused by fatigue.

OBJECTIVETo evaluate the accuracy of the latest BladderScan BVI9400 on measuring bladder volume.

METHODSTwo bladder phantoms were selected for investigating the accuracy of BVI9400. 341 patients with the iU22 ultrasound examinations were followed by BVI 9400. The difference and correlation between BVI9400 and iU22 were contrastively analyzed.

RESULTSThe relative difference between results from BVI9400 and phantom volume was 2.5% and 1.36%. There was a strong correlation for patients between BVI9400 and iU22 (R = 0.96, P < 0.001). The relative difference between BVI9400 and iU22 decreased with the increasing of bladder volume and had no significant difference with patient's gender (P > 0.1).

CONCLUSIONBladderScan BVI9400 had the ability of high accuracy and good stability of measured data. In view of quick and conveniences, BVI9400 could be as auxiliary equipment on pelvic tumor to evaluate whether the bladder volume during fractional radiotherapy was consistency with that during CT positioning.

OBJECTIVE: To establish 2-dimensional electrophoresis (2-DE) graph of A549 and A549/DDP cell lines, to identify the differentially expressed proteins, and to screen multidrug resistance (MDR) related proteins in human lung adenocarcinoma. METHODS: The total proteins of A549 and A549/DDP cells were obtained, and were extracted and separated by 2-DE. PDQuest software was applied to analyze the 2-DE images, and the differential proteins of the 2 types of cells were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). Western blot was used to determine the expression levels of the 4 proteins. RESULTS: We established 2-DE maps of total proteins from A549 and A549/DDP. A total of 40 differential protein spots in the 2 cell lines were found, and 23 differential expression proteins were identified by MALDI-TOF-MS. Western blot showed that heat shock protein beta-1, annexin A4, cofilin l, vimentin were differential expression proteins in A549 and A549/DDP, which was consistent with the results of the comparative proteomic analysis. CONCLUSION The 23 differential expression proteins in human lung adenocarcinoma are useful for studying the MDR mechanism of lung adenocarcinoma.
Adenocarcinoma ; genetics ; metabolism ; pathology ; Annexin A4 ; analysis ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Electrophoresis, Gel, Two-Dimensional ; HSP27 Heat-Shock Proteins ; analysis ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Neoplasm Proteins ; analysis ; classification ; Proteome ; analysis ; Proteomics ; methods

Objective To evaluate the accuracy of the latest BladderScan BVI9400 on measuring bladder volume. Methods Two bladder phantoms were selected for investigating the accuracy of BVI9400. 341 patients with the iU22 ultrasound examinations were fol owed by BVI 9400. The difference and correlation between BVI9400 and iU22 were contrastively analyzed. Results The relative difference between results from BVI9400 and phantom volume was 2.5% and 1.36%. There was a strong correlation for patients between BVI9400 and iU22 (R=0.96, P<0.001). The relative difference between BVI9400 and iU22 decreased with the increasing of bladder volume and had no significant difference with patient’s gender (P>0.1). Conclusion BladderScan BVI9400 had the ability of high accuracy and good stability of measured data. In view of quick and conveniences, BVI9400 could be as auxiliary equipment on pelvic tumor to evaluate whether the bladder volume during fractional radiotherapy was consistency with that during CT positioning.

Objective:To investigate the application of ultrasound imaging in evaluating the curative effect of patients with nutcracker syndrome (NCS) treated with three-dimensional(3D) printing extravascular titanium stents.Methods:From December 2015 to December 2018, a total of 41 NCS patients enrolled in the Second Affiliated Hospital of the Air Force Military Medical University to receive 3D-printing extravascular titanium stents treatment were included in this study. Ultrasound and CT angiography (CTA) were performed before and 1 week after operation to evaluate the compression of left renal vein and related hemodynamic changes.Results:Before the operative, the ultrasound examination showed that the angle between the abdominal aorta and superior mesenteric artery was (21.29±4.53)°, which was significantly improved in 1 week after treatment [(47.42±7.45)°, P<0.001]. Left renal vein was significantly compressed before treatment, with the smallest inner diameter of (1.51±0.49)mm and its peak blood flow velocity was (143.92±50.40)cm/s. Postoperative ultrasound images showed the significant expansion of left renal vein and no high velocity blood flow was observed. Ultrasound examination also showed that the diameter of left renal vein at renal hilum, blood flow velocity at renal hilum and inner diameter of spermatic vein were significantly improved after treatment ( P<0.001). Similar to ultrasound results, CTA also found that the angle between abdominal aorta and superior mesenteric artery increased significantly after treatment[(17.59±4.56)° vs (52.27±9.01)°, P<0.001]. CTA also showed the left renal vein was compressed before treatment, with the smallest inner diameter of (2.09±0.86)mm, and it was significantly expanded after operation. The inner diameter of left renal vein at renal hilum was also significantly reduced after treatment ( P<0.001). Conclusions:Ultrasound imaging can effectively evaluate the LRV compression and related hemodynamic changes before and after 3D printed stent implantation treatment in NCS patients and provide a reliable method to evaluate its clinical efficacy for these patients.

Objective To evaluate the clinical application of Catalyst system in patient positioning during breast cancer radiotherapy,and to analyze its correlation with age and body mass index (BMI).Methods Twenty-four patients with breast cancer who were admitted to our hospital from May to August,2016 were enrolled as subjects.For all patients,auxiliary positioning was made by the optical surface imaging system (CRad Catalyst) before each treatment.The kV-kV imaging was executed weekly to verify positioning.Age,BMI,and setup errors of the two systems in the anterior-posterior (AP),superior-inferior (SI),and left-fight (LR) directions were recorded and analyzed by independent samples t-test and Pearson correlation analysis.Results The C-Rad Catalyst system had a significantly larger setup error in the AP direction than the kV-kV imaging (0.22±0.17 vs.0.18±0.13 cm,P＜0.05).There were no significant differences in setup errors in the SI or LR direction between the two systems (0.23±0.18 vs.0.19±0.15 cm,P＞0.05;0.28±0.28 vs.0.20±0.15 cm,P＞ 0.05).Age and BMI of patients had significant impacts on the C-Rad Catalyst system but the kV-kV imaging (P＞0.05):there were significant differences in setup errors in the AP and SI directions between patients ≤44 years of age and those 45-59 years of age (all P＜0.05);there were significant differences in setup errors in the AP and LR directions between patients ≤44 years of age and those ≥60 years of age (all P＜0.05);there was a significant difference in setup error in the LR direction between patients 45-59 years of age and those ≥ 60 years of age (P＜0.05);there was a significant difference in setup error in the SI direction between patients with BMIs of＜ 25 and ≥ 25 kg/m2 (P＜ 0.05).For patients ≥ 60 years of age,setup error of the C-Rad Catalyst system in the SI direction was correlated with age (r=-0.496,P＜0.05).For patients with BMI of＜25 kg/m2,setup error of the C-Rad Catalyst system in the AP direction was correlated with BMI (r=-0.445,P＜ 0.05).For patients with a BMI of ≥ 25 kg/m2,setup error of the C-Rad Catalyst system in the SI direction was correlated with BMI (r=-0.252,P＜0.05).Conclusions There is significant difference in setup error in the AP direction between the C-Rad Catalyst system and the kV-kV imaging.Age and BMI have impacts on patient positioning by the C-Rad Catalyst system.

WHO Guideline on Country Pharmaceutical Pricing Policies,published in 2020,outlines 10 commonly used pricing methods internationally.However,due to the unique composition of costs for traditional Chinese medicine(TCM),directly applying pricing methods designed for chemical and biological drugs may lead to discrepancies.Currently,in China,drug pricing primarily in-volves internal reference pricing,tender negotiation pricing,promoting the use of quality-assured generic and biosimilar drugs,and centralized procurement.It systematically analyzes various pricing methods and identifies their applicability and underlying reasons concerning the pricing of TCMwithin the medical insurance system.The method of value-based pricing and increasing price transparency has advantages for the pricing regulation of traditional Chinese medicine under medical insurance.

Objective To evaluate the risk of bias and reporting quality in randomized controlled trials(RCTs)of the Chinese medicine injection for acute cerebral infarction in the last five years.Methods RCTs literature on Chinese medicine injection in the treatment of acute cerebral infarction was systematically searched in CNKI,Wanfang Data,VIP,China Biology Medicine Database(CBM),PubMed,Embase and Cochrane Library from April 20,2018 to April 20,2023.The risk of bias and reporting quality of included RCTs were evaluated using the Cochrane Risk of Bias Tool(ROB 1.0)and CONSORT-CHM Formulas 2017,respectively.Results A total of 4 301 articles were retrieved,and 408 RCTs were included according to inclusion and exclusion criteria.The ROB evaluation results showed that the the majority of studies were rated as having an unclear risk of bias due to the lack of reporting on allocation concealment,blind method,trial registration information,and funding sources.The evaluation results of CONSORT-CHM Formulas 2017 showed that the number of reported papers of 17 items was greater than or equal to 50%,and the number of reported papers of 25 items was less than 10%,and most of the RCTs did not show the characteristics of TCM syndrome differentiation and treatment.Conclusion The quality of Chinese medicine injection in the treatment of acute cerebral infarction RCTs is generally low.It is recommended that researchers refer to the methodology design of RCTs and international reporting standards,improve the trial design,standardize the trial report,and highlight the characteristics of TCM syndrome differentiation and treatment.

Humans ; Hospital Mortality ; Pulmonary Embolism ; Comorbidity ; Registries ; Neoplasms/complications*