Objective To discuss the diagnosis and management of metastatic adrenal carcinoma. Methods Forty-seven cases with metastatic tumor in the adrenal glands were analyzed retrospectively from December 1996 to April 2010. Lung was the most common primary tumor site (51.1 %, 24 cases), followed by the renal cell carcinoma (12.8%, 6 cases), liver cancer (10.6%,5 cases), breast cancer (8.5%, 4 cases), melanoma (4.2%, 2 cases), and other carcinoma (12.8%,6 cases). Most patients with metastatic adrenal carcinoma had no special clinic manifestation. Lesions of 36 cases were surgically removed and 11 cases gave up operation. Results The mean survival time were 33.8±4.5 months for 31 cases underwent adrenalectomy and 6.3±2.7 months for 6 cases without operation. Patients with surgically removed adrenal metastases had better survival than those without surgical resection. Conclusions Adrenal gland is a common site of metastatic carcinoma.Ultrasonographic and CT scans are important diagnosis methods for metastatic adrenal carcinoma. Operation is still effective and long-term survival may be achieved for those well selected patients, but surgical indication must be strictly monitored.

Objective To optimize the preparation technology of chrysophanol loaded polybutylcyanoacrylate nanocapsules by interfacial polymerization,sieve the optimal technology conditions of preparation,and study its quality. Methods Based on the single factor experiment,the formulation was optimized by L9(34) orthogonal design with entrapment efficiency as reference index. The factors including agitating speed,pH value of aqueous phase,amount of ?-butylcyanoacrylate (BCA) and of ethyl acetate were screened. At last,its shape,particle size,the encapsulation efficiency,and the drug loading were investigated as its quality inspection. Results When the ammunt of chrysophanol was 5 mg,the optimum preparation conditions were established as follows:the agitating speed was 800 r/min,the pH value of aqueous phase was 2,the amount of ?-BCA was 13 ?L and ethyl acetate was 0.6 mL. Under this optimum condition,the mean entrapment ratio was 82.19%,and the mean drug loading was 21.48%,the mean diameter of the nanocapsule was 246 nm. The particle size was well-distributed showed by electron microscope pictures. Conclusion The prepared chrysophanol loaded polybutylcy-anoacrylate nanocapsules has small size,high encapsulation efficiency,and drug loading. The preparation technique established in this study is stable and feasible. It also can be used for iv injection.

Objective To summarize the methods of diagnosing and treating solid-pseudopapillary neoplasm of pancreas SPN so as to provide reference for its early clinical diagnosis.Methods We collected the clinical data of 62 patients with pathologically confirmed diagnosis of SPN treated in the First Affiliated Hospital of Xi'an Jiaotong University between Feb.2004 and Sep.2014.Then we retroactively analyzed and summarized the clinical characteristics,diagnosis and treatment of the disease.Results Among the 62 patients,55 were female and 7 were male;the mean age was (31.58±12.67) years old.The clinical features showed no specificity and the tumor was mostly detected upon physical check-up.The tumor was seen to be located mostly in the body and tail of the pancreas,and the average maximum diameter was (7.81±3.54)cm.We did not find obvious abnormality in routine pre-operative blood test results or liver and kidney functions.The imageological examination indicated tumor occupation in the pancreas.All the patients underwent surgical resection with no complications or death and had a good recovery after operation.Pathological diagnosis after operation was SPN without metastasis in lymph modes.Until the last time we followed up all the patients,we found relapse in two patients (3.2％).Conclusion SPN is a tumor that tends to affect young and middle-aged females.The malignancy grade of SPN is low,and patients with this disease show no specificity in clinical manifestation.The imageological examination is of vital importance in diagnosing SPN and surgical resection is an effective way to treat SPN.

Objective To investigate the related factors of the prognosis of arterial embolectomy of acute cardiogenic cerebral embolism caused by atrial fibrillation.Methods The clinical data of using vein thrombolysis bridging artery embolectomy or arterial embolectomy alone for the treatment of patients with acute cardiogenic cerebral embolism of cerebral large artery occlusion due to atrial fibrillation were analyzed retrospectively.From January 2015 to December 2016,22 consecutive inpatients with cardioembolic cerebral embolism caused by paroxysmal or persistent atrial fibrillation were enrolled,including 10 patients with the 90-day modified Rankin Scale (mRS) score 0-2 (good recovery group) and 12 patients with mRS scores 3-6 (poor recovery group).The clinical features,imaging data,and treatment of the patients in both groups were compared.The factors such as age,gender,preoperative international standardization ratio (INR),embolism position,whether bridging vein thrombolysis before thrombectomy,National Institutes of Health Stroke Scale (NIHSS) score at the onset,time of onset to reperfusion (TOR),whether using tirofiban,times of thrombectomy,modified Thrombolysis In Cerebral Infarction (mTICI) blood flow grade,and postoperative intracranial symptomatic intracerebral hemorrhage were analyzed.Results There were no significant differences in age,gender,preoperative INR,embolism position,the number of intravenous thrombolysis before thrombectomy,the number of using tirofiban in surgery,the proportion of the above mTICI 2b grade,and the proportion of symptomatic cerebral hemorrhage after surgery of the patients between the two groups (P>0.05).The NIHSS score 15.2±2.0 at the onset in the good recovery group was lower than 22.9±8.4 in the poor recovery group.There was significant difference between the two groups (P<0.05).The TOR time (307±86 min) in the good recovery group was less than that of the poor recovery group (426±145 min).There was significant difference between the two groups (P<0.05).Embolectomy was performed 1.5 (0.5,3.0) times in the good recovery group,which was less than the poor recovery group (4.0 [2.0,7.0] times).There was significant difference between the two groups (P<0.05).Conclusions Shortening the time of reperfusion and reducing the number of embolectomy during operation are the important factors for improving the prognosis of patients when atrial fibrillation causes arterial embolectomy in patients with acute cerebral embolism.However,a study of larger sample is needed for further exploration.

Objective To investigate the clinical characteristics of cognitive impairment in the patients with asymptomatic unilateral severe internal carotid artery stenosis (ICAS). Methods A total of 80 patients with unilateral severe carotid stenosis (stenosis rate ≥70%)and 40 patients without carotid stenosis (control group)diagnosed by digital substract angiography (DSA)were analyzed retrospectively. According to the stenotic sides,the patients with severe ICAS were divided into a left stenosis group and a right stenosis group (n = 40 in each group). The North American Symptomatic Carotid Endarterectomy Trial (NASCET)criteria were used to grade the degree of stenosis. Montreal cognitive assessment (MoCA)was used to evaluate the cognitive function of the patients,and then the cognitive function of the patients in 3 groups was assessed. Results The MoCA total scores,visuospatial and executive functions,and language ability,and delayed memory scores of the patients in both left and right groups were lower than those of the control group. There were significant differences (21. 8 ± 3. 1,3. 4 ± 1. 3,1. 8 ± 0. 6,and 1. 6 ± 1. 3,respec-tively in the left stenosis group;22. 6 ± 2. 5,3. 5 ± 1. 1,1. 9 ± 0. 6,and 1. 7 ± 1. 4,respectively in the right stenosis group;and 26. 4 ± 1. 8,4. 2 ± 0. 9,2. 7 ± 0. 6,and 3. 8 ± 1. 0,respectively in the control group;all P < 0. 01). There were no significant differences in naming,attention,abstract ability,orientation ability scores compared with the control group (all P > 0. 05). There were no significant differences in the MoCA total scores and each single test score of the patients between the left stenosis and the right stenosis groups (P > 0. 05). Conclusion The patients with asymptomatic unilateral severe ICAS have cognitive impairment generally;it is characterized by delay memory,visuospatial and executive functions,and language dysfunction.

Objective To study the effect of two-step pretargeting radioimmunotherapy of CD45 McAb and 188Re-Avidin on lymphoma Raji cell line.Methods The CD45 McAb and Avidin were directly labeled with 188Re,and the labeling efficiency and radiochemical purity were measured by the paper chromatography.The specific binding test and competition binding test between 188 Re-CD45 McAb and Raji cells in vitro were also performed.CCK-8 assay was used to determine the inhibition effect on Raji cell proliferation in the pretargeted group,188Re-CD45 McAb,188Re-Avidin and 188ReO4 groups,then the cell survival and proliferation inhibition rate were calculated.Results The specific cell binding rate of 188Re-CD45 McAb with Raji cells was (70.92 ± 1.91) ％,in the competition group,the binging rate of 188Re-CD45 McAb with Raji cells was only (7.96 ± 0.87)％.The Raji cells proliferation was inhibited in all groups with 188Re radiolabel,and the inhibition rate was positively correlated with the radioactivity dose (r=0.907-0.992,P ＜0.05).However,at the same dose,the inhibition effect in the group of two-step pretargeting at each time point were all stronger than those of 188Re-CD45 McAb,188Re-Avidin and 188 ReO4-alone (t =124.76-607.98,P ＜ 0.05).But there was no significantly statistical difference in the inhibitory effect between the groups of 188Re-Avidin and 188ReO4-(P ＞ 0.05).Conclusions It is confirmed that 188Re-CD45 McAb could be specifically bound to Raji cells,and the two-step pretargeting of CD45 McAb and 188Re-Avidin has obvious inhibitory effect on the Raji cell proliferation.

OBJECTIVE:To establish a method for the simultaneous determination of(R,S)-goitrin,chlorogenic acid,luteolo-side and isochlorogenic acid A in Xiaoer ganmao granule. METHODS:HPLC was performed on the column of Hedera C18 with mo-bile phase of acetonitrile-0.1% formic acid aqueous at a flow rate of 1.0 ml/min,the detection wavelength was 254 nm,330 nm and 370 nm,column temperature was 40 ℃,and the injection volume was 5 μl,RESULTS:The linear range was 6.6-105 μg/ml for (R,S)-goitrin (r=0.999 9),9-140 μg/ml for chlorogenic acid (r=0.999 9),9-144 μg/ml for luteoloside (r=0.999 8) and 9-138 μg/ml for isochlorogenic acid A(r=0.999 6);the limits of quantitation were 330 ng,450 ng,450 ng and 450 ng,limits of detection were 66 ng,90 ng,90 ng and 90 ng,respectively;RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 95.01%-98.77%(RSD=1.48%,n=6),95.14%-98.91%(RSD=1.52%,n=6),95.11%-97.54%(RSD=0.93%,n=6) and 95.58%-99.63%(RSD=1.73%,n=6). CONCLUSIONS:The method is simple and accurate,and suitable for the simultaneous determination of(R,S)-goitrin,chlorogenic acid,luteoloside and isochlorogenic acid A in Xiaoer ganmao granule.

Objective To study the effect and mechanism of down-regulating Silt2/Robo 1 signaling pathway on rabbit iliac artery after angioplasty restenosis. Methods The 30 male New Zealand white rabbits were divided randomly into 3 groups , namely the blank group , the control group , and the experimental group , 10 rabbits in each group. Hign-fat feeding , the rabbits were produced endothelial denudation of iliac artery stenosis model. Another 4 weeks of feeding , percutaneous balloon angioplasty was performed. Then R5 antibody was injected into the abdominal cavity. After 4 weeks of feeding ,angiography again. The results of angiography was analysied by image workstation. The concentrations of Slit2 and Robo1 was detected by ELISA. The iliac artery tissue examined by HE staining. Results The rabbit iliac artery after angioplasty restenosis animal model was set up successfully. Compared with the control group and the experimental group , the serum concentration of Slit2 and Robo1 were significantly higher (P < 0.01) than the blank group. But in the experimental group, the Slit2 and Robo1 serum concentrations were significantly lower than those in the control group (P < 0.05) after R5 antibody intervention. The area ratio stenosis and diameter stenosis rate of iliac artery were reduced that confirmed by angiography. Conclusion The expression of Slit2/Robo1 was significantly higher in the rabbit model of vascular restenosis. R5 antibody can effectively inhibit the expression of Slit2/Robo1. Down regulation of Slit2/Robo1 signaling pathway in the treatment of restenosis after angioplasty in rabbits.

Objective To investigate the relationship between the evaluation of cerebral perfusion with CT perfusion (CTP)imaging and cognitive impairment in patients with asymptomatic severe internal carotid stenosis. Methods A total of 104 patients with asymptomatic severe unilateral internal carotid artery origin stenosis (the unilateral stenosis rate ≥70% and the contralateral stenosis rate < 30%)were enrolled respectively. After conducting Montreal Cognitive Assessment (MoCA)scores,they were divided into a non-cognitive impairment group (n = 24;MoCA ≥26)and a cognitive impairment group (n = 80;MoCA <26). All patients were performed digital subtraction angiography (DSA)and / or CT angiography (CTA)examinations. Their unilateral severe stenosis was confirmed,and they underwent brain CTP examinations. The relative cerebral blood flow (rCBF),relative cerebral blood volume (rCBV),relative mean transit time (rMTT),and relative time to peak (rTTP)were calculate by CTP. The presence rate of collateral circulation in 96 patients was calculated by DSA. The presence rate of collateral circulation,and relative perfusion parameters of the 2 groups were compared. Results (1)The MoCA score in patients of the non-cognitive impairment group was 27. 8 ± 1. 7,and the MoCA score in patients of the cognitive impairment group was 21. 4 ± 3. 1. There was significant difference between the 2 groups (t = 17. 959, P <0. 05). (2)The rate of 96 patients having collateral circulation was 68. 4% (52 / 76)in the cognitive impairment group,and in the non-cognitive impairment group was 60. 0% (12/ 20). There was no significant difference (P >0. 05). The CTP parameters rMTT,rTTP,rCBV,and rCBF in the non-cognitive impairment group were 1. 074 ± 0. 066,1. 103 ± 0. 032,1. 045 ± 0. 021 and 1. 066 ± 0. 040,respectively;the CTP parameters rMTT,rTTP,rCBV,and rCBF in the cognitive impairment group were 1. 241 ± 0. 169, 1. 328 ± 0. 248,1. 046 ± 0. 030,and 1. 093 ± 0. 058,respectively. The rTTP and rMTT of the cognitive impairment were longer than those of the non-cognitive impairment group. There were significant differences in rTTP and rMTT between the 2 groups (P < 0. 05),but there were no significant differences in rCBF and rCBV between the 2 groups (P >0.05). Conclusion Most of the patients with asymptomatic severe internal carotid stenosis has cognitive impairment,and cerebral perfusion caused by stenosis is significantly slower in patients with cognitive impairment than in those with noncognitive impairment.

5-Flucytosine (5-FC) could be changed to 5-fluorouracil (5-FU) by cytosine deaminase (CD), the latter is able to kill cancer cells. However, there is no efficient method to deliver the CD gene into the tumor cells, which hampers the application of the suicide gene system. In this experiment, for the first time, the NDV has been utilized as a vector to deliver the CD gene into the cancer cells, the virus can infect the cancer cells specifically, replicate and assemble, while the cytosine deaminase is expressed. Then the CD converts the prodrug 5-FC into 5-FU to achieve the purpose of inhibiting tumor. Firstly, the whole genome of E. coli JM109 was extracted, and the CD gene was obtained by cloning method. Then the CD and IRES-EGFP were ligated into the pEE12.4 expression vector to become a recombinant pEE12.4IE-CD eukaryotic expression plasmid. The human liver cancer cells were transfected with the plasmid. The cells were treated with different concentrations of 5-FC, MTT method was used to determine the killing effect of CD/5-FC system on the human liver cancer cells. The cell deaths were 18.07%, 42.98% and 62.20% respectively when the concentrations of prodrug were at 10, 20 and 30 mmol x L(-1). In 5-FC acute toxicity experiment, Kunming mice were injected with different concentrations of 5-FC at intervals of 1:0.5. The LD50 of 5-FC through iv injection was determined by improved Karber's method, the LD50 was 507 mg x kg(-1) and the 95% confidence limit was 374-695 mg x kg(-1). According to the maximum LD0 dose of the LD50, the maximum safe dose was 200 mg x kg(-1). Body weight and clinic symptoms of the experimental animals were observed. These results laid the foundation to verify the antitumor effect and safety of CD/5-FC system in animal models. The CD gene was ligated into the NDV (rClone30) carrier, then the tumor-bearing animal was established to perform the tumor inhibiting experiment. The result showed that the recombinant rClone30-CD/5-FC system has a high antitumor activity in vivo. To summarize, CD gene has been cloned and its bioactivity has been confirmed in the mammalian cells. It is the first time in this study to utilize the recombinant NDV to deliver the CD gene into the tumor cells; our result proves the rClone30-CD/5-FC system is a potential method for cancer therapy.