Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Tumor cells leads to enhanced glucose uptake and the conversion of a larger fraction of pyruvate into lactate even under the circumstance of abundant oxygen. This phenomenon of aerobic glycolysis is known as the Warburg effect. Lactic acid, as an important tool for tumor cells to modify the tumor microenvironment, promotes the process of tumor invasion and metastasis, and contributes to tumor development by inducing and recruiting immunosuppression-related cells and molecules. Lactic acid could efflux out of the cancer cells via the monocarboxylate transporters to prevent intracellular acidification. Lactate can inhibit the cytolytic activity of T cells and natural killer (NK) cells, promoting the differentiation of tolerogenic interleukin 10 (IL-10)-producing dendritic cells. Moreover, the lactate-derived lactylation of histone lysine residues can promote macrophage polarization toward the M2-like phenotype, suppressing the immune response within the tumor microenvironment. In this review, we discuss the role of lactate as an immunosuppressor molecule that contributes to tumor evasion from the aspects of lactic acid metabolism and its effect on immune cells. And we explore the possibility of targeting potential targets in lactate metabolism for tumor treatment. At last, we proposed a tumor immunotherapy strategy by inhibiting the pathway of aerobic glycolysis and proteins associated with the production and transport of lactic acid.

As an essential amino acid, tryptophan (Trp) has various physiological functions and is of great significance in the metabolic process of tumors. In the human body, tryptophan is mainly transformed through kynurenine metabolic pathway, which not only promotes the inherent malignant properties of tumor cells, but also leads to immune-suppressive tumor microenvironment. Changes in tryptophan metabolism often occur in tumors, accompanied by abnormal gene expression of tryptophan-related enzymes, among which indoleamine 2,3-bioxygenase (IDO)-related gene expression and tryptophan 2,3-dioxygenase (TDO)-related gene changes are the most significant. A large number of clinical trials on IDO inhibitors, TDO inhibitors and combination therapy have been carried out. This paper reviewed the tryptophan metabolic pathway, regulation of IDO (TDO), kynurenine (KYN) and other related genes in tumor cells, and outlined the development of therapeutic schedule targeting tryptophan-related genes. The new progress provides new ideas for the further exploration of tumor treatment options.

BACKGROUND: Many scholars have paid attentions on neural stem cells (NSCs), which are regarded as the cell source to repair the injured nervous tissues. And it is becoming a key point that NSCs will be obtained in an effective way.OBJECTIVE: To observe the characteristics of isolation, proliferation and differentiation of in vitro NSCs from subventricular zone (SVZ) and hippocampus of neonatal rats.DESIGN: Single-sample trial.SETTING: Department of Neurosurgery in the Third Affiliated Hospital of Sun Yat-sen University.MATERIALS: Ten SD rats aged 3 days, of either gender, were offered from the Experimental Animal Center of Sun Yat-sen University. Nestin antibody (rabbit-anti-rat), neurofilament (NF-200) antibody (rabbit-anti-rat), and glial fibrillary acidic protein (GFAP) antibody (mice-anti-rat) were all purchased from Sigma Company.METHODS: The experiment was carried out in the Laboratory of Histology and Embryology, Basic Medical College of Sun Yat-sen University from September to December in 2006. According to the ethical requirement, the serum-free DMEM/F12 medium containing basic fibroblast growth factor and epidermal growth factor was utilized to isolate and incubate NSCs from SVZ and hippocampus of neonatal rats. Then the proliferation and differentiation of NSCs in vitro were observed.MAIN OUTCOME MEASURES: Fluorescence immunocytochemistry was applied to detect the antigen of nestin expressed from NSCs, NF expressed from neuron cells and GFAP expressed from astrocytes. The differentiation of NSCs was identified.RESULTS: The cells isolated from SVZ and hippocampus of neonatal rats possessed the ability of proliferation and self-renewal. Through inverted microscope, nestin positive cells could be found in the cell clone sphere at passage 20 of cells. Cells induced to differentiate could express antigen of NF and GFAP by the attached cell clone sphere.CONCLUSION: The NSCs successfully isolated from SVZ and hippocampi of neonatal rats possess the ability of self-renewal, proliferation, and differentiation into neuron-like cells and astrocytes.

Objective To explore the MRI features of ejaculatory duct obstruction.Methods During January 2003 to Dccember 2010,transrectal ultrasonography (TRUS) was performed for 106 patients and underwent surgical treatment for ejaculatory duct obstruction.Among them,16 patients underwent MRI examination.The MRI features of ejaculatory duct obstruction in these patients were summarized.Results Ejaculatory duct cysts,ranging in size from 4 mm ×4 mm ×7 mm to 4 mm ×4 mm ×9 mm and locating in the paramedian line,were detected in 5 of the 16 patients; ejaculatory duct dilation located in the paramedian line was detected in 7 patients,with the internal diameter of 5 to 30 mm. After contrast injection,significant enhancement of the wall of the ejaculatory duct was observed in 2 patients.Mullerian duct cysts complicated with dilated ejaculatory duct and seminal vesicles were detected in 4 patients,in whom the cysts were located in the median line,ranging in size from 4 mm × 5 mm × 6 mm to 34 mm×35 mm ×44 mm,with inverted teardrop shaped pointing toward the seminal colliculus.ConclusionThe most common MRI features of ejaculatory duct obstruction are ejaculatory duct dilation and ejaculatory duct cysts.

Objective:To establish an LC-MS/MS method for the simultaneous determination of acetaminophen and its five metabolites in mice plasma,and investigate the metabolism of acetaminophen by using the method.Methods:Para aminobenzoic acid was used as the internal standard.The plasma samples were precipitated by methanol,and then separated on a C18 column with the mobile phase of methanol and 5 mmol·L-1 ammonium acetate buffer solution containing 0.1% formic acid (55∶45).The flow rate was 0.5 ml·min-1,and the column temperature was 25℃.An electrospray ionization source was applied and operated in a positive ion mode using MRM:APAP,-,m/z 152.0→110.0;APAP-cys,-,m/z 271.2→140.1;APAP-glut,-,m/z 457.0→328.0;APAP-NAC,-,m/z 313.4 →208.0;APAP-sulf,-,m/z 232.4→152.1;APAP-gluc,-,m/z 328.2→152.1;IS,-,m/z 138.2→120.0.Results:The method exhibited good linearity over the concentration range of 0.2-10 μg·ml-1for APAP,1.0-20 μg·ml-1 for APAP-gluc,1.0-20 μg·ml-1 for APAP-sulf,1.0-20 μg·ml-1 for APAP-glut,0.4-15 μg·ml-1 for APAP-NAC and 0.2-10 μg·ml-1 for APAP-cys (r≥0.990 0).The inter-day accuracy and precision of acetaminophen and its five metabolites were all below 15%.The average recovery was between 85% and 115%,and RSDs were all below 15%.Conclusion:The LC-MS/MS method is proved to be quick,sensitive and accurate,and suitable for the determination of acetaminophen and its five metabolites in mice plasma.

AIM: To investigate the function and the mechanism of transplanting bone marrow derived peripheral blood mesenchymal stem cells(PBMSCs) on restenosis after carotid balloon angioplasty in the model of carotid atherosclerosis rabbits,and to determine if the functions of PBMSCs are enhanced after hypoxia preconditioning.METHODS: Bone marrow cells were mobilized by granulocyte colony-stimulating factor(G-CSF),and PBMSCs were collected through density gradient centrifugation and adherent culture,labeled with enhancement type green fluorescent protein(EGFP) genes.All animals with carotid atherosclerosis stenosis were randomly divided into three groups: hypoxia preconditioning group(n=24,received intravenous transplantation of PBMSCs with hypoxia preconditioning),non-hypoxia preconditioning group(n=24,received normal culture of PBMSCs) and control group(n=24,only received equal-volume of culture medium).Vascular endothelial growth factor(VEGF) was determined by enzyme linked immunosorbent assay(ELISA) at 7 d,14 d and 28 d post-angioplasty,respectively.The vessel morphology,the homing of MSCs and the reendothelialization were analyzed with Weigert staining and immunohistochemistry.RESULTS: Compared to control group,the level of VEGF significantly increased in both hypoxia preconditioning group and non-hypoxia preconditioning group at all time points(P

Objective: To evaluate the efficacy of postoperative radiotherapy in the treatment of parotid gland carcinoma. Methods: Eighty-six postoperated patients with parotid gland carcinoma( 7 in stage Ⅰ, 28 in stage Ⅱ, 33 in stage Ⅲ and 18 in stage Ⅳ) were radiated by 60Co ?-ray or linear accelerator X-ray combined with electron beam. All patients were diagnosed by pathology and followed up for more than 5 years. Results: The five year survival rate and the local control rate were 73.3% and 87.2% respectively. Poor prognosis was observed in the cases with the neoplastic classification of undifferentiated carcinoma, sequamous cell carcinoma and malignant pleomorphic adenoma, but the better prognosis was obtained in the cases with acinic cell carcinoma and mucoepidermoid carcinoma. Poor prognosis was observed in the cases with stage Ⅲ and Ⅳ of clinical stage. Radiotherapy undertaken in 2 weeks after surgical operation gave higher 5- year survival ratio( 83.8%). The group given 51～60 Gy radiation showed 82.9% of five- year survival rate. Conclusion: The combination of surgery with radiation is effective in the treatment of parotid gland carcinoma.Radiation of 51～60 Gy 2 weeks after operation may result in better prognosis. Neoplastic type and clinical stage are important factors for prognosis.

ObjectiveTo detect BAG1 expressions in digestive tract cancer by tissue microarray and to evaluate its clinical significance.MethodsTissue microarray of digestive tract cancer and normal tissues were analyzed by DAKO Envision system immunohistochemical staining for apoptosis related gene BAG-1 expression.ResultsThe positive rate of BAG-1 expression among esophagus cancer,gastric cancer and rectal cancer were higher than that of normal tissues respectively(P<0.01).ConclusionThere is an overexpression of BAG-1 in digestive tract cancer,which suggest that apoptosis related gene BAG-1 may be related to these cancer.

Resident standardization training is an important means of clinical physician training in our country. Critical care medicine has important status in the training process. It is the important link to ensure the quality of resident standardization training. Residents should grasp the identification and early detection of critical ill patients. Residents should also get the ability of general basic management for critical condition and the doctor-patient communication ability. In practice, we have explored the training mode of standardized training of resident doctors in critical care medicine by developing detailed training outline, a variety of teaching methods and emphasizing the cultivation of clinical work ability.