Cyr61/CCN1 is a secreted extracellular matrix ( ECM) protein, which has been shown to regulate a multitude of cellular responses.Many researches indicate that Cyr61 plays important roles in oncogenesis and development of tumor and is considered to be a novel potential oncogene.This review would provide a comprehensive summary about the roles of Cyr61 in the diagnosis and treatment of tumor.

Objective To investigate the imaging features of chest CT and characteristics of laboratory tests in microscopic polyangitis (MPA) with pulmonary infection. Methods Based on the results of sputum culture, 42 patients with MPA were divided into two groups, MPA with pulmonary infection (16 cases)and MPA without pulmonary infection (26 cases). The results of chest CT images and laboratory tests were compared between the 2 groups by χ2 test (or Fisher exact test) and student t test (or Mann-Whitney U test), respectively. Results Compared with patients without pulmonary infection, patients with pulmonary infection showed patchy opacities(15/16 cases versus 14/26 cases,χ2=5.631,P=0.018)and consolidations(7/16 cases versus 2/26 cases,χ2=5.657,P=0.017)more frequently. Patchy opacities showed peripheral distribution less frequently in the MPA with pulmonary infection group than in the MPA without pulmonary infection group (6/15cases versus 12/14 cases,P=0.021). Patients with pulmonary infection showed the same frequent as the patients without pulmonary infection in the following CT findings including ground glass opacities, pleural effusions, mediastinal adenopathy and pulmonary fibrosis (P>0.05). The MPA with pulmonary infection group had higher neutrophil ratio than the MPA without pulmonary infection group (0.84 ± 0.12 versus 0.74 ± 0.11,t= 2.845,P= 0.007). Conclusions The MPA patients with pulmonary infection show patchy opacities and consolidations more frequently, and have higher neutrophil ratio than the MPA without pulmonary infection. The characteristics can be helpful in the diagnosis of pulmonary infection in the MPA patients and guild the treatment.

Objective To prospectively assess the therapeutic procedure and outcome of MR-guided percutaneous sclerotherapy in patients with venous vascular malformations of the extremities. Methods Fifty-seven percutaneous sclerotherapy treatments were performed under MR guidance in 28 patients with venous vascular malformation. Assessment was conducted to analyze (1) individual success of therapy, (2) improvement of clinical symptoms, ( 3 ) occurrence of complications, (4) volume changes at follow-up examinations, (5) contrast-to -noise ration (CNR) changes. Paired-t test was used to compare the volume and CNR of pre- and postintervention. Results All MR-guided percutaneous sclerotherapy were performed successfully and without serious complications. Individual predominant symptoms were improved, especially about the pain and functional impairment. The mean lesion volumes of pre- and post-intervention were (56. 8 ± 11.7 ) cm3 and ( 27.0 ± 7.2 ) cm3 respectively, which showed significant difference ( t = 8. 90, P < 0. 01 ). The percentage of volume shrinkage ranged from 28. 5% to 74. 4% [ mean ( 54. 4 ± 5. 3 ) % ]. The CNR of the pre and post-interventional images were 21.9 ± 2. 0 and 8.4 ± 0. 9 respectively. There was significant difference(t = 21.76, P < 0.01 ) between them, and the percentages of CNR decrease were 40.0% to 78. 0% [ the mean(61.0 ± 3.6)%]. Conclusion MR-guided sclerotherapy of venous vascular malformations of the extremities is a safe and efficient technique.

Objective To investigate the clinical features , diagnosis and key technique points of laparoscopic partial adrenalectomy for small adrenal pheochromocytoma . Methods From Oct.2006 to Jun. 2011, clinical data of 32 cases with small adrenal pheochromocytoma (≤3.0 cm) were collected and retro-spectively analyzed .Hypertension was observed in 12 patients, whereas 20 patients presented with adrenal incidentaloma .Thirteen patients had a left adrenal neoplasm , eighteen patients had a right adrenal tumor , while one patients had bilateral tumors .The positive rate of plasma-free metanephrines ( MNs) and 24-hours urinary catecholamine (CA) in diagnosing small renal pheochromocytomas was 92.6%(25/27) and 81.3%(26/32) respectively.The main localization diagnosis included ultrasonography , 131I-MIBG, and CT or MRI, with positive rates of 71.9%(23/32), 93.8%(15/16) and 96.9%(31/32) respectively.All the laparoscopic adrenalectomies were performed retroperitoneally .During the surgery , the internal part of the adrenal gland closing to the retroperitoneum was dissected first , and the whole adrenal gland was resected completely. Results Partial adrenalectomy was performed for 30 cases and radical adrenalectomy for 2 ca-ses.All operations were successful without perioperative or postoperative complications .The maximum diame-ter of tumor was 1.7±0.2 (1.0-3.0) cm.Histopathological results showed that all the cases were benign pheochromocytoma.The operative time was 82 (40-210) min.The estimated blood loss was 57 (20-180) ml.No patient required blood transfusion . Conclusions Plasma-free MNs, 24-hours urinary CA and VMA are important qualitative examinations in detection of adrenal pheochromocytoma .Ultrasonography , CT,MRI, and 131 I-MIBG are important in the localization of adrenal tumors .Retroperitoneal laparascopic partial adrenalectomy is the preferred choice in the management of small adrenal pheochromocytoma .Dissecting the internal part of the adrenal gland closing to the retroperitoneum first and exploring the whole adrenal tissue are the key technique points during the operations .

Objective:To explore the role and mechanism of the B7-H1 expressed by auto-keratinocytes in the intermingled skin grafting model in vitro(MELC). Methods:The intermingled skin grafting model(MELC) was established in vitro. Flow cytometry was performed to detect the expressions of B7-H1 in keratinocytes. The expressions of PD-1 in lymphocytes were measured at the same time. The levels of IL-10,Foxp3 and GATA-3 mRNA in lymphocytes were detected by Real-time quantitative PCR. Results: Through flow eytometry,in the MELC with auto-keratinocytes,the expression of B7-H1 in auto-keratinocytes and the PD-1 in lymphocytes were rising trend and the rising rate was in time-dependent manners(P<0. 01). RT-PCR assay indicated that the relative levels of IL-10, Foxp3,GATA-3mRNA expression were significant raised and the rising rate was in time-dependent manners (P<0. 01). Conclusion:In the intermingled skin grafting model,the auto-keratinocytes could express B7-H1 to enhance the expression of PD-1 in T cells. When B7-H1 combined with PD-1,the Th2 cells and Foxp3+Tregs were induced and suppressed the immune response in the intermingled skin grafting model.

Objective To investigate the diagnosis and treatment of extra-adrenal pheochromocytoma(EAP). Methods The clinicsl data of 37 cases of EAP from April 2003 to April 2010 were retrospectively analyzed.Hypertension was observed in 31 cases.The typical triad of headache,palpitation and sweating was observed in 12 cases.The positive rate of plasma-free MNs and 24-hour urinary CA in diagnosing EAP was 96.8%(30/31) and 86.5% (32/37) respectively.The main localization diagnosis included ultrasonography,CT,MRI and 131I-MIBG,with positive rates of 91.7% (33/36),97.0%(32/33),90%(9/10) and 82.6%(19/23) respectively.Two patients underwent radiotherapy, and the remaining 35 cases underwent surgical treatment. Results Among the total of 37 cases,32 cases were single tumor,and five were multiple tumors.The anatomic locations of the single tumors were as follows: 14 wre adjacent to the abdominal aorta,seven in the bladder,four adjacent to the inferior vena cava,four adjacent to the renal hilum,two adjacent to the lilac blood vessel and one in the upper pole of the right kidney.Thirty cases underwent complete tumor resection,three cases underwent tumor resection plus right nephrectomy and two cases underwent partial cystectomy.Twenty-four cases were diagnosed benign and 11 cases were diagnosed malignant by pathological examination.Among 31 cases with preoperative hypertension,postoperative blood pressure returned to normal in 23 patients,blood pressure descended mildly in six cases and blood pressure was still hypertensive in two cases.Thirty-four patients were followed up for five months to seven years,during which five cases had tumor recurrence or metastases and five cases died postoperatively. Conclusions EAP is a rare neuroendocrine tumor and its accurate diagnosis is rather difficult.Plasma-free MNs and 24-hour urinary CA are important qualitative examinations.Ultrasonography,CT,MRI and 131I-MIBG scintigraphy are important methods for the localization of the tumor.Transperitoneal resection of the tumor is the preferred choice of management and adequate perioperative preparation is the key to a successful operation,including bringing down blood pressure,expanding blood volume and correcting arrhythmia.Patients with malignant EAP may be treated with 131I-MIBG after surgical therapy.

Objective:To amendment a tool of theory of mind (TOM) tests that can be applied to children with autism spectrum disorder (ASD) in mainland China,and assess the ability of ToM of children with ASD.Methods:The items of the ToM tests were revised by observing and recording events of children's life.Totally 200 normal children were selected in line with the standard from kindergarten to Grade 6 for formal tes-ting.With 156 valid data,Pearson correlation coefficient and Cronbach α coefficient were established for the test.Three experts were invited to make sure the content validity.Researchers randomly selected 30 normal children for retest purpose after 2 months.Twenty five children with ASD were tested and compared with normal children's test scores.Results:The revised test included 39 entries,which was divided into three sub-tests,42 points in total.The correlation coefficient of three subtests of the tests was 0.54-0.77,the correlation coefficient between the test and the subtest was 0.62-0.93 (Ps ＜ 0.01).The scores of three experts for the test were 114,108,and 105.The total scores and subtest scores were lower in children with ASD than in normal children (Ps ＜0.01).The Cronbach a coefficient of the test was 0.84,Cronbach a coefficients for three subtest were 0.83,0.80,and 0.78,respectively.The retest reliability was 0.84,and reliabilities for three subtest were 0.75,0.74,and 1.00.Conclusion:The revised Theory of Mind Tests for Children with Autism Spectrum Disorder are fulfilled mostly in line with psychometric testing requirement.It might be a selection to measure the ability of theory of mind of children with ASD in mainland China.

Objective To analyze the routine test parameter levels of patients with colorectal adenoma and colorectal cancer, and develop a prediction model. Methods A total of 580 patients diagnosed with colorectal adenoma (117 patients) and colorectal cancer (463 patients) were included in the retrospective study. The patients were randomly divided into two groups according to a 7:3 ratio: a training set with 406 cases and a validation set with 174 cases. Logistic regression analysis was used to establish a prediction model, and a nomogram was drawn. The model′s discrimination, calibration, and clinical applicability were evaluated using receiver operating characteristic curve (ROC), calibration plot, and decision curve analysis (DCA). Results Univariate logistic regression analysis identified 13 potential predictors: age, fecal occult blood test (FOBT), fibrinogen (FIB), thrombin time (TT), albumin (ALB), white blood cell value (WBC), neutrophil count (NEUT#), hematocrit value (HCT), mean corpuscular hemoglobin (MCH), red cell distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), and activated partial thromboplastin time (APTT). Multivariate logistic regression analysis showed MPV, FIB, ALB, FOBT, TT, and HCT were risk factors for colorectal cancer in patients with colorectal adenoma (P<0.05). A nomogram was constructed based on these predictors to build a prediction model. The AUC of the ROC curve was 0.915 for colorectal cancer in the training set and 0.836 in the validation set. Calibration plots demonstrated high prediction accuracy and good model calibration. DCA results indicated the prediction model provided greater net benefit compared with the extreme models at threshold probabilities of approximately 55%-95%. Conclusion The developed prediction model exhibits satisfactory discrimination, calibration, and clinical applicability. The model can serve as an auxiliary tool in distinguishing between colorectal adenoma and colorectal cancer in patients.

Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.

Objective To investigate the iodine nutritional and thyroid stimulating hormone level of patients with thyroid nodules in different regions of Qinghai Province and analyze the characteristics of changes in different regions.Methods In 2014-2016,thyroid nodules in 9 regions of Qinghai Province (Tibetan areas:Xiewu,Nangqian,Jiegu,Guoluo;non-Tibetan areas:Xining,Huzhu,Menyuan,Minhe,and Ledu) were selected and serum thyroid stimulating hormone (TSH) and urine iodine were measured.Results A total of 553 thyroid nodules,the median urinary iodine (MUIC) was 160.8 μg/L and the median TSH was 2.97 mU/L.The iodine nutritional status was at an appropriate level.Among them,MUIC (206.8 μg/L) in thyroid nodules in the Menyuan area was slightly higher than the appropriate amount,there was a significant difference in MUIC among different region (x2 =47.747,P ＜ 0.05);of TSH in thyroid nudules in the 9 regions,the differences were statistically significant (x2 =34.832,P ＜ 0.05).Non-Tibetan areas were compared with Tibetan areas,there was a significant difference in MUIC (155.6,185.6 μg/L),TSH (2.68,3.45 mU/L,Z =-3.677,-5.410,P ＜ 0.05);Among them,the differences was statistically significant between MUIC (152.8,187.7 μg/L) of women with thyroid nodules (Z =-3.504,P ＜ 0.05);there was a statistically significant difference in TSH levels among men (2.58,3.46 mU/L) and women (2.80,3.44 mU/L) with thyroid nodules (Z =-3.613,-4.040,P ＜ 0.05);there were no significant differences in MUIC levels among thyroid nodules of each age groups (P ＞ 0.05);of the TSH level in 30-and 50-＜ 65 years groups (2.63,3.17;2.25,3.58 mU/L),the differences were statistically significant (Z =-2.892,-3.233,P ＜ 0.05),and other groups were no significant differences (P ＞ 0.05).Conclusion The iodine nutrition of patients with thyroid nodules in these regions of Qinghai Province is generally at an appropriate level,the MUIC and TSH levels in Tibetan areas were lower than those in non-Tibetan areas,and iodine nutrition status and TSH levels should be monitored for key populations.