Objective To review the clinical features,diagnosis,management and prognosis of patients with nonfunctional malignant adrenal tumors. Methods 12 patients admitted with nonfunctional malignant adrenal tumors from 1990 to 2000 were reviewed.Among them 6 cases had symptoms of fever,ostealgia,etc.The tumor measured 3 cm in 1 case,5 to 10 cm in 9 cases and more than 10 cm in 2 cases.Ten cases developed local invasion and (or) matastasis. Results Five cases underwent tumor excision or enucleation and 5 underwent biopsy only.Of these 10 cases,4 were pathologically diagnosed as cortical adenocarcinoma,4 as metastatic carcinoma,1 as mucous liposarcoma and 1 as lymphoma.The remaining 2 cases had no operation.One case died during hospital stay.Ten cases died within 2 years.One case of adrenocortical carcinoma experienced relapse 3 years after initial operation and died next year. Conclusions Nonfunctional malignant adrenal tumor is rare and difficult to diagnosis in early stage,indicating an extremely poor prognosis.Tumor diameter is an important factor to be considered regarding surgical indication.

Objective MiRNA-10b is an important member of the MiRNA family , which has been proven that miRNA-10b can promote the growth and invasion of a variety of tumor cells .The aim of this study was to to investigate the effect and mechanism of miR-NA-10b on proliferation and invasion of low metastasis of lung cancer cell line (95-C). Methods The recombinant of miRNA-10b was transfected into 95-C by lipofectin method .The experiment set up 3 groups:blank control group , negative control group and miRNA-10b expression plasmid transfected group .MiRNA-10b expression level and KLF4mRNA expression level were detected by real-time fluores-cence quantitative PCR ( RTFQ-PCR) .The cell proliferation was detected by cell proliferation assay .The invasive ability of cell was de-tected by Transwell experiment .The expression of KLF4 protein was assessed by Western blot . Results At 48 hours after transfection, compared with blank control group (1.01 ±0.08) and negative control group (0.86 ±0.07), the miRNA-10b expression level in miRNA-10b expression plasmid transfected group (1.61 ±0.12) increased significantly (P<0.05) and there was no statistical difference between blank control group and negative control group (P>0.05).From the growth curve, the cell proliferation rate was obviously increased in miRNA-10b expression plasmid transfected group ([188.0 ±15.1]/HP) compared with the other two groups ([151.0 ±11.3]/HP), ([136.0 ±10.8]/HP) (P <0.05) and there was no statistical difference between these two groups ( P >0.05 ).Transwell result showed more cells transferred to the other side of Transwell compared with the other two groups ( P <0.05 ) and there was no statistical difference between these two groups (P >0.05).The expression of KLF4 protein decreased in miRNA-10b expression plasmid transfected group compared with the other two groups ( P<0.05).KLF4mRNA expression decreased, but the difference had no statistical significance (P>0.05). Conclusion MiRNA-10b might promote the pro-liferation and invasion of 95-C through down-regulation of KLF4 protein expression .

Objective To evaluate the expression of CyclinD1 in gallbladder carcinoma and its relationship with clinlicopathological parameters.Method SABC immunohistochemistry was used to detect the expression of CyclinD1in 41carcinoma,15 chronic cholecystitis,10 normal tissue of gallbladder .Gallbladder carcinoma cell proliferation condition was detected by PCNA counting score .Results There were no positive signal of CyclinD1 deteted in chronic cholecystitis and in normal tissue,the positive rate of CyclinD1 in gallbladder carcinoma was 58.5%(24/41).The expression of CyclinD1 was related to tumor TNM stage, lymph node metastasis and cell differentiation (P

Objective To investigate the expressions of PTEN and p21 genes in Hazak patients with esophageal can-cer. Methods The expressions of PTEN and p21 genes were detected by RT-PCR in 48 samples (cancer tissues and nor-mal tissues) of patients with esophageal cancer. The relationship between the expressions of PTEN and p21 genes, tumor dif-ferentiation, TNM stage, clinical phase and lymph node metastasis were analyzed. Results The positive rates of PTEN gene were 75%and 45.8%in cancer and distant normal tissues. The expression of PTEN was significantly higher in cancer tis-sues than that of distant normal tissues (χ2=8.537,P＜0.05). The positive rates of p21 gene were 95.8%and 97.9%in cancer and distant normal tissues, and no significant difference between them (χ2=0.344,P>0.05). There was no correlation be-tween expressions of PTEN and p21and the tumor differentiation, the depth of invasion and lymph node metastasis in esopha-geal cancer. Conclusion PTEN and p21 genes are not the primary genes for the carcinogenesis of esophageal cancer in Hazak.

Objective To study the change of erythrocyte indices and serum iron in hyperthyroidism rats .Methods SD female rats were randomly divided into hyperthyroidism group and control group .Hyperthyroidism rats were induced by intragastric ad‐ministration of Euthyrox (Levothyroxine) and their blood and serum were obtained after administration of 1-8 weeks ,respective‐ly .And the control rats were given normal saline .Levels of T3 ,T4 and TSH were determined by a radioimmunoassay .Erythrocyte index were measured by automatic blood cell analyzer .Serum iron concentration and total iron binding capacity were determined by chromatometry .Results The concentration of serum T3 and T4 increased in hyperthyroidism rats ,whereas the TSH decreased . RBC was higher in hyperthyroidism rats at 2-8 weeks compared with the control rats (P<0 .05) .HCT was higher in hyperthy‐roidism rats at 1-8 weeks compared with the control rats (P<0 .01) .MCV was lower in hyperthyroidism rats at 2-8 weeks com‐pared with the control rats (P<0 .05) .MCHC was lower in hyperthyroidism rats at 1 -8 weeks compared with the control rats (P<0 .01) .RDW SD and RDW CV was higher hyperthyroidism rats at 1-2 weeks compared with the control rats(P<0 .01) .Ser‐um iron concentration and total iron binding capacity increased in hyperthyroidism rats at 4 -8 weeks compared with the control rats(P<0 .01) .Conclusion The hyperthyroidism rats in the present study is absent significant manifestation of anemia ,whereas the hypochromic changes of erythrocyte is significant .Serum iron concentration and total iron binding capacity increase in hyperthy‐roidism rats ,which demonstrate the iron utilization disorder .

Objective To analyze the median urinary iodine(MUI)level in normal pregnant women based on World HeMth Organization(WHO) recommended criterion,and to provide the MUI reference values for monitoring and evaluating iodine nutrition during pregnancy and related studies.Methods Total 604 normal pregnant and 192 non-pregnant women(as a comparison)were selected from a cross-sectional survey.These women were all healthy,iodine sufficient,with normal thyroid function,and negative anti-thyroid antibodies.The iodine content in drinking water,edible salt,and urine was determined by standard methods,and serum TSH,FT4,FT3,thyroid peroxidaseantibody(TPOAb),and thyroglobulin antibody(TgAb)were measured using chemiluminescent immunoassay.Resuits (1)The iodine in drinking water was 3.0μg/L indicating such small amount of iodine could be neglected for daily iodine intake.(2)All women consumed iodized salt with the median iodine in salt of 31.7 mg/kg.The daily iodine intake of at least 240 μg could be roughly estimated if an average of 10 g salt was taken per person per day and further subtracted by 20%iodine lost during cooking,which could meet the iodine needs during pregnancy.(3)The MUI of 173.1μg/L was calculated from 604 pregnant women having 174.5,167.0,and 180.7 μg/L during the first,second,and third trimesters,respectively,reaching the optimal level of 150-249 μg/L recommended by WHO for pregnant women.However,our data showed relatively lower levels,not reaching 200μg/L.The MUI of 240.2μg/L was calculated from 192 non-pregnant women,reaching the level of"above requirement"(200-299μg/L) recommended by WHO for adults.(4)All women were euthyroid and antibody-negative,but the TSH level in pregnant women was lower than that in non-pregnant women,in particular during the first trimester,while FT4 and FT3 were considerably decreased compared with the non-pregnant(with an exception of FT4 in the first trimester),and both gradually declined with the gestational age.Conclusions The optimal MUI level of 150-249 μg/,L recommended by WHO can be applied to pregnant Chinese women,but our data provided a relatively low range of 150-200μ/L throughout pregnancy.The higher MUI of 240.2μg/L in non-pregnant women indicated that iodized salt with different contents should be supplied on market to meet the requirement of different groups of population.

Objective This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES).Methods The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied.Results (1) The average age of the 123 (male 43,female 80) PES patients was (59.2 ± 13.6) years (ranging 24-92 years),among whom 61％ patients were in the age group between 50-69 years.(2) The symptoms of the patients included fatigue (56.1％),headache (34.1％),nausea and vomiting (17.9％),gonadal dysfunction (17.1％),visual disturbance (5.7％) and hypopituitarism crisis (3.3％).(3) Hypopituitarism was found in 66 of the 123 patients.Among them,36.6％,31.7％ and 17.1％ were central hypoadrenalism,hypogonadism,and hypothyroidism,respectively.The percentage of hypopituitarism in complete PES was significantly higher than that in partial PES (P ＜ 0.05).(4) Sixteen patients were concomitant with other autoimmune diseases including 11 patients with Graves' disease and 2 with Cushing's syndrome due to adrenal adenoma.Conclusions The incidence of hypopituitarism in PES was 53.7％,in which the pituitary-adrenal axis hypofunction was more common.An overall evaluation of the pituitary function was essential for the patients who had headache and fatigue,or with suspected PES.The patients with hypopituitarism should be given hormone replacement therapy in time and followed up afterword.

Objective:To develop the Self-Stigma Scale for Drug Addicts(SSSDA),and test its validity and reliability.Methods:On the basis of literature analysis,open questionnaire survey,semi-structured interview and ex-pert consultation,the theoretical structure of the questionnaire was developed,and 943 drug addicts were test-ed.Sample 1(n=483)was used for item analysis and exploratory factor analysis,and sample 2(n=460)was used for confirmatory factor analysis,criterion related validity and internal consistency reliability analysis.Sixty-four drug addicts were retested 4 weeks later for test-retest reliability test.The criterion related validity was tested with the Drug Stereotype Threat Scale.Results:The scale consisted of 6 dimensions and 31 items,including self-negative cognition,stereotype identity,confidentiality,social avoidance,stigma experience,and stigma experience in the process of detoxification(factor loadings were from 0.41 to 0.81),which explained 64.09％of the total vari-ance.The 6-factor structure model fitted the data well(x2/df=2.82,RMSEA=0.06,CFI=0.92,GFI=0.85,TLI=0.91).The total scores and factor scores of the SSSDA were positively correlated with the DSTS scores(ICC=0.10-0.22,Ps＜0.05).The Cronbach α coefficients for the total scale and each dimension were between 0.80 and 0.95,and the test-retest reliability coefficients(ICC)were between 0.82 and 0.94.Conclusion:The Self-stigma Scale for Drug Addicts(SSSDA)initially developed in this study has satisfactory reliability and validity.

Objective To evaluate the safety and effectiveness of enhanced recovery after surgery (ERAS) in laparoscopic radical gastrectomy for gastric cancer.Methods From May 2015 to July 2017,149 patients with gastric cancer in our department were prospectively enrolled and randomly divided into the ERAS group (n =75) and control group (n =74).Results In ERAS group compared to control group,the time to first passage of flatus was (51 ± 11)vs.(62 ± 11)h,first feeding time (46 ± 12) vs.(68 ±20)h,gastric tube removal time (13 ± 12)h vs.(70 ± 16) h,pain score on the first day after surgery (3.9 ±1.3) vs.(5.2 ±0.9),C-reaction protein level (8.5 ±2.6) mg/L vs.(10.1 ±3.0)mg/L,post-op hospital stay (6.9 ± 2.9) d vs.(11.2 ± 3.5) d,were all significantly different (all P ＜ 0.05).The postoperative complication rates was 25％ vs.28％ respectively,(x2 =0.101,P =0.750).Conclusions Enhanced recovery after surgery can promote the postoperative recovery and shorten the time of hospitalization in laparoscopic-assisted radical gastrectomy for gastric cancer.

Objective To identify the risk factors for postoperative complications after radical resection of rectal cancer, and study the influence of high ligation of the inferior mesenteric artery on postoperative complications of rectal cancer. Methods Clinical data of the patients who underwent radical resection of rectal cancer in the Affiliated Hospital of North Sichuan Medical College from January 2011 to December 2015 were analyzed. The χ 2test and t test were used for all the data. Results A total of 431 patients with rectal cancer were included, of which 80 cases were excluded, and finally 351 cases met the standard. Among them, 196 cases were in high ligation group, and 155 cases were in low ligation group. The total incidence of postoperative complications was 20.4 %(40/196) in the high ligation group and 27.1 %(42/155)in the low ligation group respectively,the difference of which was not statistically significant(χ2=1.336, P= 0.245). The incidence of anastomotic leakage was 10.2 % (20/196) in the high ligation group and 7.7 % (12/155) in the low ligation group respectively, and there was no significant difference between them (χ2=0.529, P= 0.467). Logistic regression analysis revealed that gender (OR= 2.102, 95 % CI 1.278-3.459, P=0.003), body mass index (OR= 2.492, 95 % CI 1.070-5.800, P= 0.027), with or without anemia before surgery(OR=2.203,95 % CI 1.085-4.472,P=0.029), and location of tumor(OR=2.861, 95 % CI 1.288-16.007,P=0.019) were independent risk factors for postoperative complications. Conclusions High ligation of the inferior mesenteric artery does not increase the incidence of postoperative complications after radical resection of rectal cancer. Anastomotic leakage after rectal cancer resection is related to gender, body mass index,with or without anemia before surgery,and location of tumor.