Adrenocortical carcinoma(ACC)is the most prevalent malignant tumor of the adrenal gland and is characterized by a poor pro-gnosis in its advanced stages.Surgical resection of the tumors is typically limited to patients diagnosed in the clinical stages Ⅰ and Ⅱ,lead-ing to a high postoperative recurrence rate.The combination of mitotane(M)with etoposide(E),doxorubicin(D),and cisplatin(P)(EDP-M)is currently the only approved first-line treatment regimen for advanced ACC.However,the efficacy of chemotherapy and radiation therapy in ACC remains limited.If the EDP-M regimen proves ineffective,there are no standardized or universally accepted second-line systemic treat-ment alternatives.Research advancements in the molecular mechanisms of ACC in recent years has led to increasing investigations on tyr-osine kinase inhibitors(TKIs)targeting EGFR,VEGFR,and mTOR,as well as immune checkpoint inhibitors(ICIs).Moreover,previous studies have identified mutations in CTNBB1,TP53,KDM5A,CENP-H,and other genes that may serve as therapeutic targets or biomarkers,thereby expanding the treatment options available for ACC.ICIs are effective against diverse cancer types,including non-small cell lung cancer(NSCLC),liver cancer,renal cell cancer,and urothelial cancer.Ongoing exploration into targeted therapies and immunotherapy,especially combination treatments,holds the promise of extending the survival of patients and enhancing their quality of life.

Myelin-forming oligodendrocytes in the central nervous system (CNS) and Schwann cells in the peripheral nervous system (PNS) are essential for structural and functional homeostasis of nervous tissue. Albeit with certain similarities, the regulation of CNS and PNS myelination is executed differently. Recent advances highlight the coordinated regulation of oligodendrocyte myelination by amino-acid sensing and growth factor signaling pathways. In this review, we discuss novel insights into the understanding of differential regulation of oligodendrocyte and Schwann cell biology in CNS and PNS myelination, with particular focus on the roles of growth factor-stimulated RHEB-mTORC1 and GATOR2-mediated amino-acid sensing/signaling pathways. We also discuss recent progress on the metabolic regulation of oligodendrocytes and Schwann cells and the impact of their dysfunction on neuronal function and disease.
Amino Acids ; Myelin Sheath/metabolism* ; Schwann Cells/metabolism* ; Oligodendroglia/metabolism* ; Signal Transduction ; Intercellular Signaling Peptides and Proteins/metabolism*

Objective:To understand the current status of mental resilience of patients undergoing hysteroscopy and its influencing factors so as to provide guidance for clinical health education.Methods:By the convenient sampling method, patients who underwent hysteroscopy in the gynecological clinic in a ClassⅢGradeA hospital in Jiaozuo from January to June 2019 were selected as research objects. Connor-Davidson Resilience Scale (CD-RISC) , Perceived Social Support Scale (PSSS) and General Data Questionnaires were used to conduct survey to explore the current status of mental resilience of patients undergoing hysteroscopy and its influencing factors. This study retrieved 157 valid questionnaires.Results:The score of CD-RISC in 157 patients undergoing hysteroscopy was (58.20±27.45) , with a minimum of 16 points and a maximum of 107 points. There were statistically significant differences in the total scores of CD-RISC among patients of different ages, education background and residential area who underwent hysteroscopy ( P<0.05) . The correlation analysis showed that the level of mental resilience of patients undergoing hysteroscopy was positively correlated with the score of social support ( P<0.05) . Multiple linear regression analysis showed that age, education background, living area, family support were the main factors influencing the mental resilience of patients undergoing hysteroscopy ( P<0.05) . Conclusions:The mental resilience of patients undergoing hysteroscopy is relatively poor. Age of patients, educational background of patients, living area, family support are the important factors affecting mental resilience. Targeted disease education and psychological counseling should be carried out for different groups. Multiple channels and diversified ways should be adopted to strengthen social support so as to improve mental resilience of patients, enable them to cope with the disease in a positive way and promote recovery.

Objective To report 1 case with pancreatic cancer after chemotherapy infected by influenza B virus, and complicated with atrial fibrillation, pulmonary infection. Methods Clinical data, treatment, outcome of this case were reviewed and the nursing emphasis was summarized. Results Through active treatment and nursing, with cured influenza, successful cardioversion of atrial fibrillation and controlled lung infection, the patient was transferred to general hospital to treat basic disease. During hospitalization, none infection occurred among medical staff and caregivers. Conclusions Key points of nursing of patient with pancreatic cancer after chemotherapy complicated with influenza B include disease observation of atrial fibrillation, lung infection and influenza B virus infection, nutritional status improvement, skin care, psychological care for patients and care-givers, disinfection and isolation to influenza B virus infection, and staff self-protection.

Objective To investigate the establishment of focal cerebral ischemia model in rabbits with the improved suture method.Methods A total of 45 healthy and clean adult New Zealand rabbits were divided into either a sham operation group (n =5) or a model group (n =40) using random number table method before modeling,and the sex was not limited.The self-made head ends of 2-0 fishing lines dipped in paraffin were used as the sutures.The external carotid artery was cut and inserted into a intracranial artery through the internal carotid artery and blocked the origin of middle cerebral artery.The neurological function score was performed after 6 h.The neurological deficit scores ≥2 was successful modeling.The rabbits were killed by anesthesia.The brain slices were stained with 2％ 2,3,5-triphenyl tetrazolium chloride solution.The infarct foci were observed.The diameters of suture head and the depth of suture insertion were compared in the model rabbits with successful modeling,failure,and death in the model group.Results There were 40 rabbits in the model group,six of them died,including 4 died of subarachnoid hemorrhage within 4 h after operation,and 2 died from anesthetic accident.The mortality rate was 15.0％.Seven rabbits failed,mainly because of cerebral vasospasm and the insertion depth of suture was insufficient.Twenty-seven had successful modeling,and the success rate was 67.5％.All the rabbits in the sham operation group survived.The diameter of the suture head and insertion depth in the successful modeling rabbits were compared with the death and failure outcome in rabbits.The difference was statistically significant (diameter:0.52 ± 0.14 mm vs.0.45 ±0.40 mm and 0.58 ±0.17 mm;depth:5.49 ±0.17 cm vs.6.04 ± 0.11 cm and 4.26 ±0.30 cm;all P ＜ 0.05).Conclusions The improved suture method can successfully prepare the focal cerebral ischemia model of middle cerebral artery in rabbits.The method is simple.Its repeatability and practicability are better.

OBJECTIVETo investigate the effect and mechanism of high dose Vitamin B3 on granulopoiesis in normal rat.

METHODSTwenty one healthy SD rats were randomly divided into three groups: the Vitamin B3 group (Vit B3 500 mg·kg⁻¹·d⁻¹, × 7 d), the rhG-CSF group (rhG-CSF 25 μg·kg⁻¹·d⁻¹, × 7 d) and the normal saline group (2 ml/d, × 7 d). The peripheral blood cell counts were analyzed by automatic blood cell counter before (day 0) treatment, the third day (day 3) and the seventh day (day 7) after administration of drugs, respectively. The concentration of serum nicotinamide adenine dinucleotide (NAD⁺) level was measured by enzymatic cycling assay before and after drugs treatment. The expressions of G-CSF, G-CSFR, SIRT1, C/EBPα, C/EBPβ, C/EBPε and NAMPT mRNA were detected by reverse transcription real-time fluorescent quantitative PCR.

RESULTSThe neutrophil counts increased significantly after 7 days of Vitamin B3 and rhG-CSF treatment compared with that of control group [(1.64 ± 0.19) × 10⁹/L, (1.88 ± 0.37)× 10⁹/L vs (0.86 ± 0.18) × 10⁹/L, P<0.01]; the level of serum NAD⁺ increased significantly [(0.96 ± 0.08) nmol/L, (0.65 ± 0.12) nmol/L vs (0.36 ± 0.15) nmol/L, P<0.01]; the expression of G-CSF, G-CSFR, SIRT1, C/EBPα, C/EBPε and NAMPT mRNA in bone marrow mononuclear cells were increased significantly compared with that of control group (P<0.01).

CONCLUSIONHigh dose of Vitamin B3 may play an important role in increasing absolute neutrophil count in healthy rat under steady state, and the mechanism may be dependent on NAMPT-NAD⁺-SIRT1 signaling pathways.

Animals ; Bone Marrow Cells ; Granulocyte Colony-Stimulating Factor ; Leukocyte Count ; Neutrophils ; drug effects ; Niacinamide ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins

Objective To screen the sequence of fibroblast growth factor receptor 3 (FGFR3) genes in children with dys-chondroplasia and their family members for searching the mutations. Methods The sequence of exon 10 and exon 13 in muta-tion hot spot region of FGFR3 gene in seven families was analyzed using polymerase chain reaction (PCR) and DNA sequenc-ing technology. Results The c.1138G>A missense mutation in exon 10 was found in 4 probands who were diagnosed as achon-droplasia (ACH), while this mutation was absent in their parents. The c.1620C>A missense mutation in exon 13 was found in one girl and her mother who both were diagnosed as hypochondroplasia (HCH) with mild symptoms. Neither mutation men-tioned above was found in the other two probands. Conclusions Through detecting the mutation in exon 10, exon 13 of FGFR3 gene, most patients of ACH or HCH can be finally diagnosed. However, it is necessary to perform the mutation screening on the other zones of FGFR3 gene and on other related genes for a few cases.

Objective To investigate the clinical features and pathogenesis of severe congenital neutropenia (SCN) by detecting the gene mutation of a SCN patient suspected by clinical diagnosis. Methods The intravenous anticoagulant and clin-ical data and laboratory results of this child were collected;the phagocyte and oxidation function of neutrophils were evaluated by flow cytometry;ELANE, HAX1, WAS, GFI1, CSF3R and CXCR4 genes were screened by PCR amplification and sequencing. Results The neutrophil function of this patient was normal; sequencing results revealed no mutation occurred in ELANE, HAX1, WAS, GFI1, CSF3R and CXCR4;and granulocyte colony-stimulating factor (G-CSF) can obviously enhance the level of neutrophils. Conclusion SCN is a kind of genetic heterogeneity syndrome associated with multiple gene mutations, gene diag-nosis will contribute to understanding of the pathogenesis of the disease and provide theoretical basis for treatment. Though more and more pathogenic genes were found to be connected with SCN, the cases of unknown mutation still account for a large proportion of this disease.

Obj ective To discuss yhe influence of nursing inyervenyion on complicayions of liver yumor payienys wiyh meyal yrack marks implanyayion.Methods 160 payienys wiyh meyal yrack marks implanyayion were randomly divided inyo inyervenyion group and conyrol group.Each group conyained 80 payienys.The payienys in yhe conyrol group were given convenyional nursing of meyal yrack marks implanyayion.Healyh educayion was given in yhe inyervenyion group on yhe basis of con-venyional nursing.Incidence raye of complicayions such as yachycardia afyer operayion,hyperyen-sion,abdominal bleeding and pain,bleeding and skin pain on yhe puncyure poinys were compared beyween yhe ywo groups.Results Afyer meyal yrack marks implanyayion,160 payienys finished yheir cyberknife yreaymeny wiyhin 5~7 days.The incidence raye of complicayions,such as yachy-cardia afyer surgery,hyperyension,abdominal bleeding and pain,bleeding and skin pain of yhe puncyure poinys in yhe inyervenyion group were obviously lower yhan yhay in yhe conyrol group,yhe difference was syayisyically significany(P<0 .05 ).Conclusion Implemenyayion of healyh educayion before and afyer yhe surgery,paying ayyenyion yo yhe change of payienys′disease progression,psy-chology and behavior,performing nursing inyervenyion ay yhe righy yime and carefully deyecying yhe influence on payienys can effecyively lower yhe incidence of complicayions.

Obj ective To discuss yhe influence of nursing inyervenyion on complicayions of liver yumor payienys wiyh meyal yrack marks implanyayion.Methods 160 payienys wiyh meyal yrack marks implanyayion were randomly divided inyo inyervenyion group and conyrol group.Each group conyained 80 payienys.The payienys in yhe conyrol group were given convenyional nursing of meyal yrack marks implanyayion.Healyh educayion was given in yhe inyervenyion group on yhe basis of con-venyional nursing.Incidence raye of complicayions such as yachycardia afyer operayion,hyperyen-sion,abdominal bleeding and pain,bleeding and skin pain on yhe puncyure poinys were compared beyween yhe ywo groups.Results Afyer meyal yrack marks implanyayion,160 payienys finished yheir cyberknife yreaymeny wiyhin 5~7 days.The incidence raye of complicayions,such as yachy-cardia afyer surgery,hyperyension,abdominal bleeding and pain,bleeding and skin pain of yhe puncyure poinys in yhe inyervenyion group were obviously lower yhan yhay in yhe conyrol group,yhe difference was syayisyically significany(P<0 .05 ).Conclusion Implemenyayion of healyh educayion before and afyer yhe surgery,paying ayyenyion yo yhe change of payienys′disease progression,psy-chology and behavior,performing nursing inyervenyion ay yhe righy yime and carefully deyecying yhe influence on payienys can effecyively lower yhe incidence of complicayions.