Multidisciplinary team therapy for left giant adrenocortical carcinoma: A case report.

BACKGROUND: Adrenocortical carcinoma (ACC) is a rare malignant epithelial tumor originating from adrenocortical cells that carries a very poor prognosis. Metastatic or inoperable diseases are often considered incurable, and treatment remains a challenge. Especially for advanced cases such as ACC complicated with renal venous cancer thrombus, there are few cumulative cases in the literature. CASE SUMMARY: The patient in this case was a 39-year-old middle-aged male who was admitted to the hospital for more than half a month due to dizziness and chest tightness. Computed tomography (CT) findings after admission revealed a left retroperitoneal malignant space-occupying lesion, but the origin of the formation of the left renal vein cancer thrombus remained to be determined. It was speculated that it originated from the left adrenal gland, perhaps a retroperitoneal source, and left adrenal mass + left nephrectomy + left renal vein tumor thrombus removal + angioplasty were performed under general anesthesia. Postoperative pathology results indicated a diagnosis of ACC. Postoperative steroid therapy was administered. At 3 mo after surgery, abdominal CT reexamination revealed multiple enlarged retroperitoneal lymph nodes and multiple low-density shadows in the liver, and palliative radiotherapy and mitotane were administered, considering the possibility of metastasis. The patient is currently being followed up. CONCLUSION: ACC is a highly malignant tumor. Even if the tumor is removed surgically, there is still the possibility of recurrence. Postoperative mitotane and adjuvant chemoradiotherapy have certain benefits for patients, but they cannot fully offset the poor prognosis of this disease.

Lipid/PAA-coated mesoporous silica nanoparticles for dual-pH-responsive codelivery of arsenic trioxide/paclitaxel against breast cancer cells.

Nanomedicine has attracted increasing attention and emerged as a safer and more effective modality in cancer treatment than conventional chemotherapy. In particular, the distinction of tumor microenvironment and normal tissues is often used in stimulus-responsive drug delivery systems for controlled release of therapeutic agents at target sites. In this study, we developed mesoporous silica nanoparticles (MSNs) coated with polyacrylic acid (PAA), and pH-sensitive lipid (PSL) for synergistic delivery and dual-pH-responsive sequential release of arsenic trioxide (ATO) and paclitaxel (PTX) (PL-PMSN-PTX/ATO). Tumor-targeting peptide F56 was used to modify MSNs, which conferred a target-specific delivery to cancer and endothelial cells under neoangiogenesis. PAA- and PSL-coated nanoparticles were characterized by TGA, TEM, FT-IR, and DLS. The drug-loaded nanoparticles displayed a dual-pH-responsive (pHe = 6.5, pHendo = 5.0) and sequential drug release profile. PTX within PSL was preferentially released at pH = 6.5, whereas ATO was mainly released at pH = 5.0. Drug-free carriers showed low cytotoxicity toward MCF-7 cells, but ATO and PTX co-delivered nanoparticles displayed a significant synergistic effect against MCF-7 cells, showing greater cell-cycle arrest in treated cells and more activation of apoptosis-related proteins than free drugs. Furthermore, the extracellular release of PTX caused an expansion of the interstitial space, allowing deeper penetration of the nanoparticles into the tumor mass through a tumor priming effect. As a result, FPL-PMSN-PTX/ATO exhibited improved in vivo circulation time, tumor-targeted delivery, and overall therapeutic efficacy.

Structural characterization, physicochemical properties and α-glucosidase inhibitory activity of polysaccharide from the fruits of wax apple.

In this study, a novel water-soluble polysaccharide fraction (WAFP) was isolated from wax apple fruits. The structural characterization, physicochemical properties and α-glucosidase inhibitory activity of WAFP were investigated. The results indicated that WAFP had average molecular weight of 49.9 kDa, it was mainly composed of rhamnose, arabinose, xylose, mannose, glucose, and galactose with a molar ratio of 1.88: 2.20: 6.37: 1.48: 5.47: 2.82. Besides, the backbone of WAFP might consist of →4)-α-D-Glcp-(1→, →3,4)-ß-D-Xylp-(1→ and →3)-ß-D-Galp-(1→, and the side chains might be composed of →3,5)-α-L-Araf-(1→, T-α-D-Glcp, →3)-ß-D-Manp-(1→, →4)-α-D-GalpA-(1→ and →2)-α-L-Rhap-(1→. AFM images revealed that the height of WAFP molecules was about 12.8 nm. WAFP had no triple-helix structure, and it exhibited a shear-thinning behavior in the solution. SEM results showed that WAFP presented loose and incompact appearance and rough surface with many small irregular particles existed in the state of aggregation. Moreover, WAFP showed significant inhibitory effect on the activity of α-glucosidase.

[A field trial for evaluating the safety of recombinant human interferon alpha-2b for nasal spray].

OBJECTIVE: To evaluate the safety of recombinant human interferon alpha-2b for nasal spray for the prevention of SARS and other upper respiratory viral infections. METHODS: Field epidemiologic evaluation was conducted, the design was randomized and had a synchronously parallel control group. In the study, the drugs were given for five days and all subjects were followed up for ten days. RESULTS: During the period of using interferon, body temperature of the experimental group was normal compared to the control group. Experimental group had more influenza-like symptoms than the control group (P < 0.05), such as headache (4.83%-7.09%), dizziness (7.17%-11.63%), lassitude (8.55%-15.06%), muscular soreness (4.43%-7.09%), pharynx dryness (12.10%-17.85%), angina (6.25%-8.72%), abdominal pain (2.30%-5.50%) and diarrhea (2.45%-5.66%). Most of side effects reached their peak with in the first 3 days. Except for pharynx dryness, the incidences of all other side effects declined after completion of the use of the trial drug, and incidences of some symptoms in experimental group were lower than those of the control group. There were no significant differences in the symptoms of cough and expectoration between the experimental group and the control group. The incidence of exanthem in the control group was significantly higher than that in the experimental group. The side effect of bloody nasal mucus was not observed in experimental group, which had been reported by other authors in several volunteer studies. CONCLUSION: Using recombinant human interferon alpha-2b for nasal spray could lead to some influenza-like symptoms, however, all those symptoms were mild , reversible, and relieved after completion of the use of the trial drug. No serious side effects were found during the period of following up. The authors conclude that the drug is safe.

[A questionnaire-based survey of the quality of life of 783 air-force soldiers and officers in the southern military region of China].

OBJECTIVE: To investigate the quality of life of the air-force soldiers and officers in the southern military region of China. METHODS: A self-rated health measurement scale was used to evaluate the quality of life of 783 air-force soldiers and officers in view of their physical, mental and social statuses. RESULTS: The quality of life of the subjects was at an intermediate level. Their physical, mental and social scores were 66.33+/-9.38, 58.99+/-10.09 and 53.69+/-12.40, respectively, with a total score of 178.44+/-22.60. The quality of life of the soldiers and officers significantly differed with educational background (P<0.01), places of enlisting (P<0.01), arm of the service (P<0.05), identities or positions (P<0.01), and occupation before enlisting (P<0.01). CONCLUSIONS: The quality of life of the soldiers and officers can be affected by such factors as educational back- ground, places of enlisting, arm of the service, identities or positions, and occupation before enlisting, but the nationalities or status of being the only child in family does not obviously influence the quality of life of the military personnel.

[Nonlinear regression analysis of cardiac enzyme kinetic model with modified simplex method and DUD method using SAS software].

OBJECTIVE: To compare the efficacy of modified simplex method and DUD method using SAS software for nonlinear regression analysis of cardiac enzyme kinetic model. METHOD: By using cardiac enzyme kinetic one-compartment mathematical model, nonlinear regression results obtained from DUD methods using SAS software and modified simplex method were compared with the same starting values to fit the creatine kinase curves in 22 patients with acute myocardial infarction. RESULTS: The parameters calculated by DUD method and modified simplex method were the same in 4 cases, and smaller least square was resulted from DUD method in 4 cases. In the other 14 cases, modified simplex method yielded smaller least square. The mean value of the least square calculated by modified simplex method was less than that by DUD method (867 747 vs 6 712 989, P=0.013). CONCLUSION: Modified simplex method appears to be more adequate than DUD method in estimating circulatory parameters of the one-compartment model.