7-fold Research Articles

Preventing pediatric accidental decannulation events: A quality improvement initiative

ObjectiveTo describe a quality improvement (QI) method to decrease pediatric accidental decannulation (AD) in the early postoperative period for children under age 3. MethodsA retrospective chart review was conducted on children under age 3 who underwent tracheostomy at Duke University Health System from August 1, 2013 to May 1, 2023 (n = 104). A root cause analysis was used to assess factors associated with AD following pediatric tracheostomy. Based on the factors identified by the research team, retrospective data was collected before (8/1/13 - 1/31/22) and after (2/1/22 - 5/1/23) a single practice change was implemented: using twill neck ties, rather than foam neck ties, to secure newly-placed tracheostomy tubes. Twill ties were applied intraoperatively as a visual cue to signal a recent tracheostomy for the interdisciplinary care team. The primary outcome in the pre-intervention and post-intervention period was measured as 30-day incidence of AD per 10 tracheostomy cases. ResultsPrior to the intervention, a total of 11 ADs occurred in 9 patients across 93 pediatric tracheostomies (1.18 AD per 10 cases). Afterward, 0 ADs occurred across 11 pediatric tracheostomies (0 AD per 10 cases). ConclusionThis data suggests that the twill tie intervention may prevent AD and the associated morbidity. With the twill tie initiative, we describe 11 ADs and associated risk factors and present a QI intervention that may help prevent AD and improve patient safety in the early postoperative period.

The mathematics of tie knots

In 2000, Thomas Fink and Young Mao studied neck ties and, with certain assumptions, found 85 different ways to tie a neck tie. They gave a formal language which describes how a tie is made, giving a sequence of moves for each neck tie. The ends of a neck tie can be joined together, which gives a physical model of a mathematical knot that we call a tie knot. In this paper we classify the knot type of each of Fink and Mao's 85 tie knots. We describe how the unknot, left and right trefoil, twist knots and $(2,p)$ torus knots can be recognized from their sequence of moves. We also view tie knots as a family within the set of all knots. Among other results, we prove that any tie knot is prime and alternating.

A Combined Tie-Fastening Method for the Reusable Surgical Gown with Two Neck Tie Belts to Improve Wearing Comfort.

The reusable surgical gowns made of slippery materials have the tendency to slip down as they are being worn. The rear neck tie(s) can sometimes loosen, and this causes the surgical gown to slip down somewhat, making the surgical staff members feel uncomfortable. If the gowns have two rear neck ties with a tendency of loosening and allowing the gowns to slip down, the surgical staff members feel more uncomfortable when there is only one tie loosening but the other tie is tethering. To fasten the neck ties of the surgical gown with two neck tie belts, we propose a simplified method of fastening the two sets of tie belts together as one tie, instead of fastening them separately. The object of this study is to evaluate this combined tying method for its ability to secure the gown and its wearing comfort. We enrolled five volunteers to evaluate the tie loosening condition of the reusable surgical gowns with two sets of rear neck tie belts after a series of upper limb motion exercises while wearing and not wearing the X-ray protective apron beneath the gown. The amount of uppermost rear neck cloth edge separation was recorded before and after the exercise. We also evaluated the wearing comfort of five enrolled operating surgeons for comparing the original and this modified tying method while wearing and not wearing the X-ray protective apron. In the results, we found that combined tying tends to have significantly more rear gown separation (0.94 cm) than separate tying (0.27 cm) after vigorous upper extremities exercise. However, during the actual performance of the surgeries, the rear neck tie(s) loosening and wearing discomfort of the combined tying method was significantly less than using the separate tying method (loosening: 0% vs. 30%) (discomfort: 0% vs. 35%) while the X-ray protective apron was not worn. For reusable surgical gowns that have two rear neck ties, we suggest the two sets of rear neck ties could be fastened together as one combined tie in routine surgical practice. With this, tying could be performed easier and faster, and wearing comfort could be improved.

Comparing the tracheostomy dislodgement and complication rate of non-sutured neck tie to skin sutured neck tie fixation.

Tracheostomy management is a routine aspect of care in the critical care setting. While there are multiple complications that can arise in the post-operative setting after creation of a tracheostomy, dislodgement of a tracheostomy tube is associated with high mortality requiring rapid intervention. It is therefore important to prevent the occurrence with proper securement of the tracheostomy. In this study, we look at two methods commonly used to secure tracheostomy tubes: suturing of the lateral flanges to the skin with the use of cloth neck ties versus cloth neck ties alone. This is a retrospective study with data collected from 1355 consecutive tracheostomy cases at a single institution. Our institution serves the County of San Bernardino, California as a level II trauma center. Patient selection occurred between 2004 and 2018, with distribution of patients to skin-sutured with neck tie tracheostomies (ST) and non-sutured neck tied only tracheostomies (NST) groups occurring by date of tracheostomy surgery. Our study investigates the dislodgement rate of percutaneous tracheostomies secured by either of these two methods. Due to a greater morbidity of tracheostomy dislodgement before a mature fistula tract is formed, we were specifically interested in the dislodgement rate within 7days. In total, 328 cases of NST and 1027 cases of ST were collected. Overall, there was no statistically significant difference regarding the dislodgement and accidental decannulation rate between NST and ST (2.32% vs 4.46% for NST and ST, respectively, p=0.1476). There was also no statistically significant difference regarding rates of dislodgement and accidental decannulation within 7days between NST and ST (1.54% vs 1.11% for NST and ST, respectively, p=0.5608). It takes 5-7days for a tracheostomy tract to mature, and therefore most dislodgement occurs perioperatively within the first week after placement. Dislodgement of the tracheostomy tube can lead to devastating complications for those patients. To our knowledge, there has been no study investigating dislodgement in the early post-operative period in relation to tracheostomy securement method. Due to the emergent nature of tracheostomy dislodgement and loss of airway, prevention of this complication is critical. Our investigation found no statistically significant difference in the rate of early tracheostomy dislodgement in the skin sutured with neck tie and non-sutured neck tie only groups. This study contributes further data to the available literature regarding tracheostomy securement methods and dislodgement rate, specifically within the early post-operative period. 2b.

Neckties or not, and a quick fix

Neckties or not, and a quick fix

Neckties on Physicians: Going the Way of Powdered Wigs

Neckties on Physicians: Going the Way of Powdered Wigs

Twenty-four-hour, weekly and annual patterns in serious falls of non-institutionalized independent Spanish seniors.

The study aimed to explore clock hour, day-of-week, and month-of-year patterns of serious falls experienced by non-institutionalized Spanish seniors (age ≥65 years) in relation to associated conventional intrinsic and extrinsic factors. Intake emergency department records from January 1 to December 31, 2013 of a tertiary hospital of southern Spain were abstracted for particulars of falls, including the time of occurrence, experienced specifically by non-institutionalized seniors. Chi-squares and Single and Multiple-Component Cosinor (time series) Analyses were applied to determine the statistical significance of observed 24-hour, 7-day, and annual variation. Falls were ~2.5-fold more numerous in older women than older men and ~7-fold more frequent between 12:00 and 14:00 hours than ~02:00 hours, respectively, the time spans corresponding to the absolute peak and trough of the 24-hour pattern in falls. The midday/early afternoon peak primarily represented incidents of women ≥75 years of age that occurred inside the home while walking, standing, or moving on stairs. A late evening less prominent excess of mostly inside-the-home incidents of women ≥75 years of age, largely due to fragility, slipping, stumbling, or tripping, was additionally detected. Cosinor Analysis substantiates statistical significance of the 24-hour patterning of falls of men and women (both p<0.001). Day-of-week differences, with prominent Thursday peak and Sunday minimum, were additionally detected, but only for falls of women occurring outside the home (Cosinor Analysis: p=0.007). Day-of-week discrepancy in female/male sex ratio (SR) of fallers was demonstrated, arising from day-of-week disparity in the SR of inside-the-home incidents, with ~4.5-fold more elderly women than elderly men falling Thursday than any other day of the week (p=0.005). Non-statistically significant month-of-year difference in falls, lowest in autumn and highest (~60% more) in winter, was observed and explained by prominent seasonal difference in incidents by elderly women. Serious falls of non-institutionalized independent seniors are characterized according to intrinsic and extrinsic factors by prominent 24-hour and 7-day patterning. These findings complement the understanding of the epidemiology of falls of the elderly and further inform fall prevention programs.

Pediatric projects funded by National Natural Science Foundation of China from 2009 to 2018: retrospect and prospects

To perform a review and data analysis of the pediatric projects funded by National Natural Science Foundation of China from 2009 to 2018, and to investigate the changes in key support areas, research interest, and research hotspots in pediatrics. The database of National Natural Science Foundation of China was searched to screen out pediatric research projects in 2009-2018, and the changes in funding intensity and research direction were analyzed. From 2009 to 2018, a total of 1 017 pediatric projects were funded by National Natural Science Foundation of China, with 485 (47.69%) General Projects, 426 (41.89%) Youth Fund Projects, 73 (7.18%) Regional Research Programs, 16 (1.57%) Key Programs, 6 (0.59%) Outstanding Youth Fund Projects, 7 (0.69%) Overseas Programs, and 4 (0.39%) other programs. There was a seven-fold increase in the total amount of subsidies, which increased from 8.42 million yuan in 2009 to 66.25 million yuan in 2018. The projects with the Primary Discipline Code of reproductive system/perinatology/neonatology, nervous system and mental illness, or circulatory system received the highest amount of fund. The support of pediatric projects by National Natural Science Foundation of China continues to increase in the past ten years, and the main types of projects are General Projects and Youth Fund Projects. Neonatology, nervous system/mental illness, and circulatory diseases are the main directions of funded projects.

Oral prevention starts with the mother.

ECC is considered as one of the most prevalent diseases in childhood globally. When compared with other infancy diseases, it is fivefold more common than asthma and sevenfold more common than hay fever. Sugar has a pivotal role in caries development, mostly during the first years of life (Paglia et al., 2019). This, together with poor oral hygiene, increases the chance of caries onset tremendously. Thus, it is clear that preventive measures are focused on oral health-related behaviours and dietary habits. Based on these premises, paediatric dentists should focus on the mother's education in order to avoid the development of caries. The paediatric dentist has the duty to be the mothers' dentist, before of the child's. Mothers should be educated on their diet and oral hygiene and on the correct nutrition of the child, starting from the first month of age, limiting the child's intake of sugars and avoiding free sugars up to 2 years of age; dentists should inform the parents on when they have to start cleaning teeth and when fluoride is needed. Caries preventive measures should be established as early as possible. For a pediatric dentist, the only real success is not treating ECC with the latest technology, but visiting ECC-free children.

Evaluation of owners' attitudes towards veterinarian attire in the small animal specialty setting in North America.

Previous studies in human medicine have found that patients prefer their doctors to be more formally attired, and that this influences their trust and confidence in their physician. The purpose of this study was to evaluate how veterinarians’ attire affected owners’ impressions and trust in the small animal specialty medicine setting. A questionnaire based study conducted during a 2‐month period at an urban based small animal private practice specialty hospital. Respondents completed a written survey after reviewing pictures of the same male and female veterinarian in five different dress styles. Respondents were asked for their preference for male and female veterinarian attire in different clinical scenarios and whether it would affect their willingness to discuss sensitive issues. Two hundred and thirty‐eight questionnaires were completed during the study period with 76.1% of respondents being female. Female respondents did not have a preference to how a male or female veterinarian was attired with the attire examples provided. However, male respondents tended to have fairly equal response rates between no preference and preferring a male veterinarian to be in either clinical or professional attire. Male owners either had no preference or preferred their male veterinarian to be attired in clinical or professional attire and had no preference or preferred their female veterinarian to be clinical attire. Most respondents do not feel it is necessary for a veterinarian to wear a white coat or neck ties and most do not feel it is inappropriate for a veterinarian to wear blue jeans, have coloured hair, or have visible tattoos.

Increase in Bacterial Resistance to Antibiotics after Cancer Therapy with Platinum-Based Drugs

The use of platinum-based anticancer drugs is limited by both their side effects and their effect on normal microflora's metagenome. Drugs that possess mutagenic and genotoxic properties may cause mutations in microbial genomes that contribute to the emergence of resistance to antimicrobial preparations and the development of complications after chemotherapy. The effects of cisplatin and oxaliplatin on microorganisms were studied using bacterial biosensors - E. coli strains MG1655 pKatG-lux, which reacts to the generation of hydrogen peroxide; MG1655 pSoxS-lux, which reacts to the superoxide anion radical; and the MG1655 pColD-lux strain, which detects DNA damage. The biosensor tests demonstrated high levels of genotoxicity for both drugs and some differences in the spectrum of reactive oxygen species generated. Ascor-bate reduced genotoxicity of cisplatin by 41%. Nonlethal doses of cisplatin induced a three- to sevenfold increase in the frequency of the mutations that confer the resistance of E. coli to rifampicin and ciprof loxacin. Ascorbate also reduced frequency of the mutations by 65%. Thus, the effect of these drugs was probably associated with the generation of reactive oxygen species and induction of SOS response. The risk of secondary antibiotic-resistant infections may be decreased by applying antioxidants and antimutagens. At the same time, these increases may also decrease the anti-tumoral action of these compounds.

Neutrophil Extracellular Traps Predict Venous Thromboembolism

Patients with cancer have a fourfold to sevenfold increased risk for venous thromboembolism (VTE), but predicting thrombosis in individual patients is

Higher rate of methicillin-resistant Staphylococcus aureus carriage amongst hospitalised patients in rural South India

Introduction: The carriage of Staphylococcus aureus is often considered an important issue in terms of infection control. The present study is aimed to determine the carriage rate of S. aureus and methicillin-resistant S. aureus (MRSA) amongst hospitalised patients in comparison to community population and healthcare workers in rural South India. Methods: A cross-sectional prospective study was conducted amongst adult participants from three different groups – healthy community population, healthcare worker (staff nurses) and hospitalised patient. Finger, nose and throat of all study participants were examined for the carriage of S. aureus and MRSA by microbiological culture, identification and susceptibility testing to oxacillin. Results: The carriage rate of S. aureus was 47.2', 55.6' and 77.8', respectively, in the community, hospitalised and healthcare workers; similarly MRSA carriers were 16.6', 47.2' and 22.2', respectively. S. aureus carriage rate was higher amongst healthcare workers, and MRSA carrier rate was higher amongst hospitalised patients. The MRSA carriage rate amongst hospitalised patients was 7-fold higher than the community population and 2-fold higher than the healthcare workers. Conclusion: Hospitalised patients tend to carry the higher rate of MRSA and are at high risk of developing invasive infections. Hence, screening/decolonization for MRSA at the time of hospitalisation and prudent infection control measures is necessary to combat this pathogen.

AB19. Testosterone replacement therapy: how safe is it?

AB19. Testosterone replacement therapy: how safe is it?

Healthcare personnel (HCP) attire in acute-care, non-surgical settings

Healthcare personnel (HCP) attire is an aspect of the medical profession steeped in culture and tradition. The role of attire in cross-transmission remains poorly established and until more definitive information exists, priority should be placed on evidence-based measures to prevent hospital acquired infections (HAI). This presentation will review the medical literature regarding a) perceptions of HCP attire from the perspective of patient and providers b) evidence for contamination of attire and its potential contribution to cross-transmission. Although the optimal choice of HCP attire for inpatient care remains undefined, recommendations on the use of white coats, neck ties, footwear, the bare-below-the-elbows strategy, and laundering will be covered.

Using Recombinant Human Granulocyte Colony-Stimulating Factor Plus Dexamethasone Sodium Phosphate Mobilize and Apheresis Granulocyte

Objective To explore the effect of mobilization agents and blood cell separator for apheresis granulocyte.Methods From December 2011 to September 2012,52 donors who donated blood in our station were included into this study.Recombinant human granulocyte colony-stimulating factor (G-CSF) plus dexamethasone sodium phosphate were used mobilizing donors' granulocyte,and apheresis granulocyte were performed on the blood cell separator.The mobilization effective and the factors that effected product content were analyzed.Results After using mobilizing agent,the peripheral blood leukocyte and neutrophil counts were significantly increased 4-fold and 7-fold (P＜0.05).In the whole apheresis granulocytes procedure,the average time of (201 ± 83) min,anticoagulated whole blood of (4209±806) mL,anticoagulant of (394±83) mL were used.The average volume of granulocytes products was (283±46) mL,and granulocyte content was (2.18±0.81) × 1010.The average product content of male blood donors [(2.48 ± 0.67) × 1010] was higher than that of female donors [(1.77 ± 0.82) × 1010] (t=3.331,P=0.002).Using univariate analysis,we found that there was a positive correlation between donors' hematocrit (HCT),hemoglobin(Hb),white blood cell(WBC),neutrophilic granulocyte (NEUT) before donation and the amount of granulocytes collected (P=0.000,0.000,0.008,0.001,respectively).Using multivariate analysis,we found regression relations between donors' Hb (P =0.030) and NEUT (P=0.0037) before donation and granulocyte yield.Conclusions Donor's peripheral blood granulocytes could be effective mobilized by using recombinant human G-CSF plus dexamethasone sodium phosphate,and using blood cell separator could collect adequate doses of granulocyte for clinical transfusions. Key words: granulocyte colony stimulating factor,recombinant; granulocyte

A correlation study between the aesthetic rating and frontal measurement of philtrum in Nanjing's young population

To summarize and classify the frontal appearance of the philtrum in Nanjing' s young population, so as to assess the role of philtrum in the face aesthetics. From August 2010 to December 2011, 160 Nanjing's youth, aged from 20 to 25 years old, underwent photographic study and measurement. The aesthetic rate was graded both for philtrum and the whole face. The results were statistically analyzed. The standard philtral aesthetic appearance is a slim isosceles trapezoid, with an isosceles triangle whose obtuse angle is about 140 degrees reversed at the bottom, like a necktie. The aesthetic rating was highest for philtrum in male NO. 105 and female NO. 33, while for the whole face in male NO.45 and female NO. 7. The mean data of the major parameters were as follows: the length of mouth width was (50.0 +/- 4. 3) mm (male), (47.0 +/- 4.0) mm (female); the length of right red lip was (20.2 +/- 2.4) mm (male), (19.3 +/- 2.3) mm (female); the length of left red lip was (20.2 +/- 2.2) mm (male), (18.9 +/- 1.8 ) mm (female); the length of right philtrum column was (15.5 +/- 2.0) mm (male), (13.6 +/- 2. 2) mm (female); the length of left philtrum column was (15.6 +/- 1.9) mm (male), (13.7 +/- 2.3) mm (female); the length of philtrum sulcus was (17.3 +/- 2.1) mm (male), (15.3 +/- 2.4) mm (female). The upper breadth of philtrum was (5.6 +/- 0.8) mm (male), (5.5 +/- 1.1) mm (female); the middle breadth was (9. 5 +/- 1.1) mm (male), (8.5 +/- 1.2) mm (female); the lower breadth( cupid bow width) was (13.8 +/- 1.8) mm (male), (11.8 +/- 1.6) mm (female). The right half of cupid bow was (7.5 +/- 0.9) mm (male), (6.5 +/- 0.9) mm (female); The left half of cupid bow was (7.2 +/- 0.9) mm (male), (6.1 +/- 0.8) mm (female). The philtrum angle was (141.2 +/- 8.0) degrees (male), (141.3 +/- 6.1) degrees (female). Although there is slight difference in the measurement results between two sides of philtrum column and cupid bow (P < 0.01), it is not obvious by naked eyes. Except for the upper width of philtrum and the philtrum angle (P > 0.05), the other parameters have significant sexual differences (P < 0.05). The beautiful philtrum can not mainly decide the whole face aesthetics, which usually shows a harmony relationship between all the facial aesthetic units. The measurement results can be used as a reference for philtrum plasty.

Serum metabolites of commerical pirarubicin injections

Aim: To investigate the cumulative toxicity of commercial pirarubicin injection after 2 intravenous administrations on the normal sprague-dawley rats with serum metabonomics. Methods: The metabolic profiles of serum sample were obtained with ultra performance liquid chromatography coupled with time-of-flight mass spectrometry (UPLC/TOF-MS). The data were further processed with Masslynx software and analyzed with partial least squares discriminate analysis (PLS-DA). On the basis of a VIP (variable importance in projection) threshold of 1 from the 7-fold cross-validated PLS-DA model and student's test, potential biomarkers responsible for the difference in the metabolic profiles were obtained. Finally, they were identified by authentic standards or available databases. Results: It could be found that multiple dosages of THP would lead to fatty acids and phospholipids disturbance and severe cardiotoxicity via adriamycinone through the reactive oxygen species (ROS) mechanism. Conclusion: This study can provide a basis for the potential biomarkers screening of the cumulative cardiotoxicity of commercial pirarubicin injection in clinic.

RNA interference for inhibiting expression of epidermal growth factor receptor in breast cancer cells

Objective To investigate whether RNA interference (RNAi) produced by small inter- ference RNA (siRNA) could induce gene silencing in breast cancer cells and to assess the degree of epidermal growth factor (EGF) receptor gene silencing and its effect on functional outcome. Methods Overexpression of EGF receptor gene was determined in breast cancer cells and a variety of other types of cancer cells. Then breast cancer cell lines MDA-MB231, MDA-MB-453S, ZR-75-30, and ZR-75 were transfected with target se- quence-specific dsRNA as well as various controls. Immune fluorescent labeling, flowcytometry and Western blot were used to monitor the reduction in production of the EGF receptor protein. Quantitative reverse- transcriptase PCR was used to detect the silencing of EGF receptor gene levels. Cell count, colony assay, scratch assay, MTT assay, cell cycle analysis, and ELISA were used to assess the functional effects of RNAi. Results EGF receptor gene was overexpressed in breast cancer cells. In cell line MDA-MB231 and MDA-MB-453S, we displayed sequence specific silencing of the EGF receptor with 71.31% of downregulation of EGF receptor protein production and 37.04% of silencing of EGF receptor gene. The reduction in EGF receptor caused growth inhibition of the cells, reducing the total cell numbers by 85.0% and colony number by 63.3%. This also retarded the migration of MDA-MB231 and MDA-MB-453S by more than 80% at 24h and 48h, enhanced the chemosensitivity to cisplatin by four-fold. Cell cycle analysis showed that dsRNA-EGFR induced accumulation of cells in Go-Gi phase by 12.67% with a decrease in the percentage of cells in S-phase by 6.56% relative to control. The results from ELISA showed EGF level was reduced by 27.74% and 11.07% in medium and cell extraction respectively. In cell line ZR-75-30 and ZR-75, we displayed sequence specific silencing of the EGF receptor with 71.78% of downregulation of EGF receptor protein production and 50.00% of silencing of EGF receptor gene. The reduction in EGF receptor caused growth inhibition of the cells, reducing the total cell numbers by 78.3% and colony number by 66.8%. This also retarded the migration of ZR-75-30 and ZR-75 by more than 80% at 24h and 48h, enhanced the chemosensitivity to cisplatin by seven-fold. Cell cycle analysis showed that dsRNA-EGFR induced accumulation of cells in G0-G1 phase by 17.48% with a significant decrease in the percentage of cells in S-phase by 19.20% relative to control. ELISA showed EGF level was reduced by 45.65% and 22.45% in medium and cell extraction, respectively. Conclusions These sequence specific siRNAs showed a blockbuster effect in downregulation of EGF receptor gene expression, inhibition of the cellular proliferation and motility, arrest of the cell cycle, and enhancement of the cellular chemosensitization. The successful application of dsRN A-EGFR to reverse the neoplastic phenotype of EGF receptor overexpressing cells extends the list of available therapeutic modalities in the treatment of human cancer. Key words: Epidermal growth factor receptor; RNA interference; Small interference RNA; Double stranded RNA; Breast cancer

Effect and significance of steroidogenic factor-1 gene silencing on proliferation of human adrenocortical H295R cells

Objective To study the influence of inhibited steroidogenic factor-1 on human adrenocortical H295R cells, and explore its role in the pathogenesis of adrenal tumors. Methods The plasmids pGenesil1-SF-1-shRNA which containing U6 promoter and SF-1-specific short hairpin RNA (shRNA) and pGenesil1-negative-shRNA containing unspecific shRNA were transfected into H295R cell. The expression of SF-1 was measured by Western blot and real-time polymerase chain reaction(RT-PCR). Cell proliferation was analyzed by WST-1 assay and cell count. Ki-67 expression was detected by immunohistochemistry and cell apoptosis was examined by TUNEL assay. Results Compared with those in control cells, the protein and mRNA level of SF-1- transfected cells were reduced by 69.7% and 71.2% (P＜0. 01). WST-1 and cell count method showed that SF-1 gene silencing obviously inhibited cell proliferation(P＜0. 01). By contrast, there was a 3. 7-fold increase in the percentage of apoptotic H295R cells in SF-1-inhibited group than that of control group (P＜0. 01). Immunohistochemistry showed that Ki-67 positive cells in SF-1-inhibited cells were lower than the negative control cells (16.90±2.17) % and (33. 48±3.16)%,(P＜0. 01). Conclusion SF-1 gene silencing can inhibit the proliferation of adrenocortical cells, and it is expected to become a key protein in understanding pathogenesis of adrenal tumors or treating them. Key words: Steroidogenic factor-1; H295R cell; Adrenal gland neoplasms; Proliferation