Objective To inveatigate the expression and clinical significance of microRNA‐204(miR‐204) in human renal clear cell carcinoma(RCCC) .Methods 65 cases of resected RCCC tissue and corresponding normal tumor‐adjacent tissue were col‐lected and detected the expression level of miR‐204 by using qRT‐PCR .The correlation between the miR‐204 expression level and clilicalpathological features was statistically analyzed .The artificial miR‐204 mimics were adopted to stranfect into Caki‐1 cells ,then the Western blot was used to detect the expression of Bcl‐2 a as the downstream potential targets of miR‐204 and SIRT1 mRNA and protein .Results The expression level of miR‐204 in the RCCC tissue was significantly lowere than that in the normal tumor‐adjacent tissues (P<0 .05);the low expression of miR‐204 was significantly associated with the tumor size (>3 cm ,P<0 .05) , lymph node metastasis(P<0 .05) and advanced TNM stage(Ⅲ + Ⅳ ,P<0 .05) .Both the mRNA and protin expression in RCCC Caki‐1 cells were down‐regulated after transfection .Conclusion The expression of miR‐204 is down-regulated in the RCCC tissue and is related to the malignant clinicopathological features ,and miR‐204 may suppress the RCCC genesis and development through down‐regulating the expression of Bcl‐2 and SIRT1 .

Objective To explore effect of preoperative neutrophil/lymphocyte ratio (NLR) on the prognosis of patients with prostate cancer.Methods A total of 51 cases died included in our hospital as the died group, also included 124 patients survival patients served as survival group.Preoperative total prostate specific antigen (tPSA), free prostate specific antigen (fPSA), albumin, white blood cell (WBC), neutrophil count, lymphocyte count, Gleason score, and NLR were collected.Receiver operating characteristic (ROC) curve was drawn.The function of the index on prognosis was evaluated.Results The average age was 74.0 (9) years in the died group, and 73.6 (11.0) years in the survival group.Gleason score was 8 ～ 10.The patients were followed up for 10 ～ 36 months with a median follow-up time of 23 months.No significant differences in albumin and Gleason score were found between death and survival groups (P ＞0.05).However, the other major indexes had significant differences between two groups (P ＜ 0.01).NLR area under curve (AUC) was 0.835.The NLR boundary value was 2.84, which was higher than the critical value of patients with poor prognosis.Conclusions NLR can predict the prognosis of patients with malignant prostate cancer as auxiliary index.Patients with NLR ＞ 2.83 had poor prognosis.

Objective To investigate the biological effects of human gastric carcinoma cell line SGC-7901 transinfected by antisence vascular endothelial growth factor-C (anti VEGF-C) gene on the tumorigenicity and vascular generation,and explore the role of VEGF-C gene in metastasis and vascular generation of gastric cancer.MethodsThirty nude mice were randomly divided into three groups (10 each):transgenic anti VEGF-C group,transgenic pure liposome group and non-transgenic group.0.2ml (1?107/ml) of SGC-7901 suspension,either transinfected by anti VEGF-C gene,or by pure liposome,or transinfected nil,was respectively subcutaneously injected into the three groups of mice,once every 2 days for 3 consecutive days.After injection,the size and growth velocity of the neoplasm were measured.The microlymphatic vessel density (MLVD) and microvessel density (MVD) of tumor were also determined.ResultsThe neoplasm grew more slowly and was smaller in the mice of transgenic anti VEGF-C group than in non-transgenic ones.At the end of the 1st,2nd and 3rd week,the MLVD in the mice of transgenic anti VEGF-C group was 4.0?2.2,6.0?3.1 and 9.0?2.7/high field (/HF),respectively.In the transgenic pure liposome group,the MLVD was 6.0?8.7,9.0?3.5 and 18.0?7.2/HF,respectively.In the non-transgenic group,the MLVD was 7.0?4.9,9.0?6.4 and 19.0?6.5/HF,respectively.The MVD in the transgenic anti VEGF-C group was 3.0?2.4,5.0?2.1 and 8.0?1.7/HF,respectively.In the transgenic pure liposome group was 4.0?1.8,6.0?2.7 and 10.0?1.3/HF,respectively,and in non-transgenic group was 4.0?1.5,6.0?1.3 and 9.0?1.2/HF,respectively.There existed significant difference in lymphangiogenesis of the tumor (P0.05).ConclusionsThe anti VEGF-C gene may suppress the tumorigenicity and lymphangiogenesis of human SGC-7901 gastric carcinoma cells,but have little effect on angiogenesis of the tumor.VEGF-C might participate in the lymphangiogenesis of gastric tumor.

Objective To evaluate the value of ultrasonographic measurement of the antral crosssectional area (CSA) in assessing the preoperative gastric content volume in preschool pediatric patients.Methods Fifty American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients of both sexes,aged ＜7 yr,undergoing elective non-gastrointestinal surgery,were fasted according to the preoperative fasting guidelines recommended by American Society of Anesthesiologists.Sedation was performed with intravenously injected midazolam or with intravenously injected midazolam and propofol after admission to the operating room.The antral CSA in the supine and right lateral decubitus positions was measured using bedside ultrasonography and free tracing method.A gastric tube was inserted after gastric sonography to collect the gastric fluid,and the total volume of the gastric fluid was considered to be the gastric content volume.Results Six pediatric patients were excluded due to the unsatisfactory ultrasound image,and 44 pediatric patients were included.Gastric content volume and gastric content volume per kilogram of body weight were positively correlated with the antral CSA in the right lateral decubitus position,and the Spearman correlation coefficients were 0.48 (P＜0.01) and 0.37 (P＜0.05),respectively.There was no correlation between gastric content volume and gastric content volume per kilogram of body weight and the antral CSA in the supine position (P＞0.05).Conclusion Ultrasonographic measurement of the antral CSA in the right lateral decubitus position can be used to assess the preoperative gastric content volume in preschool pediatric patients.

Problem-based learning(PBL) is a method of the self-study primarily and teacher' s guiding.By using the PBL in the clinical teaching application,we discuss our experience gained in carrying,out PBL and the existing problems.

BACKGROUND: The patients with severe spleen rupture can save their spleen functions by auto-transplantation of the spleen tissues in the greater omentum. Whether the transplanted spleen tissues are regulated by nerves or not is still unclear. The growth associated protein, GAP-43, is a specific protein of the nervous system, and by testing the GAP-43 in the transplanted spleen tissues, nerve regeneration can be understood.OBJECTIVE: To study the mRNA expression of the GAP-43 in the regenerated spleen tissues at different phases after the auto-transplantation of the spleen tissues, and to find the regeneration regularity of the GAP-43 + nerves in the auto-transplanted spleen tissues.DESIGN: A randomized and controlled experiment SETTING: A teaching and research office of the surgical applied anatomy and operative surgery department in a university MATERIALS: The study was done in the Surgical Applied Anatomy and Operative Surgery Department of the Third Military Medical University of Chinese PLA from September 2002 to July 2003. A total of 120 Wistar mice were chosen. The mice were randomly divided into the experiment group and pseudo-operation group(control group) to make animal models. After the operation, mice of the two groups were fed under the same circumstances. The spleen tissues were respectively taken at the 15th, 30th, 60th,90th, 120th and 180th days after the operation for the study.METHODS: The general RNA was extracted from the tissues using the Tripure agent by the routine method. The general RNA was reverse transcribed into cDNA using the M-MLV reverse transcription kit. The mRNA of the GAP-43 was quantitatively measured using the gel pattern analysis.tern analysis.RESULTS: Totally 30 days after the transplantation of the spleen tissues, the mRNA of the GAP-43 was found to be expressed in the auto-transplanted spleen tissues. Ninety days after the operation, the expression reached the peak level. Totally 120 to 180 days after the operation the amount of the mRNA of the GAP-43 in the transplanted spleen tissues gradually got close to that in the normal spleen tissues.CONCLUSION: The expression of mRNA of the GAP-43 in the auto-transplanted spleen tissues suggests the regeneration of the nervous fiber in the transplanted spleen tissues.

Objective To evaluate the accuracy of ultrasonographic measurement of the subglottic airway diameter in selecting the cuffed endotracheal tube (ETT) size for the pediatric patients with congenital heart disease.Methods Sixty pediatric patients of both sexes with congenital heart disease,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,aged 1 month-7 yr,undergoing elective open heart surgery,were included in this study.The subglottic airway diameter was measured by bedside ultrasonography after induction of anesthesia.The outer diameter of the cuffed ETT was determined according to the subglottic airway diameter.The air leak test was performed after intubation to determine whether or not the ETT size selected based on ultrasonography was appropriate.When the difference between the inner diameter of the finally selected ETT and the result calculated by the Motoyama formula was less than 0.2 mm,the ETT size selected based on the Motoyama formula was considered appropriate.The agreement and correlation between the subglottic airway diameter measured by age-based formula and ultrasonography and the outer diameter of the actually selected ETT were analyzed using Bland-Altman plot and Passing-Bablok regression analysis.Results The accurate rate of the ETT selected based on the ultrasonic measurement and Motoyama formula were 80％ and 55％,respectively,and there was significant difference (P＜0.05).Conclusion Ultrasonographic measurement of the subglottic airway diameter produces higher accuracy than the classical Motoyama formula in selecting the cuffed ETT size for the pediatric patients with congenital heart disease.

In China,few research findings in basic medicine could be translated to clinical practice,which is known as the disconnection between basic research and clinical application.Such phenomenon is mainly due to lack of ability in translational medicine,particularly,lack of training in clinical research and translational medicine.Now the emergence of translational medicine has put forward new requirements for graduate education in medical school,and demanding that the patient-centered concept be strengthened.As the major force of scientific and technological innovation,graduate students should receive long-term systematic trainings and conduct original researches.In addition,advanced courses in clinical research and translational medicine should be offered to graduate students ;furthermore,translation research platforms should be built up for them so as to improve the capacity of scientific research and innovation.

Objective:To evaluate the value of sugammadex for ultra-fast-track anesthesia in pediatric patients undergoing surgery for correction of congenital heart disease.Methods:Forty pediatric patients of both sexes, aged 1-6 yr, with American Society of Anesthesiologists physical status Ⅱ, scheduled for elective surgery for correction of congenital heart disease, were enrolled in this study and randomly assigned into sugammadex group (group S) and control group (group C) with a random number table.Sugammadex 4.0 mg/kg was injected intravenously to reverse neuromuscular relaxation in group S and the equal volume of normal saline was administrated in group C when the train-of-four (TOF) count was 0 and post-tetanic count was 1 or 2 during recovery from anesthesia.The recovery time of TOF ratio to 25%, 75% and 90%, the extubation time and the success rate of ultra-fast-track anesthesia were recorded.Results:Compared to group C, sugammadex significantly shortened the recovery time of TOF ratio to 25%, 75% and 90% and the extubation time in group S ( P<0.05); Furthermore, the success rate of ultra-fast-track anesthesia reached 100% in group S compared to 0% in group C. Conclusion:Intravenous administration of sugammadex 4.0 mg/kg significantly shortens the recovery time of neuromuscular relaxation and extubation time and enhances the success rate of ultra-fast-track anesthesia in pediatric patients undergoing surgical correction of congenital heart disease.

Objective To evaluate the efficacy and safety of chloral hydrate combined with dexmedetomidine for sedation during echocardiography in pediatric patients with Williams-Beuren syndrome.Methods Eighteen pediatric patients diagnosed with Williams-Beuren syndrome by genetic testing,aged 5-58 months,scheduled for elective echocardiography under sedation,received oral chloral hydrate 50 mg/kg.Vital signs were measured every 5 min,and sedation was assessed using Ramsay sedation score.When Ramsay sedation score＜4 points 20 min later,intranasal dexmedetomidine 1 μg/kg was given as rescue sedative.Medicine used,vital signs,onset time,moderate and deep sedation duration and emergence time were recorded.Results The success rate of sedation with chloral hydrate alone was 38.9％ and with chloral hydrate and dexmedetomidine 61.1％.The onset time,sedation duration and emergence time were (15.7+1.9) min,(75+26) min and (52+25) min,respectively,in pediatric patients received chloral hydrate alone.The onset time,sedation duration and emergence time were (33.2±3.4) min,(83±49) min and (61±46) min,respectively,in pediatric patients received chloral hydrate and dexmedetomidine.The onset time was significantly prolonged in pediatric patients received chloral hydrate and dexmedetomidine than in pediatric patients received chloral hydrate alone (P＜0.05).Heart rate,respiratory rate and SpO2 were stable during sedation in all pediatric patients,and nausea and mild vomiting were found in 3 pediatric patients received chloral hydrate and in 6 pediatric patients received chloral hydrate and dexmedetomidine,and no other adverse reactions were observed.Conclusion Oral chloral hydrate 50 mg/kg combined with intranasal dexmedetomidine 1 μg/kg provides reliable sedative efficacy and exerts less influence on respiratory and circulatory function with higher safety when used for echocardiography in pediatric patients with Williams-Beuren syndrome.