Objective To facilitate a better understanding of the progress in the research, diagnosis and treatment of Peutz Jeghers syndrome (PJS).Methods Almost all the papers related to PJS from various magazines published in English and Chinese in recent years were reviewed. Current progresses in PJS research and related diagnosis and treatment were discussed in this review.Results PJS is a rare inherited disease with autosomal dominant trait, which is characterized by the presence of hamartomatous gastrointestinal polyps and mucocutaneous pigmentation of the lips, buccal mucosa, and digits. This syndrome is commonly complicated with intestinal obstruction, bleeding, or intussusception,and patients with this disease are at high risk for the development of both GI and extraintestinal malignancies. STK11 on chromosome 19p13.3 are responsible for most cases of PJS. The polyps of PJS tend to have a high incidence of malignant change, and the recurrence of malignancy after treatment is also high. Conclusion The STK11 has been identified as one of the main genes responsible for PJS and has close correlation with formation and development of tumors. Patients with PJS are at high risk for the development of both GI and extraintestinal malignancies.

Objective To study the expressions of MMP-2 and TIMP-2 in pancreatic carcinoma and their relationship with tumor invasion, local metastasis and prognosis of the carcinoma. Methods The expressions of MMP-2 and TIMP-2 were examined in 32 patients with pancreatic carcinomas by S-P immunohistochemical technique and the correlation with pathological tumor parameters were analyzed. Survival analysis was made by using the Kaplan-Meier method. Results The positive rates of MMP-2, TIMP-2 in 32 patients with pancreatic carcinoma were 56.25% and 75.00%, which were significantly higher than those of the controls(P＜0.05). Expressions of MMP-2 and TIMP-2 were independent of sex, age, histological grading and type, but well correlated with the lymph node metastasis and TNM clinical staging(Ⅰ and Ⅲ, Ⅱ and Ⅲ). There was a significant association between MMP-2, TIMP-2 and prognosis in pancreatic carcinoma. Conclusion MMP-2 and TIMP-2 might be useful markers for biological aggressiveness of this malignancy and might contribute to the invasive properties of pancreatic carcinoma, which can be used to evaluate the prognosis of patients.

To analyze and research the transformation of teaching thoughts,adjustment of professional teachers,renewal of teaching contents and so on,and establish the foundation for the revolution of professional English teaching in medical university under the new situation.

Objective To investigate the perioperative outcomes of robot-assisted laparoscopic partial nephrectomy in solitary kidney.Methods From September 2014 to September 2015, 9 patients underwent robot-assisted laparoscopic partial nephrectomy in solitary kidney.6 of these patients were male, while the others were female.The average age of these patients was 60 years, ranged from 46-78 years.The lesion was located in left kidney of 5 cases, and the remaining in right kidney.The average diameter of lesion was 4.5 cm, ranged from 2.8-7.6 cm.One case was congenital solitary kidney, one was contralateral atrophic kidney, 2 cases were performed nephrectomy due to benign lesion, 5 cases were performed radical nephrectomy due to malignancy.All the cases were performed by robot-assisted laparoscopic surgery transperitoneally.Results The surgery of all 9 cases were successfully completed, and no conversion to open surgery.The median operation time was 104-215 min, with an average of 129 min.The estimated blood loss was 50-350 ml, with an average of 120 ml, and there was no blood transfusion.The warm ischemia time was 10-28 min, with an average of 18 min.There was no intraoperative complication occurred.The postoperative length of hospitalization was 8-17 d, with an average of 12 d.One case of urine leakage and another one of secondary hemorrhage were found after operation.The drainage tube and urinary catheter were removed in 3-5 days postoperation.The pathology analysis confirmed that 7 cases were renal clear cell carcinoma, one case was papillary carcinoma and one was angiomyolipoma, the tumor surgical margin was negative in all cases.The follow up duration was 1-12months, no recurrence or metastasis occurred.Conclusions Robot-assisted partial nephrectomy represents a safe and effective minimallyinvasive treatment option for kidney neoplasms in patients with a solitary kidney, which provided reliable cancer control and renal function preservation.

Objective To investigate the diagnostic value of fine needle aspiration biopsy for children with thyroid nodules.Methods Eleven children with thyroid nodule were examined by fine needle aspiration biopsy.The cytologic features of thyoid nodules were observed by the light microscope.The pathological sections of thyroid nodules were acquired and compared with fine needle aspiration biopsy.Results Eleven cases were diagnosed by fine needle aspiration biopsy including nodule goiter 4 cases,papillary thyroid carcinoma 2 cases,follicular adenoma 2 cases,medullary carcinima 1 cases,Hashimoto′s thyroiditis 1 case and cyst 1 case.Compared with pathological section,10 cases were diagnosed correctly and one was misdiagnosis.Conclusion Fine needle aspiration biopsy is a valuable methods to the diagnosis of children with thyroid nodules.

Objective To assess the clinical application values of the protcin markers associated with Down syndrome (DS) in maternal serum which were screened and identified.Methods Seven maternal serum samples with DS fetus ( DS group) and 7 maternal serum samples with normal fetus ( control group) in the second trimester were separated by two-dimensional gel electrophoresis (2-DE).The differentinal expression profile of proteome in maternal serum from DS group was established.The differentially expressed proteins were screened by mass spectrometry (MS) and some proteins were verified by Western blotting (WB).Results Twenty-nine proteins were discovered to be differentially expressed by more than 1.5 folds in maternal serum from DS group,among which 19 proteins were up-regulated and 10 proteins were downregulated.Eight proteins displayed 2 or more folds changes in maternal serum from DS group were identified by MS and possibly matched with 12 proteins in Ameracan National Center of Biotchnology Information (NCBI) protein sequence database,such as dGTPase and Beta2-Glycoprotein Ⅰ (β2-GPI),etc.The resuhs of WB showed that the mean a values of dGTPase and β2-GPI were 21 567.0 ± 3009.4 and 22 097.0 ±3958.9 in the DS group,3957.7 ± 250.9 and 1799.7 ± 105.5 in the control group respectively,which presented that the expression of dGTPase and β2-GPI significantly increased in DS group (t'dGTPase =- 17.66,t'β2-GPI =- 14.83,P ＜0.0001 ).Conclusions 2-DE and MS are effective methods for preliminary identification of protein markers associated with DS in maternal serum.dGTPase and β2-GPI verified by WB laid a solid fundation for further screening new biologic markers for early diaglosis of DS.

Objective To investigate the effect of whole-body irradiation with low-dose γ-rays on the central nervous system of mice.Methods Fifty C57 mice were randomly divided into 3 groups and treated with 0,0.5,1 Gy whole-body irradiation,respectively.24 or 48 h after irradiation,brain tissue of mice was resected and homogenated.The levels of amino acid neurotransmitter,including Glu,Asp,GABA and Gly in brain homogenate were measured by high performance liquid chromatography (HPLC).Results Compared to the brain tissue of untreated mice,the contents of Glu and Asp at 0.5 and 1 Gy (t=-4.080,-3.935,-4.416,-3.630,-4.831, - 4.656,P ＜0.05) in mice brain tissue significantly increased at 24 h at 1 Gy and 48 h.However,the contents of Glu and Asp had no obvious changes in mice brain tissue 24 h after 1 Gy of irradiation. The contents of GABA and Gly had no difference between irradiated groups and untreated control group. Conclusions Short-term whole-body irradiation with low-dose γ-rays induces slight stimulation effect on the central nervous system of mice.

Objective To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).Methods Clinical data of 337 traditional SAP patients,who were admitted to Peking Union Medical College Hospital (PUMCH)from January 2001 to December 2012,were retrospectively studied.These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP.Disease severity,therapy and prognosis among three groups were compared.Results Among the total 337 traditional SAP patients,253 were classified as MSAP and 84 as SAP.In the group of SAP,40 patients were categorized as CAP and 44 as non-CAP.Compared with non-CAP patients,CAP patients had significantly higher mortality rate which was 70％ (28/40).Other results were all significantly higher in CAP group rather than non-CAP group,including ICU admission rate 77.5％(31/40),length of ICU stay (15.5 ± 20.6) days,Ranson,APACHE Ⅱ,BISAP,MCTSI,modified Marshall scores 4.6 ± 1.4,16.8 ± 5.8,3.0 ± 1.0,8.6 ± 1.7,and 7.4 ± 2.9,respectively (P ＜ 0.01 in each endpoint).These parameters of SAP group were also significantly higher than those of MSAP group (P ＜0.01).Conclusions Using the new three-category classification to distinguish traditional severe acute pancreatitis,namely MSAP,SAP,and CAP,can better reflect the severity of disease,predict outcome and guide clinical management.

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

BACKGROUND:Previous study has found that hsa-miR-182 is probably related to the apoptosis-related genes such as cytochrome C (Cycs C) and calcineurin subunit CnB (PPP3R1) in nucleus pulposus cells.
OBJECTIVE:To determine whether miR-182 plays a regulatory role in nucleus pulposus cel apoptosis by detecting the relative gene expression levels after transfecting miR-182 with Cycs C and PPP3R1 into nucleus pulposus cel s via plasmid delivery.
METHODS:After a bioinformatics prediction about miR-182, miR-182 and target genes were transfected into the nucleus pulposus cel s, and at the same time, blank control group was established. Then the expression levels of the target genes were detected through cel lysis.
RESULTS AND CONCLUSION:miR-182 significantly inhibited the expression of Cycs C in nucleus pulposus cel s compared with the blank control group (P<0.05). Compared with the blank control group, miR-182 made no inhibitory effect on the expression of PPP3R1. These findings suggest that miR-182 may play a regulatory part in nucleus pulposus cel apoptosis by inhibiting the expression of Cycs C.