Nephroblastoma is one of the most common solid tumours in children,and the gene expression is closely related to the tumorigenesis,development and prognosis.The treatment regimens have been constantly updated,which includes the preoperative chemotherapy,nephron-sparing surgery and targeted therapy of cancer stem cells,aiming to maintain the excellent survival for children being treated for Wilms tumor,while minimizing therapy-related toxicity.This paper reviews the gene expression and treatment on wilms' tumor.

The reform in cultivating professional-degree programs in Clinical Medicine Education contributes to the transformation of training mode, which surpasses the connotative bounds of the inherent education management. The personalized training of students has made it more challenging for both the tutor and the faculty to involve in education management, the effectiveness of which is highly valued due to the pressing need for sound medical ethics. Furthermore, the development of information technology calls for the reform of education management as well as the emphasis of student-centered approach. This article summa-rizes the existing problems of current education management mode for master degree programs of profes-sional clinical medical education. In addition, a three-level management system composed of medical experts is brewed and put forth. This system, based on compensation and restraint, assessment and incentive, ser-vice as well as security, is meant to facilitate the training of application-oriented medical talents.

Objective To explore the effect of prospective nursing on preventing constipation for patients with acute myocardial infarction(AMI). Methods 43 AMI patients during July 2008 and June 2010 in our hospital were classified as the observation group, besides the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation, prospective nursing was implemented.Through the retrospective analysis of medical record, 41 of AMI in our hospital during March 2006 and June 2008 were classified as the control group, they were given the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation and the nursing intervention after occurrence of constipation. The defecation condition was assessed for the two groups of patients on admission and the defecation and mortality rate was compared on the eighth day of hospitalization. Results There was significant difference in constipation and mortality rate between the two groups of patients during hospitalization. Conclusions The prospective nursing for AMI patients to prevent constipation can obviously reduce the incidence of constipation, thus to avoid serious complications caused by constipation and reduce mortality.

The enrollment physical examination,as a real assessment of the physical and health condition for those high school graduates,is of great referencing significance for their major selection.Therefore,during the examination process,medical staff involved should enhance their recognition for relevant legal regulations,and fully respect graduates′ rights of privacy and informed consent,to ensure the impartiality,fairness,reality,and effectiveness of the assessment result,and guarantee the legal rights of high school graduates.

Six five renal graft biopsies were performed routinely in 36 renal transplantation patients with normal renal function 1 and 3 months after transplantation. All the patients were given the immunosuppressive regimen of cyclosporine A (CsA), prednisone (Pred), azathioprine (Aza) and Tripterygium Wilfordii Hook (TW). The histological diagnosis of allograft biopsy was made according to the Banff schema. In 18 45% of the biopsies (12/65), early subclinical rejection or borderline changes were found. There was a significant difference for different dosages of TW, but no difference for the dosages of CsA, Pred and Aza intravenous between patients with pathological changes and those without. The patients with early subclinical rejection or borderline changes, methylpredisolone was given in bolus, followed by the adjustment of immunosuppressive regimens. With this treatment, there was no difference in 5 year survival rate between them and those with normal renal allograft biopsy findings. The routine allograft biopsy helps discover early subclinical rejection and borderline changes in patients with renal transplantation, and beneficial for adjustment of immunosuppressive therapy.

To review the widespread outcomes of the treatment and prevention of amblyopia,especially for the recent large randomized controlled study.By evaluating the factors affecting the results of the trial,we expect this paper may contribute to the treatment and basic research of amblyopia.

ObjectiveTo explore the clinical characteristics, diagnosis and treatment of neonatalCandida arthritis. Methods The clinical data from one case of neonatalCandida arthritis with swelling and pain in multiple joints as the ifrst symp-toms were reviewed.Results Boy born at 31 weeks' gestational age had the birth weight of 2100 g. The patients was admitted to neonatal intensive care unit after birth and treated with antibiotics for a long time due to infection. At 24 days after birth, blood culture showed the growth ofCandida albicans. At 29 days after birth, the bilateral knee joints showed swelling. TheCandida arthritis was diagnosed through X ray and joint-cavity lfuid culture. The patient was treated with Fluconazole for 13 weeks. When discharged, the joints swelling had been disappeared, while the muscle tension of the double upper limbs was signiifcantly weak. The shoulders had visible slight activities independently. The ifngers, wrists and elbows had less independent activities. The muscle tension of the double lower limbs was slight and the independent activity was more than upper limbs, but the extend was smaller than normal. The palmar grasp relfex was weak. The 30 months follow-up showed that each joint had even length, no abnormality and normal activities. The language and intelligence were normal.Conclusions NeonatalCandida arthritis is mostly combined with or secondary to systemic disseminated candidiasis, and the priority therapy is antifungal drugs. Surgical operation can be considered if necessary, which can improve the prognosis.

BACKGROUND:Acute myocardial infarction with acute onset is dangerous, but the aided diagnosis for hyperacute disease mainly depends on electrocardiogram. The advantages of tissue Doppler strain imaging were utilized to help early diagnosis of acute myocardial infarction.
OBJECTIVE:To observe left ventricular transmural peak radial strain and strain time-to-peak of subendocardiac muscle, midmyocardium and subepicardiac muscle using tissue Doppler strain imaging in dogs before and after acute myocardial infarction, and to assess its mechanical characteristics.
METHODS:A total of 16 Beagle dog models of acute myocardial ischemia were established by ligating left anterior descending coronary artery. The two-dimensional apical short-axis views of the left ventricle in five complete cardiac cycles were acquired and stored in TDI-Q workstation before and after acute myocardial ischemia. Transmural peak radial strain and strain time-to-peak of segment, subendocardiac muscle, midmyocardium and subepicardiac muscle at infarct region and baseline were observed.
RESULTS AND CONCLUSION:Peak radial strains at infarct and subendocardiac muscle, midmyocardium and subepicardiac muscle were decreased compared with the baseline (P<0.05). Peak strain gradient disappeared in each layer of infarct myocardium. Strain time-to-peak of the whole segment and infarct myocardium at different layers was significantly postponed (P<0.05). There was a positive correlation of peak radial strain between subendocardium and segment as wel as between medium and segment at baseline (r=0.617, P<0.01;r=0.556, P<0.01). This relationship disappeared at infarct region (r=0.338, P>0.05;r=0.218, P>0.05). Results indicated that after acute myocardial infarction, peak strain gradient disappeared at different layers at infarct region. Acute myocardial ischemia induces peak radial strain decrease at subendocardium, medium, subepicardium and strain time-to-peak at infarct region was significantly postponed, which reflected abnormal cardiac structure and dysfunction, resulted in uncoordinated cardiac motion and asynchronous heart movement. This may be an important mechanical mechanism triggering heart failure.

The evolution of paper-based documentation for tactical combat casualty care in the U .S.Armed Forces was introduced .The main content , the form filler and method , and the way the field medical card issued in 2009 and 2013 carried were compared .The trend and characteristics of paper-based documentation for tactical combat casualty care in the U.S.Armed Forces were summarized , which could offer references for the optimization of paper-based and electronic documentation for tactical combat casualty care in China′s troops.

Objective To study the expression of transcription factor special protein 1(Sp1) in colorectal cancer tissues and the relationship with the biological behavior .Methods The Sp1 mRNA expressions of 60 colon cancer tissues and their corresponding normal tissues were detected by real-time PCR ,and the level of target gene was calculated by ΔΔCT method .The relationships be-tween the expression of Sp1 mRNA and the different clinical features and pathological characters were determined .Results Com-pared with the matched normal tissues ,Sp1 mRNA was significantly up-regulated in the colon cancer tissues(P<0 .01) .Sp1 mRNA positive expression rate in colon cancer tissues had no significant different with sex ,age and tumors area(P>0 .05) ,but had signifi-cant different with histological grade ,Duke′s stages and lymph node metastasis(P<0 .05) .Conclusion Sp1 plays an important role in the process of occurrence and development in colon cancer .