Apoptosis is a spontaneous process of cell-suicide process triggered in response to physiological and pathological stress stimul, which is to regulate the developmental of body, control cell senescence, maintain a stable internal enviroment in multicellular organisms. The initial and progress of apoptosis is precisely controlled, which is a unique and complex signal system. In this review, it introduced the relationship between apoptosis and bcl-2 gene family, C-myc, tumor suppressor gene p53, Caspase protease family and Fas, and Summaries the detection methods.

Objective To study the expression of clock genes in Parkinson's disease(PD) and also the molecular clock machinery of PD.Methods Seventeen PD patients(nine men,eight women)and sixteen agematched controls(nine men,seven women) were investigated in this study.Bload samples were collected over a 12h span at 21:00,00:00,06:00 and 09:00.Using a real-time PCR assay,the peripheral molecular clock was examined by measuring Bmall and Bmal2 expression in total leukocytes during the dark span(from 21:00 to 09:00)in PD patients and age-matched healthy controls.Results At PD,the relative abundance of Bmall was significantly lower at 21:00,00:00 and 06:00(21:00:(22.17±4.09)vs(51.14±8.31),P=0.003,00:00:(30.30±5.45)vs(100.00±24.71),P=0.008,06:00:(19.02±3.33)vs(65.61±14.11),P=0.002).The relative Bmal2 levels in PD patients were significantly less abundant than controls at 21:00 and 00:00(21:00:(48.09±7.40)vs(84.96±9.34),P=0.005;00:00:((65.85±7.88)vs(100.00±11.78),P=0.025).Conclusion These results suggest that a peripheral molecular clock is altered in PD patients.In addition,the relative abundance of Bmall and Bmal2 was significantly lower in PD patients versus control subjects,which can provide a molecular basis to help monitor disease progression and response to investigational drugs.

BACKGROUND: Magnesium alloy studies in orthopedic field have been carried out,and good biocompatibility has been reported.However magnesium alloys have not yet been researched in the intestine.OBJECTIVE: The biodegradable magnesium-zinc alloy samples are implanted around the rat cecum to investigate the biocompatibility in rat.METHODS: Sprague Dawley rats were randomly divided into magnesium alloy group,medical titanium group and the sham-operated group.Then magnesium-zinc alloy samples with the dimension of 5 mm × 1 mm× 1 mm were embedded in the cecum incision in the magnesium alloy group.The medical titanium was embedded in the medical titanium group,and just suture in the sham-operated group.Prior to surgery and at 7,14,21 and 28 days after operation,the serum glutamic-oxaloacetic transaminase,creatinine and magnesium ion concentration were examined in each group.X-ray film on implanted region.The pathological changes in liver,kidney and cecum were examined.RESULTS AND CONCLUSION: There were no significant differences in serum glutamic-oxaloacetic transaminase,creatinine and magnesium ion concentrations among each group(P > 0.05).Magnesium-zinc alloy degraded gradually during 28 days.The pathology of liver,kidney and cecum was normal.Results suggested that magnesium-zinc alloy had no obvious effect on the cecum.The degradation time to play a fixed function of time was longer than the intestinal healing time,with good biocompatibility.Magnesium-zinc alloy can be used as anastomotic nail for stomach intestine anastomat.

Objective To investigate the predictive value of metabolic tumor volume (MTV) in angiogenesis and hematoge‐nous metastasis of patients with colorectal cancer .Methods Totally 108 patients with colorectal cancer from January 2011 to De‐cember 2015 were enrolled into the study and divided into metastasis group (n=42) and non‐metastasis group (n=66) according to whether combining with hematogenous metastasis .All patients received 18 F‐2‐fluoro‐D‐glucose positron emission tomography/com‐puted tomography (18F‐FDG PET/CT) before operation ,then used the PET VERA software to automatically calculate MTV ac‐cording to the 40% of standard uptake value max(SUVmax ) as the threshold .The blood vessels were identified with CD34+ immu‐nohistochemical staining ,then measured the microvessel density (MVD) .The clinical pathologic data ,SUVmax ,MTV and MVD were compared between metastasis group and non‐metastasis group .The area under the receiver‐operating characteristic curve (AUC) was performed to evaluate the predictive value of MTV on hematogenous metastasis .Results SUVmax ,MTV and MVD in metastasis group were significantly higher than that in non‐metastasis group (P<0 .05) .There were significant differences in MTV and MVD among patients with different T stage (P<0 .05) .Pearson correlation analysis results showed that MTV was positively correlated with MVD (r=0 .636 ,P<0 .001) ,and there was no significant relationship between MTV and SUVmax (r= 0 .161 ,P=0 .096>0 .05) ,MVD and SUVmax (r=0 .179 ,P=0 .064>0 .05) .AUC of MTV was 0 .736 ,and the best threshold value was 15 .016 cm3 ,whose sensitivity ,specificity ,positive predictive value ,negative predictive value and Youden index were 83 .3% ,63 .6% , 59 .3% ,85 .7% and 47 .0% respectively .Conclusion Compared with SUVmax ,MTV of colorectal cancer is associated with angio‐genesis and hematogenous metastasis ,so as to predict the prognosis of colorectal cancer ,which is worthy of clinical application .

Objectives To investigate the serum uric acid level and its related factors in obese children. Methods Obese children were selected from all pupils (ages 7-14) of 3 primary schools. Age-and sex-matched children with normal body mass index (BMI) were chosen as normal controls. Fasting venous blood samples were collected to detect uric acid (UA), glucose (GLU), total cholesterol (CHOL), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipopro-tein cholesterol (LDL-C). Results Sixty-eight (2.2%) obese children (57 boys and 11 girls) were detected from 3 000 children. Compared with 136 normal controls, the blood pressure (BP), levels of UA, CHOL, TG and LDL-C, and waist circumference (WC) were higher while HDL-C was lower in obese children (P<0.05). The detection rate of hyperuricemia in obese children (35.3%) were signiifcantly higher than that in normal controls (5.9%) (P<0.05). UA was positively related with WC, BMI, BP and TG, negatively related with HDL-C. Conclusions Obesity can lead to higher serum UA, higher BP and abnormal lipid metabolism. The level of serum UA was correlated with BP and abnormal lipid metabolism.

Objective To study the white matter fiber integrity in patients with posttraumatic stress disorder by using MR diffusion tensor imaging (DTI).Methods Twelve patients with posttraumatic stress disorder and twelve healthy volunteers were examined with MR T1WI、T2WI and DTI.Fractional anisotropy maps、directionally encoded color maps were created with the software of DTV-II.Fractional anisotropy (FA) were measured in the genu (anterior),body and splenium (posterior) of corpus callosum,horizontal part and posterior part of the bilateral cingulste fibers.Results In normal volunteers group,FA measurements in white matter regions were normal and reconstructed FA images and directionally encoded color(DEC) maps could display main white fibers in normal controls.The FA value of the splenium (posterior) of corpus callosum and horizontal part of the bilateral cingulate fibers was significant lower in PTSD patients than in normal controls (P<0.05).Conclusions The fiber bundle of the limbic system in patients with PTSD may have structural abnornalities.

Objective To analyze the radiolngical findings of mediastinal ganglioneuroma and to improve its diagnostic accuracy. Methods Imaging data of 8 cases of pathologically proven mediastinal ganglioueuroma were restrospectively analyzed. Results These tumors could occur in the anterior mediastinum, middle mediastinum or posterior mediastinum, with a preference for the posterior mediastinum (6/8). No specific clinical symptoms and signs were observed. Well-defined enlargrment of mediastinum with homogeneous density was shown on plain X-Ray. CT scanning was performed in 7 cases, including non-contrast scan alone (n = 3 ), both non-coutrast and contrast-enhanced scans ( n = 4). Round or oval shaped, well circumscribed, homogeneous or slightly heterogeneous, hypadense masses were demonstrated on non-contrast scan. Spotty calification could be found in a few cases. Homogeneous or slightly heterogeneous enhancement was seen following the intravenous injection of contrast material. Large tumors showed a tendency of wedging into the space between adjacent organs and structures, and encasing the nearby large vessels. MR without contrast was performed in 1 case. T1 WI showed isointensity to adjacent muscle, T2WI showed homogeneous hyperintensity. Multi-planar reconstruction provided more information concerning the relationship of the mass lesions with neighboring structures. Conclusion Mediastinal ganglioneuromas have some specific characterstics on imaging studies, which could assist in pre-operative diagnosis and surgical planning.

Objective To investigate the epidemiological and clinical characteristics and prognosis of 31 children with hand foot and mouth disease(HFMD) complicated with acute flaccid paralysis(AFP).Methods Thirty-one HFMD children complicated with AFP served as study objective,who were admitted to Tangshan Maternity and Children Health Hospital from Jun 2011 to Dec 2014.The clinical manifestations and follow-up outcomes of 31 children with HFMD followed by AFP were retrospectively reviewed.Results Participants in this study consisted of 31 children(16 males,15 females,age from 3 months to 9 years) who met the criteria for HFMD with AFP.Among the 31 cases,27(87.1％)cases were less than 3 years old and 29(93.5％) cases were from countryside.Eleven cases (35.5％)were infected by enterovirus 71,1 case (3.2％) was infected with coxsackieviruses A16 and 19 cases(61.3％) were infected by other enteroviruses.AFP developed(7.1 ±2.9) days after the onset of fever and progressed to maximum severity within 1-2 days.All of the cases presented with fever and skin rash,38.7％ cases presented with limbs tremor and 87.1％ cases presented with startle and skip.Besides AFP of limbs, 100％ cases complicated with encephalitis.Thirty-one cases showed poliomyelitis-like syndrome(20 cases with one flaccid limb,5 cases with lower limbs,4 cases with upper limbs and 2 cases with left hemiplegia).In these cases, the muscle power varied from level 0 to level 4.The muscle strengthen and muscle tone in 21 patients were recovered within 2 weeks,and the other cases showed recovery 2 to 3 weeks later.After four weeks, the muscle strengthen in 19 cases recovered to 5 level(10 cases with single lower limb,5 cases with single upper limb,3 cases with two lower limbs and 1 case with two upper limbs).Conclusion HFMD complicated with AFP most commonly occurs in children aged less than 3 years old.The majority of cases were from countryside.Enterovirus 71 is still relatively common pathogen.All the 31 cases complicated with encephalitis.Cases clinically presented one flaccid limb, lower limbs, upper limbs and hemiplegia.AFP may be to some degree reversible in HFMD cases.In most cases described here, paralysis occurred in a single lower extremity and recovered more rapidly than those with two fimbs affected or with single upper extremity impairment.

Objective To study the feasibility and rehabilitation outcomes of one -stage cochlear implantation (CI) in profound deaf children with secretory otitis media (SOM ) .Methods A total of 11 profound deaf children with soal receired one -soage unilateral cochlear implantation with a follow -up period from 13~60 months .In-flamed mucosa in the mastoid as well as exudates were removed radical1y at the time of implantation for adequate drainage of the middle ear .After the sugery ,the patients were followed up and the hearing and rehabilitating out-comes were eveluated .Results All 11 patients were successfully operated with 8 cases in the right ear and 3 cases in the left ear .Among them ,7 cases were nucleus 24 CA ,1 case losa clarion AB 90 K ,2 cases were medel combi 40+and 1 case was pulsar .All patients were successfully operated .No infectious complications occurred .No recurrence of secretory otitis media was observed .After initial stimulation and post regular fitting ,the status of the implant-able devices were all stable .All the implantees had satisfied hearing and entered normal kindergartens or schools . Conclusion Profound deaf pediatric patients with SOM are not an absolute contraindication for CI .With sufticient pre-operation preparontion ,proper trentment and nursing .Cochlear implantation should be condnote as early as possible better rehabilitation performance .

Objective To evaluate the feasibility and clinical efficacy of intra-abdominal exposure instruments in laparoendoscopic single-port nephrectomy(LESS-N).Method From February 2012 to July 2016,61 cases of LESS-N were performed in our center.There were 34 males and 27 females with a mean age of (60.3 ± 9.4) years old (ranging 36-72 years old).There were thirty-nine cases of renal tumors and twenty two cases of nonfunctioning kidney.The patients were divided into two groups.Group A included 39 cases that underwent conventional LESS-N (22 radical nephrectomy/17 simple nephrectomy).Group B included 22 cases that underwent intra-abdominal exposure instruments assisted LESS-N (17 radical nephrectomy/5 simple nephrectomy).The perioperative and postoperative data were collected and analyzed retrospectively.Results All the procedures of these two groups were completed successfully.In Group A,four patients were added one 5 cm additional trocar and two patients were converted to open surgery.No additional trocars or conversion to open surgery were needed in Group B.For LESS radical nephrectomy,there were no significant differences of mean tumor diameter (5.7cm vs.5.4 cm,P =0.65) between two groups.The average operative time was (95.1 ± 43.9) min in Group B which was lower than that in Group A (127.4 ± 61.9) min (P ＜ 0.01).The mean renal vascular processing time was declined from (25.4 ± 10.1)rmin in Group A to (18.8 ± 8.9)min in Group B (P ＜ 0.05).The mean estimated blood loss was (128.6 ± 51.1) ml in Group A and (98.7 ±-57.6) ml in Group B (P ＜ 0.05).No severe intraoperative and postoperative complications occurred in both group.Conclusions Intra-abdominal exposure instruments are feasible and effective for LESS-N.This system may shorten the operation time,reduce the amount of bleeding and improve surgical accuracy.