Three strategies for nephrologists are to recognize the signs of early diagnosis of chronic kidney disease ( CKD),to identify and treat risk factors of progression of CKD and to cure or slow-down the progress of end-stage renal disease (ESRD). The idea of individual therapies obtaining optimal clinical results in tumor treatment urged people to find and apply biomarkers for personalized diagnosis of the risk factors of CKD susceptibility and progression,which provide a rationale for pursuing personalized medicine.(Chin J Lab Med,2012,35:784-789)

Objective To investigate the clinical characteristics of childhood intracranial tumor.Methods The age and sex distribution,location of tumor,clinical manifestation,imaging examination and pathological examination,diagnosis and treatment of 98 children under 14 years old admitted into Children′s Hospital of Chongqing Medical University from Jun.2003 to Sep.2008 were analyzed.Results There were 63 male and 35 female in the study.The gender ratio(male to female) was 1.8:1.The age range was 4 months to 14 years old,75 cases(76.5%) visited a doctor in the course of disease from 1 to 90 days.The tumors of 60 cases(61.2%) were located in posterior cranial fossa,while 14 cases(14.3%) in cerebral hemisphere.The most common intracranial tumors were medulloblastom(30 cases,30.6%),astrocytic tumor(26 cases,26.5%),ependymal tumor(17 cases,17.3%),craniopharyngioma(10 cases,10.2%) and germ cell tumor(4 cases,4.1%).The main clinical manifestations were vomiting(61 cases,62.2%),headache(58 cases,59.2%),instability of gait or incoordination(38 cases,38.8%),29 cases(29.6%) of the tumors were misdiagnosed.Obstructive hydrencephalus was found in 78 cases(79.6%) by imaging examination,positive rate of tumor′s diagnosis was 95.9% and 100% by brain CT and MRI scaning,respectively.Conclusions Intracranial tumors in childhood are mostly located in posterior cranial fossa with atypical clinical manifestations and short course of diseases.It is common to be misdiagnosed at early stage.Brain CT and MRI examinations are helpful for early diagnosis,which should be considered for the children when unreasonable increased intracranial pressure and localizing neurological sings exist.

To establish a set of perfect teaching quality management system in laboratory medicine based on ISO 9000 standard and teaching reality in laboratory medicine will be helpful to the improvement of teaching quality and management ability and sustainable development of laboratory medicine.

Objective To observe the clinical efficacy of alprostadil, benazepril combined with Danqi Decoction and herbal enema in treatment of diabetic renal proteinuria.Methods Sixty cases of diabetic renal proteinuria patients were randomly divided into the control group and the experimental group.Each group was 30 cases.The control group was given alprostadil(0.2μg/mL,2 times per day) and benazepril(10 mg,one time per day), while the experimental group was given Danqi Decoction combined with herbal enema on the basis of the control group(one time per day).The urea nitrogen, serum creatinine, quantitative of proteinuria (in 24 hours) and the excretion of urinary micro-albumin of both groups were all tested after three weeks of continuous treatment.ResuIts After three weeks of treatment, the laboratory values of urea nitrogen, serum creatinine, quantitative of proteinuria in 24 hours of both groups were all improved compared with those before treatment(P<0.05).Furthermore, the quantitative of proteinuria(in 24 hours) of the experimental group was significantly less than that of the control group(P<0.05), and the excretion of urinary micro-albumin of the experimental group was significantly less than that of the control group(P<0.05).ConcIusion The therapy of alprostadil, benazepril combined with Danqi Decoction and herbal enema is effective for diabetic renal proteinuria patients, and can significantly reduce proteinuria and renal injury.

Hypoxia results from long-term anti-angiogenic therapy and can stimulate hypoxia-inducible factors (HIFs). HIF-induced hy-poxia signaling is involved in various steps in tumor invasive-metastatic cascade. On the one hand, HIFs regulate epithelial-mesenchy-mal transition. On the other hand, the characteristics of pericytes around vessels and the links among endothelial cells can change;thus, tumor cells can more easily intravasate into blood vessels, survive in peripheral blood, and then reach specific organs, ultimately resulting in metastasis. This review discusses the emerging mechanisms of long-term anti-angiogenic therapy and the occurrence of metastasis.

Clinical surgical teaching is an important course of undergraduate teaching.Aiming at the problem of disconnection between operation and case in traditional video teaching and observing teaching in operation room,a new model of live surgery teaching based on case teaching was launched:intraoperative diagnosis and preoperative medical history collection were combined;intraoperative surgical anatomy and similar comparative study;teaching surgery were combined with pathology and postoperative adjuvant therapy.Through the questionnaire it was found that all of the students were satisfied with live surgery teaching,96.5％ of the students believed the model would contribute to their understanding of textbook knowledge and memory,and 94.8％ of the students thought the model could improve their interest in clinical learning.

Objective To discuss the application effect of FMEA in reduction of unplanned extubation of PICC.Methods FMEA was applied to find out the failure mode of unplanned extubation of PICC,and then assessed it from three dimensions,which were the likelihood of occurrence,the possibility of being discovered,and the seriousness of the failure,and then calculated the RPN values,risk priority,and plan optimization process,at the last made a proactive behavior intervention.81 patients were selected as the control group before the application of FMEA and 98 patients were set as the experimental group after the application of FMEA.The incidence of unplanned extubation was compared between two groups.Results There was statistically significant difference in unplanned extubation between two groups.Conclusions Application of FMEA can reduce the rate of unplanned extubation of PICC.

This article discusses the relevant factors which influence the assessment and diagnosis of personality disorder, especially the relationships between personality disorder and personality,personality disorder and the axis I conditions in the Diagnostic and Statistical Manual of Mental Disorders (DSM) system and its particularity of assessment. Such discussion helps to improve the clinical worker's comprehension to the psychopathology, personality disorder and their relationships.

Objective To investigate the effect of steroid receptor coactivator family in initiation, development, treatment and prognosis of breast cancer. Methods The literatures in recent years which have related to the effect of steroid receptor coactivators in breast cancer are reviewed. Results Steroid receptor coactivators are essential for several kinds of steroid hormones binding to steroid receptors, so they are important accessory factors that induce the initiation, development and recurrence of breast cancer, and predictive factors that estimate the prognosis of breast cancer. Conclusion Inhibition of the expression and signaling pathway of steroid receptor coactivators may be effective for breast cancer prevention and treatment.

Objective To review recent studies on the research advance of the relationship between RET proto-oncogene and differentiated thyroid carcinoma. Methods The literatures in recent years on the structure of RET gene and coding product,cell signal transduction,relationship between RET proto-oncogene and differentiated thyroid carcinoma were reviewed.Results RET gene encoding tyrosine kinase receptor,involving in cell signal transduction,rearrangement of RET gene was frequently seen in papillary thyroid carcinoma.Conclusion Rearrangement of RET gene was closely correlated with the occurrence and progress of differentiated thyroid carcinoma,RET gene may be considered as a new therapeutic target for differentiated thyroid carcinoma.