RNA interference is an evolutionarily conserved surveillance mechanism that responds to double-stranded RNA by sequence-specific silencing of homologous genes. It can block and regulate gene expression. Over the past few years, RNAi has already begun to revolutionize experimental biology in organisms ranging from unicellular protozoans to mammals. In neuroscience, we are only begining to know the mechanistic complexity of this process and its biological ramifications.

Objective To evaluated the safety and complications of endovasdcular stenting for symptomatic carotid stenosis with surgical high risk.Methods A series of 11 vessels in 9 patients at surgical high risk were treated by endovascular stenting. The complications during the procedures and postoperative periods were analyzed within one to five months. Results All of the operations were successfully performed without any serious complications. During the follow up period (averaging 6 months), there were no complications of TIAs, stokes and restenoses.Conclusions The study suggests that endovascular stenting may be safe and effective for patients at surgical high risk, but further more study is needed.

Purpose:To study the clinical value of percutaneous placement of biliary stents tbr treatment of malignant biliary obstruction.Materials and methods:A total of 58 stents were placed pereutaneously in 53 patients for palliative of malignant biliary obstruction. Results:The success rate of stent implantation was 98.1%(52/53).The difference between post-and pre-operation in the serum total bilirubin level of 52 patients was 182?67 ? mol/L,P

Purpose To investigate the clinical pathological features, pathological diagnosis and differential diagnosis of the non-Wilms’ renal tumors in children. Methods The clinical pathological data and immunohistochemical findings of 15 cases of non-Wilms’ renal tumors were retrospectively analyzed with review of the relevant literature. Results In 7/15 (46. 67%) cases of cystic nephroma ( CN) , microscopically the variable size of cysts were lined by a single layer flattened, cuboidal epithelia, separated by fi-broblastic stroma;in 4/15 (26. 67%) cases of rhabdoid tumor of kidney (RTK), histological characteristics were rhabdoid cells and cytoplasmic inclusions;in 2/15 (13. 33%) cases of clear cell sarcoma (CCSK), the classical pattern of histology demonstrated nests, cords of ovoid epithelioid or spindled clear cells separated by fibrovascular septa, which had a marked ’ chicken wire’ pattern of small blood vessels;in 1/15 (6. 67%) case of congenital mesoblastic nephroma (CMN), the tumor was mainly composed of spindle cells arranged in fascicular pattern, in which fetal renal tissue was seen;in 1/15 (6. 67%) case of granularity renal cell carcinoma, micro-scopically, the cancer cells with eosinophilic granular cytoplasm arranged in nests, cords and tubular pattern. Conclusions Although non-Wilms’ renal tumors is a small part of all kidney tumor, it is difficult to diagnose and distinguish from other tumors before opera-tion. The pathological diagnosis is the most reliable method for differential diagnosis of non-Wilms’ renal tumor.

Objective To analyze the feature of victims transported from Nepal Pokhara's earthquake,and summarized the rescuing experiences got by the Chinese government medical team.Methods A total of 374 casualties from the 2015 Nepal's earthquake magnitude 8.1 transported to the Field Hospital of the Chinese government medical team were classified into four groups according to different causes of injury,and then retrospectively analyzed the types of injury,vital signs,severity of injury and causes of injury.Results Of 374 casualties,the average age was (30.1 ± 12.4) years,and were divided into group A (n =154) in which casualties trapped under ruined buildings,group B (n =123) in which the victims had crushed injury during escaping with their lives,group C (n =58) in which the wounded had injury resulted from fall on the ground during fleeing for their lives and group D (n =39) in which the injury of casualties was caused by fall from high level.Of them,273 patients (296 parts of body injured) suffered from fracture including 34 patients with severe multiple trauma.The average age in the group D (22.3 ±7.4 years old) was significant younger compared with the others (all P ＜ 0.05).The average age in the group C (48.4 ± 13.3 years old) was significant older compared to the others (all P ＜ 0.05).The injury probability was higher for male in the group D (14.2％ vs.7.1％,x2 =5.077,P =0.024) and the injury probability was higher for female in the group C (19.7％ vs 10.8％,x2 =5.635,P =0.018).The incidence of limbs fracture was highest (66.6％) in all 296 parts of body injured.The incidence of skull fracture in the group B (31.6％) was higher compared to the others (all P＜0.05),and the incidence of spinal fracture in the group D (40.0％) was higher compared to the others (all P ＜ 0.05).There was no significant difference in the severe multiple trauma incidence between the group A and the group D (16.9％ vs.12.8％,x2 =0.381,P =0.537),but both group A and group D had significant higher incidence of severe multiple trauma compared to the rest two groups (all P ＜ 0.05).The wound debridement was the leading rate of treatment among variety of treatments (57.5％) and the plaster fixation was the second high rate of treatment (30.9％),and the wound infection was found in 25 patients (17.4％) at the first dressing among 144 patients with soft tissue laceration.After active and regular debridement,72％ patients' wound smear tests were negative 3 days later,and 100％ were negative 7 days later.Conclusions The casualties treated by Chinese government medical team had relatively young average age,not very severe critical illness,and quite high rate of wound infection.The treatment of all kinds of fractures and open wound was a matter of critical importance.Although facing the challenge of incomplete set of medical equipment,the lacking of medicine and many other unexpected problems,the Chinese government medical team successfully fulfilled the mission with the prior experience accumulated from several domestic earthquake disaster rescue actions.

Aim To find out the relationship between muscarinic receptor and reactive oxygen species (ROS) and the probable differences between the four muscarinic receptor subtypes. Methods We transfected the plasmid encoding muscarinic receptor (including subtypes: M_1, M_2, M_3 and M_4) into PC12 cells. Then PC12 cells were exposed to hydrogen peroxide (H_2O_2), carbachol and other inhibitors such as atropine, LY294002 and PD98059. Results The results showed that activation of muscarinic receptor by carbachol protected PC12-M_1, PC12-M_2,PC12-M_3 and PC12-M_4 cells from apoptosis induced by H_2O_2. There was no statistical difference in the protective effect between these four muscarinic receptor subtypes. By using the inhibitors, we found that atropine and LY294002 blocked the protective effect of activation of muscarinic receptor on apoptosis induced by H_2O_2. Conclusion Activation of muscarinic receptor retarded the apoptosis induced by H_2O_2. There was no difference between the four muscarinic receptor subtypes. The protective effect was mainly mediated by the activation of muscarinic receptor and phosphatidylinositol-3 kinase (PI3K).

Objective To investigate the selection of flaps for the reconstruction of facial skin defects.Methods A total of 40 patients with facial skin defects were treated from February 2011 to February 2015 in our hospital,and they were given different surgery methods ac-cording to the different facial skin defect sizes.Minor defects were primarily treated by direct suturing;medium-sized defects were treated by local skin flap transposition or island skin flap;and larger defects were treated by expanded skin flap.Results All patients were followed up for 1 to 2 years.All the flaps survived with good color and texture match.All the scars healed well which were almost invisible.There was no obvious deformity in the donor and recipient sites.In addition,there was no lesion recurred.Conclusion Select suitable flaps for the recon-struction of facial skin defects according to the face defect area could get reliable blood supply of the flap,inapparent incision scar and a high level of satisfaction.

Objective To evaluate extended vs standard left lateral lobectomy for left lateral lobe hepatolithiasis.Methods A retrospective study was conducted on the clinical data of 110 patients who underwent hepatectomy for hepatolithiasis limited to left lateral lobe of the liver.Results 42 patients received left lateral lobectomy, 68 patients did left hemihepatectomy.There were no marked difference between the two groups in the operation time, introperation or postoperation blood loss, bile leak and bleeding on the hepatic cut surface, liver function and the postoperative hospital stay.The incidence of residual and recurrent stones was 14.3％ and 11.9％ in left lateral lobectimy group and 0％, 0％ in left hemihepatectomy group.Conclusion Left hemihepatectomy for left lateral lobe hepatolithiasis is a safe and effective procedure.

Objective To evaluate the factors influencing early diagnosis and prognosis in patients with pancreatic carcinoma.Methods The clinical data of 280 patients who had complete follow-up data with pancreatic carcinoma treated from January 2002 to January 2007 were reviewed retrospectively.The medical history and follow-up data were collected from all patients.Survival rate was calculated by the life table method and the Kaplan-Meier estimation.Log-rank test was used for univariate prognostic analysis and Cox regression was used for multivariate prognostic analysis.Results 91.8%of the patients were more than 40 years old and the peak age was 50～73 years old;the major presentations were abdominal pain and jaundice.Major imaging tests included B-ultrasound and CT,the sensitivity was 70.6%,95.3%,respectively;89.3%of patients had combined B-ultrasound and CT examination.The sensitivity of CA19-9 was 81.1%.The median survival time was(7.0±0.5)months.Overall survival rates at 1～5 year survival rates were 28%,9%,6%,2%,and 1%.Univariate analysis suggested that age＞65 years old,CA19-9＞mean value,TNM Ⅲ or Ⅳ stage,lymph nodes invasion,vascular invasion,and metastasis of two or more organs,non-surgical treatment,KPS score＜60 points,weight loss≥5 kg were poor prognostic factors;Cox multivariate analysis showed that treatment modalities,age,TNM stage,KPS score and ascites were independent risk factors for dismal prognosis.Conclusions The age,ascites,tumor stage and treatment modalities affected the prognosis of patients with pancreatic cancer.Early diagnosis and treatment was important to improve the survival time of patients with pancreatic cancer.

Objective To evaluate systematically whether administration of hypertonic saline transfusion affects clinical outcomes with compared to standard fluid in the early stage of resuscitation for traumatic shock patients.Methods Seven English and Chinese routine biology and medicine databases were searched for randomized controlled trials (RCTs) published from January 2002 to August 2012,and established inclusion and exclusion criteria to evaluate these RCTs.The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad' s score scale.RevMan 5.0 statistical software was used for meta-analysis.Results After evaluated 211 related literatures,five RCTs met all the inclusion criteria and were enrolled for meta-analysis.The meta-a nalysis demonstrated that early hypertonic transfusion did not decrease short-term (first 48 hours after admission) mortality (RR =1.04,P =0.74); nor did it decrease later-term (7day to 3month after injury) mortality (RR =0.97,P =0.72).It also did not decrease the total volume of fluid and blood transfusion required during the first day (P =0.38).Similarly,it did not affect the incidents of infections (RR =1.04,P =0.70),the length of stay in ICU (P =0.2) and total length of stay in the hospital.Conclusions Compared to standard fluid,there was no advantage on mortality and hospital infection by using hypertonic supplement transfusion in the early stage of resuscitation for traumatic shock patients.Hypertonic transfusion did not have any significant effect on the volume of total fluid and blood transfusion required the first day,and no trend of reduction for the length of ICU and hospital stay.Further well-designed randomized controlled trials are needed to demonstrate the cost effectiveness of hypertonic transfusion to traumatic shock patients while in ICU.