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.

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

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.

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 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.

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.

Background and purpose:Single drug of docetaxel and pemetrexed as second line treatment is standard treatment of advanced non-small cell lung cancer (NSCLC). Whether combined with platinum can increase the response and survival is still not elucidated. This study was designed to investigate the treatment response, overall survival (OS) and the safety of combined with oxaliplatin or cisplatin regimens as second line in treating NSCLC patients. Methods:Advanced NSCLC inpatients, failure of cisplatin or carboplatin in initial treatment, were divided into three groups at random in 3∶2∶1 rate. Control group:who received docetaxel, 75 mg/m2 (for all patients), d1 or pemetrexed 500 mg/m2 (for non-squamous carcinoma);Cisplatin group:who received cisplatin 25 mg/m2, d1-3 and docetaxel/pemetrexed; Oxaliplatin group: who received oxaliplatin 130 mg/m2 d1 and docetaxel/pemetrexed. Every 3 weeks were repeated as one cycle. The side effect was assessed every cycle and treatment efifcacy was investigated every two cycles. Follow-up examination was taken every 3 months after treatment. Results:There were no differences in treatment response, progress free survival (PFS), OS and toxicity among the three groups (P>0.05). Old patients (≥60 years) had a better PFS than that of patients less than 60 years (HR=0.56, 95%CI:0.35-0.90, P=0.015). Patients with performance score 0-1 had a better PFS and OS (HR=1.52, 95%CI:1.01-2.30, P=0.048;HR=1.90, 95%CI:1.17-3.09, P=0.009). Treatment response had relation to PFS and OS (HR=2.93, 95%CI:2.01-4.26, P=0.000;HR=2.03, 95%CI:1.37-3.01, P=0.000). Patients with anemia after treatment tended to have a worse PFS and OS (HR=1.59, 95%CI:0.97-2.61, P=0.066;HR=1.60, 95%CI:0.94-2.75, P=0.085). Patients with thrombocytopenia after therapy had a worse OS (HR=2.97, 95%CI:1.01-8.78, P=0.049). Patients with neural toxicity after chemotherapy tended to have a worse PFS (HR=3.36, 95%CI:0.92-12.25, P=0.066). Patients received post treatment after second line therapy had a better OS (HR=0.36, 95%CI:0.22-0.61, P=0.000). Conclusion:Combined with oxaliplatin or cisplatin as second line treatment can’t improve the response and survival in NSCLC patient. Treatment response and PS are prognostic factors to NSCLC patients’ PFS and OS. Patients with treatment related anemia might have a worse survival. Post therapy after failure to second line chemotherapy can prolong the survival.

Objective To explore the effects of low-dose X-ray irradiation effects on ischemic flap survival and its possible mechanism.Methods From June, 2014 to December, 2014, 80 SD rats were include in the study, the rats were randomly divided into 2 groups: the experimental group A and control group B.There were 40 rats in each group.The ischemic flaps with the size of 9 cm × 3 cm were designed on the back of the rats.The pedicle of the flaps was near to the tail.A sterile biological isolating membrane was placed under the flap to block the blood supply between muscular layer and flaps.The flaps were intermittently sutured into their original position.The group A was immediately received single and local irradiation of 0.2 Gy after surgery, The group B was not treated.On days 1 to 14 after operation,general observation,HE staining and the western blot of the flaps were performed to calculate the survival vate of the flaps, observe neovascularization and determin the content of VEGF and MMP-9, respectively.Results On the third, seventh and fourteenth days, survival rates of the flaps in the experimental group [(66.46 ± 4.37)％, (44.30 ± 3.86)％, (32.20 ± 4.22)％, respectively] were higher than the control group [(43.15 ± 5.03)％, (27.71 ± 3.20)％, (16.40 ± 5.34)％, respectively] after inspection, there were statistically significant differences between these indices (P ＜ 0.01), HE staining of the flaps in the experimental group were seen in the fibroblast infiltration and neovascularization were higher than that of control group, and experimental group within the lumen of blood vessels were arranged in order, the groups were visible tissue edema obviously control, neovascularization in small numbers, the lumen was irregular.On the third and seventh days, MVD rates of the flaps in the experimental group (85.54 ± 6.12, 44.32 ± 3.56, respectively) were higher than the control group (49.35 ± 4.75,18.75 ± 2.89,respectively) after inspection, there were statistically significant differences between these indices (P ＜ 0.01).VEGF and MMP-9 protein content in the flap for the seventh day in the experimental group were significantly higher than that of the control group.Conclusion Low-dose X-ray irradiation can promote the survival rate of ischemic flap, the mechanism may be related to the expression of VEGF and MMP-9 increased and promoted angiogenesis of the flaps after low-dose X-ray irradiation.