Objective:To examine the expression of CLC-3 in colorectal tissues and the effect of CLC-3 on the viability and invasion of colorectal cancer (CRC) SW480 and SW620 cells. Methods:The mRNA levels of CLC-3 in CRC cell lines were determined by RT-PCR. CLC-3 expression was inhibited by adding DIDS or NPPB to the CRC cells. Subsequently, cell viability and invasion were assessed by CCK-8 assay and Transwell assay, respectively. In addition, the effects of DIDS and NPPB on the Wnt orβ-catenin signaling pathways were de-termined by Western blot analysis. Results:The mRNA level of CLC-3 was remarkably increased in the CRC tissues compared with that in normal colorectal tissues (P<0.05) and was positively correlated with the T stage of CRC. The blockade of CLC-3 inhibited the viability and invasion of CRC cells (P<0.05). The expression ofβ-catenin, C-myc, cyclin D1, Ki-67, and survivin were evidently reduced by the in-hibition of CLC-3 (P<0.05). Conclusion:The inhibition of CLC-3 decreases the cell viability and invasion of CRC cells by reducing the ex-pression of the proteins related to the Wnt orβ-catenin signaling pathway.

Objective To study the expression of insulin-like growth factor-Ⅱ receptor(IGF-Ⅱ R) and its relationship with the prognosis of human epidermalgrowth factor receptor 2 (HER2) positive breast cancer.Methods The expression of IGF-Ⅱ R in 104 specimens of HER2 positive breast cancer was evaluated by immunohistochemistry.The expression was rated on 2 scales:negative and positive.The age,pathological type,tumor size,lymph node involvement,status of estrogen receptor(ER),and progesterone receptor(PR) of all the cases were reviewed.The relationship between the expression of IGF-Ⅱ R and the above pathological parameters were analyzed by statistical methods.The relationship between the expression of IGF-Ⅱ R and the disease-free survival and overall survival was studied.Results The positive expression rate of IGF-Ⅱ R was 43.3％ (45/104).The positive rate of IGF-Ⅱ R was significantly higher in the lymph node positive group than in the lymph node negative group (61.5 ％ vs 25.0％,P =0.000).No significant correlation was observed between the expression of IGF-Ⅱ R and age,pathological type,tumor size,status of ER,or PR.The disease-free survival and overall survival was significantly lower in IGF-Ⅱ R positive group than in IGF-Ⅱ R negative group.(The 5-year disease-free survival:62.6％ vs 84.7％,P =0.022; The 5-year overall survival:71.5％ vs 89.6％,P =0.024).Cox regressive analysis showed that the lymph node status was an independent risk factor of disease-free survival and overall survival,while the IGF-Ⅱ R was not.Conclusion The positive expression of IGF-Ⅱ R in HER2 positive breast cancer indicates poor prognosis.The expression of IGF-Ⅱ R may be regulated by insulin-like growth factor-Ⅱ (IGF-Ⅱ).

AIM:To investigate the effect of all-trans retinoic acid ( ATRA) on the viability of gastric cancer cell SGC-7901 and the sensitivity to radiotherapy .METHODS:MTT assay was used to examine the cell viability .Radio-sensitivity and cell cycle were determined by colony formation assay and flow cytometry , respectively .The mRNA levels of Bax, Bcl-2, survivin and NF-κB in the cells were measured by RT-qPCR.RESULTS: ATRA inhibited the viability of SGC-7901 cells in a concentration-dependent manner .The maximal inhibition was at concentration of 8 μmol/L.Colony formation assay revealed that the combination of ATRA with X-ray treatment significantly reduced the values of D 0 and Dq, and shifted down the fitting survival curve , as compared with radiotherapy alone .Moreover , ATAR markedly decreased the percentage of G2/M phase in the SGC-7901 cells (P<0.05).In addition, following ATRA treatment, the mRNA levels of Bcl-2 and survivin were decreased (P<0.05), whereas the mRNA levels of Bax and NF-κB were increased (P<0.05). CONCLUSION:ATRA enhances the sensitivity of SGC-7901 cells to radiotherapy , inhibits G2/M arrest and regulates the mRNA expression of Bax , Bcl-2, survivin and NF-κB.

Objective To study the thalamic metabolic alterations and its correlation with cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods The cognitive function of 34 patients with CSVD and 26 matched volunteers were evaluated by Montreal cognitive assessment(MoCA), and received single voxel 1H-MRS examination to detect the content of NAA,Cho and Cr,and record the ratio of NAA/Cr and Cho/Cr on bilateral thalami.The differences of NAA/Cr, Cho/Cr on bilateral thalami between the two groups were compared, and the correlation between NAA/Cr,Cho/Cr and MoCA total score and its sub-items score in CSVD group were analyzed.Results ①The MoCA of total score as well as its sub-items such as visual space and executive ability,memory,attention and language for CSVD group were significantly lower than that for the control group(P<0.05);②NAA/Cr on bilateral thalami in CSVD group were both lower than that in the control group(left 1.57±0.18,1.68±0.17,t=2.46,P=0.02;right 1.66±0.21,1.78±0.19,t=2.23,P=0.03), the differences were statistically significant (P<0.05);there were no significantly differences in the ratio of Cho/Cr between the two groups(P>0.05);③In CSVD group, the ratio of NAA/Cr on both bilateral thalami were significantly positively correlated with MoCA score (left r=0.83,right r=0.79,P<0.05)as well as visual space and executive ability(left r=0.65,right r=0.46,P<0.05), memory(left r=0.59, right r=0.50, P<0.05), attention(left r=0.42, right r=0.52, P<0.05),language(left r=0.52, right r=0.41, P<0.05), abstraction(left r=0.47, right r=0.40, P<0.05), orientation(left r=0.48,right r=0.42, P<0.05),Cho/Cr were not significantly correlated with MoCA total score and its sub-items(P>0.05).Conclusion The thalamic neuron has been damaged and dysfunctioned in patients with CSVD,and this metabolic abnormality may be related to a wide range of cognitive impairment in CSVD patients.

The teaching model of Problem-Based Learning(PBL)is quite effective in developing the students’learning capacity, analytical and problem resolution skill and their ability to think independently and logically. The article summed up the instructional design, implementation of training and teaching effectiveness of PBL teaching model in medical microbiology.

Objective To explore the clinical application of 64-slice spiral CT(64SCT) in evaluation of female patients with primary osteoporosis.Methods 912 patients were clinically diagnosed as primary osteoporosis and were examined by 64SCT. The osteoporosis and pathologic fractures were evaluated on CT images.Results 912 patients in the group were diagnosed the osteoporosis in different degree.203 patients had pathologic fractures.Conclusion 64SCT can evaluate the extent of the primary osteoporosis of the females and can predict the adventures of the pathologic fracture.

The control handles( including financing, provider payment, organization, regulation and behavior) proposed by World Bank in health policy research as the basic framework,and the nature and positioning of family doctors′ contract-based service as the precondition, we recommended the system framework of such a mechanism, comprising one contract, three regulations, five control handles and seven supporting policies. Such a framework can serve as the cornerstone for family doctors′ contract-based service experiment in Zhejiang province for the sake of hierarchical medical system.

Objective To study the therapeutic effect of improved STARR (Sehapayak as a control)in the treatment of moderate and severe rectocele.Methods 70 patients diagnosed with rectocele from Jan.2015 to Oct. 2015 were selected and randomly divided into 2 groups,35 cases in each group.They were treated with either improved STARR or Sehapayak surgery.The operation time,intraoperative blood loss,postoperative pain scores, patients'satisfaction and hospitalization days were compared between 2 groups.The ODS scores and therapeutic effects were compared in 1st week,1st month,3rd month and 6th month after treatment.The defecography was implemented and compared between 2 groups before treatment and 1st week and 6th month after treatment.Results The operation time,intraoperative blood loss,postoperative pain scores,hospitalization days and time to return to work were signifi-cantly lower in STARR group than those in Sehapayak group[(29.76 ±8.40)min vs (48.38 ±9.04)min;(14.43 ± 8.16)mL vs (77.80 ±20.58)mL;(4.29 ±1.76)points vs (6.71 ±2.04)points;(6.71 ±1.22)d vs (11.23 ± 3.64)d;(7.20 ±1.36)d vs (13.14 ±2.60)d;t =8.934,16.935,5.338,6.955,11.959,all P <0.05],and the patients'satisfaction was significantly higher in STARR group[(8.83 ±0.98)points vs (7.54 ±1.20)points,t =4.908,P <0.05].There were no significant differences in efficacy between 2 groups at any time point (P >0.05). The ODS score was (20.97 ±4.38)points before treatment,(4.71 ±1.30)points 1week after treatment,(2.94 ± 0.91)points 1month later,(1.68 ±1.04)points 3months later and (0.97 ±0.88)points 6mons later in the observa-tion group.The ODS scores in the control group were (19.88 ±4.09)points,(4.65 ±1.28)points,(3.51 ±1.15) points,(2.88 ±1.67)points,(1.85 ±1.31)points,respectively.The postoperative ODS scores of the two groups of patients were compared with the preoperative decreased significantly (t =20.666,23.904,26.127,26.401,all P <0. 05;t =22.882,24.081,24.032,25.015,all P <0.05),but at 1 week after operation of the two groups of ODS score had no statistically significant difference (P >0.05);1 month,3 months and 6 months after surgery,the differences of ODS score of the two groups were statistically significant(t =2.313,3.585,323.3,all P <0.05).The depth of recto-cele in the observation group was (33.09 ±6.79)mm before treatment,(5.54 ±1.96)mm 1month after treatment and (6.67 ±1.95 )mm 6months after treatment;while (33.57 ±6.46)mm,(7.65 ±2.11 )mm and (9.32 ± 2.74)mm in the control group,respectively.There was no difference between the two groups in the depth of rectocele before treatment (P >0.05).After treatment,they were all significantly decreased (t =21.779,20.646,all P <0.05;t =25.261,20.768,all P <0.05)in the two groups,and compared with the control group,the observation group decreased more significantly(t =4.339,4.565,all P <0.05 ).The two groups of patients at months after the 6th month of the rectal protrusion were significantly higher than the 1st months after the surgery (t =2.864,3.113,all P <0.05).The incidence rate of side effects was significantly higher in STARR group than that in Sehapayak group 1st week after treatment (48.6% vs.22.9%,χ2 =5.040,P =0.025),but there was no difference in 6th month after treatment (8.1% vs.3.0%,P >0.05).Conclusion Compared with Sehapayak,improved STARR surgery has the advantage of excellent curative effects,less trauma,shorter hospitalization,less complications and higher patient satis-faction.Improved STARR surgery is conducive to the prevention of rectocele relapse.

Objective To explore the clinical treatment of Doppler guided hemorrhoid artery ligation (DG-HAL) combined with ultrasound-knife excision for severe hemorrhoids. Methods Eighty-seven patients with sever hemorrhoids were divided into 2 groups by the different admission months, the patients in group A (odd-numbered month) were treated by DG-HAL combined with ultrasound-knife excision, and the patients in Group B (bimonthly) were treated by procedure for prolaps and hemorrhoids. The clinical date were compared between 2 groups. Results There were no statistical differences in postoperative pain score and total efficient rate between 2 groups (P>0.05). The operating time, total hospitalization expenses and the incidences of postoperative bleeding, long term postoperative anal discomfort in group A were significantly lower than those in group B: (25.5 ± 2.8) min vs. (36.8 ± 4.6) min, (7 859 ± 564) yuan vs. (10 728 ± 733) yuan, 0 vs. 12.8%(5/39) and 2.1%(1/48) vs. 17.9%(7/39), the patient satisfaction score was significantly higher than that in group B: (9.3 ± 0.7) scores vs. (8.1 ± 0.6) scores, and there were statistical differences (P<0.05). Conclusions DG-HAL combined with ultrasound-knife excision to treat severe hemorrhoids has the definite treatment, less trauma, fewer complications and cheaper hospitalization expenses.

Objective To investigate the prevalence of hyperuricemia and its associated factors including dietary and Metabolic Syndrome in populations of Dongcheng district in Beijing.Methods A cross-section study of hyperuricemia was carried out in volunteers who had diabetes screening from 2003 to 2004.The prevalence of hyperuricemia was calculated in the population.Applying the form of food frequency to know the intake of nutrition-rich dietary.Results The prevalence of hyperuricemia in this population was 4.3%.In male and female were 10.7% and 1.07% respectively.Bivariate and rank analysis found that hypertriglyceride were associated with increased prevalence of hyperuricemia(P