Liver metastasis is one of the main causes of treatment failure in colorectal cancer, and the key to improve the efficacy of treatment is to adopt precision therapy. Oligometastatic classification clearly defines the treatment methods and goals for distinguish-ing liver metastases, as well as promotes nonsurgical methods for local treatments. In addition to RAS oncogene, other biomarkers with prognostic and therapeutic predictive values urgently need to be identified. Precision therapy encompasses the entire course of optimal treatment in colorectal liver metastases (CRLM) including the following:optimization of therapy sequence for initial resectable liver metastases, treatment predictive value of KRAS oncogene for liver resection, selection of sensitive subgroups for conversion ther-apy, application of the optimal follow-up strategy, and formulation of individual comprehensive treatment regimens. This review focus-es on the recent progress of precision treatment for CRLM.

Being fundamental preparation for the research of cochlear implants, study of tinnitus's mechanism and establishment of the animal model, the spontaneous discharge of single unit of auditory nerve primary fibers in normal cat was observed and analyzed. They include: Ⅰ, How to identify the spontaneous discharge potential in auditory nerve primary firbers. Ⅱ, The waveform of the spontaneous discharge potential in auditory never, Ⅲ, The discharge rate of spontaneous discharge in auditory nerve primary fibers. Ⅳ, The temporal feature of the spontaneous discharge. Ⅴ, The origin of the spontaneous discharge.

Objective To improve the diagnosis and treatment of the kidney injury.Methods 136 cases of the kidney injury were analyzed retrospectively.Results 5 cases died,the other cases were cured.69 cases were followed up for 1～3 years,the cystic kidney function was all normal.Conclusion On time,accurate proceed assessment for the kidney injury,controlling strictly the digit advertises for the operation or not operation is a key to treating kidney injury.

Objective To study the clinical, histopathologic and ultrastructural characteristics of achromic naevus (AN). Methods Clinical data, including sex, age, age of onset, pattern of lesions, involved sites, shape and number of lesions and associated systemic diseases, were collected from 85 patients with AN. Skin melanin index was detected in 34 lesions of 19 patients with AN, 30 lesions of 12 patients with vitiligo and 64 contralateral normal skin islands of the 31 patients. Reflectance confocal microscopy (RCM) was performed to analyze the lesion, normal skin and junctional area between lesional and normal skin of 62 patients with AN. Tissue samples were obtained from lesions and perilesional normal skin of 17 patients with AN and subjected to pathological examination as well as ultrastructural study with transmission electron microscopy; also, skin biopsy specimens were immunostained for tyrosinase, HMB45, tyrosinase-related protein-1 (TRP-1), TRP-2 and CD117. Results Of the 85 patients with AN, 23 (27.1%) developed lesions at birth, and 21 (24.7%) after 3 years of age; 72 (84.7%) had irregularly shaped lesions, 54 (63.5%) had only a single lesion. The mean melanin index and relative melanin index of AN lesions were 186.56 ± 52.86 and 80 ± 11, respectively, significantly lower than those in normal skin islands (223.88 ± 63.19 and 100, both P < 0.01), but higher than those in depigmented lesions from 12 patients with vitiligo (128.57 ± 64.31 and 60 ± 20, both P < 0.01). RCM revealed a decline in the number of melanocytes and brightness of melanin caps, even distribution of melanin in lesions, as well as obscure demarcation between lesions and normal skin from patients with AN. Fontana-Masson stain showed that the melanin content was lower in lesions than in perilesional skin (1810.12 ± 327.96 vs 2064.24 ± 260.41) from patients with AN. Microscopic examination demonstrated a decrease in melanocyte and melanosome number, presence of immature melanocytes at stage Ⅱ and Ⅲ in cytoplasm and dendrites of melanocytes and keratinocytes, aggregated melanosomes in affected keratinocytes in lesions of AN. In 17 patients with AN, the relative expression levels of tyrosinase and TRP-1 were 1827.35 ± 307.09 and 6102.54 ± 1642.64, respectively, in normal skin specimens, significantly higher than those in lesional skin (1477.35 ± 224.05, 5322.33 ± 1565.26, both P< 0.01); no statistical difference was observed in the expression levels of HMB45, TRP-2 or CD117 between lesional and normal skin. Conclusions AN is an early-onset, nonfamilial aggregated, stable leukoderma with irregular margins, and in lesions of AN, the number of both melanocytes and melanosomes is decreased with the presence of immature melanosomes. The measurement of relative melanin index and reflectance confocal microscopy may offer a non-invasive approach to the diagnosis of AN.

Objective To explore the prevention and cure methods of the urethra prostate electricity cutting(TURP) on the bleeding after the benign prostatic hyperplasia(BPH) treating.Methods 35 cases with BPH of the bleeding patients after TURP were statistically analyzed.Results 26 examples turned for the better after general treatment;6 examples turned for the better after resectoscope wash gore and gave or got an electric shock the hemostasis;3 examples changed to the surgical operation hemostasis cured.Conclusion Accurate disposal inside operation and process behind operation is a key to decrease bleeding after the TURP of the BPH.

Under the background of dual-track training mode, the current clinical program of professional master's graduate education lacks complete and unified content and requirements. We set out a unified teaching scheme of subspecialty, in the main subject acupuncture. We identified the teaching management and innovated the teaching and examination methods in the scheme. Our research gradually formed a multidisciplinary talents training system, as the foundation of developing the standardization training. This method could help to cultivate qualified graduates as the high quality talents for the national medicine development.

Objective To explore the measurement of(1,3)-β-D glucan in plasma for the diagnosis of pulmonary fungal infections in pulmonary tuberculosis patients. Methods 40 pulmonary tuberculosis patients with pulmonary fungal infections in Guangzhou chest hospital from January 2015 to December 2015 were enrolled as a test group,among which 35 were confirmed and 5 were suspected pulmonary fungal infections. 52 pulmonary tuber-culosis patients without fungal infections were selected as a control group.(1,3)-β-D glucan content(G test)in this 92 patients plasma were detected. The results of G tests were compared with those from etiological diagnosis to assess the performance of G test. Results 13 strains of candida albicans,13 strains of aspergillus,2 strains of candida tropicalis,2 strains of candida glabrata and 6 strains of other yeast were obtained from patients of test group,but no fungal identified from those of control group. The median of G test in test group and in control group was 126.1 and 29.56 pg/mL,respectively,the level in test group was significantly higher than that in control group (P<0.001). 35 cases were identified as positive and 5 were negative in test group by G test ,while 41 cases were identified as negative and 11 were positive in control group. The sensitivity,specificity,positive predictive value, negative predictive value ,concordance and Youden index of G test were 87.5%,78.85%,76.09%,89.13%, 82.6%and 0.663,respectively. Conclusions Candida albicans and aspergillus are more common pathogens than the other fungi isolated from pulmonary tuberculosis patients with pulmonary fungal infection. G test ,used in pul-monary tuberculosis with pulmonary fungal infections diagnosis,is reliable and fast,and has a higher sensitivity, specificity and accuracy.

Objective To study plasmid-mediated transfer,plasmid replicon typing,and genetic environment of blaNDM-1 gene in Enterobacteraerogenes(E.aerogenes).Methods E.aerogenes HN-NDM0711 was used as the subject of this research,the transferable properties of plasmid were analyzed by conjugation testing,conjugant was performed stability testing,plasmid type was determined by PCR-based replicon typing (PBRT),downstream and upstream of blaNDM-1 were sequenced using chromosome walking method,genetic context was analyzed by BLASTN and BALSTP,as well as annotated using Vector NTI 11.5.1 software,sequence pipeline graph was made,the sequence was submitted to Genbank through software Banklt.Results The conjugation testing of E.aerogenes pHN-NDM0711 was positive,after positive conjugant was conducted 4-day passage,minimal inhibitory concentrations (MICs) of imipenem and meropenem to all the cloned strains didn't change,blaNDM-1 were all positive.The replicon type was IncA/C;blaNDM-1 gene was localized between ISAba14 and IS91,at upstream of the blaNDM-1,class 1 integron and Tn3 transposon were identified,class 1 integron contained a new mosaic structure of a drug-resistant resistance gene cassette.Conclusion E.aerogenes pHN-NDM071 1,bearing blaNDM-1 gene in IncA/C plasmid,derived from gene recombination under different antimicrobial selection pressure.Antimicrobial use in clinical,industrial and agricultural area should be strictly controlled,so as to reduce the emergence of such bacteria.

Objective To observe the effects of fluorosis on the levels of endogenous cystathionine beta-synthase (CBS) and hydrogen sulfide (H2S) in rats.Methods According to body weight,forty-eight Sprague-Dawley rats (body weight 105-180 g) were divided into three groups by a random number table(16 rats in each group,half male).Fluorine contents of the feed in control group,low-fluoride group and high-fluoride group were 9.80,15.40 and 23.80 mg/kg.After 6 months of fluorine exposure,the fluorine contents of urine and bone were determined by the method of fluorine ion-selective electrode ; H2S levels in serum and brain and the activity of CBS in brain were detected by methylene blue; and protein expression of CBS was detected by Western blotting.Results Compared with control group,dental fluorosis was found in rats of low-fluoride and high-fluoride groups.The differences of fluorine contents of urine and femur were statistically significant between groups(F =65.16,67.93,all P ＜ 0.05).The urinary and femoral fluorine in low-fluoride groups [(5.25 ± 0.45)mg/L,(1 196.54 ± 72.78)mg/kg] and high-fluoride groups[(13.17 ± 0.98)mg/L,(2 656.61 ± 170.12)mg/kg] were higher than those of control groups [(3.64 ± 0.20)mg/L,(870.71 ± 71.51)mg/kg,all P ＜ 0.05],and the increases were in a dose-dependent fashion(all P ＜ 0.01).The differences of H2S contents in serum and brain were statistically significant(F =4.83,1 456.13,all P ＜ 0.05).The H2S content in serum was higher in high-fluoride group [(17.64 ± 2.38) μ mol/L] than that of the control group [(10.29 ± 0.74) μ mol/L,P ＜ 0.01].The H2S contents in brain were higher in the low-fluoride [(364.74 ± 2.06)μmol/L] and high-fluoride groups [(513.43 ± 4.18) μmol/L] than those of the control group[(314.94 ± 0.72)μmol/L,all P ＜ 0.01],and the increase was in a dose-dependent fashion (P ＜ 0.01).The difference of CBS activity was statistically significant between groups (F =760.63,P ＜ 0.01).The CBS activities were lower in low-fluoride [(438.90 ± 2.83) mmol· kg-1· min-1] and high-fluoride groups [(529.83 ± 2.37)mmol· kg-1· min-1] than those of the control group [(596.33 ± 2.75) mmol · kg-1· min-1,all P ＜ 0.01],whereas the protein expression of CBS in brain in high-fluoride group (1.49 ± 0.08) was higher than that of the control group (1.19 ± 0.06,P ＜ 0.05).Conclusion Chronic fluorosis can affect the levels of endogenous CBS and H2,S,and the increases are in a dose-dependent fashion in addition to CBS activity.

ZnO nanoparticles ( ZnO NPs ) were obtained by a direct precipitation method. With the as-prepared ZnO NPs as seeds, Au/ZnO heterostructure was synthesized by seed-mediated growth method without any surfactant, and the diameters of ZnO NPs and Au NPs were about 50 nm and 10 nm, respectively. Then ionic liquids (ILs), trihexyltetradecylphosphonium bis (trifluoromethylsulfonyl) imide ([P(C6)3C14] [ Tf2 N] ) , and functionalized graphene ( GN ) were prepared under room temperature. The ILs as bridges could connect Au/ZnO heterostructure to form a new kind of graphene nanocomposite, Au/ZnO/GN. Then the penicillinase and hematein were immobilized on Au/ZnO/GN. And the biosensors based on penicillinase-hematein-Au/ZnO/GN (PH-AZG) were used for detecting penicillin G. In PBS buffer solution (pH 7. 0), PH-AZG exhibited a detection range from 2 . 5 × 10-14 to 3 . 3 × 10-6 mol/L with a detection limit of 1 . 5 × 10-14 mol/L (S/N≥3). Five PH-AZG electrodes were prepared with the same conditions, and the RSDs for their current response were less than 3. 2%. Furthermore, the standard curves were linear in the range of 5× 10-14-5×10-7 mol/L for milk. The average recoveries were 99. 7%-101. 4% with RSDs of 2. 3%-3. 5%(n=5). The method is sensitive and repeatable, and can be applied to the field of residue analysis about penicillins G with low concentration levels.