Objective To facilitate a better understanding of the progress in the research, diagnosis and treatment of Peutz Jeghers syndrome (PJS).Methods Almost all the papers related to PJS from various magazines published in English and Chinese in recent years were reviewed. Current progresses in PJS research and related diagnosis and treatment were discussed in this review.Results PJS is a rare inherited disease with autosomal dominant trait, which is characterized by the presence of hamartomatous gastrointestinal polyps and mucocutaneous pigmentation of the lips, buccal mucosa, and digits. This syndrome is commonly complicated with intestinal obstruction, bleeding, or intussusception,and patients with this disease are at high risk for the development of both GI and extraintestinal malignancies. STK11 on chromosome 19p13.3 are responsible for most cases of PJS. The polyps of PJS tend to have a high incidence of malignant change, and the recurrence of malignancy after treatment is also high. Conclusion The STK11 has been identified as one of the main genes responsible for PJS and has close correlation with formation and development of tumors. Patients with PJS are at high risk for the development of both GI and extraintestinal malignancies.

To analyze and research the transformation of teaching thoughts,adjustment of professional teachers,renewal of teaching contents and so on,and establish the foundation for the revolution of professional English teaching in medical university under the new situation.

Objective To study the expressions of MMP-2 and TIMP-2 in pancreatic carcinoma and their relationship with tumor invasion, local metastasis and prognosis of the carcinoma. Methods The expressions of MMP-2 and TIMP-2 were examined in 32 patients with pancreatic carcinomas by S-P immunohistochemical technique and the correlation with pathological tumor parameters were analyzed. Survival analysis was made by using the Kaplan-Meier method. Results The positive rates of MMP-2, TIMP-2 in 32 patients with pancreatic carcinoma were 56.25% and 75.00%, which were significantly higher than those of the controls(P＜0.05). Expressions of MMP-2 and TIMP-2 were independent of sex, age, histological grading and type, but well correlated with the lymph node metastasis and TNM clinical staging(Ⅰ and Ⅲ, Ⅱ and Ⅲ). There was a significant association between MMP-2, TIMP-2 and prognosis in pancreatic carcinoma. Conclusion MMP-2 and TIMP-2 might be useful markers for biological aggressiveness of this malignancy and might contribute to the invasive properties of pancreatic carcinoma, which can be used to evaluate the prognosis of patients.

Objective To investigate the perioperative outcomes of robot-assisted laparoscopic partial nephrectomy in solitary kidney.Methods From September 2014 to September 2015, 9 patients underwent robot-assisted laparoscopic partial nephrectomy in solitary kidney.6 of these patients were male, while the others were female.The average age of these patients was 60 years, ranged from 46-78 years.The lesion was located in left kidney of 5 cases, and the remaining in right kidney.The average diameter of lesion was 4.5 cm, ranged from 2.8-7.6 cm.One case was congenital solitary kidney, one was contralateral atrophic kidney, 2 cases were performed nephrectomy due to benign lesion, 5 cases were performed radical nephrectomy due to malignancy.All the cases were performed by robot-assisted laparoscopic surgery transperitoneally.Results The surgery of all 9 cases were successfully completed, and no conversion to open surgery.The median operation time was 104-215 min, with an average of 129 min.The estimated blood loss was 50-350 ml, with an average of 120 ml, and there was no blood transfusion.The warm ischemia time was 10-28 min, with an average of 18 min.There was no intraoperative complication occurred.The postoperative length of hospitalization was 8-17 d, with an average of 12 d.One case of urine leakage and another one of secondary hemorrhage were found after operation.The drainage tube and urinary catheter were removed in 3-5 days postoperation.The pathology analysis confirmed that 7 cases were renal clear cell carcinoma, one case was papillary carcinoma and one was angiomyolipoma, the tumor surgical margin was negative in all cases.The follow up duration was 1-12months, no recurrence or metastasis occurred.Conclusions Robot-assisted partial nephrectomy represents a safe and effective minimallyinvasive treatment option for kidney neoplasms in patients with a solitary kidney, which provided reliable cancer control and renal function preservation.

Objective To investigate the diagnostic value of fine needle aspiration biopsy for children with thyroid nodules.Methods Eleven children with thyroid nodule were examined by fine needle aspiration biopsy.The cytologic features of thyoid nodules were observed by the light microscope.The pathological sections of thyroid nodules were acquired and compared with fine needle aspiration biopsy.Results Eleven cases were diagnosed by fine needle aspiration biopsy including nodule goiter 4 cases,papillary thyroid carcinoma 2 cases,follicular adenoma 2 cases,medullary carcinima 1 cases,Hashimoto′s thyroiditis 1 case and cyst 1 case.Compared with pathological section,10 cases were diagnosed correctly and one was misdiagnosis.Conclusion Fine needle aspiration biopsy is a valuable methods to the diagnosis of children with thyroid nodules.

Objective To assess the clinical application values of the protcin markers associated with Down syndrome (DS) in maternal serum which were screened and identified.Methods Seven maternal serum samples with DS fetus ( DS group) and 7 maternal serum samples with normal fetus ( control group) in the second trimester were separated by two-dimensional gel electrophoresis (2-DE).The differentinal expression profile of proteome in maternal serum from DS group was established.The differentially expressed proteins were screened by mass spectrometry (MS) and some proteins were verified by Western blotting (WB).Results Twenty-nine proteins were discovered to be differentially expressed by more than 1.5 folds in maternal serum from DS group,among which 19 proteins were up-regulated and 10 proteins were downregulated.Eight proteins displayed 2 or more folds changes in maternal serum from DS group were identified by MS and possibly matched with 12 proteins in Ameracan National Center of Biotchnology Information (NCBI) protein sequence database,such as dGTPase and Beta2-Glycoprotein Ⅰ (β2-GPI),etc.The resuhs of WB showed that the mean a values of dGTPase and β2-GPI were 21 567.0 ± 3009.4 and 22 097.0 ±3958.9 in the DS group,3957.7 ± 250.9 and 1799.7 ± 105.5 in the control group respectively,which presented that the expression of dGTPase and β2-GPI significantly increased in DS group (t'dGTPase =- 17.66,t'β2-GPI =- 14.83,P ＜0.0001 ).Conclusions 2-DE and MS are effective methods for preliminary identification of protein markers associated with DS in maternal serum.dGTPase and β2-GPI verified by WB laid a solid fundation for further screening new biologic markers for early diaglosis of DS.

Objective To investigate the effect of whole-body irradiation with low-dose γ-rays on the central nervous system of mice.Methods Fifty C57 mice were randomly divided into 3 groups and treated with 0,0.5,1 Gy whole-body irradiation,respectively.24 or 48 h after irradiation,brain tissue of mice was resected and homogenated.The levels of amino acid neurotransmitter,including Glu,Asp,GABA and Gly in brain homogenate were measured by high performance liquid chromatography (HPLC).Results Compared to the brain tissue of untreated mice,the contents of Glu and Asp at 0.5 and 1 Gy (t=-4.080,-3.935,-4.416,-3.630,-4.831, - 4.656,P ＜0.05) in mice brain tissue significantly increased at 24 h at 1 Gy and 48 h.However,the contents of Glu and Asp had no obvious changes in mice brain tissue 24 h after 1 Gy of irradiation. The contents of GABA and Gly had no difference between irradiated groups and untreated control group. Conclusions Short-term whole-body irradiation with low-dose γ-rays induces slight stimulation effect on the central nervous system of mice.

Objective To study the differences between renal clear cell renal cell carcinoma (CCRCC)and angiomyolipoma (AML)with minimal fat,whose size were both smaller than 3cm and the lesions center were both located outside the renal contour. Methods 6 cases of CCRCC and 18 cases of AML with minimal fat were analyzed retrospectively.All the lesions were confirmed pathologically.The morphological characteristics,plain and enhanced CT values were obtained for compare.Results The lesion length diameter,morphology,the early excretory phase CT value and the pattern of enhancement were not significant different between the two groups (P>0.05).There was significant difference in the focal cystic and necrotic between CCRCC group and AML group (P<0.05).Plain scan density,enhanced uniformity,pseudo capsule sign,plain CT values,medullary junction CT value and the pattern of enhancement from medullary junction phase were statistically different between those two groups (P< 0.001).Conclusion The focal cystic and necrotic,plain scan density, enhanced uniformity,pseudo capsule signs,plain CT values,the cortex and medullary junction CT value and the enhanced amplitude were very important role in differential diagnosis of CCRCC and AML with minimal fat.

OBJECTIVETo compare the clinical outcomes of anterior cervical decompression plus sublevel fusion and posterior cervical laminoplasty in treating multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 56 patients with multilevel cervical spondylotic myelopathy were retrospectively analyzed from July 2009 to June 2012. There were 32 males and 24 females, aged from 42 to 79 years old with an average of (56.9 +/- 12.8) years. All patients had the typical clinical features of cervical spondylotic myelopathy,radiological evidences, and courses of disease were from 2 months to 16 years with an average of (10.6 +/- 3.2)years. Of them,34 patients were treated with anterior cervical decompression plus sublevel fusion (anterior fusion group) and 22 patients with posterior cervical laminoplasty (posterior laminoplasty group). JOA score and radiological data were used to evaluate the clinical results:

RESULTSNo complications about nerve and blood vessel was found and the patients were followed up from 24 to 36 months with an average of 28.6 months. In anterior fusion group, the cervical anterior column height was significantly increased and the anterior cervical curvature angle was significantly decreased at 2 weeks after surgery (P < 0.05). In posterior laminoplasty group, there was no significant difference in above items between preoperative and postoperative at 2 weeks,final follow-up. Postoperative at 2 weeks and final follow-up, there was significant difference in anterior cervical curvature angle between two groups (P<0.05). Postoperative JOA score had obviously improved in all patients, at 3 months after operation and final follow-up, anterior fusion group was better than that of posterior laminoplasty group (P < .05).

CONCLUSIONThe anterior sublevel fusion can effectively restore cervical anterior column height, and compared with the posterior cervical laminoplasty, it can obviously improve the spinal cord function. It is an effective method for the multilevel cervical spondylotic myelopathv.

Adult ; Aged ; Case-Control Studies ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spinal Fusion ; Spondylosis ; diagnostic imaging ; surgery

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.