?Retinoblastoma is a common eye malignant tumor which has high degree of malignancy.The traditional treatment methods are destructive, and the prognosis is poor. Hypoxia-inducible factor-1αhighly express in retinoblastoma and regulate the development and progression of retinoblastoma ( by influencing the proliferation and differentiation of tumor cells and involving in the generation of vascular mimicry ) . This article reviewed the role of hypoxia inducible factor-1αin the development of retinoblastoma which will initiate a new avenue for the treatment of retinoblastoma.

Familial non-medullary thyroid carcinoma (FNMTC) is de fi ned as the presence of two or more affected fi rst-degree relatives with non-medullary thyroid cancers without other known familial syndromes. FNMTC is one of the most inheritable forms of all cancers, with a high risk of a first-degree relative developing the disease. Compared with sporadic non-medullary thyroid carcinoma (NMTC), FNMTC presents at a younger age and is associated with a higher incidence of multifocal disease and metastasis. This in-creased aggressiveness has been hypothesized to translate into higher recurrence rates and decreased survival of patients with FNMTC. The genes involved in the pathogenesis of FNMTC are yet to be elucidated, although some recent studies identified several predisposi-tion loci with a high degree of genetic heterogeneity. Since 2005, next-generation sequencing (NGS) technologies have been developing as rapid, high-throughput, and cost-effective approaches to fulfill medical sciences and research demands. With the use of NGS, the un-derlying causative genes can be directly distinguished via systematic filtering, through which the identified gene variants are verified for novelty and functionality.

Objective : To understand the prevalence of overweight and obesity, and the influencing factors among students aged 7-22 years in Zhejiang Province. Methods : Stratified random cluster sampling was used to randomly select students aged 7-22 years in 11 prefectures of Zhejiang Province in 2019. Height and weight were measured. The general information, dietary habits and living habits of students were collected using the Student Health Status and Influencing Factors Questionnaire. The multivariate logistic regression model was used to analyze the influencing factors of overweight and obesity. Results : A total of 33 800 respondents were included, 7 685 (22.74%) were overweight/obese, 4 729 ( 13.99% ) were overweight, and 2 956 ( 8.75% ) were obese. The multivariate logistic regression analysis suggested that boys ( OR=2.059, 95%CI：1.949-2.175), not living on campus( OR=1.306, 95%CI: 1.214-1.405), history of alcohol consumption ( OR=1.158, 95%CI：1.083-1.238 ), average daily consumption of sugar-sweetened beverages in the past week ( less than once, OR=1.214, 95%CI: 1.103-1.336; once and more, OR=1.431, 95%CI: 1.259-1.626 ), average daily consumption of fries in the past week ( less than once, OR=1.171, 95%CI: 1.065-1.288; once and more, OR=1.266, 95%CI: 1.102-1.454 ), and average daily consumption of sweets in the past week (less than once, OR=0.727, 95%CI: 0.658-0.802; once and more, OR=0.504, 95%CI: 0.444-0.572) were associated with overweight and obesity in students. Conclusion The prevalence rates of overweight and obesity among students aged 7-22 years in Zhejiang Province are 13.99% and 8.75%, respectively, which are associated with boys, not living on campus, and consumption of sugar-sweetened beverages, fries, sweets and alcohol.

ObjectiveTo explore the changes of serum high sensitive C-reaction protein (HS-CRP) and matrix metalloproteinase-9 (MMP-9) in patients with acute coronary syndrome (ACS) and their effects in nursing.Methods103 ACS patients, including 56 cases of unstable angina (UA)) and 47 cases of acute myocardial infarction (AMI), and other 40 persons (no abnormal results in coronary artery angiography, selected as control group) were examined for serum levels of HS-CRP and MMP-9. The difference among the groups was analyzed.ResultsThe HS-CRP levels of UA group, AMI group and control group were (3.87± 0.76 )g/L, (4.12 ±0.67)g/L and (1.67±0.38)g/L respectively; MMP-9 were (113.25±7.76)ng/ml, (193.09±25.87)ng/ml and (42.05±3.81)ng/ml respectively. The concentrations of HS-CRP and MMP-9 of ACS patients were significatly higher than those of the control group (P<0.01).ConclusionThe changes of HS-CRP and MMP-9 concentrations of ACS patients are remarkable, and may be as the markers to instruct nursing works.

Objective To evaluate the relationship between sternum protection and bone marrow suppression in postoperative radiotherapy for esophageal carcinoma. Methods Total of 98 postoperative patients with thoracic esophageal carcinoma were randomly divided into experimental group (52 cases) and control group (46 cases). All patients were given intensity-modulated radiotherapy (IMRT), with the dose of 50-50.4 Gy. The patients in experimental group were irradiated by 6 fields (4-fields in front, 2-fields behind) which were crossed to avoid direct exposure to the sternum. The patients in control group were irradiated by 5 fields (3-fields in front, 2-fields behind) with front-middle of the field passing through the sternum. Concurrently all patients received 2 cycles of cisplatin chemotherapy. Results Dmean, V20 and V30 of the sternum in the experimental group were (20.21 ±3.60) Gy, (40.78 ±7.19) % and (33.78 ±9.44) %, which were lower than those in the control group [(30.91±5.21) Gy, (81.01±4.81) %, (51.60±6.84) %], respectively (P<0.05). However, the volume and dose distribution of lung, spinal cord and heart were similar between the two groups (P> 0.05). Both the incidence rates of bone marrow suppression at 14th day and 35th day after radiotherapy were significantly higher in the control group (52.2%, 73.9%) than those in the experimental group (28.8 %, 50.0 %) (P< 0.05), and the incidence rate of bone marrow suppression at 7th day after radiotherapy was similar between the two groups. Conclusion Protecting and sketching for sternum in postoperative radiotherapy for esophageal carcinoma can reduce the incidence of bone marrow suppression effectively, which would not increase the radiation dose in the lung, heart and spinal cord.

Objective To investigate the factors affecting health-related quality of life (HRQOL) in patients with chronic liver disease (CLD).Methods HRQOL was measured with SF-36v2 Chinese version.All patients with CLD diagnosed between December 2009 and May 2011 in Liver Research Center,Beijing Friendship Hospital and Digestive Department,Beijing Chaoyang Hospital were enrolled in this study.Patients with CLD were divided into 4 groups according to their Child-Turcotte-Pugh scores:no cirrhosis,Child's classes A,B,and C.Demographic and clinical data were collected in each group.Results A total of 392 patients with CLD and 91 healthy controls were included.HRQOL in patients with CLD was lower than that in healthy controls.Physical component score (PCS) in healthy controls was 54.6 ± 5.5,and in CLD was 47.8 ± 8.8 (t =9.343,P ＜ 0.01).Mental component score (MCS) in healthy controls was 56.4 ± 8.1,and in CLD was 51.7 ± 7.4 (t =5.302,P ＜ 0.01).Increasing severity of CLD from no cirrhosis to advanced cirrhosis was associated with a decrease on HRQOL,PCS scores were 53.1 ± 5.9,48.7 ± 6.6,42.4 ± 7.1 and 37.2 ± 8.9 (F =93.353,P ＜ 0.01) ; MCS scores were 53.2 ± 4.8,52.7 ±6.5,51.8 ±7.5,and 46.8 ± 7.5 (F =11.325,P ＜0.01),for no patients with cirrhosis,Child's classes A,B and C respectively.Stepwise linear regression analysis showed that severity of disease,age,present ascites,present varices,and prothrombin time had significant effects on physical health area (F =100.893,P ＜ 0.010).Severity of disease,female gender,present varices,total bilirubin,prothrombin time and hemoglobin had significant effects on mental health area (F =19.237,P ＜ 0.010).Conclusions Patients with CLD have reduced HRQOL.Increasing severity of CLD is associated with a decreasing HRQOL.Old age,female gender,advanced stage of CLD,present ascites,hyperbilirubinemia and prolonging prothrombin time are risk factors for reducing HRQOL.

Epilepsy is a complications of brain injury or stroke,and is a common diseases in reha-bilitation or neurology department.Transcranial magnetic stimulation as a classical treatment means for stroke or brain injury,but also can promote the recovery of epilepsy.However,there is no clear clinical re-port for safety of epilepsy patients use both donepezil and transcranial magnetic stimulation .The article re-views the literature.Clinicians maybe provided some help.

ObjectiveTo evaluate the efficacy of short-segment transpedicular fixation combined with augmentation vertebroplasty in treatment of thoracolumbar burst fractures. MethodsFrom November 2006 to September 2009, 37 patients with thoracolumbar burst fracture were admitted and received transpedicular fixation combined with calcium sulfate cement augmentation vertebroplasty, and the clinical data including fracture types, complications and following-up results were collected for analysis. The multimethod evaluation strategies involved the anterior vertebral body height, the sagittal Cobb's angle, the restoration of nervous function, internal fixation failure, visual analogue scale (VAS) and Oswestry disability index (ODI) were retrospective analyzed. Results All patients were followed up for average 19 months (range, 14-37). There were no internal fixation failure, loss of reduction, neurological complications in all the patients. In 16 patients with partial neurologic deficits, 14 initially improved at the final follow-up, with no deterioration of neurologic functions. The mean time of calcium sulfate cement obvious absorption and union was 3 months and 5 months postoperatively, respectively. The anterior vertebral body height was 55.40％before surgery and 85.46％ after surgery on average, ended up with 82.35％. The sagittai Cobb's angle was improved from 22.45° to 6.86°, ended up with 9.66° on average. The mean VAS and ODI at the final followup were respectively 1.2 and 20.4 on average. ConclusionShort-segment transpedicular fixation combined with augmentation vertebroplasty appears to be effective in achieving stable biomechanics with high security,which seems to be a feasible option in the management of thoracolumbar burst fractures.

Objective To observe the expression of HER-2 and TOPO-Ⅱα in ovarian epithelial cancer,analyze the correlation between their expression and provide theoretical basis for clinical diagnosis,prognosis and treatment. Methods Expression levels of HER-2 and TOPO- Ⅱα in 10 normal ovarian tissues,20 benign tumors and 58 cases of ovarian epithelial cancers were detected by immunohistochemical method, and their correlations with pathological features were analyzed. Results The positive expression rate of HER-2 in normal ovarian and benign tumor tissues were significantly lower than ovarian epithelial cancers respectively ( 10. 0% , 15.0% VS 46. 6% ;P ＜ 0. 05 ). The positive expression rate of TOPO- Ⅱα in ovarian epithelial cancers was significantly higher than normal and benign epithelial ovarian tumor tissue (53.4% vs 10. 0%, and 15.0%,Ps ＜ 0. 05 ), but we did not find significant difference in the comparison between normal and benign epithelial ovarian tumor tissue ( Ps ＞ 0. 05 ). The expression of HER-2 and TOPO- Ⅱα were significantly correlated with clinical stages, histological differentiation of tumor cells (Ps ＜ 0. 05 ) ,but there were no correlations between the age or histological type. In ovarian cancer tissues, a positive correlation between the expression of HER-2 and TOPO- Ⅱα was observed ( r = 0. 324, P ＜ 0. 05 ) . Conclusion The overexpression of HER-2 and TOPO- Ⅱαplay an important role in ovarian carcinogenesis and development. The expression of HER-2 is positively correlated with TOPO- Ⅱα in ovarian epithelial cancers. Coexpression of the two moleculars may be involved in the development and progression of ovarian epithelial cancer, which should be further studied.

Objective:To understand the patients'satisfaction on catastrophic medical insurance of New Rural Cooperative Medical Scheme ( NRCMS ) , and provide references for effective management and policy improvement. Methods:According to the principles of representative sampling, a questionnaire survey conducted. 484 patients got compensation for catastrophic insurance in 2013 were surveyed, and information of medical costs was analyzed. Re-sults:The average medical cost accounts for 84. 57% of total household expenditure. Mandatory medical expenditure is still high and economic burden of diseases is heavy. This policy has increased the compensation rate, and the actu-al compensation rate increases 4. 79% in three districts. The average score of patients' attitude toward catastrophic medical insurance is (3.95±1.05) points, 88. 43% of patients continue to participate in medical insurance. Con-clusions and suggestions:Patients' satisfaction on catastrophic medical insurance of NRCMS is high. It is suggested that the existing financing modes should maintain stability in the short term, and the compensatory rate should be im-proved reasonably.