Objective To inveatigate the expression and clinical significance of microRNA‐204(miR‐204) in human renal clear cell carcinoma(RCCC) .Methods 65 cases of resected RCCC tissue and corresponding normal tumor‐adjacent tissue were col‐lected and detected the expression level of miR‐204 by using qRT‐PCR .The correlation between the miR‐204 expression level and clilicalpathological features was statistically analyzed .The artificial miR‐204 mimics were adopted to stranfect into Caki‐1 cells ,then the Western blot was used to detect the expression of Bcl‐2 a as the downstream potential targets of miR‐204 and SIRT1 mRNA and protein .Results The expression level of miR‐204 in the RCCC tissue was significantly lowere than that in the normal tumor‐adjacent tissues (P<0 .05);the low expression of miR‐204 was significantly associated with the tumor size (>3 cm ,P<0 .05) , lymph node metastasis(P<0 .05) and advanced TNM stage(Ⅲ + Ⅳ ,P<0 .05) .Both the mRNA and protin expression in RCCC Caki‐1 cells were down‐regulated after transfection .Conclusion The expression of miR‐204 is down-regulated in the RCCC tissue and is related to the malignant clinicopathological features ,and miR‐204 may suppress the RCCC genesis and development through down‐regulating the expression of Bcl‐2 and SIRT1 .

Objective: To observe the therapeutic effect of An-pressing and Rou-kneading manipulations for exercise fatigue of the anterior tibial muscle. Methods: Sixty healthy subjects were randomly divided into two groups, 30 in each group. Isokinetic test training was employed to induce left anterior tibial muscle fatigue. After this, subjects in the observation group received 5 min of tuina treatment, while subjects in the control group just lay down for 5 min. Then the integral myoelectricity, maximum amplitude, mean frequency and slope of the anterior tibial muscle and gastrocnemius muscle were measured using a surface electromyography (EMG) during the passive movements of the ankle joints in two groups. Results: Before treatment, the integral myoelectricity, maximum amplitude, mean frequency and slope of the anterior tibial muscle during exercise in two groups were consistent under isokinetic mode (P>0.05). After 5 min of tuina or rest, the myoelectric signals during exercise in two groups were both decreased. However, subjects in the observation group obtained a remarkably increased gain and gain rates of myoelectric signal than the control group (P<0.05). This indicates that the myoelectric signals were not fully recovered, but tuina has a better effect than rest on improving the myoelectric signal of the anterior tibia. Conclusion: Rest and tuina can both improve muscle fatigue. Tuina can obtain a better effect within the same time frame.

Objective To study the feasibility of endoscopic thyroidectomy with bipolar electrocoagulation. Methods Endoscopic partial thyroidectomy via precordial approach, mainly by using bipolar electrocoagulation and scissors, was accomplished in 21 patients with thyroid tumors with a diameter of 0.7～5.5 cm. Results The operation was accomplished endoscopically in 20 patients, whereas a conversion to open thyroidectomy was conducted in 1 patient. The mean incision length was 22 mm, the operation time was 69?47 min, and the blood loss was 55?41 ml. Postoperative analgesic treatment was required in 2 patients and no serious complications happened. Conclusions Endoscopic thyroidectomy with bipolar electrocoagulation is feasible in the absence of ultrasonic scalpel.

Objective To evaluate the feasibility of hand-assisted laparoscopic colorectal resection. Methods Clinical data of 21 cases of hand-assisted laparoscopic colorectal resection in this hospital from October 2003 to August 2004 were retrospectively reviewed. Results The hand-assisted laparoscopic resection was accomplished in 20 cases. The mean operation time was 144 min, the mean blood loss was 120 ml, the mean number of dissected lymph nodes was 8.5, and the mean time to intestinal function recovery, 69 h. Postoperative abdominal bleeding was found in 1 case, which was cured with conservative therapy. A conversion to open surgery was needed in 1 case. Conclusions Hand-assisted laparoscopic colorectal resection safe, feasible, and radical, with advantages of fewer complications and simplicity of performance.

Objective To explore effect of preoperative neutrophil/lymphocyte ratio (NLR) on the prognosis of patients with prostate cancer.Methods A total of 51 cases died included in our hospital as the died group, also included 124 patients survival patients served as survival group.Preoperative total prostate specific antigen (tPSA), free prostate specific antigen (fPSA), albumin, white blood cell (WBC), neutrophil count, lymphocyte count, Gleason score, and NLR were collected.Receiver operating characteristic (ROC) curve was drawn.The function of the index on prognosis was evaluated.Results The average age was 74.0 (9) years in the died group, and 73.6 (11.0) years in the survival group.Gleason score was 8 ～ 10.The patients were followed up for 10 ～ 36 months with a median follow-up time of 23 months.No significant differences in albumin and Gleason score were found between death and survival groups (P ＞0.05).However, the other major indexes had significant differences between two groups (P ＜ 0.01).NLR area under curve (AUC) was 0.835.The NLR boundary value was 2.84, which was higher than the critical value of patients with poor prognosis.Conclusions NLR can predict the prognosis of patients with malignant prostate cancer as auxiliary index.Patients with NLR ＞ 2.83 had poor prognosis.

Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.

Objective To investigate the causes,diagnosis,treatment of the difficult postoperative decannulation resulting from tracheotomy between children and adults and the method of improving the rate of successful decannulation.Methods Clinical data of 56 cases with difficult decannulation after tracheotomy were analysed retrospectively,all the patients were admitted in our hospital between Jan 1990 and Oct 2006.All the patients were separated into two groups,children group including 24 cases of 14 months ～ 14 years old,adult group including 32 cases of age ranging 15 ～ 48 years old.The postoperative time after tracheotomy were 6 month ～ 1.5 year and 6 month ～ 2 year respectively.Results There were differences of the etiology,diagnostic choice and the clinical manifestation in the treatment of the diffficult decannulation after tracheotomy between children and adults.Children with difficult decannulation after tracheotomy occurred mainly in laryngitis and airway foreign body airway caused by obstruction retrieved after tracheotomy (14/24,58.33 ％),followed by the emergency tracheotomy,such as head and neck trauma (7/24,29.17％).Adults with difficult decannulation after tracheotomy mainly occurred in the throat caused by traumatic lesions of the larynx (including malformations,subglottic stenosis of larynx or vocal cord paralysis) (23/32,71.88％).The average block time in children with anti-inflammatory treatment was significantly lower than that in without anti-inflammatory therapy (6.2 d vs 10.1 d,t =4.26,P ＜ 0.01).However,there was no significant difference in the average block time in adults with anti-inflammatory and without anti-inflammatory treatment (t =1.63,P ＞ 0.05).In the course of treatment,rates of children consciously breathing difficulties (21/21,100％) was also significantly higher than the adult group (13/28,46.43％).Conclusion Children less than 3 years old should avoid tracheotomy.There is no definite relation between the successful treatment in the difficult decannulation and the age of the patients over 3 years old.The first failure treatment in children may be related with the local inflammation.When in treatment,doctors should observe the characteristics of respiratory difficulties,take attention to the influence of children psychological factors to the treatment.Children should be treated in the non-traumatic examination methods.

Objective To study the influence of mill speed on extract of ultra- fine powder of Bulbus Fritillariae Cirrhosae. Methods The extraction rate of ultra- fine powder of Bulbus Fritillariae Cirrhosae, which passed a 400- mesh screen, was detected and compared with that passed a 100- mesh screen under different mill speeds. At the same time, mathematical models for extraction established with applied hyperbolic function and Weibuer function were compared. Result The extraction rate of the ultra- fine powder was higher than that of the fine powder when the mill speed was over 70 r/min (P 0.05). Applied hyperbolic function was superior to Weibuer function for the simulation of extraction. Conclusion The mill speed has an influence on the extraction of to ultra- fine powder of Bulbus Fritillariae Cirrhosae, indicating that the effect of divergent function on the extraction should be considered.

Objective:To assess the efficacy and safety of electroacupuncture (EA) at Houxi (SI 3) in treating acute lumbar sprain. Methods: Randomized controlled trials (RCTs) involving EA at Houxi (SI 3) for acute lumbar sprain were retrieved from PubMed (1966-2014), EMBASE (1980-2014), Cochrane Library (Issue 1, 2014), CQVIP Database (1989-2014), Wanfang Digital Journal (1998-2014), the Chinese Biological Medical Literature Database (CBM, 1978-2014), and China National Knowledge Internet (CNKI, 1979-2014). The collection of data also adopted hand-search of the relevant journals from the Library of Shanghai Jiao Tong University. All of the data were first evaluated and extracted by two reviewers independently with a specially designed form. Then, the available data were analyzed by the Cochrane Collaboration's RevMan 5.2.0 software. Results:A total of 6 trials involving 1 288 patients were eligible. Meta-analysis showed that the total effectiveness rate in the EA group was significantly different when compared with Nimesulide [RR=1.33; 95% CI (1.19 to 1.49)] and Mobic [RR=1.08; 95% CI (1.03 to 1.14)], but similar to that of acupuncture at Yaotongdian (EX-UE 7) [RR=71.09; 95% CI (1.00 to 1.19)] and Diclofenac Sodium [RR=1.08; (95% CI 0.96 to 1.21)]. The recovery rate in the EA group was significantly different when compared with Mobic [RR=1.67; (95% CI 1.45 to 1.92)] and Nimesulid [RR=1.37; (95% CI 1.15 to 1.62)], but similar to that of acupuncture at Yaotongdian [(RR=1.35; 95% CI 0.99 to 1.84)] and Diclofenac Sodium [(RR=1.19; 95% CI 0.88 to 1.61)]. Conclusion:Up to the search date, there are few high quality RCTs to evaluate the clinical efficacy of EA at Houxi (SI 3) for acute lumbar sprain, especially studies in English. Yet EA at Houxi (SI 3) still appeared to be an efficacious method for acute lumbar sprain, despite several inherent defects of the included studies. Further large scale trials are required to define the role of EA at Houxi (SI 3) in the treatment of this disease.

Objective To evaluate the short -term efficacy and adverse reactions of gemcitabin combined with nedaplatin to patients with metastatic triple -negative breast cancer after taxane and/or anthracycline treatment. Methods Thirty -three patients with anthracycline and/or taxane -resistant metastatic triple -negative breast cancer received gemcitabin and nedaplatin regimen:gemcitabin 1 000 mg/m2,d1,8 days,intravenous;nedaplatin 80mg/m2,d1,intravenous.Treatments were repeated every 21 days and response rate was evaluated every two cycles. Results Of 33 patients, complete remission ( CR) in 1 case ( 3.03%), partial remission ( PR) in 13 cases (39.39%),stable disease(SD) in 11 cases(33.33%),progressive disease(PD) in 8 cases(24.24%),objective response rate was 42.42%.The main adverse reaction was bone marrow suppression and gastrointestinal reaction. Conclusion Combination therapy of gemcitabin and nedaplatin is an effective and well tolerated rescue regimen in anthracycline and/or taxane -resistant metastatic triple -negative breast cancer patients.