Nephroblastoma is one of the most common solid tumours in children,and the gene expression is closely related to the tumorigenesis,development and prognosis.The treatment regimens have been constantly updated,which includes the preoperative chemotherapy,nephron-sparing surgery and targeted therapy of cancer stem cells,aiming to maintain the excellent survival for children being treated for Wilms tumor,while minimizing therapy-related toxicity.This paper reviews the gene expression and treatment on wilms' tumor.

To review the widespread outcomes of the treatment and prevention of amblyopia,especially for the recent large randomized controlled study.By evaluating the factors affecting the results of the trial,we expect this paper may contribute to the treatment and basic research of amblyopia.

The reform in cultivating professional-degree programs in Clinical Medicine Education contributes to the transformation of training mode, which surpasses the connotative bounds of the inherent education management. The personalized training of students has made it more challenging for both the tutor and the faculty to involve in education management, the effectiveness of which is highly valued due to the pressing need for sound medical ethics. Furthermore, the development of information technology calls for the reform of education management as well as the emphasis of student-centered approach. This article summa-rizes the existing problems of current education management mode for master degree programs of profes-sional clinical medical education. In addition, a three-level management system composed of medical experts is brewed and put forth. This system, based on compensation and restraint, assessment and incentive, ser-vice as well as security, is meant to facilitate the training of application-oriented medical talents.

Objective To explore the effect of prospective nursing on preventing constipation for patients with acute myocardial infarction(AMI). Methods 43 AMI patients during July 2008 and June 2010 in our hospital were classified as the observation group, besides the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation, prospective nursing was implemented.Through the retrospective analysis of medical record, 41 of AMI in our hospital during March 2006 and June 2008 were classified as the control group, they were given the nursing routine of the acute myocardial infarction plus routine therapy to prevent constipation and the nursing intervention after occurrence of constipation. The defecation condition was assessed for the two groups of patients on admission and the defecation and mortality rate was compared on the eighth day of hospitalization. Results There was significant difference in constipation and mortality rate between the two groups of patients during hospitalization. Conclusions The prospective nursing for AMI patients to prevent constipation can obviously reduce the incidence of constipation, thus to avoid serious complications caused by constipation and reduce mortality.

The enrollment physical examination,as a real assessment of the physical and health condition for those high school graduates,is of great referencing significance for their major selection.Therefore,during the examination process,medical staff involved should enhance their recognition for relevant legal regulations,and fully respect graduates′ rights of privacy and informed consent,to ensure the impartiality,fairness,reality,and effectiveness of the assessment result,and guarantee the legal rights of high school graduates.

Six five renal graft biopsies were performed routinely in 36 renal transplantation patients with normal renal function 1 and 3 months after transplantation. All the patients were given the immunosuppressive regimen of cyclosporine A (CsA), prednisone (Pred), azathioprine (Aza) and Tripterygium Wilfordii Hook (TW). The histological diagnosis of allograft biopsy was made according to the Banff schema. In 18 45% of the biopsies (12/65), early subclinical rejection or borderline changes were found. There was a significant difference for different dosages of TW, but no difference for the dosages of CsA, Pred and Aza intravenous between patients with pathological changes and those without. The patients with early subclinical rejection or borderline changes, methylpredisolone was given in bolus, followed by the adjustment of immunosuppressive regimens. With this treatment, there was no difference in 5 year survival rate between them and those with normal renal allograft biopsy findings. The routine allograft biopsy helps discover early subclinical rejection and borderline changes in patients with renal transplantation, and beneficial for adjustment of immunosuppressive therapy.

Objective To investigate retrospectively CT,MRI and DSA appearances of giant cell tumors(GCT) of bone in unusual sites,in order to improve the diagnosis of it.Methods CT,MRI and DSA features of GCT in 11 cases proved by surgery and pathology,were retrospectively analyzed.GCTs located in iliac bone in 4,sacral vertebrae in 3,ischial bone in 2, calcaneus and temporal bone in one respectively.Results (1) At CT,the tumors were mainly showed as expanding growth and osteolytic destruction,without periosteal reaction and calcification.(2)At MRI,the tumors were hypo-,isointensity on T_1WI and heterogeneously iso, hyperintensity on T_2WI.Low intensity curvilinear strips inside the tumor on T_1WI and T_2WI were found in 5 patients,and "bright patches sign" on T_2WI were also displayed in 2 cases.(3)At DSA,abundant blood supply to the tumors was demonstrated,the thickened and twisted feeding artery and,"tumor's stain sign" were also found.Conclusion To analyse imaging data synthetically,including CT,MR imaging and DSA,can improve the knowledge of GCT of bone in unusual sites.

Purpose To investigate the adverse reactions and management in the process of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy).Materials and Methods A total of 976 patients with infertility accepting 3D-HyCoSy in Jiangsu Provincial Hospital of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,from December 2014 to August 2016 were retrospectively analyzed.The pain degree was evaluated using visual analog scale (VAS).Adverse reactions,including contrast countercurrent,vomiting,syncope and allergies,were recorded.The relationship between adverse reactions and ultrasound imaging signs was explored.Results There were 66 cases (6.76％) of VAS grade 0,346 cases of mild pain (35.45％),374 cases of moderate pain (38.32％) and 190 cases (19.47％) of severe pain.With the increase in the degree of tubal obstruction,the degree of pain gradually increased.Pain was the most common adverse reaction among patients,followed by vomiting (15 cases,1.54％),syncope (1 case,0.10％),and allergies (1 case,0.10％).The incidence of contrast countercurrent was 12.30％ (120 cases).The adverse reaction incidence of patients with abnormal ultrasound imaging signs was significantly higher than that of patients with normal signs (x2=29.02,P＜0.01).Conclusion With the extensive use of 3D-HyCoSy examination,its clinical application value has attracted a lot of attention,meanwhile,the understanding of its safety and related adverse reactions should also be improved.The state of patients should be closely observed before,during and after 3D-HyCoSy.Medical personnel should watch out for syncope and allergic reactions,and prepare for emergency management.

Objective To investigate the optimal time and molecular mechanism of gene therapy for promoting distraction osteogenesis by observing the effect of gene transfecting at different time on expression of cyclins in mandibular distraction area.Methods Forty eight New-Zealand rabbits were employed.After accomplishing bilateral mandibular distraction osteogenesis model,the rabbits were randomly divided into the group A,B,C and D.The group A,B and C were transfected by recombinant plasmids pIRES-hBMP2-hVEGF165 2 μg(0.1 μg/μL)at the distraction area instantly after operation,on postoperative 4,14 d and given local electroporation stimulation.The four groups entered the consolidation stage after 10 d continuous traction at a rate of 1 mm/d on postoperative 4 d.Three rabbits in each group were respectively sacrificed on 7,14,28,56 d of the consolidation stage.The expression of cyclin A,D1,and E of fresh bone tissue in distraction area were detected by immunohistochemical staining.Results Cyclin A,D1,and E were strongly expressed in the traction gap on 7,14 d of consolidation stage found,which was strongest on 7 d,moreover the group A,B and C were stronger than the group D.The expression in each group was weakened on 28,56 d.The expression on 7 d in the group B was stronger than that in the4 group A,C and D(P<0.05),the expression had no statistical difference between the group A and C(P>0.05),but all were stronger than the group D(P<0.05);the expression in the group B and C on 14 d was stronger than that in the group A and D,but the expression had no statistical difference between the group B and C and between the group A and D(P>0.05).Conclusion The high expression of cyclin A,D1 and E can promote the cellular division,proliferation and differentiation in distraction area,thus accelerates the new bone formation in the distraction area,prompting that the distraction period is the best time for distraction osteogenesis under gene therapeutic intervention.

Objective To investigate the effect of the aqueous extracts from Dioscorea nipponica Makino (AEDN) against the carbon tetrachloride (CCl4)-induced mice acute liver injury by regulating TLR4/MyD88 signal pathway.Methods 60 mice were randomly divided into control group, model group, low, medium and high dose AEDN groups according to radom number table with 10 mice in each group. Mice in low, medium and high dose AEDN groups were adiminstrated with 50, 100 and 200 mg/kg AEDN, in control and model groups were adiminstrated with solvent once a day for 7 consecutive days. Two hours after the last administration, mice were intraperitoneal injected with with 0.3% CCl4 olive oil solution to induce acute liver injury model, except for the mice in control group. Twenty-four hours after injection, the expressions of TLR4, MyD88 and NF-κB in liver tissue were evaluated by Western blot, mRNA levels were evaluated by PCR, and the AST and ALT levels in serum were also detected.Results Compared with model group, the serum AST (98.00 ± 17.75 U/L, 57.49 ± 9.66 U/L, 39.60 ± 9.49 U/Lvs. 113.40 ± 9.71 U/L) and ALT levels (76.00 ± 14.73 U/L, 50.70 ± 9.35 U/L, 35.25 ± 9.93 U/Lvs. 95.42 ± 11.64 U/L) were significantly decreased in low, medium and high dose AEDN groups (P<0.01); MyD88 (0.67 ± 0.21vs. 1.74 ± 0.42), NF-κB p65 (0.51 ± 0.09vs. 1.76 ± 0.31) and TLR4 (0.97 ± 0.25vs. 2.99 ± 0.72) levels were down-regulated in high dose AEDN group (P<0.01); the mRNA levels of IL-6 (2.22 ± 0.25, 1.76 ± 0.31vs. 5.20 ± 0.60), IL-1β (1.96 ± 0.35, 1.47 ± 0.23vs. 7.37 ± 0.99)、TNF-α (2.06 ± 0.25, 1.34 ± 0.33vs. 2.98 ± 0.50) in medium and high dose AEDN groups significantly decresed (P<0.01).Conclusions The AEDN has protective effect against CCl4-induced acute liver injury in mice via adjusting TLR4/MyD88 signal pathway.