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.

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.

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.

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.

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.

Kidney transplantation is a high-cost and high-risk surgery,thus genuine informed consent from the patients and their family members is indispensable both for protecting rights of patients and ensuring medical safety.Guided by related regulations and ethical guidelines,this paper proposes necessary information which should be provided for patients,one example of Informed Consent Form(ICF) composing of information sheet,and consent signature form offered for reference.The proposed ICF applies three accepted requirements for informed consent,i.e.,completely being informed,fully understood and free to make choice.

Objective To investigate the clinical efficacy of autologous fat transplantation in augmentation mammoplasty with two different methods of purification treatment .Methods Selected 86 patients undergoing autologous fat granule replant mammaplasty .They were randomly and equally divided into the centrifuge group and the static group .After extracting the body fat in the centrifuge group ,obtained the high purity granular fat by using the Centrifugal technique;After the extraction of autologous fat in the static group ,obtain the purified particle fat by using the natural static suspension and physiological saline washed the im‐purities .Respectively ,the processed fat was injected the breast of two groups with multi tunnels and multi layers .After 6 months compared the clinical efficacy of two groups by evaluating the survival rate of autologous fat in augmentation mammoplasty and pre‐operative and postoperative breast volume ,the change of breast shape and patient satisfaction .Results Two groups of patients were successfully completed surgery ,and postoperative wound healed well .After 6 months ,in the centrifuge group and the static group the survival rate of autologous fat was 74 .42 ± 6 .35 and 65 .12 ± 5 .83 (P<0 .05) ,the satisfaction rate was 88 .37% and 76 .74%(P<0 .05) ,respectively .Conclusion The augmentation mammoplasty by injecting autologous fat granules in will not produce im‐mune rejection and surgical scar ,the breast shape is good and can be repeated without satisfactory ,until the desired effect is a‐chieved .The Centrifugal autologous fat can increase the survival rate of fat and patients′satisfaction ,which is suitable for clinical application .

Objective:To evaluate the left ventricular segmental strains,global strains and systolic function in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention(PCI)with three-dimensional speckle tracking echocardiography(3D-STI),and to clarify the characteristics of early myocardial strain changes after PCI and their clinical values.Methods:Thirty patients received PCI for left anterior descending branch disease were enrolled as case group;at the same period, 30 healthy middleaged and elderly people were selected as control group.After two-dimensional ultrasound data were obtained regularly, the myocardial motion and systolic functions of the patients in two groups were detected with 3D-STI, and all segmental strain, global longitudinal strain(GLS), global radial strain(GRS), global circumferential strain (GCS)and global area strain(GAS) values of left ventricle and left ventricular ejection fraction (LVEF) values were collected.Results:Compared with control group, the global strain values of the patients in case group were lower than those in control group;9/16 longitudimal strain(LS), 8/16 circumferential strain(CS), 5/16 radial strain(RS) and 11/16 area strain(AS) were significantly lower than those in control group(P<0.05).The decrease of strain value was mainly concentrated in the anterior segment of the anterior wall, the anterior segment of the anterior wall, anterior apical segment, anterior septal basal segment, anterior septal segment, posterior septal basal segment, posterior septal segment, and posterior septal segment.The GLS,GAS and GCS in case group were negatively correlated with LVEF(r=-0.819,r=-0.897,r=-0.807,P<0.0001);the GRS was postively correlated with LVEF(r=0.862,P<0.0001).Conclusion:3D-STI can quantitatively analyze the segmental wall motion of left ventricle and could apply the parameters to evaluate the therapeutic efficacy after PCI.

Objective To analyze the effect of the rhinoplasty on body image in the patients receiving cosmetic surgery,to investigate the change of postoperative body image disturbance(BDD)and to analyze the influencing factors of preoperative BDD in order to provide a basis for the psychological health management and reference for the diagnosis and treatment of plastic surgery.Methods A prospective study was performed on 84 patients with rhinoplasty admitted to the Affiliated Friendship Aesthetic Plastic Surgery Hospital of Nanjing Medical University from January 2015 to March 2016.The general data were investigated.The Plastic Psychological State Self-rating Scale was adopted to evaluate the patient′s body image situation,which was reexamined at postoperative 1-3 months.Results The preoperative non-BDD accounted for 60.71％,the occurrence rate of BDD was 19.05％,the other mental disorders,mental diseases or nervous system disease which had no relation with the BDD accounted for 20.24％;the occurrence rate of postoperative BDD was significantly lower than that of preoperative BDD(P＜0.05),moreover the patients with non-BDD had no postoperative BDD occurrence.The scores of question 1-10 before operation in the BDD group were higher than those in the non-BDD group,the scores of question 1-4 after operation in the non-BDD group were decreased,the scores of question 1-4,6-10 in the BDD group were decreased,while the scores of question 1,7,9-10 in the BDD group were higher than those in the non-BDD group(P＜0.05).The proportion of preoperative rhinoplasty and plastic surgery in the BDD group was higher than that in the non-BDD group,the difference was statistically significant(P＜0.05).Conclusion The occurrence rate of BDD in the patients with rhinoplasty is higher,operation is conducive to lessen the BDD,moreover operation itself will not result in new BDD.