Natural orifice translumenal endoscopic surgery(NOTES)is a surgical technique which is performed with an endoscope passed through a natural orifice,and then through an internal incision in the viscera(stomach,vagina or rectum)to perform intraabdominal operations.Since the first successful transgastric appendectomy performed by Dr.Rao and Reddy in 2004,NOTES is developing rapidly.The advantages of NOTES include no injury and scar in the body surface;lower anesthesia requirements;faster recovery and shorter hospital stays;avoidance of transabdominal wound infections.NOTES can also be applied to patients who are not suitable for open surgery and lapascopic surgery.NOTES has the potential to revolutionize the field of minimally invasive surgery by eliminating abdominal incisions,however,the safety and efficacy of NOTES still needs to be investigated in lhe future.

Fibronectin in normal human breast tissue and in breast tumors were stu-died by immuno-gold silver staining method.In normal mammary tissue,fibronectin was present in basement membrane and stroma but absent in epi-thelial cells.Changed distribution pattern was observed in benign tumorsand malignant tumors,there was an appearance of fibronectin in epithelialcells of acini and ductules and decreased in stroma.The differences wasthat fibronectin decreased in basement membrane in benign tumors and dis-appeared in that of malignant tumors which reflect to some extent the inva-sive nature of tumors.

Objective: To investigate the mechanism of the effect of Linweidihuang Pills on diabetic neuropathy in rat. Methods: The diabetic rats were induced by alloxan. Serum glucose was tested by glucose oxidase and sciatic nerve sorbitol was determined by GC. Results: After Liuweidihuang Pills,0.5～2g/kg taken orally for 3 months, the level of sciatic nervous sorbitol and serum glucose in rat decreased significantly and the results showed certain dose effect relationship.Conclusion: Liuweidihuang Pills can controll diabetic neuropathy by inhibiting sorbitol biosynthesis.

ObjectiveTo investigate the application and effect of problem-based learning ( Problem-based learning,PBL ) pedagogy in theoretical teaching of pediatric nursing.MethodsThe two nursing classes in the same grade were selected respectively as a control group of 62 people and research group of 62 people.Traditional pedagogy was taken in control group to give lessons for theory pediatric nursing,while PBL pedagogy was taken in research group to give lessons ftr theory pediatric nursing.At the end of the semester,students' scores in theory exam,practice exam and case care were analyzed by using t tests.ResultsThe results of the two groups of students were compared,with t value 4.96 of the theoretical results,t value 5.312 of the experimental results,t value 8.06 of the case study,and P ＜0.05 in three items,suggesting statistically significant difference.ConclusionsPBL pedagogy can raise nursing students' learning interest in the theory of pediatric nursing,and improve teaching effect on theory of pediatric nursing.

Microwave ablation(MA)has been one of the most quickly developed minimally invasive techniques for trearing hepatocellular carcinoma(HCC)in the last decade.Under accurate imaging guidance,MA shares the common advantages of thermal ablation such as flexible treatment approaches,good tolerability and the ability to consistently create reproducible and predictable necrotic areas.It also exhibits several particular advantages compared with other thermal ablation methods,including higher thermal efficiency,higher capability of coagulating blood vessels,faster ablation time,and an improved convention profile.Over the years,MA equipments,especially the antenna,have been refined for safety and to increase the coagulation zone.With the development of internally-cooled antenna and using the frequency of 915 MHz nficrowave,the technique is becoming safer and the coagulation zone increased significantly.Initially,MA was limited to the treatment of small HCC,but with the improvement of antenna and treatment strategV,large HCC(＞5 cm)can also be ablated effectively.For the"curative"treatment of HCC.the following eriteria need to be met:single HCC with the lesion of 6 am or smaller;three or fewer HCC lesions with a maximum diameter of 4 cm,and absence of portal vein thrombosis or extrahepatic metastases.A five-year cumulative survival rate has exceeded 50%,which is comparable with resection.Moreover,the local immune function is enhanced after MA.A change in immunocyte infiltration takes place in number,configuration and location after patients with HCC are treated with MA.Further research for MA may be focused on the improvement of the maneuverability of the equipment,increase of the accuracy of antenna puncture and consummate the clinical therapeutic standardization.

OBJECTIVE:To control the drug quality risk in drug withdrawal links of hospital pharmacy,and provide reference for the application of quality risk management(QRM)in hospital pharmacy. METHODS:Drug QRM was developed in drug with-drawal links through risk identification,risk assessment,risk control,risk assessment and other steps. Using the incidence of risk factors and reusable rate of withdrawal drug as indexes,related data of before(Jul.-Dec. 2015)and after(Jan.-Jun. 2016)devel-oping QRM in our hospital were compared to evaluate the effect of drug QRM. RESULTS:Determining whether specific storage drugs kept the required storage conditions,whether the numbers of withdrawal drugs counted to minimal packaging and other 5 fac-tors were high-risk factors(the risk score of each factor>4 points);control measures were taken separately for high risk factors, then high-risk factors were reduced to acceptable levels(risk score<4 points). After developing QRM,the incidence of risk factors were reduced than before(reduce 1.35%-6.19%),reusable rate of withdrawal drug was increased(98.64% vs. 86.32%)(all P<0.05). CONCLUSIONS:Developing QRM in drug withdrawal links of hospital pharmacy can reduce the drug quality risk.

Objective To investigate the effect of down-regulation of transient receptor potential melastatin 8 (TRPM8) on the proliferation and apoptosis of human bladder transitional cell carcinoma cells T24.Methods shRNA targeting TRPM8 was designed and synthesized, and then transfected into the T24 cells via lipofectamine 2000 mediation.The proliferation and apoptosis of T24 cells were detected with methyl thiazolyl tetrazolium (MTT) assay and flow cytometry.Expression of extracellular regulated kinase (ERK), cyclin D1, and Bcl-2 were detected with Western blot.Results TRPM8-targeted shRNA downregulated TRPM8 expression of T24 cells.MTT assay showed a significant acceleration of the proliferation of shRNA interference group compared to blank and control groups (P ＜0.01).Compared to control group, cell apoptosis rate was significantly higher in shRNA interference group (P ＜ 0.01).In addition, the expressions of PI3K, cyclin D1, and Bcl-2 were decreased in shRNA interference group.Conclusions Down-regulation of TRPM8 can induce inhibition of proliferation and promotion of cell apoptosis in human bladder transitional cell carcinoma cells T24 via regulating PI3K.It might be regarded as a novel target for clinical diagnosis and gene therapy of bladder cancer.

Acute lymphoblastic leukemia (ALL) is a common hematopoietic malignancy. The initial complete remission rates of adult ALL reach over 80%, but most of the patients eventually relapse and the long-term survival re-mains poor. This article reviewed advances in the biological features and treatment of adult ALL during the past decade with a view to further improving the survival quality rate of the patients.

Osteopontin (OPN), a phosphorylated and glycosylated protein, is a prominent matricellular component of the extracellular matrix of mineralized tissues of bones and teeth, in which they can regulate the formation and growth of hydroxyapatite crystals and influence a variety of cell activities. Recent studies have reported that the expression of OPN is not only correlated with bone formation and bone resorption but also with tumor aggression and metastasis in several types of human cancer, and OPN is even considered to be an index for the diagnosis and prognosis of tumor. The roles of OPN in angiogenesis were also reviewed.

With the development of thermal ablation techniques,thermal ablation has been a curative method in the treatment of liver cancer.Preoperative treatment planning as the first step in the thermal ablation process,its core purpose is to lower the complications,ensure tumor-free safety margin after ablation and improve patients' long-term survival.Preoperative treatment planning determines directly the effect of thermal ablation therapy.Preoperative treatment planning is significant to improve the accuracy and sci entific of thermal ablation therapy.Therefore,preoperative treatment planning of thermal ablation for liver cancer has become one of the research focuses in the thermal ablation fields.This review focuses on the treatment planning studies of image-guided thermal ablation for liver cancer in recent years.