Wilms' tumor is the most common kidney tumor in childhood.MicroRNAs (miRNAs) are about the size of 19-22 nucleotide sequences that exist widely in the non-coding RNA in eukaryotes,function primarily through combination with mRNA target base pairing causing target mRNA degradation or inhibition of translation,and then develop his inhibiting or promoting the role of tumor.Abnormal expressions of miRNAs can cause a lot of kidney diseases,such as chronic kidney disease,polycystic kidney disease,renal fibrosis and renal cancer.Wilms'tumor,abnormal expression of key genomes,such as miR-17-92,miR-185,miR-204,miR-48 anomalies and tumors are closely related.Paper of miRNAs in incidence of Wilms'tumor expression,and the possible role for future targeted gene targeted drug sites are reviewed.

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for intraperitoneal bladder rupture.Methods From January 2004 to August 2013,the clinical data and therapeutic methods of 50 patients with intraperitoneal bladder rupture were retrospectively reviewed,inclu-ding 26 cases of laparoscopic surgery and 24 cases of open surgery.The operative time,intraoperative blood loss,postoperative intestinal recovery,hospital stay,analgesic use rate and complication ratio were com-pared between the two groups.Results All surgeries were successfully performed.There were significant differences in intraoperative blood loss [(54.24 ±5.38)ml vs(89.35 ±12.17)ml],intestinal recovery time [(23.24 ±2.39)h vs(38.42 ±6.98)h],hospital stay [(4.64 ±1.42)d vs(7.04 ±1.29)d]and analgesic use rate [38.64%(10 /26)vs 75.00%(18 /24)]between laparoscopy group and open surgery group,respectively(P <0.05 ).No significant differences in operative time [(56.12 ±8.53 )min vs (64.48 ±13.21)min]and incidence of postoperative complication [7.69%(2 /26)vs 8.33%(2 /24)] were observed between laparoscopy group and open surgery group,respectively(P >0.05).Conclusion Laparoscopic treatment of intraperitoneal bladder rupture has the advantages of mini-invasion and rapid re-covery compared with traditional open surgery.

Objective To explore the expression and clinical value of major histocompatibility complex class-Ⅰ related chain A (sMICA) molecule in serum of patients with renal tumor.Methods From March 2013 to July 2013,60 patients with renal tumor,including 37 male patients and 23 female patients were enrolled in this study as experimental group.The mean age was 46 years (range 34-76 years).The pathological diagnosis included renal cell carcinoma in 48 cases and renal angiomyolipoma in 12 cases.The stage classification included T1 stage in 20 cases,T2 stage in 14 cases,T3 stage in 10 cases and T4 stage in 4 cases.Lymphatic metastases were found in 11 cases and metastases in other organs were found in 4 cases.Another 20 healthy volunteers were enrolled as control group,including 10 male and 10 female.The mean age was 31 years (range 24-50 years).The ELISA method was used to detect the soluble MICA's (sMICA) level in serum.And the results were compared with tumor's malice,TNM pathology stages,metastasis.In 15cases with renal cell carcinoma,the expression of MICA molecule in tumor masses and paraneoplastic masses was measured by immunohistochemical (IHC) method.The quantitative expression of MICA-mRNA was detected by RT-PCR in 9 tumor masses and 3 paraneoplastic masses.Results The level of sMICA in renal malignant tumor group was (348.5±32.5) pg/ml,while the sMICA's level in benign renal tumor groups was (289.3±30.4) pg/ml and that in the control group was (168.4±43.2) pg/ml.The level of sMICA in malignant group is statistically higher than that in benign group and control group (P＜0.05).The level of sMICA in T1 、T2 、T3 and T4 stage was (304.3±27.4),(308.4±26.8),(368.3±33.4),(378.4±43.4) pg/ml,respectively.Insignificant difference only demonstrated between T1 and T2 stage.The level of sMICA in those patients with and without lymphatic metastasis was (326.2±32.4),(319.4±32.5) pg/ml,respectively (P＞0.05).Significant difference in the sMICA level could also be observed between patients with other organ metastasis (373.4±45.4) pg/ml and those without metastasis (346.4±31.5) pg/ml (P＜0.05).The IHC results revealed that high expression of MICA molecule in tumor cell.However,this oppsite result was demonstrated in cells located in paraneoplastic tissues.In the results of RT-PCR,the MICA-mRNA level (2.03) in tumor masses was significantly higher than that in pareneoplastic masses (0.77) (P＜0.05).Conclusions MICA highly expressed in renal tumor,and its expression correlates with tumor's malice,TNM pathologic stages,and metastasis.

Objective To investigate the treatment of recipients carrying hepatic virus after renal transplantation. Methods Of the 14 patients, 8 carried HBV and 4 HCV, and the other 2 both HBV and HCV. HBV DNA or RNA was negative before transplantation.Results During the follow-up period of 3 to 20 months, 10 patients had liver dysfunction with higher ALT and AST, but negative for HBV DNA and/or HCV RNA. After adjusting the dosage of immunosuppressants and treatment of liver protection, liver function of these patients all restored to normal level.Conclusion In the hepatic virus carriers receiving renal transplantation, liver dysfunction caused by drug-induced liver damage or hepatic viral injury should be distinguished and corresponding treatment should be given in time.

Objective To explore the significance of complement split product C4d in monitoring chronic rejection of renal allografts in rats.Methods Healthy closed population rats were used as donors and SD rats as recipients. The Wistar to SD model of graft rejection was developed. All the 42 recipients were randomly divided into 2 groups: group A receiving nothing except CsA (5mg?kg~ -1 ? d~ -1 ) in the first 10 days after operation, and group B receiving MMF (10 mg/kg) and CsA after operation. On the 3rd, 5th and 10th week, all the allografts were tested by light microscopy and immunofluorescence. Pathological changes of the kidneys and the expression of C4d in allograft tissue were observed.Results From the 3rd week, the rats in group A showed light pathological changes of chronic rejection and they became more and more obvious as time increased. Pathological changes occurred in group B at the 5th week and lighter than in group A. At the same time, C4d deposition in PTC was obviously observed on the 3rd week in group A, and on the 10th week C4d widespread deposition in allografts.Conclusion The deposition of complement split product C4d in allografts appears earlier than pathological change of chronic rejection, which can be regarded as a significant indicator to predict chronic rejection of renal allografts.

Objective To evaluate the effect of carbon fiber couch on dose distribution of radiotherapy planning and verification pass rate.Methods Establishing the carbon fiber treatment couch model in Pinnacle8.0m Treatment Planning system (TPS),and then this model was used to correct dose calculations of oblique fields in the treatment plans of 10 cases of nasopharyngeal carcinoma,10 cases of breast cancer and 10 cases of lung cancer and evaluate the effect of carbon fiber couch on the whole dose distribution of the plans.Then these plans were measured by three-dimensional dose verification equipment Delta4 to confirm the improvement extent of Gamma pass rate after considering the carbon fiber treatment couch.Results For the majority of plans,when the carbon fiber couch was taken into consideration,the target doses was significantly reduced (4772 cGy-7266 cGy vs.4859 cGy-7347 cGy,P=0.000-0.002) and the relative deviation of D95 was 1％ to 3％.Measurement results of Delta4 showed that Gamma pass rate (3 mm/3％ criteria) increased in all plans (96.4％-98.8％ vs.93.4％-97.3％,P =0.000),some of that were up to 5 percentage when the couch model was applied.Conclusions Target doses will be overestimated if the treatment couch is ignored in TPS measurement.,However it should arouse enough attention when the disease with smaller doses corresponding gradient.

To explore the clinical ,pathological and immunohistochemical features of carcinoma with multi-directional differentiation derived from junction of bladder and prostate .We collected clinical data and tissue samples of three typical cases of carcinoma from our hospital .Routine preparation of slides and immunohistochem-ical methods combined with clinical data and pathological changes analysis were adopted .We found that all 3 ca-ses occurred in the elderly lesions involving the bladder and prostate .Dysuria was the main common symptom .All the cases had a history of chronic inflammation in urethral and prostate gland .The following up data showed that survival time in two of them were no more than 15 months.The third patient without chemotherapy who took drugs of bicalutamide,enantone and pamidronate still was alive after 28 months.The pathological changes of these cases had the common features with diversity .They all showed the structure with nests ,papillary,solid,adenoid,single or syncytial cells .The nuclear of cancer cell was enlarged with hyperchromatic feature .The mitotic figures were easily found.The metaplasia and atypical hyperplasia of prostate were all found .The immunohistochemistry results showed positive results for HCK,LCK,p53,p63,PSA,P504S and negative for vimentin and S -100.The average proliferation index of Ki-67 was 77%.

Objective To explore renal transplantation model in non-human primate cynomolgus monkeys.Methods 50 non-human primates' kidneys were transplanted into the lower part of the abdomen with end-to-side anastomosis of renal artery to aorta and renal vein to inferior vena eava,and with end-to-end anastomosis of ureter to bladder.Results In the 50 cases,1 case death as accident of anesthesia;7 cases with postoperative complications,and all with creatinine sudden rise,after ultrasonic examinations showed that 2 cases with renal vein thrombosis,and 5 cases appeared urinary leakage.All animal models were without surgical infections,and with normal serum creatinine,urine output.Conclusion Non-human primate animal kidney transplantation model establishment method is reliable,but should pay attention to the the surgical technique training,complications prevention.The model is valuable for application in the research of immune tolerance,heterogeneous transplant.

Objective To investigate the development status of tumor radiotherapy in Guangxi Zhuang autonomous region in order to provide reference for the decision-making of the competent administrative departments for public health.Methods A questionnaire survey was conducted by the aid of on-site inspection and telephone or Email investigation among the medical institutions in Guangxi to know the current status of radiotherapy units and settings,human resources,allocation of radiotherapy facilities,and standardization of medical practices.Results Up to the end of August 2014,radiotherapy was carried out in 39 hospitals,with other 5 hospitals under preparation for construction.Among these 40 hospitals were three-dimensional conformal radiotherapy in 38,intensity modulated radiation therapy (IMRT) in 23,and image guided radiation therapy (IGRT) in 5.There were 48 linear accelerators,15 afterloading therapy apparatus,and 4 γ-knife or X-knife in Guangxi.There were 647 professional personnel (except nurses),including 322 radiation oncologists,100 radiotherapy physicists,213 radiotherapy technologists and 12 professional engineers.There were 2 000 to 2 500 hospital beds and 20 000 cancer patients had received radiotherapy in 2013.1 600 to 2 000 people received treatment on average every day.Conclusions The present radiotherapy resources in Guangxi are insufficient and the input to radiotherapy equipment is deficient,with low proportion of cancer patients treated with radiotherapy.Because of the uneven radiotherapy quality among different hospitals,the reasonable planned development and unified diagnostic and treatment practices are required to improve radiotherapy level in Guangxi.For shortage of medical staff and high-quality physical and technical personnel,the improvements are needed by fostering and introduction of personnel.Compared with developed regions in China,the introduction of new technology is largely needed.

Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.