Retinoblastoma is the most common pediatric retinal tumor initiated by biallelic inactivation of the retinoblastoma gene ( RB1 ) , affecting roughly 1 in 15000 children with 1100 new cases each year.In China, RB remains a potentially devastating disease while lack of early diagnosis and aggressive treatment strategies.Moreover, RB patients individually show a variety of drug response to regular systemic chemotherapy since intensive chemotherapy and long-term follow-up are not as readily available.The majority of patients with advanced diseases require enucleation which affects the future quality of children life.Recent studies showed that alterations in genomics and epigenomics of RB play very important roles in RB progress and therapy.We thereby review current understanding changes of genomics and epigenomics in RB as potential prognostic and therapeutic targets.

Objective To evaluate the intraoperative opioid-sparing effect of different frequency transcutaneous electrical acupoint stimulation (TEAS) in the patients undergoing video-assisted thoracoscopic pneumonectomy.Methods Eighty patients,aged 40-64 yr,weighing 50-90 kg,of ASA physical status Ⅰ-Ⅲ,scheduled for elective thoracoscopic pneumonectomy under general anesthesia,were randomly divided into 4 groups (n =20 each) using a random number table:control group (group Con),stimulation on Lieque (LU7)-Quchi (LI11)-Neiguan (PC6)-Hegu (LI4) at 2/100 Hz group (group 2/100 Hz),stimulation on LU7-LI11-PC6-LI4 at 2 Hz group (group 2 Hz),and stimulation on LU7-LI1 1-PC6-LI4 at 100 Hz group (group 100 Hz).The patients in group Con had the electrodes applied,but received no stimulation.In 2/100 Hz,2 Hz and 100 Hz groups,the patients received 2/100,2 and 100 Hz TEAS on LU7-LI11-PC6-LI4 acupoints ipsilateral to the surgery site,respectively,starting from 30 min before induction of anesthesia until the end of surgery,and the intensity was the maximum current that could be tolerated.Anesthesia was induced with iv midazolam,propofol,sufentanil and cisatracurim,and maintained with target-controlled infusion of remifentanil and propofol,continuous infusion of cisatracurim,and iv boluses of sufentanil when necessary.The target plasma concentration of propofol was adjusted to maintain BIS value at 40-60 during operation.The initial target effect-site concentration of remifentanil was 1 ng/ml,and adjusted to 4 ng/ml at skin incision.The concentration of remifentanil and consumption of sufentanil were adjusted to maintain Analgesia Nociception Index (ANI) at 50-70.When the concentration of remifentanil was increased to 4 ng/ml,ANI was still less than 50,and then 0.1 μg/kg sufentanil was given.The duration of operation and intraoperative consumption of remifentanil and sufentanil (the consumption of sufentanil was converted to the consumption of remifentanil producing the equivalent effect by 1:10) were recorded.Results The intraoperative consumption of remifentanil was significantly reduced in 2/100 Hz group as compared with Con,2 Hz and 100 Hz groups.There was no significant difference in the intraoperative consumption of remifentanil between Con group,2 Hz group and 100 Hz group.Conclusion The use of 2/100 Hz but not 2 and 100 Hz TEAS on LU7-LI11-PC6-LI4 significantly reduces intraoperative opioid consumption in the patients undergoing video-assisted thoracoscopic pneumonectomy.

Objective To investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) on early postoperative lung function in patients undergoing video-assisted thoracoscopic pneumonectomy.Methods Sixty ASA physical status Ⅰ or Ⅱ patients whose preoperative forced expiratory volume in 1 second (FEV1) ＞ 1.5 L,scheduled for elective video-assisted thoracoscopic pneumonectomy under general anesthesia,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group C),Lieque (LU7)-Quchi (LI11)-Neiguan (PC6)-Hegu (LI4) group (group S1),and Xinshu (BL1S)-Feishu (BL13)-PC6-LI4 group (group S2).TEAS was applied to the corresponding acupoints on the operated side for 30 min once a day starting from 30 min before induction of anesthesia until the end of surgery,and on 1 st and 2nd days after surgery in S1 and S2 groups.The frequency was 2/100 Hz,the intensity was the maximum current that could be tolerated,and the intensity was about 6-18 mA for LU7,LI11,PC6 and LI4,or about 20-35 mA for BL15 and BLI3.Patient-controlled intravenous analgesia was performed to maintain the score for the intensity of pain ＜ 4.Before and after surgery,forced vital capacity (FVC) and FEV1 were measured after the chest tube was withdrawn and the changing rate was calculated.Results FEV1 and FVC were significantly lower after surgery than before surgery in all the groups (P ＜ 0.05).There was no significant difference in FEV1 and FVC before and after surgery and the changing rate between the three groups (P ＞ 0.05).Conelusion TEAS (applied during surgery and within 2 days after surgery,30 min/d,2/100 Hz) provides no obvious improvement in early postoperative lung function for the patients undergoing video-assisted thoracoscopic pneumonectomy.

Objective To compare the intraoperative opioids-sparing effects of transcutaneous electrical acupoint stimulation (TEAS) of Lieque (LU7)-Quchi (LI11)-Neiguan (PC6)-Hegu (LI4) versus Xinshu (BL15)-Feishu (BL13)-PC6-LI4 in patients undergoing video-assisted thoracoscopic lobectomy.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 34-83 yr,weighing 50-93 kg,scheduled for elective video-assisted thoracoscopic lobectomy,were randomly divided into 3 groups (n =20 each):control group (group C),LU7-LI11-PC6-LI4 group (group S1),and BL15-BL13-PC6-LI4 group (group S2).TEAS was applied to the corresponding acupoints on the operated side starting from 30 min before induction of anesthesia until the end of operation in S1 and S2 groups.The wave length was 0.6 ms when the frequency was 2 Hz,and the wave length was 0.2 ms when the frequency was 100 Hz.The intensity was the maximum current that could be tolerated,and the intensity was 6-18 mA for LU7,LI11,PC6 and LI4,or 20-35 mA for BL15 and BL13.Anesthesia was induced with iv injection of midazolam,propofol,sufentanil and cisatracurium and maintained with target-controlled infusion of remifentanil and propofol,iv infusion of cisatracurium,and iv boluses of sufentanil when necessary.The plasma concentration of propofol was adjusted to maintain BIS value at 40-60 during operation.The initial effect-site concentration of remifentanil was set at 1 ng/ml and then adjusted to 4 ng/ml at skin incision,and the concentration of remifentanil and consumption of sufentanil was adjusted to maintain Analgesia Nociception Index (ANI) value at 50-70.If the concentration of remifentanil was increased to 4 ng/ml,ANI value was still less than 50,and then sufentanil 0.1 μg/kg was injected intravenously.The time of operation and intraoperative consumption ofremifentanil and propofol were recorded.Results Compared with group C,the intraoperative consumption of remifentanil was significantly decreased in S1 and S2 groups (P ＜ 0.05).There was no significant difference in the intraoperative consumption of remifentanil between group S1 and group S2 (P ＞ 0.05).There was no significant difference in the time of operation and intraoperative consumption of propofol between the three groups (P ＞0.05).Conclusion TEAS of LU7-LI1 1-PC6-LI4 provides similar opioids-sparing effects during operation as TEAS of BL15-BL13-PC6-LI4 in patients undergoing video-assisted thoracoscopic lobectomy.

Objective To investigate the change of serum retinol binding protein 4(RBP4)levels in subjects with metabolic syndrome(MS),and their relationship with the components of MS.Methods Eighty subjects were enrolled and divided into different groups:MS,nonMS(NMS)and healthy controls(C).Subjects' anthropometric parameters,blood pressure,glucose and lipid metabolism parameters and insulin resistance index were measured.Serum RBP4 level,adiponectin(APN),high-sensitivity C-reactive protein(hsCRP)and fasting insulin(FINS)were measured.Homeostatic model assessment of insulin resistance(HOMA-IR)was calculated.A questionnaire was used to obtain participants' medical history and lifestyle information,such as smoking and alcohol ingestion habits.Results Serum RBP4 levels were significantly higher in the MS group compared with the NMS and C group.Males had significantly higher RBP4 levels than females.Serum RBP4 levels were positively correlated with BMI,WC,SBP,DBP,TC,LDL-C,lnhsCRP,lnUAE and smoking,and negatively correlated with ANP.Multiple stepwise regression anlysis showed that sex and BMI were independent related factors influencing serum RBP4 levels.Conclusion Serum RBP4 levels are significantly increased in subjects with MS.In all subjects,RBP4 is positively correlated with adiposity index(BMI,WC),blood pressure,lipid profile(TC,LDL-C),inflammatory indice(lnhsCRP),lnUAE and smoking,and negatively correlated with ANP,which is cardiovascular disease risk factor.RBP4 is independently associated with sex and BMI.

Objective To investigate the effects of exogenous osteopontin (OPN ) the migration of bone marrow mesenchymal stem cells(MSCs) in mice .Methods Using the OPN -/- and wild-type C57 mice ,the MSCs were isolated and cultured .These cells were analysed and sorted by flow cytometry .Then ,Transwell migration assay detected whether OPN can induce the migration of these MSCs .Finally ,the method of Western blot was used to detect the changes of expression of OPN ,CD44 and Integrinβ1 pro-teins .Results The morphology and features of MSCs were proved correctly on 3 passages ,which these cells expressed the proteins of CD44 and CD105 ,but not CD34 .The surface marker antigens were accorded with the general features of MSCs .Compared with OPN -/- mice ,the MSCs significantly increased cell migration in groups of 0 .5 μg/mL OPN and wild type C57 mice ,which was positively related to the times using OPN .Using recombinant OPN protein(0 .5μg/mL) ,expression of related proteins was signifi-cantly increased ,but still lower than the group of wild type mice (P<0 .01) .Compared with OPN -/- mice ,expression of OPN , CD44 ,and Integrinβ1 protein increased significantly different (P<0 .01) in groups of 0 .5 μg/mL OPN and wild type C57 mice . Conclusion OPN can up-regulate the expression of CD44 and Integrinβ1 proteins and promote MSCs migration .

Objective To explore the expression and role of LAT 1 in mouse uterus on early placenta formation on day 8 of pregnancy (D8).Methods One hundred and twenty 6-8-week old SPF female Kunming mice were used in this study.Immunohistochemistry was applied to determine the localization of LAT 1 protein in the mouse uterus on D8 of preg-nancy.The ectoplacental cones (EPCs) were dissected out from D8.5 uterus, and then cultured in vitro with different con-centrations of BCH (2-aminobicyclo-(2,2,1)-heptane-2-carboxylic acid, specific antagonist of LAT1) and L-leucine ( substrate of LAT1) to determine the role of LAT1 during the EPC attachment and outgrowth .Results LAT1 protein was highly expressed in secondary decidual zone and also positively expressed in the mouse uterus on D 8.As a specific antago-nist of LAT1, BCH significantly suppressed the ectoplacental cone outgrowth , whereas L-leucine showed no significant effect on it.Conclusions LAT1 is expressed in the mouse uterus during early placenta formation and promotes ectoplacen -tal cone outgrowth , suggesting that LAT1 may promote the trophoblast invasion into maternal decidual tissue , and partici-pates in the early formation of placenta .

Objective To explore the enhancement pattern and characterization of hepatic hemangionmas with contrast enhanced ultrasound (CEUS).Methods A total of 44 patients with 49 nodules preliminary diagnosed of liver hemangioma were included in this study.For each nodule,the enhancement pattern,level,and dynamic change of CEUS were evaluated,and the features of hemangionmas were groups as echoic and compared with those on CEUS.Results All hemangiomas enhanced in arterial phase with centripetal progression in venous and late phase on CEUS,among which 41 lesions showed peripheral nodular enhancement while 8 showed peripheral rim-like enhancement.The whole-tumor enhancement pattern was seen in 13 lesions and part-tumor enhancement was shown in 36 lesions.The performance of part-tumor was independent of tumor echoic and hypoechoic tumors mostly presented to be whole tumor enhancement pattern.During portal venous and late phase,42 lesions showed hyperenhancement,while 7 lesions showed isoenhancement.Conclusions CEUS can suggest the enhancement dynamic characters of hepatic giant hemangionmas and reveals the relationship of grey-scale echoic and enhancement pattern of hemangiomas.It is important to diagnose the hepatic giant hemangionmas for CEUS.

Objective To observe the change in IL-1β,IL-13mRNA expression in drowning rat lungs and serum,so as to investigate the significance of IL-1β and IL-13 mechanism in the development of drowning.Methods SD rats were randomly divided into control group,drowning group.Then using TaqMan probe method to determine the expression of IL-1β and IL-13 mRNA in Right lower lobe of lung tissue and the serum of right ventricle,which were extracted respectively from each group of rats.Results (1) The lung tissue morphological changes:Typical appearance signs and anatomy of drowning group meet ante-mortem drowning feature.(2) The expression of IL-1β,IL-13 in lung tissue:compared with the control group,the expression of IL-1β and IL-13 were slightly decreased,which has no statistical significance.(3) The expression of IL-1β and IL-13 in serum:compared with the control group,the expression of IL-1β and IL-13 were significant increased,both of which has statistical significance.Conclusion (1)The expression of IL-1β and IL-13 were decreased in lung tissue may be due to drowned rats present compensatory anti-inflammatory response syndrome which causes immune incompetent performance.(2) The expression of IL-1β and IL-13 were significant increased in serum may be relate to drown stress and drowning associated acute lung injury after traumatic stress.

Objective To explore the feasibility of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional (3D) printing model.Methods The retrospective descriptive study was conducted.The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected.Digital imaging and standardized format data of enhanced computed tomography (CT) scan were collected,3D reconstruction of liver and bile duct were done under a 3D printing model,and then a hollow model of bile duct was achieved.Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts.Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration.Results After registration,the scope can be tracked in main hepatic segmental bile ducts.The locations of choledochoscope matched precisely the navigation results.Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.