Phosphatidylinositol 3-kinase,Akt,and the mammalian target of rapamycin (PI3K/Akt/mTOR)signaling pathway is shown to play a key role in the tumorigenesis,proliferation,metastasis,apoptosis,and angiogenesis of hepatocellular carcinoma (HCC)by regulating gene expression.The components and functions of PI3K/Akt/mTOR signaling pathway are briefly described,and the research advances in the action mechanism of PI3K/Akt/mTOR signaling pathway in the progression of HCC and related inhibitors are reviewed.It is disclosed that blocking the PI3K/Akt/mTOR signaling pathway may become a new therapy for HCC.

Objective To analyze the clinical characteristic,treatment and prognosis of traumatic macular holes resulted from ocular contusion.Methods The clinical data of 47 cases with traumatic macular hole was retrospectively reviewed.The general condition of the patients was summarized,optical coherence tomography and multifocal electroretinogram (mfERG) were used to evaluate anatomic and functional outcomes.The patients were divided into observation group and surgery group by the treatment they received,and the prognosis was evaluated.Results Traumatic macular hole occurs mainly in male.In the observation group,the mean diameter of macular hole was(490.0±86.9) μm.During the 12 month follow up,the holes in 7 cases (33.3％) were closed spontaneously,Vision and diameters of 14 cases (57.1％) maintained stable for a long time,the vision of 1 case (3.3 ％) declined mildly and the diameter of 1 case (3.3％) enlarged slightly.Visual acuity was improved significantly at last follow up (Z=-2.40,P＜ 0.05).The amplitudes of N1 wave of mfERG increased both in central fovea and macular area(t=13.30,5.06;P＜0.05).These data suggests that the macular function was recovered well.In the surgery group,the mean diameter of macular hole was (643.3 ± 125.0) μm and statistically larger than that of the observation group (t=-4.76,P＜0.05).At the last follow-up,visual acuity were not improved significantly (Z=-1.79,P＞0.05).The amplitudes of N1 wave in 6 cases (23.1 ％) improved merely and the difference was not statistically significant (t =1.98,P ＞ 0.05).These data suggests that the macular function was recovered slightly only in a few patients.Conclusions A part of the patients with smaller diameters of macular holes may close spontaneously,and they may get better visual acuity.Vitrectomy may help to close the macular holes in some severe cases,but the improvement of functional outcomes is not significant.

Objective:To investigate the priorities of each factor influencing the casualties in refugees living in border areas, so as to provide evidence for casualty forecasting in the refugees. Methods: We summarized the factors affecting the refugee casualty in the border area through searching and reviewing the related literatures. The identified factors were classified into 3 levels and the quantitative index system was established by using Delphi method, i.e. expert consulting method. The names and the meanings of each index were revised according to experts’ suggestions after 3 rounds of consulting. The weights of each index were determined by analytic hierarchy process (AHP) and comparing-reordering method. Results: A 3-level quantitative system was successfully constructed, which consisted of 4 first level indices (including natural factors, social factors, medical factors, and war factors), 12 second level indices, and 37 third level indices; the weights of all indices were determined. Conclusion: The result of our study can be used in predicting refugee casualty and provide a reference for the medical service of refugees living in the border areas.

A literature review of the criteria for discharge after the day ambulatory surgery includes four aspects, which are the importance and significance, the scoring system, the physical and mental exam, and the risk factors for delayed discharge. The results are the basis for the further research.

OBJECTIVE:To systematically review the efficacy and safety of Danshu capsule in the treatment of chronic chole-cystitis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Li-brary,Web of science,CJFD,CBM,VIP Database and Wanfang Database,randomized controlled trials(RCT)about Danshu capsule versus other medicines in the treatment of chronic cholecystitis were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extracting and quality evaluating by Cochrane 5.1.0. RESULTS:Totally 12 RCTs were enrolled,involving 1140 patients. Results of Meta-analysis showed the cure rate of Danshu capsule in the treatment of chronic cholecystitis was higher than control group,there was statistically significant difference between 2 groups [RR=1.62,95%CI(1.33,1.96),P<0.001];total effec-tive rate in Danshu capsule group was higher than Ursodeoxycholic acid tablet group[RR=1.37,95%CI(1.14,1.64),P<0.001], Xiaoyan lidan tablet group [RR=1.40,95%CI(1.24,1.58),P<0.001],Jindan tablet group[RR=1.13,95%CI(1.04,1.23),P=0.005] and Danning tablet group[RR=1.16,95%CI(1.05,1.28),P=0.004],there were statistically significant differences among groups. Incidence of adverse reactions of Danshu capsule was lower than control group,there was statistically significant difference between 2 groups [RR=0.20,95%CI(0.12,0.34),P<0.001]. CONCLUSIONS:Both efficacy and safety of Danshu capsule are good in the treatment of chronic cholecystitis.

Objective:To study the effectiveness and safety of different acupuncture therapies in treating Posttraumatic stress disorder(PTSD)after Wenchuan‘5.12’earthquake.And choose a desirable acupuncture therapy.Methods:A total of 276 patients were recruited in this trial and randomly divided into four groups:scalp electric acupuncture group(group A),scalp electric acupuncture with moxibustion group(group B),scalp electric acupuncture with auricular acupuncture group(group C)and paroxetine hydrochloride group(group D).Each group was treated for 12 weeks.Patients were scored using Clinicianadministered Scale for DSM-IV(CAPS),Hamilton Depression Rating Scale for Depression(HAMD),and Hamilton Anxiety Scale(HAMA).Results:The study was finished well with a balanced grouping and fine baseline.After the analysis of integrations of CAPS,HAMD,and HAMA,we found that the score differences before and after the treatment were of statistical significance in all four groups(P

AIM:To study the blocking effect of shRNA on the expression of PSMA gene in LNCaP cell line by using shRNA eukaryotic expression vector.METHODS:Three pairs of DNA templates coding shRNA,synthesized against PSMA and cloned into the vector pSilencer 2.1-U6-neo,which was named pSilencer 2.1-U6-neo-shRNA,were identified by restriction endonuclease digestion analysis and DNA sequencing.LNCaP cells were then transfected with these three pSilencer 2.1-U6-neo-shRNAs and the negative control pSilencer 2.1-U6-neo-NC.After G418 selection,the cells were selected and the interfering effect was detected by RT-PCR and Western blotting.The biological behaviours of the transfected LNCaP cells were also tested.RESULTS:Restriction endonuclease digestion analysis and DNA sequencing results all showed that the 3 target segments were cloned into pSilencer 2.1-U6-neo vector respectively.After transfected into LNCaP cells,the inhibitory ratio of PSMA mRNA was 33.15%,9.26% and 41.97% respectively,and that of PSMA protein was 26.26%,6.47%,40.69% respectively.The p-shRNA3 was chosen to test the cell growth and its invasive power in vitro.The results showed that after interfering,the invasiveness of LNCaP cells were enhanced.CONCLUSION:The vector-based shRNA on PSMA gene effectively knocks down the PSMA gene expression.The successful construction of PSMA shRNA makes it possible for further study of the interaction between PSMA and prostate cancer.

Objective To assess the effectiveness of donepezil versus huperzine in the treatment of elderly patients with mild cognitive impairment (MCI).Methods Total 122 elderly patients with MCI were divided into two groups:donepezil treatment (5.0 mg once daily) (n=71) and huperzine treatment group (0.1 mg twice daily) (n=51).All the patients were followed up for 24 weeks.Before and 12 weeks,24 weeks after drug treatment,the cognitive functions were evaluated,including MMSE,MOCA,ADAS-cog,CDR,GDS,ADL,HIS and HAMD.Results There was no significant difference in age,sex,education time and neuropsychology rating scales between the groups before drug use.As compared with the score before drug use,the donepezil group showed a significant increase in MMSE after 12-weeks (t=4.47) or 24-weeks (t=6.16) (P＜0.01),a decrease in the score of ADAS-cog after 12-weeks (t=2.33,P＜0.05) or 24-weeks( t=3.68,P＜0.05),and an increase in the score of MOCA after 24-weeks drug use (t=2.56,P＜0.05).The huperzine group showed significant improvement in MMSE after 24-weeks drug use (t=2.80,P＜0.05),but there was no difference in other time points or in the score of MOCA and ADAS-cog as compared with the score before drug use.After 24 weeks' treatment,the donepezil group had higher MMSE (t=2.01,P＜0.05) and lower ADAS-cog (t=2.09,P＜0.05) scores than the huperzine group.30 patients (total effective rate was 42.3 ％) and 9 patients (total effective rate was 17.6 ％ ) became improved in donepezil and huperzine group,respectively,with significant difference (x2 =8.26,P＜0.01 ).There were 5 cases in the donepezil group and 3 cases in the huperzine group getting slight side-effects which disappeared by continuing to take drugs or by adjusting drug taking time.Conclusions Donepezil and huperzine as the cholinesterase inhibitors are effective and safe,and the efficacy of donepezil is faster and better in treating elderly patients with MCI.

Standardized patient(SP) is the core element of medical student evaluation system and completes the contents and tasks of objective structured clinical skills examination(OSCE).Its training level directly affects the accuracy and science of the evaluation system.By training and management,SP can be applied in interrogation,physical and other exams for undergraduate,graduate,continuing education students.It has been recognized apparently that the application of SP meets the target of cultivating innovative medical talents and plays a key role in practice evaluation and appraisal system.SP is the useful supplement for the cmrent clinical teaching methods and means.

ObjectiveTo assess the impairment of liver function and investigate possible causes in local residents in Miaofeng Village, Mali Town, Wushan County, Gansu Province, China, and to provide a basis for the etiological study of idiopathic liver damage. MethodsThe residents in Miaofeng Village were screened for liver function and an epidemiological study was conducted. Serological testing was performed for those with abnormal screening results. Trace elements in drinking water and soil such as arsenic, chromium, and selenium were also tested. ResultsOf all residents, 23.8% and 10.7% showed abnormal levels of alanine aminotransferase and aspartate aminotransferase, respectively. Positivity of HBsAg was detected in 11 cases, fatty liver was identified in 3 cases, and absence of selenium in soil was also confirmed. ConclusionA proportion of local residents in Miaofeng Village have impaired liver function and the absence of selenium in soil may be a contributing factor to this phenomenon.