The decade practical training experiences in vascular department of Xuanwu Hospital were reviewed.Quality training and medical education measures for further study physicians in department of vascular surgery were introduced and summarized from medical ethics education,professional training,theoretical knowledge training and quantitative assessment.All these measures were intended to improve the overall quality of vascular surgical further study physicians and to guarantee the most gain for trainees.

Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant inherited disease,and may be related to the mutation of CDH1 or CTNNA1 genes.Microscopically,signet-ring cell carcinoma is suggested frequently in endoscopic biopsy or gastrectomy specimens.Some patients may have concomitant extra-stomach tumor (frequently breast cancer in females).Detection of CDH1 gene mutation should be performed in high-risk individuals,and diagnosis and treatment should be carried out by a multidisciplinary team.Prophylactic gastrectomy is recommended for those with pathogenic CDH1 mutation.Endoscopic surveillance is an option for those with CDH1 mutation of undetermined significance and those without germline CDH1 mutation.This review discussed the concept,genetic characteristics,clinicopathological features and genetic screening of HDGC for providing a reference for clinicians.

Objective To assess the effect of nicotinic acid on hyperphosphatemia in maintenance hemodialysis (MHD) patients.Methods Twenty-six MHD patients with stable disease condition and hyperphosphatemia that could not be successfully controlled by conventional methods were selected.All patients were treated with oral nicotinic acid for 20 weeks.The changes of serum calcium,high sensitivity Creactive protein (hs-CRP),albumin (ALB),aspartate aminotransferase (AST),alanine aminotransferase (ALT),gamma-glutmyltransferase (GGT),total bilirubin (TBIL),derect bilirubin (DBIL),high density lipoprotein cholesferol (HDL-C),low density lipoprotein cholesferol (LDL-C),triacylglycerol (TG),total cholesterol (TC),intact parathyroid hormone,hemoglobin,platelet count,etc were observed before and after treatment.Results Two patients withdrew from this study because.of pruritus and diarrhea after two weeks of oral nicotinic acid.In 24 cases,compared with that before treatment,the serum phosphate,calcium-phosphorus product was decreased [(1.49 ± 0.19) mmol/L vs.(2.13 ± 0.16) mmol/L,(4.40 ± 0.49)mmol2/L2 vs.(5.45 ± 0.36) mmol2/L2] and HDL-C was increased [(1.45 ± 0.14) mmol/L vs.(1.18 ± 0.15)mmol/L] after treatment,and there was significant difference (P ＜ 0.05).There was no significant difference in the serum calcium,iPTH,LDL-C,TG,TC,ALB,AST,ALT,GGT,TBIL,DBIL,hs-CRP,platelet count,hemoglobin between before and after treatment (P ＞ 0.05).Conclusions Nicotinic acid is effective as all adjuvant measure in control of hyperphosphatemia in patients on MHD and can increase HDL-C.It provides a new approach for the treatment of hyperphosphatemia.

Objective To report a rare case of M3r subtype of acute promyelocytic leukemia (APL)with 3'-end of RARα (3'RARα) submicroscopic deletion, and the characters of morphologic, cytogenetic,molecular genetic and molecular biology studies. Methods Chromosomes of bone marrow (BM) cells were prepared with direct method and short-term culture method, and R-banding technique was used for karyotypic analysis. Fluorescence in situ hybridization (FISH) assays were performed on fixed BM cells using the following specific DNA probes: CEP X/Y alpha satellite DNA probe, LSI PML-RARα dual-color dual-fusion and LSI RARα dual-color break apart probes. A quantitative real-time reverse-transcription polymerase chain reaction (RT-PCR) was performed to detect the PML-RARα transcript. A multiplex nested RT-PCR was also performed, which may simultaneously detect the fusion genes derived from 29 chromosomal aberrations in acute leukemia including PML-RARα, PLZF-RARα and NPM-RARα fusion transcripts. Results R-banding analysis revealed a karyotype of 45,X,-Y[6]/46,XY[8], FISH using CEP X/Y probe further confirmed Y-chromosome loss. FISH analysis with RARα dual-color break apart probe demonstrated a deletion of the entire 3'-end of one allele of RARα gene. Cytogenetic, FISH and RT-PCR analyses showed no PML-RARα,PLZF-RARα, NPM-RARα, NuMA-RARα and STAT5b-RARα rearrangements. Conclusion A new RARαrearrangement involving 3'RARα submicroscopic deletion in APL without X-RARα fusion has been identified.FISH analysis with RARα dual-color break apart probe is a useful method for characterization of this abnormality, but its molecular consequences remain to be elucidated.

0.05). Conclusion 1. Exogenous glutamate application via scala tympani can result in a rapid excitotoxic damage of cochlear typeⅠspiral ganglion cells of guinea pigs. 2. NT-3 can protect typeⅠspiral ganglion cell from glutamate neurotoxicity even applied 60 minutes after the occurrence of glutamate induced cochlear impairment. The result indicates that NT-3 may be an ideal candidate for the treatment of a series of acute neural hearing loss.It may lead to a better outcome when NT-3 gene therapy is actilized.

Objective To explore effects of arterial self-expanding stents implanted in different position for treating lower limb ischemia.Methods Follow-up records of 65 patients of lower limb ischemia(71 limbs) teated by stent implantation from January 2002 to March 2006 were retrospectively reviewed.Out of the 71 patients,there were 38 patients(52.3%) of diabetic lower limb ischemia and 33 patients(47.7%) of non-diabetic ischemia.Stent implantation included 2 abdominal aortic stents in 2 patients,1 abdominal aortic and 2 iliac stents in 1 patient with the Leriche syndrome,38 iliac stents in 33 patients(35 limbs),12 stents for iliacofemoral lesions in 6 patients(6 limbs),23 femoral stents in 16 patients(19 limbs),10 stents for femoral and prioxiaml popliteal arterial lesions in 5 patients(6 limbs),and 2 stents for distal popliteal arterial lesions in 2 patients(2 limbs).Results The patients were followed for 2~50 months(mean,16.1 months).The patency rate was 100% in 3 patients with abdominal aortic stent implantation or abdominal and aortoiliac stent implantation.Iliac artery occlusion occurred in 4 patients(4 limbs),with the patency rate of iliac arterial stents being 88.6%(31/35).The patency rate of femoral arterial stents was 78.9%(15/19),and that of femoral and prioxiaml popliteal arterial stents was 83.3%(5/6).Stents in distal popliteal artery were occluded in all the 2 patients.Stents remained patent after a mean of 5.6 months postoperatively in 3 patients with 2 femoral stents in 2 limbs and 1 femoropopliteal stent in 1 limb while distal outflow arteries were blocked.Conclusions Stent implantation can be the first choice for aortoiliac stenosis or occlusive arterial diseases.It is also recommendable for stenotic or occlusive femoral and proximal popliteal arterial diseases.It is a proper option for the senile patients or those who can not stand bypass procedures.However,for tibial arterial stenosis or occlusion,it is not a favorable consideration.

0.15) was 81%(17/21) and the clinical improvement of symptoms was achieved in 95%(20/21) of cases.The 17 cases were followed up for a mean of 15.7 months(range,12～35 months).One patient died of cerebral infarction at 6 months postoperatively.One patient with stent occlusion at 3 months after operation was given an embolectomy(the artery has remained patent for 13 months).Stent occlusion also happened in 2 patients(at 3 and 4 months after operation,respectively),on whom a subsequent infragenicular femoropopliteal bypass was operated,and in 2 other patients(at 8 and 12 months after operation,respectively),on whom a below-knee amputation was operated.At one year postoperatively,the patency rate was 75%(15/20) after primary operation and 80%(16/20) after re-operation.The rate of clinical improvement of symptoms was 75%(15/20).The limb salvage rate in patients with critical limb ischemia was 88%(14/16).Conclusions Primary angioplasty with self-expending nitinol stent implantation is a safe, minimally invasive,and effective method,which can be used as the first choice for femoral arterial occlusive diseases,especially in senile patients who cannot tolerate bypass procedures.

0.05).The results differentiated by Sysmex XS-800i showed excellent correlation with those by handwork.Conclusion The performance of the Sysmex XS-800i automated hematology analyzer is satisfied.

In order to detect and localize melatonin receptor and its mRNA expression in the human skin, human skin was obtained from healthy volunteers. Immunohistochemistry and RT-PCR were applied to detect MR in human skin and to identify its subcellular distribution. Electrophoresis of RT-PCR product showed positive band of mt 1 subtype in human skin. The subtype of MR, mt 1was present in the membrane, cytosol and nucleus of skin cells as shown by immunohistochemistry. It is suggested that skin is the target organ of melatonin.

Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms.81 aneurysms were confirmed by DSA,all of them were sac aneurysms,among which 75 cases (body/neck≥ 1) were treated with balloon-assisted coiling,29 narrow-necked (body/neck≥2) aneurysms and 30 wide-necked (1 ≤ body/neck＜ 2) aneurysms were treated with balloon-assisted coiling successfully,but 6 narrow-necked (body/neck≥2) were treated with balloonassisted coiling in emergency,followed by a stent-assisted coiling in secondary embolization,4 cases with body/neck＜1 were treated with stent-assisted coiling technique in emergency,2 non ruptured aneurysms could not be treated.The times of balloon dilation were (2.1 ± 1.3),single expansion of filling was (33.4±14.1)s. Results The arterial thrombosis happened in two patients (2.7 ％),two aneurysms ruptured (5.3％) during the procedure. No stent-related thrombosis happened. 86were elevated as good,8 as serious according to the Glasgow outcome scale,neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.