Nephroblastoma is one of the most common solid tumours in children,and the gene expression is closely related to the tumorigenesis,development and prognosis.The treatment regimens have been constantly updated,which includes the preoperative chemotherapy,nephron-sparing surgery and targeted therapy of cancer stem cells,aiming to maintain the excellent survival for children being treated for Wilms tumor,while minimizing therapy-related toxicity.This paper reviews the gene expression and treatment on wilms' tumor.

Objective To learn the correlation between thyroid function and arteriosclerosis in elderly popu-lation,and to provide research data for early clinical intervention.Methods 7 1 elderly patients with hypothyroidism were selected as A group,76 elderly patients with subclinical hypothyroidism were selected as B group,70 healthy elderly cases were selected as C group.Triiodothyronine (FT3 ),tetraiodothyronine (FT4 ),thyrotrophin (TSH ), triglyceride (TG),total cholesterol (TC ),low density lipoprotein cholesterol (LDL -C ),high density lipoprotein cholesterol (HDL-C),C reactive protein (CRP)levels of the three groups were detected.Carotid artery intima media thickness (CIMT)was examined by color Doppler ultrasonography.Results FT4 levels of A group,B group were (5.25 ±4.17)pmol/L,(10.74 ±5.02)pmol/L respectively,which were lower than (18.53 ±6.38)pmol/L of C group.TSH levels of A group,B group were (16.45 ±6.96)mU/L,(6.25 ±3.84)mU/L respectively,which were higher than (3.37 ±1.13)mU/L of C group (t=14.650,8.232,15.522,6.037,all P<0.05).FT4 level of A group was lower than that of B group,TSH level of A group was higher than B group (t=7.185,11.097,P<0.05).TC, LDL-C levels of A group,B group were (5.96 ±1.01)mmol/L,(4.15 ±1.69)mmol/L,(5.64 ±0.94)mmol/L, (3.64 ±1.17)mmol/L respectively,which were higher than those of C group [(5.17 ±1.12)mmol/L,(3.20 ± 1.06)mmol/L](t=4.400,2.754,3.992,2.374,all P<0.05).TC,LDL-C levels of A group were higher than B group (t=1.990,2.139,all P<0.05).CIMT,CRP levels of A group,B group were (0.90 ±0.23)mm,(6.20 ± 1.31)mg/L,(0.79 ±0.17)mm,(4.55 ±1.05)mg/L respectively,which were higher than those of C group [(0.68 ±0.11)mm,(3.12 ±0.88)mg/L](t=7.229,4.599,16.364,8.878,all P<0.05).CIMT,CRP levels of A group were higher than B group (t=3.312,8.453,all P<0.05 ).CIMT and TSH,LDL -C,CRP levels were positively correlated (r=0.789,0.647,0.583,all P<0.05),CIMT and FT4 levels were negatively correlated (r=-0.636,P<0.05 ).Conclusion Hypothyroidism,subclinical hypothyroidism are associated with atherosclerosis in elderly population,and elderly patients with hypothyroidism,subclinical hypothyroidism are at high risk of atherosclerosis.

Objective Aims To investigate the dynamic changes of multi-organ functional indices in esophageal carcinoma patients during peri-operation period at flatland and moderate high altitude. Methods 44 cases of esophageal carcinoma scheduled to receive gastroesophagostomy were categorized semi-randomly into three groups: Flatland control group (FCG, n=8), moderate altitude lung protection group (MPG, n=16), moderate altitude control group (MCG, n=20). The cases in FCG and MCG underwent routine pulmonary function examination and respiratory tract preparation peri-operatively. Besides the above routine treatment, the cases in MTG received administration of Rahdiola compound capsules preoperatively, with 2 pills a day. Blood-gas and biochemical indices of multi-organs were recorded in the three groups preoperatively and at 1, 3, and 5 days postoperatively respectively. The patients' systematic reaction, the changing trend of the indices reflecting organs function and the postoperative complication were observed. Results The blood-gas parameters were different significantly both preoperatively and postoperatively between the three groups. While other indices reflecting the organs function were not different significantly between the three groups before the operation, but at 1, 3, 5 days postoperatively, the indices in MCG and MPG were significantly different with that in FCG (P

Objecive To evaluate the causes of 60 cases for clinical failure in post crown.Methods Sixty cases with failure in post crown cure were entered the study.The causes of failure were analyzed.Results Among the 60 cases with failure in post crown cure,38 cases were due to the crown'loosing or broken away,12 cases with the broken dental crown,10 cases with periapical periodontitis,6 cases with broken root.Conclusions It was the loosing or broken away of post crown,periapical periodontitis,dental crown and root broken consist of the main causes for clinical failure in post crown.

Objective CA125 has been proved to be closely related to peritoneal metastasis of gastric cancer.This study aimed to screen and identify a novel ssDNA aptamer targeting the extracellular domain of Mucin16. Methods Using capillary elec-trophoresis, we screened the aptamers targeting the synthetic peptide of the extracellular domain of Mucin16 and quantitatively deter-mined the Kd value of each cycle and the affinity of the aptamers for the synthetic peptide by CE-SELEX.Then we evaluated the ability of the obtained aptamers to target cancer cells using confocal laser imaging. Results After five cycles of screening, sequencing, af-finity determination, we obtained an ssDNA aptamer targeting the extracellular domain of Mucin16, with a Kd value of 122.7 nm and visible green fluorescent signals on the cell membrane of the human ovarian cancer cell line expressing Mucin16, but not on that of the normal hepatocytes not expressing Mucin16.This confirmed the binding ability of the aptamer to the extracellular domain of Mucin16. Conclusion A novel aptamer targeting the synthetic peptide of the extracellular domain of Mucin16 was successfully obtained by capil-lary electrophoresis, which could be used as a new agent in the diagnosis and treatment of peritoneal metastasis of gastric cancer.

Objective To determine the detection rate of duodenal papilla and the diagnostic rate of small bowel diseases by capsule endoscopy(CE)and its possible influencing factors.Methods A total of 369 cases with suspected small bowel disease who had undergone CE were retrospectively reviewed. The de- tection rate of duodenal papilla and that of small bowel disease were calculated respectively. The detection rate of duodenal papilla in another 369 patients having received gastroscopy was also counted in order to findout the miss detection rate of forward-viewing endoscopy. The CE findings were reviewed at the rate of 1 im-age and 15 images per second by hand-motion respectively. The detection rate of duodenal papilla was calcu-lated,and the number of frames showing duodenal papilla was counted. Differences of detection rate of duo-denal papilla were also analyzed by different age and gender groups. In addition,the potential difference in detection rate of duodenal papilla between different bowel preparations before CE of two different reviewing approaches was also investigated respectively. Results The miss detection rate of duodenal papilla with for-ward-viewing gastroscopy was 22. 0%. The detection rate of duodenal papilla reviewed at the rate of 1 image by hand-motion,where less frames were needed to visualize duodenal papilla(3. 7vs7. 0),was significantly higher than that at the rate of 15 images per second(32. 2%vs13. 6%,P=0. 001). The diagnostic rate of small bowel diseases was also significantly higher than that of duodenal papilla by CE(67. 2%vs32. 2%,P=0. 000). Age and gender were not significantly correlated with the detection rate of duodenal papilla. No significant correlation was found between various kinds of bowel preparation before CE at different viewing rate and the detection rate of duodenal papilla. Conclusion It iS relatively difficult to identify duodenal pa- pilla by CE,as they are peculiarly positioned in anatomy,so the detection of duodenal papilla does not nec- essarily represent the detection rate of small bowel diseases. The major factors that influencing the detection of duodenal papilla by CE include local anatomy,viewing rate and technical limitations of CE.

Objective To discuss the clinical value of immunofecal occult blood test in screening of colorectal cancer and its precancerous lesions in a large series of health checkup population. Methods Colorectal cancer and its precancerous lesions in 5919 subjects undergoing health checkup in our hospital were screened out by using immunofecal occult blood test from July 2006 to June 2007; positive cases with the test were subjected to colorectal endoscopy or X-ray barium enema examination. Relevant results were analyzed in combination with clinical and pathological data. Results Positive result was obtained in 314 out of the 5919 subjects undergoing health checkup with immunofecal occult blood test; the positive rate was 5.30%. 241 cases(76.75% )of them accepted colorectal endoscopic examination and 23 cases(7.32%) accepted X-ray barium enema examination. The total follow up rate was 84.08% with 50 cases out of contact. After excluding the cases out of cantact, 16 cases of colorectal cancer were found morbidity 2.37‰ including 8(50.00% )cases of Dukes A,7 cases (43.75%)of Dukes B and 1 case of Dukes C (6 .25%).The detection rate of colorectal cancer with postive imunofecal occult blood test was 6.06% (16/264). 94 cases (16.01‰) of adenomatous polyps were found including 55 cases (58.51%) of tubular adenoma, 23 cases (24.47% )of villiform- tubular adenoma and 16 cases(17.02%) of villfform adenoma. Among these cases 55 (58.51%)were solitary and 39(41.49%) multiple. In addition, 6 cases of ulcerative colitis in active phase were found. Altogether 116 (43.94%)of the 264 cases with positive immunofecal blood test and not out of contact were found to have colorectal cancer or its precancerous lesions. Conclusion Immunofecal occult blood test is suitable for screening of colorectal cancer and its precancerous lesions in large series of population. Colorectal cancer and its precancerous lesions may be found in relatively early phase and be eradicated in curable stage, thus to reduce the morbidity and mortality.

Objective To evaluate the use of spiral enteroscopy in diagnosis and treatment of smallbowel diseases.Methods The data of 8 patients who underwent spiral enteroscopy from July to September 2009 were retrospectively studied.The variables including maximal insertion depth,total procedure time,complications,and outcome were evaluated.Results The average maximal depth of intubation was 2.2 m beyond the Ligament of Triez (0-3.6 m beyond Ligament of Triez),with a mean procedure time at 41 min (25 to 77 min).Small bowel Crohn's disease was diagnosed in 2 cases with biopsy suggesting active inflammation and granular formation.Small intestinal tumor was detected in 1 patient with pathological finding of high grade dysplasia.Jejunal ulcer was detected in 1 patient.Multiple polyps were found in 1 patient after jejunal anastomosis,which were then treated with endoscopic argon plasma coagulation (APC).No abnormalities were found in 3 other patients.No complications occurred during and after the procedure.The maneuver of spiral enteroscopy and APC were same as that of balloon enteroscopy.Conclusion Spiral enteroscopy is simple and convenient to operate,which is of great potential in clinical use.

Objective To evaluate the predictive value of morphology of superficial depression in estimation of histology and invasive depth in colorectal neoplasia by using magnifying chromo-endoscopy.Methods Flat or depressed and sessile eolorectal lesions which were indicated for endoscopic mucosal resection (EMR) were consecutively collected. Depressed lesions were classified into type 1 (star-like) and type 2 (round) according to the morphology of depressive areas in the colorectal neoplasia with magnifying ehromoendoscopy. The relationship between morphologic classification with histology and invasive depth was studied with reference to pathological diagnosis after EMR. Results Ninety lesions including 25 sessile and 65 flat were resected with EMR. Lesions with central depression (54. 4%,49/90) were more likely to have high-grade dysplasia (HGD) or cancer than those without ( 51.0% vs. 17. 1%,P＜0. 001 ). Depressive lesions of type 2 were more susceptible to have HGD or cancer than those of type 1 (89. 5% vs. 26. 7%,P＜0. 001 ). The overall accuracy of depression morphology for distinction between lesions of superficial submueosal (m-sm1) and deep submucosal (sm2-sm3) invasion was 83. 7% (41/49). Conclusion The morphology of superficial depression on colorectal neoplasia is highly correlated with the histology and invasive depth,which facilitates the EMR treatment.

lem and direct necessary intervention to improve the completion rate of whole small intestine examination.