Objective To observe the expressions of microRNA-126 (miR-126) and vascular endothelial growth factor (VEGF) in gastric carcinoma tissues,and their associations with clinicopathologic features in gastric carcinoma.Methods Fifty cases of gastric carcinoma and matched tumor adjacent tissue specimens were collected from January 2012 to March 2014 in Shangqiu First People's Hospital of He' nan Province.Expression levels of miR-126 and VEGF were examined using reverse transcriptase-polymerase chain reaction.Their correlations and the relationships between them and the clinicopathologic features in gastric carcinoma were analyzed.Results The expression levels of miR-126 in the tumor tissues and in the adjacent tissues were 0.652 ± 0.102 and 0.379 ± 0.069,and the expression levels of VEGF in the two kinds of tissues were 1.523 ± 0.142 and 0.604 ± 0.152,with statistical differences (t =8.374,P =0.001;t =29.508,P =0.000).The expressions of miR-126 and VEGF were significantly positively correlated (r =0.735,P =0.001).The expressions of miR-126 and VEGF were associated with TNM stage (t =22.981,P =0.001;t =18.053,P =0.001),depth of tumor invasion (t =26.792,P =0.001;t =20.234,P =0.001) and tumor node metastasis (t=26.668,P=0.001;t=14.857,P=0.001).Conclusion miR-126 is high expressed in the gastric carcinoma tissue,which may up-regulate the expression of VEGF,and lead to the formation of new blood vessels,then to promote gastric carcinogenesis and the development process.

The paper introduces the basic structure and operating principle of a new portable music therapeutic instrument. Connected to PC via USB port, the instrument can cause therapeutic current to be visualized. The application of Class-D audio power amplifier makes power dissipation lower.

With the development of the health service in china,the old talent-training program for clinical medicine major was failed in meeting higher demands for talents of clinical medicine. To create the new talent-training program,therefore,has become the main content of teaching reform for medical col-leges and universities. Taking University of South China as an example,the paper analyzed the changing trend of talent-training program for five-year clinical medicine majors from talent-training goal,curriculum system,practical teaching and content of courses,which proposed some thoughts on the optimization of training program for clinical medicine majors.

Objective To evaluate the efficacy of intravenous recombinant human brain natriuretic peptide in acute anterior myocardial infarction complicated with heart failure.Methods Two hundred patients suffered from acute anterior myocardial infarction complicated with heart failure were randomly divided into two groups:rhBNP group ( n =100) and control group ( n =100 ).All patients were given conventional treatment,patients in rhBNP group were given rhBNP on the basis of conventional therapy.The clinical effectiveness including the improvement of cardiac function,cardiac ultrasound data,the incidence of hospital adverse cardiac events,and six month follow-up were compared between the two groups.Results The degree of decompensation and Killip class in rhBNP group were better than those of control group after treatment ( improved dyspnea:significantly improved:36 vs 27 ; improved:49 vs 46; no improvement:11 vs 20 ; deterioration:4 vs 7 ; Ridit value:0.4618 vs 0.5382,P =0.043) ( Killip class:significantly improved:26 vs 20; improved:56 vs 45; no improvement:14 vs 25 ; deterioration:4 vs 10; Ridit value:0.4553 vs 0.5447,P =0.017 ).After treatment for one week,The LVEF improvement in rhBNP group was more remarkable than that of control group ( [ 53.0 ± 5.2 ] ％vs.[ 50.0 ±:6.2 ] ％,P =0.014).The occurrence rate of angina ( 13.0％ vs.27.0％,P =0.013 ),heart failure ( 18.0％ vs.32.0％,P =0.022) and major adverse cardiac events(MACE) ( 17.0％ vs.30.0％,P =0.030) inrhBNP group was lower than that in control group.During 6 months follow-up period,event-free survival in rhBNP group was higher than that in control group ( 69.0％ vs.55.0％,P =0.041 ).Conclusion Transvenous injection of rhBNP combined with other routine treatment can improve cardiac function in patients with myocardial infarction in acute anterior myocardial infarction.It can also decrease adverse cardiac events during hospitalization and increase event-free survival in 6 months follow-up period.

Narrative medicine has brought new ideas to medical humanities education, and its con-notation is suitable to Undergraduate Medical Education Standards-Clinical Medicine (Trial). By analyz-ing the proposal and development of narrative medicine, its foundation and core, its programs and methods, as well as its forms and values, the author deepened the understanding of narrative medicine. And through the following four pathways including strengthening the renewal of ideas and concepts on medical humanities quality education, promoting the diversification of teaching ways and methods of medical humanities educa-tion, enhancing the effect of early exposure to clinical medical students, opening the path of integration narrative medicine and evidence-based medicine, the author analyzed narrative medical enlightenment on medical humanities quality education in China.

Objective To study the characteristic findings on magnetic resonance imaging (MRI) in children with cerebral palsy (CP) induced by chronic kernicterus.Methods The MR imagings in 13 CP cases induced by chronic kernicterus were retrospectively studied, which were compared with 6 healthy and age-matched controls. 13 cases were finally diagnosed as dyskinetic cerebral palsy (athetoid subtype).Results In 13 cases, all showed symmetric high signals in the the globus pallidus on T2-weighted imaging. There were not apparent abnormality on T1-weighted imaging.Conclusion The bilateral high intensity signals in the globus pallidus on T2-weighted imaging are the characteristic findings on MRI in CP children induced by chronic kernicterus. Paying attention to the globus pallidus on MRI may be useful in determining the type of cerebral palsy.

Objective To measure the ratio of the length between upper edge of eyebrow and edge of lower eyelid(L1)/the length between edge of lower eyelid and nasal base(L2)in the fordless-eyelid and upper lid ptosis patients who received levator aponeurosis folding surgery. To analyze the change in the proportion of midfa-cial aesthetics. Methods From December 2015 to October 2016,a total of 21 patients were recruited as study group. Those patientswere diagnosed with foldless eyelid and upper lid ptosis. They received levator aponeurosis folding procedures were carried out in our departmentand the pre- and post-operative photographs were collected. Full-face pictures of 20 Chinese female movie stars were prepared as control group. The ratiosof L1/L2(J)were measured via Adobe Photoshop CS6. The statistical significance was analyzed and the change of midfacial propor-tion was evaluated. Results In study group,the mean value of pre- and post-operative L1/L2(J1)is 0.746 and (J2)0.657 postoperatively. In control group,the mean value of L1/L2(J3)is 0.667. Statistical differences showed between the pre- and post-operative samples and between pre-operative samples and control group. There was no statistical difference between post-operative and control group samples. The ratios between L1 and L2 in post-opera-tive samples are close to those in control group ,which are closer to the golden radio. Conclusions Levator aponeurosis folding can effectively lower eyebrow in patients with upper lid ptosis and shorten the length between eyebrow and lower eyelid. Therefore harvesting a more appropriate and harmonious ratio of L1/L2 according the golden section theory. The changes in the proportion of midfacial aesthetics after operation could be used as a key point in the pre-operative communication and post-operative effect evaluation ,besides the size of palpebral fissure and corneal exposure rate.

Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal carcinoma. In July 2019, one case of mucinous tubular and spindle cell carcinoma of the kidney was admitted to our hospital, The laparoscopic partial nephrectomy was performed, and there was no recurrence or metastasis during the follow-up period of 13 months. The disease has no obvious clinical manifestations and its diagnosis depends on pathological and immunohistochemical features. Surgical treatment is the main treatment for this disease, and most patients have a good prognosis.Howerer, the possibility of progression remains in the late stage of the disease.

Objective:To investigate the prognosis value of baseline contrast-enhanced CT in predicting progression-free survival (PFS) and overall survival (OS) for clinically diagnosed as metastatic far-advanced gastric cancer patients.Methods:Between January 2019 and May 2020, 85 pathologically confirmed gastric adenocarcinoma patients with peritoneal or hepatic metastasis at Shanghai Ruijin Hospital with complete preoperative clinical, image and follow-up data were enrolled in this retrospective study. Clinical factors included performance status (PS) score, tumor location, and tumor serological indicators. Imaging factors included the longest diameter and maximum cross-sectional area of the tumor, CT value, enhancement uniformity, CT extramural venous invasion (ctEMVI), the largest short diameter of the metastatic lymph nodes, confluent lymph nodes, lymph nodes necrosis, fused bulk lymph nodes, the maximum cross-sectional area and CT value of the liver metastases, peritoneal metastasis score, longest diameter of nodules with peritoneal metastasis. Kaplan-Meier survival curve and log-rank test were used to analyze the prognostic differences between groups. Univariate and multivariate Cox proportional hazards regression models were used to identify independent risk factors for PFS and OS.Results:There were significant differences in the maximum cross-sectional area of the tumor, non-contrast CT value, delayed-phase CT value, and delayed-phase CT ratio value between the high- and low-risk groups in PFS ( P<0.05). There were significant differences between the high- and low-risk groups with the maximum cross-sectional area of the tumor in PFS and OS ( P<0.05). In the univariate analysis, the maximum cross-sectional area of tumor, plain-scan CT value, delayed-phase CT value, delayed-phase CT ratio value and the largest short diameter of metastatic lymph nodes were risk factors for PFS ( P<0.05). PS score, CA724, maximum cross-sectional area of the tumor, maximum cross-sectional area of liver metastases, and peritoneal metastasis score were shown as risk factors for OS ( P<0.05). In the multivariate analysis, the maximum cross-sectional area of the tumor and non-contrast CT value were independent risk factors for PFS (HR=0.41, 2.50, P<0.05, 0.006). PS score, CA724 and peritoneal metastasis score were independent risk factors for OS (HR=46.78, 6.26, 92.92, P=0.026, 0.009, 0.007). Conclusions:Tumor size, CT attenuations, and peritoneal metastasis score on baseline CT can be used as independent risk factors for survival in patients with far-advanced gastric cancer with peritoneal or hepatic metastasis. Baseline CT is potentially useful in prediction of the survival status for patients with metastatic far-advanced gastric cancer.

Objective To investigate the mechanism of iron death induced by TRPC6/NF-κB in glomerular podiocytes mediated by high homocysteine(Hcy).Methods Mouse glomerulopocytes were cultured in vitro and divided into Control group(0 μmol/L Hcy)and Hcy group(80 μmol/L Hcy).After 48h of intervention,Western blot was used to detect the expression levels of iron death related proteins GPX4 and SLC7A11 and TRPC6 and NF-κ B.Real-time quantitative fluorescence PCR(qRT-PCR)and immunofluorescence were used to detect the expression of TRPC6.The level of podocyte apoptosis was detected by flow cytometry.Malondialdehyde(MDA)assay kit was used to determine intracellular MDA levels.After transfection of TRPC6 interference fragment and TRPC6 negative control(NC),qRT-PCR was divided into Control,si-NC and si-TRPC6(Si-TRPC6-1,Si-TRPC6-2,Si-TRPC6-3).Western Blot was divided into Control,Hcy,si-NC+Hcy,si-TRPC6+Hcy.The expression of TRPC6 mRNA was detected by qRT-PCR.The expression levels of GPX4,SLC7A11,NF-κB and TRPC6 were detected by Western Blot.The level of podocyte apoptosis after interference was detected by flow cytometry.Results(1)Compared with Control group,the expression levels of iron death related proteins GPX4 and SLC7A11 in Hcy group were decreased,and the apoptosis rate was increased(P<0.05).(2)Compared with Control group,TRPC6 protein,mRNA levels and immunofluorescence expression were increased in Hcy group.The level of MDA and the expression of NF-κB signaling pathway protein increased in Hcy group,and the comparison between the two groups had statistical significance(P<0.05).(3)Compared with the si-NC group,the mRNA expression level of TRPC6 in si-TRPC6(Si-TRPC6-1,Si-TRPC6-2,Si-TRPC6-3)group was decreased,and the interference effect of Si-TRPC6-3 was the best(P<0.05).After transfecting TRPC6 NC and TRPC6 interference fragment and administering Hcy,there was no difference in GPX4,SLC7A11,NF-κB and TRPC6 expression in si-NC+Hcy group compared with Hcy group.Compared with the si-NC+Hcy group,the si-TRPC6+Hcy group had higher expression of iron death related proteins,GPX4 and SLC7A11,lower expression of NF-κB and TRPC6,and decreased apoptosis rate(P<0.05).Conclusion This study confirmed that TRPC6/NF-κB can regulate iron death of renal podocytes under the induc-tion of Hcy,which is one of the mechanisms leading to kidney injury.