Hepatocellular carcinoma (HCC) has the characteristics of high malignancy and poor prognosis.Liver transplantation and hepatectomy are applied in a small portion of patients with localized disease.Due to the hidden onset,HCC is usually diagnosed at an intermediate-advanced stage or with advancing cirrhosis.In most cases,various non-operative treatments are applied,including transarterial chemoembolization (TACE),local ablation,radiotherapy and molecular targeted drugs.The therapeutic effect of non-surgical treatments is not always ideal because the incidence of recurrence and metastasis after treatment is high.It also may be associated with treatment resistance of HCC to non-operative treatments.Optimizing the current management schemes has great significance in improving patients' quality of life and prolonging their survival.

The training of clinical skill is closely linked with medical personnel education.However,traditional paper-type training materials were unable to meet the training needs.As a new type of training materials,trial-and-error video-type clinical skill training materials (abbreviated as TEVT clinical skill training materials) have gradually attracted attention with its characteristics of lively and interesting,potentially informative,high acceptance among students,the advantages' of stimulating students' initiative exploration and consideration,fostering students' critical spirit and humanities.On the basis of analyzing the advantages' of TEVT training materials,we discussed the developing specialties of TEVT clinical skill training materials from four aspects as the material orientation and the application object,material sources,constructing the developing team and editing the teaching materials.Furthermore,we reflected the application prospect of TEVT clinical skill training materials in the future,in order to explore an available implementation path for the development of TEVT clinical skill training materials.

Objective: To investigate the relationship between qi and blood quantity in the twelve meridians and musculature,and enrich the theory of meridian doctrine.Methods: By summarizing classic literatures on qi and blood quantity in the twelve meridians and musculature,and combining with clinical practice,the relationship between qi and blood quantity in the twelve meridians and musculature was analyzed and the directive effect of qi and blood quantity in the twelve meridians on diseases of musculature was investigated.Results: Qi and blood in the twelve meridians moisten and nourish the musculature,on the other hand,the musculature also influence the quality of qi and blood.Conclusion: Treatment for diseases of musculature with acupuncture and moxibustion can be perfected by the theory of qi and blood quantity in the twelve meridians,then,the curative effect can also be improved.

Objective:Through the introduction of BioImp Vet Body Composition principle and application of the second classroom experimental teaching practice in medical function, analyzer application characteristics of BioImp Vet Body Composition. Methods:We studied the distribution of body fluid and fat content determination of rats using BioImp Vet Body Composition. The device using the complex impedance measurement technique in vivo, within the second 4 k-1000 kHz scope, scanned the 256 frequency bands. We measured body water content (TBW), extracellular fluid (ECF) and intracellular fluid (ICF), in addition to the amount of fat (FFM) and fat mass (FM). Results:This measurement technique is very convenient, reliable and quick data acquisition in our second classroom teaching and laboratory. Conclusion:the measurement of BioImp Vet Body Composition can be used in the field of medical experimental teaching, has the application and characteristics of portable and feasible of the second class in the experimental teaching of Medical Function.

Objective To analyze the risk factors impeding early extubation after off-pump coronary artery bypass grafting (OPCAB) in Chinese patients, so that to identify the applicable patients for "fast track recovery". Methods Clinical data of 680 consecutive patients who had received OPCAB were analyzed retrospectively. The patients were divided into two groups according to the time of extubation (group Ⅰ,n=333, extubation was performed within 12 h postoperation; group Ⅱ,n=347, extubation failed in 12 h). Univariate and multivariate analyses were used to determine risk factors prolonging mechanical ventilation. Results Univariate analyses showed significant difference between the two groups in the percentages of patients over 70 years [25% (84/333) vs 39% (136/347), ?2=15.148, P=0.000], with history of stroke [14% (46/333) vs 22% (75/347), ?2=7.068, P=0.008], with LVEF70 (OR=2.003), LVEF70, severe coronary artery lesion, emergency operation, and poor cardiac function are risk factors impeding early extubation. "Fast track recovery" protocol is applicable to young patients who have good cardiac function without left main lesion and do not need IABP during perioperative period.

Objective To observe the expression of protein kinase C(PKC)isoforms in pulmonary artery of chronic inflammatory pulmonary hypertension(PHT)rats.Methods Chronic inflammatory PHT model rats were established induced by monocrotaline(MCT).Western blotting analysis was used to detect the expression of four PKC isoforms(PKC?,PKC?Ⅱ,PKC? and PKC?)in pulmonary arteries of rats during the development of PHT.Results The values of mean pulmonary artery pressure and right ventricular hypertrophy index increased significantly after the injection of MCT,which suggested successful formation of PHT.Western blotting analysis showed that PKC?,PKC?Ⅱ and PKC? isoforms were presented in pulmonary arteries of normal and PHT rats,while PKC? isoform was not detected.The expressions of PKC? in both cytosolic and membranous fractions increased within 14 days,and decreased a little during the development of PHT.But the increase of PKC? in cytosolic fraction was much more obvious than that in membranous fraction.The highest expression of both PKC?Ⅱ and PKC? in cytosolic fractions appeared at the eighth day,while the expression of both isoforms in membranous fraction went up continuously.Conclusions PKC?,PKC?Ⅱ and PKC? isoforms were involved in the development of chronic inflammatory PHT.The changes of their expression might be the results of PKC isoforms translocation which is related to the proliferation regulation of pulmonary artery smooth muscle cells.

砄bjective:To investigate the variation of nm23 H1 gene structure and its expression in oral squamous cell carcinoma (OSCC) and to study the relationship between nm23 H1 expression and OSCC metastasis to neck lymph nodes.Methods: nm23 H1 gene in the samples of 30 cases of OSCC,7 of normal oral mucous tissue,human OSCC cell line TSCCa and human oral metastatic cancer cell line GNM was extracted and amplified by PCR. PCR products were investegated with SSCP analysis; nm23 m RNA level in the samples was studied by in situ hybridization.The relationship between mRNA expression and metastasis to neck lymph nodes was analyzed statistically.Results: All samples showed no change in nm23 H1 gene structure except deletion in one case of OSCC;7 out of 9 cases with metastasis to neck lymph nodes showed no hybridization signal of nm23 H1 mRNA,however,only 5 were found no nm23 H1 mRNA in 21 cases without metastasis,positive rate of nm23 H1 expression in GNM cells was lower than that in TSCCa (41.2% versus 63.1%);The expression of nm23 H1 gene showed significant negative relationship with neck lymph nodes metastasis ( P

Objective To introduce the clinical significance and pathophysiologic aspects of the circulatory and cardiac complications in terminal stage cirrhosis.Methods Recently relevant literatures were reviewed and summarized.Results Haemodynamic changes in cirrhosis arose on the basis of combined humoral and nervous dysregulation,with abnormalities in cardiovascular regulation,volume distribution and cardiac performance.Conclusion Comprehending the mechanisms of cardiovascular complications will contribute a lot for the treatment of terminal stage cirrhosis.

Purpose:To invastigate the changes of the related signaling pathways and it's mechanism of reguation of mitogen activated protein kinase cascade(MAPK) by SUM149 cells induced plasmid of dominant-negative E-cadherin mutant H-2k~d-E-cadherin.Methods:Using western blot method,we examined the signal pathway of mitogen activated protein kinase(MAPK) between the dominant-negative mutant E-cadherin transfected SUM149 cells and controls.Results:Compared with the controls,the phosphorylated extracellular signal regulated kinase P44/42 expresion of the SUM149 cells which expressed higher dominant-negative mutant E-cadherin was significantly down-regulated.Conclusions:In this cell line model,the down-regulation of P44/42 may involve the regulation of MMPs.

Objective To analyze and discuss the effects of preserving the intercostobrachial nerve(ICBN)in modified radical mastectomy for breast cancer. Methods A total of 80 patients with breast cancer were randomly divided into the observation group and control group(n = 40 in each). The ICBN in the observation group were reserved and it was removed in the control group. Operation time,the number of lymph nodes,blood loss and complication rates were compared between groups. Two groups of patients were followed up for abnormal sensory function and relapse and metastasis. Results There were no differences in the operation time,the number of dissected lymph nodes and blood loss(P > 0. 05). There was no difference in complication rate(12. 50% vs 15. 00% )between the observation group and control group(P > 0. 05). There were significant differences in the incidence of abnormal sensory function at the first week(10. 00% vs 52. 50% ),the first month(5. 00% vs 47. 50% ),the third month(2. 50%vs 45. 50% ),the sixth month(2. 50% vs 37. 50% ),and the twelfth month(0. 00% vs 27. 50% )after op-eration between the observation group and control group(P < 0. 05). During the one-year follow-up peri-od,there was no relapse or metastasis. Conclusion Preserving ICBN in modified radical mastectomy can effectively reduce the incidence of abnormal sensory function of the upper limb.