Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with various genomic alterations.In most patients,HCC is associated with cirrhosis which contributes to treatment morbidity and mortality.Cirrhosis adds difficulties to clinical management of HCC.Over the past decade,several molecular targets which are involved in the etiology of HCC have been identified.Among them,treatment with sorafenib,an antiangiogenic and Raf kinase inhibitor,has shown survival benefit.This represents a breakthrough in treatment of this complex disease,and proves that molecular therapies can be effective in HCC.It is becoming apparent that to overcome the complexity of genomic aberrations in HCC,combination therapies are essential.Several ongoing clinical trials show encouraging results.Future researches are necessary to identify new compounds to block important undruggable pathways,and to identify new oncogenes as targets for therapies through novel high throughout technologies.Ultimately,a molecular classification of HCC based on genome investigations and identification of patient subclasses using drug responsiveness will lead to a more personalized treatment.Although molecular therapy is a promising treatment for HCC with cirrhosis,surgery,if applicable,remains the first choice of treatment.

Objective To explore the causes and treatment measures of hyponatremia after liver transplantation. Methods The clinical data of 27 patients with hyponatremia after liver transplantation were analyzed retrospectively. Results Among the 27 patients, postoperative hyponatremia occurred in 25 cases in about one week, and preoperative hyponatremia occurred in 2 cases and severe ~hyponatre -mia occurred immediate after operation. Acute hyponatremia occurred in one case. Blood natrium was 130 to 135 mmol/L in 10 cases, 120 to 130 mmol/L in 12 cases and less than 120 mmol/L in 5 cases. The levels of blood potassium, phosphor and calcium were all normal. Urinary natrium, potassium and chlorine levels were all normal. The ascites natrium level was higher than blood natrium at the same time. Hyponatremia was treated by supply of hypertonic saline via gastrointestine an/or veins. Conclusion Various causes could result in hyponatremia after liver transplantation. The hyponatremia was treated by supply of hypertonic saline constantly and slowly.

In intensive care units (ICU) , the occurrence of acute hypotensive episodes (AHE) is the key problem for the clinical research and it is meaningful for clinical care if we can use appropriate computational technologies to predict the AHE. In this study, based on the records of patients in ICU from the MIMIC II clinical data, the chaos signal analysis method was applied to the time series of mean artery pressure, and then the patient's Lyapunov exponent curve was drawn ultimately. The research showed that a curve mutation appeared before AHE symptoms took place. This is powerful and clear basis for AHE determination. It is also expected that this study may offer a reference to research of AHE theory and clinical application.
Humans ; Hypotension ; diagnosis ; Intensive Care Units ; Nonlinear Dynamics ; Software

Objective To investigate the inhibitory effects of PPARγ ligand rosiglitazone in vivo of mice which were transplanted the human gastric carcinoma cells line MGC803 into subrenal-capsule.Methods To establish kunming mouse tumor modles of MGC803 cells transplanted into subrenal-capsule and assay the inhibiting growth effects of 50 mg／kg rosiglitazone which were continuously poured into mice gastric for five days by the dissect microscope and HE stain.Results Rosiglitazone could inhibit the growth of MGC803 cells transplanted into subrenal-capsule of mice in vivo by inhibiting proliferation and inducting apoptosis,the tumor inhibitory rate was 62.9％.Conclusion PPARγ ligand rosiglitazone can inhibit the growth of MGC803 cells transplanted into subrenal-capsule of mice in vivo.

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. In ad-dition to genetic alterations, epigenetic inactivation of (tumor suppressor) genes has been recognized as an important and alternative mechanism in tumorigenesis. In recent years, increasing evidence has shown that ep-igenetic silencing of those genes is essential to carcinogenesis and metastasis. Epigenetics include two main forms: histone acetylation and DNA methylation, histone acetylation and DNA hypomethylation can promote gene expression,otherwise, they will inhibit gene expression. It is important to the methylation especially the hypermethylation of the tumor suppressor gene during the hepatocarcinogencsis. The study of epigenetics will be proved valuable for early diagnosis and disease monitoring at hepatocell.

Objective To analyze the clinical value of laparoscopic ultrasonography (LUS) in laparoscopic hepatobiliary surgeries. Methods A total of 156 cases of laparoscopic hepatectomy, hepatic abscess fenestration, and complicated cholecystectomy were analyzed. LUS was used during all the 156 operations; the anatomy and stage of the tumors were investigated. Results In 19 cases of hepatectomy and 39 cases of hepatic abscess fenestration, the direction of critical intrahepatic and extrahepatic ducts were indicated by using LUS, and the operations were performed under the guidance of LUS. Moreover, in 15 cases of complicated cholecystectomy, the tumor was precisely located and further distinguished by LUS. Conclusions Laparoscopic ultrasonography can precisely locate the tumor, guide the treatment, and resolve the problem of reduced feedback in touching for surgeons during laparoscopic hepatobiliary surgeries. It is of value to improve the operative outcomes.

Objective The aim of our study was to investigate the effects and mechanisms of ghrelin on neovascularization in atherosclerosis plaque. Methods 30 male New Zealand rabbits were randomly divided into normal control group ( CON group) , atherosclerosis model group ( AS group) , and ghrelin treatment group ( ghrelin group) , and each group of 10 rabbits. The AS group and ghrelin group underwent balloon-induced arterial wall injury and then fed with high fat diet, the CON group was fed only on a regular diet. They were all fed for 3 months. Then the ghrelin group was given ghrelin 25μg·kg-1 ·d-1 , the other two groups received the same amount of sterile normal saline only. Four weeks later, body weight and blood lipids were detected. The thickness ratio of the intima to media was measured by HE staining. Degree of intra-plaque angiogenesis was evaluated by CD31+ cells immunohisto-chemistry. The vascular endothelial growth factor ( VEGF ) and vascular endothelial growth factor receptor 2 ( VEGFR2) were detected by quantitative realtime PCR and Western blot. The expressions of matrix metalloproteinase ( MMP)-2 and MMP-9 were detected by immunohistochemistry and Western blot. Results ( 1 ) No significant differences in body weight and blood lipids were found between the AS group and the ghrelin group(P>0. 05), but both items were significantly higher than those of the CON group(P<0. 05). (2)The thickness ratio of the intima to media in the ghrelin treated group was distinctly less than that in the AS group(P<0. 05). (3)Compared with the AS group, the ghrelin group showed significantly decreased microvascular density and the expressions of VEGF and VEGFR2 (P<0. 05). (4)Compared with the AS group, ghrelin dramatically inhibited the plaque contents of MMP-2 and MMP-9 ( P<0. 05 ). Conclusions Ghrelin is able to inhibit the growth of neovascularizationin in the atherosclerotic plaque and the development of plaque. And these beneficial effects derive from downregulation of VEGF, VEGFR2, MMP-2, and MMP-9 at the advanced stage of atherosclerosis in rabbits.

Objective: To explore the relationship between prevalence of atrial fibrillation (AF), iskhemia stoke and CHA2DS2-VASc score in patients≥65 years in order to provide prevention and treatment basis in clinical practice. Methods: A total of 5016 patients admitted in our hospital from 2013-10 to 2015-10 were enrolled. The patients were divided into 2 groups: AF group, n=437 and Non-AF patients, n=4579; according to age, the patients were further assigned into 4 subgroups as <65 years subgroup, (65-74) years subgroup, (75-84) years subgroup and ≥85 years subgroup. The risk factors for AF occurrence were retrospectively studied. Results: Compared with the Non-AF group, the patients in AF group had the elder age and more male gender, both P<0.001; more patients combining with hypertension, coronary artery disease (CAD), diabetes, sick sinus syndrome and rheumatic heart disease, all P<0.001. Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were the independent risk factors for AF occurrence. Compared with Non-AF group, AF group showed the higher prevalence rate of ischemic stroke and the elder onset age, both P<0.01. For non-valvular AF, the ratio of patients with CHA2DS2-VASc score≥2 was higher than those with CHA2DS2-VASc score<2 and the rate of anticoagulant therapy was decreasing by age increasing, all P<0.001. Conclusion: Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were independently related to AF occurrence. Non-valvular AF patients had the higher risk for ischemic stroke than non-AF patients, anticoagulation therapy should be conducted at the early stage.

Objective To investigate the expression of cyclin G1、cyclin G2 in gastric carcinoma and its significance. Methods The mRNA expression of cyclin G1、cyclin G2 in 55 cases of gastric carcinoma was measured with RT-PCR. The protein expression of cyclin G1 and cell cycle were detected by flow cytometry.Results Expression rate of cyclin G1 in gastric carcinoma was 58%,which was higher than that in normal tissue(P

Objective To discuss the feature of transient intrahepatic cholestasis in early stage of orthotopic liver transplantation. Methods Based on the review of early (within 1 month) postoperative hyperbilirubinemia in consecutive 200 patients undergoing liver transplantation, we summarized the occurrence, development and outcome of early postoperative intrahepatic cholestasis. Results Early transient intrahepatic cholestasis was identified in 112 patients. The characteristic of early intrahepatic cholestasis is that DBIL and?-GT increasingly elevated from the second or third day postoperatively, with a peak on the 7 - 14th d, then descended to normal level on approximately 21 -28th day. The average peak level of DBIL and?-GT were( 157. 32?82. 08)?mol/L and (172?80) IU/L respectively. During the period of DBIL and?-GT ascending, AST and ALT kept descending, and within 1 week it could fall to normal level. Acute rejection, drug toxicosis and bile duct obstruction were excluded. Conclusions Postoperative early transient intrahepatic cholestasis associated with ischemia-reperfusion injury has its special clinical process and most patients recover themselves without the need for special therapy.