Precision medicine is currently being paid much attention and greatly promotes the diagnosis and treatment of various diseases,especially cancer.Surgery plays a pivotal role in the treatment of hepatocellular carcinoma (HCC) and precision hepatectomy stands as the most updated surgical idea.Application of the concept and techniques of precision medicine to further improve HCC surgery,consummate the skills and modalities of HCC surgical treatment,enrich the nature of precision hepatectomy,so as to make precise evaluation,early prediction,reduce postoperative recurrence and metastasis,find biomarkers of molecular targeted therapy and improve the prognosis is the prime task of HCC surgery.

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Objective:To study the effect of increased expression of Fas on the killing of ? cells Methods:The level of Fas expression and apoptosis of human ? cells strain (NIT) were detected by FACS Results:There is no Fas expression on NIT But Fas expression can detected by culturing NIT with IFN ? and/or TNF ? The apoptosis of NIT induced by sFasL and anti Fas correlates with the level of Fas expression Conclusion:Fas expression induced by cytokine may represent a factor for the initiation of ? cells destruction

Objective To determine the optimum process of ZTC1+1Ⅱnatural clarifying agents edulcorated mulberry leaf extracts. Methods The remaining rate of mulberry leaf alkaloid,flavone,polysaccharide and the solids removal rate were used as indexes,optimized by single factor experiment to study the effect of some factors,such as the order and dosage of clarifying agents,the concentration and the temperature of the extracting solution,whisking time,whisking speed and holding time,response surface methodology was selected to decide the best clarfication process. Results The optimal process:the order of the ZTC1+1Ⅱ natural clarifying agents was part B after part A,the dosage of clarifiers B and A were 10% and 5%volume of the extract,the extract solution was 0.17 g·mL-1 ,the temperature was 76 ℃,the whisking speed was 120 r·min-1 , the whisking time was 10 min,80 ℃ holding 30 min,and standing time was 12 h,the remaining rate of mulberry leaf alkaloid, flavone and polysaccharide were 92.5%,90.2% and 91.1%,the solids removal rate was 26.5%. Conclusion ZTC1+1Ⅱnatural clarifying agents could effectively purify the extracts of mulbery leaf,optimized by the response surface method,the method is simple and feasible,and clarity is good.

Objective To explore the relative importance of factors of sleep quality in predicting the anxiety and depression emotion. Methods Sleep quality and emotional condition of 112 patients with coronary heart disease were investigated with Pittsburgh sleep quality index(PSQI), self-rating anxiety scale (SAS)and self-rating depression scale (SDS). The relation between sleep quality and emotional condition was analyzed deeply by dominance regression analysis. Results After controlling the demographic vari-able of the sex,factors of the sleep quality such as sleep efficiency and function in the daytime had predict-ing effect on depression emotion;factors such as function in the daytime, sleep quality, sleep efficiency and sleep time possessed predicting effect on anxiety emotion. Conclusions According to different contribu-tion of various factors of sleep quality to anxiety and depression emotion, we should implement selective medical and nursing intervention during clinical work.

Objective:To explore the effect of behavioral training of creative art therapy(CAT) on interpersonal communication in teenagers.Methods:Eighty teenagers were randomly divided into study group( n=40) and control group( n=40).The study group was received the behavioral training of CAT (12 times, each activity lasts for 120 min), and the control group did not take part in the behavioral training of CAT.The two groups were measured with self-esteem scale(SES), shyness scale(SS) and social anxiety scale for children(SASC) before and after behavior training.SPSS 17.0 software was used for statistical analysis, and t-test variance analysis and Mann-Whitney U test were used to compare the differences between groups or within groups. Results:Before and after behavioral training, changes in the SES total score (7.00(5.00, 9.75) vs 1.00(0, 2.00)), the SS total score (7.00(6.00, 12.75) vs 2.00(1.00, 3.00)), the SASC total score (5.00(2.00, 8.75) vs 0(0, 1.00)) and two factor scores (3.00(0.25, 5.00) vs 1.00(0, 1.00), 2.00(1.00, 4.00) vs 0(0, 1.00))in the study group were obviously higher than those in the control group( Z=-7.347, -7.338, -5.841, -4.122 and -5.393, all P<0.05).The score differences of the SASC total score ((7.19±3.82) vs (3.21±3.04)) and two factor scores ((4.00±2.23) vs (1.68±2.05), 3.00 (1.00, 5.00) vs 2.00 (0, 2.00)) of girls were significantly higher than those of boys in the study group ( t=-3.611, -3.398, Z=-2.111, P=0.001, 0.002, 0.035). Conclusion:Behavioral training of CAT can improve teenagers' self-esteem, relieve their shyness and social anxiety, as well as promote their interpersonal communication.

OBJECTIVE:To optimize the ultrasonic extraction process of total alkaloids from mulberry leaves. METHODS:Based on the single factor experiment,response surface method was adopted to investigate the effects of ultrasonic extraction time, ultrasonic power,ethanol volume fraction,solid-liquid ratio and pH of solvent on the extraction rate of total alkaloids from mulber-ry leaves,then test data were analyzed by Design Expert 8.0.5 software,and the optimized process was confirmed and verified. RE-SULTS:The multiple correlation coefficient of established binomial equation fitting model was 0.969 9;the optimized condition for extracting alkaloid from mulberry leaf was ultrasonic extraction time of 48 min,ultrasonic extraction power of 800 W,ethanol vol-ume fraction of 70%,material-liquid ratio of 1∶25,pH 5. Under these conditions,the extraction rate of total alkaloids was 0.422%, with the bias ratio was less than 2% compared with the model predictions. CONCLUSIONS:The established model has good fit-ting performance,the extraction process is stable and reliable,and can be used for the extraction of alkaloids from mulberry leaves.

BACKGROUND:Studies have shown that fibrin glue can promote the survival of myoblast grafts, reduce infarct size and induce neovascularization of infarct zone. OBJECTIVE:To understand the condition of revascularization of infarcted heart muscle using endothelial progenitor cells combined with degradable fibrin glue materials. METHODS:A total of 27 Sprague-Dawley rats were randomized into three groups, 9 rats in each group:non-myocardial infarction group, immediate transplantation group and 1-week post-infarction transplantation group. Then, these three groups were sub-grouped into two groups, respectively:endothelial progenitor cells+fibrin glue group (experimental group) and fibrin glue group (control group). At 3 and 8 weeks after transplantation, the rats were sacrificed in each group. The revascularization and function of infracted heart muscle were observed by microscope, immunohistochemistry and echocardiography. RESULTS AND CONCLUSION:Under the microscope, there were some lax connective tissues between the heart and chest in the experimental groups, but no difference existed between the experimental and control groups. The heart structure was normal relatively and difficult to be distinguished between the experimental and control groups histological y and immunological y, and there was no angeioma, vascular malformation and tumor. The number of revascularization of heart muscle showed no difference between experimental and control groups as wel as between different experimental groups. Additional y, there was no significant difference in cardiac function between experimental and control groups. Although there are no positive results of endothelial progenitor cells, we wil modify and improve the strategy and believe that the celldelivery system is of benefit and efficacy.

Objective To study the clincial effectiveness and safety of endoscopic sphincteropapillotomy combined with balloon dilation for decompensated cirrhosis accompanied with choledocholithiasis.Methods Data of 79 cases of decompensated cirrhosis patients with choledocholithiasis who underwent limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD,the ESBD group) and 42 cases who underwent endoscopic papillary balloon dilation(EPBD,the EPBD group)were retrospectively analysed and compared for complete stone clearance rate,one-time stone clearance rate and complications.Results The rate of complete stone clearance and one-time stone clearance were 94.9％ (75/79) and 77.2％ (61/79)in ESBD group,and those were 88.1％ (37/42) and 59.5％ (25/42) in EPBD group respectively.The rate of complete stone clearance was a little higher in ESBD group than that in EPBD group.In ESBD group,ERCP-related bleeding occurred in 3 patients (3.8％),post-ERCP hyperamylasemia in 3 (3.8％)and post-ERCP pancreatitis in 2 (2.5％) ; while in EPBD group,post-ERCP hyperamylasemia occurred in 8 patients(19.0％),post-ERCP pancreatitis in 6(14.3％) and ERCP-related bleeding did not occur.There were no significant difference in ERCP-related bleeding between ESBD group and EPBD group (P =0.551).However,the rates of post-ERCP pancreatitis and hyperamylasemia in ESBD group were significantly lower than those in EPBD group(P ＜ 0.05).Conclusion ESBD is a safe and effective procedure for choledocholithiasis accompanied by decompensated cirrhosis,with several advantages over EPBD in terms of higher one-time stone clearance rate,reduced risk of post-ERCP pancreatitis and hyperamylasemia,and without noticeable increase in the risk of bleeding related to ERCP.

Objective:To explore the independent risk factors of death during hospitalization in patients with acute myocardial infarction (AMI) .Methods :Clinical data of 614 cases ,who were diagnosed as AMI during hospitaliza‐tion in our hospital from 2011 to 2013 ,were retrospectively analyzed .According to AMI patients'survival or not during hospitalization ,they were divided into death group (n=62) and survival group (n=552) ,single and multi-variable Logistic regression analysis were used to analyze the relationship among baseline feature factors and thera‐peutic methods of all patients and hospital mortality .Results:The mean age was (66.58 ± 12.87) years and there were 39 males (62.9% ) among the 62 dead patients .Hospital mortality was 10.10% (62/614) .Multi‐variable Lo‐gistic regression analysis screened following factor were independent risk factors related to AMI hospital mortality :age (OR= 3.065 ,95% CI:1.188~ 7.915) ,female (OR= 2.775 ,95% CI :1.200~ 6.419) ,heart rate (OR=2.836 ,95% CI:1.405~ 5.722) ,blood glucose (OR = 1.943 ,95% CI :1.186 ~ 3.184) ,Killip class IV (OR=1.744 ,95% CI:1.211~2.513) and left main or triple -vessel coronary disease (OR= 3.157 ,95% CI :1.244 -8.014) . P < 0.05 ~ < 0.01 .Conclusion : Advanced age ,female ,rapid heart rate ,elevated blood glucose level at hospitalization ,Killip class IV and left main or triple‐vessel coronary disease may be independent risk factors of death during hospitalization in patients with acute myocardial infarction .