Portal vein tumor thrombus (PVTT) influence the prognosis of hepatocellular carcinoma.The development of PVTT is a multi-factor,multi-part process.According to anatomic features of the portal vein in the liver and tumor thrombus of HCC developing modes,a uniform tumor thrombus types system (typesⅠ -Ⅳ) is recommended.Multi-modal therapy based on surgery,interventional therapy and radiotherapy can improve the curative effect enormously.

Acetazolamide, a sulfonamide-derived medication, is frequently used in the treatment of various types of glaucoma. But this kind of medicine is associated with acute angle closure glaucoma. This paper is a review for the researches of this rare adverse reaction at internal and abroad. It can prompt more ophthalmologists to understand and pay attention to this rare adverse reaction of acetazolamide and sulfonamides derived drugs. Then the doctor will make accurate diagnosis, timely treatment and grasp the right operation opportunity and reduce the occurrence of postoperative complications ultimately.

Mind map is a kind of thinking tool, which draws the mind′s thoughts through words and pictures and can be applied instudy,life and work.Through biblio-metrological analysis, this study finds that domestic application of mind map in nursing focuses on fields such as nursing teaching, clinical nursing management and health education. The study and application of mind map in domestic nursing field are only in the beginning and exploration stage, lacking experimentation and evaluation study under the guidance of scientific methods, both the depth and breadth of research are yet to be improved.

Objective To reveal the change tendency of serum osteopontin(OPN) in carcinogenesis and development of gastric cancer(GC), and explore the usefulness of serum OPN in the diagnosis of GC and the differential diagnosis of early GC and advanced GC.Method Serum OPN levels were detected by enzyme-linked immunosorbent assay, including 70 advanced GC, 24 early GC, 47 dysplasia, 42 intestinal metaplasia, 46 chronic superficial gastritis patients and 38 normal controls.Results Serum OPN level in GC group (57.03 ng/ml) was significantly higher than those in other groups.Serum OPN level in advanced GC group (66.05 ng/ml) was significantly higher than that in early GC group (41.93 ng/ml), serum OPN level in early GC group was significantly higher than those in dysplasia, intestinal metaplasia and chronic superficial gastritis, and serum OPN level in the latter three groups was significantly lower than that in normal controls (P

Objective To investigate the relationship of gastric pH value with intragastric bacterium and pulmonary infection in rats at different ages.Methods Thirty Wister rats were divided into three groups: young control group, senile group garaged with saline and young omeprazole group garaged with omeprazole (30mg/kg/d). The gastric pH value was measured after two weeks, and bacterial culture of gastric and lung tissues were done and the pathological sections of lung tissues were made.Results The gastric pH (2. 450±1. 344), number of intragastric bacterium (5. 579±4. 316) cfu/g and number of pulmonary bacterium (1. 617±3. 509) cfu/g in senile group had no differences compared with young control group [(2. 010±0. 507), (1. 505±3. 259)cfu/ g, (0. 475±1. 503)cfu/g, respectively, all P>0. 05]. The differences in gastric pH value, number of intragastric bacterium and number of pulmonary bacterium had statistical significances between young omeprazole group and young control group [(5. 560±1. 007)vs. (2. 010±0. 507), (9. 942±1. 663) cfu/g vs. (1. 505±3. 259)cfu/g, (6. 272±3. 830) cfu/g vs. (0. 475±1. 503)cfu/g, all P<0. 01]. The lung tissues were slightly infiltrated with lymphocytes both in young control group and senile group, and 30% of rats in young omeprazole group had pulmonary infection.Conclusions The number of intragastric bacterium and pulmonary bacterium is increased with the increasing of the gastric pH value, and the pulmonary infection becomes heavier in these rats. But the number of intragastric bacterium and pulmonary bacterium and the pulmonary inflammation have no changes with the increasing of age.

Objective To observe the changes of tissue structure of gastric mucosa with aging in rats. Methods Twelve healthy Wistar rats were divided into two groups: aged (12 months,n=6) and non-aged rats (3 months,n=6). The thickness of gastric gland and muscular layer of mucosa were observed under the light microscopy. Pepsin activity and the expression of proliferating cell nuclear antigen (PCNA) were detected by biochemical method and immunohistochemical method respectively. Results Intestinal metaplasia, dysplasia and adenoma were not found in gastric mucosa in two groups. In aged versus non-aged rat group, the thickness of gastric gland was decreased [(271.5±47.4) μm vs. (350.9±53.3) μm, t=2.731, P<0.05], while the thickness of muscular layer of mucosa was increased [(98.1±13.1) μm vs. (62.4±10.6)μm, t=5.174, P<0.01]. The content of pepsin in aged rats were lower than in non-aged rats[(3. 011±1. 222) U vs. (4.733±1.304) U, t= 2.361, P<0.05]. Immunohistochemistry results showed that the positive cells of PCNA were located in gastric stem cells in cervical part, and the thickness of the gastric stem cells was decreased in aged rats. Conclusions The incidences of gastric gland atrophy and muscular layer hypertrophy are increased, and the secretion of pepsinogen and the proliferation ability of gastric stem cells are decreased in aged rats.

Objective To analyze clinical characteristics of patients with gastrointestinal bleeding (GIB)and the death-related risk factors.Methods A retrospective analysis Was conducted in 414 patients hospitalized for GIB during a 16-year period of 1994 to 2009.Logistic regression analysis identified predictors of mortality.Results The mean age of the 414 patients is 83.5 years old,ranging from 65 to 96years old.The main causes of GIB were peptic ulcer(33.1%,137/414),gastroduodenal mucosal erosion (28.5%,118/414)and tumor(21.0%,87/414).The main symptom was melena(71.0%,294/414).Drugs that induced GIB were mainly non-steroidal anti-inflammatory drugs,including aspirin(11.1%,46/414),acetaminophen(8.9%,37/414)and indomethacin(1.9%,8/414).14%of patients(58/414) died of GIB in 30 days.The proportion of drug-induced GIB and gastroduodenal mucosal erosion caused GIB had increased significantly during the period of 2004 to 2009(P<0.05).Analysis of 30-day mortality risk showed advanced age,low diastolic blood pressure,high heart rate,low hemoglobin levels at presentation and hemorrhage volume in dead GIB elderly patients were significantly different compared with GIB elderly patients alive.Presence of severe comorbidity(heart failure and renal failure)and caused by cirrhosis and portal hypertension in GIB elderly patients were the only independent predictors of 30-day mortality (P<0.001).Conclusion Death of GIB patients occurred predominantly in elderly patients with severe comorbidities and systemic conditions at presentation.

Objective To investigate the methylation status of E-cadherin(E-cad)and its protein expression in human small bowel adenocarcinomas(SBAC),and the association of these findings with clinico-pathological characteristics.Methods E-cad gene hypermethylation and its protein expression in 36 patients with primary SBAC and the paired adjacent tissues were tested by methylation-specific PCR(MSP)assay and immunohistochemistry(IHC)respectively.Data associated with clinico-pathological characteristics was analyzed.Results The hypermethylation frequency of E-cad was 38.9% in cancerous tissues and 8.3% in adjacent tissues(P＜0.01).The positive rate of E-cad expression was 41.7% in cancerous tissues and 97.2% in adjacent tissues(P＜0.01).Twelve out of 21 cases without protein expression revealed methylated(P＜0.01).Methylation status was closely related to E-cad protein expression in SBAC.The hypermethylation of E-cad gene and the expression Of E-cad protein were significantly correlated with the depth of invasion,the differentiation and lymph node metastasis(P＜0.05),but were not correlated with other clinico-pathologic parameters such as age,sex,tumor size or location(P＞0.05).Conclusions The hypermethylation of E-cad gene can down regulate the protein expression,which closely related to the depth of invasion,the differentiation and lymph node metastasis.

Objective To explore the influence of catheterization for urinary tract infections and the importance of humanistic nursing. Methods Totally 248 patients who were admitted into our hospital from February 2013 to April 2014 were randomly divided into two groups. Patients in the control group (117 cases) were given spray fungicide and regular disinfection of urethra by nursing staff, and patients in the observation group (131 cases) were nursed by themselves or their family after been taught the way of spraying fungicide and cleaning. Ana-lyzed the psychological status, routine urine, urinary tract infections, nursing job satisfaction of the patients, and the relevant data were ana-lyzed by SPSS 17. 0 software. Results The third day after placing urinary catheter urethra, the relevant nursing can reduce the rate of urina-ry tract infections in patients. the difference of the two groups was statistically significant (P<0. 05). The rate of urinary tract infections at the seventh day after placing urinary catheter urethra was 39. 69% in the observation group and 41. 03% in the control group, the difference of the two groups was not statistically significant (P >0. 05). Infection rate of male patients (29. 01%) is higher than female patients (10. 69%). The satisfaction rate of urethra care in the observation group was 87. 79%, and the satisfaction rate of other project were all higher than 92. 5%. The satisfaction rate of urinary tract nursing check in the control group was 79. 49%, and the satisfaction rate of nurse-patient communication was 83. 76%. It was found that the difference of communication between nurses and patients, service attitude and the urethra care were statistically significant. Conclusion It can reduce the rate of urinary tract infection after placing urinary catheter in pa-tients for 7 days and nursed by patients themselves with spraying fungicide and cleaning. Strengthen the humanistic nursing care can improve nursing satisfaction.

Objective To determine the effects and mechanisms of somatostatin analogues (sandostatin) on pancreatic repair and regeneration in caerulein induced pancreatitis. Methods Acute pancreatitis was induced by intra abdominal infusion of caerulein in rats, sandostatin was administered intra abdominally at the time of induction of pancreatitis and 24, 48 and 72 hours after. Rats were sacrificed at 6, 24, 48, 72 and 96 hours after the operation. The mRNA expression for Transforming growth factor ? 1 (TGF ? 1) was evaluated by reverse transcription polymerase chain reaction, pancreatic tissue DNA synthesis was measured by 3H thymidine method in vitro and protein content was detected by Lowry's method. Results The serum amylase level was decreased significantly in the sandostatin treated group. Expression of TGF ? 1 mRNA was undetectable in the normal pancreas and the treated group at 6 hours. TGF ? 2 was observed at 24 hours after the induction of pancreatitis, reaching maximum at 72 hours. It could be detected in the sandostatin treated group at 6 hours, reaching maximum at 24 hours, the expression of TGF ? 1 was increased significantly in the sandostatin treated group as compared with the non treated group at 24, 48 hours. Pancreatic tissue DNA synthesis showed a significant decrease during the first 72 hours following the induction of pancreatitis and a marked increase was observed at 96 hours after treatment with sandostatin. Within 48 hours of the induction of pancreatitis, total protein content in pancreatic tissue declined, and there was a significant increase in the sandostatin treated group at 48 hours, reaching maximum at 96 hours. Conclusions Effects of somatostatin analogues (sandostatin) on pancreatic tissue regeneration in acute pancreatitis in rats might be attributed to the enhancement of TGF ? 1 gene expression which subsequently stimulates formation of extracellular matrix components, increases protein content and DNA synthesis, thus accelerates pancreatic repair and regeneration.