Objective To investigate the expression of DNA methyltransferase 1,3a,3b (DNMT1,DNMT3a,DNMT3b) in human hepatocellular carcinoma (HCC) and to determine their clinical significance.Methods The expression of DNMT1,3a,3b proteins was detected in 47 HCC tumor specimens and 42 HCC paracarcinoma liver tissues by immunohistochemistry.12 normal liver tissues were used as control.The results and clinicopathological parameters were analyzed.Results The positive expression rates of DNMT1,3a and 3b in HCC tissues were 80.9％,68.1％ and 78.7％ respectively.The positive expression rates of DNMT1,DNMT3a and DNMT3b in paracarcinoma tissues were 50.0％,52.4％ and 57.1％ respectively.The expression rates of DNMT1,3a and 3b in both HCC tissues and paracarcinoma tissues were significantly higher than normal liver tissues.The expression of DNMT1,DNMT3a,DNMT3b was correlated with tumor differentiation (P＜0.05) and hepatitis B surface antigen (HBsAg) positivity.Conclusions DNMT1,3a and 3b play important roles in carcinog(c)n(c)sis and development of HCC.

Objective To observe the selective regulation of peroxisome proliferator-activated receptors (PPAR) on fatty acid binding protein-4 (FABP4) in human syncytiotrophoblasts.Methods Cultivate normal human syncytiotrophoblast cells,and put in the specific antagonists and agonists of PPAR each subtypes receptors,then observe the different expression of FABP4 mRNA and protein.Results Pretreated the human syncytiotrophoblast cells with the agonists (GW7647,GW0742) and antagonists (GW6471,GSK0660) of PPARα and PPARβ receptors,the expression of the FABP4 was not significantly change (P＞0.05).However pretreated with PPARγ agonists (rosiglitazone,1 × 10-9,1 × 10-8,1 × 10-7 and 1 × 10-6 mol/L),the expression of FABP4 mRNA and protein could be dose dependent-promoted significantly (mRNA:1.27 ±0.12,1.45 ±0.14,1.57±0.14,1.72 ±0.12,protein:1.10 ±0.08,1.37 ±0.09,1.60 ±0.13,1.79 ± 0.14 ; P ＜ 0.05),furthermore,the promotion can be dose dependent-reversed by specific antagonists GW9662 (mRNA:0.92 ± 0.06,0.77 ± 0.06,0.64 ± 0.05,0.55 ± 0.05,protein:0.91 ±0.03,0.78 ±0.06,0.70±0.07,0.55 ±0.06; P ＜ 0.05).Conclusions In normal human syncytiotrophoblast cells,FABP4 is a target factor of PPARγ.PPARγ regulated the expression of FABP4 mRNA and protein selectively.And the regulation will not be influenced by the other two PPAR subtypes.

ObjectiveTo study the clinical value of minimally invasive treatment of the doppler-guided hemorrhoid artery ligation with lauromacrogal sclerosis injection in treatment of hemorrhoids.MethodsA retrospective analysis was made on treatment of 32 cases with hemorrhoids using doppler-guided hemorrhoid artery ligation combined with lauromacrogal sclerosis injection.ResultsAccording to the branch of the Chinese Medical Association by the Surgery the clinical diagnosis and Treatment Guidelines of Hemorrhoids (draft),the Ⅰ degree hemorrhoid was found in 1 case,Ⅱ degree hemorrhoids in 18 cases,Ⅲ degree hemorrhoids in 13 cases.Recovery was found in 32 cases.The longest follow-up time was 30 weeks.No relapse was found. ConclusionsDoppler-guided hemorrhoid artery ligation combined with lauromacrogal case sclerosis injection is a low aggressive minimally invasive method to treat hemorrhoid and has small trauma,definite effect,less pain,fewer complications,and short course and other advantages,but the longterm outcome needs further observation.

OBJECTIVE To find standard for the management of the medical waste through the plan,do,check and action(PDCA) loop method. METHODS Four steps of PDCA were done to treat the medical wastes. RESULTS Establishment of the effective management of organization and the feasible rules and regulations was an important pledge.Training,propaganda and education for enhancing every-one′s management consciousness were a considerable element.Matching institutions for treating medical waste was the most important basis.Examinations according to the formulated quality specification were the artifice. CONCLUSIONS PDCA loop method is one of the scientific management for treating the medical wastes.

Objective:To establish a method for the determination of residual 5 heavy metal elements in single use and gravity feed infusion sets and intravenous infusion needles, including Cd, Cr, Cu, Sn and Pb. Methods:After the pre-preparation,the sample was dissolved in 1% nitrate. The 5 heavy metal elements in the sample solution were determined by inductively coupled plasma mass spec-trometry (ICP-MS). Results:Under the ICP-MS assay conditions, each element showed good linearity within the range of 0-50 ng· ml-1(r>0. 999 0). The average recoveries were within the range of 92%-116% and 1. 6%-2. 9%, respectively (RSD<3,n=9). Conclusion:The operation is simple and can meet the demand for the analysis of heavy metal elements in single use and gravity feed infusion sets and intravenous infusion needles.

The combination of chemotherapy, radiotherapy and targeted therapies are considered to be major treatments for metastatic pancreatic cancer. At present, the target therapy-related medications include mainly antagonist of epidermal growth factor receptor, monoclonal antibody of vascular endothelial growth factor and so on. Erlotinib combined with gemcitabine has been demonstrated to prolong the survival of patients with pancreatic cancer.

Objective To investigate the clinical characteristics between elderly and non-elderly patients with ulcerative colitis (UC) in Shanghai, so as to improve the diagnosis and management of the disease. Methods The clinical and endoscopic data from 214 patients with UC,who were admitted to Shanghai Ruijin Hospital between 1998 and 2009,were retrospectively analyzed. The database was established and according to onset age,the patients were divided into elderly group (n= 28, ≥60 years of age) and non-elderly group (n = 128, ＜60 years of age), The comparisons between two groups were performed using Chi square test for non-quantitative variables, and student's t test and nonparametric tests for quantitative variables. Logistic regression was used to analyze the risk factor.Results Onset peak of UC was found in patients ranged from 40 to 49 years of age, and elderly patients were accounted for 13.08 % in Shanghai. There was no significant difference between two groups with respect to clinical manifestation, complications, Truelove and Witts criteria index, or endoscopic score. In active phase, elevated peripheral platelet counts were seen in more elderly patients than those in non-elderly patients (75% vs 29%, F= 4. 4, P= 0. 043). However, high level of peripheral platelet was found in non-elderly patients (Z= -2.6, P=0. 008). Endoscopic examination revealed that the colonic lesion in elderly patients was limited and was more common in left-sided colon and protosigmoid (F=5. 8, P = 0. 012). More non-elderly patients were treated with steroid in comparison to elderly patients with mild or severe UC (28. 6% vs 55.7%, F=7.7,P=0. 007). In addition, the high mortality was found in elderly patients when compared with non-elderly patients (20.8 % vs 2.84%, F= 12. 8, P = 0. 008). Conclusion The differences existed between elderly and non-elderly UC patients with respect to clinical manifestation, lab investigation, involved extent of colon, medication and prognosis.

The key of individualized therapy is that using molecular markers to select more suitable drug.At present,some studies have confirmed that certain molecular markers can predict the efficacy of the drugs.For example,cetuximab is beneficial in patients with K-ras wild-type colorectal cancer,gefitinib and erlotinib are beneficial in patients with epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer( NSCLC),imatinib is beneficial in patients with C-KIT gene-positive gastrointestinal stromal tumor.In terms of safety,the promoter polymorphism of UDP glucuronosyltransferase 1 polypeptide A1 ( UGT1 A1 ) can predict the toxicity of irinotecan.

Objective To investigate the effect of alternating shift on general well-being of nurses,and analyze its relationships with related factors. Methods Alternating shift nurses from general hospi-tals above courty-level in Liaocheng city who were engaged in clinical work were selected by duster sam-pling.Questionnnires were sent out and later gathered. The investigation tools included general well-being schedule(GWB) ,marital quality inventory, social support inventory, Eysenck personality questionnaire were used in survey. Results (1)There was difference in the score of general well-being between nurses with different ages and professional titles(P<0.01). (2)There was significant difference between GWB and oth-er factors such as marital quality,EPQ (psychoticism, neuroticism and introversion and extroversion), so-cial support(P<0.01). (3)Multivariable linear regression which took general well-being as dependent vari-able, the variables which entered the equation were neuroticism, family relationship,support utilization,psychoticism, objective support, introversion and extroversion, marriage satisfaction,arrangement of econ-omy. Conclusions (1)The older, the higher of professional tltles,the stronger general well-being of nurses. (2)Sabjective well-being and marital quality, social support, lying defense were positively corre-lated; neuroticism, psychoticism were negatively correlated. (3)Neuroticism, family relationship,support and utilization, psychoticism, objective Support, introversion and extroversion, marriage satisfaction,ar-rangement of economy can affect general well-being,among which neuroticism had great influence.

Objective To improve the diagnostic accurate rate by studying best values of chest posterior-anterior digital medical images in soft-copy reading. Methods 100 normal adults’ chest posterior-anterior digital medical images in recent 10 days in our hospital were randomly chosen. Five specialists of our department were invited to see these images by soft-copy reading and the best WW/WL values of different parts of the chest they selected were recorded. All the data were analyzed in statistics and the best WW/WL was got. Results The best WW/WL values of soft tissues of chest wall were 2 083/4 840,ribs 2 667/4 908,lung fiber 2 067/4 960,hilum of lung 1 848/5 130,heart and large vessels 2 206/5 438,mediastinum and diaphragm 2 180/5 530,thoracic vertebrae 1 471/5 801,ribs that covered by heart and diaphragm1 428/5 975. Conclusion Different parts in chest poster -anterior digital medical images need special WW/WL in soft-copy reading for better diagnosis of images.