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 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 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.

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.

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.

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 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 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.

ObjectiveTo explore adrenal insufficiency in the preterm infants who had critical lung diseases and the relationship between adrenal insufifciency and long-term or short-term prognosis.Methods The basal cortisol and ACTH of iffty preterm infants enrolled were tested. The peak cortisol at 30 minutes after low dose ACTH stimulation was tested. The adrenal insufifciency was deifned as the concentration of the basal cortisol less than 15 μg/dl or the increment of cortisol concentration after low dose ACTH stimulation less than 9 μg/dl. The pretern infants with adrenal insufifciency were the AI group and others were the adrenal normality, AN group.Results Thirty-one cases were adrenal insufifciency in 50 preterm infants with critical lung disease. The incidence was 62%. The concentrations of the basal and peak cortisol in AI group were lower than those in AN group (P<0.01). The increment of cortisol concentration after low dose ACTH stimulation had not signiifcant difference between two groups. The concentration of ACTH in AI group was lower than that in AN group (P<0.01). The mean arterial blood pressure in AI group was lower than that in AN group (P<0.01). The blood sugar, potassium and sodium had no signiifcant difference between two groups (P>0.05). There was no signiifcant difference in the mortality and the incidence of BPD between two groups (P>0.05).Conclusions The incidence of adrenal insufifciency was high in the preterm infants with critical lung diseases, which may be due to insufifcient production of endogenous ACTH. When the adrenal insufifciency was happened, the blood pressure is relatively low in preterm infants with critical lung diseases, but it was not related to the mortality and the incidence of BPD.

Objective To discuss the techniques and efficacy of Ho:YAG laser incision by using uteroscopy for ureterostenosis.Methods From July 2004 to April 2007,52 patients with ureterostenosis received ureteral incision by using Ho:YAG laser under a endoscope.Two double pigtail stents(F5 or F6) were placed in the ureters after the operation and left indwelling for 8 to 12 weeks.Ultrasonography and excretion urography were performed 3 to 6 months after extubation.Results Follow-up was available for 3 to 24 months(mean,17 months) in 46 patients,of which 40(87%) were cured after the treatment.In the cured patients,hydronephrosis,ureteral dilation,and ureterostenosis were improved,and the pain in the kidney region was relieved;none of them showed signs of infection.In the other 6 patients,4 were improved after the treatment(no deterioration of the symptoms of hydronephrosis,ureteral dilation,and pain in the kidney region,and no infection);and 2 failed(the symptoms of hydronephrosis and ureteral dilation deteriorated,and pain in the kidney region and infection were developed).Conclusion Endoscopic ureteral excision using holmium laser combined with indwelling of two double pigtail stents is effective and safe for ureterostenosis.