Hepatocellular carcinoma is one of the most common cancer with a high incidence and mortality,representing a main type of primary liver cancer.However,the molecular and cellular mechanisms of hepatocellular carcinoma pathogenesis are still poorly understood.Traditionally,the development of hepatocellular carcinoma has been viewed as a process of transforming of normal cells into malignant driven by the genetic alterations in tumor-suppressor gene deactivation and pro-oncogene activation.In recent years,with the deeper understanding of tumor,it has been found that epigenetic alterations are closely related to the occurrence and the development of hepatocellular carcinoma.DNA methylation is one of the most common epigenetic events occurring in human genome,as well as the best studied of the epigenetic changes.This review focuses on the state-of-the-art advancements of DNA methylation in hepatocellular carcinoma.

Because of the particularity of the interventional therapy,that is,the interventional management covers a large scope in clinical application and involves the diagnosis and treatment of various diseases of multiple systems and organs,the clinical interventional practice has really brought an unprecedented challenge for the administration of the nursing care in the intervention ward.In our hospital,independent nursing group for the intervention ward was established two years ago.For the past two years,we have constantly groped and summarized the reasonable and effect administration of interventional nursing care.Pertinent administrative measures,such as nurse training,strengthening of communication with physicians and focusing on key links in nursing care and promptly finding out the weak points in clinical work,have effectively improved the quality of clinical nursing,in this way the clinical nursing practice has been integrated into the interventional therapy and the safe and high-quality nursing service has been provided to the patients.

ObjectiveTo determine the principle and method of surgical management of acute colon obstruction caused by carcinoma in the elder patients. MethodsClinical data of 98 patients with acute colon obstruction caused by carcinoma were analyzed retrospectively. ResultsOf 98 patients undergoing operation,complications occurred in 8 cases,and 3 ( 3.1%)died postoperatively.The other patients were healed. ConclusionsThe management of acute colon obstruction caused by carcinoma in the elder patients depends on the patients,general condition and local condition of the carcinoma.If it is an indication, one-stage resection of the cancer and anastomosis of the colon may be safe and suitable .

Objective To assess the conscious sedative effect of midazolam during the procedure of ERCP, in terms of general stress responses of the patients, the circulatory change, tolerance, patient cooperation and safety during and after the procedure. Method One hundred twenty patients undergoing standard ERCP using the same model of endoscope. Each patient received intramuscular injection of midazolam at 0. 15mg/kg 20 min before starting the procedures. The sedative score (OAA/S) and the major vital signs (mean arterial pressure( MAP) ,heart rate(HR) and atrerial oxygen saturation (SpO2) ) were recorded during and after the endoscopic procedure. The degree of amnesia of the patients and the extent of satisfaction on both patient and physician sides were also assessed. Results The procedures were successfully completed in all patients. There was no significant change in MAP,HR and SpO2 in these patients. The adverse reactions to the procedures were significantly reduced. No signs of respiratory suppression was observed among this group of patients during and in the immediate post procedure period. Conclusion Conscious sedation by intramuscular injection of midazolam at a dose of 0. 15mg/kg 20min before the ERCP ameliorates the stress of the patients , maintained and steady hemodynamic condition for the procedure and an amnesia status after the procedure. Hence, midazolam is a satisfactory consions selative agent applicable in the ERCP examination.

Objective To assess the efficacy of combination therapy with all-trans-retinoic acid (ATRA ) and arsenic trioxide (ATO) in treating patients with acute promyelocytic leukemia (APL) .Methods A retrospective study was conducted to evaluate the efficacy of combining ATO with ATRA based induction therapy ,followed by 3 courses of consolidation chemotherapy and 2-year sequential ATO/ATRA maintenance therapy in newly diagnosed APL ,and the efficacy between high risk group and low/inter-mediate risk group ,also between different PML-RARa isoform sub-group were compared .Results In high risk group and low/in-termediate risk group ,the complete remission(CR)rates were 70 .0% and 96 .9% (P=0 .04) ,respectively ;the 3 years overall sur-vival rates(OS) and disease free survival rates (DFS) were(70 .0 ± 14 .5)% ,(96 .9 ± 3 .1)% ,P= 0 .01 and(66 .7% ± 19 .2)% , (93 .8 ± 6 .1)% ,P=0 .08 ,respectively .In BCR1 group and BCR3 group ,the CR were 78 .6% and 95 .6% (P=0 .14) ,respectively ;the rates of 3 years OS and DFS were(95 .7 ± 4 .3)% ,(78 .6 ± 11 .0)% ,P=0 .18 ,and(92 .9 ± 6 .9)% ,(87 .5 ± 11 .7)% ,P=0 .24 , respectively .Conclusion The results indicate that ATO based first-line protocol is highly effective for treatment of newly diagnosed APL ,especially for the PML-RARa BCR3 isoform APL .

ObjectiveTo observe the effects of traditional Chinese medicine which supplements Qi and activates blood circulation on the treatment of the X-ray radiotherapy-induced lung injury.MethodsEighty-four patients who were given three-dimensional conformal radiotherapy were randomized into treatment group and control group.The patients in treatment group were given traditional Chinese medicine, which supplements Qi and activates blood circulation, while the patients in control group were given antibiotics and hormone instead.ResultsThe outcome of treatment group was better than that of control.The response rates were 88.6％ and 60.0％, respectively (x2 = 9.16, P ＜ 0.05) .Compared with the patients in control group, the clinical manifestations and pulmonary CT reflected better response in the patients of the treatment group(x2 =12.22,P ＜ 0.05) .ConclusionThe traditional Chinese medicine, which supplements Qi and activates blood circulation,has a good therapeutical effect on radiation pneumonitis and protective role for radiation-induced pulmonary fibrosis.

Objective To eveluate the pancreatic injury induced by smoking alone or combined with alcohol consumption,and its possible mechanism.Methods The Wistar rats were divided into control group (n=10),smoking group (n=30),drinking group (n=42) and smoking combined with drinking group (combination group,n=48).Serum levels of interleukin (IL)-6,superoxide dismutase (SOD) activities,monocyte chemoattractant protein-1 (MCP-1) and hydroxyproline were determined at 4th-,8th- and 12th- week.The pathohistological changes of the pancreas were examined using HE staining and the expression of α-smooth muscle actin (α-SMA) were measured by immunohistochemistry.ResultsIn contrast to control group,pancreatic changes including cytoplasmic vacuolation and increased levels of α-SMA and hydroxyproline were found in both smoking and drinking groups at the 8th-week (P<0.01).Whereas these changes were aggravated in combination group (P<0.05).Serum level of IL-6 and MCP-1 expression in pancreatic tissue were significantly increased in smoking group when compared with control group.But MCP-1 expression was lower in drinking group than control group.Moreover,the SOD activity in pancreatic tissue decreased in smoking and drinking groups,especially in combination group.Conclusions Long-term smoking can induce cytoplasmic vacuolation in pancreatic acinar cells,enhance inflammatory factors and chemokine expression and aggravate oxidative stress response in pancreas.These changes are aggravated when smoking and drinking coexisted.The mechanism behind it may be associated with increased oxidative stress response in pancreas.

Objective To summarize the experience of nursing the patients with liver transplantation complicated with early portal vein thrombosis treated with post-embolectomic anticoagulation. Method The clinical data of 5 cases of liver transplantation-induced portal vein thrombosis treated with post-embolectomic anticoagulation was reviewed to summarize the curative effect , key points for disease conditions and anticoagulative nursing. Results The anticoagulative effect was not good in only one case. 4 other cases were recovered by embolectomy and postoperative anticoagulation therapy as well as related nursing measures. Conclusion The nursing measures such as close observation of the disease processing, early reasonable anticoagulation, accurate medication, prevention of patent complication are critical for preventing the recurrence of portal vein thrombosis after liver transplantation.

Single-supervisor system is the widespread practice for graduates of clinical medicine at present. But in terms of education to clinical medical graduate students, students rotate in the departments of various disciplines for a long time, and there are more rotary department, resulting in some students' unbalanced learning development. Combined with the charac-teristics of the department of hematology, multi-supervisors training model was carried out to the rotating masters of other disciplines when they rotated in hematology department. With supervisor equipment and teaching implementation, we applied the principle of integrating theory with practice and trained students' innovation ability and doctor-patient communication ability. Compared with traditional single supervisor training pattern, multi-supervisors system can effec-tively improve the students' theoretical level, practical skills and comprehensive ability when the clinical medical graduate students rotate in the department of hematology.

ObjectiveTo investigate the imaging characteristics of solitary fibrous tumor(SFT).MethodsThis study included 11 cases with SFT proved by pathological results.The imaging manifestations were retrospectively reviewed and analyzed in comparison with surgical and pathological results. Among them,8 patients underwent CT plain scan (1/8) or enhanced scan (7/8),4 patients underwent MR plain scan (2/4) or enhanced scan (2/4),and only 1 patient underwent both CT and MR scan.Results( 1 )SFT were located in the thoracic cavity(2/11 ),abdominal and pelvis(5/11 ),and somatic soft tissues (4/11 ).The average tumor size was 11.8 cm ( 2.5 to 23.0 cm).Among them,4 tumors were round or ellipse,and 7 tumors were irregular.Eight tumors had well-defined contours,and the others showed illdefined contours.(2)On CT scan,all SFTs showed inhomogeneous density with low density areas.Calcification was seen in I case,and hemorrhagic foci were detected in 2 cases.(3)On MR scan,all SFTs showed intermediate signal intensity on T1 WI.Three tumors were slightly hyperintense and the other was hypointense on T2WI.All of them were rich of vascular signal voids.Three tumors,including 2 tumors with scattered long T1 and T2 signal and 1 tumor in the liver with hyperintense haemorrhage,displayed inhomogeneous mixed signal.One tumor in the orbit showed homogeneous signal.(4)On enhanced scan,9 tumors showed irregular enhancement with multiple circuitous vessels in the arterial phase,and continuous or progressive enhancement with patch non-enhanced areas in the venous phase.( 5 ) Histologically,SFTs were composed of juxtaposed hyper- and hypo-cellular spindle cells,dense collagenous stromas and numerous thin-walled blood vessels with a staghorn configuration.Conclusion The possibility of SFT should be considered when a single soft tissue mass with sharp border,inhomogeneous density is detected,especially with inhomogeneous enhancement maintaining in the venous phase.