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.

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 investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .

ObjectiveTo investigate the characteristics of patients with flaccid paralysis after high spinal cord injury. Methods1014 cases with traumatic spinal cord injury were investigated. The patients with flaccid paralysis after high spinal cord injury (spinal fractures above the level of T10) were analyzed. Results6 patients were ananlyzed, including 5 males and 1 female, mean of age was (42±12). The neurological injury involved C7 to T8, and the fractures involved T3 to T10. 3 cases had the neurological deterioration upward at least 3 spinal segments after operation compared with the fractures. One case accomplicated with severe pain in the chest had the subacute progressive ascending myelopathy up to C7 level. MRI showed extensive atrophy of thoracic spinal cord 6 months later in 5 cases. ConclusionThe incidence of flaccid paralysis after high spinal cord injury was rare. It presents the extensive thoracic spinal cord atrophy, and the causes and mechanisms are not clear.

BACKGROUND: In the central nervous system(CNS) of normal adults there are neural stem cells or neural progenitor cells, which are capable of self-renewing and multiple differentiating. In normal physiological conditions, intrinsic neural stem cells are in a resting state. What state will they be in during cerebral ischemia?OBJECTIVE: To observe the distribution, proliferation and differentiation of intrinsic neural stem cells in focal transient ischemia in rats.DESIGN: A randomized controlled exploratory trial based on the rats.SETTING: Neurobiological department, histological and embryological department of a medical college.MATERIALS: The experiment was conducted in the Neurobiological Department of Luzhou Medical College from July 2001 to July 2002. Altogether 41 healthy adult SD rats of either gender, weighting 250 g - 300 g, were selected.INTERVENTIONS: The focal ischemia model was made by blocking middle cerebral artery(MCA) and reperfusing for 0.5 hour, 3 hours, 6 hours, 12 hours, 1 day, 2 days, 3 days, 5 days and 10 days. Sham-operation group was treated by the same method, but the filament was not long enough to block MCA, and normal rats served as control group. The rats were sacrificed at given time points, and their brains were made into cerebral slices. The single-and double-labeled immunohistochemical staining was employed to detect the proliferation, distribution and differentiation of intrinsic neural stem cells.MAIN OUTCOME MEASURES: The distribution, proliferation and differentiation of intrinsic neural stem cells.RESULTS: Immunoreactivity of proliferating cell nuclear antigen(PCNA)was present in most ependymal cells in ventricular zone(VZ), and PCNA-positive cells were sparsely distributed in the parenchyma in normal and sham-operation groups. At 3 hours of reperfusion, PCNA-labeled cells were first detected in rostral subventricular zone. At 12 hours of reperfusion and onward, PCNA-positive cells appeared in some choroid plexus cells in bilateral lateral VZ. At day 3 to day 10 of reperfusion, PCNA-labeled cells significantly increased in infarct boundary in preoptic area, striatum and deep layer of frontoparietal cortex. PCNA-labeled cells were first detected in subgranular zone of dentate gyrus 3 days after reperfusion, and increased with time. A very small number of double-positive cells expressed with PCNA and glial fibrillary acidic protein(GFAP) were first detected in infract boundary in preoptic area on day 3 and onward. No double-PCNA and NF-positive cells were detected within 10 days of reperfusion.CONCLUSION: Focal cerebral ischemia activates intrinsic neural stem cells, which proliferate and differentiate, and migrate toward ischemic striatum and frontoparietal cortex. This may help clarify the mechanism of functional recovery after ischemia.

Objective To evaluate the effects of acute peritonitis on rocuronium?induced neuromus?cular blockade in abdominal muscles and function of the sarcoplasmic reticulum of rats. Methods Thirty?six pathogen?free male Sprague?Dawley rats, weighing 220-250 g, were divided into 2 groups using a ran?dom number table: control group (group C, n=12) and acute peritonitis group (group P, n=24). After the rats were anesthetized with pentobarbital sodium, acute peritonitis was induced by artificial gastric per?foration in group P. At 1 and 2 h after operation, the changes in the intra?abdominal pressure (IAP) with different volumes were detected, and blood samples were collected from the orbital veins for determination of serum levels of interleukin?6, tumor necrosis factor?alpha and interleukin?13. Rocuronium 3. 5 mg∕kg was then injected via the caudal vein. The IAP was recorded at 1, 5 and 10 min after administration. The intra?cellular free Ca2+ concentration was assessed using fura?2, and the maximal Ca2+ uptake and release rate in the sarcoplasmic reticulum were calculated. Results Compared with group C, the serum levels of interleu?kin?6 and tumor necrosis factor?alpha at 2 h after operation and IAP at 1 and 2 h after operation were signifi?cantly increased, the IAP was increased at 1, 5 and 10 min after administration of rocuronium, and the maximal Ca2+ uptake rate and amount of calcium uptake in the sarcoplasmic reticulum were decreased in group P ( P<0.01) . Conclusion Acute peritonitis decreases rocuronium?induced neuromuscular blockade in abdominal muscles, which may be related to the impaired Ca2+uptake function of the sarcoplasmic reticu?lum of rats.

Objective To explore the value of time-invariant CTA in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.Methods The score of collateral circulation was compared between single-phase and time-invariant CTA.NIHSS score was calculated at admission and two weeks after admission.A 50% or greater decrease in NIHSS score over two weeks was considered as major neurologic improvement,which showed good clinical outcome;otherwise,it indicated bad outcome.The predictive ability of time-invariant CTA for clinical outcomes was assessed based on ROC curves.Results Compared with single-phase CTA,more collateral vessels could be viewed on time-invariant CTA.The average score of collateral circulation on time-invariant and single-phase CTA was 1.50±0.69 and 1.15±0.49 respectively (P=0.006<0.05 ).Time-invariant CTA had the moderate predictive ability for clinical outcomes in patients with acute ischemic stroke (AUC=0.810;P=0.032<0.05). Conclusion The time-invariant CTA showed potential value in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.

Objective The micro-vascular element plays a key role in the delivery of nutrients and the regulation of hemodynamic behavior, however, research is often hindered by ethical , economic and technological issues .Therefore, construction of a micro-vascular network in vitro will help to study the related pathological and physiological behavior in microvessels.Methods In this study, a micro-vascular element model with features of a micro-vascular network in vivo was designed based on the network structure of retinal arterioles .A micro-vascular network model in vitro, characterized by network asymmetry and the presence of both bifurcation-and side-branches , was developed by soft lithography technology . The developed microdevice allowed for the quantification of the cell -depletion layer ( CDL) thickness and hematocrit ( Ht) distribution within the microchannel networks .Results and Conclusion The study showed the potential of the developed in vitro model in revealing key hemodynamic features which have been detected for microvascular elements in vivo, including the relationships between CDL thickness , Ht and red blood cell distribution .The present study provides a new strategy and a technology for studying hemodynamics and microvascular system diseases in vitro.

Objective To understand the undergraduate nursing students’ awareness of the basic situation of occupational exposure in Kunming Medical University, and to understand their knowing status of occupational exposure knowledge. Methods We used self- designed questionnaire to investigate 449 undergraduate nursing students in Kunming Medical University to obtain the status of occupational exposure and protection knowledge level of students.Results (1) 449 students were investigated, and 258 of them had been in clinical practice, and occupational exposure occurred in 48.8% of them. (2) Occupational exposure factors included grade, washing hands and wearing gloves;The results showed that:Grade was a risk factor and wearing glove and washing hands were protective factors. (3) There was relevance between accepting the occupational protection education and the occupational exposure. Conclusions A useful measure to reduce the occurrence of occupational exposure is Pre-service training for undergraduates nursing students. Operation should be in strict accordance with operating specifications. Schools and departments should implement occupational protection system, so as to strengthen the related knowledge vocational education,enhance self-protection awarenes,and reduce or minimize the occurrence of occupational exposure.