Hepatocellular carcinoma (HCC) is one of the most frequent human malignancies worldwide with very poor prognosis. It is generally accepted that the progression of HCC is a long-term process with accumulation of multiple genetic and epigenetic alterations, which further lead to the activation of critical oncogenes or inactivation of tumor suppressor genes. HCC is characterized with multiple cancer hallmarks including their ability to proliferate, anti-apoptosis, invade, metastasis, as well as the emerging features such as stem cell properties and energy metabolic switch. The irreversible alterations at genetic level could be detected as early as in the pre-neoplastic stages and accumulate during cancer progression. Thus, they might account for the cancer initiating steps and further malignant transformation. In addition to genetic alterations, epigenetic alterations can affect the cancer transcriptome more extensively. Alterations in DNA methylation, histone modification, miRNAs, RNA editing, and lncRNAs might result in disrupted gene regulation networks and substantially contribute to HCC progression. In this review, the genetic and epigenetic alterations which significantly contribute to the malignant capabilities of HCC will be updated and summarized in detail. Further characterization of those critical molecular events might better elucidate the pathogenesis of HCC and provide novel therapeutic targets for treatment of this deadly disease.
Carcinoma, Hepatocellular ; genetics ; metabolism ; pathology ; Chromosome Aberrations ; Disease Progression ; Epigenesis, Genetic ; Gene Expression Regulation, Neoplastic ; Genetic Predisposition to Disease ; genetics ; Humans ; Liver Neoplasms ; genetics ; metabolism ; pathology ; Models, Genetic ; Mutation

Objective To understand the correlation of enterovirus 71 (EV71), P-selectin glycoprotein ligand-1 (PSG L-1), and scavenger receptor B2 (SCARB2) and to explore the possible pathway and mechanismof EV71 infection by observing the expression of EV71, PSG L-1 and SCARB2 in tissues of infants with brain stemencephalitis. Methods T he organs and tissues of infants with EV71-VP1 positivi-ty in their brain stems were chosen. Expression and distribution of EV71-VP1, PSG L-1, and SCARB2 were detected and compared by immunohistochemistry. Results Strong staining of EV71-VP1 was ob-served in the neuron, glial cells, the inflammatory cells of perivascular cuffing, parietal cells of the gas-tric fundus gland while alveolar macrophages, intestinal gland epitheliumcells, mucosa lymphoid nodule and lymphocyte of palatine tonsil showed moderate staining and weak staining were displayed in mesen-teric lymph nodes and lymphocyte of spleen. PSG L-1 expression was detected in parietal cells of the gastric fundus gland, tonsillar crypt squamous epithelium, alveolar macrophages and leukocytes in each tissue. SCARB2 expression was observed in all the above tissues except the intestines and spleen. Con-clusion T he distribution of EV71 correlates with SCARB2 expression. SCARB2 plays an important role in virus infection and replication. Stomach may be an important site for EV71 replication.

Objective:To compare the economic characteristics of the four artificial liver models [plasma exchange, half-dose plasma exchange combined with double plasma adsorption (DPMAS), pre-equal amount of plasma exchange followed by DPMAS, and pre-DPMAS followed by equal amount of plasma exchange] in the treatment of liver failure.Methods:A decision tree model was established with the Treeage pro 2011 software. The cost-effectiveness ratio and incremental cost-effectiveness value of four different treatment modalities were calculated and compared in patients with liver failure at early, mid and late stages, respectively. The sensitivity analysis of the model was performed using data from the preliminary research results of these groups.Results:The cost-effectiveness ratio and incremental cost-effectiveness value of patients treated with artificial liver therapy with half-dose plasma exchange combined with DPAMS plan in early stage liver failure were 89 547.79 and 34 665.34, which was lower than per capita GDP, so the increased cost had cost-effective advantages. In the middle and late stage of liver failure, the cost-effectiveness ratio and incremental cost-effectiveness value of pre-DPMAS followed by equal plasma exchange plan was 122 865.5 and 284 334.97, and 70 744.55 and 75 299.48, respectively, which was less than three times of per capita GDP. The increased cost was acceptable and had economic advantages. The sensitivity analysis results showed that the basic analysis results were reliable.Conclusion:Half-dose plasma exchange combined with DPAMS plan is the most cost-effective treatment for early liver failure, while pre-DPMAS followed by equal plasma exchange plan is the most economical treatment for mid and late stage liver failure.

As an important auxiliary material, adhesive materials have many important applications in various fields including but not limited to industrial packaging, marine engineering, and biomedicine. Naturally occurring adhesives such as mussel foot proteins are usually biocompatible and biodegradable, but their limited sources and poor mechanical properties in physiological conditions have limited their widespread uses in biomedical field. Inspired by the underwater adhesion phenomenon of natural organisms, a series of biomimetic adhesive materials have been developed through chemical or bioengineering approaches. Notably, some of those synthetic adhesives have exhibited great promise for medical applications in terms of their biocompatibility, biodegradability, strong tissue adhesion and many other attractive functional properties. As natural adhesive materials possess distinctive "living" attributes such as environmental responsiveness, self-regeneration and autonomous repairs, the development of various biologically inspired and biomimetic adhesive materials using natural adhesives as blueprints will thus be of keen and continuous interest in the future. The emerging field of synthetic biology will likely provide new opportunities to design living glues that recapitulate the dynamic features of those naturally occurring adhesives.
Adhesives ; Animals ; Biocompatible Materials ; Biomimetic Materials ; chemistry ; Biomimetics ; Bivalvia

OBJECTIVE： To evaluate the clinical efficacy and economics of α-lipoic acid injection alone or combined with Mecobalamin injection versus Mecobalamin injection in the adjunctive treatment of diabetic peripheral neuropathy （DPN）. METHODS： Retrieved from PubMed， Cochrane Library， Embase， CNKI， VIP， CBM and Wanfang database， using “mecobalamin” “α-lipoic acid” and“diabetic peripheral neuropathy”as Chinese retrieval words， “Thioctic acid” “α-lipoic acid” “Methylcobal” “Mecobalamin” “Diabetic peripheral neuropathy” as English retrieval words， relevant randomized controlled trials （RCTs） were collected during the date of database establishment to Aug. 30th， 2018. Meta-analysis was conducted for total response rate. From the perspective of health care providers， cost-effectiveness analysis was used for economic evaluation and sensitivity analysis was conducted by a 15％ fluctuation of cost and total response rate. RESULTS： Totally 13 RCTs were included， involving 1 131 patients. The results of Meta-analysis showed that the total response rate of two-drug combination therapy in the treatment of DPN was higher than that of mecobalamin alone [RR＝1.41， 95％CI（1.28， 1.55）， P＜0.000 01]； that of α-lipoic acid injection alone in the treatment of DPN was higher than that of mecobalamin injection alone [RR＝1.35， 95％CI（1.25，1.47）， P＜0.000 01]， with statistical significance. Results of cost-effectiveness analysis showed that the cost-effectiveness ratio （CER） of Mecobalamin injection was 211.38 yuan， and CER of two-drug combination and α-lipoic acid injection alone were 1 484.42 and    1 383.49 yuan， respectively. The incremental cost-effectiveness ratio （ICER） were 4 589.52 and 4 638.82 yuan， which were all lower than per capita GDP in 2017. Sensitivity analysis showed that the cost-effectiveness analysis results kept stable. CONCLUSIONS： Compared with Mecobalamin injection， α-lipoic acid injection combined with Mecobalamin injection in the adjunctive treatment of DPN show high total response rate and economics.

OBJECTIVE：To study the potential ris k of Chinese patent medicine for the treatment of stable chronic obstructive pulmonary disease （COPD），and to provide reference for the safety of clinical drug use. METHODS ：Retrieved from Chinese journal full-text database ，CBM，Wanfang database and VIP ，using“stable”“Chronic obstructive pulmonary disease ”“COPD” “Chinese patent medicine ”as retrieval words ，relative literatures about Chinese patent medicine in the treatment of stable COPD were retrieved ，and retrieval time limitation was from their establishment to Sept. 2019. The type and components of Chinese patent medicine were collected. The potential risk of Chinese patent medicine was analyzed in terms of the contraindications of traditional Chinese medicines ，the interaction between traditional Chinese medicines and chemical medicines ，and its effects on stable COPD with other common chronic diseases. RESULTS ：Eleven related studies covering 29 kinds of Chinese patent medicines for the treatment of stable COPD were included in this study. There were several incompatibility between two Chinese patent medicines containing Aconitum carmichaelii and eleven Chinese patent medicines containing “Pinellia ternata ，Trichosanthes kirilowii ， Bolbostemma paniculatum ，Ampelopsis japonica ，Bletilla striata ”as an ancient rule of traditional Chinese medicine incompatibility “Eighteen antagonisms ”and“Nineteen mutual ”inhibitors. Meanwhile ，it should be avoided that four Chinese patent medicines containing ephedra combined with β2 receptor agonists or theophylline. Moreover ，oral antibiotics and 14 kinds of Chinese patent medicine containing licorice would reduce the curative effect. In addition ，patients with stable COPD who also had hypertension ， hyperlipidemia or diabetes should be careful to use Chinese patent medicines containing ingredients such as Glycyrrhiza uralensis ， A. carmichaelii ，Ephedra sinica ，Citrus aurantium ，Cornus officinalis ，Fritillaria cirrhosa ，Panax ginseng （Panax notoginseng ）. CONCLUSIONS：There are many potential risks （such as combined use ，compatibility）in the use of Chinese patent medicines for stable COPD. It is suggested to comprehensively evaluate the patient ’s previous medical history and medication before using Chinese patent medicines ，so as to provide scientific guide for clinical rational medication.

OBJECTIVE To evalu ate relat ed researches about the cost- benefit of pharmaceutical care in medical institutions with cost- benefit analysis，in order to provide evidence-based basis for related policy decisions and provide methodological reference for the cost- benefit evaluation of pharmaceutical care in the future. METHODS Retrieved from PubMed ，Embase，the Cochrane Library ，CBM，Wanfang database ，VIP and CNKI ，cost-benefit analysis was used to evaluate the researches about the cost-benefit of pharmaceutical care in medical institutions. Two researchers independently screened the research and extracted data according to the “Consolidated Health Economic Evaluation Reporting Standards Checklist ”. The quality of included studies was scored and evaluated systematically. RESULTS A total of 46 studies from 17 countries were included. Most of them came from the United States （21.74％），China（19.57％）and France （8.70％）. Average score of 46 literature was 14.30，of which 1 literature was excellent ，5 literature were good ，25 literature were qualified and 14 literature were unqualified. There were 25 research protocols of prospective study type ；the type of pharmaceutical care involved mostly was pharmaceutical monitoring （60.87％）， followed by prescription review （23.91％），medication reconciliation （8.70％）and outpatient pharmacy （6.52％）were less. The median cost-benefit ratio of pharmaceutical care was 5.05 （3.08，11.28）. CONCLUSIONS Pharmaceutical care shows good economic value ，and pharmacists have played an important role in saving medical resources ，but the design level and report quality of the existing studies need to be improved.

OBJECTIVE：To evaluate the preventive effect of dexmedetomidine （DEX）on adverse drug reactions induced by carboprost tromethamine used in cesarean section ，and to provide evidence-based reference for rational drug use of cesarean section. METHODS：Retrieved from PubMed ，Cochrane library ，Embase，CNKI，CBM，Wanfang database and VIP during inception to June of 2019，randomized controlled trials about DEX （trial group ）versus normal saline （control group ）in the prevention of adverse drug reactions induced by carboprost tromethamine in cesarean section were collected. After data extraction of included literatures and quality evaluation with modified Jadad scale ，Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 11 RCTs with 714 patients were included in this study. Results of Meta-analysis showed that the incidence of nausea [OR ＝0.09，95％CI（0.06，0.14），P＜0.000 01]，vomiting [OR ＝0.09，95％CI（0.05，0.15），P＜0.000 01]， facial flushing [OR ＝0.15，95％CI（0.10，0.22），P＜0.000 01]，chest distress [OR ＝0.12，95％CI（0.08，0.18），P＜0.000 01]， hypertension [OR ＝0.06，95％CI（0.04，0.11），P＜0.000 01] and tachycardia [OR ＝0.17，95％CI（0.12，0.25），P＜0.000 01] in trial group were significantly lower than control group ，with statistical significance. CONCLUSIONS ：DEX can reduce adverse drug reactions such as nausea and vomiting caused by carboprost tromethamine used in cesarean section.