Idiopathic thrombocytopenic purpura (ITP)is the syndrome with platelet destruction increase through immunologic mechanism. In this case,the patient's main performance was oral mucosal bloody bulla with the ecchymosis on whole body.

DNA methylation is part of the epigenetic modification process,which can lead to aberrant gene expression. Cytochrome P450 enzyme,cyclooxygenase,lipoxygenase and monoamine oxidase are a class of enzymes produced by human tissues,which are involved in the oxidization pro?cess of endogenous and exogenous chemicals. The methylation patterns of these enzyme genes are dif?ferent between normal tissues and pathological ones. Abnormal methylation patterns will change en?zymes′expression and function,and affect the occurrence and development of diseases. This paper re?viewed the characteristic changes of four oxidative metabolic enzyme genes in certain diseased tis?sues,the impact on methylation status of the metabolic activity of chemicals and on human health. It is hoped that this review can provide a new theoretical basis for the study on the toxic mechanism of chemicals and for diagnosis of diseases.

Objective:To analyse the difference of torque performance between lingual and labial brackets as well as the influence of the archwires of different materials with different dimension on the torque capability of lingual brackets.Methods:The 3D finite mo-del of lingual and labial brackets from the right upper canine to the left upper canine was established,all brackets were with 0.56 mm slot size.The center of the bracket slot of the left upper central incisor was used as the central point and the two brackets were rotated clockwise and counterclockwise with a rotation angle of ±20°along the horizontal axis of bracket slot.The torque load on the left up-per central incisors with different materials and dimensions of the archwires was simulated.Results:The torque force of both lingual and labial brackets increased with the increase of rotation angle and the elastic modulus of archwire.The lingual archwire generated torque force was nearly 3 -5 times more than the labial system under the same torque angle.The torque value generated with 0.48 mm ×0.64 mm archwires was greater than 0.43 mm ×0.64 mm.The lingual bracket generated torque force decreased gradually from nickel-titanium(NiTi),Beta-titanium(TMA)to stainless steel(SS)under the same dimension.Conclusion:Torque moments of lin-gual and labial brackets both increases with the increase of torque angle in each operating condition.The lingual orthodontic brackets produce more torque force than labial brackets under the same torque angle.Torque performance of lingual bracket was affected by the material and dimension of the archwires.

Objective To valuate different effects in hepatectomy of three inflow occlusion methods including pringle maneuver, hemihepatic occlusion and portal venous occlusion. Methods 180 patients undergoing hepatectomy were randomly assigned to pringle group (group A), hemehepatic occlusion group (group B)or PV occlusion group (group C). The amount of blood lost, measurements of liver enzymes alanine aminotransferase (ALT), aspirate aminotransferase (AST), total bilirubin (TB), Serum albumin (ALB) and postoperative complication were also recorded. Results There was no operative mortality. One patient in group B changed into pringle maneuver due to the difficulties in dissecting the hemi-hepatic portal and was excluded. The amount of hemorrhage of three groups had no statistical difference. The ALT, AST, ALB and TB level of 1,3,7 days after operation had significant differences in three groups. The pringle group had a higher level ALT,AST,TB and lower ALB level than the other two groups. Conclusions All techniques of occlusion are effective and feasible for patients undergoing hepatectomies. However, compared with pringle maneuver, PV clamping and hemihepatic occlusion can relieve the liver function damage after hepatectomy.

Objective To explore the safety and efficacy of hepatic resection with selective hepatic vascular exclusion(SHVE). Methods SHVE was used in 246 consecutive patients undergoing major or complex liver resection in our center. Preoperative demographic and clinical data,details of the surgical procedure, pathologic diagnosis, postoperative course and complications were collected and analy zed. Results From January 2000 to July 2007, liver resections were performed IJnder SHVE in 246 patients; total SHVE, right partial SHVE and left partial SHVE in 145, 54 and 47 patients, respectively. SHVE was converted to total hepatic vascular exclusion(THVE)in 3 patients to repair the wall of inferior vena cava(IVC). Hemodynamic tolerance to SHVE was excellent, only with a slight increase in systemic and pulmonary vascular resistance during clamping.There were no deaths. and the morbidity was 24.8%.The mean leyth of hospital stay was 9.6 days(range 8-18) .Conclusion Our study showed that SHVE is a safe and effective procedurei and it is applicable to liver tumors near but not invade the inferior vena cava.

Objective To explore the expression of matrix metalloproteinase-14(MMP-14)protein in the human stomach carcinoma tissues and its correlation with carcinoma invasiveness and metastasis.Methods The MMP-14 protein expression was detected by immunohistochemistry in 59 cases of stomach carcinoma tissues (observation group)and 20 cases of normal stomach tissues (control group,the adjacent normal tissues from the tumor margin of 5 cm confirmed by pathology),and its correlation with the clinically pathological parameters was analyzed.The expression characteristics of MMP-14 among various TNM stages of stom-ach carcinoma were also analyzed.Results The positive rate of MMP-14 expression was 50.85%(30/59)in the observation group and 5.00% (1/20)in the control group,the positive rate of the observation group was significantly higher than that of the control group (P <0.01);the expression level of MMP-14 was correlated with the differentiation degree,regional lymph node metastasis degree,invasion depth,lymphatic invasion and TNM stage,which showing the statistical difference(P < 0.01);the expression of MMP-14 protein was up-regulated and showed the transferring trend from cytoplasm to cellular membrane along with the progres-sion of TNM stage.Conclusion The overexpression of MMP-14 protein exists in stomach carcinoma tissues,which contributing to the invasion and metastasis of stomach carcinoma cells.

Objective To investigate the anti-tumor effect and mechanism of curcumin in pancreatic cancer (PC). Methods Smad4 and Jab1 expressions were detected by immunohistochemistry in tumor tissues and pericarcinomatous tis?sue from 35 PC cases, and the correlation of Smad4 and Jab1 were analyzed based on the percentage of positive staining in?tissues from 21 random selected PC cases. The effect of curcumin on expressions of tumor suppressors p53, Smad4 and cell cycle inhibitor p27 were examined by Western Blotting after human pancreatic cancer cell line PANC-1 were divided into PANC-1 control group (no treatments were given) and PANC-1 curcumin group (treated with cell culture medium containing 10μmol/L curcumin). The effect of curcumin on expressions of combination of β-TrCP1 and Smad4 was examined by Co-Immunoprecipitation after human embryonic kidney cell line 293T were divided into 293T control group (no treatments were given), 293T curcumin group (treated with cell culture medium containing 10μmol/L curcumin) and 293T Jab1 group (trans?fected by HA-Jab1 plasmid). Results Compared with expressions in pericarcinomatous tissues, Smad4 was down regulated while the expression of Jab1 was upregulated in PC tissues (P<0.01), and the expression of Smad4 was negatively correlated with the expression of Jab1 (n=21, r=-0.71, P=0.007). After treated with curcumin, the protein expression of p53, Smad4 and p27 was increased in PANC1 cell, and the protein expression of the combination ofβ-TrCP1 and Smad4 was decreased in 293T cell (P<0.05). After transfected by HA-Jab1 plasmid, the protein expression of the combination ofβ-TrCP1 and Smad4 was increased in 293T cell (P<0.05). Conclusion Curcumin may have suppression effect of PC through increasing the protein expression of p53, Smad4 and p27, and the mechanism of Smad4 upregulation may be related with the inhibition of Smad4 ubiquitination process, while Jab1 may be also involved in Smad4 degradation through ubiquitination.

Objective To investigate the effects of cyclooxygenase-2 inhibitor celecoxib on proliferation , invasion and migration of human pancreatic cancer cell line PANC-1 and then determine the optimal concentration of cele-coxib and the most suitable application time .Methods Human pancreatic cancer cell line PANC-1 was treated with diverse concentrations of celecoxib (20,60,100 μmol/L) for different durations (24,48,72 h).Cell prolifer-ation, invasion and migration capabilities were measured by MTT colorimetry , Transwell invasion assay , and scratch assay respectively .Results The proliferation capability of PANC-1 cell was reduced by celecoxib in a con-centration-and time-dependent manner ( P <0.05 ) .In addition , the invasion and migration capabilities were decreased by celecoxib in a concentration-dependent manner(P<0.01).Conclusions Celecoxib attenuates the proliferation of human pancreatic cancer cell line PANC-1 in a concentration-and time-dependent manner .Cele-coxib attenuates the invasion and migration in a concentration-dependent manner .

Retrograde caudate lobectomy is a proper technique to resect the tumor in caudate lobe when the tumor is too big or closely adherent to the inferior vena cava.A male patient aged 44 years was admitted to the Eastern Hepatobiliary Surgery Hospital in November 2007.The ligaments around the liver were firstly dissected to mobilize the whole liver,and the right hepatic pedicle was dissected and ligated,then the liver was splited anteriorly along the Cantlie's line.The tumor was opposed in the sight and then it was dissected from the liver parenchyma.The short hepatic veins were ligated and the tumor was detached from the inferior vena cava.The inflow blood was occluded for 19 minutes,and the total blood loss was 4500 ml.The technique of retrograde caudate lobectomy can improve the success rate and safety of caudate lobectomy when the tumor in the caudate lobe is too large or adherent to the inferior vena cava.

Total caudate lobectomy via anterior hepatic transection is still a new technique to resect the tumor in the caudate lobe,which is mastered only by few surgeons.The procedure was successfully performed on a 21-year old patient with focal nodular hyperplasia in caudate lobe.The right and left lobes were first mobilized,then the short hepatic veins were dissected to detach the caudate lobe from the retrohepatic vena cava.Then the liver was split anteriorly and the partial middle lobe was resected.With this process,the tumor was in the sight and we dissected it from the liver parenchyma.The inflow blood was occluded 3 times with a period of 29,27 and 27 minutes,respectively,with an interval of 5 minutes.The total blood loss during operation was 1000 ml.The patient recovered quickly without any complications.The technique for caudate lobectomy via anterior hepatic transection can improve the success rate and safety of caudate lobectomy and deserve clinical consideration.